References of "Desaive, Thomas"
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See detailA graphical method for practical and informative identifiability analyses of physiological models: A case study of insulin kinetics and sensitivity
Docherty, Paul D.; Chase, J Geoffrey; Lotz, Thomas F. et al

in Biomedical Engineering Online (2011), 10

Background: Derivative based a-priori structural identifiability analyses of mathematical models can offer valuable insight into the identifiability of model parameters. However, these analyses are only ... [more ▼]

Background: Derivative based a-priori structural identifiability analyses of mathematical models can offer valuable insight into the identifiability of model parameters. However, these analyses are only capable of a binary confirmation of the mathematical distinction of parameters and a positive outcome can begin to lose relevance when measurement error is introduced. This article presents an integral based method that allows the observation of the identifiability of models with two-parameters in the presence of assay error. Methods: The method measures the distinction of the integral formulations of the parameter coefficients at the proposed sampling times. It can thus predict the susceptibility of the parameters to the effects of measurement error. The method is tested in-silico with Monte Carlo analyses of a number of insulin sensitivity test applications. Results: The method successfully captured the analogous nature of identifiability observed in Monte Carlo analyses of a number of cases including protocol alterations, parameter changes and differences in participant behaviour. However, due to the numerical nature of the analyses, prediction was not perfect in all cases. Conclusions: Thus although the current method has valuable and significant capabilities in terms of study or test protocol design, additional developments would further strengthen the predictive capability of the method. Finally, the method captures the experimental reality that sampling error and timing can negate assumed parameter identifiability and that identifiability is a continuous rather than discrete phenomenon. [less ▲]

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See detailPilot proof of concept clinical trials of Stochastic Targeted (STAR) glycemic control.
Evans, Alicia; Shaw, Geoffrey M; Le Compte, Aaron et al

in Annals of intensive care (2011), 1

ABSTRACT: INTRODUCTION: Tight glycemic control (TGC) has shown benefits but has been difficult to achieve consistently. STAR (Stochastic TARgeted) is a flexible, model-based TGC approach directly ... [more ▼]

ABSTRACT: INTRODUCTION: Tight glycemic control (TGC) has shown benefits but has been difficult to achieve consistently. STAR (Stochastic TARgeted) is a flexible, model-based TGC approach directly accounting for intra- and inter- patient variability with a stochastically derived maximum 5% risk of blood glucose (BG) < 4.0 mmol/L. This research assesses the safety, efficacy, and clinical burden of a STAR TGC controller modulating both insulin and nutrition inputs in pilot trials. METHODS: Seven patients covering 660 hours. Insulin and nutrition interventions are given 1-3 hourly as chosen by the nurse to allow them to manage workload. Interventions are calculated by using clinically validated computer models of human metabolism and its variability in critical illness to maximize the overlap of the model-predicted (5-95th percentile) range of BG outcomes with the 4.0-6.5 mmol/L band while ensuring a maximum 5% risk of BG < 4.0 mmol/L. Carbohydrate intake (all sources) was selected to maximize intake up to 100% of SCCM/ACCP goal (25 kg/kcal/h). Maximum insulin doses and dose changes were limited for safety. Measurements were made with glucometers. Results are compared to those for the SPRINT study, which reduced mortality 25-40% for length of stay >/=3 days. Written informed consent was obtained for all patients, and approval was granted by the NZ Upper South A Regional Ethics Committee. RESULTS: A total of 402 measurements were taken over 660 hours (~14/day), because nurses showed a preference for 2-hourly measurements. Median [interquartile range, (IQR)] cohort BG was 5.9 mmol/L [5.2-6.8]. Overall, 63.2%, 75.9%, and 89.8% of measurements were in the 4.0-6.5, 4.0-7.0, and 4.0-8.0 mmol/L bands. There were no hypoglycemic events (BG < 2.2 mmol/L), and the minimum BG was 3.5 mmol/L with 4.5% < 4.4 mmol/L. Per patient, the median [IQR] hours of TGC was 92 h [29-113] using 53 [19-62] measurements (median, ~13/day). Median [IQR] results: BG, 5.9 mmol/L [5.8-6.3]; carbohydrate nutrition, 6.8 g/h [5.5-8.7] (~70% goal feed median); insulin, 2.5 U/h [0.1-5.1]. All patients achieved BG < 6.1 mmol/L. These results match or exceed SPRINT and clinical workload is reduced more than 20%. CONCLUSIONS: STAR TGC modulating insulin and nutrition inputs provided very tight control with minimal variability by managing intra- and inter- patient variability. Performance and safety exceed that of SPRINT, which reduced mortality and cost in the Christchurch ICU. The use of glucometers did not appear to impact the quality of TGC. Finally, clinical workload was self-managed and reduced 20% compared with SPRINT. [less ▲]

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See detailFirst pilot trial of the STAR-Liege protocol for tight glycemic control in critically ill patients
Penning, Sophie ULg; Le Compte, Aaron J.; Moorhead, Katherine T. et al

in Computer Methods & Programs in Biomedicine (2011)

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See detailPhysiological modeling, tight glycemic control, and the ICU clinician: what are models and how can they affect practice?
Chase, J. Geoffrey; Le Compte, Aaron J.; Preiser, Jean-Charles et al

in Annals of Intensive Care (2011), 1:11

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See detailStudy of six models of the instantaneous pressure-volume relationship
Lucas, Alexandra ULg; Dauby, Pierre ULg; Desaive, Thomas ULg et al

in Proceedings of the XXIIIth Congress of the ISB (2011)

Models and simulations are very useful to study interactions between anatomic structures and physical cardiac phenomena. In this work, we are interested in models of the instantaneous pressure-volume ... [more ▼]

Models and simulations are very useful to study interactions between anatomic structures and physical cardiac phenomena. In this work, we are interested in models of the instantaneous pressure-volume relationship, i.e. isochrone models. More precisely, we concentrate on the 6 models considered by Lankhaar et al. [1]. We propose a critical analysis of the work of these authors and suggest some improvement of their procedure. [1] Lankhaar J.-W. et al. Modeling the Instantaneous Pressure–Volume Relation of the Left Ventricle: A Comparison of Six Models. Annals of Biomedical Engineering, Volume 37, Number 9, 1710-1726, 2009. [less ▲]

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See detailSubject-specific cardiovascular system model-based identification and diagnosis of septic shock with a minimally invasive data set: animal experiments and proof of concept.
Chase, J Geoffrey; Lambermont, Bernard ULg; Starfinger, Christina et al

in Physiological Measurement (2011), 32(1), 65-82

A cardiovascular system (CVS) model and parameter identification method have previously been validated for identifying different cardiac and circulatory dysfunctions in simulation and using porcine models ... [more ▼]

A cardiovascular system (CVS) model and parameter identification method have previously been validated for identifying different cardiac and circulatory dysfunctions in simulation and using porcine models of pulmonary embolism, hypovolemia with PEEP titrations and induced endotoxic shock. However, these studies required both left and right heart catheters to collect the data required for subject-specific monitoring and diagnosis-a maximally invasive data set in a critical care setting although it does occur in practice. Hence, use of this model-based diagnostic would require significant additional invasive sensors for some subjects, which is unacceptable in some, if not all, cases. The main goal of this study is to prove the concept of using only measurements from one side of the heart (right) in a 'minimal' data set to identify an effective patient-specific model that can capture key clinical trends in endotoxic shock. This research extends existing methods to a reduced and minimal data set requiring only a single catheter and reducing the risk of infection and other complications-a very common, typical situation in critical care patients, particularly after cardiac surgery. The extended methods and assumptions that found it are developed and presented in a case study for the patient-specific parameter identification of pig-specific parameters in an animal model of induced endotoxic shock. This case study is used to define the impact of this minimal data set on the quality and accuracy of the model application for monitoring, detecting and diagnosing septic shock. Six anesthetized healthy pigs weighing 20-30 kg received a 0.5 mg kg(-1) endotoxin infusion over a period of 30 min from T0 to T30. For this research, only right heart measurements were obtained. Errors for the identified model are within 8% when the model is identified from data, re-simulated and then compared to the experimentally measured data, including measurements not used in the identification process for validation. Importantly, all identified parameter trends match physiologically and clinically and experimentally expected changes, indicating that no diagnostic power is lost. This work represents a further with human subjects validation for this model-based approach to cardiovascular diagnosis and therapy guidance in monitoring endotoxic disease states. The results and methods obtained can be readily extended from this case study to the other animal model results presented previously. Overall, these results provide further support for prospective, proof of concept clinical testing with humans. [less ▲]

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See detailInfluence of thermoelectric coupling on ectopic beats generated by mechano-electric feedback (MEF) in a one-dimensional cardiac fiber model
Collet, Arnaud ULg; Desaive, Thomas ULg; Pierard, Luc ULg et al

in 9th Belgian Day on Biomedical Engineering, Friday November 26th 2010 in the Academy Palace, Hertogstraat 1, 1000 Brussels (2010, November 26)

The influence of thermal processes on electrophysiology has clearly been underlined by Bini et al., using a FitzHugh--Nagumo-type (FHN-type) model. When the temperature is raised, the action potential ... [more ▼]

The influence of thermal processes on electrophysiology has clearly been underlined by Bini et al., using a FitzHugh--Nagumo-type (FHN-type) model. When the temperature is raised, the action potential duration (APD) has been shown to shorten, while the action potential (AP) amplitude decreases, and the conduction velocity increases. In this research, we investigate the effects of thermoelectric coupling on mechano-electric feedback (MEF), and more specifically, on ectopic beats generated by MEF. To investigate these effects, thermoelectric coupling is introduced in a one-dimensional electromechanical model of a cardiac fiber, which considers excitation-contraction coupling (ECC), as well as MEF. [less ▲]

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See detailModeling the instantaneous pressure-volume relationship in the left ventricle
Lucas, Alexandra ULg; Dauby, Pierre ULg; Desaive, Thomas ULg et al

in 9th Belgian Day on Biomedical Engineering, Friday November 26th 2010 in the Academy Palace, Hertogstraat 1, 1000 Brussels (2010, November 26)

Models and simulations are very useful to study interactions between anatomic structures and physical cardiac phenomena. In this work, we are interested in models of the instantaneous pressure-volume ... [more ▼]

Models and simulations are very useful to study interactions between anatomic structures and physical cardiac phenomena. In this work, we are interested in models of the instantaneous pressure-volume relationship, i.e. isochrone models. More precisely, we concentrate on the 6 models considered by Lankhaar et al. [1]. We propose a critical analysis of the work of these authors and suggest some improvement of their procedure. [1] Lankhaar J.-W. et al. Modeling the Instantaneous Pressure–Volume Relation of the Left Ventricle: A Comparison of Six Models. Annals of Biomedical Engineering, Volume 37, Number 9, 1710-1726, 2009. [less ▲]

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See detailTight Glycemic Control Models for Critically Ill Patients in Intensive Care Units
Penning, Sophie ULg; Le Compte, Aaron; Desaive, Thomas ULg et al

Poster (2010, November 26)

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See detailTight Glycemic Control Models for Critically Ill Patients in Intensive Care Units
Penning, Sophie ULg; Le Compte, Aaron; Moorhead, Katherine ULg et al

in 9th Belgian Day on Biomedical Engineering, "Bridging the gap between medicine and engineering', Friday November 26th 2010 in the Academy Palace, Hertogstraat 1, 1000 Brussels (2010, November 26)

Critically ill patients often present stress-induced hyperglycemia and low insulin sensitivity. Recent studies have shown that high blood glucose (BG) levels are linked to worsened patient outcomes and ... [more ▼]

Critically ill patients often present stress-induced hyperglycemia and low insulin sensitivity. Recent studies have shown that high blood glucose (BG) levels are linked to worsened patient outcomes and increased mortality. Tight glycemic control (TGC) aims at reducing BG levels taking into account inter-patient variability, evolving physiological patient conditions and minimizing hypoglycemic risks. Clinical protocols are used to specify insulin and nutrition rates and BG measurement time interval during control. This research compares different protocols to determine the best one to use at the CHU of Liege. [less ▲]

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See detailInfluence of thermoelectric coupling on ectopic beats generated by mechano-electric feedback (MEF) in a one-dimensional cardiac fiber model
Collet, Arnaud ULg; Desaive, Thomas ULg; Pierard, Luc ULg et al

Poster (2010, November 26)

The influence of thermal processes on electrophysiology has clearly been underlined by Bini et al., using a FitzHugh--Nagumo-type (FHN-type) model. When the temperature is raised, the action potential ... [more ▼]

The influence of thermal processes on electrophysiology has clearly been underlined by Bini et al., using a FitzHugh--Nagumo-type (FHN-type) model. When the temperature is raised, the action potential duration (APD) has been shown to shorten, while the action potential (AP) amplitude decreases, and the conduction velocity increases. In this research, we investigate the effects of thermoelectric coupling on mechano-electric feedback (MEF), and more specifically, on ectopic beats generated by MEF. To investigate these effects, thermoelectric coupling is introduced in a one-dimensional electromechanical model of a cardiac fiber, which considers excitation-contraction coupling (ECC), as well as MEF. [less ▲]

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See detailminimal cardiovascular system model including physiological mitral valve opening
Paeme, Sabine ULg; Moorhead, Katherine ULg; chase, J. Geoffrey et al

in 9th Belgian National Day on Biomedical Engineering, Bruxelles, 26th november (2010, November 26)

A minimal cardiovascular system (CVS) model has been previously validated in silico, and in several animal model studies. It accounts for valve dynamics by means of a Heaviside function to simulate the ... [more ▼]

A minimal cardiovascular system (CVS) model has been previously validated in silico, and in several animal model studies. It accounts for valve dynamics by means of a Heaviside function to simulate the “open on pressure, close on flow” law. However, this model does not describe the progressive valve opening and therefore, it is not suitable for studying valve dysfunctions. [less ▲]

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See detailMinimal cardiovascular system model including physiological mitral valve opening
Paeme, Sabine ULg; Moorhead, Katherine ULg; Chase, J. Geoffrey et al

Poster (2010, November 26)

This research describes a new closed-loop cardiovascular system (CVS) model including a model of the left atrium and a model describing the progressive aperture of the mitral valve

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See detailModeling the instantaneous pressure-volume relationship in the left ventricle
Lucas, Alexandra ULg; Dauby, Pierre ULg; Kolh, Philippe ULg et al

Poster (2010, November 26)

Pressure-volume loops are a common modeling tool of the cardiovascular system. They are very useful because they characterize the global function of the cardiac pump and can also be analyzed ... [more ▼]

Pressure-volume loops are a common modeling tool of the cardiovascular system. They are very useful because they characterize the global function of the cardiac pump and can also be analyzed by considering the various phases of the cardiac cycle and marking each point of a cycle with the corresponding time. When several loops are considered, the points corresponding to the same time t in each loop can be joined to define a curve named isochrone. In this work, we are interested in models of the instantaneous pressure-volume relationship, i.e. isochrone models. More precisely, we concentrate on the 6 models considered by Lankhaar et al. [1] and we propose a critical analysis of the work of these authors and suggest some improvement of their procedure. [1] Lankhaar J.W. et al. Annals of Biomedical Engineering, Volume 37, Number 9, 1710-1726, 2009. [less ▲]

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See detailPilot Trials of the STAR TGC Protocol in a Cardiac Surgery ICU
LeCompte, Aaron J.; Penning, Sophie ULg; Moorhead, Katherine ULg et al

in Proceedings of the 10th Annual Diabetes Technology Meeting (2010, November)

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See detailA Simplified Rotational Spring Model for Mitral Valve Dynamics
Moorhead, K. T.; Hann, C. E.; Chase, J. Geoffrey et al

in Proceedings of control 2010 (2010, September 07)

A simple non-linear rotational spring model has been implemented to model the motion of mitral valve, located between the left atrium and ventricle. A measured pressure difference curve was used as the ... [more ▼]

A simple non-linear rotational spring model has been implemented to model the motion of mitral valve, located between the left atrium and ventricle. A measured pressure difference curve was used as the input into the model, which represents an applied torque to the valve chords. Various damping and hysteresis states were investigated to find a model that best matches reported animal data of chord movement during a heartbeat. The study is limited by the use of one dataset from the literature, however results clearly highlight some physiological issues such as the damping and chord stiffness changing within one cardiac cycle. Very good correlation was achieved between modeled and experimental valve angle, indicating good promise for future simulation of cardiac dysfunction, such as mitral regurgitation or stenosis. [less ▲]

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See detailMathematical model of the mitral valve and the cardiovascular system, application for studying, monitoring and in the diagnosis of valvular pathologies
Paeme, Sabine ULg; Moorhead, Katherine ULg; Chase, J. Geoffrey et al

in UKACC international Conference on Control 2010 : Coventry, 7-10 september 2010 (2010, September 07)

A cardiovascular and circulatory system (CVS) model has been validated in silico, and in several animal model studies. It accounts for valve dynamics using Heaviside functions to simulate a physiological ... [more ▼]

A cardiovascular and circulatory system (CVS) model has been validated in silico, and in several animal model studies. It accounts for valve dynamics using Heaviside functions to simulate a physiological accurate “open on pressure, close on flow” law. Thus, it does not consider the real time scale of the valve aperture dynamics and thus doesn’t fully capture valve dysfunction particularly where the dysfunction involves partial closure. This research describes a new closed-loop CVS model including a model describing the progressive aperture of the mitral valve and valid over the full cardiac cycle. This new model is solved for a healthy and diseased mitral valve. [less ▲]

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See detailReduced organ failure with effective glycemic control
Preiser, Jean-Charles; Chase, J. G.; Pretty, C. G. et al

in Intensive Care Medicine (2010), 36(2), 173-173

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See detailNAVA enhances ventilatory variability and diaphragmaticactivity/tidal volume coupling
Moorhead, K.; Piquilloud, L.; Desaive, Thomas ULg et al

in Intensive Care Medicine (2010), 36(2), 326-326

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See detailPatient-specific modelling of the cardiovascular system – application to septic shock with a minimal data set
Desaive, Thomas ULg; Chase, J. G.; Starfinger, C. et al

in World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany (2010)

Detailed reference viewed: 47 (23 ULg)