在全身麻醉期间设计一种药理动力学/药理动力学模型,用于在全身麻醉期间给予低剂量外周诺阿匹内弗林
Jona Joachim1,2, Jérôme Cartailler1,2, Fabrice Vallee1,2
1Université Paris Cité, Paris, France.
这项研究开发了一种对诺拉上腺素 (NOR) 的药理动力学/药理动力学模型,以标准化其用于治疗手术内低血压并改善患者的治疗结果.
科学领域:
- 麻醉学和药理学 麻醉学和药理学
- 医学中的数学建模.
背景情况:
- 术后低血压会增加术后并发症的风险,影响脏,心脏和认知.
- 低剂量的外周性诺拉上腺素 (NOR) 可能会减少器官功能障碍,但其管理并未标准化.
研究的目的:
- 为NOR开发一个药理动力学/药理动力学 (PK/PD) 模型,以预测其对平均动脉压 (MAP) 的影响.
- 建立标准化NOR注射和潜在的目标控制输注的基础.
主要方法:
- 在29名接受外周NOR治疗低血压的神经外科患者中,为NOR开发了一种PK/PD模型.
- 动脉血液样本追踪NOR血度,使用对PK的隔间建模和对PD的Emax/Windkessel模型进行分析.
- 模型参数适用于全人口,并与患者的人口统计和病史相关联.
主要成果:
- 上腺素对MAP的峰值作用发生在中位数的74秒后,增加了24%的MAP.
- 一个具有仓库的2个隔间模型最好地描述了NOR PK,而Emax模型最好地代表了它对MAP的PD效应.
- 患者的年龄,身高,体重,吸烟史和高血压与模型参数相关.
结论:
- 成功开发了NOR的强大的PK/PD模型,准确地跟踪了血度和MAP效应.
- 该模型为开发针对NOR.的目标控制输液策略提供了基础.
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