iiinova — where your digital self keeps evolving

Terence Luk @simtiva.app · 10/02/2026

The reason why we developed this is that, there is nothing like this on the market. A free, cloud-connected timer, with no ads, that is simple and intuitive. If you are interested, have a play around! May be buggy still. Will continue to improve.

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Terence Luk @simtiva.app · 10/02/2026

This serves the purpose of syncing the timers across different stations/exam rooms. You can share the timer via a link, or a QR code. You may also arrange a timetable schedule in advance, and describe each stage of the timetable.

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Terence Luk @simtiva.app · 10/02/2026

Introducing CloudTimer.app Have you conducted a viva or osce examination? My friend Eric and I wrote this app to help synchronize the countdown timer - this web app is a cloud-connected timer, so that the host can control a timer session and multiple viewers can connect to it simultaneously.

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Terence Luk @simtiva.app · 05/12/2025

The live preview feature can help to decide the induction dosing. As you enter the initial bolus, the graph will be updated simultaneously. Similarly, you change the bolus and infusion input values after simulation has started and the predicted curves (dotted lines) will automatically appear

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Terence Luk @simtiva.app · 05/12/2025

December updates - Simtiva.app: (1) Infusulator, a retrospective data entry tool to simulate the infusion data from time series of CP/CE target values. (2) Live preview for manual mode. The graph will be plotted as you type in the bolus or infusion values so you can preview the change in real time

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Terence Luk @simtiva.app · 04/12/2025

"Live preview" feature: another demo of adding a fentanyl bolus, as u enter "20mcg", the graph updates simultaneously to show the predicted curves of CP/CE. You may also use this feature to plan your induction (what induction dose to use?) if you are using manual mode. Coming soon to SimTIVA!

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Terence Luk @simtiva.app · 04/12/2025

Upcoming feature: live preview of bolus/infusion rate change in manual mode. Sometimes, we need to change our inf rate or give an extra bolus, SimTIVA now plots the curve for the predicted changes dynamically as you enter your values. Video demo of "live preview" of reducing inf rate from 50 to 30

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Terence Luk @simtiva.app · 21/11/2025

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

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Terence Luk @simtiva.app · 21/11/2025

"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.

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Terence Luk @simtiva.app · 20/09/2025

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

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Terence Luk @simtiva.app · 04/09/2025

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

Kamp model for ketamine using different ke0's

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Terence Luk @simtiva.app · 06/07/2025

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

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Terence Luk @simtiva.app · 28/06/2025

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

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Terence Luk @simtiva.app · 12/06/2025

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.

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Terence Luk @simtiva.app · 02/05/2025

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

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Terence Luk @simtiva.app · 22/04/2025

Minor update to Simtiva.app: propofol concentration options available: 10mg/ml, 20mg/ml, or custom dilution; plus other bug fixes

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Terence Luk @simtiva.app · 17/04/2025

Feature preview: propofol concentration can be customized (10mg/ml, 20mg/ml, or custom dilution)

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Terence Luk @simtiva.app · 11/04/2025

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)

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Terence Luk @simtiva.app · 11/04/2025

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

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Terence Luk @simtiva.app · 07/04/2025

Simtiva.app update: RSI mode to facilitate guidance of TIVA in an RSI situation. Eleveld model. #AnSky

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Terence Luk @simtiva.app · 07/04/2025

Simtiva.app update: Dexmedetomidine (Hannivoort) model. CET/CPT/Manual mode available. Welcome any feedback

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Terence Luk @simtiva.app · 04/04/2025

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

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Terence Luk @simtiva.app · 04/04/2025

Feature preview: testing dexmedetomidine TCI on simtiva.app - coming soon #ansky

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Terence Luk @simtiva.app · 21/03/2025

Upcoming feature: y-axis (concentration) can be adjusted. User can define the max. concentration on graph display instead of relying on automatic algorithm

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Terence Luk @simtiva.app · 21/03/2025

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.

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Terence Luk @simtiva.app · 18/12/2024

At work, with SimTIVA 😁

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Terence Luk @simtiva.app · 14/12/2024

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

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Terence Luk @simtiva.app · 14/12/2024

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.

Warning prompt 6 hours max limit reached

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Terence Luk @simtiva.app · 14/12/2024

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.

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Terence Luk @simtiva.app · 14/12/2024

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

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Terence Luk @simtiva.app · 07/12/2024

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

Probability of tolerance to laryngoscopy index trend on SimTIVA.app

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Terence Luk @simtiva.app · 25/11/2024

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.

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Terence Luk @simtiva.app · 21/11/2024

Pls watch this video to see how you can view a shared simulation file. The interactive viewer allows u to review the infusion scheme, events, and pharmacological data at specific time points. SimTIVA.app

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Terence Luk @simtiva.app · 21/11/2024

Simtiva.app TIP: ✨ U may share your simulation via the "share" button (A). U may then choose to share the sim as a picture (B) or a weblink (C) via your favorite apps. U may enter a filename(D). Weblinks can be opened by the SimTIVA viewer which has an interactive interface. manual.simtiva.app?ch=9

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Terence Luk @simtiva.app · 20/11/2024

Hi, also introducing: Simtiva.vet is a web app developed by me and Enzo Minghella. It helps to guide total intravenous anaesthesia (TIVA) in small animals. The models included are Beths (Propofol), Cattai (Propofol), Cattai (Fentanyl) in dogs and Cattai (Propofol) in cats. #vetsky #vetmed

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Terence Luk @simtiva.app · 14/11/2024

...such as Marsh, Schnider & Paedfusor (propofol), Shafer (fentanyl), Maitre (alfentanil) & Eleveld or Minto (remifentanil). Also, in "complex mode", you can explore the PD interaction between propofol-opioid, using Probability of Tolerance to Laryngoscopy (PTOL) as measure of combined effect.

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Terence Luk @simtiva.app · 14/11/2024

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...

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