An approach to study recruitment/derecruitment dynamics in a patient-specific computational model of an injured human lung

Geitner, Carolin M.; Becher, Tobias; Frerichs, Inéz; Weiler, Norbert; Bates, Jason H. T.; Wall, Wolfgang A.

doi:10.48550/arxiv.2212.01114

Cited by 1 publication

(2 citation statements)

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“…However, the microscale pattern of the "avalanches" in (Baudoin et al, 2013;Stewart and Jensen, 2015) requires tracking liquid lining flows and surfactant transport at the airway level, which is not included in our current model. The excessive mechanical stress on epithelial cells due to plug propagation and rupture have been investigated in (Bilek et al, 2003;Kay et al, 2004;Ghadiali and Gaver, 2008) and cannot yet be investigated with our model. Nevertheless, our model provides a multiscale platform that can be expanded by utilizing those studies as "building blocks" by interconnecting the microscale, mesoscale and macroscale interactions to elucidate how physicochemical properties affect this behavior.…”

Section: Discussionmentioning

confidence: 99%

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Full-lung simulations of mechanically ventilated lungs incorporating recruitment/derecruitment dynamics

Ma,

Fujioka,

Halpern

et al. 2023

Front. Netw. Physiol.

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This study developed and investigated a comprehensive multiscale computational model of a mechanically ventilated ARDS lung to elucidate the underlying mechanisms contributing to the development or prevention of VILI. This model is built upon a healthy lung model that incorporates realistic airway and alveolar geometry, tissue distensibility, and surfactant dynamics. Key features of the ARDS model include recruitment and derecruitment (RD) dynamics, alveolar tissue viscoelasticity, and surfactant deficiency. This model successfully reproduces realistic pressure-volume (PV) behavior, dynamic surface tension, and time-dependent descriptions of RD events as a function of the ventilation scenario. Simulations of Time-Controlled Adaptive Ventilation (TCAV) modes, with short and long durations of exhalation (TLow- and TLow+, respectively), reveal a higher incidence of RD for TLow+ despite reduced surface tensions due to interfacial compression. This finding aligns with experimental evidence emphasizing the critical role of timing in protective ventilation strategies. Quantitative analysis of energy dissipation indicates that while alveolar recruitment contributes only a small fraction of total energy dissipation, its spatial concentration and brief duration may significantly contribute to VILI progression due to its focal nature and higher intensity. Leveraging the computational framework, the model may be extended to facilitate the development of personalized protective ventilation strategies to enhance patient outcomes. As such, this computational modeling approach offers valuable insights into the complex dynamics of VILI that may guide the optimization of ventilation strategies in ARDS management.

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Section: Discussionmentioning

confidence: 99%

“…However, this representation does not account for potential interactions between acini, the airflow among alveolar regions and liquid fluxes. Another variation of this trajectory model has recently been published in (Geitner et al, 2022).…”

Section: Limitationsmentioning

confidence: 99%