Amini Reza, Kaczka David W
Harvard Medical School, Boston, MA, USA.
Ann Biomed Eng. 2013 Dec;41(12):2699-711. doi: 10.1007/s10439-013-0866-7. Epub 2013 Jul 20.
To determine the impact of ventilation frequency, lung volume, and parenchymal stiffness on ventilation distribution, we developed an anatomically-based computational model of the canine lung. Each lobe of the model consists of an asymmetric branching airway network subtended by terminal, viscoelastic acinar units. The model allows for empiric dependencies of airway segment dimensions and parenchymal stiffness on transpulmonary pressure. We simulated the effects of lung volume and parenchymal recoil on global lung impedance and ventilation distribution from 0.1 to 100 Hz, with mean transpulmonary pressures from 5 to 25 cm H2O. With increasing lung volume, the distribution of acinar flows narrowed and became more synchronous for frequencies below resonance. At higher frequencies, large variations in acinar flow were observed. Maximum acinar flow occurred at first antiresonance frequency, where lung impedance achieved a local maximum. The distribution of acinar pressures became very heterogeneous and amplified relative to tracheal pressure at the resonant frequency. These data demonstrate the important interaction between frequency and lung tissue stiffness on the distribution of acinar flows and pressures. These simulations provide useful information for the optimization of frequency, lung volume, and mean airway pressure during conventional ventilation or high frequency oscillation (HFOV). Moreover our model indicates that an optimal HFOV bandwidth exists between the resonant and antiresonant frequencies, for which interregional gas mixing is maximized.
为了确定通气频率、肺容积和实质硬度对通气分布的影响,我们构建了一个基于解剖结构的犬肺计算模型。该模型的每个肺叶都由一个不对称分支气道网络组成,其末端为粘弹性腺泡单位。该模型考虑了气道段尺寸和实质硬度对跨肺压的经验依赖性。我们模拟了肺容积和实质回缩对0.1至100Hz的整体肺阻抗和通气分布的影响,平均跨肺压为5至25cmH₂O。随着肺容积增加,对于低于共振频率的情况,腺泡流的分布变窄且变得更加同步。在较高频率下,观察到腺泡流有很大变化。最大腺泡流出现在第一个反共振频率处,此时肺阻抗达到局部最大值。在共振频率下,腺泡压力的分布变得非常不均匀,并且相对于气管压力有所放大。这些数据表明频率与肺组织硬度在腺泡流和压力分布方面存在重要相互作用。这些模拟为传统通气或高频振荡通气(HFOV)期间频率、肺容积和平均气道压力的优化提供了有用信息。此外,我们的模型表明,在共振频率和反共振频率之间存在一个最佳的HFOV带宽,在此带宽下区域间气体混合最大化。