we developed a comprehensive cerebral blood flow and intracranial pressure model to simulate and study the complex alterations in cerebrovascular dynamics caused by multiple simultaneous alterations, including normal and abnormal functional states of the auto-regulation of the brain. Equations (derived from animal and human studies) were programmed into a simulation program (Berkeley Madonna, version 8.0.1, 1997-2000 Robert I. Macey & George F. Oster). Included in the normal physiological modelling: one single path leading to an independently regulated area following changes in cerebral blood flow, blood pressure, and carbon dioxide (CO2) partial pressure. We also added external and pathological perturbations, such as intracranial haemorrhage and head up position. The model was stable when tested for extremes of input parameters. The main manoeuvres simulated include changes of basic physiological inputs (e.g. blood pressure, central venous pressure, CO2 tension, head up position, and respiratory effects on vascular pressures) as well as acute intracranial bleeding, and obstruction. The model performed clinically realistically given inputs of published traumatized patients, and cases encountered by clinicians. The pulsatile nature of the output graphics was easy for clinicians to interpret. Based on the results, we believe the model would be useful to teach complex relationships of brain physiology and study clinical questions such as the optimal head-up position, the effects of intracranial haemorrhage on cerebral haemodynamics as well as the best CO2 concentration to reach the optimal compromise between ICP and perfusion. With the ability to vary the model’s complexity, we believe it would be useful for both beginners and advanced learners. The model could also be used by practicing clinicians to model individual patients (entering the effects of needed clinical manipulations, and then running the model to test for optimal combinations of therapeutic manoeuvres).
W.B. Murray, M. Giannessi, M. Ursino (2007). Design of a Digital Cerebro-vascular Simulation Model for Teaching and Research. s.l : s.n.
Design of a Digital Cerebro-vascular Simulation Model for Teaching and Research
GIANNESSI, MASSIMO;URSINO, MAURO
2007
Abstract
we developed a comprehensive cerebral blood flow and intracranial pressure model to simulate and study the complex alterations in cerebrovascular dynamics caused by multiple simultaneous alterations, including normal and abnormal functional states of the auto-regulation of the brain. Equations (derived from animal and human studies) were programmed into a simulation program (Berkeley Madonna, version 8.0.1, 1997-2000 Robert I. Macey & George F. Oster). Included in the normal physiological modelling: one single path leading to an independently regulated area following changes in cerebral blood flow, blood pressure, and carbon dioxide (CO2) partial pressure. We also added external and pathological perturbations, such as intracranial haemorrhage and head up position. The model was stable when tested for extremes of input parameters. The main manoeuvres simulated include changes of basic physiological inputs (e.g. blood pressure, central venous pressure, CO2 tension, head up position, and respiratory effects on vascular pressures) as well as acute intracranial bleeding, and obstruction. The model performed clinically realistically given inputs of published traumatized patients, and cases encountered by clinicians. The pulsatile nature of the output graphics was easy for clinicians to interpret. Based on the results, we believe the model would be useful to teach complex relationships of brain physiology and study clinical questions such as the optimal head-up position, the effects of intracranial haemorrhage on cerebral haemodynamics as well as the best CO2 concentration to reach the optimal compromise between ICP and perfusion. With the ability to vary the model’s complexity, we believe it would be useful for both beginners and advanced learners. The model could also be used by practicing clinicians to model individual patients (entering the effects of needed clinical manipulations, and then running the model to test for optimal combinations of therapeutic manoeuvres).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
