MTRSurg@MITIE - December 12, 2011 Abstract
Mathematical modeling for monitoring of short term control of circulation: physiological and clinical applications.
F. Aletti, G. Baselli, M. Ferrario
Dipartimento di Bioingegneria, Politecnico di Milano
Monitoring of hemodynamic function requires the use of mathematical modeling techniques to interpret the information conveyed by cardiovascular measurements which are routinely available in operating room or intensive care units. For instance, an intriguing problem for engineers is represented by the development of efficient models for the continuous estimation of cardiac output and its variations. Such tools can prove of great usefulness in assisting anesthesiologists or intensivists during crucial maneuvers such as fluid challenges in prevention, or in response to, hypotensive episodes.
Our research focuses on the aspects inherent in the short term regulation of arterial blood pressure, which can shed light on the patho-physiology of control systems of circulation under anesthesia and during major surgery. By means of a variety of methodological approaches to the assessment of cardiovascular variability (heart rate and blood pressure variability analyzed in the frequency domain by spectral analysis, system identification of input-output relationship between cardiovascular variables, spectral decomposition techniques, Windkessel modeling of the arterial tree,…) we have developed physical models for the description of total peripheral resistance variability and black box prediction models for the identification of the responsiveness of cardiac, arterial and cardiopulmonary baroreflex following major anesthesiological maneuvers.
In this talk, results from the physiological and clinical applications of such signal processing and modeling based techniques will be presented, with a specific focus on: 1) the significance of estimating total peripheral resistance variations to interpret the sources of arterial blood pressure regulation; 2) the respective contribution of arterial and cardiopulmonary baroreflex regulation of vascular resistance in mediating neural responses to fluid infusion; 3) the critical interpretation of the impact of mechanical ventilation on cardiac output following rapid infusions during liver transplantation.
Federico Aletti obtained his master degree and Ph.D. in Bioengineering from Politecnico di Milano in 2005 and 2009 respectively. He is currently a post-doctoral fellow with the Biomedical Signal and Image Processing Laboratory in the Dipartimento di Bioingegneria at Politecnico di Milano. He has been a visiting scholar with the Physiologic Signal Processing and Modeling Laboratory in the Electrical and Computer Engineering Department at Michigan State University since 2007. His research interests include: cardiovascular physiology and disease; system identification of cardiovascular control; cardiovascular signal processing and modeling; cardiovascular space physiology; autoregulation of blood flow; hemodynamic monitoring; microcirculation dynamics; multiscale modeling of sepsis.