Computer model of oxygenation in neonates

A demonstration of utility

Jakub Rafl 1 , 2 , Veronika Huttova 3 , 4 , Knut Möller 4 , Thomas E. Bachman 5 , Leos Tejkl 5 , Petr Kudrna 5 , Martin Rozanek 5 ,  and Karel Roubik 5
  • 1 Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, nam. Sitna,, Kladno, Czech Republic
  • 2 Institute of Technical Medicine, Furtwangen University, Jakob- Kienzle Strasse 17,, Villingen-Schwenningen, Germany
  • 3 Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague,, Kladno, Czech Republic
  • 4 Institute of Technical Medicine, Furtwangen University,, Villingen-Schwenningen, Germany
  • 5 Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague,, Kladno, Czech Republic

Abstract

Maintaining a prescribed peripheral oxygen saturation (SpO2) target during routine care of neonates is challenging and inspired fraction of oxygen (FiO2) titration practices differ among caregivers and centers. Algorithms for automatic feedback control of SpO2 are being developed and tested, that would adapt to the changing neonatal organism and better maintain the required SpO2 target range. While clinical data is necessary to validate differences in the titration strategies, a continuous physiological model of oxygenation in neonates would facilitate baseline testing of different approaches, manual or automated. The objective of our study was to enhance a mathematical model of oxygenation of the neonate and to compare the performance of the model with available clinical data. We have implemented the diffusion resistance into the model as well as a variable oxyhemoglobin dissociation relationship and the bias between arterial and peripheral oxygen saturation. Values of model parameters were scaled to fit preterm infant scenarios. The comparison of the clinical data and computer simulations suggest that the model can reliably simulate episodes of oxygen desaturation and describe the relation between ventilation, FiO2and SpO2. It appears that the model may be an effective tool to test manual and automatic FiO2titration strategies.

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Current Directions in Biomedical Engineering is an open access journal and closely related to the journal Biomedical Engineering - Biomedizinische Technik. CDBME is a forum for the exchange of knowledge in the fields of biomedical engineering, medical information technology and biotechnology/bioengineering for medicine and addresses engineers, natural scientists, and clinicians working in research, industry, or clinical practice.

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