A model-based study for new insights in determining the optimal weaning protocol of intensive care patients on cardiopulmonary mechanical support

  • M.E.J. de Munnik

Scriptie/Masterproef: Master

Samenvatting

At the intensive care unit of a hospital, critically ill patients are monitored 24 hours a day and treated by specialised doctors and nurses. Some of these  patients are in need of cardiopulmonary mechanical support. This support is provided by extracorporeal membrane oxygenation (ECMO). The process of disconnecting the patient from ECMO is called weaning. The aim of this study is to develop a physicsbased model to gain insight in the clinically measurable hemodynamic parameters that are relevant in the process of weaning. The timing of weaning is crucial and largely patient-specific. Currently, the optimal weaning protocol for individual patients is unknown. Multiple interacting factors need to be taken into account and it is difficult to conduct an evidence-based study, since there are relatively few patients and the patients are heterogeneous. Therefore, a computerbased approach is used. A lumped parameter model for a patient on ECMO was developed that includes the left ventricle, the right ventricle, the systemic circulation, the pulmonary circulation, the coronary circulation, the baroreflex mechanism, and an oxygen model. Also,
a sensitivity analysis was performed, which shows the relevance of the ECMO related parameters, left ventricular contractility, and the total systemic peripheral resistance. Furthermore, two different perturbation simulations are performed, because perturbations might be useful to assess heart function (represented by left ventricular contractility).
confidential
Datum prijs19 mrt. 2019
Originele taalEngels
Prijsuitreikende instantie
  • Technische Universiteit Eindhoven
BegeleiderFrans N. van de Vosse (Afstudeerdocent 1), Wouter Huberts (Afstudeerdocent 2), Martine E. Bol (Externe coach) & Jan Willem Sels (Externe coach)

Citeer dit

'