Application Of Integrative
Thermodynamic-hemodynamicpharmacokinetic
Model To Propofol
Anesthesia For Hypothermic Decompression
Author(s)
L. Gaohua & H. Kimura
Abstract
A novel strategy of propofol anesthesia is proposed to improve clinical propofol
anesthesia for hypothermic decompression. Theoretical analysis is carried out
based on our previously developed integrative model of thermodynamics,
hemodynamics and pharmacokinetics, after introducing a linear relationship of
plasma propofol concentration with temperature thresholds of thermoregulatory
responses. The therapeutic strategy proposed and simulated tentatively consists
of four steps, that is, (i) the elevated intracranial pressure is decreased by
therapeutic cooling; (ii) the brain temperature is cooled down simultaneously;
(iii) the minimum plasma propofol concentration is calculated according to the
propofol-threshold relationship and (iv) an adequate propofol is administered to
realize the desired minimum plasma concentration. Simulation results suggest
that the proposed propofol anesthesia is more appropriate than the empirical
Roberts’ step-down infusion schema for hypothermic decompression.
Keywords: brain hypothermia treatment, cooling, modeling, simulation, control.
1 Introduction
High intracranial pressure (ICP) is still a major cause of mortality in the
intensive care unit [1]. Therefore, achieving a sustained reduction in ICP in
patients with intracranial hypertension remains a great challenge in the clinical
practice. Due to its hypothermic decompression, brain hypothermia treatment has
been verified to be especially effective in such patients with refractory
intracranial hypertension, in whom all other conventional therapeutic options
Keywords
brain hypothermia treatment, cooling, modeling, simulation, control.
Related Book
Other papers in this volume
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