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PEDIATRIC ANESTHESIA

A Model for Educational Simulation of Infant Cardiovascular Physiology

Jane A. Goodwin, MD^*,, Willem L. van Meurs, PhD^*,,, Carla D. Sá Couto, MSc, Jan E. W. Beneken, PhD^*, and Shirley A. Graves, MD^*

*Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida; Nemours Children’s Clinic-Jacksonville, Jacksonville, Florida, and Mayo Medical School, Rochester, Minnesota; Medical Education Technologies, Inc., Sarasota, Florida; and Instituto de Engenharia Biomédica, Laboratório de Sinal e Imagem Biomédica, Porto, Portugal

Address correspondence to Jane A. Goodwin, MD, Nemours Children’s Clinic-Jacksonville, 807 Children’s Way, Jacksonville, FL 32207. Address e-mail to jgoodwin{at}nemours.org Reprints will not be available from the authors.

Full-body patient simulators provide the technology and the environment necessary for excellent clinical education while eliminating risk to the patient. The extension of simulator-based training into management of basic and critical situations in complex patient populations is natural. We describe the derivation of an infant cardiovascular model through the redefinition of a complete set of parameters for an existing adult model. Specifically, we document a stepwise parameter estimation process, explicit simplifying assumptions, and sources for these parameters. The simulated vital signs are within the target hemodynamic variables, and the simulated systemic arterial pressure wave form and left ventricular pressure volume loop are realistic. The system reacts appropriately to blood loss, and incorporation of aortic stenosis is straightforward. This infant cardiovascular model can form the basis for screen-based educational simulations. The model is also an essential step in attaining a full-body, model-driven infant simulator.

IMPLICATIONS: We describe the adaptation of a cardiovascular model that reflects infant cardiovascular physiology and reacts appropriately to a set of interventions. This model can form the basis for a screen-based educational simulator. The ultimate goal is the simulation of a 6-mo-old infant in full-scale.

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