Comput Math Methods Med - Evaluation of a model-based hemodynamic monitoring method in a porcine study of septic shock.

Tópicos

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Resumo

TRODUCTION: The accuracy and clinical applicability of an improved model-based system for tracking hemodynamic changes is assessed in an animal study on septic shock.METHODS: This study used cardiovascular measurements recorded during a porcine trial studying the efficacy of large-pore hemofiltration for treating septic shock. Four Pietrain pigs were instrumented and induced with septic shock. A subset of the measured data, representing clinically available measurements, was used to identify subject-specific cardiovascular models. These models were then validated against the remaining measurements.RESULTS: The system accurately matched independent measures of left and right ventricle end diastolic volumes and maximum left and right ventricular pressures to percentage errors less than 20% (except for the 95th percentile error in maximum right ventricular pressure) and all R(2) > 0.76. An average decrease of 42% in systemic resistance, a main cardiovascular consequence of septic shock, was observed 120 minutes after the infusion of the endotoxin, consistent with experimentally measured trends. Moreover, modelled temporal trends in right ventricular end systolic elastance and afterload tracked changes in corresponding experimentally derived metrics.CONCLUSIONS: These results demonstrate that this model-based method can monitor disease-dependent changes in preload, afterload, and contractility in porcine study of septic shock.

Resumo Limpo

troduct accuraci clinic applic improv modelbas system track hemodynam chang assess anim studi septic shockmethod studi use cardiovascular measur record porcin trial studi efficaci largepor hemofiltr treat septic shock four pietrain pig instrument induc septic shock subset measur data repres clinic avail measur use identifi subjectspecif cardiovascular model model valid remain measurementsresult system accur match independ measur left right ventricl end diastol volum maximum left right ventricular pressur percentag error less except th percentil error maximum right ventricular pressur r averag decreas system resist main cardiovascular consequ septic shock observ minut infus endotoxin consist experiment measur trend moreov model tempor trend right ventricular end systol elast afterload track chang correspond experiment deriv metricsconclus result demonstr modelbas method can monitor diseasedepend chang preload afterload contractil porcin studi septic shock

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