Prediction of hemodynamic changes towards PEEP titrations at different volemic levels using a minimal cardiovascular model.

Abstract:

:A cardiovascular system model and parameter identification method have previously been validated for porcine experiments of induced pulmonary embolism and positive end-expiratory pressure (PEEP) titrations, accurately tracking all the main hemodynamic trends. In this research, the model and parameter identification process are further validated by predicting the effect of intervention. An overall population-specific rule linking specific model parameters to increases in PEEP is formulated to predict the hemodynamic effects on arterial pressure, pulmonary artery pressure and stroke volume. Hemodynamic changes are predicted for an increase from 0 to 10 cm H(2)O with median absolute percentage errors less than 7% (systolic pressures) and 13% (stroke volume). For an increase from 10 to 20 cm H(2)O median absolute percentage errors are less than 11% (systolic pressures) and 17% (stroke volume). These results validate the general applicability of such a rule, which is not pig-specific, but holds over for all analyzed pigs. This rule enables physiological simulation and prediction of patient response. Overall, the prediction accuracy achieved represents a further clinical validation of these models, methods and overall approach to cardiovascular diagnosis and therapy guidance.

authors

Starfinger C,Chase JG,Hann CE,Shaw GM,Lambert P,Smith BW,Sloth E,Larsson A,Andreassen S,Rees S

doi

10.1016/j.cmpb.2008.03.004

subject

Has Abstract

pub_date

2008-08-01 00:00:00

pages

128-34

issue

2

eissn

0169-2607

issn

1872-7565

pii

S0169-2607(08)00078-3

journal_volume

91

pub_type

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