Beat-to-beat estimation of the continuous left and right cardiac elastance from metrics commonly available in clinical settings.

in BioMedical Engineering OnLine (2012), 11(1), 73

ABSTRACT: INTRODUCTION: : Functional time-varying cardiac elastances (FTVE) contain a rich amount of information about the specific cardiac state of a patient. However, a FTVE waveform is very invasive to ... [more ▼]

ABSTRACT: INTRODUCTION: : Functional time-varying cardiac elastances (FTVE) contain a rich amount of information about the specific cardiac state of a patient. However, a FTVE waveform is very invasive to directly measure, and is thus currently not used in clinical practice. This paper presents a method for the estimation of a patient specific FTVE, using only metrics that are currently available in a clinical setting. METHOD: : Correlations are defined between invasively measured FTVE waveforms and the aortic and pulmonary artery pressures from 2 cohorts of porcine subjects, 1 induced with pulmonary embolism, the other with septic shock. These correlations are then used to estimate the FTVE waveform based on the individual aortic and pulmonary artery pressure waveforms, using the "other" dysfunction's correlations as a cross validation. RESULTS: : The cross validation resulted in 1.26% and 2.51% median errors for the left and right FTVE respectively on pulmonary embolism, while the septic shock cohort had 2.54% and 2.90% median errors. CONCLUSIONS: : The presented method accurately and reliably estimated a patient specific FTVE, with no added risk to the patient. The cross validation shows that the method is not dependent on dysfunction and thus has the potential for generalisation beyond pulmonary embolism and septic shock. [less ▲]

European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR).

in European Heart Journal (2012)

EACTS guidelines for the use of patient safety checklists.

in European Journal of Cardio - Thoracic Surgery (2012), 41(5), 993-1004

The Safety Checklist concept has been an integral part of many industries that face high-complexity tasks for many decades and in industries such as aviation and engineering checklists have evolved from ... [more ▼]

The Safety Checklist concept has been an integral part of many industries that face high-complexity tasks for many decades and in industries such as aviation and engineering checklists have evolved from their very inception. Investigations of the causes of surgical deaths around the world have repeatedly pointed to medical errors that could be prevented as an important cause of death and disability. As a result, the World Health Organisation developed and evaluated a three-stage surgical checklist in 2007 demonstrating that complications were significantly reduced, including surgical infection rates and even mortality. Together with the results from other large cohort studies into the utility of the surgical checklist, many countries have fully implemented the use of surgical checklists into routine practice. A key factor in the successful implementation of a surgical checklist is engagement of the staff implementing the checklist. In surgical specialties such as our own it was quickly seen that there were many important omissions in the generic checklist that did not cover issues particular to our specialty, and thus the European Association for Cardio-Thoracic Surgery embarked on a process to create a version of the checklist that might be more appropriate and specific to cardiothoracic surgery, including checks on preparations for excessive bleeding, perfusion arrangements and ICU preparations, for example. The guideline presented here summarizes the evidence for the surgical checklist and also goes through in detail the changes recommended for our specialty. [less ▲]

Structural model of the mitral valve included in a cardiovascular closed loop model

Poster (2011, December)

A minimal cardiovascular system (CVS) model including mitral valve dynamics has been previously validated in silico. However parameters of this model are difficult to link with structural and anatomical ... [more ▼]

A minimal cardiovascular system (CVS) model including mitral valve dynamics has been previously validated in silico. However parameters of this model are difficult to link with structural and anatomical components of the valve. This research describes the integration of a structural model of the mitral valve in an existing closed-loop cardiovascular system (CVS) model [less ▲]

Minimal cardiovascular system model including a physiological description of progressive mitral valve orifice dynamics for studying valve dysfunction

in XXIIIrd congress of the International Society of Biomechanics, July 3-7, 2011 (2011, July)

This research presents a new closed-loop cardiovascular system model including a description of the progressive opening and closing dynamic of the mitral valve. Furthermore, this model includes a ... [more ▼]

This research presents a new closed-loop cardiovascular system model including a description of the progressive opening and closing dynamic of the mitral valve. Furthermore, this model includes a mathematical description of the left atrium. This new CVS model enables the study of valve dysfunction in the appropriate clinical context of the overall cardiac and circulatory hemodynamics. [less ▲]

ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC).

in European Heart Journal (2011), 32(23), 2999-3054

Assessing the causes inducing lengthening of hospital stays by means of the Appropriateness Evaluation Protocol.

in Health Policy (2011)

OBJECTIVES: The objective is to evaluate the use of the Appropriateness Evaluation Protocol (AEP) as a screening tool for determining the causes of the non-justified days to help hospitals to decrease the ... [more ▼]

OBJECTIVES: The objective is to evaluate the use of the Appropriateness Evaluation Protocol (AEP) as a screening tool for determining the causes of the non-justified days to help hospitals to decrease the length of stay while preserving the quality of care. METHODS: Three successive cross-sectional surveys were conducted from 2003 till 2005, in 23 Belgian hospitals. During this period, 10921 days were audited by means of the AEP. This study is focused on adult acute non-intensive care units. The appropriateness of each day of the sample was assessed, and for those considered as inappropriate, the reasons explaining the prolongation of the stay were investigated. RESULTS: The proportion of inappropriate days was 24.61%. There is a high variability across specialties and hospitals. Regarding inappropriate days, the analysis of causes of prolongation, globally, by bed index or by hospital, indicated clearly internal and external factors that lengthen stays. The most frequent reasons are waits for an examination (22%) and the lack of extra-hospital structures (31%). CONCLUSIONS: The use of AEP as a tool of internal audit to measure the proportion of non-justified days and their causes turns out to be possible and the obtained results has provided some accurate and useful information for the participating, and allowed them to take concrete decisions which lead to shrinking of the length of hospital stay. [less ▲]

Pulmonary embolism diagnostics from the driver function

in Critical Care: the Official Journal of the Critical Care Forum (2011), 15 (Suppl 1)

Model-based cardiovascular monitoring of large pore hemofiltration during endotoxic shock in pigs

in Critical Care: the Official Journal of the Critical Care Forum (2011), 15 (Suppl 1)

Processing aortic and pulmonary artery waveforms to derive the ventricle time-varying elastance

in Proceedings of the 18th IFAC World Congress, 2011 (2011)