Abstract：
:Mechanical ventilation is a life-support therapy for intensive care patients suffering from respiratory failure. To reduce the current rate of ventilator-induced lung injury requires ventilator settings that are patient-, time-, and disease-specific. A common lung protective strategy is to optimise the level of positive end-expiratory pressure (PEEP) through a recruitment manoeuvre to prevent alveolar collapse at the end of expiration and to improve gas exchange through recruitment of additional alveoli. However, this process can subject parts of the lung to excessively high pressures or volumes. This research significantly extends and more robustly validates a previously developed pulmonary mechanics model to predict lung mechanics throughout recruitment manoeuvres. In particular, the process of recruitment is more thoroughly investigated and the impact of the inclusion of expiratory data when estimating peak inspiratory pressure is assessed. Data from the McREM trial and CURE pilot trial were used to test model predictive capability and assumptions. For PEEP changes of up to and including 14 cmH2O, the parabolic model was shown to improve peak inspiratory pressure prediction resulting in less than 10% absolute error in the CURE cohort and 16% in the McREM cohort. The parabolic model also better captured expiratory mechanics than the exponential model for both cohorts.
journal_name
Ann Biomed Engjournal_title
Annals of biomedical engineeringauthors
Morton SE,Knopp JL,Chase JG,Möller K,Docherty P,Shaw GM,Tawhai Mdoi
10.1007/s10439-019-02253-wsubject
Has Abstractpub_date
2019-07-01 00:00:00pages
1626-1641issue
7eissn
0090-6964issn
1573-9686pii
10.1007/s10439-019-02253-wjournal_volume
47pub_type
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journal_title：Annals of biomedical engineering
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journal_title：Annals of biomedical engineering
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journal_title：Annals of biomedical engineering
pub_type： 杂志文章,评审
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journal_title：Annals of biomedical engineering
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journal_title：Annals of biomedical engineering
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journal_title：Annals of biomedical engineering
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