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气道分泌物对机械通气呼吸系统气流动力学的影响。

Influence of Airway Secretion on Airflow Dynamics of Mechanical Ventilated Respiratory System.

出版信息

IEEE/ACM Trans Comput Biol Bioinform. 2018 Sep-Oct;15(5):1660-1668. doi: 10.1109/TCBB.2017.2737621. Epub 2017 Aug 9.


DOI:10.1109/TCBB.2017.2737621
PMID:28796621
Abstract

Secretions in the airways of mechanical ventilated patients are extremely dangerous to patients' health. In recent studies, the continuous constant airflow is adopted, however, it is not consistent with a clinical situation. To study respiratory airflow dynamic characteristics with secretion in the airways, a mathematical model based on clinical mechanical ventilation is established in this paper. To illustrate the secretion's influence on the airflow dynamics of mechanical ventilated respiratory system, three key parameters which are cross section area ratio of secretion/ pipe, air-secretion contact area, and secretion viscosity are involved in the study. Through the experimental study, the accuracy and dependability of the model are confirmed. By the simulation study, we find that: based on the model which combines two airways and two model lungs, when one of the airways was covered with secretion, the maximum pressure of the model lung which is attached to the end of this airway maintains constant when the cross section area ratio is less than 66 percent, and then it tends to decline sharply with the ratio increasing, but it remains constant with the augment of air-secretion contact area, the maximum flow declines both with the increasing of cross section area ratio and air-secretion contact area. Furthermore, as for the other airway, the maximum pressure of the model lung has no significant changes with the augment of area ratio and air-secretion contact area, however, along with the increasing of area ratio and air-secretion contact area, the maximum flow rises up. Moreover, the secretion viscosity has barely any influence on airflow dynamics. According to our analysis results, we conclude that the cross section area ratio of secretion/pipe has bigger influence on airflow dynamic characteristics than air-secretion contact area and secretion viscosity. This paper lays the foundation for the further study of efficacy and safety in mechanical ventilation and the secretion clearance of mechanical ventilated patients. In addition, the mathematical model proposed in this paper can also be referred to study on the secretion movement in human airways.

摘要

机械通气患者气道中的分泌物对患者的健康极为危险。在最近的研究中,采用了连续恒流,但这与临床情况并不一致。为了研究气道分泌物对机械通气呼吸动力学的影响,本文建立了一个基于临床机械通气的数学模型。为了说明分泌物对机械通气呼吸系统气流动力学的影响,研究中涉及了三个关键参数,即分泌物/管的截面积比、空气-分泌物接触面积和分泌物粘度。通过实验研究,验证了模型的准确性和可靠性。通过模拟研究,我们发现:基于结合了两条气道和两个模型肺的模型,当一条气道被分泌物覆盖时,与该气道末端相连的模型肺的最大压力在截面积比小于 66%时保持恒定,然后随着比值的增加而急剧下降,但随着空气-分泌物接触面积的增加而保持恒定,最大流量随着截面积比和空气-分泌物接触面积的增加而下降。此外,对于另一条气道,模型肺的最大压力随着面积比和空气-分泌物接触面积的增加没有明显变化,但随着面积比和空气-分泌物接触面积的增加,最大流量上升。此外,分泌物粘度对气流动力学几乎没有影响。根据我们的分析结果,我们得出结论,分泌物/管的截面积比比空气-分泌物接触面积和分泌物粘度对气流动力学特性的影响更大。本文为进一步研究机械通气的疗效和安全性以及机械通气患者的分泌物清除奠定了基础。此外,本文提出的数学模型也可用于研究人体气道中分泌物的运动。

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