Abstract
In this study we propose, and implement in the time domain, an anatomically consistent model of the respiratory system in critical care conditions that allows us to evaluate the impact of different ventilator strategies as well as of constrictive pathologies on the time course of acinar pressures and flows. We discuss the simplifications of the original Horsfield structure (Horsfield, K., [et_al.] Models of the human bronchial tree. J. Appl. Physiol. 31:207–217, 1971), which were needed to enable the model implementation. The model has a binary tree structure including large airways represented as a combination of wall compliance and laminar resistance, small airways that have the same arrangement but can be heterogeneously constricted, and alveolar compartments that are viscoelastic second-order models to represent the stress adaptation behavior of lung tissue. We have described patient–ventilator interactions modeling the ventilator and the endotracheal tube. In conclusion this model makes it possible to investigate realistically the effect of homogeneous versus heterogeneous constrictive pathologies and the impact of different ventilatory patterns on pressure and flow distribution at the acinar level in the mechanically ventilated patient. © 2002 Biomedical Engineering Society.
PAC2002: 8719Uv, 8719Rr, 8710+e
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REFERENCES
Bates, J. H. T., P. Baconnier, and J. Milic-Emili. A theoretical analysis of interrupter technique for measuring respiratory mechanics. J. Appl. Physiol. 64:2204–2214, 1988.
Benade, A. H. On the propagation of sound waves in a cylindrical conduit. J. Acoust. Soc. Am. 26:726–731, 1968.
D'Angelo, E., F. M. Robatto, E. Calderini, M. Tavola, D. Bono, G. Torri, and J. Milic-Emili. Pulmonary and chest wall mechanics in anesthetized paralyzed humans. J. Appl. Physiol. 70:2602–2610, 1991.
D'Angelo, E., E. Rocca, and J. Milic-Emili. A model analysis of the effects of different inspiratory flow patterns on inspiratory work during mechanical ventilation. Eur. Respir. Monograph: Resp. Mech. 12:279–295, 1999.
Fredberg, J. J., and A. Hoenig. Mechanical response of the lungs at high frequencies. J. Biomech. Eng. 100:57–66, 1978.
Ghazanshahi, S. D., and C. K. Khoo. Optimal application of high-frequency ventilation in infants: A theoretical study. IEEE Trans. Biomed. Eng. 40:788–795, 1993.
Gillis, H. L., and K. R. Lutchen. Impact of heterogeneous bronchoconstriction on convective ventilation distributions among acini in humans. Ann. Biomed. Eng. 27:14–22, 1999.
Gillis, H. L., and K. R. Lutchen. Airway remodeling in asthma amplifies heterogeneities in smooth muscle shortening causing hyper-responsiveness. J. Appl. Physiol. 86:2001–2012, 1999.
Habib, R. H., R. B. Chalker, B. Suki, and A. C. Jackson. Airway geometry and wall mechanical properties estimated from subglottal input impedance in humans. J. Appl. Physiol. 77:441–451, 1994.
Hantos, Z., B. Daroczy, B. Suki, S. Nagy, and J. J. Fredberg. Input impedance and peripheral inhomogeneity of dog lungs. J. Appl. Physiol. 72:168–178, 1992.
Hickling, K. G. The pressure-volume curve is greatly modified by recruitment. A mathematical model of ARDS lung. Am. J. Respir. Crit. Care Med. 158:194–202, 1998.
Horsfield, K., G. Dart, D. E. Olson, G. F. Filley, and G. Cumming. Models of the human bronchial tree. J. Appl. Physiol. 31:207–217, 1971.
Horsfield, K., W. Kemp, and S. Phillips. An asymmetrical model of the airway of the dog lung. J. Appl. Physiol.-Resp. Environ. Exercise Physiol. 52:21–26, 1982.
Lutchen, K. R., and K. D. Costa. Physiological interpretations based on lumped element models fit to respiratory impedance data: Use of forward-inverse modeling. IEEE Trans. Biomed. Eng. 37:1076–1085, 1990.
Lutchen, K. R., K. Yang, D. W. Kaczka, and B. Suki. Optimal ventilation waveform for estimating low-frequency respiratory impedance. J. Appl. Physiol. 75:478–488, 1993.
Lutchen, K. R., D. W. Kaczka, B. Suki, G. M. Barnas, P. Barbini, and G. Cevenini. Low-frequency respiratory mechanics using ventilator-driven oscillations. J. Appl. Physiol. 75:2549–2560, 1993.
Lutchen, K. R., J. L. Greenstein, and B. Suki. How inhomogeneities and airway wall affect frequency dependence and separation of airway and tissue properties. J. Appl. Physiol. 80:1696–1707, 1996.
Lutchen, K. R., and H. Gillis. Relationship between heterogeneous changes in airway morphometry and lung resistance and elastance. J. Appl. Physiol. 83:1192–1201, 1997.
Marini, J. J., and P. S. Crooke. A general mathematical model for respiratory dynamics relevant to the clinical setting. Am. Rev. Respir. Dis. 147:14–24, 1993.
Navajas, D., G. N. Maksym, and J. H. T. Bates. Dynamic viscoelastic nonlinearity of lung parenchymal tissue. J. Appl. Physiol. 79:348–356, 1995.
Peslin, R., and J. J. Fredberg. Oscillation mechanics of the respiratory system. In: Handbook of Physiology. Mechanics of Breathing, edited by P. T. Macklem and J. Mead. Bethesda: American Physiological Society, 1986, pp. 145–177.
Petak, F., M. J. Hayden, Z. Hantos, and P. D. Sly. Volume dependence of respiratory impedance in infants. Am. J. Respir. Crit. Care Med. 156:1172–1177, 1997.
Rossi, A., Polese, G., and J. Milic-Emili. Monitoring respiratory mechanics in ventilator-dependent patients. In: Principles and Practice of Intensive Care Monitoring, edited by M. J. Tobin. New York: McGraw-Hill, 1998, pp. 553–596.
Schuessler, T. F., S. B. Gottfried, and J. H. T. Bates. A model of the spontaneous breathing patient: Applications to intrinsic PEEP and work of breathing. J. Appl. Physiol. 82:1694–1703, 1997.
Sly, P. D., and J. H. T. Bates. Computer analysis of physical factors affecting the use of the interrupter technique in infants. Pediatr. Pulmonol. 4:219–224, 1988.
Suki, B. Nonlinear phenomena in respiratory mechanical measurements. J. Appl. Physiol. 74:2574–2584, 1993.
Suki, B., R. H. Habib, and A. C. Jackson. Wave propagation, input impedance, and wall mechanics of the calf trachea from 16 to 1600 Hz. J. Appl. Physiol. 75:2755–2766, 1993.
Thorpe, C. W., and J. H. T. Bates. Effect of stochastic heterogeneity on lung impedance during acute bronchoconstriction: A model analysis. J. Appl. Physiol. 82:1616–1625, 1997.
Vladimirescu, A. The Spice Book. New York: Wiley, 1994.
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Nucci, G., Tessarin, S. & Cobelli, C. A Morphometric Model of Lung Mechanics for Time-Domain Analysis of Alveolar Pressures during Mechanical Ventilation. Annals of Biomedical Engineering 30, 537–545 (2002). https://doi.org/10.1114/1.1475344
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DOI: https://doi.org/10.1114/1.1475344