Modeling systolic pressure variation due to positive pressure ventilation.
Although many clinical techniques have been proposed to assess blood volume none have been established as an undisputed standard practice, Volume studies suggest systolic pressure variation (SPV) as a promising volume indicator but underlying influences on SPV are not well understood. Successful modeling of SPV will reveal the major SPV influencers, guide algorithm development to accommodate these influencers, and potentially lead to a more clinically relevant interpretation of SPV values, thus improving upon current clinical methods for assessing blood volume. This study takes a first step towards identifying SPV influencers by investigating three variations of an existing pressure-flow cardiovascular model. Each successive version introduces an additional modification in attempt to model SPV under normovolemic and hypovolemic conditions, where the last model accounts for positive pressure ventilation, venous compression, and a rightward septum shift. Under normovolemic conditions, each model yields SPV values of 5.8, 6.4, and 6.7 mmHg, respectively. Under hypovolemic conditions the results do not agree with clinical findings, suggesting these three mechanisms alone do not dictate the clinical SPV response to a decrease in volume. Model results are used to suggest improvements for future work.
Messerges
Joanne
J
GE Healthcare Inf. Technol., Milwaukee, WI 53201, USA. joanne.messerges@med.ge.com
D003198:Computer Simulation; D006801:Humans; D020896:Hypovolemia / Q000503:physiopathology*; D008955:Models, Cardiovascular; D011175:Positive-Pressure Respiration / Q000379:methods*; D011652:Pulmonary Circulation / Q000502:physiology*; D015203:Reproducibility of Results; D015656:Respiratory Mechanics / Q000502:physiology*; D012680:Sensitivity and Specificity; D013599:Systole / Q000502:physiology*