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Olli A. Meretoja - One of the best experts on this subject based on the ideXlab platform.
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Potency and hourly Maintenance Requirement of combinations of mivacurium and pancuronium in adults
Canadian Journal of Anaesthesia, 1998Co-Authors: Pekka Rautoma, O. Erkola, Olli A. MeretojaAbstract:Purpose To evaluate the dose-response and Maintenance Requirements of a combination of mivacurium and pancuronium (cMP) in clinical practice. Methods In a randomised, open clinical study, 70 patients, 17–50 yr of age, were anaesthetised with propofol, alfentanil and nitrous oxide in oxygen. Thirty patients received mivacurium and 20 patients received pancuronium to establish dose-response curves for these agents. Hourly Maintenance Requirements of mivacurium and pancuronium to maintain 90–95% neuromuscular blockade (NMB) were determined. Thereafter, 20 additional patients received cMP in incremental doses to establish a cumulative dose-response curve for cMP followed by Maintenance doses of cMP NMB was recorded by adductor pollicis electromyography. Results The ED_95 values for mivacurium and pancuronium were 100 and 66μg·kg^−1, respectively; and for the cMP 2:1 (in mg:mg basis), 32 μg·kg^−1 mivacurium together with 16 μg·kg^−1 pancuronium. This cMP was 1.8 times more potent than one parent agent ( P < 0.0001 ). When cMP 2:1 was used, 60% of normal Maintenance Requirement of pancuronium reduced the Requirement of mivacurium by > 90%. If cMP 20:1 was used, then 20% of normal Maintenance Requirement of pancuronium reduced the Requirement of mivacurium by > 70%. Neostigmine 35 μg·kKg^−1 given at T_1 10% recovery following cMP reversed the NMB to a TOF ratio of 0.70 in 9.5 ±3.9 min. Conclusion These results reflect considerable synergism between mivacurium and pancuronium. The cMP is near intermediate-acting and the NMB is easily reversed with neostigmine. By using cMR it may be possible to save some pharmacological costs during Maintenance of anaesthesia. Objectif Évaluer les besoins dose-réponse de même que les besoins d’entretien d’un mélange mivacurium et pancuronium (cMP) en pratique clinique. Méthodes Dans une étude clinique ouverte et aléatoire, 70 patients âgés de 17 à 50 ans ont été anesthésiés avec propofol, alfentanil, N_2O et O_2. Trente patients ont reçu du mivacurium et 20 patients ont reçu du pancuronium pour construire des courbes dose-réponse pour les deux médicaments. On a ensuite déterminé les besoins horaires de mivacurium et de pancuronium pour maintenir un bloc neuro-musculaire (BNM) à 90–95%. Par la suite, 20 patients supplémentaires ont reçu le cMP en doses croissantes pour établir une courbe dose-réponse cumulative pour le cMR suivi de doses de maintien de cMP Le bloc a été enregistré par électromyographie de l’adducteur du pouce. Résultats Les valeurs ED_95 pour le mivacurium et le pancuronium ont été respectivement de 100 et 66 μg·kg^−1; et pour le mélange cMP, en rapport 2:1 sur la base de mg:mg, 32 μg·kg^−1 pour le mivacurium et 16 μg^−1kg pour le pancuronium. Cette combinaison cMP a été 1,8 fois plus puissante que chacun des agents constituants ( P < 0,000l). Lorsqu’on a utilisé le cMP 2:1, 60% de la dose d’entretien normale de pancuronium a réduit les besoins de mivacurium de > 90%. Si on utilisait un mélange cMP 20:1, 20% de la dose de maintien normale de pancuronium réduisait les besoins de mivacurium de > 70%. La néostigmine 35 μg·kg^−1 administrée lorsque le bloc produit par cMP avait récupéré à une valeur T_1 = 10% entraînait une récupération du BNM évalué par le train-de-quatre de 0,70 en 9.5 ± 3.9 min. Conclusion Ces résultats indiquent une synergie considérable entre le mivacurium et le pancuronium. Le mélange cMP se comporte presque comme un relaxant musculaire de durée intermédiaire dont le bloc est facilement antagonisé par la néostigmine. Par l’utilisation du cMR il est possible de faire des économies quant aux coûts des médicaments durant le maintien de l’anesthésie.
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Potency and hourly Maintenance Requirement of combinations of mivacurium and pancuronium in adults
Canadian journal of anaesthesia = Journal canadien d'anesthesie, 1998Co-Authors: Pekka Rautoma, O. Erkola, Olli A. MeretojaAbstract:Purpose To evaluate the dose-response and Maintenance Requirements of a combination of mivacurium and pancuronium (cMP) in clinical practice.
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Pipecuronium revisited: Dose-response and Maintenance Requirement in infants, children, and adults
Journal of clinical anesthesia, 1997Co-Authors: Olli A. Meretoja, O. ErkolaAbstract:Study Objective To compare dose-response relationship and Maintenance Requirement of pipecuronium in anesthetized infants, children, and adults. Design Prospective, consecutive sample trial. Setting Operating room at a university hospital. Patients: 15 infants (1–11 months), 15 children (3–10 years), and 15 adults (35–50 years) of ASA physical status I and II. Interventions Anesthesia was induced and maintained with N 2 O:O 2 2:1 and 1 minimum alveolar concentration end-tidal halothane. The neuromuscular function was recorded by adductor pollicis electromyogram evoked by a train-of-four ulnar nerve stimulation at 20 second intervals. An individual cumulative log-probit dose-response curve was established and Maintenance Requirement of pipecuronium determined. Between-group comparisons were made by analysis of variance and Scheffe F-test. Measurements and Main Results Dose-response curves were parallel with a doseRequirement of pipecuronium similar in infants and adults (ED 95 of 40–42 μg/kg) and greater in children (ED 95 of 52 μg/kg). After 30 minutes of surgical neuromuscular block, pipecuronium was required in each age group at a rate oj 0.6 to 0. 7 individual ED 95 doses per hour to maintain an 85 % to 95% neuromuscular block. Conclusions Bolus dose Requirement of pipecuronium is greatest in children. Maintenance Requirement is related to potency in each age group studied.
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Potency and Maintenance Requirement of atracurium and vecuronium given alone or together
Acta anaesthesiologica Scandinavica, 1995Co-Authors: Pekka Rautoma, O. Erkola, Olli A. MeretojaAbstract:A synergism exists between some competitive muscle relaxants. However, Maintenance Requirement of a combination of muscle relaxants has been evaluated only in paediatric patients. We studied 45 elective adult surgical patients (ASA I-II) during propofol-alfentanyl-N2O-O2-anaesthesia. The first 30 patients were randomized to receive either atracurium or vecuronium to create individual dose-response curves for these muscle relaxants. ED95-values for atracurium and vecuronium were 260 +/- 9 and 59 +/- 3 micrograms.kg-1, respectively (mean +/- s.e. mean). Requirements of atracurium and vecuronium to maintain an 85-95% neuromuscular blockade were 301 and 83 micrograms kg-1 h-1, respectively. An additional 15 patients received a combination of atracurium and vecuronium (cAV) in an equipotent dose ratio. An ED95 of a cAV was 94 +/- 7 micrograms.kg-1 of atracurium together with 21 +/- 2 micrograms.kg-1 of vecuronium, or 72 +/- 6% of one ED95 dose of a parent agent. Potentiation was significant (P = 0.0001). A Maintenance Requirement of a cAV was 120 micrograms kg-1 h-1 of atracurium together with 27 micrograms kg-1 h-1 of vecuronium. Thus, a significant potentiation was maintained also during the course of anaesthesia. A cAV had an effect like one intermediate-acting agent. If a cAV is used instead of using atracurium or vecuronium alone, the maximal reduction of drug consumption would be approximately 30%.
J A J Verreth - One of the best experts on this subject based on the ideXlab platform.
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the effect of food type formulated diet vs natural and fish size on feed utilization in common sole solea solea l
Aquaculture Research, 2017Co-Authors: Stephan S W Ende, Saskia Kroeckel, J W Schrama, Oliver Schneider, J A J VerrethAbstract:This study compares the effect of food type (formulated diet vs. natural food) and fish size on protein and energy utilization efficiencies for growth in common sole, Solea solea (L.). Replicate groups of common sole (mean initial body weight ± SD was 45.7 g ± 2.1 and 111.2 g ± 4.2) received the diets at five (natural feed) or four (formulated diet) feeding levels. The protein utilization efficiency for growth (kgCP) was higher (P > 0.001) in common sole fed ragworms than in common sole fed the formulated diet (respectively, 0.40 and 0.31). Likewise, the energy utilization efficiency for growth (kgGE) was higher (P = 0.001) in common sole fed ragworms than in common sole fed the formulated diet (respectively, 0.57 and 0.33). The protein Maintenance Requirement was not different between food types (P = 0.64) or fish size (P = 0.41) being on average 0.82 g kg−0.8 day−1. The energy Maintenance Requirement was not different between food type (P = 0.390) but differed between fish size (P = 0.036). The gross energy Maintenance Requirement of small common sole was 35 kJ g−0.8 day−1. The gross energy Maintenance Requirement of large common sole was 25 kJ g−0.8 day−1. In conclusion, the low growth of common sole fed formulated diets was related to reduced feed utilization.
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effect of stocking density and feeding level on energy expenditure and stress responsiveness in european sea bass dicentrarchus labrax
Aquaculture, 2010Co-Authors: Ingrid Lupatsch, J W Schrama, G A Santos, J A J VerrethAbstract:Abstract European sea bass (initial weight 72 ± 4 g) were stocked in 200-L tanks at two densities: a low density (LD) ∼ 5.5 kg m − 3 and a high density (HD) ∼ 36 kg m − 3 . The tanks were part of a recirculation system and were equipped to carry out frequent oxygen measurements. At each density the fish were fed at increasing levels from around Maintenance Requirement up to apparent satiation. The experiment was carried out for 10 weeks at 22 °C, after which the density in the LD treatment had increased to ∼ 10 kg m − 3 and to ∼ 60 kg m − 3 in the HD treatment. At the end of the trial blood samples were taken from several fish to determine the basal levels of cortisol and glucose. Furthermore, to assess the responsiveness to an acute stressor, additional fish were subjected to individual confinement in submerged nets, blood was sampled and cortisol and glucose analysed. At the end of the trial there was no significant difference in growth performance and voluntary feed intake between the groups raised at different densities. The partitioning of energy demand for Maintenance and growth highlighted a slightly higher energy Maintenance Requirement in the LD fish (50.9 kJ (kg) 0.80 day − 1 ) compared to the HD groups (43.15 kJ (kg) 0.80 day − 1 ). In accordance with this, an increased oxygen demand for sea bass kept at the low density was detected through weekly measurements. Analyses of the blood parameters showed, that higher stocking density resulted in higher cortisol levels in both control and stressed groups (after netting), but the effect of stocking density on the acute stress response was less pronounced at the higher feeding level.
Pekka Rautoma - One of the best experts on this subject based on the ideXlab platform.
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Potency and hourly Maintenance Requirement of combinations of mivacurium and pancuronium in adults
Canadian Journal of Anaesthesia, 1998Co-Authors: Pekka Rautoma, O. Erkola, Olli A. MeretojaAbstract:Purpose To evaluate the dose-response and Maintenance Requirements of a combination of mivacurium and pancuronium (cMP) in clinical practice. Methods In a randomised, open clinical study, 70 patients, 17–50 yr of age, were anaesthetised with propofol, alfentanil and nitrous oxide in oxygen. Thirty patients received mivacurium and 20 patients received pancuronium to establish dose-response curves for these agents. Hourly Maintenance Requirements of mivacurium and pancuronium to maintain 90–95% neuromuscular blockade (NMB) were determined. Thereafter, 20 additional patients received cMP in incremental doses to establish a cumulative dose-response curve for cMP followed by Maintenance doses of cMP NMB was recorded by adductor pollicis electromyography. Results The ED_95 values for mivacurium and pancuronium were 100 and 66μg·kg^−1, respectively; and for the cMP 2:1 (in mg:mg basis), 32 μg·kg^−1 mivacurium together with 16 μg·kg^−1 pancuronium. This cMP was 1.8 times more potent than one parent agent ( P < 0.0001 ). When cMP 2:1 was used, 60% of normal Maintenance Requirement of pancuronium reduced the Requirement of mivacurium by > 90%. If cMP 20:1 was used, then 20% of normal Maintenance Requirement of pancuronium reduced the Requirement of mivacurium by > 70%. Neostigmine 35 μg·kKg^−1 given at T_1 10% recovery following cMP reversed the NMB to a TOF ratio of 0.70 in 9.5 ±3.9 min. Conclusion These results reflect considerable synergism between mivacurium and pancuronium. The cMP is near intermediate-acting and the NMB is easily reversed with neostigmine. By using cMR it may be possible to save some pharmacological costs during Maintenance of anaesthesia. Objectif Évaluer les besoins dose-réponse de même que les besoins d’entretien d’un mélange mivacurium et pancuronium (cMP) en pratique clinique. Méthodes Dans une étude clinique ouverte et aléatoire, 70 patients âgés de 17 à 50 ans ont été anesthésiés avec propofol, alfentanil, N_2O et O_2. Trente patients ont reçu du mivacurium et 20 patients ont reçu du pancuronium pour construire des courbes dose-réponse pour les deux médicaments. On a ensuite déterminé les besoins horaires de mivacurium et de pancuronium pour maintenir un bloc neuro-musculaire (BNM) à 90–95%. Par la suite, 20 patients supplémentaires ont reçu le cMP en doses croissantes pour établir une courbe dose-réponse cumulative pour le cMR suivi de doses de maintien de cMP Le bloc a été enregistré par électromyographie de l’adducteur du pouce. Résultats Les valeurs ED_95 pour le mivacurium et le pancuronium ont été respectivement de 100 et 66 μg·kg^−1; et pour le mélange cMP, en rapport 2:1 sur la base de mg:mg, 32 μg·kg^−1 pour le mivacurium et 16 μg^−1kg pour le pancuronium. Cette combinaison cMP a été 1,8 fois plus puissante que chacun des agents constituants ( P < 0,000l). Lorsqu’on a utilisé le cMP 2:1, 60% de la dose d’entretien normale de pancuronium a réduit les besoins de mivacurium de > 90%. Si on utilisait un mélange cMP 20:1, 20% de la dose de maintien normale de pancuronium réduisait les besoins de mivacurium de > 70%. La néostigmine 35 μg·kg^−1 administrée lorsque le bloc produit par cMP avait récupéré à une valeur T_1 = 10% entraînait une récupération du BNM évalué par le train-de-quatre de 0,70 en 9.5 ± 3.9 min. Conclusion Ces résultats indiquent une synergie considérable entre le mivacurium et le pancuronium. Le mélange cMP se comporte presque comme un relaxant musculaire de durée intermédiaire dont le bloc est facilement antagonisé par la néostigmine. Par l’utilisation du cMR il est possible de faire des économies quant aux coûts des médicaments durant le maintien de l’anesthésie.
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Potency and hourly Maintenance Requirement of combinations of mivacurium and pancuronium in adults
Canadian journal of anaesthesia = Journal canadien d'anesthesie, 1998Co-Authors: Pekka Rautoma, O. Erkola, Olli A. MeretojaAbstract:Purpose To evaluate the dose-response and Maintenance Requirements of a combination of mivacurium and pancuronium (cMP) in clinical practice.
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Potency and Maintenance Requirement of atracurium and vecuronium given alone or together
Acta anaesthesiologica Scandinavica, 1995Co-Authors: Pekka Rautoma, O. Erkola, Olli A. MeretojaAbstract:A synergism exists between some competitive muscle relaxants. However, Maintenance Requirement of a combination of muscle relaxants has been evaluated only in paediatric patients. We studied 45 elective adult surgical patients (ASA I-II) during propofol-alfentanyl-N2O-O2-anaesthesia. The first 30 patients were randomized to receive either atracurium or vecuronium to create individual dose-response curves for these muscle relaxants. ED95-values for atracurium and vecuronium were 260 +/- 9 and 59 +/- 3 micrograms.kg-1, respectively (mean +/- s.e. mean). Requirements of atracurium and vecuronium to maintain an 85-95% neuromuscular blockade were 301 and 83 micrograms kg-1 h-1, respectively. An additional 15 patients received a combination of atracurium and vecuronium (cAV) in an equipotent dose ratio. An ED95 of a cAV was 94 +/- 7 micrograms.kg-1 of atracurium together with 21 +/- 2 micrograms.kg-1 of vecuronium, or 72 +/- 6% of one ED95 dose of a parent agent. Potentiation was significant (P = 0.0001). A Maintenance Requirement of a cAV was 120 micrograms kg-1 h-1 of atracurium together with 27 micrograms kg-1 h-1 of vecuronium. Thus, a significant potentiation was maintained also during the course of anaesthesia. A cAV had an effect like one intermediate-acting agent. If a cAV is used instead of using atracurium or vecuronium alone, the maximal reduction of drug consumption would be approximately 30%.
Richie Soong - One of the best experts on this subject based on the ideXlab platform.
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interethnic variability of warfarin Maintenance Requirement is explained by vkorc1 genotype in an asian population
Clinical Pharmacology & Therapeutics, 2006Co-Authors: Soochin Lee, Johannes Oldenburg, Peiyi Chong, Simone Rost, J Guo, Huiling Yap, Sheila Clare Rankin, Huiboon Khor, Tiongcheng Yeo, Richie SoongAbstract:Background Chinese and Malay subjects have been reported to require less Maintenance warfarin than Indians that could not be accounted for by cytochrome P450 (CYP) 2C9 variants. Vitamin K epoxide reductase complex 1 (VKORC1) is the target enzyme of warfarin, and VKORC1 intronic variants and haplotypes have recently been shown to influence VKORC1 activity and warfarin Requirements. Methods We sequenced the coding regions of CYP2C9 and VKORC1 and inferred VKORC1 haplotype from 10 intronic variants in 147 Chinese, 85 Malay, and 43 Indian patients receiving Maintenance warfarin. Results The mean weight-normalized warfarin dose was lower for Chinese and Malays than for Indians (0.058 ± 0.025 mg/kg, 0.059 ± 0.023 mg/kg, and 0.089 ± 0.036 mg/kg, respectively; P < .001 for comparisons between Chinese and Malays with Indians). CYP2C9*2 and VKORC1 coding region variants were rare (<2%), whereas CYP2C9*3 associated with lower warfarin Requirements was less common in Chinese and Malays (7% and 9%, respectively) than in Indians (18%) and could not account for their lower warfarin Requirements. VKORC1 H1 and H7/H8/H9 haplotypes were associated with lower and higher warfarin Requirements, respectively (0.050 ± 0.019 mg/kg and 0.092 ± 0.057 mg/kg, respectively; P < .001). VKORC1 H1 haplotype (requiring low warfarin doses) was common in Chinese (87%) and Malays (65%) but uncommon in Indians (12%), whereas H7, H8, and H9 haplotypes (requiring high warfarin doses) were rare in Chinese (9%), intermediate in Malays (30%), and common in Indians (82%). The interethnic difference in warfarin Requirements became nonsignificant when adjusted for VKORC1 haplotype. Conclusions Interethnic difference in VKORC1 haplotypes accounts for the difference in warfarin Requirements between Chinese, Malays, and Indians, providing interesting insights into genetic variation between ethnogeographically distinct Asian groups. Clinical Pharmacology & Therapeutics (2006) 79, 197–205; doi: 10.1016/j.clpt.2005.11.006
Ingrid Lupatsch - One of the best experts on this subject based on the ideXlab platform.
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effect of stocking density and feeding level on energy expenditure and stress responsiveness in european sea bass dicentrarchus labrax
Aquaculture, 2010Co-Authors: Ingrid Lupatsch, J W Schrama, G A Santos, J A J VerrethAbstract:Abstract European sea bass (initial weight 72 ± 4 g) were stocked in 200-L tanks at two densities: a low density (LD) ∼ 5.5 kg m − 3 and a high density (HD) ∼ 36 kg m − 3 . The tanks were part of a recirculation system and were equipped to carry out frequent oxygen measurements. At each density the fish were fed at increasing levels from around Maintenance Requirement up to apparent satiation. The experiment was carried out for 10 weeks at 22 °C, after which the density in the LD treatment had increased to ∼ 10 kg m − 3 and to ∼ 60 kg m − 3 in the HD treatment. At the end of the trial blood samples were taken from several fish to determine the basal levels of cortisol and glucose. Furthermore, to assess the responsiveness to an acute stressor, additional fish were subjected to individual confinement in submerged nets, blood was sampled and cortisol and glucose analysed. At the end of the trial there was no significant difference in growth performance and voluntary feed intake between the groups raised at different densities. The partitioning of energy demand for Maintenance and growth highlighted a slightly higher energy Maintenance Requirement in the LD fish (50.9 kJ (kg) 0.80 day − 1 ) compared to the HD groups (43.15 kJ (kg) 0.80 day − 1 ). In accordance with this, an increased oxygen demand for sea bass kept at the low density was detected through weekly measurements. Analyses of the blood parameters showed, that higher stocking density resulted in higher cortisol levels in both control and stressed groups (after netting), but the effect of stocking density on the acute stress response was less pronounced at the higher feeding level.
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feed formulations based on energy and protein demands in white grouper epinephelus aeneus
Aquaculture, 2005Co-Authors: Ingrid Lupatsch, George Wm KissilAbstract:White grouper a Mediterranean species, is a new promising candidate for Israeli mariculture. In order to develop feeds that promote the most efficient growth and cause low environmental impact the Requirements of grouper for key nutrients have been quantified. Daily Requirements for energy and protein were determined as the sum of Maintenance and growth and the efficiencies for energy and protein deposition were estimated according to the following approach: Requirement=aBW (kg) b +cgain; BW (kg) b =Metabolic body weight; a=Maintenance Requirement; c=coefficient describing the efficiency of utilization of dietary energy or protein for growth. The daily weight gain as a function of body weight (g) and temperature (8C) was predicted by the equation: y=0.062 � BW (g) 0.558 � exp 0.030 � Temp . The composition of the gain was measured by analyzing whole fish ranging from 1 to 1600 g. The energy content was dependent upon fish weight and increased from 4.8 to 7.5 kJ g � 1 body mass, whereas the protein content remained constant at 169 mg g � 1 . The efficiencies of utilization of digestible energy (DE) and digestible protein (DP) for Maintenance and growth in white grouper were determined by feeding fish of various sizes at increasing levels from zero to maximum voluntary feed intake, as well as three different water temperature regimes. Maintenance Requirement for energy and protein increased with increasing temperatures. The relationships between DE intake and energy gain as well as DP intake and protein gain were found to be linear throughout and were both independent of feed intake, body weight and temperature. Daily Requirements of white grouper at 24 8C can be thus calculated as follows: Digestible energy need (kJ fish � 1 day � 1 )=40.7 � BW (kg) 0.80 +1.52 � energy gain; Digestible protein need (g fish � 1 day � 1 )=0.39 � BW (kg) 0.70 +1.85 � protein gain. Based on those results, feeds can be formulated for white grouper with optimal energy to protein ratio during the entire grow-out period to increase retention efficiency and reduce excretion of nutrients. D 2005 Elsevier B.V. All rights reserved.
