uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
TCI: Target Controlled Infusion, or Totally Confused Infusion? Call for an Optimised Population Based Pharmacokinetic Model for Propofol.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
2008 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 113, no 2, 161-169 p.Article in journal (Refereed) Published
Abstract [en]

Different pharmacokinetic models for target controlled infusion (TCI) of propofol are available in the recently launched open TCI systems. There is also a compelling choice to work with either plasma-or effect-site targets. Knowledge about the clinical consequences of different alternatives is of importance. We aimed to illustrate the potential differences in the actual drug delivery/output between three present commercially available and clinically used pharmacokinetic models: the original Marsh model, which is also implemented in the Diprifusor (R), the "modified Marsh-" and the Schnider models. Simulations were made in the TivaTrainer program (eurosiva.com). Firstly, our standard plasma target regimen was simulated, and secondly an effect-site target of 3.5 mu g/mL was chosen. Thirdly, real infusors were used for measuring the time to reach defined predicted effect-site concentrations when aiming at a plasma target of 6 mu g/mL. Identical patient characteristics were used in all simulations: male, 170 cm, 70 kg, 40 years of age. Resulting predicted effect- site peak concentrations, and used bolus doses were recorded, as were the resulting plasma over-shoot, and time frames. The plasma target regimen gave predicted effect- site peaks in the different models ranging from 3.6 to 7.2 mu g/mL, reached after 2(3)/(4) to 4 minutes. To reach the same effect- site target, the three models used bolus doses ranging from 68 to 150 mg given during 22 to 46 seconds. The predicted plasma concentration over-shoots varied from 5.0 to 13.4 mu g/mL. There were obvious differences between the models in the time taken to reach defined effect- site concentrations. We observed clinically significant different results between the models. The choice of model will make a difference for the patient. To eliminate confusion-not necessarily to improve precision-we call for an optimised population based pharmacokinetic model for propofol-a consensus model!

Place, publisher, year, edition, pages
2008. Vol. 113, no 2, 161-169 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-149287ISI: 000263415200004PubMedID: 18509810OAI: oai:DiVA.org:uu-149287DiVA: diva2:404534
Available from: 2011-03-17 Created: 2011-03-17 Last updated: 2013-01-29Bibliographically approved

Open Access in DiVA

No full text

By organisation
Centre for Clinical Research, County of VästmanlandAnaesthesiology and Intensive Care
In the same journal
Upsala Journal of Medical Sciences
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 226 hits
ReferencesLink to record
Permanent link

Direct link