Mechanical ventilation and thoracic artificial lung assistance during mechanical circulatory support with PUCA pump: In silico study

Lazzari, Claudio De; Genuini, Igino; Quatember, Bernhard; Fedele, Francesco

doi:10.1016/j.cmpb.2013.11.011

Cited by 10 publications

(11 citation statements)

References 51 publications

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“…In the following, we will deal with simulation studies which we carried out by using our simulator CARDIOSIM © . We designed a special module for TAL [6], [7] and configured CARDIOSIM © for our investigations in a straightforward manner by appropriately interconnecting the already existing individual software modules and the newly-developed module for the TAL. The TAL can be arranged either in parallel or "in series" with the natural lung.…”

Section: Mechanical Ventilation (Mv)mentioning

confidence: 99%

“…This module describes all the small intra-pulmonary arteries proximal to the arterioles by one resistance-inertance-compliance (RLC) lumped element (Windkessel-like modeling approach [7], [12]). …”

Section: A Numerical Simulatormentioning

confidence: 99%

“…This section was modeled by only a single resistance, since the arterioles are relatively stiff, and, moreover, the inertial forces are negligible [7], [12].…”

Section: A Numerical Simulatormentioning

confidence: 99%

“…Module "Thoracic Artificial Lung" This module is based on a lumped parameter modeling approach by using resistance -inertance -compliance (RLC) elements [6], [7]. Of particular importance are the resistances (variables) R TALan , R TALala and R TALpab .…”

Section: A Numerical Simulatormentioning

confidence: 99%

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Lung assist devices influence cardio-energetic parameters: Numerical simulation study

Lazzari¹,

Quatember

Recheis

et al. 2015

2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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Abstract-We aim at an analysis of the effects mechanical ventilators (MVs) and thoracic artificial lungs (TALs) will have on the cardiovascular system, especially on important quantities, such as left and right ventricular external work (EW), pressure-volume area (PVA) and cardiac mechanical efficiency (CME). Our analyses are based on simulation studies which were carried out by using our CARDIOSIM © software simulator. At first, we carried out simulation studies of patients undergoing mechanical ventilation (MV) without a thoracic artificial lung (TAL). Subsequently, we conducted simulation studies of patients who had been provided with a TAL, but did not undergo MV. We aimed at describing the patient's physiological characteristics and their variations with time, such as EW, PVA, CME, cardiac output (CO) and mean pulmonary arterial/venous pressure (PAP/PVP). We were starting with a simulation run under well-defined initial conditions which was followed by simulation runs for a wide range of mean intrathoracic pressure settings. Our simulations of MV without TAL showed that for mean intrathoracic pressure settings from negative (-4 mmHg) to positive (+5 mmHg) values, the left and right ventricular EW and PVA, right ventricular CME and CO decreased, whereas left ventricular CME and the PAP increased. The simulation studies of patients with a TAL, comprised all the usual TAL arrangements, viz. configurations "in series" and in parallel with the natural lung and, moreover, hybrid configurations. The main objective of the simulation studies was, as before, the assessment of the hemodynamic response to the application of a TAL. We could for instance show that, in case of an "in series" configuration, a reduction (an increase) in left (right) ventricular EW and PVA values occurred, whereas the best performance in terms of CO can be achieved in the case of an in parallel configuration. I. INTRODUCTIONMechanical ventilators (MVs) and thoracic artificial lungs (TALs) are being applied to assist patients affected by respiratory failure. In the following, we will investigate specific aspects of their use in clinical practice. Mechanical Ventilation (MV).Generally, the treatment with a ventilator is mandatory whenever a patient's respiratory system becomes unable to keep the concentrations of O 2 and CO 2 in blood at tolerable levels. There exists a whole range of clinical applications of MV. Severe impairments of the lungs may occur in serious cases of chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), and in pneumonia. A ventilator may also be necessary for patients who need ventricular assist device (VAD) assistance [1]. MV of the respiratory system gives rise to specific interactions with other organs. These interactions may cause complications and other adverse effects. In particular, MV has a significant effect on the cardiovascular system [2]. We will focus here on these interactions and quantitatively describe the effects of MV on the cardiovascular system by carrying out simu...

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Section: Mechanical Ventilation (Mv)mentioning

confidence: 99%

Section: A Numerical Simulatormentioning

confidence: 99%

“…This section was modeled by only a single resistance, since the arterioles are relatively stiff, and, moreover, the inertial forces are negligible [7], [12].…”

Section: A Numerical Simulatormentioning

confidence: 99%

Section: A Numerical Simulatormentioning

confidence: 99%

See 2 more Smart Citations

Lung assist devices influence cardio-energetic parameters: Numerical simulation study

Lazzari¹,

Quatember

Recheis

et al. 2015

2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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show abstract

“…In order to achieve this purpose, we carried out computer simulation studies with our numerical cardiovascular simulator CARDIOSIM © [4] [5]. Recently, we designed a special module for TAL [6] [7] as an extension of CARDIOSIM © and configured the software for our investigations in a straightforward manner by appropriately interconnecting the already existing individual software modules and the newlydeveloped module for the TAL. The TAL can be arranged either in series or in parallel mode, whereby both modes are involving the native lung.…”

Section: Introductionmentioning

confidence: 99%

Cardiac Energetics in Presence of Lung Assist Devices: <i>In Silico</i> Study

Lazzari¹,

Quatember²

2016

MNSMS

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The treatment with a mechanical ventilator is required whenever a patient's respiratory system becomes unable to keep the concentrations of O 2 and CO 2 in blood at tolerable levels. However, in particular cases, the thoracic artificial lung (TAL) can be regarded as a viable alternative to mechanical ventilation (MV). We aim at studying the effects of mechanical ventilators and thoracic artificial lungs devices will have on the cardiovascular system. We will give careful consideration to cardiovascular energetic parameters, such as left and right ventricular external work, pressure-volume area, and cardiac mechanical efficiency. We simulated both, mechanically ventilated patients who are not subject to the application of an artificial lung and patients who are provided with a thoracic artificial lung (TAL). In the case of a thoracic artificial lung, we involved in our simulation studies all the usual operating modes of a TAL, viz. series mode, parallel mode, and hybrid mode of the TAL with regard to the native lung. In particular, the presented simulation results will contribute to elucidate the specific characteristics of each of the aforementioned operating modes. Generally, the energetic variables are influenced by different values of input TAL resistance in both modes: parallel and in series. In this paper, we concentrated on simulation studies of the effects evoked by TAL assistance on cardiac energetic and some other important circulatory parameters. The simulation results presented show that at all modes of TAL assistance exists a strong dependency on the TAL input variables and on the value of the mean intrathoracic pressure which has been assumed for a given situation.

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ECMO Assistance during Mechanical Ventilation: Effects Induced on Energetic and Haemodynamic Variables

Lazzari

Iacovoni

Mottaghy

et al. 2021

Computer Methods and Programs in Biomedicine

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Mechanical ventilation and thoracic artificial lung assistance during mechanical circulatory support with PUCA pump: In silico study

Cited by 10 publications

References 51 publications

Lung assist devices influence cardio-energetic parameters: Numerical simulation study

Lung assist devices influence cardio-energetic parameters: Numerical simulation study

Cardiac Energetics in Presence of Lung Assist Devices: <i>In Silico</i> Study

ECMO Assistance during Mechanical Ventilation: Effects Induced on Energetic and Haemodynamic Variables

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Mechanical ventilation and thoracic artificial lung assistance during mechanical circulatory support with PUCA pump: In silico study

Cited by 10 publications

References 51 publications

Lung assist devices influence cardio-energetic parameters: Numerical simulation study

Lung assist devices influence cardio-energetic parameters: Numerical simulation study

Cardiac Energetics in Presence of Lung Assist Devices: &lt;i&gt;In Silico&lt;/i&gt; Study

ECMO Assistance during Mechanical Ventilation: Effects Induced on Energetic and Haemodynamic Variables

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Cardiac Energetics in Presence of Lung Assist Devices: <i>In Silico</i> Study