Fluids are by far the most administered intravenous treatment in patient care. During surgery and critical illness, fluids are usually administered to increase blood volume to maintain or increase cardiac output and arterial blood pressure, thereby avoiding tissue hypoperfusion and hypoxia. Until recently, fluids were not considered “medications”. However, it is now understood that intravenous fluids should be viewed as drugs. Administering the wrong iv dose can compromise the performance of the cardiovascular, renal, gastrointestinal and immune systems. Fluid administration should therefore always be accompanied by consideration for the risk/benefit ratio, of the volume being administered. 

How to judge administering the “correct” fluid volume is still not fully resolved. Continuous hemodynamic and fluid response parameters, introduced over 25 years ago by companies including LiDCO, were the first step in the evolution of a next generation of fluid management tools. However, these parameters  are indirect assessments of circulatory blood volume changes and this limits both their interpretation and clinical utility.

There has been considerable success  integrating  advanced technologies into infusion systems to enhance the efficacy, safety of administered drugs. When large fluid volumes are being used to manage the circulation, a similar approach needs to be applied to determine the effective fluid dose.

Drawing on experience and expertise in developing, patenting, and commercializing innovative medical products. TOB1 is developing the OFIS® platform technology, which provides pharmacokinetic modelling of blood volume changes following  fluid administration.  Our new approach is  initially aimed at improving the understanding of fluid kinetics. Ultimately integrating OFIS® computer simulation with existing fluid response and hemodynamic parameters should allow much finer control of the administered iv-dose , provide better care and help reduce fluid complications.

At least 310 million patients undergo major surgery worldwide.  Blood volume simulation following fluid administration in surgery  is the first application for the OFIS® Platform technology.