A Mathematical Model for Simulation of Vasoplegic Shock and Vasopressor Therapy

Area of Science:

• Physiology
• Pharmacology
• Mathematical Modeling

Background:

• Vasoplegic shock and hypotension necessitate vasopressor therapy.
• Accurate simulation of cardiovascular (CV) responses is crucial for patient management.
• Existing models may not fully capture complex CV dynamics during vasopressor treatment.

Purpose of the Study:

• To develop a high-fidelity mathematical model of CV responses.
• To replicate patient responses to vasoplegic shock and vasopressor therapy.
• To incorporate baroreflex modulation and direct drug effects.

Main Methods:

• Developed a lumped-parameter CV physiology model with baroreflex feedback.
• Integrated a dynamic dose-response model for vasopressors.
• Validated the model using experimental data from pigs receiving phenylephrine after induced vasoplegic shock.

Main Results:

• The calibrated model accurately replicated dynamic changes in blood pressure, cardiac output, and systemic vascular resistance.
• Achieved high correlation coefficients (r values) for key CV variables.
• Predicted physiologically plausible behaviors of unmeasured CV variables and baroreflex effects.

Conclusions:

• This model is the first to comprehensively replicate primary and secondary vasopressor effects on CV variables.
• It is suitable for pre-clinical virtual evaluation of autonomous vasopressor control algorithms.
• The model architecture may serve as a platform for in silico simulation of CV responses in vasoplegic shock.