Model-based prediction of the patient-specific response to adrenaline

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dc.contributor.authorChase, Geoff
dc.contributor.authorStarfinger, C.
dc.contributor.authorHann, C.E.
dc.contributor.authorShaw, Geoff
dc.contributor.authorDesaive, T.
dc.date.accessioned2011-06-08T21:20:01Z
dc.date.available2011-06-08T21:20:01Z
dc.date.issued2010en
dc.description.abstractA model for the cardiovascular and circulatory systems has previously been validated in simulated cardiac and circulatory disease states. It has also been shown to accurately capture the main hemodynamic trends in porcine models of pulmonary embolism and PEEP (positive end-expiratory pressure) titrations at different volemic levels. In this research, the existing model and parameter identification process are used to study the effect of different adrenaline doses in healthy and critically ill patient populations, and to develop a means of predicting the hemodynamic response to adrenaline. The hemodynamic effects on arterial blood pressures and stroke volume (cardiac index) are simulated in the model and adrenaline-specific parameters are identified. The dose dependent changes in these parameters are then related to adrenaline dose using data from studies published in the literature. These relationships are then used to predict the future, patient-specific response to a change in dose or over time periods from 1-12 hours. The results are compared to data from 3 published adrenaline dosing studies comprising a total of 37 data sets. Absolute percentage errors for the identified model are within 10% when re-simulated and compared to clinical data for all cases. All identified parameter trends match clinically expected changes. Absolute percentage errors for the predicted hemodynamic responses (N=15) are also within 10% when re-simulated and compared to clinical data. Clinically accurate prediction of the effect of inotropic circulatory support drugs, such as adrenaline, offers significant potential for this type of model-based application. Overall, this work represents a further clinical, proof of concept, of the underlying fundamental mathematical model, methods and approach, as well as providing a template for using the model in clinical titration of adrenaline in a decision support role in critical care. They are thus a further justification in support of upcoming human clinical trials to validate this model.en
dc.identifier.citationChase, J.G., Starfinger, C., Hann, C.E., Shaw, G.M., Desaive, T. (2010) Model-based prediction of the patient-specific response to adrenaline. The Open Medical Informatics Journal, 4, pp. 149-163.en
dc.identifier.doihttps://doi.org/10.2174/1874431101004010149
dc.identifier.urihttp://hdl.handle.net/10092/5221
dc.language.isoen
dc.publisherUniversity of Canterbury. Electrical and Computer Engineeringen
dc.publisherUniversity of Canterbury. Mechanical Engineeringen
dc.rights.urihttps://hdl.handle.net/10092/17651en
dc.subjectcardiovascular systemen
dc.subjectcardiac modelen
dc.subjectparameter identificationen
dc.subjectintegral methoden
dc.subjectadrenalineen
dc.subjectepinephrineen
dc.subjectmathematical modelen
dc.subjectsimulationen
dc.subject.anzsrcField of Research::11 - Medical and Health Sciencesen
dc.subject.anzsrcField of Research::11 - Medical and Health Sciences::1102 - Cardiovascular Medicine and Haematologyen
dc.subject.anzsrcField of Research::09 - Engineering::0903 - Biomedical Engineeringen
dc.titleModel-based prediction of the patient-specific response to adrenalineen
dc.typeJournal Article
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