[en] Estimation of ventricular contractility and ventricular arterial coupling is clinically important in diagnosing and treating cardiac dysfunction in the critically ill. However, experimental assessment of indexes of ventricular contractility, such as the end-systolic pressure-volume relationship, requires a highly invasive maneuver and measurements that are not typical in an intensive care unit (ICU). This research describes the use of a previously validated cardiovascular system model and parameter identification process to evaluate the right ventricular arterial coupling in septic shock. Model-based ventricular arterial coupling is defined by the ratio of the end systolic right ventricular elastance (E(esrvf)) over the pulmonary artery elastance (E(pa)) or the mean pulmonary inflow resistance (R(pulin)). Results are compared to the clinical gold-standard assessment (conductance catheter method). Six anesthetized healthy pigs weighing 20-30kg received a 0.5mgkg(-1) endotoxin infusion over a period of 30min from T0 to T30, to induce septic shock and veno-venous hemofiltration was used from T60 onward. The results show good agreement with the gold-standard experimental assessment. In particular, the model-based right ventricular elastance (E(esrvf)) correlates well with the clinical gold standard (R(2)=0.69) and the model-based non-invasive coupling (E(esrvf)/R(pulin)) follow the same trends and dynamics (R(2)=0.37). The overall results show the potential to develop a model-based sensor to monitor ventricular-arterial coupling in clinical real-time.
Disciplines :
Engineering, computing & technology: Multidisciplinary, general & others
Author, co-author :
Desaive, Thomas ; Université de Liège - ULiège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
LAMBERMONT, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Frais communs médecine
JANSSEN, Nathalie ; Centre Hospitalier Universitaire de Liège - CHU > Urgences
GHUYSEN, Alexandre ; Centre Hospitalier Universitaire de Liège - CHU > Urgences
Kolh, Philippe ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Biochimie et physiologie générales, humaines et path.
MORIMONT, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Frais communs médecine
Dauby, Pierre ; Université de Liège - ULiège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
Starfinger, C
Shaw, GM
Chase, JG
Language :
English
Title :
Assessment of ventricular contractility and ventricular-arterial coupling with a model-based sensor.
Publication date :
February 2013
Journal title :
Computer Methods and Programs in Biomedicine
ISSN :
0169-2607
eISSN :
1872-7565
Publisher :
Elsevier Scientific, Limerick, Ireland
Volume :
109
Issue :
2
Pages :
182-189
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2011 Elsevier Ireland Ltd. All rights reserved.
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