Validation of a computational platform for the analysis of the physiologic mechanisms of a human experimental model of hemorrhage.

Computational models of integrative physiology may serve as a framework for understanding the complex adaptive responses essential for homeostasis in critical illness and resuscitation and may provide insights for design of diagnostics and therapeutics. In this study a computer model of human physio...

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Published in:Resuscitation Vol. 80; no. 12; pp. 1405 - 1411
Main Authors: Summers RL, Ward KR, Witten T, Convertino VA, Ryan KL, Coleman TG, Hester RL, Summers, Richard L, Ward, Kevin R, Witten, Tarynn, Convertino, Victor A, Ryan, Kathy L, Coleman, Thomas G, Hester, Robert L
Format: research Journal Article
Published: Elsevier B.V. Dec2009
Online Access:View this record in EBSCOhost
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      dt: Dec2009
      vid: 80
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      pub: Elsevier B.V.
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        10.1016/j.resuscitation.2009.09.001
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        atl: Validation of a computational platform for the analysis of the physiologic mechanisms of a human experimental model of hemorrhage.
      aug:
        au:
          Summers RL
          Ward KR
          Witten T
          Convertino VA
          Ryan KL
          Coleman TG
          Hester RL
          Summers, Richard L
          Ward, Kevin R
          Witten, Tarynn
          Convertino, Victor A
          Ryan, Kathy L
          Coleman, Thomas G
          Hester, Robert L
        affil: University of Mississippi Medical Center, Jackson, MS 39216, United States
      sug:
        subj:
          Computer Simulation
          Hemorrhage Physiopathology
          Models, Biological
          Blood Pressure Physiology
          Cardiac Output Physiology
          Decompression Sickness Prevention and Control
          Female
          Homeostasis Physiology
          Human
          Male
          Young Adult
          Female
          Male
      ab: Computational models of integrative physiology may serve as a framework for understanding the complex adaptive responses essential for homeostasis in critical illness and resuscitation and may provide insights for design of diagnostics and therapeutics. In this study a computer model of human physiology was compared to results obtained from experiments using Lower Body Negative Pressure (LBNP) analog model of human hemorrhage. LBNP has been demonstrated to produce physiologic changes in humans consistent with hemorrhage. The computer model contains over 4000 parameters that describe the detailed integration of physiology based upon basic physical principles and established biologic interactions. The LBNP protocol consisted of a 5min rest period (0mmHg) followed by 5min of chamber decompression of the lower body to -15, -30, -45, and -60mmHg and additional increments of -10mmHg every 5min until the onset of hemodynamic decompensation (n=20). Physiologic parameters recorded include mean arterial pressure (MAP), cardiac output (CO), and venous oxygen saturation (SVO(2); from peripheral venous blood), during the last 30s at each LBNP level. The computer model analytic procedure recreates the investigational protocol for a virtual individual in an In Silico environment. After baseline normalization, the model predicted measurements for MAP, CO, and SVO(2) were compared to those observed through the entire range of LBNP. Differences were evaluated using standard statistical performance error measurements (median performance error (PE) <5%). The simulation results closely tracked the average changes observed during LBNP. The predicted MAP fell outside the standard error measurement for the experimental data at only LBNP -30mmHg while CO was more variable. The predicted SVO(2) fell outside the standard error measurement for the experimental data only during the post-LBNP recovery point. However, the statistical median PE measurement was found to be within the 5% objective error measure (1.3% for MAP, -3.5% for CO, and 3.95% for SVO(2)). The computer model was found to accurately predict the experimental results observed using LBNP. The model should be explored as a platform for studying concepts and physiologic mechanisms of hemorrhage including its diagnosis and treatment.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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