Digital Computer Simulation of Cardiovascular System in Bleeding Patient for Clinical Management

  • Yasuhiro Fukui
  • Toru Masuzawa
  • Makoto Ozaki
  • N. Ty. Smith
Conference paper


A cardiovascular system model that simulates interactive responses to drugs has been developed on a small digital computer to realize virtual reality. The overall model basically consists of three models. The first is a momentum transport model that represents relations between blood pressure and flow in the cardiovascular system. In this model, the cardiovascular system is divided into Twelve components and modeled by using equivalent electrical circuits. The second is a mass transport model comprising twelve compartments corresponding to the respective components of the cardiovascular system. This model represents the distribution of the administered drug in the various cardiovascular components. The third is an interaction model that represents the relations between the momentum and mass transport models. This model causes variations in the resistance and capacitance parameters of the momentum transport model as a function of the current drug concentrations in the appropriate compartments of the mass transport model. The capacitances representing the ventricles are varied in a time- dependent fashion to simulate the beat of the heart. Simulation is performed by using the Euler method to solve a system of 24 ordinary differential equations governing the momentum and mass transport models on a 32-bit micro computer, a Macintosh IIfx.

The model was assessed by performing a demonstration of the cardiovascular response to the dopamine during hemorrhage. The effect of hemorrhage upon to the cardiovascular system is added to the models as hemorrhagic model. The hemorrhagic model affects the momentum transport model by reducing total blood volume and changing the peripheral resistance, compliance, heart contractility and rate. Hemorrhage model reduces total blood volume, cardiac output, mean arterial pressure, central venous pressure, coronary flow, cerebral flow, renal flow and other ogans’ flow by 28 %, 49%, 43%, 58%, 15%, 16%, 65% and 53% respectively and increases heart rate and systemic vascular resistance by 53 % and 14% of each value in normal cardiovascular condition.

The effect of dopamine upon the cardiovascular system is incorporated into the interaction model. Administration of dopamine as a constant infusion (10 μg/kg/min.) during hemorrhagic hypotension results in the increase of cardiac output, mean arterial pressure, central venous pressure, coronary flow, cerebral flow, renal flow, and other ogans’ flow by 11 %, 16%, 6%, 6%, 7%, 24% and 8% of each value in normal cardiovascular condition from hemorrhagic level respectively.

Simulated hemodynamics during hemorrhage and dopamine infusion was similar to real hemodynamics. We believe that it will become possible to estimate the hemodynamics of dopamine administered to the bleeding patient before actual administration of the drug by adding parameter estimation to match the model to a real patient. Also, The simulation is very useful to educate medical students for hemodynamics.


Equivalent Electrical Circuit Total Blood Volume Mass Transport Model Heart Contractility Cerebral Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Smith, N.T. Mathematical Model of Uptake and Distribution of Inhalation Anaesthetic Agents. In Anesthesia par Inhalation, ed P. Viars, Paris: Arnette Publishers, 1987; 87–118.Google Scholar
  2. 2.
    Fukui, Y A study of the human cardiovascular-respiratory system using hybrid computer modeling. Ph.D. thesis at University of Wisconsin 1972Google Scholar
  3. 3.
    Beneken JEW, Rideout VC. The use of multiple model in cardiovascular system studies: transport and perturbation methods. IEEE Trans Bio Med Eng 1968; 15(4): 281–289CrossRefGoogle Scholar
  4. 4.
    Fukui Y, Smith NT. Interactions among ventilation, the circulation, and the uptake distribution of halothane—Use of a hybrid computer multiple model: I. The basic model. Anesthesiology 1981; 54 (2): 107–118Google Scholar
  5. 5.
    Fukui Y, Smith NT. Interactions among ventilation, the circulation, and the uptake distribution of halothane—Use of a hybrid computer multiple model: II. Spontaneous versus controlled ventilation and the effects of C02. Anesthesiology 1981; 54 (2): 107–118Google Scholar
  6. 6.
    Simth NT, Zwart A, Beneken JEW.interaction between the circulatory effects and the uptake and distribution of halothane: use of a multiple model. Anesthesiology 1972;37(1): 47–58CrossRefGoogle Scholar
  7. 7.
    Zwart A, Smith NT, Beneken JEW. Multiple model approach to uptake and distribution of halothane: The use of an analog computer. Computers and Biomedical Research 1972; 5: 228–238PubMedCrossRefGoogle Scholar
  8. 8.
    Guyton AC, Coleman TG. Long-Term regulation of the circulation: interrelationship with body fluid volumes. In: Reeve EB, Guyton AC eds. Physical basis of circulatory transport: Saunders, 1967; 179–201Google Scholar
  9. 9.
    Milhom Jr HD. The application of control theory to physiological systems. Philadelphia: W B Saunders, 1966Google Scholar
  10. 10.
    Nagumo J (ed) Physiological systems (in Japanese: Seitai sisutemu). Nikkan Kogyo Shimbun, Ltd., 1971.Google Scholar
  11. 11.
    Sunagawa K. and Sugawa K Models of ventricular contraction based on time-varying elastance. CRC Crit Rev Biom Eng 1982; Feb. 1982: 193–228Google Scholar
  12. 12.
    Bhatt-Mehta V and Nahata MC. Dopamine and dobutamine in pediatric therapy. Pharmacotherapy, 1989; 9(5): 303–314PubMedGoogle Scholar
  13. 13.
    Greenway CV. Mechanisms and quantitative assessment of drug effects on cardiac output with a new model of the circulation. Pharmacological Reviews, 1982; 33 (4): 213–251Google Scholar
  14. 14.
    Yamada K, Hojima T and Marumo H. The parmacological studies on Dopamine (1) Effects on the blood pressure and various pharmacological preparations. OuyouYakuri, 1974; 8 (6): 835–846Google Scholar
  15. 15.
    Kubo K, Hojima T and Marumo H. The pharmacological studies on Dopamine (II) Effects of dopamine on the cardiovascular system in anesthetized dogs. OuyouYakuri, 1974; 8(6): 847–864Google Scholar
  16. 16.
    Hirano S, Fujitani S, Nakamura S, Tanimura C, Adachi H, Nakagawa M and Ijichi H. Hemodynamic effects of dopamine during hemorrhagic hypotension in anesthetized rats. Cardioangiology, 1979; 6 (4): 295–302Google Scholar
  17. 17.
    Runciman WB and Skowronski GA. Pathophysiology of hemorrhagic shock. Anaesth Intens Care, 1984; 12: 193–205Google Scholar
  18. 18.
    Kimoto S and Wada T (ed). New Encyclopedia of surgical science, 1990; 5: 59–70Google Scholar
  19. 19.
    Bassin R, Vladeck BC, Kark AE and Shoemaker WC. Rapid and Slow hemorrhage in man. Annals of Surgery, 1971; 173 (3): 325–330PubMedCrossRefGoogle Scholar
  20. 20.
    Dedichen H. Hemodynamic changes in experimental hemorrhagic shock. Acta Chir Scand, 1972; 138: 129–141PubMedGoogle Scholar
  21. 21.
    Berman J, O’Bener JD and Bellamy RE A computer model of hemorrhagic shock in domestic swine. Circulatory Shock, 1987; 21: 85–96PubMedGoogle Scholar
  22. 22.
    Pardy BJ and Dudley HA. Sequential patterns of hemodynamic and metabolic changes in experimental hypovolaemic shock. 1. Responses to acute hemorrhage. Br. J. Surg., 1979; 66: 84–88PubMedCrossRefGoogle Scholar
  23. 23.
    Desai JM, Kim SI and Shoemaker WC. Part I. Sequential hemodynamic changes in an experimental hemorrhagic shock, Preparation designed to simulate clinical shock. Annals of Surgery, 1969;170 (2):157–165PubMedCrossRefGoogle Scholar
  24. 24.
    Rothe CF and Drees JA. Vascular capacitance and fluid shifts in dogs during prolonged hemorrhagichypotension. Circulation Research, 1976; 38 (5): 347–356PubMedGoogle Scholar
  25. 25.
    Bellamy RF, Pedersen DC and DeGuzman LR. Organ blood flow and the cause of death following massive hemorrhage. Circulatory Shock, 1984; 14: 113–127PubMedGoogle Scholar
  26. Friedman JN, Cowan MJ Waldhausen JA and Feigl EO. Myocardial contractile force in hemorrhagic shock. Surgical Forum, 1969; 20: 32–34PubMedGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1992

Authors and Affiliations

  • Yasuhiro Fukui
    • 1
  • Toru Masuzawa
    • 2
  • Makoto Ozaki
    • 3
  • N. Ty. Smith
    • 4
  1. 1.Dept. of Applied Elect. Eng., Faculty of Sci. and EngTokyo Denki UnivHiki-gun, SaitamaJapan
  2. 2.Dept. of Artifical Organ, Research InstituteNational Cardiovascular CenterSuita, OsakaJapan
  3. 3.Dept. of AnesthesiologyTokyo Woman’s Medical CollegeShinjuku-ku, TokyoJapan
  4. 4.Dept. of AnesthesiaUniversity of California San Diego and U.S.V.A. Medical CenterUSA

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