Department of Cardiology, Thorax Center, Erasmus Medical Center, Rotterdam.
Department of Intensive Care Adults, Erasmus Medical Center, Rotterdam.
Curr Opin Crit Care. 2024 Aug 1;30(4):340-343. doi: 10.1097/MCC.0000000000001164. Epub 2024 May 22.
The purpose of this review is to explain the value of computational physiological modeling for in-depth understanding of the complex derangements of cardiopulmonary pathophysiology during cardiogenic shock, particularly when treated with temporary mechanical circulatory support (tMCS) devices.
Computational physiological models have evolved in recent years and can provide a high degree of clinical realism in the simulation of cardiogenic shock and related conservative and interventional therapies. These models feature a large spectrum of practically relevant hemodynamic and respiratory parameters tunable to patient-specific disease states as well as adjustable to medical therapies and support device settings. Current applications work in real-time and can operate on an ordinary computer, laptop or mobile device.
The use of computational physiological models is increasingly appreciated for educational purposes as they help to understand the complexity of cardiogenic shock, especially when sophisticated management of tMCS is involved in addition to multimodal critical care support. Practical implementation of computational models as clinical decision support tools at the bedside is at the horizon but awaits rigorous clinical validation.
本文旨在解释计算生理模型在深入理解心源性休克期间心肺病理生理学的复杂紊乱方面的价值，特别是在心源性休克患者接受临时机械循环支持（tMCS）设备治疗时。
近年来，计算生理模型不断发展，在模拟心源性休克和相关保守及介入治疗方面能够提供高度的临床现实性。这些模型具有广泛的实际相关血流动力学和呼吸参数，可根据患者特定的疾病状态进行调整，也可根据医疗治疗和支持设备的设置进行调整。目前的应用可以实时运行，并且可以在普通计算机、笔记本电脑或移动设备上运行。
计算生理模型的使用越来越受到重视，因为它们有助于理解心源性休克的复杂性，特别是在除了多模式重症监护支持之外还涉及复杂的 tMCS 管理时。计算模型作为床边临床决策支持工具的实际应用即将实现，但仍需要严格的临床验证。
