Influence of bronchial diameter change on the airflow dynamics based on a pressure‐controlled ventilation system

Bronchial diameter is a key parameter that affects the respiratory treatment of mechanically ventilated patients. In this paper, to reveal the influence of bronchial diameter on the airflow dynamics of pressure-controlled mechanically ventilated patients, a new respiratory system model is presented that combines multigeneration airways with lungs. Furthermore, experiments and simulation studies to verify the model are performed. Finally, through the simulation study, it can be determined that in airway generations 2 to 7, when the diameter is reduced to half of the original value, the maximum air pressure (maximum air pressure in lungs) decreases by nearly 16%, the maximum flow decreases by nearly 30%, and the total airway pressure loss (sum of each generation pressure drop) is more than 5 times the original value. Moreover, in airway generations 8 to 16, with increasing diameter, the maximum air pressure, maximum flow, and total airway pressure loss remain almost constant. When the diameter is reduced to half of the original value, the maximum air pressure decreases by 3%, the maximum flow decreases by nearly 5%, and the total airway pressure loss increases by 200%. The study creates a foundation for improvement in respiratory disease diagnosis and treatment.

[1]  C. Wen,et al.  Trace ratio criterion for feature extraction in classification , 2014 .

[2]  Bill Diong,et al.  Respiratory Impedance Values in Adults Are Relatively Insensitive to Mead Model Lung Compliance and Chest Wall Compliance Parameters , 2010 .

[3]  J. Sancho,et al.  Mechanical Insufflation-Exsufflation vs. Tracheal Suctioning via Tracheostomy Tubes for Patients with Amyotrophic Lateral Sclerosis: A Pilot Study , 2003, American journal of physical medicine & rehabilitation.

[4]  Yan Shi,et al.  Pressure Dynamic Characteristics of Pressure Controlled Ventilation System of a Lung Simulator , 2014, Comput. Math. Methods Medicine.

[5]  R. C. Johnson,et al.  Lung compliance following cardiac arrest. , 1995, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

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

[7]  Andrew R. Martin,et al.  Theoretical and experimental evaluation of the effects of an argon gas mixture on the pressure drop through adult tracheobronchial airway replicas. , 2017, Journal of biomechanics.

[8]  Charles Hirsch,et al.  Anatomically based three-dimensional model of airways to simulate flow and particle transport using computational fluid dynamics. , 2005, Journal of applied physiology.

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

[10]  Timon Rabczuk,et al.  Fluid–structure interaction in lower airways of CT‐based lung geometries , 2008 .

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

[12]  J. E. W. Beneken,et al.  Serial lung model for simulation and parameter estimation in body plethysmography , 1991, Medical and Biological Engineering and Computing.

[13]  J. Chevallier,et al.  Pressure-controlled ventilation improves oxygenation during laparoscopic obesity surgery compared with volume-controlled ventilation. , 2008, British journal of anaesthesia.

[14]  John G. Eyles,et al.  Estimating Respiratory Mechanical Parameters in Parallel Compartment Models , 1981, IEEE Transactions on Biomedical Engineering.

[15]  M. M. Culiner.  OBLITERATIVE BONCHITIS AND BRONCHIOLITIS WITH BRONCHIECTASIS. , 1963, Diseases of the chest.

[16]  Maolin Cai,et al.  Working characteristics of a new ventilator with automatic secretion clearance function , 2015 .

[17]  Fritz Rohrer,et al.  Der Strömungswiderstand in den menschlichen Atemwegen und der Einfluss der unregelmässigen Verzweigung des Bronchialsystems auf den Atmungsverlauf in verschiedenen Lungenbezirken , 1915, Pflüger's Archiv für die gesamte Physiologie des Menschen und der Tiere.

[18]  Maolin Cai,et al.  Dimensionless study on dynamics of pressure controlled mechanical ventilation system , 2015 .

[19]  Maolin Cai,et al.  Working Characteristics of a Mechanical Insufflation-Exsufflation Device , 2014 .

[20]  P. Behrakis,et al.  Volume and flow dependence of respiratory mechanics in mechanically ventilated COPD patients , 2003, Respiratory Physiology & Neurobiology.

[21]  Andrew R. Martin,et al.  The ventilation distribution of helium-oxygen mixtures and the role of inertial losses in the presence of heterogeneous airway obstructions. , 2011, Journal of biomechanics.

[22]  Jian Wang,et al.  Simulating frictional contact in smoothed particle hydrodynamics , 2013 .

[23]  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.

[24]  E. Israel,et al.  Inhaled Albuterol, but Not Intravenous Lidocaine, Protects Against Intubation-induced Bronchoconstriction in Asthma , 2000, Anesthesiology.

[25]  Andrew R. Martin,et al.  Validation of airway resistance models for predicting pressure loss through anatomically realistic conducting airway replicas of adults and children. , 2015, Journal of biomechanics.

[26]  E. Çamcı,et al.  Comparison of volume controlled with pressure controlled ventilation during one-lung anaesthesia. , 1997, British journal of anaesthesia.

[27]  Grzegorz Redlarski,et al.  A new approach to modeling of selected human respiratory system diseases, directed to computer simulations , 2013, Comput. Biol. Medicine.

[28]  T Gemci,et al.  Computational model of airflow in upper 17 generations of human respiratory tract. , 2008, Journal of biomechanics.

[29]  J. Bates,et al.  Estimating respiratory mechanics in the presence of flow limitation. , 1999, Journal of applied physiology.

[30]  Janusz Mroczka,et al.  Nonlinear model for mechanical ventilation of human lungs , 2006, Comput. Biol. Medicine.

[31]  Ewald R. Weibel,et al.  Lung morphometry: the link between structure and function , 2017, Cell and Tissue Research.

[32]  R C Schroter,et al.  Energy losses and pressure drop in models of human airways. , 1970, Respiration physiology.

[33]  Nattapong Jaimchariyatam,et al.  Polysomnographic determinants of nocturnal hypercapnia in patients with sleep apnea. , 2013, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[34]  Guido Avanzolini,et al.  Nonlinear Mechanisms Determining Expiratory Flow Limitation in Mechanical Ventilation: A Model-Based Interpretation , 2003, Annals of Biomedical Engineering.

[35]  E. Abraham,et al.  clinical investigations in critical care-Cardiorespiratory Effects of Pressure Controlled Ventilation in Severe Respiratory Failure * , 2006 .