Sedative agents are routinely administered to critically ill patients, both on and off extracorporeal membrane oxygenation (ECMO), to enable patients to be comfortable and facilitate patient management. It has been observed empirically in our paediatric intensive care unit that doses of sedative drugs required to achieve desired levels of sedation in ECMO patients are far greater than those used in non-ECMO patients. These differences could not simply be accounted for by differences in patient types, clinical status or sedation levels. We therefore undertook an in vitro evaluation of drug binding in ECMO circuits. This study investigated how the polyvinyl chloride (PVC) and silicone rubber components of neonatal ECMO circuits affect drug delivery in patients through drug sorption. Phase 1 investigated drug uptake by the two polymers in static solutions of known concentrations of four commonly used sedative drugs: lorazepam, midazolam, diazepam and propofol. Phase 2 involved the setting up of a complete neonatal ECMO circuit, injecting the drug solutions pre reservoir at a flow rate of 350 ml/min and collecting samples post-oxygenator for analysis. Phase 1 results revealed significant uptake of drugs with losses in the range 40-98% and in the order propofol > diazepam > midazolam > orazepam. Phase 2 results were similar and in the first 40 min of running an ECMO circuit only 10% of propofol passed through the circuit. These results may help to explain observed clinical phenomena and raise important issues regarding drug dosing in ECMO patients.

The increasing demand for food and the globalisation of the supply chain, have resulted in a rise in food fraud, and recent high profile cases, such as the Chinese milk scandal in 2008 and the EU horsemeat scandal in 2013 have emphasised the vulnerability of the food supply system to adulteration and authenticity frauds. Fourier Transform Infrared (FTIR) spectroscopy is routinely used in cases of suspected food fraud as it offers a rapid, easy and reliable detection method for these investigations. In this review we first present a brief summary of the concepts of food adulteration and authenticity as well as a discussion of the current legislation regarding these crimes. Thereafter, we give an extensive overview of FTIR as an analytical technique and the different foods where FTIR analysis has been employed for food fraud investigations as well as the subsequent multivariate data analysis have been applied successfully to investigate case of adulteration or authenticity. Finally, we give a critical discussion of the applications and limitations of FTIR, either as a standalone technique or incorporated in a test battery, in the fight against food fraud.

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These results reveal significantly increased volume of distribution and plasma half-life in neonates receiving extracorporeal membrane oxygenation. Altered kinetics may reflect sequestration of midazolam by components of the extracorporeal membrane oxygenation circuit.