Target controlled infusion

Target Controlled Infusion (TCI) is a method of drug delivery used in anesthesia and critical care where the rate of infusion is adjusted to maintain a desired drug concentration in the body. This method is commonly used for drugs with a narrow therapeutic index, such as propofol and remifentanil, where small changes in drug concentration can lead to significant changes in effect.

Mechanism

The TCI system uses a computer algorithm to control the infusion pump, adjusting the rate of drug delivery based on the patient's weight, age, and other factors. The algorithm is based on pharmacokinetic and pharmacodynamic models, which describe how the body absorbs, distributes, metabolizes, and excretes the drug.

Advantages

TCI has several advantages over traditional methods of drug delivery. It allows for more precise control of drug concentration, reducing the risk of overdose or underdose. It also allows for rapid adjustment of drug concentration, which can be beneficial in situations where the patient's condition changes rapidly.

Disadvantages

Despite its advantages, TCI also has some disadvantages. The accuracy of the system depends on the accuracy of the pharmacokinetic and pharmacodynamic models, which can vary between individuals. In addition, the system requires a sophisticated infusion pump and computer algorithm, which can be expensive and require specialized training to use.

Clinical Applications

TCI is commonly used in anesthesia and critical care for the delivery of drugs such as propofol and remifentanil. It is also used in pain management, where it can provide a constant level of analgesia while minimizing side effects.

See Also

• Pharmacokinetics
• Pharmacodynamics
• Anesthesia
• Critical care
• Pain management