The following settings are automatically saved at app closure and retrieved at app re-activation:

The following therapies are available

Up to 6 therapies can be selected in total. 

The following scenarios are available

Therapy menu

The therapy menu contains different choices for medication to be applied to the model. Up to 6 therapies can be started simultaneously. Each therapy has its own effect on the cardiovascular system.

View menu

In the view menu options are provided to increase or decrease the total number of data points in the running graph of blood pressure (red) and middle cerebral artery flow (blue). 

The graph mode can be altered for comparison of flow in different branches of the arterial tree. In later versions a simultaneous display of flow velocity signals can be displayed over the different branches of the arterial tree from proximal to distal. Optionally, these can be superimposed (starting from version 1.11).

Extra bars can be displayed either animating the pressure within the various capacitances or the hydrostatic pressure which depends on the head up tilt selected.

For feedback on the model performance FPS can be displayed. FPS will deteriorate when multiple windows are opened. The model performs best at an FPS over 120.

Optionally, a color legend can be added to show the range of colors used for indicating the CO2 level within the model resistances and capacitances.

Window menu

The window menu allows to add extra windows allowing to study aspects of the model function.

The window test parameters displays parameter settings of the model. Either modifiable or unmodifiable parameters are displayed.

The window patient condition displays the clinical condition of a symbolic patient

From version 1.9 onward a window can be added with clinical interpretation based upon Z-scores. Not all combinations of Z-scores lead to a clinical diagnosis. Work on automatic interpretation is ongoing.

The patient monitor displays vital patient parameters on a symbolic ICU monitor. 

The analysis graphs allow to follow different model parameters as a function of time. There are three options: cerebral auto regulation, CO2 reactivity and ICP graphs. There are scenario's that can be used to follow the model behavior in response to changes in blood pressure, in CO2 level or in ICP.

The waveform NMA window allows to study the arterial blood pressure and middle cerebral artery wave form in more detail. There are three options: both signals versus time, middle cerebral artery flow versus blood pressure and middle cerebral artery flow versus blood pressure after normalization of the two signals. In version 1.11 the option was added to superimpose the raw flow velocity signals over a period of 10s. that underly calculation of the average flow used for NMA.

The time chart window displays the results of the NMA analysis over time. A NMA analysis is performed over 10 s intervals updated every 5 s. There are three options: cerebral blood flow, a combined plot of arterial blood pressure, middle cerebral artery flow and pCO2 and the pulsatile apparent resistance (PaR) and pulsatility index (PI).

Extra menu

The extra menu allows to change several menu settings:

selecting anesthesia will decrease the intra- as well as extra cranial metabolic rate with 50%.

selecting add noise to waveform will exactly do as it says, allowing to study the effect of averaging on the NMA analysis

selecting toggle S1 PaR will shift between the calculation of the pulsatile apparent resistance based upon the S1 measurement or upon the S2 measurement.

selecting sound will provide audible sounds to the model using either beeps like from an ICU monitor or auscultation sounds like from listening to heart activity.

selecting tilt anticipation will allow changes in the venous capacitance starting directly with the first change in head up tilt, as if the subject anticipates the effects of a change of posture. Without tilt anticipation the cardiovascular responses will lag to changes in body posture.

selecting variable acceleration with HR will cause the strength of the arterial acceleration to increase with a lower heart rate or with a longer RR'-interval.

selecting left<>right shunt provides four options between none, intermediate or full shunting between the left and right cerebral circulation. This  shunt is of interest when the carotid occlusion scenario is chosen.

selecting specials aims to change the settings of the cardiovascular reflexes so that the model becomes like a patient with orthostatic hypotension or like a patient with postural orthostatic tachycardia syndrome. 

selecting CardioVascularSimulationHelp has not been implemented so far

Tests menu

in the test menu the thermodilution method can be selected allowing to calculate an estimate for cardiac output by injecting a small amount of tracer in the right atrium. The surface below the concentration curve recorded more distally in the vascular system is calculated in order to make an estimate for cardiac output.

In version 1.11 the option was added to choose a block pulse cardiac output, instead of the more physiological sinusoidal output wave normally modeled. Selecting a block pulse gives a better impression of the model's viscoelastic properties and how it can be changed by selecting different values for the capacitance and resistance sliders in the lower mid portion of the front window.