Terence Luk
@simtiva.app
Terence Luk, Anaesthetist, Creator of http://SimTIVA.app - free & open source TCI/TIVA simulator - progressive web app #ansky
Conversely: you can also enter a series of manual bolus+infusion regimen to see the PKPD response over time. Below is the Roberts manual infusion scheme, simulated based on Eleveld model, with resultant CE/CP values
November 21, 2025 at 7:41 AM
Conversely: you can also enter a series of manual bolus+infusion regimen to see the PKPD response over time. Below is the Roberts manual infusion scheme, simulated based on Eleveld model, with resultant CE/CP values
"Infusulator", first created by Matthew Hart, coming soon to SimTIVA. It allows easy entry of a time series of CE (or CP) targets to generate TCI simulations. The conversion from CET/CPT to dosage (volume infused, or the total dose) over time is made simple. An export module is also provided.
November 21, 2025 at 7:35 AM
"Infusulator", first created by Matthew Hart, coming soon to SimTIVA. It allows easy entry of a time series of CE (or CP) targets to generate TCI simulations. The conversion from CET/CPT to dosage (volume infused, or the total dose) over time is made simple. An export module is also provided.
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
E.g. low dose ketamine infusion regimen described in the literature (0.3mg/kg bolus followed by 0.15mg/kg/h infusion) resulted in stable CP of 100ng/ml for the first 2h. (100-200ng/ml: target range for analgesia). Alternatively, u may use CE or CP targeting in SimTIVA to guide TCI ketamine.
#ansky
#ansky
July 6, 2025 at 5:55 AM
E.g. low dose ketamine infusion regimen described in the literature (0.3mg/kg bolus followed by 0.15mg/kg/h infusion) resulted in stable CP of 100ng/ml for the first 2h. (100-200ng/ml: target range for analgesia). Alternatively, u may use CE or CP targeting in SimTIVA to guide TCI ketamine.
#ansky
#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
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)
To further demonstrate the drawback of RSI using 1200ml/h bolusing speed of pump-delivered bolus, in the same patient, CE of 3 cannot be achieved within 60s. It needs 1m23s to deliver that bolus and achieve a CE of 3 according to simtiva.app simulation (picture)
April 11, 2025 at 7:34 AM
To further demonstrate the drawback of RSI using 1200ml/h bolusing speed of pump-delivered bolus, in the same patient, CE of 3 cannot be achieved within 60s. It needs 1m23s to deliver that bolus and achieve a CE of 3 according to simtiva.app simulation (picture)
Interesting! I agree. Simtiva.app has an RSI mode that lets u simulate this scenario, either with a hand bolus or a pump-delivered bolus with max rate of either 1200ml/h or 1500ml/h. Eleveld model was used in the demo. The app lets u set the CE target to be achieved within a specific time, say 60s
April 11, 2025 at 2:26 AM
Interesting! I agree. Simtiva.app has an RSI mode that lets u simulate this scenario, either with a hand bolus or a pump-delivered bolus with max rate of either 1200ml/h or 1500ml/h. Eleveld model was used in the demo. The app lets u set the CE target to be achieved within a specific time, say 60s
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.
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
2024 Recap (3)
In March, I have increased the max infusion duration to 6h (previously 2h). This should be adequate for most cases. A warning prompt will appear to suggest the user to continue with usage of SimTIVA.
Once a new target is updated, you can run the sim for another six hours.
In March, I have increased the max infusion duration to 6h (previously 2h). This should be adequate for most cases. A warning prompt will appear to suggest the user to continue with usage of SimTIVA.
Once a new target is updated, you can run the sim for another six hours.
December 14, 2024 at 2:08 AM
2024 Recap (3)
In March, I have increased the max infusion duration to 6h (previously 2h). This should be adequate for most cases. A warning prompt will appear to suggest the user to continue with usage of SimTIVA.
Once a new target is updated, you can run the sim for another six hours.
In March, I have increased the max infusion duration to 6h (previously 2h). This should be adequate for most cases. A warning prompt will appear to suggest the user to continue with usage of SimTIVA.
Once a new target is updated, you can run the sim for another six hours.
2024 Recap (2)
Time travel: SimTIVA is designed to be run in real-time, in parallel to the time course of an actual clinical case. In addition, SimTIVA also allows you to jump back and forth in time, like skipping to different time points of a video; resetting to time zero; or pause a sim.
Time travel: SimTIVA is designed to be run in real-time, in parallel to the time course of an actual clinical case. In addition, SimTIVA also allows you to jump back and forth in time, like skipping to different time points of a video; resetting to time zero; or pause a sim.
December 14, 2024 at 1:57 AM
2024 Recap (2)
Time travel: SimTIVA is designed to be run in real-time, in parallel to the time course of an actual clinical case. In addition, SimTIVA also allows you to jump back and forth in time, like skipping to different time points of a video; resetting to time zero; or pause a sim.
Time travel: SimTIVA is designed to be run in real-time, in parallel to the time course of an actual clinical case. In addition, SimTIVA also allows you to jump back and forth in time, like skipping to different time points of a video; resetting to time zero; or pause a sim.
2024 Recap (1)
SimTIVA.app has introduced a number of features this year. In Jan, we have added a “preview box” to describe the upcoming infusion scheme as you input a new Target, so you can can adjust your pump settings in advance
SimTIVA.app has introduced a number of features this year. In Jan, we have added a “preview box” to describe the upcoming infusion scheme as you input a new Target, so you can can adjust your pump settings in advance
December 14, 2024 at 1:47 AM
2024 Recap (1)
SimTIVA.app has introduced a number of features this year. In Jan, we have added a “preview box” to describe the upcoming infusion scheme as you input a new Target, so you can can adjust your pump settings in advance
SimTIVA.app has introduced a number of features this year. In Jan, we have added a “preview box” to describe the upcoming infusion scheme as you input a new Target, so you can can adjust your pump settings in advance
Of all the nerdy things that I do, I find much joy in troubleshooting the “arrow” problem: the arrow of the trend line of the PTOL index was always a bit off… but why? I finally fixed it
December 7, 2024 at 5:05 AM
Of all the nerdy things that I do, I find much joy in troubleshooting the “arrow” problem: the arrow of the trend line of the PTOL index was always a bit off… but why? I finally fixed it
Working over the weekend to clean up and optimize the code, most of the changes are under the hood, this won't add new features but will minimize the load times and initial file size transferred. As a web app, performance and speed matter. Load times consistently around 1s across the globe.
November 25, 2024 at 12:19 AM
Working over the weekend to clean up and optimize the code, most of the changes are under the hood, this won't add new features but will minimize the load times and initial file size transferred. As a web app, performance and speed matter. Load times consistently around 1s across the globe.