Hemodynamic Management Modeling can only be performed while
observing the patient in the Hemodynamic Management Page.
Following is an example of hemodynamic management modeling of a hypertensive patient described in the Monitoring Page (All Noninvasive data) and Hemodynamic Management Page.
In this example, the patient's Hemodynamic Management Page is displayed below:
Hemodynamic Management Page of a hypertensive patient:
Heading HEMODYNAMIC STATE: This patient's blood pressure at the time of the measurement was 192/101, resulting in MAP = 131 Torr = mmHg (a 53% hypertension). The patient has both systolic and diastolic hypertension. SI = 24 ml/m2 (98% hypodynamic state). As you can see under the heading HEMODYNAMIC MODULATORS, the causes of this patients hypertension were (a) 25% hypervolemia, (b) 51% hypoinotropy (ISI = 0.63 1/sec2), and (c) 209% vasoconstriction. The Perfusion blood flow was identified as 58% hypochronotropy.
By pressing the "E" key (while in the Hemodynamic Management Page), the pane with analog traces is replaced by the hemodynamic management modeling pane, where the operator can adjust the level of three hemodynamic modulators (volume, inotropy and vasoactivity) and one perfusion blood flow modulator (chronotropy) using the mouse to move the corresponding sliders as to correct the listed deviations in the modulators. The yellow dot represents the original hemodynamic state of the patient, the red dot represents the predicted hemodynamic state after application of therapies correcting the above-listed deviations in hemodynamic modulators. The predicted hemodynamic state is the vectorial sum of individual therapies:
This modeling example shows the fallacy of current treatment of hemodynamic disorders
by trial-and-error or by a dogmatic application of step therapy or other therapies
designed to treat the cause (i.e., the hypertension) and not striving to identify
the causes and to correct them therapeutically.
A general rule for selection of dosage of a cardioactive and/or vasoactive drug is:
For displayed deviations 20-40% use a low dosage of available drug, for deviations 40-60%, use a medium dosage of available drug, and for deviations >60% use a high dose of available drug.