Journal article
Impact of Positive End-Expiratory Pressure During Heterogeneous Lung Injury: Insights from Computed Tomographic Image Functional Modeling
Annals of biomedical engineering, Vol.36(6), pp.980-991
06/2008
DOI: 10.1007/s10439-008-9451-x
PMID: 18340535
Abstract
Image Functional Modeling (IFM) synthesizes three dimensional airway networks with imaging and mechanics data to relate structure to function. The goal of this study was to advance IFM to establish a method of exploring how heterogeneous alveolar flooding and collapse during lung injury would impact regional respiratory mechanics and flow distributions within the lung at distinct positive end-expiratory pressure (PEEP) levels. We estimated regional respiratory system elastance from computed tomography (CT) scans taken in 5 saline-lavaged sheep at PEEP levels from 7.5 to 20 cmH2O. These data were anatomically mapped into a computational sheep lung model, which was used to predict the corresponding impact of PEEP on dynamic flow distribution. Under pre-injury conditions and during lung injury, respiratory system elastance was determined to be spatially heterogeneous and the values were distributed with a hyperbolic distribution in the range of measured values. Increases in PEEP appear to modulate the heterogeneity of the flow distribution throughout the injured lung. Moderate increases in PEEP decreased the heterogeneity of elastance and predicted flow distribution, although heterogeneity began to increase for PEEP levels above 12.5–15 cmH2O. By combining regional respiratory system elastance estimated from CT with our computational lung model, we can potentially predict the dynamic distribution of the tidal volume during mechanical ventilation and thus identify specific areas of the lung at risk of being overdistended.
Details
- Title: Subtitle
- Impact of Positive End-Expiratory Pressure During Heterogeneous Lung Injury: Insights from Computed Tomographic Image Functional Modeling
- Creators
- C Bellardine Black - Department of Biomedical Engineering Boston University 44 Cummington St. Boston MA 02215 USAA Hoffman - Tufts University Cummings School of Veterinary Medicine N. Grafton MA USAL Tsai - Pulmonary Division Brigham and Women’s Hospital Boston MA USAE Ingenito - Pulmonary Division Brigham and Women’s Hospital Boston MA USAB Suki - Department of Biomedical Engineering Boston University 44 Cummington St. Boston MA 02215 USAD Kaczka - Department of Biomedical Engineering Johns Hopkins University Baltimore MD USAB Simon - Department of Medince Johns Hopkins University Baltimore MD USAK Lutchen - Department of Biomedical Engineering Boston University 44 Cummington St. Boston MA 02215 USA
- Resource Type
- Journal article
- Publication Details
- Annals of biomedical engineering, Vol.36(6), pp.980-991
- Publisher
- Springer US; Boston
- DOI
- 10.1007/s10439-008-9451-x
- PMID
- 18340535
- ISSN
- 0090-6964
- eISSN
- 1573-9686
- Language
- English
- Date published
- 06/2008
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Anesthesia
- Record Identifier
- 9984007159002771
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