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Modelování cirkulačního systému

Modelování cirkulačního systému. v lékařském simulátoru METI. METI‘S Human Patient Simulator (HPS). METI‘S Human Patient Simulator (HPS). METI‘S Human Patient Simulator (HPS). ADULT MANNEQUIN: Full - size reproduction of an adult male or female patient with interchangeable genitalia

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Modelování cirkulačního systému

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  1. Modelování cirkulačního systému v lékařském simulátoru METI

  2. METI‘S HumanPatient Simulator (HPS)

  3. METI‘S HumanPatient Simulator (HPS)

  4. METI‘S HumanPatient Simulator (HPS) ADULT MANNEQUIN: Full-sizereproductionofanadult male orfemalepatientwithinterchangeablegenitalia Fullyoperational in supine, sitting, lateralandpronepositions Demonstratesclinicalsigns such as heart, breathandbowelsounds, palpablepulses, chestexcursionandairwaypatency, which are dynamicallycoupledwithmathematicalmodelsofhumanphysiologyandpharmacologyairway.  Realisticadultupperairway (oropharynx, nasopharynxand larynx)  Directlaryngoscopyand oral ornasaltrachealintubation Rightorleftmainstemendobronchialintubationautomaticallyresults in unilateralbreathsoundsandchestexcursion Esophagealintubationresults in gastricdistensionandthe absence ofbreathsounds, chestexcursionandcarbon dioxide output Airwayvisualizationoccluder Varyingdegreesoftongueswelling, hinderinglaryngoscopyandendotrachealintubation Laryngospasm Needlecricothyrotomy, transtracheal jet ventilation, retrogradewiretechniquesand tube cricothyrotomycanbepracticed Supports standard clinicaldevices such as combitubes, lightedstyletsandfibre-opticintubationtubes

  5. METI‘S HumanPatient Simulator (HPS) • PULMONARY:  • Spontaneousrespiration • Mechanicalventilation • Assistedventilation • Chestexcursion • Oxygen consumption • Uptakeandeliminationofanestheticgases • Variablelungandthoraxcompliance • Variableairwayresistance • Breathsounds • Intrapleural volume  • Functionalresidualcapacity

  6. METI‘S HumanPatient Simulator (HPS) • CARDIOVACULAR: • Heartsounds • Electrocardiogram • Palpablecarotid, radial, brachial, femoral, poplitealandpedalpulses • Cardiacoutput • Cardiacdysrhythmias • Arterialbloodtemperature • Centralvenouspressure • Hemodynamic monitoring  • Pulmonaryarterycatheter • Chestcompression • Airway management andventilation • Cardiacarrhythmias • Defibrillation • Pacing • Cardioversion

  7. METI‘S HumanPatient Simulator (HPS) • PHARMACOLOGIC: • Includeslibraryofpre-programmedpharmacokineticandpharmacodynamicparametersforover 50 intravenousmedications • Barcodereaderidentifiesdrug, concentrationanddosageandpatientrespondsappropriately • Threeintravenousaccesspoints: rightarm, rightinternaljugularandleftfemoralveins

  8. METI‘S HumanPatient Simulator (HPS) PATIENT MONITORING:  Connects to standard patient monitors to display the followingparameters:  Arterial blood pressure  Left ventricular pressure Central venous pressure  Right arterial pressure  Right ventricular pressure Pulmonary artery pressure  Thermodilution cardiac output  Pulmonary capillary occlusion pressure  Pulmonary artery catheter insertion NIBP 5-lead ECG  SpO2  Temperature  Inspired and expired gas concentrations and ventilatory mechanics can be measured and displayed on respiratory gas monitors

  9. METI‘S HumanPatient Simulator (HPS) rozhraní Model pacienta Model pacienta posluchači Stavový automat rozhraní Model přístroje Lékařský přístroj učitel rozhraní simulátor Figurína pacienta Willem van Meurs: Modeling andSimulation in BiomedicalEngineering, Applications in CardiorespiratoryPhysiology

  10. Konceptuální schéma

  11. Konceptuální schéma

  12. Konceptuální schéma

  13. Konceptuální schéma

  14. Konceptuální schéma

  15. Konceptuální schéma

  16. Konceptuální schéma

  17. Konceptuální schéma

  18. Komponenty

  19. Propojky vtok/výtok

  20. Propojky vtok/výtok connectorBloodFlowConnector"Connectorforbloodflow" flow Real Q "bloodflow in ml/sec"; Real Pressure "Pressure in torr"; endBloodFlowConnector; connectorBloodFlowInflow"Bloodflowinflow" flow Real Q "bloodinflow in ml/sec"; Real Pressure "Pressure in torr"; endBloodFlowInflow; connectorBloodFlowOutflow"Bloodflowinflow" flow Real Q "bloodflowoutflow in ml/sec"; Real Pressure "Pressure in torr"; endBloodFlowOutflow;

  21. Propojky vtok/výtok flow Real Q flow Real Q Real Pressure Real Pressure partial model BloodFlowOnePort BloodFlowInflowInflow; BloodFlowOutflowOutflow; Real PressureDrop; Real BloodFlow; equation PressureDrop=Inflow.Pressure - Outflow.Pressure; Inflow.Q + Outflow.Q=0; BloodFlow=Inflow.Q; endBloodFlowOnePort;

  22. Resistor

  23. Resistor model BloodResistor parameter Real BloodResistance(start=1) "resistance in torr sec/ml"; extendsBloodFlowOnePort; equation PressureDrop=BloodFlow*BloodResistance; endBloodResistor; model VariableBloodResistor extendsBloodFlowOnePort; Modelica.Blocks.Interfaces.RealInputBloodResistance "in torr sec/ml“; equation PressureDrop=BloodFlow*BloodResistance; endVariableBloodResistor;

  24. Conductor model VariableBloodConductance extendsBloodFlowOnePort; Modelica.Blocks.Interfaces.RealInputBloodConductance "in torr ml/sec“; equation PressureDrop*BloodConductance=BloodFlow; endVariableBloodConductance;

  25. Compliance

  26. Compliance BloodElasticCompartment Místo dvou konektorů (vtok/výtok) stačí jeden konektor

  27. Compliance – BloodElasticCompartment model BloodElasticCompartment"Elastic compartment with unstressed volume" Modelica.Blocks.Interfaces.RealInputElastance "\"in torr/ml\“; Modelica.Blocks.Interfaces.RealOutput Volume(start=V0); Modelica.Blocks.Interfaces.RealInputExternalPressure "\"in torr\„“; Modelica.Blocks.Interfaces.RealInputUnstressedVolume "in ml“; parameter Real V0=1 "initial volume in ml"; Real StressedVolume; Real TransmuralPressure; Modelica.Blocks.Interfaces.RealOutputPressure "Bloodpressure in torr“; BloodFlowConnectorbloodFlow; equation bloodFlow.Pressure=Pressure; TransmuralPressure=Pressure - ExternalPressure; der(Volume)=bloodFlow.Q; StressedVolume=Volume - UnstressedVolume; ifStressedVolume > 0 then TransmuralPressure=Elastance*StressedVolume; else TransmuralPressure=0; endif; endBloodElasticCompartment;

  28. Inductor

  29. Inductor Setrvačnost krve

  30. Inductor model Inductor extendsBloodFlowOnePort; Modelica.Blocks.Interfaces.RealInputInertance "in torr * sec^2/ml“; equation PressureDrop=der(BloodFlow)*Inertance; endInductor;

  31. Valve

  32. Valve

  33. Valve model Valve BloodFlowInflowbloodFlowInflow; BloodFlowOutflowbloodFlowOutflow; Real q; Real dp; Boolean open(start=true); Real passableVariable; equation bloodFlowInflow.Q + bloodFlowOutflow.Q=0; q=bloodFlowInflow.Q; dp=bloodFlowInflow.Pressure - bloodFlowOutflow.Pressure; open=passableVariable > 0; if open then dp=0; q=passableVariable; else dp=passableVariable; q=0; endif; endValve;

  34. CardiacValve

  35. Time-VaryingCompliance (orElastance)

  36. HeartIntervals model heartIntervals Modelica.Blocks.Interfaces.RealInputHR; RealDiscreteOutput Tas "durationofatrialsystole“; RealDiscreteOutput Tav "atrioventriculardelay“; RealDiscreteOutputTvs "durationofventricularsystole“; RealDiscreteOutput T0 "start timeof systole in sec“ discrete Real HP(start=0) "heart period - durationofcardiaccycle in sec"; Boolean b(start=false); equation b=time - pre(T0) >= pre(HP); when b then T0=time; HP=60/HR; Tas=0.03 + 0.09*HP; Tav=0.01; Tvs=0.16 + 0.2*HP; endwhen; endheartIntervals;

  37. AtrialElastance model AtrialElastance Modelica.Blocks.Interfaces.RealInput Tas "durationofatrialsystole“; Modelica.Blocks.Interfaces.RealOutputEt "elasticity (torr/ml)“; Modelica.Blocks.Interfaces.RealInput T0 "timeof start ofcardiaccycle ; parameter Real EMIN=0.05 "Diastolicelastance (torr/ml)"; parameter Real EMAX=0.15 "Maximum systolicelastance (tor/ml)"; equation iftime - T0 < Tas then Et=EMIN + (EMAX - EMIN)*sin(Modelica.Constants.pi*(time - T0)/Tas); else Et=EMIN; endif endAtrialElastance;

  38. VentricularElastance model VentricularElastance Modelica.Blocks.Interfaces.RealInput Tas "durationofatrialsystole“; Modelica.Blocks.Interfaces.RealOutputEt "elasticity (torr/ml)“; Modelica.Blocks.Interfaces.RealInput T0 "timeof start ofcardiaccycle„; Modelica.Blocks.Interfaces.RealInput Tav "atrioventriculardelay“; Modelica.Blocks.Interfaces.RealInputTvs "durationofventricularsystole“); Modelica.Blocks.Interfaces.RealOutput Et0 "elasticity (torr/ml)“; Modelica.Blocks.Interfaces.RealOutputHeartInterval "elasticity (torr/ml)“; constant Real Kn=0.57923032735652; parameter Real EMIN=0 "Diastolicelastance (torr/ml)"; parameter Real EMAX=1 "Maximum systolicelastance (tor/ml)"; equation HeartInterval=time - T0; Et=EMIN + (EMAX - EMIN)*Et0; ifHeartInterval >= Tas + Tav andHeartInterval < Tas + Tav + Tvsthen Et0=(HeartInterval - (Tas + Tav))/Tvs*sin(Modelica.Constants.pi*(HeartInterval - (Tas + Tav))/Tvs)/Kn; else Et0=0; endif; endVentricularElastance;

  39. Skládáme Lego

  40. RightHeart

  41. LeftHeart

  42. SystemicArteries

  43. SystemicPeripheralVessels

  44. SystemicVeins

  45. PulmonaryCirculation

  46. Výstup modelu – tlaky v levé síni a v aortě

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