An Open Reliability Atlas of Sensitivity and Failure Modes in the Pulse Physiology Engine
Pulse is an actively maintained open-source adult-physiology simulator, yet its maintainers report no formal sensitivity analysis of its operational inputs. We present the first open reliability atlas across its critical-care envelope: Morris elementary-effects sampling of seven inputs, four severity scenarios, male and female bodies (1,280 simulations). Sensitivity is skewed: three inputs carry a median 93% of each output's total. A four-flag classifier reveals failure modes: two operator-actionable, one sex-stratified. Tidal-volume oscillation (20.6% of runs) is consistent with patient-ventilator dyssynchrony; locking the VC-AC trigger to -2 cmH2O collapses that variability. At FiO2 = 1.0, transient hyperoxia makes 120-second runs underestimate plateau PaO2; 300-second healthy-lung reruns give a median 643 mmHg. Solver divergence was all-male in an input-extreme regime (20/1,280); reducing the male blood-volume baseline to the 4,082 mL floor eliminated it. Runs and flags are released openly, showing users which regions need checking before training on Pulse output.