Primary blast lung injury simulator: a new computerised model

Mainul Haque,J G Hardman,D Bates,A Das,T E Scott

doi:10.1136/jramc-2018-000989

Mainul Haque, J G Hardman + Show 3 more

Open Access

https://doi.org/10.1136/jramc-2018-000989

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Abstract

Mathematical modelling and computational simulation are becoming increasingly important tools in many fields of medicine where in vivo studies are expensive, difficult or impractical. This is particularly the case with...

Highlights

Recent advances in capability to accurately model and simulate human pulmonary pathophysiology have opened up the possibility of rationally “designing” new multiintervention treatment strategies in silico by exploiting the speed, reproducibility, and cost-effectiveness of “virtual” patient trials
As discussed in this paper recently, 3 one such area where computational modelling could be of benefit is in improving the management of primary blast lung injury (PBLI)
The situation is challenging, but computational modelling could provide considerable insight into improving the understanding and treatment of PBLI and in this paper we provide a brief outline of our primary blast lung injury simulator, it’s validation and some preliminary results

Summary

Introduction

Recent advances in capability to accurately model and simulate human pulmonary pathophysiology have opened up the possibility of rationally “designing” new multiintervention treatment strategies in silico by exploiting the speed, reproducibility, and cost-effectiveness of “virtual” patient trials. VILI is characterized by serious lung parenchymal injury including increased permeability of the alveolar-capillary membrane with resultant pulmonary oedema and surfactant inactivation This leads to atelectasis and systemic biotrauma. The extra fluid due to oedema results excess pressure in the alveoli which can be modelled by modifying the equation (11) as below adding a fluid compartment Vext, Palv,i = Si ∗ ( Valv,i + Vext,i − Colvol,i)2 − Pexti [12]. Once optimisation was complete we exposed six virtual patients to the same blast insult as our source data and compared averaged model predicted outcomes with actual outcomes recorded over an 8 hour period An example of this comparison is demonstrated in figure 3 in which values for PaO2 and PaCO2 can be seen. We will extend this ventilation study to a 48 hour interval period

Limitations of the model

Conclusion

PLEURAL CAVITY