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Related Concept Videos

Two-Compartment Open Model: IV Bolus Administration01:18

Two-Compartment Open Model: IV Bolus Administration

680
The two-compartment model for intravenous (IV) bolus administration illustrates drug distribution in the body, subdividing it into central and peripheral compartments. This model operates on the concept of two-compartment kinetics. The drug's plasma concentration shows a bi-exponential decline following IV bolus administration, signaling the presence of two disposition processes: distribution and elimination.
The disparity between drug input and the sum of drug transfer rates between...
680
One-Compartment Open Model for IV Bolus Administration: Estimation of Clearance00:56

One-Compartment Open Model for IV Bolus Administration: Estimation of Clearance

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Clearance is a key pharmacokinetic parameter that quantifies the volume of body fluid from which a drug is entirely removed within a specific time frame. It is crucial in assessing how a drug is eliminated from the body and has critical clinical applications.
In the one-compartment open model for intravenous (IV) bolus administration, clearance is estimated by dividing the elimination rate by the plasma drug concentration. This equation leverages the elimination rate constant and the apparent...
135
One-Compartment Open Model for IV Bolus Administration: General Considerations01:19

One-Compartment Open Model for IV Bolus Administration: General Considerations

306
The one-compartment model is a pharmacokinetic tool that models the body as a single, uniform compartment, facilitating the understanding of drug distribution and elimination. This model is particularly beneficial for intravenous (IV) bolus administration, where the drug rapidly circulates throughout the body.
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...
306
One-Compartment Open Model for IV Bolus Administration: Estimation of Elimination Rate Constant, Half-Life and Volume of Distribution01:09

One-Compartment Open Model for IV Bolus Administration: Estimation of Elimination Rate Constant, Half-Life and Volume of Distribution

474
The one-compartment open model is a simplified approach used in pharmacokinetics to understand the distribution and elimination of a drug administered through an intravenous bolus. This model assumes rapid drug dispersal throughout the body and elimination using a first-order process. Key pharmacokinetic parameters, such as the elimination rate constant (k), half-life (t1/2), and the apparent volume of distribution (Vd), can be estimated from this model. The elimination rate is calculated...
474
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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One-Compartment Model: IV Infusion01:09

One-Compartment Model: IV Infusion

273
Intravenous (IV) infusion is often utilized when continuous and controlled drug delivery is necessary, such as during surgery or in the treatment of chronic diseases. This method offers numerous advantages, including immediate drug action, precise control over dosage, and bypassing the first-pass metabolism.
The one-compartment model for IV infusion uses mathematical equations to describe the rate of change in drug quantity in the body. At steady-state or infusion equilibrium, the drug input...
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Author Spotlight: Exploring Venous Waveforms in Porcine Models to Tackle Volume Overload in Medicine
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Intravenous Fluid Bolus Rates Associated with Outcomes in Pediatric Sepsis: A Multi-Center Analysis.

Paul C Mullan1, Christopher M Pruitt2, Kelly A Levasseur3

  • 1Department of Pediatrics, Division of Emergency Medicine, Eastern Virginia Medical School, Children's Hospital of the King's Daughters, Norfolk, VA, USA.

Open Access Emergency Medicine : OAEM
|August 4, 2022
PubMed
Summary

Rapid intravenous fluid bolus administration rates in pediatric sepsis were linked to increased mortality and need for intubation. Further controlled trials are necessary to confirm these findings in pediatric sepsis management.

Keywords:
collaborativeemergency departmentintubationmortality

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Area of Science:

  • Pediatric critical care
  • Emergency medicine
  • Clinical pharmacology

Background:

  • Current pediatric sepsis guidelines advocate for rapid intravenous fluid bolus administration rates (BAR).
  • Emerging evidence suggests a potential association between rapid BAR and increased patient morbidity.
  • The clinical implications of current fluid resuscitation strategies in pediatric sepsis require further investigation.

Purpose of the Study:

  • To investigate the association between emergency department (ED) intravenous fluid (IVF) bolus administration rates (BAR) and clinical outcomes in pediatric sepsis.
  • To analyze the relationship between ED IVF BAR and 30-day mortality, intubation, and non-invasive positive pressure ventilation (NIPPV) in pediatric sepsis patients.

Main Methods:

  • Secondary post-hoc analysis of retrospective data from the Pediatric Septic Shock Collaborative (PSSC) database (19 hospitals).
  • Inclusion criteria: Patients aged 2 months to 21 years with presumed septic shock and complete data on weight, antibiotics, bolus timing, and volumes.
  • Outcomes assessed: 30-day mortality, intubation, and NIPPV using unadjusted and adjusted logistic regression.

Main Results:

  • The study included 3969 pediatric sepsis patients with a median ED fluid volume of 40.2 mL/kg and a median BAR of 25.7 mL/kg/hr.
  • Increased BAR was significantly associated with higher adjusted odds of 30-day mortality (aOR=1.11), intubation (aOR=1.25), and NIPPV (aOR=1.20) for each 20 mL/kg/hr increment.
  • 1.9% of patients died, 3.8% required intubation, and 5.9% received NIPPV.

Conclusions:

  • Faster ED IVF bolus administration rates in pediatric sepsis patients were associated with increased adjusted odds of mortality, intubation, and NIPPV.
  • These findings suggest a potential risk associated with rapid fluid resuscitation in pediatric sepsis.
  • Controlled trials are warranted to confirm these associations and guide optimal fluid resuscitation strategies in pediatric sepsis.