To create clinically useful computer simulation models of intracranial pressure (ICP) dynamics by using prospective clinical data to estimate subject-specific physiologic parameters

Fusion, Joe

Goldstein, Brahm

Wakeland, Wayne W.

English

PDXScholar (Portland State University)

Portland State University PDXScholar Systems Science Faculty Publications and Presentations Systems Science 2005 Creating Clinically Useful In Silico Models of Intracranial Pressure Dynamics Wayne W. Wakeland Portland State University, wakeland@pdx.edu Joe Fusion Portland State University Brahm Goldstein Oregon Health & Science University Follow this and additional works at: https://pdxscholar.library.pdx.edu/sysc_fac  Part of the Biomedical Commons Let us know how access to this document benefits you. Citation Details Wakeland, W., Fusion, J., and Goldstein, B. Creating Clinically Useful in silico Models of Intracranial Pressure Dynamics. Poster presentation at the 4th International Conference on Complexity in Acute Illness (ICCAI), Cologne, 2005. This Poster is brought to you for free and open access. It has been accepted for inclusion in Systems Science Faculty Publications and Presentations by an authorized administrator of PDXScholar. Please contact us if we can make this document more accessible: pdxscholar@pdx.edu. Oregon Health & Science Univ.Complex Systems LaboratorySystems SciencePh.D. ProgramWayne Wakeland1, Joe Fusion1, Brahm Goldstein21 System Science Ph.D. Program, Portland State University, Portland, Oregon USA2 Oregon Health & Science University, Portland, Oregon USACreating Clinically Useful in silico Models of Intracranial Pressure DynamicsAimTo create clinically useful computer simulation models of intracranial pressure (ICP) dynamics by using prospective clinical data to estimate subject-specific physiologic parameters.Methods  A differential equation-based model was used to simulate ICP dynamics ICP data was collected from patients with severe traumatic brain injury During data collection, changes to Head of Bed (HOB) and Respiratory Rate (RR) were applied according to a physiological challenge protocol Patient-specific parameters were estimated by a curve-fitting algorithm to minimize error between the model’s prediction and the recorded ICP Estimated parameters included: base cranial volume, normal bleed rate, CSF drainage rate, systemic venous pressure, effectiveness of autoregulation, and smoothing factors that affect the moving averages on pressure changesB I O M E D I C A L  S I G N A L  PR O C E S S I N G  LA B O R A T O R Yb s p . p d x . e d uPatient and SessionSession Length (minutes)Mean Absolute Error (mmHg)Types of ChallengesP1, S1.5 12 0.9174 1 HOBP1, S3 18 0.8935 1 HOBP1, S4 45 3.7827 1 HOB, 3 RRP1, S5b 35 3.2661 4 HOBP2, S1 55 0.6864 4 HOBP2, S4 65 0.8029 2 RRP2, S7a 55 2.5520 5 HOBP2, S7b 55 1.4257 4 RRP2, S9b 55 0.5029 4 HOBP3, S3b 70 3.0410 6 HOBP201, S2 50 1.2125 3 HOBFigure 4: Patient 2, Session 9bFigure 3: Patient 2, Session 4Figure 5: Patient 201, Session 2Figure 2: Patient 1, Session 4This work was supported, in part,by the Thrasher Research Fund.ConclusionsWhile the model is not yet ready for clinical use, its performance continues to improve. We believe that these results support the pursuit of subject-specific models based on clinically annotated data.References[1] Wakeland, Wayne, Joe Fusion and Brahm Goldstein. 2005. Estimation of subject specific ICP dynamic models using prospective clinical data. Biomedicine 2005 (07-09Sep2005).[2] Ursino, M., Ter Minassian, A. Lodi, C A. Beydon, L. Cerebral hemodynamics during arterial and CO(2) pressure changes: in vivo prediction by a mathematical model. Am J Physiol Heart Circ Physiol. 279(5):H2439-55, 2000 Nov. All sessionsHOB challengesRR challenges1-3 challenges4-6 challengesµ 1.73 1.63 2.00 0.96 2.18 1.19 1.13 1.57 0.18 1.31ResultsTable 1: Summary of resultsTable 2: Means and Standard Deviations of ResultsNonlinearOptimizing AlgorithmInitialParametersICPDynamicModelEstimated ParametersHOB and RRChallengesErrorComputationPredicted ICPMeasured ICPErrorFigure 1: The Process for Estimating Patient-Specific Parameters

Creating Clinically Useful \u3ci\u3eIn Silico\u3c/i\u3e Models of Intracranial Pressure Dynamics

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Creating Clinically Useful \u3ci\u3eIn Silico\u3c/i\u3e Models of Intracranial Pressure Dynamics

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