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Biomedical subjects

D Jaron

Publications and source records attributed to D Jaron.

At least 19 recordsLinked to original sources
PubMed1992

Cardiovascular responses to external counterpulsation: a computer simulation.

A mathematical model of the human cardiovascular system is presented which includes a simulation of cardiac assistance by external counterpulsation. The model was established to study the effects of external counterpulsation on cardiovascular haemodynamics. The closed simulation includes both the left and the right heart and the pulmonary circulation. The model is able to provide data for the behaviour of the system under varying modes of assistance. Our results suggest that control of external counterpulsation is more difficult than control of the intra-aortic balloon pump and requires regulation of a larger number of variables. The results also suggest that a tradeoff exists between improved oxygen delivery to the heart and reduction in the oxygen consumption of the myocardium, an observation similar to that reported for the intra-aortic balloon pump.

Counterpulsation↗
PubMed1992

Optimal controller for intraaortic balloon pumping.

An optimal control algorithm was adapted to identify and track the optimal deflation time of the intraaortic balloon pump (IABP). Routines for handling physiologically imposed constraints were added to the algorithm which was implemented in a computer-controlled system. The system was designed to provide real time optimization for the clinical setting. The controller continuously maximizes a performance index while observing the constraints. The index is composed of clinically available hemodynamic variables which indicate changes in myocardial energy balance. Proper values for the algorithm parameters were determined and the system was tested in animal experiments. The results indicate that controlling deflation time relative to the R wave, which precedes the next ejection phase, reduces the time required for optimization when the heart rate varies.

Algorithms↗
PubMed1991

Optimal control system for the intra-aortic balloon pump.

An optimal control system for the intra-aortic balloon pump (IABP) is presented. Control of the IABP is based on a performance index formulated to reflect a tradeoff between maximising cardiac oxygen supply and minimising cardiac oxygen consumption. In the performance index, mean diastolic pressure (MDP) was used to represent oxygen availability and peak systolic pressure (PSP) was used to represent oxygen consumption. An algorithm, implemented using an 8-bit microcomputer, changes the deflation time of the IABP to maximise this performance index by using an optimisation technique that employs both a search and an approximation. The search produces three equally spaced points which define a region that includes the maximum of the performance index. From these points, the optimum deflation time is estimated by a quadratic approximation. The algorithm has been successfully tested using performance index curves generated by computer simulations.

Algorithms↗
PubMed1990

Computer simulation of the mechanically-assisted failing canine circulation.

A model of the cardiovascular system is presented. The model includes representations of the left and right ventricles, a nonlinear multielement model of the aorta and its main branches, and lumped models of the systemic veins and the pulmonary circulation. A simulation of the intra-aortic balloon pump and representations of physiological compensatory mechanisms are also incorporated in the model. Parameters of the left ventricular model were set to simulate either the normal or failing canine circulation. Pressure and flow waveforms throughout the circulation as well as ventricular pressure and volume were calculated for the normal, failing, and assisted failing circulation. Cardiac oxygen supply and consumption were calculated from the model. They were used as direct indices of cardiac energy supply and utilization to assess the effects of cardiac assistance.

Animals↗
PubMed1990

Cardiac energy considerations during intraaortic balloon pumping.

Cardiac oxygen availability and oxygen consumption were used in a theoretical study as indexes of myocardial energy supply and utilization, respectively. A detailed computer simulation of the closed-loop canine cardiovascular system was utilized to study the dependence of these indexes on timing of the intraaortic balloon pump. Oxygen availability exhibited higher sensitivity to balloon timing than oxygen utilization. While maximum augmentation of oxygen availability was 58 percent, oxygen consumption could be reduced by only 13 percent. Animal experiments were initiated to validate the theoretical results. The results of both the animal experiments and the computer simulation suggested that neither balloon timing which maximizes oxygen availability nor timing which minimizes oxygen consumption correlates with timing which minimizes aortic end diastolic pressure. Thus, end diastolic pressure, presently used as a determinant of proper timing in patients undergoing cardiac assistance, was found to be a poor index of ventricular energy consumption. A performance index comprised of clinically available variables, was formulated to reflect myocardial energy balance. In this performance index, mean diastolic pressure was used to represent energy availability and peak systolic pressure was used as an index of oxygen consumption. Their relationship to oxygen balance and their dependence on timing were studied using the computer simulation of the canine cardiovascular system and animal experiments. Theoretical and experimental results suggest that such an index is capable of representing O2 balance and can be used to control phasing of the device.

Animals↗
PubMed1987

Reflectance photoplethysmography as an adjunct to assessment of gravitational acceleration tolerance: preliminary findings.

We have examined the feasibility of using reflectance photoplethysmography to assess Gz acceleration tolerance. Reflectance plethysmograms recorded using a sensor placed on the region of the superficial temporal artery were analysed along with the mean value and the pulsatile component of the Doppler velocity recorded from the opposite temporal artery. The photoplethysmogram signal and pulsatile and mean Doppler velocities were examined as predictors of impending peripheral light loss (PLL) during the experiments. Photoplethysmography correctly predicted a large percentage of the PLL runs (80.5%) and non-PLL runs (98.3%). Mean Doppler velocity predicted a higher percentage of PLL runs (88.1%), but with an unacceptably low rate of non-PLL runs (77.2%). The pulsatile Doppler velocity yielded only 50.7% correct prediction of PLL runs. The results of this preliminary study indicate that, with an improved design of the sensor and the electronics, it may be possible to use reflectance photoplethysmography in acceleration tolerance experiments as a reliable predictor of impending peripheral light loss.

Acceleration↗
PubMed1987

An experimental microcomputer controlled system for synchronized pulsating anti-gravity suit.

An experimental system to deliver synchronized external pressure pulsations to the lower body is described in this technical note. The system is designed using a microcomputer with a real time interface and an electro-pneumatic subsystem capable of delivering pressure pulses to a modified anti-G suit at a fast rate. It is versatile, containing many options for synchronizing, phasing and sequencing of the pressure pulsations and controlling the pressure level in the suit bladders. Details of its software and hardware are described along with the results of initial testing in a Dynamic Flight Simulator on human volunteers.

Computers↗
PubMed1985

Control of intraaortic balloon pumping: theory and guidelines for clinical applications.

The effectiveness of intraaortic balloon pumping was investigated by using a lumped parameter model of the cardiovascular/assist device system. The model consists of a time-varying elastance left ventricular simulation, a 2-element windkessel arterial simulation, and an RC venous return and pulmonary simulation. The four major hemodynamic variables, stroke volume (SV), aortic mean diastolic pressure (MDP), tension time index (TTI), and aortic end diastolic pressure (EDP), were divided into two categories related to system energy supply and demand: "external" and "internal" variables. The effects of balloon pumping on these variables can be described by closed-form equations that yield an optimal solution. The model prediction suggests that, in the ideal case, optimization of balloon pumping calls for instantaneous inflation of the balloon to maximum volume at end systole and instantaneous complete deflation at end diastole. For finite inflation/deflation rates, the optimal time for the start of inflation is end systole. Deflation timing, however, involves a tradeoff between maximizing the external variables and minimizing the internal variables. These predictions were tested using a nonlinear digital computer model. The results also suggest that when SV is not being monitored, optimal inflation timing can be controlled from the measurements of TTI or pulmonary venous pressure; optimal deflation timing can be controlled by a weighted combination of MDP and EDP.

Assisted Circulation↗
PubMed1976

A temporary catheter-tip aortic valve: hemodynamic effects on experimental acute aortic insufficiency.

A catheter-mounted polyurethane cusp was designed to act as a temporary prosthetic aortic valve in the ascending aorta. Acute aortic insufficiency was created in 15 dogs by transventricular tearing of the two aortic valve leaflets with a wire hook. Hemodynamic variables were measured during aortic insufficiency and with the prosthetic valve in place. Comparison of the values showed that the prosthesis functioned as a competent aortic valve. Aortic diastolic pressure increased by 62 +/- 42%, pulse pressure was lowered by 44 +/- 9%, and left ventricular end-diastolic pressure decreased by 45 +/- 18%. Neither cardiac output, coronary blood flow, nor peak systolic pressure was significantly altered. The observed hemodynamic improvement and the simplicity of the design and application suggest that the prosthetic aortic valve may be applicable in the temporary treatment of decompensated aortic insufficiency.

Acute Disease↗