Quasi-static pulmonary P–V curves of patients with ARDS, Part I: Characterization

Nabian, Mohsen; Narusawa, Uichiro

doi:10.1016/j.resp.2017.10.011

Cited by 3 publications

(10 citation statements)

References 24 publications

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“…3.9(c)) due to the nearly linear P− V relation at P = 0 ( Fig. 3.2 [Nabian and Narusawa, 2018b], although here we dealt with both inflation-and deflation-part of the envelope P-V curve.…”

Section: Plotted Inmentioning

confidence: 99%

“…Five data groups used for analyses in this report are the same as those in Part I [Nabian and Narusawa, 2018b]; (1) Data group 1 [Medoff et al, 2000]: Canine model of acute lung injury before (Data group 1 Before Injury) and after oleic-acid-induced injury (Data group 1 After Injury) (2) Data group 2 [Downie et al, 2004]: Canine model of acute lung injury by saline lavage;…”

Section: Introductionmentioning

confidence: 99%

“…They were obtained by procedures that satisfied the animal care and use requirements of respective institution. [Nabian and Narusawa, 2018b]. ) Selected P-V inflation curves are shown in Fig.…”

Section: Introductionmentioning

confidence: 99%

“…(1) Since Λ rt = Λ Data group 2 Bef ore Injury = 1.10 (Tables 2, 5 In Part I [Nabian and Narusawa, 2018b], four stages of ARDS (Early ARDS, Deep Knee, Advanced ARDS and Baby Lung) were identified and defined in terms of Λ, −V L /∆V and V U .…”

Section: Introductionmentioning

confidence: 99%

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2018

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ix ii 4 Conclusion 73 Bibliography 75 iii List of Figures 2.1 (a) Alveolar element for inflation. A s y 0 = V 0 (pop-open volume of an element), A s y T = V distension (volume increase due to elastic wall distension). (b) Alveolar element for deflation. Superscript, d, indicates properties of deflation. (c) Quasi-static inflation-deflation P-V curve. V U = upper volume asymptote (total lung capacity), V L = lower volume asymptote, ∆V (= V U − V L ) = vital lung capacity, P 0 = pressure at the midpoint of P-V curve, P ID = pressure at the intersection of inflationand deflation-curve. (d) P-V curves of Data group 1 and Data group 2 (solid = Before Injury, dotted = After Injury). (e) Normalized distribution of alveolar elements at P = P 0 . Data sets D, J, R,

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“…3.9(c)) due to the nearly linear P− V relation at P = 0 ( Fig. 3.2 [Nabian and Narusawa, 2018b], although here we dealt with both inflation-and deflation-part of the envelope P-V curve.…”

Section: Plotted Inmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“…Some protective ventilation strategies have been proposed for patients in intensive care units. For example, positive end-expiratory pressure (PEEP) has been associated with alveolar recruitment for effective gas exchange as well as lung over-distention which results in ventilator-induced lung injury [25][26][27][28][29][30][31][32][33][34][35][36]. However, it is a difficult task to propose optimum conditions of ventilation in terms of both the efficacy and the safety of the entire ARDS patient populations given large variability in the mechanical properties of the respiratory systems in the ARDS patients.…”

Section: Introductionmentioning

confidence: 99%

Quantification of Alveolar Recruitment for the Optimization of Mechanical Ventilation Using Quasi-Static Pressure Volume Curve

Nabian¹,

Narusawa²

2018

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Quasi-static, pulmonary pressure-volume (P-V) curves over an inflation-deflation cycle are analyzed using a respiratory system model (RSM), which had been developed for quantitative characterization of the mechanical behavior of the total respiratory system. Optimum mechanical ventilation setting of Positive End Expiratory Pressure (PEEP) for total alveolar recruitment is quantified based on the existing P-V curves of healthy and injured animal models. Our analytical predictions may contribute to the optimization of mechanical ventilation settings for the Acute Respiratory Distress Syndrome (ARDS) patients.

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Patient-specific optimization of mechanical ventilation for patients with acute respiratory distress syndrome using quasi-static pulmonary P-V data

Nabian¹,

Narusawa²

2018

Informatics in Medicine Unlocked

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Quasi-static, pulmonary pressure-volume (P-V) curves were combined with a respiratory system model to analyze tidal pressure cycles, simulating mechanical ventilation of patients with acute respiratory distress syndrome (ARDS). Two important quantities including 1) tidal recruited volume and 2) tidal hyperinflated volume were analytically computed by integrating the distribution of alveolar elements over the affected pop-open pressure range. We analytically predicted the tidal recruited volume of four canine subjects and compared our results with similar experimental measurements on canine models for the validation. We then applied our mathematical model to the P-V data of ARDS populations in four stages of Early ARDS, Deep Knee, Advanced ARDS and Baby Lung to quantify the tidal recruited volume and tidal hyperinflated volume as an indicator of ventilator-induced lung injury (VILI). These quantitative predictions based on patient-specific P-V data suggest that the optimum parameters of mechanical ventilation including PEEP and Tidal Pressure (Volume) are largely varying among ARDS population and are primarily influenced by the degree in the severity of ARDS.

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Quasi-static pulmonary P–V curves of patients with ARDS, Part I: Characterization

Cited by 3 publications

References 24 publications

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Quantification of Alveolar Recruitment for the Optimization of Mechanical Ventilation Using Quasi-Static Pressure Volume Curve

Patient-specific optimization of mechanical ventilation for patients with acute respiratory distress syndrome using quasi-static pulmonary P-V data

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