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Human Circulatory Response Physical Modeling in Anesthesiology and Critical Care (Review)
Russian version
Mikhaleva I. 1, Vasileva G. N. 1, Bairova T.V. 1, Koleboshina M. A. 1, Shevkulenko D. A. 2, Bestaev G. G. 3, Egorov M. G. 4, Ovsiannikov R.Iu. 1, Kurapeev I. S. 1, Lenkin A.I. 1, Semkichev V. A. 1, Saiganov S. A. 1, Lebedinskii K. M. 1,5
1Mechnikov North-Western State Medical University, St. Petersburg, Russia
2International Medical Clinic, Moscow, Russia
3North-Ossetian State Medical Academy, Vladikavkaz, Russia
4Center for Prevention and Control of AIDS and Infectious Diseases, St. Petersburg, Russia
5Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
Email: j_mikhaleve@mail.ru, vasilyeva_galina@mail.ru, koleboshina.m.a@mail.ru, dshevkulenko@yandex.ru, georbest@mail.ru, dark_prince@list.ru, ovsiannikov.roman@gmail.com, ikurapeev@gmail.com, www.starfish@mail.ru, semkichev@mail.ru, ssayganov@gmail.com, mail@lebedinski.com
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The narrative review discusses the problem of modeling patient's circulatory responses to various challenges during anesthesia, surgery and intensive care. The authors justify the point of view that in order to avoid perioperative critical incidents such a forecast should be based on a goal-targeted clinical tests &ndash; physical modeling of the system response using safe test stimuli, physically similar to disturbing challenges by their biomechanical nature. As an examples, authors analyze the prediction of circulatory response to neuraxial block using a test dose of nitroglycerin, to induction of general anesthesia using esmolol test, to volume load infusion using preload maneuver tests, a hemodynamic test for the surgical hemostasis consistency, optimal PEEP titration balancing the contradictory requirements of alveolar recruitment and pulmonary capillaries blood flow support. Keywords: systemic hemodynamic response, general anesthesia induction, neuraxial block, nitroglycerine, esmolol, phenylephrine, surgical hemostasis, positive end-expiratory pressure.
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