Fluid Dynamics of Gas Exchange in High-Frequency Oscillatory Ventilation: In Vitro Investigations in Idealized and Anatomically Realistic Airway Bifurcation Models

The objective of this work is to develop understanding of the local fluid dynamic mechanisms that underpin gas exchange in high-frequency oscillatory ventilation (HFOV). The flow field during HFOV was investigated experimentally using particle image velocimetry in idealized and realistic models of a single bifurcation. Results show that inspiratory and expiratory fluid streams coexist in the airway at flow reversal, and mixing between them is enhanced by secondary flow and by vortices associated with shear layers. Unsteady flow separation and recirculation occurs in both geometries. The magnitude of secondary flow is greater in the realistic model than in the idealized model, and the structure of secondary flow is quite different. However, other flow structures are qualitatively similar.

[1]  M. Nishida,et al.  Gas dispersion in a model pulmonary bifurcation during oscillatory flow. , 1997, Journal of biomechanical engineering.

[2]  A. Mehta,et al.  Primary Pulmonary Sporotrichosis: A Case Report , 2004 .

[3]  G. Taylor Dispersion of soluble matter in solvent flowing slowly through a tube , 1953, Proceedings of the Royal Society of London. Series A. Mathematical and Physical Sciences.

[4]  A S Wexler,et al.  Detailed flow patterns in the nasal cavity. , 2000, Journal of applied physiology.

[5]  Sangeeta Mehta,et al.  High-frequency oscillatory ventilation for acute respiratory distress syndrome in adults: a randomized, controlled trial. , 2002, American journal of respiratory and critical care medicine.

[6]  Clement Kleinstreuer,et al.  Flow structures and particle deposition patterns in double-bifurcation airway models. Part 1. Air flow fields , 2001, Journal of Fluid Mechanics.

[7]  H. Chang,et al.  Mechanisms of gas transport during ventilation by high-frequency oscillation. , 1984, Journal of applied physiology: respiratory, environmental and exercise physiology.

[8]  R C Schroter,et al.  Flow patterns in models of the human bronchial airways. , 1969, Respiration physiology.

[9]  C. Carrington,et al.  Morphometry of the Human Lung , 1965, The Yale Journal of Biology and Medicine.

[10]  R D Kamm,et al.  Some features of oscillatory flow in a model bifurcation. , 1989, Journal of applied physiology.

[11]  J. Gerrard,et al.  The flow due to an oscillating piston in a cylindrical tube: a comparison between experiment and a simple entrance flow theory , 1971, Journal of Fluid Mechanics.

[12]  A. C. Bryan The oscillations of HFO. , 2001, American journal of respiratory and critical care medicine.

[13]  Geoffrey Ingram Taylor,et al.  The dispersion of matter in turbulent flow through a pipe , 1954, Proceedings of the Royal Society of London. Series A. Mathematical and Physical Sciences.

[14]  V. Craig,et al.  HIGH-FREQUENCY OSCILLATORY VENTILATION IN AN ADOLESCENT WITH AN ANTERIOR MEDIASTINAL MASS: 631 , 2004 .

[15]  J. Grotberg,et al.  Oscillatory flow and mass transport in a curved tube , 1988, Journal of Fluid Mechanics.

[16]  F. Durst,et al.  Applications of Laser Techniques to Fluid Mechanics , 1991 .

[17]  J. Womersley Method for the calculation of velocity, rate of flow and viscous drag in arteries when the pressure gradient is known , 1955, The Journal of physiology.

[18]  D. Schoenfeld,et al.  Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. , 2000, The New England journal of medicine.

[19]  R. Peattie,et al.  Experimental investigation of oscillatory flow through a symmetrically bifurcating tube. , 1998, Journal of biomechanical engineering.

[20]  W. K. Thompson,et al.  Treatment of RDS by high-frequency oscillatory ventilation: a preliminary report. , 1981, The Journal of pediatrics.

[21]  G. Rubenfeld Epidemiology of acute lung injury , 2003, Critical care medicine.

[22]  Michael Klaas,et al.  Time resolved analysis of steady and oscillating flow in the upper human airways , 2007 .

[23]  K. Oka,et al.  Oscillatory flow and gas transport through a symmetrical bifurcation. , 2001, Journal of biomechanical engineering.

[24]  E. Weibel Morphometry of the Human Lung , 1965, Springer Berlin Heidelberg.

[25]  Richard Banvard,et al.  The visible human project? image data set from inception to completion and beyond , 2002 .

[26]  Ananth V. Annapragada,et al.  Computational Fluid Dynamics Simulation of Airflow and Aerosol Deposition in Human Lungs , 2004, Annals of Biomedical Engineering.

[27]  D. Olson,et al.  Fluid mechanics relevant to respiration : flow within curved or elliptical tubes and bifurcating systems , 1971 .

[28]  J. Krishnan,et al.  High-frequency ventilation for acute lung injury and ARDS. , 2000, Chest.

[29]  Baruch B. Lieber,et al.  Oscillatory Flow in a Symmetric Bifurcation Airway Model , 1998, Annals of Biomedical Engineering.

[30]  H. K. Chang Mechanisms of gas transport during ventilation by high-frequency oscillation. , 1984 .

[31]  M. Berner,et al.  First intention high-frequency oscillation with early lung volume optimization improves pulmonary outcome in very low birth weight infants with respiratory distress syndrome. , 2000, Pediatrics.

[32]  Markus Raffel,et al.  Particle Image Velocimetry: A Practical Guide , 2002 .

[33]  K. Tanishita,et al.  Augmentation of axial dispersion by intermittent oscillatory flow. , 1998, Journal of biomechanical engineering.

[34]  Frederick R. Haselton,et al.  Flow visualization of steady streaming in oscillatory flow through a bifurcating tube , 1982, Journal of Fluid Mechanics.

[35]  K Tanishita,et al.  Spatial and temporal variation of secondary flow during oscillatory flow in model human central airways. , 1999, Journal of biomechanical engineering.

[36]  S. Mehta,et al.  High-frequency oscillatory ventilation in adults: the Toronto experience. , 2004, Chest.

[37]  Anthony S. Wexler,et al.  Expiration flow in a symmetric bifurcation , 2003 .