ArticleBMC pulmonary medicine2012
Physiological relevance and performance of a minimal lung model: an experimental study in healthy and acute respiratory distress syndrome model piglets.
Article in BMC pulmonary medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Article
- Thoracoabdominal asynchrony in a virtual preterm infant: computational modeling and analysis.American journal of physiology. Lung cellular and molecular physiology · 2023Article
- Quantifying neonatal patient effort using non-invasive model-based methods.Medical & biological engineering & computing · 2022Article
- Biomedical engineer's guide to the clinical aspects of intensive care mechanical ventilation.Biomedical engineering online · 2018Review
- Prediction of high airway pressure using a non-linear autoregressive model of pulmonary mechanics.Biomedical engineering online · 2017Article
- Computational Models of Ventilator Induced Lung Injury and Surfactant Dysfunction.Drug discovery today. Disease models · 2015Article
- Acute Respiratory Distress Syndrome: Role of Oleic Acid-Triggered Lung Injury and Inflammation.Mediators of inflammation · 2015Review
- Visualisation of time-varying respiratory system elastance in experimental ARDS animal models.BMC pulmonary medicine · 2014Article
- Expiratory model-based method to monitor ARDS disease state.Biomedical engineering online · 2013Article
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Authors and funding
8 authors.
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Abstract
backgroundMechanical ventilation (MV) is the primary form of support for acute respiratory distress syndrome (ARDS) patients. However, intra- and inter- patient-variability reduce the efficacy of general protocols. Model-based approaches to guide MV can be patient-specific. A physiological relevant minimal model and its patient-specific performance are tested to see if it meets this objective above.
methodsHealthy anesthetized piglets weighing 24.0 kg [IQR: 21.0-29.6] underwent a step-wise PEEP increase manoeuvre from 5cmH2O to 20cmH2O. They were ventilated under volume control using Engström Care Station (Datex, General Electric, Finland), with pressure, flow and volume profiles recorded. ARDS was then induced using oleic acid. The data were analyzed with a Minimal Model that identifies patient-specific mean threshold opening and closing pressure (TOP and TCP), and standard deviation (SD) of these TOP and TCP distributions. The trial and use of data were approved by the Ethics Committee of the Medical Faculty of the University of Liege, Belgium. RESULTS AND DISCUSSIONS: 3 of the 9 healthy piglets developed ARDS, and these data sets were included in this study. Model fitting error during inflation and deflation, in healthy or ARDS state is less than 5.0% across all subjects, indicating that the model captures the fundamental lung mechanics during PEEP increase. Mean TOP was 42.4cmH2O [IQR: 38.2-44.6] at PEEP = 5cmH2O and decreased with PEEP to 25.0cmH2O [IQR: 21.5-27.1] at PEEP = 20cmH2O. In contrast, TCP sees a reverse trend, increasing from 10.2cmH2O [IQR: 9.0-10.4] to 19.5cmH2O [IQR: 19.0-19.7]. Mean TOP increased from average 21.2-37.4cmH2O to 30.4-55.2cmH2O between healthy and ARDS subjects, reflecting the higher pressure required to recruit collapsed alveoli. Mean TCP was effectively unchanged.
conclusionThe minimal model is capable of capturing physiologically relevant TOP, TCP and SD of both healthy and ARDS lungs. The model is able to track disease progression and the response to treatment.
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