Terence Luk
@simtiva.app
Terence Luk, Anaesthetist, Creator of http://SimTIVA.app - free & open source TCI/TIVA simulator - progressive web app #ansky
Pinned
Terence Luk
@simtiva.app
· Nov 14
First post here!
Simtiva.app is a web-based simulator for TCI/TIVA. It allows the use of Eleveld model (the latest one!) for propofol in "CE targeting", so you may use the suggested scheme on any syringe pump without TCI Eleveld functionality.
Other drugs and models also available for simulation...
Simtiva.app is a web-based simulator for TCI/TIVA. It allows the use of Eleveld model (the latest one!) for propofol in "CE targeting", so you may use the suggested scheme on any syringe pump without TCI Eleveld functionality.
Other drugs and models also available for simulation...
Reposted by Terence Luk
Total intravenous anaesthesia (TIVA) for rapid sequence induction (RSI)
Worried your TIVA infusion is too slow for RSI?
Why not work with your local manufacturer to develop an ‘RSI-TCI’ mode for your target-controlled infusion pumps?
#AnSky #PharmSky
doi.org/10.1111/anae...
Worried your TIVA infusion is too slow for RSI?
Why not work with your local manufacturer to develop an ‘RSI-TCI’ mode for your target-controlled infusion pumps?
#AnSky #PharmSky
doi.org/10.1111/anae...
October 1, 2025 at 6:03 AM
Total intravenous anaesthesia (TIVA) for rapid sequence induction (RSI)
Worried your TIVA infusion is too slow for RSI?
Why not work with your local manufacturer to develop an ‘RSI-TCI’ mode for your target-controlled infusion pumps?
#AnSky #PharmSky
doi.org/10.1111/anae...
Worried your TIVA infusion is too slow for RSI?
Why not work with your local manufacturer to develop an ‘RSI-TCI’ mode for your target-controlled infusion pumps?
#AnSky #PharmSky
doi.org/10.1111/anae...
Reposted by Terence Luk
"... a ‘RSI–TCI’ mode with a pre-programmed manual bolus offers a pragmatic solution for those who wish to preserve an intact pharmacokinetic model for accurate propofol delivery, while allowing the rapid induction clinicians expect from a manual bolus."
#AnSky #MedSky
doi.org/10.1111/anae...
#AnSky #MedSky
doi.org/10.1111/anae...
October 1, 2025 at 8:06 AM
"... a ‘RSI–TCI’ mode with a pre-programmed manual bolus offers a pragmatic solution for those who wish to preserve an intact pharmacokinetic model for accurate propofol delivery, while allowing the rapid induction clinicians expect from a manual bolus."
#AnSky #MedSky
doi.org/10.1111/anae...
#AnSky #MedSky
doi.org/10.1111/anae...
Today I have updated simtiva.app and simtiva.vet -
The changes are mainly visual, with a refreshed look. Part of the reason is user feedback regarding the new iOS 26 on iPhones partially breaking the user interface with malpositioned top and bottom elements.
Minor bugfixes as well.
#ansky
The changes are mainly visual, with a refreshed look. Part of the reason is user feedback regarding the new iOS 26 on iPhones partially breaking the user interface with malpositioned top and bottom elements.
Minor bugfixes as well.
#ansky
September 20, 2025 at 10:47 AM
Today I have updated simtiva.app and simtiva.vet -
The changes are mainly visual, with a refreshed look. Part of the reason is user feedback regarding the new iOS 26 on iPhones partially breaking the user interface with malpositioned top and bottom elements.
Minor bugfixes as well.
#ansky
The changes are mainly visual, with a refreshed look. Part of the reason is user feedback regarding the new iOS 26 on iPhones partially breaking the user interface with malpositioned top and bottom elements.
Minor bugfixes as well.
#ansky
Ketamine (Kamp) model will be improved soon. On Simtiva, the Kamp model used a ke0 of 0.238, from Navarette PD study using ANI index (ref1). However, that PD study applies to the Domino PK set, and ke0 is model-specific and should not be naively applied to another PK model...
(1/4)
#ansky
(1/4)
#ansky
September 4, 2025 at 7:10 AM
Ketamine (Kamp) model will be improved soon. On Simtiva, the Kamp model used a ke0 of 0.238, from Navarette PD study using ANI index (ref1). However, that PD study applies to the Domino PK set, and ke0 is model-specific and should not be naively applied to another PK model...
(1/4)
#ansky
(1/4)
#ansky
jaj42.github.io/blog/posts/2...
An excellent and interesting read for those interested in TCI and programming! STANPUMP is an amazing piece of software
An excellent and interesting read for those interested in TCI and programming! STANPUMP is an amazing piece of software
Deep dive into STANPUMP – blog
jaj42.github.io
August 27, 2025 at 3:35 AM
jaj42.github.io/blog/posts/2...
An excellent and interesting read for those interested in TCI and programming! STANPUMP is an amazing piece of software
An excellent and interesting read for those interested in TCI and programming! STANPUMP is an amazing piece of software
Low-dose ketamine infusion is an excellent component of multi-modal opioid-sparing analgesia. Kamp model uses meta-analytical technique to facilitate better plasma site targeting for TCI ketamine. This model is now introduced in SimTIVA.app
pubmed.ncbi.nlm.nih.gov/32997732/
(1/2) #ansky
pubmed.ncbi.nlm.nih.gov/32997732/
(1/2) #ansky
SimTIVA | Free TIVA Simulation App to Simulate Target-Controlled Infusion | Simple TCI Calculator
Simple and free TIVA simulator
SimTIVA.app
July 6, 2025 at 5:51 AM
Low-dose ketamine infusion is an excellent component of multi-modal opioid-sparing analgesia. Kamp model uses meta-analytical technique to facilitate better plasma site targeting for TCI ketamine. This model is now introduced in SimTIVA.app
pubmed.ncbi.nlm.nih.gov/32997732/
(1/2) #ansky
pubmed.ncbi.nlm.nih.gov/32997732/
(1/2) #ansky
Renewed interest in Ketamine emerged as a result of potentially new indications. Kamp model is an allometric model based on meta-analytical analysis. journals.lww.com/anesthesiolo...
Coming soon to simtiva.app
#ansky
Coming soon to simtiva.app
#ansky
June 28, 2025 at 3:28 AM
Renewed interest in Ketamine emerged as a result of potentially new indications. Kamp model is an allometric model based on meta-analytical analysis. journals.lww.com/anesthesiolo...
Coming soon to simtiva.app
#ansky
Coming soon to simtiva.app
#ansky
Happy to share that Simtiva (veterinary version), a TIVA simulator for small animals, was successfully used to guide TIVA in prolonged surgery in a cat, and the results were recently published in VAA journal.
Simtiva.vet was co-developed by Enzo Minghella & me 1 yr ago and is actively updated.
Simtiva.vet was co-developed by Enzo Minghella & me 1 yr ago and is actively updated.
June 12, 2025 at 6:46 AM
Happy to share that Simtiva (veterinary version), a TIVA simulator for small animals, was successfully used to guide TIVA in prolonged surgery in a cat, and the results were recently published in VAA journal.
Simtiva.vet was co-developed by Enzo Minghella & me 1 yr ago and is actively updated.
Simtiva.vet was co-developed by Enzo Minghella & me 1 yr ago and is actively updated.
SimTIVA.app is fully capable of offline support. The app can be run offline. Internet connection can be unstable sometimes, but rest assured you can still run SimTIVA normally. Also, minor changes to the mcg/kg/min default rate unit display (manual mode) for Propofol, the bug is fixed.
#ansky
#ansky
May 2, 2025 at 12:14 AM
SimTIVA.app is fully capable of offline support. The app can be run offline. Internet connection can be unstable sometimes, but rest assured you can still run SimTIVA normally. Also, minor changes to the mcg/kg/min default rate unit display (manual mode) for Propofol, the bug is fixed.
#ansky
#ansky
Reposted by Terence Luk
You've been meaning to get around to reading about the differences between adult TCI models for propofol? On the to do list for .... ever??
Listen to this to get you warmed up, and check out the references in the show notes for the in depth excitement you're desperate to have!
#ansky #FOAMed
Listen to this to get you warmed up, and check out the references in the show notes for the in depth excitement you're desperate to have!
#ansky #FOAMed
TIVA Models for Propofol
TIVA Models for Propofol delivery in anaesthesia. Comparing their pharmacokinetics, clinical use, and pitfalls for the FRCA exam and beyond.
gasgasgas.uk
April 25, 2025 at 7:24 AM
Minor update to Simtiva.app: propofol concentration options available: 10mg/ml, 20mg/ml, or custom dilution; plus other bug fixes
April 22, 2025 at 10:11 AM
Minor update to Simtiva.app: propofol concentration options available: 10mg/ml, 20mg/ml, or custom dilution; plus other bug fixes
Feature preview: propofol concentration can be customized (10mg/ml, 20mg/ml, or custom dilution)
April 17, 2025 at 4:54 AM
Feature preview: propofol concentration can be customized (10mg/ml, 20mg/ml, or custom dilution)
Reposted by Terence Luk
The term "TIVA RSI" misrepresents the issue.
All RSIs are IV. Whether it's a TIVA anaesthetic depends on whether the subseq maintenance agent is inhaled or IV (& irrelevant to the process of RSI).
The question is whether IV induction agents should be administered by an infusion pump during RSI.
All RSIs are IV. Whether it's a TIVA anaesthetic depends on whether the subseq maintenance agent is inhaled or IV (& irrelevant to the process of RSI).
The question is whether IV induction agents should be administered by an infusion pump during RSI.
Do you use TIVA when you are doing a rapid sequence induction in theatre?
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
April 11, 2025 at 12:43 AM
The term "TIVA RSI" misrepresents the issue.
All RSIs are IV. Whether it's a TIVA anaesthetic depends on whether the subseq maintenance agent is inhaled or IV (& irrelevant to the process of RSI).
The question is whether IV induction agents should be administered by an infusion pump during RSI.
All RSIs are IV. Whether it's a TIVA anaesthetic depends on whether the subseq maintenance agent is inhaled or IV (& irrelevant to the process of RSI).
The question is whether IV induction agents should be administered by an infusion pump during RSI.
Reposted by Terence Luk
Do you use TIVA when you are doing a rapid sequence induction in theatre?
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
April 10, 2025 at 11:46 AM
Do you use TIVA when you are doing a rapid sequence induction in theatre?
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
Reposted by Terence Luk
What is your preferred methodology for in-theatre TIVA RSI?
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
April 10, 2025 at 12:00 PM
What is your preferred methodology for in-theatre TIVA RSI?
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
Simtiva.app update: RSI mode to facilitate guidance of TIVA in an RSI situation. Eleveld model.
#AnSky
#AnSky
April 7, 2025 at 8:23 AM
Simtiva.app update: RSI mode to facilitate guidance of TIVA in an RSI situation. Eleveld model.
#AnSky
#AnSky
Simtiva.app update: Dexmedetomidine (Hannivoort) model. CET/CPT/Manual mode available. Welcome any feedback
April 7, 2025 at 8:22 AM
Simtiva.app update: Dexmedetomidine (Hannivoort) model. CET/CPT/Manual mode available. Welcome any feedback
Feature preview: RSI mode coming soon to simtiva.app! How do you do RSI with TIVA? The algorithm suggests a bolus dose based on user-defined CE target at a specified time point (e.g. 60s). It also predicts a CE overshoot & when to resume infusion. Also testing live preview feature...
#ansky
#ansky
April 4, 2025 at 6:18 AM
Feature preview: RSI mode coming soon to simtiva.app! How do you do RSI with TIVA? The algorithm suggests a bolus dose based on user-defined CE target at a specified time point (e.g. 60s). It also predicts a CE overshoot & when to resume infusion. Also testing live preview feature...
#ansky
#ansky
April 4, 2025 at 6:15 AM
Upcoming feature: y-axis (concentration) can be adjusted. User can define the max. concentration on graph display instead of relying on automatic algorithm
March 21, 2025 at 11:42 AM
Upcoming feature: y-axis (concentration) can be adjusted. User can define the max. concentration on graph display instead of relying on automatic algorithm
Out of the 6500+ simulations performed with simtiva.app in the past 3 months, Eleveld model was the most popular model, accounting for over half of the sessions performed. Schnider and Marsh models were 2nd and 3rd most used models.
March 21, 2025 at 2:06 AM
Out of the 6500+ simulations performed with simtiva.app in the past 3 months, Eleveld model was the most popular model, accounting for over half of the sessions performed. Schnider and Marsh models were 2nd and 3rd most used models.
Reposted by Terence Luk
🆕The @who.int has announced that the theme of World Patient Safety Day 2025 will be “Safe care for every newborn and every child”, emphasising the need for stronger measures to protect children from preventable harm. Read more below⬇️
www.pslhub.org/learn/organi... #patientsafety
www.pslhub.org/learn/organi... #patientsafety
World Patient Safety Day 2025
This year’s World Patient Safety Day on 17 September is focused on the theme “Safe care for every newborn and every child”. This article explains the aims of the event and the areas it will cover.
www.pslhub.org
March 18, 2025 at 8:57 AM
🆕The @who.int has announced that the theme of World Patient Safety Day 2025 will be “Safe care for every newborn and every child”, emphasising the need for stronger measures to protect children from preventable harm. Read more below⬇️
www.pslhub.org/learn/organi... #patientsafety
www.pslhub.org/learn/organi... #patientsafety
At work, with SimTIVA 😁
December 18, 2024 at 12:46 AM
At work, with SimTIVA 😁
2024 Recap (4)
Do you prefer to use Schnider or Marsh model in TCI? SimTIVA.app has an “Eleveld emulation tool” that converts a Marsh/Schnider TCI infusion scheme into CP, CE & estimated BIS values as predicted by the Eleveld model. This helps to compare older models with the Eleveld model.
#ansky
Do you prefer to use Schnider or Marsh model in TCI? SimTIVA.app has an “Eleveld emulation tool” that converts a Marsh/Schnider TCI infusion scheme into CP, CE & estimated BIS values as predicted by the Eleveld model. This helps to compare older models with the Eleveld model.
#ansky
December 14, 2024 at 3:20 AM
2024 Recap (4)
Do you prefer to use Schnider or Marsh model in TCI? SimTIVA.app has an “Eleveld emulation tool” that converts a Marsh/Schnider TCI infusion scheme into CP, CE & estimated BIS values as predicted by the Eleveld model. This helps to compare older models with the Eleveld model.
#ansky
Do you prefer to use Schnider or Marsh model in TCI? SimTIVA.app has an “Eleveld emulation tool” that converts a Marsh/Schnider TCI infusion scheme into CP, CE & estimated BIS values as predicted by the Eleveld model. This helps to compare older models with the Eleveld model.
#ansky