Lanzarone E, Liani P, Baselli G, Costantino M L
Department of Bioengineering, Politecnico di Milano, Milan, Italy.
Med Eng Phys. 2007 Jun;29(5):542-55. doi: 10.1016/j.medengphy.2006.08.004. Epub 2006 Oct 2.
Peripheral vasomotion, interstitial liquid exchange, and cardiovascular system behaviour are investigated by means of a lumped parameter model of the systemic and peripheral circulation, from the aortic valve to the venules. This modelling work aims at combining arterial tree hemodynamics description, active peripheral flow regulation, and fluid exchange. The arterial compartment is constructed with 63 RCL segments and 30 peripheral districts including myogenic control on arterioles, metabolic control on venules, and Starling filtration through capillary membrane. The arterial behaviour is characterised as to the long term stability of pressure/flow waves in the different segments. Peripheral districts show autoregulatory capabilities against pressure changes over a wide range and also self-sustained oscillations mimicking vasomotor activity. A preliminary study was carried out as to the model response to changes induced by cardiopulmonary bypass (CPB). Among the induced alterations, the system responds mainly to hemodilution, which increased peripheral fluid loss and oedema beyond the compensatory capabilities of local regulation mechanisms. This resulted in an overall increase total arterial resistance. Local transport deficits were assessed for each district according to the different metabolic demand. This study shows the requirement of a suitable description of both arteries and peripheral mechanisms in order to describe cardiovascular response non-physiological conditions, as well as assisted circulation or other pathological conditions.
通过一个从主动脉瓣到小静脉的体循环和外周循环的集总参数模型,对外周血管运动、组织液交换和心血管系统行为进行了研究。这项建模工作旨在将动脉树血流动力学描述、外周主动血流调节和液体交换结合起来。动脉部分由63个RCL节段和30个外周区域构成,包括对小动脉的肌源性控制、对小静脉的代谢控制以及通过毛细血管膜的斯塔林滤过。动脉行为的特征在于不同节段压力/流量波的长期稳定性。外周区域在很宽的范围内对压力变化表现出自身调节能力,并且还表现出模拟血管运动活性的自持振荡。针对该模型对体外循环(CPB)引起的变化的响应进行了一项初步研究。在诱导的改变中,系统主要对血液稀释作出反应,这增加了外周液体流失和水肿,超出了局部调节机制的代偿能力。这导致总动脉阻力总体增加。根据不同的代谢需求评估每个区域的局部运输缺陷。这项研究表明,为了描述心血管系统在非生理条件下以及辅助循环或其他病理条件下的反应,需要对动脉和外周机制进行适当的描述。