Individualizing propofol dosage: a multivariate linear model approach

• Tipo: Artigo em Revista Científica Internacional
• Data: 2014

Autores

Conceicao Rocha (Autor) FEP; Teresa Mendonca (Autor) FCUP; Maria Eduarda Silva (Autor) FEP

Revista

Título: Journal of Clinical Monitoring and Computing

Vol. 28

Páginas: 525-536

ISSN: 1387-1307

Editora: Springer Nature

Indexação

ISI Web of Knowledge - 8 Citações

Scopus - 9 Citações

Classificação Científica

FOS: Ciências médicas e da saúde > Medicina clínica

Outras Informações

ID Authenticus: P-00A-02C

DOI: 10.1007/s10877-013-9510-1

Abstract (EN): 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.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 12