Academic Journal

In-silico credibility assessment of a computational physiological model for non-invasive monitoring of respiratory effort in critically ill patients.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: In-silico credibility assessment of a computational physiological model for non-invasive monitoring of respiratory effort in critically ill patients.
Συγγραφείς: Warnaar RSP; Cardiovascular and Respiratory Physiology, Technical Medical Center, University of Twente, Enschede, The Netherlands., Geraats S; Biomedical Engineering & Technical Medicine, University of Twente, Enschede, The Netherlands., Cornet AD; Department of Intensive Care, Medisch Spectrum Twente, Enschede, The Netherlands., Aarts RGKM; Control and Mechatronics, University of Twente, Enschede, The Netherlands., Graßhoff J; Fraunhofer Research Institution for Individualized Medical Technology and Engineering IMTE, Lübeck, Germany., Donker DW; Cardiovascular and Respiratory Physiology, Technical Medical Center, University of Twente, Enschede, The Netherlands.; Department of Intensive Care, University Medical Centre Utrecht, Utrecht, The Netherlands., Oppersma E; Cardiovascular and Respiratory Physiology, Technical Medical Center, University of Twente, Enschede, The Netherlands.
Πηγή: Physiological measurement [Physiol Meas] 2026 Sep 25; Vol. 47 (9). Date of Electronic Publication: 2026 Sep 25.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: IOP Pub. Ltd Country of Publication: England NLM ID: 9306921 Publication Model: Electronic Cited Medium: Internet ISSN: 1361-6579 (Electronic) Linking ISSN: 09673334 NLM ISO Abbreviation: Physiol Meas Subsets: MEDLINE
Imprint Name(s): Original Publication: Bristol, UK : IOP Pub. Ltd., c1993-
Ιατρικοί όροι (MeSH): Critical Illness* , Models, Biological* , Computer Simulation*, Monitoring, Physiologic/methods ; Respiratory Muscles/physiopathology ; Humans ; Electromyography ; Respiration, Artificial ; Reproducibility of Results
Περίληψη: Objective.Monitoring respiratory effort in critically ill patients during assisted mechanical ventilation is essential to individualize ventilatory support and prevent over- or underassistance. A non-invasive method to estimate respiratory muscle pressure () combines respiratory surface electromyography (sEMG) with ventilator pressure-flow waveforms through the integrated equation of motion (iEqM). Implemented within a computational physiological model (CPM), the iEqM links muscle activation to generated pressure. This study investigates the reliability of an iEqM-based CPM under critical care conditions.Approach.CPM performance to estimate respiratory muscle pressure-time product () was evaluated in-silico using simulated patient profiles. Credibility activities included numerical verification, Monte-Carlo-based uncertainty quantification, and sensitivity analysis, exploring variations in respiratory mechanics, effort variability, sEMG signal quality, and patient-ventilator timing. Model outputs were compared with simulated reference values, with an acceptable clinical error margin set at 20%.Main results.Verification confirmed correct model implementation (errors < 0.3%). Input data uncertainty quantification showed limited variability (SD 1.8%). Sensitivity analysis revealed reduced accuracy under lowvariability (< 5.0 cmH2O), low sEMG signal-to-noise ratios (< 1.4), highmagnitudes (17.5 cmH2O), and persistent inspiratory efforts during expiration. Calibration using end-expiratory occlusion maneuvers improved accuracy, except at the lowestmagnitude ands.Significance.The iEqM performs reliably when calibrated via end-expiratory occlusion maneuvers. Without calibration, accuracy declined with lower effort variability, poorer sEMG quality, or patient-ventilator asynchrony. These findings emphasize the need for context-aware application, accounting for patient-specific mechanics, signal integrity and ventilator interaction, to ensure credible and reliable monitoring of respiratory effort in critically ill patients.
(Creative Commons Attribution license.)
Contributed Indexing: Keywords: computational physiological model; mechanical ventilation; neuro-mechanical coupling; respiratory effort; respiratory failure; respiratory surface electromyography
Entry Date(s): Date Created: 20260911 Date Completed: 20260925 Latest Revision: 20260925
Update Code: 20260925
DOI: 10.1088/1361-6579/aea685
PMID: 42727606
Βάση Δεδομένων: MEDLINE