Phenobarbital in intensive care unit pediatric population: predictive performances of population pharmacokinetic model
| Autor: | Romain Guilhaumou, Amélie Marsot, Olivier Blin, Fabrice Michel, Olivier Paut, Estelle Chasseloup |
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| Přispěvatelé: | Institut de Neurosciences des Systèmes (INS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Population Models Biological 030226 pharmacology & pharmacy law.invention 03 medical and health sciences 0302 clinical medicine Pharmacokinetics Predictive Value of Tests law Intensive care Humans Medicine Pharmacology (medical) Child Infusions Intravenous education ComputingMilieux_MISCELLANEOUS Retrospective Studies Pharmacology Pediatric intensive care unit education.field_of_study medicine.diagnostic_test business.industry [SCCO.NEUR]Cognitive science/Neuroscience Infant Newborn Infant Intensive care unit NONMEM Intensive Care Units Therapeutic drug monitoring Child Preschool Phenobarbital Anesthesia Anticonvulsants Female Drug Monitoring business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Fundamental & Clinical Pharmacology Fundamental & Clinical Pharmacology, Wiley, 2017, 31 (5), pp.558-566. ⟨10.1111/fcp.12291⟩ |
| ISSN: | 0767-3981 1472-8206 |
| DOI: | 10.1111/fcp.12291 |
| Popis: | An external evaluation of phenobarbital population pharmacokinetic model described by Marsot et al. was performed in pediatric intensive care unit. Model evaluation is an important issue for dose adjustment. This external evaluation should allow confirming the proposed dosage adaptation and extending these recommendations to the entire intensive care pediatric population. External evaluation of phenobarbital published population pharmacokinetic model of Marsot et al. was realized in a new retrospective dataset of 35 patients hospitalized in a pediatric intensive care unit. The published population pharmacokinetic model was implemented in nonmem 7.3. Predictive performance was assessed by quantifying bias and inaccuracy of model prediction. Normalized prediction distribution errors (NPDE) and visual predictive check (VPC) were also evaluated. A total of 35 infants were studied with a mean age of 33.5 weeks (range: 12 days-16 years) and a mean weight of 12.6 kg (range: 2.7-70.0 kg). The model predicted the observed phenobarbital concentrations with a reasonable bias and inaccuracy. The median prediction error was 3.03% (95% CI: -8.52 to 58.12%), and the median absolute prediction error was 26.20% (95% CI: 13.07-75.59%). No trends in NPDE and VPC were observed. The model previously proposed by Marsot et al. in neonates hospitalized in intensive care unit was externally validated for IV infusion administration. The model-based dosing regimen was extended in all pediatric intensive care unit to optimize treatment. Due to inter- and intravariability in pharmacokinetic model, this dosing regimen should be combined with therapeutic drug monitoring. |
| Databáze: | OpenAIRE |
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