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Innovation in Medical Devices used in extra-corporeal circulation

NeckEpur is a set of activities aiming at assessing drug sequestration (adsorption) in medical devices with extracorporeal circulation with filters, including continuous renal replacement therapy (CCRT) and extracorporeal oxygenation (ECMO) for supporting either respiratory failure (veno-venous) or cardiac failure (arterio-venous). Sequestration has been previously reported, but the clinical relevance of the studies is highly questionable.
After more than 3 years period of research leading to the inception of NeckEpur, it is now possible to prove the sequestration, to quantify and characterize the risk and to test in vitro solutions balancing drug sequestration.
Sequestration should be systematically investigated in drugs administered in critically ill patients hospitalized in intensive care unit and undergoing any extracorporeal procedure(s). Cumulative evidence from case reports in the litterature and NeckEpur results highlight early lack of efficacy, and late overdose (consequence of the delayed drug release from filters). Both major concerns should compromise patients’ health improvement. Sequestration should be assessed for drugs, marketed or under development, whatever the route of administration, intravenous or per oral.

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