The use of a virtual patient to follow pleural pressure changes associated with therapeutic thoracentesis. 2017

Tomasz Gólczewski, and Anna M Stecka, and Marcin Michnikowski, and Elżbieta M Grabczak, and Piotr Korczyński, and Rafał Krenke
 Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw - Poland.

OBJECTIVE Influence of therapeutic thoracentesis on the pleural pressure (Pp) has been discussed in many clinical studies, however reasons of Pp changes are not precisely established. The aim of the study was to use a previously elaborated virtual cardiopulmonary patient (VP) in analysis of impact of physiological factors on Pp during the procedure. METHODS Simulations were performed on VP with default values of parameters for which VP simulated the respiratory system of the average 50-year-old healthy Polish woman according to spirometric examination. Alterations of Pp and the amplitude of Pp changes related to breathing (AP) were analyzed. Model parameters related to chosen factors were deviated from their default values to analyze the degree of their impact on Pp and AP. The analysis was based on and supported by our own clinical data. RESULTS The Pp and AP alteration intensity appeared to be most sensitive to the compliances of the rib cage and mediastinum, and the nonlinearity of the dependence between the recoil pressure and the lung volume: the lower the compliances and the higher the nonlinearity were, the deeper the Pp fall during the procedure and the bigger the AP increase were observed. CONCLUSIONS Experiments in silico are very useful in analyzing sophisticated physiological and medical problems. They made it possible to show which factors are particularly responsible for changes in Pp during thoracentesis. In the future, they may be useful in establishing objective conditions under which thoracentesis needs to be stopped.

UI MeSH Term Description Entries
D008297 Male Males
D010996 Pleural Effusion Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself. Effusion, Pleural,Effusions, Pleural,Pleural Effusions
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D012143 Respiratory Physiological Phenomena Physiological processes and properties of the RESPIRATORY SYSTEM as a whole or of any of its parts. Respiratory Physiologic Processes,Respiratory Physiological Processes,Respiratory Physiology,Physiology, Respiratory,Pulmonary Physiological Phenomena,Pulmonary Physiological Phenomenon,Pulmonary Physiological Process,Pulmonary Physiological Processes,Respiratory Physiological Concepts,Respiratory Physiological Phenomenon,Respiratory Physiological Process,Concept, Respiratory Physiological,Concepts, Respiratory Physiological,Phenomena, Pulmonary Physiological,Phenomena, Respiratory Physiological,Phenomenas, Pulmonary Physiological,Phenomenas, Respiratory Physiological,Phenomenon, Pulmonary Physiological,Phenomenon, Respiratory Physiological,Phenomenons, Pulmonary Physiological,Phenomenons, Respiratory Physiological,Physiologic Processes, Respiratory,Physiological Concept, Respiratory,Physiological Concepts, Respiratory,Physiological Phenomena, Pulmonary,Physiological Phenomena, Respiratory,Physiological Phenomenas, Pulmonary,Physiological Phenomenas, Respiratory,Physiological Phenomenon, Pulmonary,Physiological Phenomenon, Respiratory,Physiological Phenomenons, Pulmonary,Physiological Phenomenons, Respiratory,Physiological Process, Pulmonary,Physiological Process, Respiratory,Physiological Processes, Pulmonary,Physiological Processes, Respiratory,Process, Pulmonary Physiological,Process, Respiratory Physiological,Processes, Pulmonary Physiological,Pulmonary Physiological Phenomenas,Pulmonary Physiological Phenomenons,Respiratory Physiological Concept,Respiratory Physiological Phenomenas,Respiratory Physiological Phenomenons
D003198 Computer Simulation Computer-based representation of physical systems and phenomena such as chemical processes. Computational Modeling,Computational Modelling,Computer Models,In silico Modeling,In silico Models,In silico Simulation,Models, Computer,Computerized Models,Computer Model,Computer Simulations,Computerized Model,In silico Model,Model, Computer,Model, Computerized,Model, In silico,Modeling, Computational,Modeling, In silico,Modelling, Computational,Simulation, Computer,Simulation, In silico,Simulations, Computer
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069258 Thoracentesis Aspiration of fluid or air from the THORACIC CAVITY. It is coupled sometimes with the administration of drugs into the PLEURAL CAVITY. Chest Aspiration,Pleural Aspiration,Pleurocentesis,Thoracocentesis,Aspiration, Chest,Aspiration, Pleural,Aspirations, Chest,Aspirations, Pleural,Chest Aspirations,Pleural Aspirations,Pleurocenteses,Thoracenteses,Thoracocenteses
D014584 User-Computer Interface The portion of an interactive computer program that issues messages to and receives commands from a user. Interface, User Computer,Virtual Systems,User Computer Interface,Interface, User-Computer,Interfaces, User Computer,Interfaces, User-Computer,System, Virtual,Systems, Virtual,User Computer Interfaces,User-Computer Interfaces,Virtual System
D035422 Pleural Cavity Paired but separate cavity within the THORACIC CAVITY. It consists of the space between the parietal and visceral PLEURA and normally contains a capillary layer of serous fluid that lubricates the pleural surfaces. Cavities, Pleural,Cavity, Pleural,Pleural Cavities

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