570: AN IN SILICO MODEL OF CIRCLE OF WILLIS BLOOD FLOW IN PEDIATRIC PATIENTS WITH SEPSIS
570: AN IN SILICO MODEL OF CIRCLE OF WILLIS BLOOD FLOW IN PEDIATRIC PATIENTS WITH SEPSIS
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570：败血症儿科患者 Willis 血流的计算机模型
DOI：
10.1097/01.ccm.0001000456.74856.ba
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发表时间：
2023
影响因子：
8.8
通讯作者：
Luchette M
中科院分区：
文献类型：
--
作者：
Luchette M
研究方法：我们创建了一个新的Willis环主要分支的一维Navier-Stokes模型，并使用已发表的数据对患者从出生到18岁的模型进行了缩放。使用文献中描述的血压、每搏输出量和心率的年龄特异性值计算全身血管顺应性（SVC）和全身血管阻力（SVR）。然后，我们在两种状态下模拟大脑中动脉中的脑血流速度（CBFv）：健康状态（其中SVC和SVR对应于年龄的第50百分位数的血压）和脓毒症状态（其中SVC和SVR对应于年龄的第5百分位数的血压）。模拟进行了四个年龄组：新生儿，一个五岁，一个十岁，和一个adult.Results：峰值主动脉血流量下降13.9%和39%之间的脓毒症状态相对于健康状态在四个年龄组。新生儿、5岁、10岁和成人通过大脑中动脉的CBFv估计值分别为0.29、0.33、0.40和0.54 m/s，接近文献中报告的值（从出生到18岁的儿童为0.28-1.29 m/s）。在脓毒症状态下，这些值分别降低至0.27、0.26、0.35和0.40 m/s，或健康新生儿、5岁、10岁和成人CBFv的93、79、88和74%。我们为儿科患者设计的新型脑动脉血流计算机模拟模型，近似于四个年龄组，显示CBFv在脓毒症中降低，并且在较高年龄时降低的程度更大。未来的工作将尝试将独特的血液动力学状态，脓毒症，如早期脓毒症和脓毒性休克，以及脑自动调节的影响纳入模型。
Methods: We created a novel one-dimensional Navier-Stokes model of the primary branches of the Circle of Willis and scaled the model for patients from birth to 18 years of age using published data. Systemic vascular compliance (SVC) and systemic vascular resistance (SVR) were calculated using age-specific values for blood pressure, stroke volume, and heart rate described in the literature. We then simulated cerebral blood flow velocity (CBFv) in the middle cerebral artery in two states: the healthy state (in which the SVC and SVR correspond to a blood pressure at the fiftieth percentile for age) and the septic state (in which the SVC and SVR correspond to a blood pressure at the fifth percentile for age). The simulation was performed for four age groups: a neonate, a five-year-old, a ten-year-old, and an adult.Results: Peak aortic blood flow decreased between 13.9% and 39% in the septic state relative to the healthy state across the four age groups. CBFv through the middle cerebral artery for the neonate, the five-year-old, the ten-year-old, and the adult were estimated as 0.29, 0.33, 0.40, and 0.54 m/s, respectively, which approximate values reported in the literature (0.28-1.29 m/s for children ranging from birth to 18 years of age). In the septic state, these values decrease to 0.27, 0.26, 0.35, and 0.40 m/s, or 93, 79, 88, and 74% of the CBFv for the healthy neonate, five-year-old, ten-year-old, and adult, respectively.Conclusions: Our novel in silico model of cerebral artery blood flow for pediatric patients, approximated for four age groups, shows that CBFv decreases in sepsis and to a proportionally greater degree at higher ages. Future work will attempt to incorporate unique hemodynamic states in sepsis, such as early sepsis and septic shock, as well as the effects of cerebral autoregulation into the model.