Computers in biology and medicine · 2025
Agitation-sedation models for critical care: Insights into endogenous agitation reduction and stimulus.
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O'Sullivan Ryan, Flett Isaac, Pretty Chris, Chase J Geoffrey
Аннотация
BACKGROUND: Sedation and agitation management are core treatments in the intensive care unit. This study uses pharmacokinetic-pharmacodynamic (PKPD) models to capture the endogenous agitation response. The identification and validation of these models allow for a better understanding of agitation-sedation dynamics and improves the clinical implementation.
METHODS: A cohort of healthy volunteers (N=25) was exposed to a controlled psychological stimulus, with agitation levels quantitatively measured using heart rate-derived metrics. Endogenous agitation reduction (EAR) coefficients were determined from the post-stimulus decay. Using these parameters and a priori information about the experienced stimulus, the model was validated against the measured agitation data.
RESULTS: The model demonstrated a good fit between measured and modelled agitation. EAR parameters were identified with 45% of the cohort ranging between 0.003-0.004 s-1. Using a population value for EAR still resulted in a good fit to measured data. Minimal differences were observed between female and male participants.
CONCLUSION: This study provides further development of PKPD models of agitation-sedation dynamics. The identified EAR parameter can be used in future studies and in the clinical application of these models.
METHODS: A cohort of healthy volunteers (N=25) was exposed to a controlled psychological stimulus, with agitation levels quantitatively measured using heart rate-derived metrics. Endogenous agitation reduction (EAR) coefficients were determined from the post-stimulus decay. Using these parameters and a priori information about the experienced stimulus, the model was validated against the measured agitation data.
RESULTS: The model demonstrated a good fit between measured and modelled agitation. EAR parameters were identified with 45% of the cohort ranging between 0.003-0.004 s-1. Using a population value for EAR still resulted in a good fit to measured data. Minimal differences were observed between female and male participants.
CONCLUSION: This study provides further development of PKPD models of agitation-sedation dynamics. The identified EAR parameter can be used in future studies and in the clinical application of these models.