EBM Clinical Tools · v3.2 · MediNjuz
Ighi, MD, MPH — Anesthesiologist & Intensivist. Working in the field of anesthesiology, intensive care, and emergency medicine. Focused on evidence-based clinical practice, patient safety, and practical application of pharmacological models at the bedside.
This calculator was built to provide quick, EBM-verified pharmacological estimates for daily clinical use — from TCI propofol dosing across three validated models to TXA protocols, opioid conversions, fluid calculations, and vasopressor dosing. All formulas are sourced from original publications and cross-verified against peer-reviewed implementations.
TCI Propofol — Eleveld 2018, Schnider 1998, Marsh 1991 with automatic IBW/LBM/FFM/ABW calculation, PRIS safety limits, and lipid load tracking. TXA — Evidence-based dosing for trauma (CRASH-2), PPH (WOMAN), TBI (CRASH-3), cardiac surgery (OPTIMAL), and orthopedics with renal adjustment and time-dependent alerts. Opioid Equivalents — 11 opioids including piritramide, sufentanil, and fentanyl TTS with CDC 2022 MME factors. Fluid Resuscitation — Holliday-Segar 4-2-1 and Parkland burn formula. Vasopressors — SSC 2021 hierarchy with weight-based ml/h calculations for NE, vasopressin, epinephrine, dobutamine, phenylephrine, and milrinone.
Every pharmacological parameter in this calculator has been independently verified against original publications, OpenTCI NONMEM reference code, FDA prescribing information, and clinical guideline documents.
Key corrections (v3.2, dual factcheck): Eleveld sex-coefficient direction corrected (females have higher CL); unverifiable Eleveld theta values (sex, opioid) removed pending full-paper access; opioid covariate changed from exponential to binary; James LBM paradox threshold corrected (BMI 43♂, 37♀); Parkland TBSA cap removed (fictitious); vasopressin max corrected to 0.03 U/min (SSC 2021); milrinone lower bound to 0.375 µg/kg/min (FDA); TXA renal alternative added; PMID 361169→712111 (Schwartz ABW); PMID 34599691→34605781 (SSC CCM); piritramide MME corrected 2.14→2.1; phenylephrine range expanded to FDA label (bolus 250µg, inf 1.0 µg/kg/min); sufentanil conversion annotated as upper-range estimate.
All calculations are based on the following peer-reviewed publications:
| # | Reference | ID |
|---|---|---|
| 1 PK | Eleveld DJ, et al. PK-PD model for propofol. Br J Anaesth 2018;120(5):942–959. | PMID 29661412 |
| 2 PK | Schnider TW, et al. PK of propofol in adult volunteers. Anesthesiology 1998;88(5):1170–1182. | PMID 9605675 |
| 3 PK | Schnider TW, et al. Influence of age on propofol PD. Anesthesiology 1999;90(6):1502–1516. | PMID 10360845 |
| 4 PK | Marsh B, et al. PK model driven infusion of propofol in children. Br J Anaesth 1991;67(1):41–48. | PMID 1859758 |
| 5 PK | Struys MM, et al. Comparison of plasma and effect-site TCI. Anesthesiology 2000;92(2):399–406. | PMID 10691226 |
| 6 PK | Absalom AR, et al. PK models for propofol — defining the devil in the detail. BJA 2009;103(1):26–37. | PMID 19520702 |
| 7 PK | Al-Sallami HS, et al. Prediction of FFM in children. Clin Pharmacokinet 2015;54:1169–1178. | PMID 25940825 |
| 8 PRIS | Bray RJ. Propofol infusion syndrome in children. Paediatr Anaesth 1998;8(6):491–499. | PMID 9836214 |
| 9 PRIS | Kam PC, Cardone D. Propofol infusion syndrome. Anaesthesia 2007;62(7):690–701. | PMID 17567345 |
| 10 PRIS | Hemphill S, et al. PRIS: structured literature review. BJA 2019;122(4):448–459. | PMID 30857601 |
| 11 PRIS | Roberts RJ, et al. Incidence of PRIS in critically ill adults. Crit Care 2009;13(5):R169. | PMID 19874582 |
| 12 LIPID | Singer P, et al. ESPEN guideline on clinical nutrition in the ICU. Clin Nutr 2019;38(1):48–79. | PMID 30348463 |
| 13 TXA | CRASH-2 collaborators. Tranexamic acid in trauma. Lancet 2010;376:23–32. | PMID 20554319 |
| 14 TXA | WOMAN trial. TXA in postpartum haemorrhage. Lancet 2017;389:2105–2116. | PMID 28456509 |
| 15 TXA | CRASH-3 collaborators. TXA in traumatic brain injury. Lancet 2019;394:1713–1723. | PMID 31623894 |
| 16 TXA | Shi J, et al. OPTIMAL trial — high vs low dose TXA in cardiac surgery. JAMA 2022;328(4):336–347. | PMID 35881121 |
| 17 TXA | Myles PS, et al. ATACAS trial — TXA in coronary surgery. NEJM 2017;376(2):136–148. | PMID 27774838 |
| 18 OME | Dowell D, et al. CDC Clinical Practice Guideline for Prescribing Opioids. MMWR 2022;71(RR-3):1–95. | PMID 36327391 |
| 19 OME | Dinges HC, et al. Equianalgesic potency ratios — NMA. J Opioid Manag 2022;18(6):567–586. | PMID 36523208 |
| 20 GUIDE | Evans L, et al. Surviving Sepsis Campaign 2021. Crit Care Med 2021;49(11):e1063–e1143. | PMID 34605781 |
| 21 GUIDE | Holliday MA, Segar WE. Maintenance need for water. Pediatrics 1957;19(5):823–832. | PMID 13431307 |
| 22 GUIDE | Baxter CR, Shires T. Physiological response to crystalloid resuscitation of severe burns. Ann N Y Acad Sci 1968;150:874–894. | PMID 4973463 |
| 23 GUIDE | Devlin JW, et al. PADIS Guidelines. Crit Care Med 2018;46(9):e825–e873. | PMID 30113379 |
This calculator is for informational and educational purposes only. It does not replace clinical judgement, individual patient assessment, or the manufacturer's prescribing information. All calculations are approximations and may differ from actual TCI pump values.
The author and MediNjuz.com accept no liability whatsoever for any direct, indirect, or consequential harm — including patient injury or death — arising from use of this tool.
Per EU MDR 2017/745, this tool has not undergone conformity assessment and is not registered as a medical device (MDSW). Clinical dosing must be based on a certified TCI system and approved SmPC. Use is entirely at the user's own risk.
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