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Interpretation of volume kinetics in terms of pharmacokinetic principles

대한마취과학회지 2021년 74권 3호 p.204 ~ 217
최병문,
소속 상세정보
최병문 ( Choi Byung-Moon ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine

Abstract


Volume kinetics is the pharmacokinetics of infusion fluids and describes the distribution and elimination of infused volume. Generally, pharmacokinetic parameters can be estimated by measuring the concentration of a drug. However, it is almost impossible to directly measure the concentration of fluids. Therefore, in volume kinetics, the disposition of fluids is indirectly quantified by measuring the hemoglobin concentration under the premise of no hemoglobin loss. If the hemoglobin concentration is repeatedly measured while administering the fluids, the dilution (relative change of the plasma volume) for each corresponding hemoglobin concentration can be obtained. The dilution is based on the concept of plasma volume expansion. The method of quantifying the drugs disposition with compartmental analysis has been equally applied to volume kinetics. The transfer of fluids between compartments is explained by first-order kinetics, and it is assumed that fluid is only removed from the central compartment. Population analysis can be used to identify covariates that can account for inter-individual variability in volume kinetic parameters. Body weight and mean blood pressure are well-known representative covariates of kinetic volume parameters. Using volume kinetic parameters, the volume expansion effects of crystalloid and colloid solutions can be understood more effectively, thereby facilitating appropriate fluid therapy. Although limitations exist in volume kinetics, its implications are important for clinicians when administering fluids.

키워드

Body fluids; Colloids; Crystalloid solutions; Hemoglobins; Pharmacokinetics; Statistical models

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