Deep hypothermic circulatory arrest is necessary for some types of cardiac and aortic surgery. Perfusion of the brain can be maintained using a heart-lung machine and unilateral antegrade cerebral perfusion (ACP). Cooling rates during extracorporeal circulation depend on local perfusion. A core temperature of 24-25 degrees C is aimed at to extend ischemic tolerance of tissues. Information on cerebral perfusion and temperature is important for the safety of patients but hardly accessible to measurement. A combined simulation model of haemodynamics and temperature is presented in this paper. The haemodynamics model employs the transmission line approach and integrates the Circle of Willis. This allows for parametrization of individual aberrations. Simulation results of cerebral perfusion are shown for two configurations of the Circle of Willis. The temperature model provides spatial information on temperature fields. It considers heat transfer in the various tissues retrieving data of local tissue perfusion from the haemodynamics model. The combined model is evaluated by retrospective simulation of two aortic operations.
In open heart surgery the patient is connected to a heart-lung machine which pumps and oxygenizes the blood. The body core temperature is reduced by cooling the blood in a heat exchanger to reduce oxygen consumption of the tissues and so protect organs from hypoxia. Monitoring of vital parameters is crucial for safety of the patient. However, only little information is available from direct measurement. Models of haemodynamics and heat exchange in the human body are presented in this paper which provide the perfusionist with detailed data on blood flow and temperature in regions of the body which cannot be accessed by measurement devices. Simulation is performed on a real-time hardware platform which receives measured signals from the heart-lung machine via a serial interface.