Individualizing propofol dosage: a multivariate linear model approach.
In the last decades propofol became established as an intravenous agent for the induction and maintenance of both sedation and general anesthesia procedures. In order to achieve the desired clinical effects appropriate infusion rate strategies must be designed. Moreover, it is important to avoid or...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 28; no. 6; pp. 525 - 537 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Dec2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109766614&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109766614 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Dec2014 vid: 28 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 109766614 NLM24072471 2012819664 10.1007/s10877-013-9510-1 NLM24072471 109766614 ppf: 525 ppct: 12 formats: fmt: @attributes: type: P tig: atl: Individualizing propofol dosage: a multivariate linear model approach. aug: au: Rocha, Conceiçao Mendonça, Teresa Silva, Maria Eduarda Rocha, Conceição Gambús, Pedro affil: Faculdade de Ciências da Universidade do Porto, Rua do Campo Alegre, 4169-007, Porto, Portugal sug: subj: Anesthetics Administration and Dosage Drug Monitoring Methods Drug Therapy, Computer Assisted Methods Linear Regression Propofol Administration and Dosage Propofol Pharmacokinetics Anesthetics, Intravenous Administration and Dosage Anesthetics, Intravenous Blood Anesthetics, Intravenous Pharmacokinetics Computer Simulation Human Infusions, Intravenous Multivariate Analysis Propofol Blood ab: In the last decades propofol became established as an intravenous agent for the induction and maintenance of both sedation and general anesthesia procedures. In order to achieve the desired clinical effects appropriate infusion rate strategies must be designed. Moreover, it is important to avoid or minimize associated side effects namely adverse cardiorespiratory effects and delayed recovery. Nowadays, to attain these purposes the continuous propofol delivery is usually performed through target-controlled infusion (TCI) systems whose algorithms rely on pharmacokinetic and pharmacodynamic models. This work presents statistical models to estimate both the infusion rate and the bolus administration. The modeling strategy relies on multivariate linear models, based on patient characteristics such as age, height, weight and gender along with the desired target concentration. A clinical database collected with a RugLoopII device on 84 patients undergoing ultrasonographic endoscopy under sedation-analgesia with propofol and remifentanil is used to estimate the models (training set with 74 cases) and assess their performance (test set with 10 cases). The results obtained in the test set comprising a broad range of characteristics are satisfactory since the models are able to predict bolus, infusion rates and the effect-site concentrations comparable to those of TCI. Furthermore, comparisons of the effect-site concentrations for dosages predicted by the proposed Linear model and the Marsh model for the same target concentration is achieved using Schnider model and a factorial design on the factors (patients characteristics). The results indicate that the Linear model predicts a dosage profile that is faster in leading to an effect-site concentration closer to the desired target concentration. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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