Estimation Of Subject Specific ICP
Dynamic Models Using Prospective Clinical Data
Author(s)
W. Wakeland, J. Fusion & B. Goldstein
Abstract
We used a prospective clinical trial to generate physiologic data to create
subject-specific in silico (computer simulation) models of intracranial pressure
dynamics in children with severe traumatic brain injury. The trial included a
physiologic challenge protocol with changes in head-of-bed elevation and minute
ventilation, applied over multiple iterations to three subjects. Physiologic signals
(electrocardiogram, respiration, arterial blood pressure, intracranial pressure
[ICP], oxygen saturation) were recorded continuously, along with clinical
annotations indicating the precise timing of physiologic challenges. Several
parameters within the model of ICP dynamics were estimated for each subject
based on the ICP response to the challenges. Estimation was done using a
standard optimization algorithm to minimize the difference between the ICP
trajectory predicted by the model and the actual ICP data. The ICP trajectory
predicted by the model was similar to the actual ICP data in all cases, and the
mean absolute error varied between 0.5 - 2.8 mmHg (mean = 1.4mmHg). These
results demonstrate the potential for using clinically annotated prospective data
to create subject-specific computer simulation models. Future research will focus
on improvements in the logic for cerebral autoregulatory mechanisms and
physiologic adaptation.
Keywords: intracranial pressure, simulation model, clinical data, optimization.
Keywords
intracranial pressure, simulation model, clinical data, optimization.
Related Book
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