The Value of Real Time Pharmacokinetic and

Pharmacodynamic Modeling in Critical Care

Pharmacodynamic Modeling(V1)Central Compartment

(V2)Rapid Peripheral Compartment

(V3)Slow

Peripheral Compartment

(Ve) Effect Site

Infusion Pumps

Bar-codedBolus

Syringes

PharmacokineticModels

Drug delivery devices

Syroid N, Anesth 2002;96:565-575

[remi] (ng/ml) [prop] (ug/ml)

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184.816.4

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[remi] (ng/ml)

[prop] (ug/ml)

(b)

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(c)

[prop] (ug/ml)

[remi] (ng/ml)

[prop] (ug/ml)

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(d)

Return of Responsiveness

Laryngoscopy

Mertens and Kern

Effect Path

Figure 2 –

Analgesia Level (Control)

Analgesia Level (Display)

Skin Incisions

Artho-scopic Procedure

Bankart Procedure

Maintenance Phase Time (min).

0 10 20

Level of Pain/Analgesia

Experiment 1: ResultsHeart Rate

Bankhart Procedure

52

54

56

58

60

62

64

66

hr

bp

m controlDD

*

Experiment 1: ResultsBlood Pressure

Bankhart Procedure

74767880828486889092

bp

mm

Hg

controlDD

*

0

1

2

3

4

5

6

7

8

9

10

Perf

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ance

Fru

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n L

eve

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Effort

Menta

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Phys

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Without Drug Display With Drug Display

*

*

**

Anesthesia Advisory Display: Real time guidance through the pharmacokinetic and interaction pharmacodynamic relationship during simultaneous administration of multiple drugs.Schumacher, Bouillon, Leibundgut, Sartori, Zbinden, ASA 2004

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