Optimal efficiency of high-frequency chest wall oscillations and links with resistance and compliance in a model of the lung

Abstract

Chest physiotherapy is a set of techniques used to help the draining of the mucus from the lung in pathological situations. The choice of the techniques and their adjustment to the patients or to the pathologies remain as of today largely empirical. High-frequency chest wall oscillation (HFCWO) is one of these techniques, performed with a device that applies oscillating pressures on the chest. However, there is no clear understanding of how HFCWO devices interact with the lung biomechanics. Hence, we study idealized HFCWO manipulations applied to a mathematical and numerical model of the biomechanics of the lung. The lung is represented by a fluid–structure interaction model based on an airway tree that is coupled to a homogeneous elastic medium. We show that our model is driven by two dimensionless numbers that drive the effect of the idealized HFCWO manipulation on the model of the lung. Our model allows us to analyze the stress applied to an idealized mucus by the air–mucus interaction and by the airway walls deformation. This stress behaves as a buffer and has the effect of reducing the stress needed to overcome the idealized mucus yield stress. Moreover, our model predicts the existence of an optimal range of the working frequencies of HFCWO. This range is in agreement with the frequencies actually used by practitioners during HFCWO maneuvers. Finally, our model suggests that analyzing the mouth airflow during HFCWO maneuvers could allow us to estimate the compliance and the hydrodynamic resistance of the lung of a patient.