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Biomedical subjects

A Cappello

Publications and source records attributed to A Cappello.

At least 55 records · Page 3Linked to original sources

Comparison of algorithms for tracking short-term changes in arterial circulation parameters.

Three recursive methods especially suited for identification of systems with rapidly changing parameters are applied to tracking of the viscoelastic properties of the systemic arterial bed. These methods include two least squares (LS) algorithms with constant or variable forgetting factor (RLS and LSVF) and a LS algorithm incorporating both a constant forgetting factor and covariance modification (CFCM). The methods are presented in a unified framework and their sensitivity with respect to the design variables is investigated using noisy data from computer simulations. All analysed methods have shown themselves to be able to satisfactory track rapid changes in peripheral resistance. The LSVF method, which offers slightly better performances than the classical RLS, may be preferred when calculation efficiency is the prime requirement. The CFCM algorithm, although maintaining reasonable simplicity, shows the best tracking ability also on varying of the noise sequence.

Algorithms↗

Real-time tracking of parameters of lung mechanics: emphasis on algorithm tuning.

We consider the problem of tracking rapid changes in the viscous and elastic properties of the respiratory system by using mouth flow and transpulmonary pressure data measured during mechanical ventilation. A recursive least-squares algorithm with adjustable compensator is used for online estimation of an R-C model of the breathing mechanics. Specific simulation experiments are presented to provide guidelines to select suitable values for the key variable, which controls the compromise between tracking ability and noise sensitivity. The results obtained confirm the critical role of the optimum tuning in relation to the noise level. Experimental results obtained from data measured on mechanically-ventilated dogs, in which respiratory distress syndrome was intravenously induced by oleic acid, demonstrate that the tuned algorithm is able to track appropriately both the viscous and elastic properties of lung mechanics. Parameter estimates are consistent with those obtained by standard and robust offline algorithms and their time course is in qualitative agreement with known physiopathological behaviour.

Airway Resistance↗

Sensitivity analysis of the systemic circulation with a view to computer simulation and parameter estimation.

A sensitivity analysis study has been performed on a seven-parameter model of the systemic vascular bed in order to obtain structure reductions appropriate for simulation and estimation. This analysis considers separately the systolic and diastolic transfer functions between arterial and venous pressures in order to divide a non-linear problem in two distinct linear problems. The results obtained refer to nominal parameter values corresponding to normal circulatory conditions in man and supply guide-lines for an application-oriented selection of reduced models. Simple resistance-compliance models are preferred because the inertial effects appear to have only slight influence. In particular, the choice of a five-parameter model seems to be convenient for simulation purposes. An additional structure reduction is suggested to reach reliable results in parameter estimation problems. The resulting model is characterized by three elements: peripheral resistance, arterial compliance and venous compliance.

Blood Circulation↗

Electrical analogs for monitoring vascular properties in artificial heart studies.

The problem of choosing parametric descriptions of the systemic vascular bed suitable for monitoring beat-to-beat changes in peripheral vascular properties is considered. Three simple models with two, three, and five elements are compared, essentially exploiting the Akaike information criterion combined with reasonable requirements for estimate accuracy. Analysis of pressure data, which are either simulated by the five-element model or measured on a mock circulatory system during abrupt changes in peripheral resistance, suggests guidelines for model selection. In particular, the five-element model exhibits very close adherence to physical reality by allowing for reflection, while the classical windkessel model provides the most reproducible estimates.

Cardiovascular Physiological Phenomena↗

Tracking time-varying properties of the systemic vascular bed.

The problem of tracking changes in viscoelastic properties of the systemic arterial bed is considered and a recursive estimation procedure, belonging to the class of output-error algorithms with adjustable compensator, is developed and discussed. By means of computer simulations, suitable values are determined for the key design variable which controls the tradeoff between tracking ability and noise sensitivity of the algorithm. In this way, the algorithm allows on-line estimation of arterial compliance, peripheral resistance, and characteristic impedance on the basis of aortic pressure and flow signals. Furthermore, the results obtained from data numerically simulated, as well as measured on a mock circulatory system, demonstrate that the dominant arterial time-constant can be tracked by the algorithm using only measurements of the aortic pressure during diastole.

Algorithms↗

CADCS simulation of the closed-loop cardiovascular system.

A pulsatile simulator of the closed-loop cardiovascular system, designed to solve simulation, identification and control problems in a research and education context, is presented. Its implementation makes use of a command-driven interactive program for simulation of non-linear ordinary differential equations. The flexibility of the simulator is demonstrated by the results presented which refer to a basal steady-state circulatory condition as well as a transient induced by an abrupt change in peripheral resistance.

Blood Pressure↗

Three-element model for total systemic circulation: emphasis on the accuracy of parameter estimates.

In this study, the accuracy achievable in the parameter estimates of a three-element linear model for the systemic vascular bed is considered. The model neglects inertial effects and includes only three elements representing arterial compliance, peripheral resistance and venous compliance, in agreement with recent sensitivity investigations. Parameter estimation starts from arterial and right atrial pressure signals generated by a closed-loop simulator of the cardiovascular circulation and corrupted with normal noise to account for measurement errors. In this way, the influences of a wide variety of circulatory conditions were investigated. The results achieved give evidence that arterial compliance is generally well estimated, while venous compliance is more variable, particularly at high peripheral resistance when measured signals appear to be less sensitive to this parameter. However, presence of cardiac disease, such as heart failure and valvular stenosis has minimal influence on compliance estimates. These results suggest that this simple model can be conveniently applied even under noisy conditions.

Blood Circulation↗

Model selection for ventricular mechanics: a sensitivity analysis approach.

Quantitative characterization of left ventricle pump properties has been recognized as being of great significance for both physiological and clinical purposes. Several descriptions have been proposed in the past to this end, where the ventricle is viewed as an isovolumic pressure generator coupled to an internal impedance, considered as either only viscous, only elastic or viscoelastic. Though these models have been used widely, the respective advantages and limits have not been fully elucidated. In this paper, six models for the left ventricular pumping function, of the viscoelastic type, are compared using both simulated and experimental data in a typical parameter estimation approach. Elastic and viscous parameters are estimated starting from ventricular pressure and aortic flow, together with the isovolumic pressure at the same preload. The basis for the comparison is the well-established criterion relating the fit obtained from collected data and the covariance matrix of the parameter estimates. The latter allows evaluation of the so-called indifference region in the parameter space, which is represented by an ellipse if both elastic and viscous elements are present. The properties of the indifference region are synthetically represented by two indices linked to the area and the eccentricity of the ellipse: the first represents the mean accuracy of the parameter estimate, the second gives information about the different sensitivities to variation of single parameters. This comparison, in both simulated and experimental cases, generally leads to preference for a model where elastance and viscosity vary with time in linear proportion to the isovolumically developed ventricular pressure. Appropriate description of the elastic effect reveals it to be very crucial while the viscous effect, though improving the fitting of data, is less critical.

Animals↗

Identification of the three-element windkessel model incorporating a pressure-dependent compliance.

A new one-step computational procedure is presented for estimating the parameters of the nonlinear three-element windkessel model of the arterial system incorporating a pressure-dependent compliance. The data required are pulsatile aortic pressure and flow. The basic assumptions are a steady-state periodic regime and a purely elastic compliant element. By stating two conditions, zero mean flow and zero mean power in the compliant element, peripheral and characteristic resistances are determined through simple closed form formulas as functions of mean values of the square of aortic pressure, the square of aortic flow, and the product of aortic pressure with aortic flow. The pressure across as well as the flow through the compliant element can be then obtained so allowing the calculation of volume variation and compliance as functions of pressure. The feasibility of this method is studied by applying it to both simulated and experimental data relative to different circulatory conditions and comparing the results with those obtained by an iterative parameter optimization algorithm and with the actual values when available. The conclusion is that the proposed method appears to be effective in identifying the three-element windkessel even in the case of nonlinear compliance.

Algorithms↗

A new approach for tracking respiratory mechanical parameters in real-time.

A new recursive least-squares procedure for on-line tracking of changes in viscoelastic properties of respiratory mechanics is proposed and applied to artificially ventilated patients. Classical least-squares methods based on simple first-order linear models with time-constant parameters generally provide systematic residuals that hardly satisfy standard statistical tests for model validation in terms of residuals. On the other hand, high order and/or nonlinear models introduce parameters whose estimates are of difficult interpretation in a clinical context. The present procedure overcomes these limitations by using the well-known first-order model of respiratory mechanics, wherein variability of resistance and elastance during the breathing cycle is allowed to take into account nonlinear and high-order behavior. Mean and standard deviation of resistance and elastance estimates, relative to a respiratory cycle, are then determined recursively. Feasibility of the method is evaluated by applying it both to experimental and simulated pressure-airflow signals measured in an intensive care unit during mechanical ventilation of patients recovering from heart surgery. Results demonstrate that the proposed procedure provides data description satisfying statistical tests, such as residual whiteness, and reliable estimates of viscoelastic lung parameters even during substantial and fast variations in the respiratory status. In addition, unlike classical methods, the new technique provides the means for on-line evaluation of parameter variability during each respiratory cycle, by the estimate of their standard deviations. This is important in clinical practice, because only the knowledge of reliable parameter values and standard deviations enables significant changes in the respiratory viscoelastic characteristics, and thus in patient status, to be assessed.

Airway Resistance↗

Analysis of titanium induced CT artifacts in the development of biomechanical finite element models.

X-ray computerized tomography (CT) is capable of providing detailed information about the geometry and mineral density of skeletal structures. Such accurate data are of great interest in studying the effects of orthopaedic implants on bone adaptive behaviour in vivo. Metallic implants, however, generate artifacts, typically seen as starburst streaking. These artifacts can degrade the capabilities of CT images to provide accurate information about the geometry and mineral density of bone structures. The aim of this work was to investigate the possibility of developing finite element models (FEM) of the human femur after hip joint arthroplasty using CT images acquired directly after surgery. The capability of modern CT scanners to accurately reconstruct the cross-section geometry of titanium alloy hip joint prosthetic stems was primarily investigated. A new measuring procedure dealing with the geometry of real stems was developed and its accuracy assessed. Secondly, the artifacts generated by a prosthetic stem on the radiological density of the bone were analysed, and their effects on the assessment of FEM material properties were evaluated. Results showed that CT images provide accurate information on metal stem geometry. An average error of 0.45 mm was estimated in the reconstruction of stem cross-section geometry. Concerning bone density estimation around the implant, it was observed that the effect of metal artifacts on tissue density becomes zero at a distance of 2 mm from the implant.

Alloys↗