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This book uses a validated cardiovascular simulator to illustrate cardiovascular physiology and pathophysiology, principles of hemodynamic monitoring, and the impact of therapy in patients with a wide spectrum of critical care diseases. The simulator considers the closed-loop nature of the cardiovascular system and is thus ideally suited for demonstrating the complex and dynamic nature of the cardiovascular system. The book uses the Harvi cardiovascular simulator (Harvi Dynamics, Inc) in which heart chambers are modeled according to the time-varying elastance principles of Suga and Sunagawa, and Guyton's model of the vasculature, which describes systemic and pulmonary vascular properties by a series of resistances and capacitances. The simulator generates ventricular pressure-volume loops from each of the four chambers, time-dependent tracings of pressure, flow and volumes, and the hemodynamic parameters derived from these signals. The principles of the time varying elastance model are reviewed and then applied to a spectrum of cardiovascular lesions, including acute and chronic systolic heart failure, sepsis phenotypes, pulmonary hypertension, valvular disease, and the impact of therapies such as vasoactive agents and acute and chronic mechanical circulatory support devices. Simulation in Cardiovascular Critical Care Medicine is a valuable resource for all levels of learners in the fields of Cardiology, Critical Care Medicine, and Cardiac Critical Care Medicine. |
