Why the study?
Does a combination of baseline physiological variables predict circulatory collapse following hemorrhage in a computational model?
Does a combination of baseline physiological variables predict circulatory collapse following hemorrhage in a computational model?
Answers are grounded in this paper and cite their sources.
A computational model of cardiovascular physiology demonstrated that a combination of variables, including systemic compliance and total peripheral resistance, can predict circulatory collapse following hemorrhage with >90% accuracy.
We present a small integrative model of human cardiovascular physiology. The model is population-based; rather than using best fit parameter values, we used a variant of the Metropolis algorithm to produce distributions for the parameters most associated with model sensitivity. The population is built by sampling from these distributions to create the model coefficients. The resulting models were then subjected to a hemorrhage. The population was separated into those that lost less than 15 mmHg arterial pressure (compensators), and those that lost more (decompensators). The populations were parametrically analyzed to determine baseline conditions correlating with compensation and decompensation. Analysis included single variable correlation, graphical time series analysis, and support vector machine (SVM) classification. Most variables were seen to correlate with propensity for circulatory collapse, but not sufficiently to effect reasonable classification by any single variable. Time series analysis indicated a single significant measure, the stressed blood volume, as predicting collapse in situ, but measurement of this quantity is clinically impossible. SVM uncovered a collection of variables and parameters that, when taken together, provided useful rubrics for classification. Due to the probabilistic origins of the method, multiple classifications were attempted, resulting in an average of 3.5 variables necessary to construct classification. The most common variables used were systemic compliance, baseline baroreceptor signal strength and total peripheral resistance, providing predictive ability exceeding 90%. The methods presented are suitable for use in any deterministic mathematical model.
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Pruett et al. (2013) studied Simulated hemorrhage (n=300). Simulated hemorrhage was evaluated on Circulatory decompensation (MAP drop > 15 mmHg).
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