CHU Sainte Justine Research Center, Université de Montreal, Montreal, Canada.
Pediatric Intensive Care Unit, CHU de Caen, Caen, France.
Pediatr Pulmonol. 2023 Oct;58(10):2832-2840. doi: 10.1002/ppul.26595. Epub 2023 Aug 2.
Mathematical models based on the physiology when programmed as a software can be used to teach cardiorespiratory physiology and to forecast the effect of various ventilatory support strategies. We developed a cardiorespiratory simulator for children called "SimulResp." The purpose of this study was to evaluate the quality of SimulResp.
SimulResp quality was evaluated on accuracy, robustness, repeatability, and reproducibility. Blood gas values (pH, PaCO , PaO and SaO ) were simulated for several subjects with different characteristics and in different situations and compared to expected values available as reference. The correlation between reference and simulated data was evaluated by the coefficient of determination and Intraclass correlation coefficient. The agreement was evaluated with the Bland & Altman analysis.
SimulResp produced healthy child physiological values within normal range (pH 7.40 ± 0.5; PaCO 40 ± 5 mmHg; PaO 90 ± 10 mmHg; SaO 97 ± 3%) starting from a weight of 25-35 kg, regardless of ventilator support. SimulResp failed to simulate accurate values for subjects under 25 kg and/or affected with pulmonary disease and mechanically ventilated. Based on the repeatability was considered as excellent and the reproducibility as mild to good. SimulResp's prediction remains stable within time.
The cardiorespiratory simulator SimulResp requires further development before future integration into a clinical decision support system.
基于生理学原理编写成软件的数学模型可用于教授心肺生理学，并预测各种通气支持策略的效果。我们开发了一款名为“SimulResp”的儿童心肺模拟器。本研究旨在评估 SimulResp 的质量。
评估 SimulResp 的准确性、鲁棒性、可重复性和再现性。针对不同特征和不同情况的多个研究对象模拟血气值（pH 值、PaCO 、PaO 和 SaO ），并与可作为参考的预期值进行比较。通过决定系数和组内相关系数评估参考值与模拟值之间的相关性。采用 Bland–Altman 分析评估一致性。
SimulResp 能够模拟出健康儿童的生理值（pH 值 7.40 ± 0.5；PaCO 40 ± 5mmHg；PaO 90 ± 10mmHg；SaO 97 ± 3%），体重在 25-35kg 之间，无论是否使用呼吸机支持。SimulResp 无法准确模拟体重低于 25kg 且患有肺部疾病和机械通气的研究对象的生理值。根据可重复性被认为是优秀的，再现性是轻度到良好的。SimulResp 的预测值在一段时间内保持稳定。
心肺模拟器 SimulResp 在未来集成到临床决策支持系统之前需要进一步开发。
