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Monitoring of cardiovascular physiology augmented by a patient-specific biomechanical model during general anesthesia. A proof of concept study

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Monitoring of cardiovascular physiology augmented by a patient-specific biomechanical model during general anesthesia. A proof of concept study. / Le Gall, Arthur; Vallee, Fabrice; Pushparajah, Kuberan; Hussain, Tarique; Mebazaa, Alexandre; Chapelle, Dominique; Gayat, Etienne; Chabiniok, Radomir.

In: PloS one, Vol. 15, No. 5, e0232830, 14.05.2020.

Research output: Contribution to journalArticle

Harvard

Le Gall, A, Vallee, F, Pushparajah, K, Hussain, T, Mebazaa, A, Chapelle, D, Gayat, E & Chabiniok, R 2020, 'Monitoring of cardiovascular physiology augmented by a patient-specific biomechanical model during general anesthesia. A proof of concept study', PloS one, vol. 15, no. 5, e0232830. https://doi.org/10.1371/journal.pone.0232830

APA

Le Gall, A., Vallee, F., Pushparajah, K., Hussain, T., Mebazaa, A., Chapelle, D., ... Chabiniok, R. (2020). Monitoring of cardiovascular physiology augmented by a patient-specific biomechanical model during general anesthesia. A proof of concept study. PloS one, 15(5), [e0232830]. https://doi.org/10.1371/journal.pone.0232830

Vancouver

Le Gall A, Vallee F, Pushparajah K, Hussain T, Mebazaa A, Chapelle D et al. Monitoring of cardiovascular physiology augmented by a patient-specific biomechanical model during general anesthesia. A proof of concept study. PloS one. 2020 May 14;15(5). e0232830. https://doi.org/10.1371/journal.pone.0232830

Author

Le Gall, Arthur ; Vallee, Fabrice ; Pushparajah, Kuberan ; Hussain, Tarique ; Mebazaa, Alexandre ; Chapelle, Dominique ; Gayat, Etienne ; Chabiniok, Radomir. / Monitoring of cardiovascular physiology augmented by a patient-specific biomechanical model during general anesthesia. A proof of concept study. In: PloS one. 2020 ; Vol. 15, No. 5.

Bibtex Download

@article{3a49a483c85c4c97b9cc4a1540ea75b0,
title = "Monitoring of cardiovascular physiology augmented by a patient-specific biomechanical model during general anesthesia. A proof of concept study",
abstract = "During general anesthesia (GA), direct analysis of arterial pressure or aortic flow waveforms may be inconclusive in complex situations. Patient-specific biomechanical models, based on data obtained during GA and capable to perform fast simulations of cardiac cycles, have the potential to augment hemodynamic monitoring. Such models allow to simulate Pressure-Volume (PV) loops and estimate functional indicators of cardiovascular (CV) system, e.g. ventricular-arterial coupling (V va), cardiac efficiency (CE) or myocardial contractility, evolving throughout GA. In this prospective observational study, we created patient-specific biomechanical models of heart and vasculature of a reduced geometric complexity for n = 45 patients undergoing GA, while using transthoracic echocardiography and aortic pressure and flow signals acquired in the beginning of GA (baseline condition). If intraoperative hypotension (IOH) appeared, diluted norepinephrine (NOR) was administered and the model readjusted according to the measured aortic pressure and flow signals. Such patients were a posteriori assigned into a so-called hypotensive group. The accuracy of simulated mean aortic pressure (MAP) and stroke volume (SV) at baseline were in accordance with the guidelines for the validation of new devices or reference measurement methods in all patients. After NOR administration in the hypotensive group, the percentage of concordance with 10{\%} exclusion zone between measurement and simulation was >95{\%} for both MAP and SV. The modeling results showed a decreased V va (0.64±0.37 vs 0.88±0.43; p = 0.039) and an increased CE (0.8±0.1 vs 0.73±0.11; p = 0.042) in hypotensive vs normotensive patients. Furthermore, V va increased by 92±101{\%}, CE decreased by 13±11{\%} (p < 0.001 for both) and contractility increased by 14±11{\%} (p = 0.002) in the hypotensive group post-NOR administration. In this work we demonstrated the application of fast-running patient-specific biophysical models to estimate PV loops and functional indicators of CV system using clinical data available during GA. The work paves the way for model-augmented hemodynamic monitoring at operating theatres or intensive care units to enhance the information on patient-specific physiology.",
author = "{Le Gall}, Arthur and Fabrice Vallee and Kuberan Pushparajah and Tarique Hussain and Alexandre Mebazaa and Dominique Chapelle and Etienne Gayat and Radomir Chabiniok",
year = "2020",
month = "5",
day = "14",
doi = "10.1371/journal.pone.0232830",
language = "English",
volume = "15",
journal = "PloS one",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "5",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Monitoring of cardiovascular physiology augmented by a patient-specific biomechanical model during general anesthesia. A proof of concept study

AU - Le Gall, Arthur

AU - Vallee, Fabrice

AU - Pushparajah, Kuberan

AU - Hussain, Tarique

AU - Mebazaa, Alexandre

AU - Chapelle, Dominique

AU - Gayat, Etienne

AU - Chabiniok, Radomir

PY - 2020/5/14

Y1 - 2020/5/14

N2 - During general anesthesia (GA), direct analysis of arterial pressure or aortic flow waveforms may be inconclusive in complex situations. Patient-specific biomechanical models, based on data obtained during GA and capable to perform fast simulations of cardiac cycles, have the potential to augment hemodynamic monitoring. Such models allow to simulate Pressure-Volume (PV) loops and estimate functional indicators of cardiovascular (CV) system, e.g. ventricular-arterial coupling (V va), cardiac efficiency (CE) or myocardial contractility, evolving throughout GA. In this prospective observational study, we created patient-specific biomechanical models of heart and vasculature of a reduced geometric complexity for n = 45 patients undergoing GA, while using transthoracic echocardiography and aortic pressure and flow signals acquired in the beginning of GA (baseline condition). If intraoperative hypotension (IOH) appeared, diluted norepinephrine (NOR) was administered and the model readjusted according to the measured aortic pressure and flow signals. Such patients were a posteriori assigned into a so-called hypotensive group. The accuracy of simulated mean aortic pressure (MAP) and stroke volume (SV) at baseline were in accordance with the guidelines for the validation of new devices or reference measurement methods in all patients. After NOR administration in the hypotensive group, the percentage of concordance with 10% exclusion zone between measurement and simulation was >95% for both MAP and SV. The modeling results showed a decreased V va (0.64±0.37 vs 0.88±0.43; p = 0.039) and an increased CE (0.8±0.1 vs 0.73±0.11; p = 0.042) in hypotensive vs normotensive patients. Furthermore, V va increased by 92±101%, CE decreased by 13±11% (p < 0.001 for both) and contractility increased by 14±11% (p = 0.002) in the hypotensive group post-NOR administration. In this work we demonstrated the application of fast-running patient-specific biophysical models to estimate PV loops and functional indicators of CV system using clinical data available during GA. The work paves the way for model-augmented hemodynamic monitoring at operating theatres or intensive care units to enhance the information on patient-specific physiology.

AB - During general anesthesia (GA), direct analysis of arterial pressure or aortic flow waveforms may be inconclusive in complex situations. Patient-specific biomechanical models, based on data obtained during GA and capable to perform fast simulations of cardiac cycles, have the potential to augment hemodynamic monitoring. Such models allow to simulate Pressure-Volume (PV) loops and estimate functional indicators of cardiovascular (CV) system, e.g. ventricular-arterial coupling (V va), cardiac efficiency (CE) or myocardial contractility, evolving throughout GA. In this prospective observational study, we created patient-specific biomechanical models of heart and vasculature of a reduced geometric complexity for n = 45 patients undergoing GA, while using transthoracic echocardiography and aortic pressure and flow signals acquired in the beginning of GA (baseline condition). If intraoperative hypotension (IOH) appeared, diluted norepinephrine (NOR) was administered and the model readjusted according to the measured aortic pressure and flow signals. Such patients were a posteriori assigned into a so-called hypotensive group. The accuracy of simulated mean aortic pressure (MAP) and stroke volume (SV) at baseline were in accordance with the guidelines for the validation of new devices or reference measurement methods in all patients. After NOR administration in the hypotensive group, the percentage of concordance with 10% exclusion zone between measurement and simulation was >95% for both MAP and SV. The modeling results showed a decreased V va (0.64±0.37 vs 0.88±0.43; p = 0.039) and an increased CE (0.8±0.1 vs 0.73±0.11; p = 0.042) in hypotensive vs normotensive patients. Furthermore, V va increased by 92±101%, CE decreased by 13±11% (p < 0.001 for both) and contractility increased by 14±11% (p = 0.002) in the hypotensive group post-NOR administration. In this work we demonstrated the application of fast-running patient-specific biophysical models to estimate PV loops and functional indicators of CV system using clinical data available during GA. The work paves the way for model-augmented hemodynamic monitoring at operating theatres or intensive care units to enhance the information on patient-specific physiology.

UR - http://www.scopus.com/inward/record.url?scp=85084857084&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0232830

DO - 10.1371/journal.pone.0232830

M3 - Article

VL - 15

JO - PloS one

JF - PloS one

SN - 1932-6203

IS - 5

M1 - e0232830

ER -

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