Contrasting paired signals arising from the same physiological process

Abstract

using CRISP-TDMn and STDMn0. Plasma and effect site concentrations (Cp/Ce) were simulated by the PKPD modeling module of the Artemis platform. Encinas' PKPD8 model for fentanyl was used in this retrospective analysis. HRV and RRV were analyzed using the estimated Cp/Ce at the specific point in time. Data from the periods of the infant's NICU hospital course were used for the analysis of the relationship between drug concentration, HRV, RRV, and PIPP score. Results: A fentanyl Ce of 0.02 μg/mL was correlated with a low HRV, statistical significance P = .01 (P b .05), and a PIPP score of 6. The infant's PIPP score was 9 before the increased fentanyl drug dose. There was no detectable effect on RRV for this infant whose respiratory failure was managed with high-frequency jet ventilation at 240 breaths per minute. Conclusions: This case study demonstrates that a high concentration of fentanyl in this critically ill premature infant is associated with a reduction in PIPP score and correlates with decreased HRV. The estimated effect site concentration correlations with low HRV suggests that high-fidelity cardiorespiratory physiological data could serve as an indicator for fentanyl's pharmacodynamics as well as controller variable for a novel pain profile index.