TY - THES ID - 135937792 TI - Pilot test of a new cardiorespiratory simulator for the prediction of fluid responsiveness in ICU patients AU - Cottyn, Jannes AU - Wauters, Joost. AU - Fresiello, Libera AU - Claus, Piet. AU - Claus, Piet AU - KU Leuven. Faculteit Geneeskunde. Opleiding Master in de geneeskunde (Geen nieuwe inschrijvingen vanaf 2015-2016) (Leuven) PY - 2017 PB - Leuven KU Leuven. Faculteit Geneeskunde DB - UniCat UR - https://www.unicat.be/uniCat?func=search&query=sysid:135937792 AB - Fluid resuscitation is an essential part of early goal directed therapy in critically ill patients with septic shock to improve tissue perfusion. However, there is increasing evidence that unnecessary or excess use of intravenous fluids is associated with increased risk of complications, length of ICU stay and morbidity and mortality. Therefore, the benefit of fluid administration must outweigh the risk of possible complications. Dynamic indices, such as the pulse pressure variation (PPV), are shown to be valid predictors of fluid responsiveness despite some restrictions to use these parameters in clinical practice. In this thesis, we tested the suitability of a cardiorespiratory simulator as a part of a personalized cardiorespiratory model to predict fluid responsiveness in ICU patients. The simulator we tested provides a representation of the cardiovascular system and assisted mechanical ventilation. As a first step in assessing the capacity of such a cardiorespiratory simulator to predict fluid responsiveness and as a proof of concept pilot experiment, we aimed to compare the simulator capacity to predict PPV in a limited number of fully-sedated and mechanically ventilated patients with the real-life monitor data. We did not only test the simulator during one baseline measurement but we also evaluated the effect of two interventions on the prediction of PPV. We adjusted the tidal volume of the ventilator and gave the patients a fluid challenge to evaluate the effect on PPV. Patients’ data were collected and subsequently used as input for the cardiorespiratory simulator. Simulator output, in terms of pressure profiles, cardiac output, ventricular volumes and PPV were collected. The simulated data were eventually compared to the real-life clinical data. Our comparison shows a reliable prediction of basic hemodynamic parameters like heart rate, blood pressure and central venous pressure. Concerning the PPV, the differences between the measured and predicted simulated data show that the current simulation is not yet accurate enough, but the simulator tends to follow the changes that occur due to our interventions. Further testing in future will be necessary in order to improve the current simulator, making it a reliable bedside decision support system in the evaluation of fluid responsiveness. ER -