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模拟氦、六氟化硫和二氧化碳的稳态肺清除:形态测量的影响。

Modelling steady state pulmonary elimination of He, SF6 and CO2: effect of morphometry.

作者信息

Neufeld G R, Schwardt J D, Gobran S R, Baumgardner J E, Schreiner M S, Aukburg S J, Scherer P W

机构信息

Department of Anesthesia, School of Medicine, University of Pennsylvania, Philadelphia 19104.

出版信息

Respir Physiol. 1992 Jun;88(3):257-75. doi: 10.1016/0034-5687(92)90001-d.

Abstract

We studied the influence of acinar morphometry on the shape of simulated expirograms computed from a single path convection-diffusion model that includes a source term for gas evolution from the blood (Scherer et al., J. Appl. Physiol. 64: 1022-1029, 1988). Acinar structure was obtained from published data of 3 different lung morphometries. The simulations were performed over a range of tidal volumes (VT) and breathing frequencies (f) comparable to those observed in a previously reported human study. Airways dead space (VDaw) increased with VT in all the morphometric models tested and in the experimental data. The increase in VDaw with VT was inversely related to the diffusivity of the evolving gas and to the rate of increase in airway cross-section of the most mouthward (proximal) alveolated generations of the models. Normalized phase III slope for all the gases decreased with increasing VT in all the models as was previously reported for healthy human subjects. In the model simulations, the greatest sensitivity of phase III slope to VT was seen with the least diffusible gas using the airway morphometry with the smallest cross-sectional areas in the proximal alveolated generations. We conclude that both VDaw and phase III slope of an evolving gas are sensitive to the geometry of the proximal acinar airways and that this is manifest by their dependence on tidal volume, breathing frequency, molecular diffusivity and alveolar/blood source emission rate. The model simulations indicate that heterogeneity of gas washout is not required to explain the magnitude of the phase III slope in healthy human subjects.

摘要

我们研究了腺泡形态测量学对从单路径对流扩散模型计算得到的模拟呼气图形状的影响,该模型包括血液中气体释放的源项(Scherer等人,《应用生理学杂志》64: 1022 - 1029,1988年)。腺泡结构取自3种不同肺形态测量学的已发表数据。模拟是在一系列潮气量(VT)和呼吸频率(f)范围内进行的,这些值与先前报道的人体研究中观察到的数值相当。在所测试的所有形态测量模型以及实验数据中,气道死腔(VDaw)均随VT增加。VDaw随VT的增加与释放气体的扩散率以及模型中最靠近口腔(近端)有肺泡的代的气道横截面积增加率呈负相关。正如先前对健康人体受试者所报道的那样,在所有模型中,所有气体的标准化III期斜率均随VT增加而降低。在模型模拟中,使用近端有肺泡的代中横截面积最小的气道形态测量学,对于扩散性最小的气体,III期斜率对VT的敏感性最高。我们得出结论,释放气体的VDaw和III期斜率均对近端腺泡气道的几何形状敏感,这表现为它们对潮气量、呼吸频率、分子扩散率和肺泡/血液源发射率的依赖性。模型模拟表明,不需要用气体清除的异质性来解释健康人体受试者中III期斜率的大小。

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