Author: James Morse

Background Cardiac surgery induces metabolic and haemodynamic changes, often resulting in hyperlactatemia. Hyperlactatemia is a marker of adverse postoperative outcomes including organ dysfunction, prolonged mechanical ventilation, and increased mortality (1). The time-course of lactate concentration after cardiac surgery remains poorly understood, limiting the use of lactate as a prognostic biomarker or therapeutic target. The objective […]

Introduction: Propofol is used for the induction and maintenance of anaesthesia in neonates, infants and children. Clearance is the pharmacokinetic parameter that determines maintenance infusion rates and clearance matures over the first years of life. Postmenstrual age (PMA) is typically used to quantify clearance maturation as it accounts for maturation that begins in utero. Maturation […]

A universal pharmacokinetic model was developed from pooled paediatric and adult data (40.6 postmenstrual weeks, 70.8 years, 3.1-152 kg). A three-compartment pharmacokinetic model with first-order elimination was superior to a two-compartment model to describe these pooled dexmedetomidine data. Population parameter estimates (population parameter variability %) were clearance (CL) 0.9 L/min/70 kg (36); intercompartmental clearances (Q2) […]

There are no validated propofol infusion regimens in neonates and infants. Existing pharmacokinetic pharmacodynamic (PKPD) models do not include data from babies under the age of 1 year (1) making dosing in this population empirical, largely based on recommendations from Steur et al (2). Steur and colleagues recommend a bolus dose between 3-5 mg·kg-1 followed by infusion rates […]