Wintermeeting 2024: Hugo Vereecke

The Eleveld model dissected

Prof. Dr. Hugo Vereecke, University of Groningen, The Netherlands

Friday 19 January 9:00-9:30

In 2018, Douglas Eleveld, from the University of Groningen,  published a new PKPD model for propofol based on the “open TCI initiative” database.¹ This database, initiated by S. Shafer and C. Minto, combined a large amount of raw data derived from previously published studies on the PKPD of propofol, remifentanil and some other drugs. By combining these  globally acquired data, including several  demographic subgroups of people, Eleveld developed a so called “general purpose” model for propofol,  a single PKPD model that can adjust the propofol administration towards predictable results in all types of patients, including lean and obese adults, elderly and children. As even the largest database may contain limited information on rare demographic characteristics, the model also incorporates mathematical solutions to avoid extreme deviations of drug administration in such patients. The first prospective validation studies reveal promising results.² However, when switching from one TCI model to the new Eleveld model, some do’s and don’ts need to be taken into account.³

In a plenary lecture, the typical characteristics of the model will be discussed first. In the workshops, clinical examples of how to apply the model in daily practice will be demonstrated and discussed.

After the session, the attendant should be able to start using the Eleveld PKPD model in clinical practice and should be aware of the advantages and limitations of switching towards the general purpose model.

References:

1. Eleveld DJ, Colin P, Absalom AR, Struys MMRF. Pharmacokinetic-pharmacodynamic model for propofol for broad application in anaesthesia and sedation. Br J Anaesth. 2018 May;120(5):942-959. doi: 10.1016/j.bja.2018.01.018. Epub 2018 Mar 12. Erratum in: Br J Anaesth. 2018 Aug;121(2):519. PMID: 29661412.
2. Vellinga R, Hannivoort LN, Introna M, Touw DJ, Absalom AR, Eleveld DJ, Struys MMRF. Prospective clinical validation of the Eleveld propofol pharmacokinetic-pharmacodynamic model in general anaesthesia. Br J Anaesth. 2021 Feb;126(2):386-394. doi: 10.1016/j.bja.2020.10.027. Epub 2020 Dec 13. PMID: 33317804.
3. Vandemoortele O, Hannivoort LN, Vanhoorebeeck F, Struys MMRF, Vereecke HEM. General Purpose Pharmacokinetic-Pharmacodynamic Models for Target-Controlled Infusion of Anaesthetic Drugs: A Narrative Review. J Clin Med. 2022 Apr 28;11(9):2487. doi: 10.3390/jcm11092487. PMID: 35566617; PMCID: PMC9101974.