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TivatrainerXfor Iphone, Ipad and MacBook(with M1 chip)

"TivatrainerX available in Itunes"

Check out the I-Manual page for an interactive explanation of the current functions

What we are working on

30 Dec 2021 by Frank Engbers

These pages have not been updated for a while, but TivatrainerX was!

The team in Groningen, the Netherlands, produced models in recent years for propofol, remifentanl and dexmedetomidine that really could make TCI mature and an important instrument to support an anaesthetic-gas free hospital.
When these models are implemented in all our TCI systems, anyone with appropriate training could benefit from applying patient tailored drug dosing without worrying about the complexity of pharmacokinetic pharmacodynamic modeling.
This includes anaesthesiologists, sedation practitioners, nurses, intensivists and other persons that are certified to handle infusion devices. But first we will have to get rid of the old confusing mess of models that were simply taken from research publications and implemented in the past without proper clinical testing or all population encompassing advanced simulations, and no suitable Summary of Product Characteristics to inform the user on appropriate targets. But that is a different story to be told later.

For the last two years or so I have been busy to incorporate the above rather complex models into TivatrainerX including the sometimes even more complex pharmacodynamic models. On the screenshot of tivatrainer on this page you see a simulation of dexmedetomidine using the Hannivoort model with the different effect-site concentrations and in the upper part the expected effects on heartrate, Mean arterial blood pressure, BIS and Modified Observer's Alertness/Sedation scale
For propofol the expected effect, which is predominantly the Bispectral Index, is available with the Eleveld2 model. Clinicians are (unlike pharmacology researchers) not really interested in blood concentrations but in the effect and side effects of a drug and dosing scheme. By pasting the output from another model, using copy/paste, into this Eleveld2 model the effect of other models and infusion schemes can be studied and the real clinical important differences between models revealed.
Although simulations of blood concentration and 1 effect-site concentration can be saved in an excel file it is not yet possible to save the Pd data. We will address this issue in the coming platform independent version.
At the moment I am looking for possibilities to implement Remimazolam pharmacokinetics and dynamics (if usable).