Daudre-Vignier, Clara
(2024)
Replacement of animal models of cardiac arrest and resuscitation strategies using a computer simulation.
PhD thesis, University of Nottingham.
Abstract
This doctoral thesis explores cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) from a multidisciplinary perspective, with a focus on three main objectives: enhancing the Interdisciplinary Collaboration in Systems Medicine (ICSM) simulation suite, investigating the pathophysiology of CA, and proposing an alternative to animal models in CA and CPR research.
The ICSM simulation suite was significantly improved, with additions such as a thoracic model for chest compressions, multiple organ tissue compartments, a vasculature equation accounting for resistance changes, circulatory transport delays, retrograded blood flow during CPR, and respiratory and cardiovascular control mechanisms.
Utilizing the enhanced ICSM simulation suite, a series of studies were conducted to examine various aspects of CPR strategies, all with the aim of improving resuscitation outcomes. These studies encompassed investigations into the impact of positive end-expiratory pressure (PEEP) on cardiac output during CPR, the effects of chest compression rate, depth, and duty cycle, the influence of the precipitating aetiology on CPR strategy optimization, and the comparison of personalized CPR strategies to current guidelines. The research also quantitatively identified the effect of CPR parameters on cardiac output, with end compression force and positive end expiratory pressure emerging as significant contributors. The validation of the ICSM simulation suite thoracic model using individual haemodynamic recordings of a patient undergoing CPR demonstrated its capacity to simulate individualized patient data for retrospective identification of optimized CPR protocols. These outcomes collectively emphasize the potential of computational models, particularly the ICSM simulation suite, to revolutionize CA and CPR research by providing humane, informative, and personalized alternatives to traditional animal models.
The findings of this research suggest that the ICSM simulation suite offers a valuable alternative to animal models in the study of CA and CPR. This computational model allows for the simulation and investigation of personalized CPR strategies, which can be tailored to individual patients' needs
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