Background and Objective

The intra-aortic balloon pump (IABP) is the most widely available device for short-term mechanical circulatory support, often used to wean off cardiopulmonary bypass or combined with extra-corporeal membrane oxygenation support or as a bridge to a left ventricular assist device. Although based on a relatively simple principle, its complex interaction with the cardiovascular system remains challenging and open to debate. The aim of this work was focused on the development of a new numerical model of IABP.

Methods

The new model was implemented in CARDIOSIM©, which is a modular software simulator of the cardiovascular system used in research and e-learning environment. The IABP is inserted into the systemic bed divided in aortic, thoracic and two abdominal tracts modelled with resistances, inertances and compliances. The effect induced by the balloon is reproduced in each tract of the aorta by the presence of compliances connected to P_IABP generator and resistances. P_IABP generator reproduces the balloon pressure with the option to change IABP timing. We have used literature data to validate the potential of this new numerical model.

Results

The results have shown that our simulations reproduced the typical effects induced during IABP assistance. We have also simulated the effects induced by the device on the hemodynamic variables when the IABP ratio was set to 1:1, 1:2, 1:4 and 1:8. The outcome of these simulations is in accordance with literature data measured in the clinical environment.

Conclusions

The new IABP module is easy to manage and can be used as a training tool in a clinical setting. Although based on literature data, the outcome of the simulations is encouraging. Additional work is ongoing with a view to further validate its features. The configuration of CARDIOSIM© presented in this work allows the simulation of the effects induced by mechanical ventilatory assistance. This facility may have significant importance in the management of patients affected by COVID-19 when they require mechanical circulatory support devices.

中文翻译：

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主动脉内球囊反搏计时：用于临床环境中编程和训练的新数值模型。

背景和目的

主动脉内球囊反搏 (IABP) 是最广泛使用的短期机械循环支持设备，通常用于脱离体外循环或与体外膜氧合支持相结合，或作为左心室辅助装置的桥梁。尽管基于相对简单的原理，但其与心血管系统的复杂相互作用仍然具有挑战性且有争议。这项工作的目的是开发一个新的 IABP 数值模型。

方法

新模型在 CARDIOSIM© 中实现，CARDIOSIM© 是用于研究和电子学习环境的心血管系统模块化软件模拟器。IABP 被插入系统床中，系统床分为主动脉、胸部和两个腹部管道，以阻力、惯性和顺应性为模型。通过与 P _IABP发生器和电阻连接的顺应性，在主动脉的每个管道中再现由球囊引起的效应。P _IABP发生器可重现球囊压力，并可选择更改 IABP 计时。我们使用文献数据来验证这种新数值模型的潜力。

结果

结果表明，我们的模拟再现了 IABP 援助期间引起的典型效应。我们还模拟了当 IABP 比率设置为 1:1、1:2、1:4 和 1:8 时设备对血流动力学变量的影响。这些模拟的结果与临床环境中测量的文献数据一致。

结论

新的 IABP 模块易于管理，可用作临床环境中的培训工具。尽管基于文献数据，模拟结果还是令人鼓舞的。其他工作正在进行中，以进一步验证其功能。这项工作中提出的 CARDIOSIM© 配置允许模拟机械通气辅助引起的效果。当受 COVID-19 影响的患者需要机械循环支持设备时，该设施可能具有重要意义。