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衰老对人类细支气管气流动力学和肺功能的影响。

Aging effects on airflow dynamics and lung function in human bronchioles.

作者信息

Kim JongWon, Heise Rebecca L, Reynolds Angela M, Pidaparti Ramana M

机构信息

College of Engineering, University of Georgia, Athens, Georgia, United States of America.

Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, United States of America.

出版信息

PLoS One. 2017 Aug 28;12(8):e0183654. doi: 10.1371/journal.pone.0183654. eCollection 2017.

Abstract

BACKGROUND AND OBJECTIVE

The mortality rate for patients requiring mechanical ventilation is about 35% and this rate increases to about 53% for the elderly. In general, with increasing age, the dynamic lung function and respiratory mechanics are compromised, and several experiments are being conducted to estimate these changes and understand the underlying mechanisms to better treat elderly patients.

MATERIALS AND METHODS

Human tracheobronchial (G1 ~ G9), bronchioles (G10 ~ G22) and alveolar sacs (G23) geometric models were developed based on reported anatomical dimensions for a 50 and an 80-year-old subject. The aged model was developed by altering the geometry and material properties of the model developed for the 50-year-old. Computational simulations using coupled fluid-solid analysis were performed for geometric models of bronchioles and alveolar sacs under mechanical ventilation to estimate the airflow and lung function characteristics.

FINDINGS

The airway mechanical characteristics decreased with aging, specifically a 38% pressure drop was observed for the 80-year-old as compared to the 50-year-old. The shear stress on airway walls increased with aging and the highest shear stress was observed in the 80-year-old during inhalation. A 50% increase in peak strain was observed for the 80-year-old as compared to the 50-year-old during exhalation. The simulation results indicate that there is a 41% increase in lung compliance and a 35%-50% change in airway mechanical characteristics for the 80-year-old in comparison to the 50-year-old. Overall, the airway mechanical characteristics as well as lung function are compromised due to aging.

CONCLUSION

Our study demonstrates and quantifies the effects of aging on the airflow dynamics and lung capacity. These changes in the aging lung are important considerations for mechanical ventilation parameters in elderly patients. Realistic geometry and material properties need to be included in the computational models in future studies.

摘要

背景与目的

需要机械通气的患者死亡率约为35%,而老年人的这一比例则升至约53%。一般而言,随着年龄增长,肺动态功能和呼吸力学会受到损害,目前正在进行多项实验以评估这些变化并了解其潜在机制,从而更好地治疗老年患者。

材料与方法

基于报道的50岁和80岁受试者的解剖学尺寸,建立了人气管支气管(G1G9)、细支气管(G10G22)和肺泡囊(G23)的几何模型。通过改变为50岁受试者建立的模型的几何形状和材料特性来建立老年模型。对细支气管和肺泡囊的几何模型进行机械通气下的流固耦合计算模拟,以评估气流和肺功能特征。

研究结果

气道力学特性随年龄增长而下降,具体而言,80岁受试者与50岁受试者相比,压降增加了38%。气道壁上的剪应力随年龄增长而增加,在80岁受试者吸气时观察到最高剪应力。呼气时,80岁受试者与50岁受试者相比,峰值应变增加了50%。模拟结果表明,80岁受试者与50岁受试者相比,肺顺应性增加了41%,气道力学特性变化了35% - 50%。总体而言,气道力学特性以及肺功能因衰老而受损。

结论

我们的研究证明并量化了衰老对气流动力学和肺容量的影响。衰老肺的这些变化是老年患者机械通气参数的重要考虑因素。未来研究的计算模型中需要纳入实际的几何形状和材料特性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af3c/5573216/b40a240b7468/pone.0183654.g001.jpg

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