Abstract
Background and objectiveThe mortality rate for patients requiring mechanical ventilation is about 35% and this rate increases to about 53% for the elderly. In general, with increasing age, the dynamic lung function and respiratory mechanics are compromised, and several experiments are being conducted to estimate these changes and understand the underlying mechanisms to better treat elderly patients.Materials and methodsHuman tracheobronchial (G1 ~ G9), bronchioles (G10 ~ G22) and alveolar sacs (G23) geometric models were developed based on reported anatomical dimensions for a 50 and an 80-year-old subject. The aged model was developed by altering the geometry and material properties of the model developed for the 50-year-old. Computational simulations using coupled fluid-solid analysis were performed for geometric models of bronchioles and alveolar sacs under mechanical ventilation to estimate the airflow and lung function characteristics.FindingsThe airway mechanical characteristics decreased with aging, specifically a 38% pressure drop was observed for the 80-year-old as compared to the 50-year-old. The shear stress on airway walls increased with aging and the highest shear stress was observed in the 80-year-old during inhalation. A 50% increase in peak strain was observed for the 80-year-old as compared to the 50-year-old during exhalation. The simulation results indicate that there is a 41% increase in lung compliance and a 35%-50% change in airway mechanical characteristics for the 80-year-old in comparison to the 50-year-old. Overall, the airway mechanical characteristics as well as lung function are compromised due to aging.ConclusionOur study demonstrates and quantifies the effects of aging on the airflow dynamics and lung capacity. These changes in the aging lung are important considerations for mechanical ventilation parameters in elderly patients. Realistic geometry and material properties need to be included in the computational models in future studies.
Highlights
Many patients with obstructive lung diseases such as Chronic Obstructive Pulmonary Disease (COPD), asthma, pneumonia, and Acute Respiratory Distress Syndrome (ARDS) need mechanical ventilation in order to support their breathing and restore respiratory function
Our study demonstrates and quantifies the effects of aging on the airflow dynamics and lung capacity
Realistic geometry and material properties need to be included in the computational models in future studies
Summary
Many patients with obstructive lung diseases such as Chronic Obstructive Pulmonary Disease (COPD), asthma, pneumonia, and Acute Respiratory Distress Syndrome (ARDS) need mechanical ventilation in order to support their breathing and restore respiratory function. Mechanical ventilation can cause further lung injury. The mortality rate for patients on mechanical ventilation is approximately 35% and this rate surges up to about 53% for the elderly [1]. With increasing age, the severity of ventilator-induced lung injury (VILI) increases [2]. With increasing age, the dynamic lung function and respiratory mechanics are compromised. Several simulations are carried out to estimate these changes and understand the underlying mechanisms to better treat elderly patients. The mortality rate for patients requiring mechanical ventilation is about 35% and this rate increases to about 53% for the elderly. With increasing age, the dynamic lung function and respiratory mechanics are compromised, and several experiments are being conducted to estimate these changes and understand the underlying mechanisms to better treat elderly patients.
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