Description
The full version includes all the currenty functionality of the software and updates during at least one year. Neonatal, pediatric and adult physiology can be simulated. Patient scenarios can be saved whenever you like and re-opened at your request. Systolic and diastolic cardiac function can be fine-tuned. The vascular tree properties interact with cardiac function as in real life. Combined and isolated valve pathology can be analyzed. Congenital cardiac malformations like atrial septal defects, ventricular septal defects, transposition of the great arteries. single-ventricle physiology and persistent ductus arteriosus can be explored with a detailed control of any parameters in the underlying simulation model. Treatment options like intra-aortic balloon pump, pulsatile and non-pulsatile left/right ventricular assist devices, veno-venous and veno-arterial extra-corporeal membrane oxygenation with a selection of cannulation options, manual resuscitation and positive pressure ventilation is available. Cardiac and vascular analysis modules give detailed information about cardiac energetics, systolic and diastolic function as well as vascular wave transmission, vascular wall stress and shear stress. The model can be scaled to the size of your patients with automatic algorhitms creating realistic physiology all the way from extreme prematures to ageing adults. The cardiac chambers, vasculature and pericardium can be set to remodel according to biomechanical rules determining dilatation and hypertrophy in agreement with clinical data.
Overview
The block diagram above shows the compartments included in the model. The cardiac chambers are contained in the pericardium. The four cardiac valves are not seen in the sketch. The pericardium and the thoracic part of the circulation are contained in the intrathoracic space. Pressures, flows and volumes in each node of the circuit are recalculated every 0.25 ms by default.
Features
Aplysia CardioVascular Lab is a real-time simulation model and software developed to fulfill the needs for basic education in physiology and pathophysiology as well as patient-specific modeling of cardiovascular disease in modern health care. User interaction is a powerful pedagogical tool and the possibility to change the parameters one by one increases understanding. Aplysia CardioVascular Lab can be used in interactive e-learning tutorials as well as in traditional seminars during education of medical students and specialized nurses, cardiologists, anesthesiologists, intensive care doctors, pediatric and adult cardiac surgeons.Aplysia CardioVascular Lab is developed for PC and Windows, but other platforms will be targeted in the future. It is a stand-alone software, but can interact with web-based tutorials and case presentations.Normal physiology, systolic and diastolic heart failure, valve stenosis and regurgitation, rhythm disorders, arteriosclerosis, atrial septal defects, ventricular septal defects, persistent ductus arteriosus and transposition of great arteries and more can be simulated in neonatal, pediatric and adult patients.Diagnostic cardiac catheterization and treatment options such as inotropic and vasoactive drugs, mechanical ventilation, intra-aortic balloon pump, left/right pulsatile or non-pulsatile ventricular mechanical assist devices, cardiopulmonary resuscitation, extra-corporeal veno-venous and veno-arterial membrane oxygenation as well as open surgical and catheter-based valve interventions can be simulated one by one or in combination.
Details in simulation model
The cardiac model is based on time-varying elastance functions containing both cardiac systolic, diastolic and timing properties. The valves open and close gradually and are characterised by both resistive and inertial propertiers.The vascular segments consist of a non-linear resistance, a non-linear elastance (exponential increase in stiffness with expansion), an inertial element and a non-linear viscoelastic resistance. All parameter values are based on actual vascular dimensions and properties (length, radius, thickness, Young’s modulus and blood viscosity). The pericardium has an exponential pressure-volume relation. Normal pressure is close to zero. Pressure in the intrathoracic space is changing depending on the breathing pattern of the patient. Normal spontaneous breathing is characterised by mean pressures close to zero with slightly negative pressures during inspiration. Mechanical ventilation is characterised by positive pressures compromising circulation.Airway mechanics including resistance and compliance of both central and peripheral airways are included in the model. Both pulmonary compliance and chest wall compliance are included permitting calculation of trans-pulmonary pressures. The lung model also includes anatomical and alveolar dead-space affecting gas exchange of both oxygen and carbon dioxide.
References
1. Mulder MP, Broome M, Donker DW, Westerhof BE. Distinct morphologies of arterial waveforms reveal preload-, contractility-, and afterload-deficient hemodynamic instability: An in silico simulation study. Physiol Rep. 2022;10(7):e15242.
2. Donker DW, Sallisalmi M, Broome M. Right-Left Ventricular Interaction in Left-Sided Heart Failure With and Without Venoarterial Extracorporeal Membrane Oxygenation Support-A Simulation Study. ASAIO J. 2021;67(3):297-305.
3. Maksuti E, Westerhof B, Ugander M, Donker D, Carlsson M, Broome M. Cardiac Remodeling in Aortic and Mitral Valve Disease – a Simulation Study with Clinical Validation. J Appl Phys. 2019;126:1377-89.
4. Donker DW, Brodie D, Henriques JPS, Broome M. Left Ventricular Unloading during Veno-Arterial ECMO – A Simulation Study. ASAIO J. 2018;65(1):11-20.
5. Broome M, Donker DW. Individualized real-time clinical decision support to monitor cardiac loading during venoarterial ECMO. J Transl Med. 2016;14(1):4.
6. Lindfors M, Frenckner B, Sartipy U, Bjallmark A, Broome M. Venous Cannula Positioning in Arterial Deoxygenation During Veno-Arterial Extracorporeal Membrane Oxygenation-A Simulation Study and Case Report. Artif Organs. 2016.
7. Broman M, Frenckner B, Bjallmark A, Broome M. Recirculation during veno-venous extra-corporeal membrane oxygenation – a simulation study. The International journal of artificial organs. 2015;38(1):23-30.
8. Broome M, Maksuti E, Bjallmark A, Frenckner B, Janerot-Sjoberg B. Closed-loop real-time simulation model of hemodynamics and oxygen transport in the cardiovascular system. Biomed Eng Online. 2013;12:69.
aplysia (verified owner) –
A fantastic software to teach and analyze complex cardiovascular physiology.