Model-based administration of inhalation anaesthesia. 3. Validating the system model

Lerou, J.G.C.; Booij, L.H.D.J.

doi:10.1093/bja/88.1.24

Cited by 11 publications

(11 citation statements)

References 27 publications

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“…We prefer the term ideal F D -FGF sequence because we also want to include the F D changes. Most authors [5][6][7][8][9] first developed a model that describes mass balances in the circle system (circuit and lung wash-in, uptake by the patient, and kinetics in the circle system) and then prospectively tested their model. Clinical performance of these models varies and is agent-dependent [3,10].…”

Section: Discussionmentioning

confidence: 99%

Development and performance of a two-step desflurane—O2/N2O fresh gas flow sequence

Hendrickx

Dewulf

Mey

et al. 2008

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 99%

Development and performance of a two-step desflurane—O2/N2O fresh gas flow sequence

Hendrickx

Dewulf

Mey

et al. 2008

Journal of Clinical Anesthesia

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“… Drug Simulations: Simulations were performed using published pharmacokinetic and inhalation–opioid interaction models . Sevoflurane levels are presented as effect‐site (not end‐tidal) concentrations.…”

Section: Key Concepts Of Drug Display Monitorsmentioning

confidence: 99%

“…The time window presented starts 50 min into the anaesthetic to 20 min after the anaesthetic is turned off. Isoflurane and fentanyl simulations were performed using published pharmacokinetic and pharmacodynamic models . Definitions, simulated patients’ characteristics, assumptions and limitations are presented below Table .…”

Section: Emergencementioning

confidence: 99%

“…The simulation assumes that a sufentanil infusion was started at the beginning of the procedure at a rate of 0.7 μg.kg −1 .h −1 , desflurane was maintained at 6.6%, and the anaesthetic duration is 3 h. The sufentanil infusion was stopped 45 min, 30 min, 15 min and 0 min before turning the desflurane off. Desflurane and sufentanil simulations were performed using published pharmacokinetic and pharmacodynamic models . Definitions, simulated patients’ characteristics, assumptions and limitations are presented below Table .…”

Section: Emergencementioning

confidence: 99%

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An introduction to predictive modelling of drug concentration in anaesthesia monitors

DeCou

Johnson

2017

Anaesthesia

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Summary A significant amount of anaesthetists’ work involves the prediction of drug effects and interactions to produce a smooth general anaesthetic that minimises drug side effects and promotes rapid emergence. Successfully managing this process requires a basic understanding of drug effects, experience and inevitably some guesswork, since it is difficult (and in some cases impossible) to anticipate all relevant patient and surgical factors. Although data are generally available to allow calculation of plasma drug and effect site concentrations, this is often difficult to apply in complex clinical contexts, particularly when multiple drug types are used. In recent years, manufacturers have developed and incorporated into anaesthetic workstations technologies that use drug pharmacodynamic and pharmacokinetic data to predict drug effects and interactions. Such systems can predict the duration and effects of drugs during anaesthesia and assist the anaesthetist to understand complex drug interactions. With this information available, different drug types, doses and combinations may be tailored in a scientific way to maximise useful effects whilst minimising overdose and side‐effects, particularly in high‐risk patients. Examples are used to illustrate how such systems can be used in practice, and how drug effects and interactions can be simulated to “rehearse” an anaesthetic before any drugs are actually administered. At present only a small number of anaesthetic workstations use this technology, and as yet they are not able to manage all drugs used in anaesthetic practice. However, such systems have the potential to help anaesthetists manage the complexity of their work, and to provide information on predicted drug effects in a way that is useful and relevant to both experienced anaesthetists and trainees.

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“…End-expired concentrations of gas species were calculated as described elsewhere. 3 Nitrous oxide concentrations were averaged over the respiratory cycle (=the sum of one-third of the inspired and two-thirds of the endexpired concentration (I:E ratio=1:2)) to match measured nitrous oxide concentrations (vide infra).…”

Section: Computer Studymentioning

confidence: 99%

Model-based administration of inhalation anaesthesia. 4. Applying the system model

Lerou

Verheijen

Booij

2002

British Journal of Anaesthesia

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Model-based administration of inhalation anaesthesia. 3. Validating the system model

Abstract: Administration of inhalation anaesthesia can be based on version 2 of this model, but must be guided by active monitoring.

Cited by 11 publications

References 27 publications

Development and performance of a two-step desflurane—O2/N2O fresh gas flow sequence

Development and performance of a two-step desflurane—O2/N2O fresh gas flow sequence

An introduction to predictive modelling of drug concentration in anaesthesia monitors

Model-based administration of inhalation anaesthesia. 4. Applying the system model

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