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See detailModel-based computation of total stressed blood volume from a preload reduction manoeuvre
Pironet, Antoine ULg; Desaive, Thomas ULg; Chase, J. Geoffrey et al

in Mathematical Biosciences (2015), 265(0), 28-39

Total stressed blood volume is an important parameter for both doctors and engineers. From a medical point of view, it has been associated with the success or failure of fluid therapy, a primary treatment ... [more ▼]

Total stressed blood volume is an important parameter for both doctors and engineers. From a medical point of view, it has been associated with the success or failure of fluid therapy, a primary treatment to manage acute circulatory failure. From an engineering point of view, it dictates the cardiovascular system’s behavior in changing physiological situations. Current methods to determine this parameter involve repeated phases of circulatory arrests followed by fluid administration. In this work, a more straightforward method is developed using data from a preload reduction manoeuvre. A simple six-chamber cardiovascular system model is used and its parameters are adjusted to pig experimental data. The parameter adjustment process has three steps: (1) compute nominal values for all model parameters; (2) determine the five most sensitive parameters; and (3) adjust only these five parameters. Stressed blood volume was selected by the algorithm, which emphasizes the importance of this parameter. The model was able to track experimental trends with a maximal root mean squared error of 29.2%. Computed stressed blood volume equals 486 ± 117 ml or 15.7 ± 3.6 ml/kg, which matches previous independent experiments on pigs, dogs and humans. The method proposed in this work thus provides a simple way to compute total stressed blood volume from usual hemodynamic data. [less ▲]

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See detailVeno-venous extracorporeal CO2 removal improves pulmonary hemodynamics in a porcine ARDS model
MORIMONT, Philippe ULg; GUIOT, Julien ULg; Desaive, Thomas ULg et al

in Acta Anaesthesiologica Scandinavica (2015)

BACKGROUND: Protective lung ventilation is recommended in patients with acute respiratory distress syndrome (ARDS) to minimize additional injuries to the lung. However, hypercapnic acidosis resulting from ... [more ▼]

BACKGROUND: Protective lung ventilation is recommended in patients with acute respiratory distress syndrome (ARDS) to minimize additional injuries to the lung. However, hypercapnic acidosis resulting from ventilation at lower tidal volume enhances pulmonary hypertension and might induce right ventricular (RV) failure. We investigated if extracorporeal veno-venous CO2 removal therapy could have beneficial effects on pulmonary circulation and RV function. METHODS: This study was performed on an experimental model of ARDS obtained in eight anaesthetized pigs connected to a volume-cycled ventilator. A micromanometer-tipped catheter was inserted into the main pulmonary artery and an admittance micromanometer-tipped catheter was inserted into the right ventricle. RV-arterial coupling was derived from RV pressure-volume loops. ARDS was obtained by repeated bronchoalveolar lavage. Protective ventilation was then achieved, and the pigs were connected to a pump-driven extracorporeal membrane oxygenator (PALP, Maquet, Germany) in order to achieve CO2 removal. RESULTS: ARDS induced severe hypercapnic acidosis. Systolic pulmonary artery pressure significantly increased from 29.6 ± 1.8 to 43.9 ± 2.0 mmHg (P < 0.001). After the PALP was started, acidosis was corrected and normocarbia was maintained despite protective ventilation. Pulmonary artery pressure significantly decreased to 31.6 ± 3.2 mmHg (P < 0.001) and RV-arterial coupling significantly improved (RV-arterial coupling index = 1.03 ± 0.33 vs. 0.55 ± 0.41, P < 0.05). CONCLUSION: Veno-venous CO2 removal therapy enabled protective ventilation while maintaining normocarbia during ARDS. CO2 removal decreased pulmonary hypertension and improved RV function. This technique may be an effective lung- and RV-protective adjunct to mechanical ventilation. [less ▲]

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See detailRelation between global end-diastolic volume and left ventricular end-diastolic volume
Pironet, Antoine ULg; MORIMONT, Philippe ULg; Kamoi, S. et al

in Critical Care (2015), 19(Suppl 1), 175

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See detailTime-varying respiratory system elastance: a physiological model for patients who are spontaneously breathing.
Chiew, Yeong Shiong; Pretty, Christopher; Docherty, Paul D. et al

in PloS one (2015), 10(1), 0114847

BACKGROUND: Respiratory mechanics models can aid in optimising patient-specific mechanical ventilation (MV), but the applications are limited to fully sedated MV patients who have little or no ... [more ▼]

BACKGROUND: Respiratory mechanics models can aid in optimising patient-specific mechanical ventilation (MV), but the applications are limited to fully sedated MV patients who have little or no spontaneously breathing efforts. This research presents a time-varying elastance (Edrs) model that can be used in spontaneously breathing patients to determine their respiratory mechanics. METHODS: A time-varying respiratory elastance model is developed with a negative elastic component (Edemand), to describe the driving pressure generated during a patient initiated breathing cycle. Data from 22 patients who are partially mechanically ventilated using Pressure Support (PS) and Neurally Adjusted Ventilatory Assist (NAVA) are used to investigate the physiology relevance of the time-varying elastance model and its clinical potential. Edrs of every breathing cycle for each patient at different ventilation modes are presented for comparison. RESULTS: At the start of every breathing cycle initiated by patient, Edrs is < 0. This negativity is attributed from the Edemand due to a positive lung volume intake at through negative pressure in the lung compartment. The mapping of Edrs trajectories was able to give unique information to patients' breathing variability under different ventilation modes. The area under the curve of Edrs (AUCEdrs) for most patients is > 25 cmH2Os/l and thus can be used as an acute respiratory distress syndrome (ARDS) severity indicator. CONCLUSION: The Edrs model captures unique dynamic respiratory mechanics for spontaneously breathing patients with respiratory failure. The model is fully general and is applicable to both fully controlled and partially assisted MV modes. [less ▲]

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See detailTracking stressed blood volume during vascular filling experiments
Pironet, Antoine ULg; Dauby, Pierre ULg; Chase, J. Geoffrey et al

in 13th Belgian Day on Biomedical Engineering (2014, November 28)

A three-chamber cardiovascular system model is used to compute stressed blood volume from filling experiments. As previously observed, stressed blood volume is a good predictor of the change in cardiac ... [more ▼]

A three-chamber cardiovascular system model is used to compute stressed blood volume from filling experiments. As previously observed, stressed blood volume is a good predictor of the change in cardiac output after fluid infusion. [less ▲]

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See detailTracking stressed blood volume during vascular filling experiments
Pironet, Antoine ULg; Dauby, Pierre ULg; Chase, J. Geoffrey et al

Poster (2014, November 28)

A three-chamber cardiovascular system model is used to compute stressed blood volume from filling experiments. As previously observed, stressed blood volume is a good predictor of the change in cardiac ... [more ▼]

A three-chamber cardiovascular system model is used to compute stressed blood volume from filling experiments. As previously observed, stressed blood volume is a good predictor of the change in cardiac output after fluid infusion. [less ▲]

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See detailEstimating Ventricular Stroke Work from Aortic Pressure Waveform
Kamoi, Shun; Pretty, Christopher; Chiew, Yeong Shiong et al

Poster (2014, November 28)

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See detailModeling of the cardio-pulmonary system assisted by ECMO
Habran, Simon ULg; Dauby, Pierre ULg; Desaive, Thomas ULg et al

in National Day on Biomedical Engineering 2014 (2014, October)

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See detailModel-Based Computation of Total Stressed Blood Volume from a Preload Reduction Experiment
Pironet, Antoine ULg; Desaive, Thomas ULg; Chase, J. Geoffrey et al

Conference (2014, August)

Total stressed blood volume is an important parameter for both doctors and engineers. From a medical point of view, it has been associated with the success or failure of fluid resuscitation therapy, which ... [more ▼]

Total stressed blood volume is an important parameter for both doctors and engineers. From a medical point of view, it has been associated with the success or failure of fluid resuscitation therapy, which is a treatment for cardiac failure. From an engineering point of view, this parameter dictates the cardiovascular system's dynamic behavior. Current methods to determine this parameter involve repeated phases of circulatory arrests followed by fluid administration. In this work, a method is developed to compute stressed blood volume from preload reduction experiments. A simple six-chamber cardiovascular system model is used and its parameters are adjusted to pig experimental data. The parameter adjustment process has three steps: (1) compute nominal values for all model parameters; (2) determine the most sensitive parameters; and (3) adjust only these sensitive parameters. Stressed blood volume was determined sensitive for all datasets, which emphasizes the importance of this parameter. The model was able to track experimental trends with a maximal mean squared error of 11.77 %. Stressed blood volume has been computed to range between 450 and 963 ml, or 15 to 28 ml/kg, which matches previous independent experiments on pigs, dogs and humans. Consequently, the method proposed in this work provides a simple way to compute total stressed blood volume from usual hemodynamic data. [less ▲]

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See detailStructural identifiability analysis of a cardiovascular system model
Pironet, Antoine ULg; Dauby, Pierre ULg; Chase, J. Geoffrey et al

Conference (2014, August)

A simple experimentally validated cardiovascular system model has been shown to be able to track the evolution of various diseases. The model has previously been made patient-specific by adjustment of its ... [more ▼]

A simple experimentally validated cardiovascular system model has been shown to be able to track the evolution of various diseases. The model has previously been made patient-specific by adjustment of its parameters on the basis of a minimal set of hemodynamic measurements. However, this model has not yet been shown to be structurally identifiable, which means that the adjusted model parameters may not be unique. The model equations were manipulated to show that, from a theoretical point of view, all of their parameters can be exactly retrieved from a restricted set of model outputs. However, this set of model outputs is still too large for a clinical application, because it includes left and right ventricular pressures. Consequently, further hypotheses that determine some model parameter values have to be made for the model to be clinically applicable. [less ▲]

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See detailStructural Identifiability Analysis of a Cardiovascular System Model
Pironet, Antoine ULg; Dauby, Pierre ULg; Chase, J. Geoffrey et al

in Preprints of the 19th World Congress (2014, August)

A simple experimentally validated cardiovascular system model has been shown to be able to track the evolution of various diseases. The model has previously been made patient-specific by adjustment of its ... [more ▼]

A simple experimentally validated cardiovascular system model has been shown to be able to track the evolution of various diseases. The model has previously been made patient-specific by adjustment of its parameters on the basis of a minimal set of hemodynamic measurements. However, this model has not yet been shown to be structurally identifiable, which means that the adjusted model parameters may not be unique. The model equations were manipulated to show that, from a theoretical point of view, all of their parameters can be exactly retrieved from a restricted set of model outputs. However, this set of model outputs is still too large for a clinical application, because it includes left and right ventricular pressures. Consequently, further hypotheses that determine some model parameter values have to be made for the model to be clinically applicable. [less ▲]

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See detailModel-Based Computation of Total Stressed Blood Volume from a Preload Reduction Experiment
Pironet, Antoine ULg; Desaive, Thomas ULg; Chase, J. Geofrrey et al

in Preprints of the 19th World Congress (2014, August)

Total stressed blood volume is an important parameter for both doctors and engineers. From a medical point of view, it has been associated with the success or failure of fluid resuscitation therapy, which ... [more ▼]

Total stressed blood volume is an important parameter for both doctors and engineers. From a medical point of view, it has been associated with the success or failure of fluid resuscitation therapy, which is a treatment for cardiac failure. From an engineering point of view, this parameter dictates the cardiovascular system’s dynamic behavior. Current methods to determine this parameter involve repeated phases of circulatory arrests followed by fluid administration. In this work, a method is developed to compute stressed blood volume from preload reduction experiments. A simple six-chamber cardiovascular system model is used and its parameters are adjusted to pig experimental data. The parameter adjustment process has three steps: (1) compute nominal values for all model parameters; (2) determine the most sensitive parameters; and (3) adjust only these sensitive parameters. Stressed blood volume was determined sensitive for all datasets, which emphasizes the importance of this parameter. The model was able to track experimental trends with a maximal mean squared error of 11.77 %. Stressed blood volume has been computed to range between 450 and 963 ml, or 15 to 28 ml/kg, which matches previous independent experiments on pigs, dogs and humans. Consequently, the method proposed in this work provides a simple way to compute total stressed blood volume from usual hemodynamic data. [less ▲]

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See detailSurvey about diffusion and adoption of glycaemic controller in European intensive care units
Penning, Sophie ULg; Pironet, Antoine ULg; Chase, J. Geoffrey et al

Conference (2014, August)

Detailed reference viewed: 8 (1 ULg)
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See detailSurvey about diffusion and adoption of glycaemic controller in European intensive care units
Penning, Sophie ULg; Pironet, Antoine ULg; Chase, J. Geoffrey et al

in Proceedings of the 19th IFAC Conference (2014, August)

Detailed reference viewed: 16 (7 ULg)
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See detailInsulin Sensitivity Variability during Hypothermia
Sah Pri, Azurahisham; Chase, J. Geoffrey; Pretty, Christopher et al

in Proceedings of the 19th IFAC Conference (2014, August)

Detailed reference viewed: 7 (1 ULg)