Evaluation of the SIMULRESP: a simulation software of child and teenager
cardiorespiratory physiology
Abstract
BACKGROUND: Mathematical models based on the physiology when programmed
as a software can be used to teach cardiorespiratory physiology and to
forecast the effect of various ventilatory support strategies. We
developed a cardiorespiratory simulator for children called
“SimulResp”. The purpose of this study was to evaluate the quality of
SimulResp. METHODS: SimulResp quality was evaluated on accuracy,
robustness, repeatability and reproducibility. Blood gas values (pH,
PaCO 2, PaO 2 and SaO 2)
were simulated for several subjects with different characteristics and
in different situations and compared to expected values available as
reference. The correlation between reference and simulated data was
evaluated by the coefficient of determination and Intraclass correlation
coefficient. The agreement was evaluated with the Bland & Altman
analysis. RESULTS: SimulResp produced healthy child physiological values
within normal range (pH 7.40 +/- 0.5; PaCO2 40 +/- 5 mmHg, PaO2 90 +/-
10 mmHg; SaO2 97% +/- 3%) starting from a weight of 25 to 35 kg,
regardless of ventilator support. SimulResp failed to simulate accurate
values for subjects under 25 kg and/or affected with pulmonary disease
and mechanically ventilated. Based on the repeatability was considered
as excellent and the reproducibility as mild to good. SimulResp’s
prediction remains stable within time. CONCLUSIONS: The
cardiorespiratory simulator SimulResp requires further development
before future integration into a clinical decision support system.