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D'Orsi L, Curcio L, Cibella F, Borri A, Gavish L, Eisenkraft A, De Gaetano A. A mathematical model of cardiovascular dynamics for the diagnosis and prognosis of hemorrhagic shock. MATHEMATICAL MEDICINE AND BIOLOGY-A JOURNAL OF THE IMA 2021; 38:417-441. [PMID: 34499176 DOI: 10.1093/imammb/dqab011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 08/16/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022]
Abstract
A variety of mathematical models of the cardiovascular system have been suggested over several years in order to describe the time-course of a series of physiological variables (i.e. heart rate, cardiac output, arterial pressure) relevant for the compensation mechanisms to perturbations, such as severe haemorrhage. The current study provides a simple but realistic mathematical description of cardiovascular dynamics that may be useful in the assessment and prognosis of hemorrhagic shock. The present work proposes a first version of a differential-algebraic equations model, the model dynamical ODE model for haemorrhage (dODEg). The model consists of 10 differential and 14 algebraic equations, incorporating 61 model parameters. This model is capable of replicating the changes in heart rate, mean arterial pressure and cardiac output after the onset of bleeding observed in four experimental animal preparations and fits well to the experimental data. By predicting the time-course of the physiological response after haemorrhage, the dODEg model presented here may be of significant value for the quantitative assessment of conventional or novel therapeutic regimens. The model may be applied to the prediction of survivability and to the determination of the urgency of evacuation towards definitive surgical treatment in the operational setting.
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Affiliation(s)
- Laura D'Orsi
- National Research Council of Italy, Institute for Systems Analysis and Computer Science 'A. Ruberti', Biomathematics Laboratory, UCSC Largo A. Gemelli 8, 00168 Rome, Italy
| | - Luciano Curcio
- National Research Council of Italy, Institute for Biomedical Research and Innovation, Biomathematics Laboratory, Via Ugo La Malfa, 153, 90146 Palermo, Italy
| | - Fabio Cibella
- National Research Council of Italy, Institute for Biomedical Research and Innovation, Biomathematics Laboratory, Via Ugo La Malfa, 153, 90146 Palermo, Italy
| | - Alessandro Borri
- National Research Council of Italy, Institute for Systems Analysis and Computer Science 'A. Ruberti', Biomathematics Laboratory, UCSC Largo A. Gemelli 8, 00168 Rome, Italy
| | - Lilach Gavish
- Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem, 9112001, Israel, Institute for Medical Research (IMRIC), Faculty of Medicine, The Hebrew University of Jerusalem, 9112001, Israel
| | - Arik Eisenkraft
- Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem, 9112001, Israel
| | - Andrea De Gaetano
- National Research Council of Italy, Institute for Systems Analysis and Computer Science 'A. Ruberti', Biomathematics Laboratory, UCSC Largo A. Gemelli 8, 00168 Rome, Italy
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