Abstract
Individualized models of respiratory mechanics help to reduce potential harmful effects of mechanical ventilation by supporting the evaluation of patient-specific lung protective ventilation strategies. Assessing ventilation inhomogeneities might be an important aspect in optimizing ventilator settings. The aim of this studyis to capture and analyze ventilation inhomogeneity by a mathematical model using clinical data. The results show that the lung physiology of mechanically ventilated patients without lung condition can be described by an inhomogeneity model revealing two alveolar compartments with median time constants of 0.4 and 3.9 s. Thus, the IHM in combination with specific ventilation maneuver might be suitable to capture lung physiology for model-based optimization of ventilator settings but requires additional image-based investigations to further support the validity of the model.
Highlights
Non-adapted ventilator settings risks are severe side effects in intensive care patients during mechanical ventilation [1]
The results show that the lung physiology of mechanically ventilated patients without lung condition can be described by an inhomogeneity model revealing two alveolar compartments with median time constants of 0.4 and 3.9 s
This paper presents the assessment and analysis of the inhomogeneity model in mechanically ventilated patients to evaluate its potential for model-based therapy
Summary
Non-adapted ventilator settings risks are severe side effects in intensive care patients during mechanical ventilation [1]. Optimized patient-specific settings can be obtained by individualizing physiological models using clinical data and parameter identification methods. Individualized models provide insight into patient’s physiology that is not directly measurable. They offer significant potential to evaluate and guide personalized lung protective ventilator strategies on intensive care units [2,3,4]. The concept of model-based therapy applicable at the bedside of the patient requires models that are as simple as possible, while capturing all relevant dynamics and being identifiable with limited available measurement set. Relevant dynamics of lung mechanics are significantly affected by ventilation inhomogeneity [5]. An alternative approach involves the Inhomogeneity Model (IHM) of respiratory mechanics [8], which has been a strong force in the field of pulmonary physiology ever since [5]
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