Corrected and Improved Model for Educational Simulation of Neonatal Cardiovascular Pathophysiology

Zijlmans, Mariken; Sá-Couto, Carla; Meurs, Willem L. van; Goodwin, Justin A.; Andriessen, Peter

doi:10.1097/sih.0b013e31818b27a8

Cited by 10 publications

(5 citation statements)

References 12 publications

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“…It also included a baroreflex model and was adapted to simulate four congenital heart defects in a one-week-old term neonate: PDA, tetralogy of Fallot, coarctation of the aorta, and transposition of the great arteries (see Figure 7). Some corrections and improvements to parameterization were published by Zijlmans et al (2009) with the resulting simulations closer to the target hemodynamic data.…”

Section: Term Neonatal Modelsmentioning

confidence: 99%

“…The Sá‐Couto et al (2010) model is an extension of the earlier educational neonatal models discussed in the following section (Goodwin et al, 2004; Zijlmans et al, 2009) (see Figure 3). The aspects of the transitional circulation in this model include the onset of breathing, cord clamping, and a number of other parameter changes to mimic the transitory phase up to the first 24 h after birth.…”

Section: Review Of Existent Modelsmentioning

confidence: 99%

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From fetus to neonate: A review of cardiovascular modeling in early life

May

Talou

Clark

et al. 2023

WIREs Mechanisms of Disease

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Computational modeling has well‐established utility in the study of cardiovascular hemodynamics, with applications in medical research and, increasingly, in clinical settings to improve the diagnosis and treatment of cardiovascular diseases. Most cardiovascular models developed to date have been of the adult circulatory system; however, the perinatal period is unique as cardiovascular physiology undergoes drastic changes from the fetal circulation, during the birth transition, and into neonatal life. There may also be further complications in this period: for example, preterm birth (defined as birth before 37 completed weeks of gestation) carries risks of short‐term cardiovascular instability and is associated with increased lifetime cardiovascular risk. Here, we review computational models of the cardiovascular system in early life, their applications to date and potential improvements and enhancements of these models. We propose a roadmap for developing an open‐source cardiovascular model that spans the fetal, perinatal, and postnatal periods. This article is categorized under: Cardiovascular Diseases > Computational Models Cardiovascular Diseases > Biomedical Engineering Congenital Diseases > Computational Models

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Section: Term Neonatal Modelsmentioning

confidence: 99%

Section: Review Of Existent Modelsmentioning

confidence: 99%

From fetus to neonate: A review of cardiovascular modeling in early life

May

Talou

Clark

et al. 2023

WIREs Mechanisms of Disease

View full text Add to dashboard Cite

show abstract

“…In 2010, Sa Couto et al ( 58 ) studied the hemodynamic effects of the transition from fetus to neonate including the effect of clamping the umbilical cord. This model builds on previously published models of the cardiovascular system of neonates ( 61 – 63 ). With a similar research question and inspired by ( 29 ), Yigit et al simulated the effect of the transition and the effect of cord clamping on the hemodynamics and oxygen saturation of a full-term ( 30 ) and preterm fetuses ( 31 ).…”

Section: Fetal Circulatory Modelsmentioning

confidence: 99%

A review study of fetal circulatory models to develop a digital twin of a fetus in a perinatal life support system

et al. 2022

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BackgroundPreterm birth is the main cause of neonatal deaths with increasing mortality and morbidity rates with decreasing GA at time of birth. Currently, premature infants are treated in neonatal intensive care units to support further development. However, the organs of, especially, extremely premature infants (born before 28 weeks of GA) are not mature enough to function optimally outside the womb. This is seen as the main cause of the high morbidity and mortality rates in this group. A liquid-filled incubator, a so-called PLS system, could potentially improve these numbers for extremely premature infants, since this system is designed to mimic the environment of the natural womb. To support the development and implementation of such a complex system and to interpret vital signals of the fetus during a PLS system operation, a digital twin is proposed. This mathematical model is connected with a manikin representing the digital and physical twin of the real-life PLS system. Before developing a digital twin of a fetus in a PLS system, its functional and technical requirements are defined and existing mathematical models are evaluated.Method and resultsThis review summarizes existing 0D and 1D fetal circulatory models that potentially could be (partly) adopted for integration in a digital twin of a fetus in a PLS system based on predefined requirements. The 0D models typically describe hemodynamics and/or oxygen transport during specific events, such as the transition from fetus to neonate. Furthermore, these models can be used to find hemodynamic differences between healthy and pathological physiological states. Rather than giving a global description of an entire cardiovascular system, some studies focus on specific organs or vessels. In order to analyze pressure and flow wave profiles in the cardiovascular system, transmission line or 1D models are used. As for now, these models do not include oxygen transport.ConclusionThis study shows that none of the models identified in literature meet all the requirements relevant for a digital twin of a fetus in a PLS system. Nevertheless, it does show the potential to develop this digital twin by integrating (parts) of models into a single model.

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“…The mathematical model consists of coupled cardiovascular, respiratory gas transport, autonomic nervous system (baro- and chemoreceptors), lung- and chest wall mechanics, pulmonary gas exchange, and myocardial oxygen balance models [14]. The cardiovascular and baroreflex models are based on Goodwin [9] and adapted and expanded to reflect the neonatal circulation [10, 12, 15]. The oxygen transport model is based on van Meurs [6] and Sá Couto [16].…”

Section: Transposition Of the Great Arteriesmentioning

confidence: 99%

Explanatory models in neonatal intensive care: a tutorial

Meurs

Antonius

2018

Adv Simul

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BackgroundAcute care providers intervening on fragile patients face many knowledge and information related challenges. Explanation based on causal chains of events has limitations when applied to complex physiological systems, and model-driven educational software may overwhelm the learner with information. We introduce a new concept and educational technology to facilitate understanding, reasoning, and communication in the clinical environment. The aim is to grasp complex physiology in a more intuitive way.Explanatory models (EM)An EM is a representation of relevant physiologic processes that provides insight into the relationships between therapeutic interventions and monitored variables, and their dependency on incidents and pathologies. We systematically analyze types of information incorporated into models and displayed in simulations and consider their explanatory relevance.Transposition of the great arteries (TGA)A conceptual model (diagram) of the normal neonatal cardiorespiratory system is adapted to reflect TGA and implemented in animated, interactive software.Illustration of educational useThe use of this model is illustrated via the explanation to pediatric residents of the relationships between blood pressures, blood flow rates, ventilation, oxygen saturation, and oxygen distribution in a neonate with TGA. Learners explore clinical scenarios and effects of therapeutic interventions.DiscussionExplanatory models hold promise as mental models for clinical practice and could possibly play a role in clinical decision making in neonatal intensive care and beyond.Companion softwareThe software is freely available via the web addendum: https://www.dropbox.com/sh/ciufq5rqxgs9bkt/AAC7oKsvkEr73eYUJkx0pZ1Ya?dl=0

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Corrected and Improved Model for Educational Simulation of Neonatal Cardiovascular Pathophysiology

Cited by 10 publications

References 12 publications

From fetus to neonate: A review of cardiovascular modeling in early life

From fetus to neonate: A review of cardiovascular modeling in early life

A review study of fetal circulatory models to develop a digital twin of a fetus in a perinatal life support system

Explanatory models in neonatal intensive care: a tutorial

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