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Abstract
Elderly patients with obstructive lung diseases often receive mechanical ventilation to support their breathing and restore respiratory function. However, mechanical ventilation is known to increase the severity of ventilator-induced lung injury (VILI) in the elderly. Therefore, it is important to investigate the effects of aging to better understand the lung tissue mechanics to estimate the severity of ventilator-induced lung injuries. Two age-related geometric models involving human bronchioles from generation G10 to G23 and alveolar sacs were developed. The first is for a 50-year-old (normal) and second is for an 80-year old (aged) model. Lung tissue mechanics of normal and aged models were investigated under mechanical ventilation through computational simulations. Results obtained indicated that lung tissue strains during inhalation (t = 0.2 s) decreased by about 40% in the alveolar sac (G23) and 27% in the bronchiole (G20), respectively, for the 80-year-old as compared to the 50-year-old. The respiratory mechanics parameters (work of breathing per unit volume and maximum tissue strain) over G20 and G23 for the 80-year-old decreased by about 64% (three-fold) and 80% (four-fold), respectively, during the mechanical ventilation breathing cycle. However, there was a significant increase (by about threefold) in lung compliance for the 80-year-old in comparison to the 50-year-old. These findings from the computational simulations demonstrated that lung mechanical characteristics are significantly compromised in aging tissues, and these effects were quantified in this study.
Highlights
Patients with obstructive lung diseases often receive mechanical ventilation to support their breathing and restore respiratory function
The majority of patients requiring mechanical ventilation are elderly and advanced age is known to increase the severity of ventilator-induced lung injury (VILI) or ventilator-associated lung injury (VALI) [1]
The purpose of this study is to investigate how the respiratory mechanics parameters of aging tissue are affected during mechanical ventilation
Summary
Patients with obstructive lung diseases often receive mechanical ventilation to support their breathing and restore respiratory function. Mechanical ventilation might lead to lung injury depending on the respiratory tract’s condition. The majority of patients requiring mechanical ventilation are elderly and advanced age is known to increase the severity of ventilator-induced lung injury (VILI) or ventilator-associated lung injury (VALI) [1]. The mortality rate for patients requiring mechanical ventilation is about 35% and this rate increases to about 53% for the elderly. The incidences of mechanical ventilation and in-hospital mortality both sharply rise with patient age [2]. With increasing age, the severity of VILI increases [1]. Ventilator-associated lung injury is severer due to an increase in lung compliance [3]. Techniques for reducing VALI include the application of positive end expiratory pressure (PEEP), patient positioning, and low-volume and pressure-controlled
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