Evaluation of the SIMULRESP: A simulation software of child and teenager cardiorespiratory physiology.

Background: Mathematical models based on the physiology when programmed as a software can be used to teach cardiorespiratory physiology and to forecast the effect of various ventilatory support strategies. We developed a cardiorespiratory simulator for children called "SimulResp." The purpose of this study was to evaluate the quality of SimulResp.

Methods: SimulResp quality was evaluated on accuracy, robustness, repeatability, and reproducibility. Blood gas values (pH, PaCO , PaO  and SaO ) were simulated for several subjects with different characteristics and in different situations and compared to expected values available as reference. The correlation between reference and simulated data was evaluated by the coefficient of determination and Intraclass correlation coefficient. The agreement was evaluated with the Bland & Altman analysis.

Results: SimulResp produced healthy child physiological values within normal range (pH 7.40 ± 0.5; PaCO 40 ± 5 mmHg; PaO 90 ± 10 mmHg; SaO 97 ± 3%) starting from a weight of 25-35 kg, regardless of ventilator support. SimulResp failed to simulate accurate values for subjects under 25 kg and/or affected with pulmonary disease and mechanically ventilated. Based on the repeatability was considered as excellent and the reproducibility as mild to good. SimulResp's prediction remains stable within time.

Conclusions: The cardiorespiratory simulator SimulResp requires further development before future integration into a clinical decision support system.