Design of an interface for teaching cardiovascular physiology to anesthesia clinicians with a patient simulator connected to a minimally invasive cardiac output monitor (LiDCO rapid®)

Daniela Chaló; Joana Marques; Henrique Mendes; Consuelo Sancho

doi:10.1186/s41077-020-00134-0

Design of an interface for teaching cardiovascular physiology to anesthesia clinicians with a patient simulator connected to a minimally invasive cardiac output monitor (LiDCO rapid®)

Adv Simul (Lond). 2020 Jul 31:5:16. doi: 10.1186/s41077-020-00134-0. eCollection 2020.

Authors

Daniela Chaló^{1

2

3}, Joana Marques^{3

4}, Henrique Mendes⁵, Consuelo Sancho¹

Affiliations

¹ Department of Physiology and Pharmacology, Faculty of Medicine, University of Salamanca, Salamanca, Spain.
² Department of Anesthesiology, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
³ SIMULA-Health Sciences School, University of Aveiro, Aveiro, Portugal.
⁴ Department of Anesthesiology, Hospital de Braga, Braga, Portugal.
⁵ SEEMSREAL, Leiria, Portugal.

Abstract

Cardiovascular physiology can be simulated in patient simulators but is limited to the simulator monitor curves and parameters, missing some important data that today is known as essential to fluid management and therapeutic decision in critical ill and high-risk surgical patients. Our main objective was to project and implement a unidirectional communication channel between a pre-existing patient simulator and a minimally invasive cardiac output monitor (LiDCO rapid®); a monitor that connects to real patients and interprets the arterial wave. To connect the patient simulator to the hemodynamic monitor, firstly, we had to assess both systems and design a communication channel between them. LiDCO monitor accepts as an input an analog voltage varying between 0 V and 5 V and that every volt is directly proportional to a blood pressure (mmHg) value ranging from 0 mmHg (0 V) to 500 mmHg (5 V). A Raspberry Pi 0 (Rpi0) with a WIFI chip integrated was needed and added to a digital analogue converter connected to the board. We designed a system that allowed us to collect, interpret and modify data, and feed it to the LiDCO rapid® monitor. We had developed a Python® script with three independent threads and a circular buffer to handle the data transmission between both systems. The LiDCO hemodynamic monitor successfully received data sent from our setup like a real patient arterial wave pulse and interpreted it to estimate several hemodynamic parameters, as cardiac output, stroke volume, systemic vascular resistance, pulse pressure variation, and stroke volume variation. The connection between the patient simulator and the LiDCO monitor is being used to create arterial curves and other hemodynamic parameters for clinical scenarios where residents and anesthesiologists can simulate a variety of unstable hemodynamic conditions, preparing them to face similar situations with real patients in a safe environment and with their own monitors.

Keywords: Clinical simulation, Cardiovascular physiology, Medical education, Healthcare innovation.