Nhoroondo yeTarged-Controlled Infusion
Infusion inodzorwa nechinangwa (TCI) inzira yekupinza zvinodhaka IV kuti uwane mushandisi-anotsanangurwa akafanotaurwa ("chinangwa") musanganiswa wezvinodhaka mune imwe nzvimbo yemuviri kana matishu ekufarira. Muongororo iyi, tinotsanangura iyo pharmacokinetic misimboti yeTCI, kuvandudzwa kweTCI masisitimu, uye tekinoroji uye zvekutonga nyaya dzakatariswa mukusimudzira prototype. Isu tinotsanangurawo kutangwa kwemaitiro aripo ekiriniki anowanikwa.
Chinangwa chemhando yega yega yekuendesa zvinodhaka ndeye kuwana uye kuchengetedza nguva yekurapa kosi yemhedzisiro yezvinodhaka, uchidzivirira mhedzisiro yakaipa. Mishonga yeIV inowanzopihwa pachishandiswa zvakajairwa dosing nhungamiro. Kazhinji iyo chete murwere covariate iyo inosanganisirwa muyero ndeye metric yehukuru hwemurwere, kazhinji huremu hweIV anesthetics. Hunhu hwemurwere hwakadai sezera, bonde, kana creatinine clearance kazhinji hazvibatanidzwe nekuda kwehukama hwakaoma hwemasvomhu hweava covariates kudoro. Nhoroondo kare kwave kune nzira mbiri dzekupa IV mishonga panguva yeanesthesia: bolus dose uye infusion inopfuurira. Bolus doses rinowanzo kupihwa nesirinji inobatwa neruoko. Infusions inowanzo kupihwa nepombi yekupinza.
Yese mushonga weanesthetic inoungana munyama panguva yekuendesa zvinodhaka. Kuunganidza uku kunovhiringa hukama huri pakati pehuwandu hwekupindwa muropa hwakatarwa nachiremba uye huwandu hwezvinodhaka mumurwere. A propofol infusion rate ye 100 μg/kg/min inosanganiswa nemurwere anenge akamuka 3 maminetsi muinfusion uye murwere akanyanya kugadzikana kana akarara maawa maviri gare gare. Nekushandisa zvinonyatso nzwisiswa pharmacokinetic (PK) misimboti, makomputa anogona kuverenga kuti yakawanda sei mushonga waunga munyama panguva yekunyudzwa uye inogona kugadzirisa infusion rate kuchengetedza yakagadzikana kusungwa muplasma kana matishu ekufarira, kazhinji uropi. Kombiyuta inokwanisa kushandisa muenzaniso wakanakisisa kubva mumabhuku, nokuti kuoma kwemasvomhu yekubatanidza maitiro evarwere (kurema, kureba, makore, zvepabonde, uye mamwe biomarkers) zviverengero zviduku zvekombiyuta.1,2 Ichi ndicho chikonzero che a yechitatu rudzi rweanesthetic drug delivery, target-controlled infusions (TCI). NeTCI masisitimu, murapi anopinda mune inodiwa chinangwa chekutarisa. Iyo komputa inoverengera huwandu hwemushonga, unounzwa semaboluses uye infusions, inodiwa kuti iwane chinangwa chekuisa uye inotungamira infusion pombi kuendesa yakaverengerwa bolus kana infusion. Iyo komputa inogara ichiverenga kuti wakawanda sei mushonga uri munyama uye chaizvo kuti izvo zvinopesvedzera huwandu hwezvinodhaka hunodiwa kuti uwane chinangwa chekutarisa nekushandisa modhi yePKs yemushonga wakasarudzwa uye murwere covariates.
Munguva yekuvhiyiwa, chiyero chekuvhiya chinokurudzira chinogona kushanduka nekukurumidza, chinoda chaiyo, kukurumidza titration yemushonga. Zvakajairwa infusions hazvigone kuwedzera kuwandisa kwezvinodhaka nekukurumidza zvakaringana kuverengera kuwedzera kamwe kamwe mukukurudzira kana kudzikisa kukwirisa nekukurumidza zvakaringana kuverengera nguva yekuderera kwekusimudzira. Zvakajairwa infusions hazvigone kuchengetedza zvakatsiga zvinodhaka muplasma kana huropi panguva dzekugara uchikurudzira. Nekubatanidza maPK modhi, masisitimu eTCI anogona kukurumidza kudonhedza mhinduro sezvinodiwa uye nenzira imwecheteyo kuchengetedza zvakadzikama kana zvakakodzera. Iyo inogona kubatsira kune varapi ndiyo yakanyatsojeka titration yeanesthetic drug effect.3
Muongororo iyi, tinotsanangura misimboti yePK yeTCI, kuvandudzwa kweTCI masisitimu, uye tekinoroji uye zvekutonga nyaya dzakatariswa mukusimudzira prototype. Zvinyorwa zviviri zvinofambidzana zvekuongorora zvinofukidza kushandiswa kwepasi rose nekuchengetedza nyaya dzine chokuita nekombiyuta iyi.4,5
Sezvo TCI masisitimu akashanduka, vaongorori vakasarudza idiosyncratic mazwi eiyo nzira. TCI masisitimu akatumidzwa sekombuta-assisted total IV anesthesia (CATIA),6 titration yeIV agents nekombuta (TIAC), 7 computer-assisted continuous infusion (CACI),8 uye computer-controlled infusion pump.9 Kutevera zano naIain Glen, White naKenny vakashandisa izwi rekuti TCI muzvinyorwa zvavo mushure megore ra1992. Kubvumirana kwakasvikwa muna 1997 pakati pevaongorori vaishingaira kuti izwi rekuti TCI rigamuchirwe setsananguro yeruzivo rwechizvino-zvino.10
Nguva yekutumira: Nov-04-2023