Predictive Accuracy of a Model of Volatile Anesthetic Uptake
Predictive Accuracy of a Model of Volatile Anesthetic Uptake
复制标题
挥发性麻醉剂摄取模型的预测准确性
DOI：
10.1097/00000539-200212000-00027
复制
发表时间：
2002
影响因子：
5.7
通讯作者：
Christopher Spencer
中科院分区：
文献类型：
--
作者：
R. R. Kennedy;Richard A. French;Christopher Spencer
一个模拟麻醉剂摄取和分布的计算机程序已经在我们部门作为教学工具使用了20年。新的麻醉机，电子测量新鲜气体流速和蒸发器设置，使我们能够评估该模型在临床麻醉过程中的性能。在30次选择性麻醉期间，以10秒的间隔从麻醉机（Datex S/5 ADU）中收集气体流量、蒸发器设置和潮气末浓度。这些都被输入到吸收模型中。计算呼出的麻醉剂蒸汽浓度，并与患者监护仪（Datex AS/3）测量的实际值进行比较。16例患者使用七氟烷，14例患者使用异氟烷。对于所有患者，中位性能误差为-0.24%，中位绝对性能误差为13.7%，发散为2.3%/h，摆动为3.1%。七氟醚和异氟醚之间无显著差异。该模型很好地预测了这些患者的呼气浓度。这些结果与比较丙泊酚输注系统中计算的丙泊酚浓度和实际丙泊酚浓度时观察到的结果相似，并且符合靶控麻醉系统中所用模型准确性的已发布指南。该模型可用于预测对新鲜气体和蒸汽设置的变化的响应。
A computer program that models anesthetic uptake and distribution has been in use in our department for 20 yr as a teaching tool. New anesthesia machines that electronically measure fresh gas flow rates and vaporizer settings allowed us to assess the performance of this model during clinical anesthesia. Gas flow, vaporizer settings, and end-tidal concentrations were collected from the anesthesia machine (Datex S/5 ADU) at 10-s intervals during 30 elective anesthetics. These were entered into the uptake model. Expired anesthetic vapor concentrations were calculated and compared with actual values as measured by the patient monitor (Datex AS/3). Sevoflurane was used in 16 patients and isoflurane in 14 patients. For all patients, the median performance error was −0.24%, the median absolute performance error was 13.7%, divergence was 2.3%/h, and wobble was 3.1%. There was no significant difference between sevoflurane and isoflurane. This model predicted expired concentrations well in these patients. These results are similar to those seen when comparing calculated and actual propofol concentrations in propofol infusion systems and meet published guidelines for the accuracy of models used in target-controlled anesthesia systems. This model may be useful for predicting responses to changes in fresh gas and vapor settings.