Overview

This research line focuses on the computational modeling of fetal and neonatal physiology, with particular emphasis on the physiological processes occurring during birth and the transition from fetal to extrauterine life.

The work combines physiological modeling, hybrid systems, discrete-event representations, simulation-based education and clinical decision-support concepts to improve the understanding of neonatal adaptation and cardiovascular-respiratory physiology.

The research has led to the development of dynamic simulation models, physiological digital twins, educational simulators and formal representations of neonatal clinical guidelines.

Scientific Context

Birth is one of the most complex physiological transitions in human life.

During the fetal-to-neonatal transition, major cardiovascular and respiratory changes occur simultaneously, including:

• Lung aeration.
• Pulmonary vascular recruitment.
• Closure of fetal shunts.
• Changes in systemic and pulmonary resistance.
• Adaptation of oxygen transport mechanisms.
• Umbilical cord clamping.
• Cardiovascular stabilization.

Understanding these processes is essential for neonatology, pediatric medicine, biomedical engineering and simulation-based medical education.

Despite their importance, many physiological mechanisms remain difficult to visualize, study and teach using conventional educational approaches.

Research Objectives

This research line pursues several complementary objectives:

• Develop computational models of fetal and neonatal physiology.
• Simulate cardiovascular and respiratory adaptation at birth.
• Study physiologically based umbilical cord clamping strategies.
• Investigate neonatal adaptation under healthy and pathological conditions.
• Create educational simulators for medical and engineering students.
• Develop hybrid and discrete-event representations of neonatal clinical guidelines.
• Support interdisciplinary collaboration between clinicians and engineers.

Main Research Axes

Axis 1 – Cardiovascular and Respiratory Physiological Modeling

This axis focuses on dynamic physiological models capable of representing the interaction between:

• Cardiovascular circulation.
• Pulmonary circulation.
• Gas exchange.
• Oxygen transport.
• Tissue consumption.
• Hemodynamic regulation.

These models were implemented using OpenModelica and object-oriented physiological modeling techniques.

Axis 2 – Fetal-to-Neonatal Transition

This research investigates the physiological events that occur during birth.

The models represent:

• Fetal circulation.
• Pulmonary recruitment.
• Ductus arteriosus dynamics.
• Foramen ovale adaptation.
• Umbilical circulation.
• Transition to independent respiration.

Special attention is given to the timing and physiological consequences of umbilical cord clamping.

Axis 3 – Physiologically Based Umbilical Cord Clamping

This axis investigates the influence of umbilical cord clamping on neonatal adaptation.

The objective is to move from time-based recommendations toward physiologically based strategies driven by measurable neonatal indicators.

Topics include:

• Delayed cord clamping.
• Physiologically based cord clamping.
• Placental transfusion.
• Cardiovascular stabilization.
• Oxygenation dynamics.

Axis 4 – Congenital Heart Disease Simulation

The physiological framework has been extended to simulate several congenital heart diseases, including:

• Aortic stenosis.
• Tetralogy of Fallot.
• Patent ductus arteriosus.
• Coarctation of the aorta.
• Transposition of the great arteries.

These simulations support education, research and physiological understanding of neonatal cardiovascular disorders. :contentReference[oaicite:1]{index=1}

Axis 5 – Hybrid and Discrete-Event Clinical Modeling

Beyond continuous physiological simulation, this research also explores formal representations of neonatal clinical protocols using:

• Statecharts.
• Hybrid systems.
• Discrete-event models.
• Clinical decision workflows.

These approaches facilitate the representation of neonatal adaptation guidelines and improve communication between engineers and clinicians.

Main Contributions

This research line has contributed to:

• Open-source physiological simulation.
• Neonatal cardiovascular-respiratory modeling.
• Fetal circulation modeling.
• Umbilical cord clamping research.
• Simulation-based medical education.
• Hybrid physiological systems.
• Statechart-based clinical representations.
• Biomedical digital twins.

Software and Research Outputs

Several research outputs have emerged from this work:

• PatientEvoPhysio.
• OpenModelica neonatal simulator.
• Statechart models of neonatal adaptation.
• Physiologically based cord clamping models.
• Educational physiological simulators.
• Biomedical modeling libraries.

Educational Impact

The developed models have been used in interdisciplinary teaching activities involving engineering and medical students.

The simulation environments facilitate the visualization of physiological phenomena that are otherwise difficult to observe directly and support simulation-based learning approaches. :contentReference[oaicite:2]{index=2}

Long-Term Vision

The long-term objective is the development of patient-centered physiological digital twins capable of supporting:

• Medical education.
• Clinical training.
• Physiological research.
• Decision support.
• Personalized neonatal care.

Future developments will integrate physiological simulation, artificial intelligence, hybrid systems and explainable clinical decision-support mechanisms.

Keywords

Neonatal Physiology · Fetal Physiology · Fetal-to-Neonatal Transition · Umbilical Cord Clamping · Cardiovascular Modeling · Respiratory Modeling · Hybrid Systems · Statecharts · Biomedical Simulation · Digital Twins · OpenModelica · Medical Education

Project Status

Ongoing research line