ENERGY ANALYSIS OF A NONLINEAR MODEL OF THE NORMAL HUMAN LUNG

Despite the existence of respiratory mechanics models in the literature, rarely one finds analytical expressions that predict the work of breathing (WOB) associated with natural breathing maneuvers in non-ventilated subjects. In the present study, we develop relations that explicitly identify WOB, based on a proposed nonlinear model of respiratory mechanics. The model partitions airways resistance into three components (upper, middle and small), includes a collapsible airways segment, a viscoelastic element describing lung tissue dynamics and a static chest wall compliance. The individual contribution of these respiratory components on WOB is identified and analyzed. For instance, according to model predictions, during the forced vital capacity (FVC) maneuver, most of the work is expended against dissipative forces, mainly during expiration. In addition, expiratory dissipative work during FVC is almost equally partitioned among the upper airways and the collapsible airways resistances. The former expends work at the beginning of expiration, the latter at the end of expiration. The contribution of the peripheral airways is small. Our predictions are validated against laboratory data collected from volunteer subjects and using the esophageal catheter balloon technique.

[1]  Gerald M. Saidel,et al.  A Nonlinear Model Combining Pulmonary Mechanics and Gas Concentration Dynamics , 1982, IEEE Transactions on Biomedical Engineering.

[2]  J. Mead,et al.  IMPROVED TECHNIQUE FOR ESTIMATING PLEURAL PRESSURE FROM ESOPHAGEAL BALLOONS. , 1964, Journal of applied physiology.

[3]  A. Guyton,et al.  Textbook of Medical Physiology , 1961 .

[4]  E. Campbell Book Review: The Respiratory Muscles and the Mechanics of Breathing , 1958 .

[5]  J. J. Marini,et al.  Work of Breathing During Mechanical Ventilation , 1990 .

[6]  Jerome Meisel Principles of Electromechanical Energy Conversion , 1984 .

[7]  A. Bethe,et al.  Handbuch der Normalen und Pathologischen Physiologie , 1925 .

[8]  G. G. Stokes "J." , 1890, The New Yale Book of Quotations.

[9]  J. Clark,et al.  Airway mechanics, gas exchange, and blood flow in a nonlinear model of the normal human lung. , 1998, Journal of applied physiology.

[10]  R. Kirby,et al.  Decreasing imposed work of the breathing apparatus to zero using pressure‐support ventilation , 1993, Critical care medicine.

[11]  J. Clark,et al.  Mathematical modeling of pulmonary airway dynamics. , 1973, IEEE transactions on bio-medical engineering.

[12]  Blanch Pb,et al.  A new respiratory monitor that enables accurate measurement of work of breathing: a validation study. , 1994 .

[13]  C. Svantesson,et al.  Respiratory mechanics in rabbits ventilated with different tidal volumes. , 1996, Respiration physiology.

[14]  H RAHN,et al.  Mechanics of breathing in man. , 1950, Journal of applied physiology.

[15]  J. Widdicombe,et al.  Physical characteristics of the chest and lungs and the work of breathing in different mammalian species , 1961, The Journal of physiology.

[16]  J. Sharp,et al.  Hysteresis and stress adaptation in the human respiratory system. , 1967, Journal of applied physiology.

[17]  R. Kirby,et al.  Site of pressure measurement during spontaneous breathing with continuous positive airway pressure: Effect on calculating imposed work of breathing , 1992, Critical care medicine.

[18]  A. Gabrielli,et al.  Partially and totally unloading respiratory muscles based on real-time measurements of work of breathing. A clinical approach. , 1994, Chest.

[19]  B Jonson,et al.  Mechanics of respiratory system in healthy anesthetized humans with emphasis on viscoelastic properties. , 1993, Journal of applied physiology.

[20]  John W. Clark,et al.  Analog Computer Simulation of Maximum Expiratory Flow Limitation , 1975, IEEE Transactions on Biomedical Engineering.

[21]  M. Banner Respiratory muscle loading and the work of breathing. , 1995, Journal of cardiothoracic and vascular anesthesia.

[22]  M. Mcilroy,et al.  The work of breathing in normal subjects. , 1954, Clinical science.

[23]  William B. Hamilton,et al.  The Respiratory Muscles and the Mechanics of Breathing. , 1958 .

[24]  F. A. Seiler,et al.  Numerical Recipes in C: The Art of Scientific Computing , 1989 .

[25]  R. Kirby,et al.  Components of the work of breathing and implications for monitoring ventilator‐dependent patients , 1994, Critical care medicine.

[26]  Joseph B. Zwischenberger,et al.  An Automated LabVIEW™ - Based Data Acquisition System for Analysis of Pulmonary Function , 1998 .

[27]  Arthur T. Johnson,et al.  Biomechanics and exercise physiology , 1991 .