Cardiovascular fetal-to-neonatal transition: an in silico model

Munneke, Anneloes G.; Lumens, Joost; Delhaas, Tammo

doi:10.1038/s41390-021-01401-0

Cited by 7 publications

(14 citation statements)

References 109 publications

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“…Except for ( 94 ) and ( 95 ), all other closed-loop models [e.g. ( 27 – 29 , 31 , 52 , 56 – 58 , 60 )] are 0D models and choices for lumping are based on the specific research question. These models give a good general description of the fetal circulation [e.g., ( 27 – 29 , 56 , 57 )] and, especially, the global hemodynamic effect of specific events, such as labor [e.g., ( 52 )] or the transition from fetus to neonate [e.g., ( 31 , 58 , 60 )].…”

Section: Discussionmentioning

confidence: 99%

“…( 27 – 29 , 31 , 52 , 56 – 58 , 60 )] are 0D models and choices for lumping are based on the specific research question. These models give a good general description of the fetal circulation [e.g., ( 27 – 29 , 56 , 57 )] and, especially, the global hemodynamic effect of specific events, such as labor [e.g., ( 52 )] or the transition from fetus to neonate [e.g., ( 31 , 58 , 60 )]. Although several models allow simulation of fetal hemodynamics of different GAs ( 31 , 59 , 74 ), none of these models simulate the transport of oxygen in combination with fetal growth.…”

Section: Discussionmentioning

confidence: 99%

“…While the above mentioned models use a time varying elastance model, CircAdapt contains a one fiber model to simulate the contraction of the heart. These models (30,31,(58)(59)(60) show that lumped parameter models can be used to simulate specific events (e.g., transition from fetus to neonate or fetal growth) and evaluate the new distribution of blood flow, pressure, volume, and oxygen saturation. However, when evaluating the model results, it should be taken into account that only spatial average effects can be modeled and that wave propagation and reflections are not taken into account, which could affect the pulsatility index of the flow in the arteries and, in particular, the umbilical arteries.…”

Section: Lumped Parameter Modelsmentioning

confidence: 99%

“…In the next decades, the hemodynamics of growth and transition from fetus to neonate were simulated for healthy fetuses ( 30 , 31 , 58 – 60 ). Pennati and Fumero ( 59 ) applied scaling laws to their model ( 29 ) in order to evaluate the effect of growth on the pulsatility index in several vessels, on the velocity across the valves, and through the shunts during pregnancy ( 59 ).…”

Section: Fetal Circulatory Modelsmentioning

confidence: 99%

“…The latter was achieved by scaling the model on GA ( 64 ). Similarly, Munneke et al ( 60 ) used CircAdapt ( 65 ) to mimic this transition. While the above mentioned models use a time varying elastance model, CircAdapt contains a one fiber model to simulate the contraction of the heart.…”

Section: Fetal Circulatory Modelsmentioning

confidence: 99%

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A review study of fetal circulatory models to develop a digital twin of a fetus in a perinatal life support system

et al. 2022

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BackgroundPreterm birth is the main cause of neonatal deaths with increasing mortality and morbidity rates with decreasing GA at time of birth. Currently, premature infants are treated in neonatal intensive care units to support further development. However, the organs of, especially, extremely premature infants (born before 28 weeks of GA) are not mature enough to function optimally outside the womb. This is seen as the main cause of the high morbidity and mortality rates in this group. A liquid-filled incubator, a so-called PLS system, could potentially improve these numbers for extremely premature infants, since this system is designed to mimic the environment of the natural womb. To support the development and implementation of such a complex system and to interpret vital signals of the fetus during a PLS system operation, a digital twin is proposed. This mathematical model is connected with a manikin representing the digital and physical twin of the real-life PLS system. Before developing a digital twin of a fetus in a PLS system, its functional and technical requirements are defined and existing mathematical models are evaluated.Method and resultsThis review summarizes existing 0D and 1D fetal circulatory models that potentially could be (partly) adopted for integration in a digital twin of a fetus in a PLS system based on predefined requirements. The 0D models typically describe hemodynamics and/or oxygen transport during specific events, such as the transition from fetus to neonate. Furthermore, these models can be used to find hemodynamic differences between healthy and pathological physiological states. Rather than giving a global description of an entire cardiovascular system, some studies focus on specific organs or vessels. In order to analyze pressure and flow wave profiles in the cardiovascular system, transmission line or 1D models are used. As for now, these models do not include oxygen transport.ConclusionThis study shows that none of the models identified in literature meet all the requirements relevant for a digital twin of a fetus in a PLS system. Nevertheless, it does show the potential to develop this digital twin by integrating (parts) of models into a single model.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Lumped Parameter Modelsmentioning

confidence: 99%

Section: Fetal Circulatory Modelsmentioning

confidence: 99%

Section: Fetal Circulatory Modelsmentioning

confidence: 99%

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A review study of fetal circulatory models to develop a digital twin of a fetus in a perinatal life support system

et al. 2022

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From fetus to neonate: A review of cardiovascular modeling in early life

May

Talou

Clark

et al. 2023

WIREs Mechanisms of Disease

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Computational modeling has well‐established utility in the study of cardiovascular hemodynamics, with applications in medical research and, increasingly, in clinical settings to improve the diagnosis and treatment of cardiovascular diseases. Most cardiovascular models developed to date have been of the adult circulatory system; however, the perinatal period is unique as cardiovascular physiology undergoes drastic changes from the fetal circulation, during the birth transition, and into neonatal life. There may also be further complications in this period: for example, preterm birth (defined as birth before 37 completed weeks of gestation) carries risks of short‐term cardiovascular instability and is associated with increased lifetime cardiovascular risk. Here, we review computational models of the cardiovascular system in early life, their applications to date and potential improvements and enhancements of these models. We propose a roadmap for developing an open‐source cardiovascular model that spans the fetal, perinatal, and postnatal periods. This article is categorized under: Cardiovascular Diseases > Computational Models Cardiovascular Diseases > Biomedical Engineering Congenital Diseases > Computational Models

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