A tidally breathing model of ventilation, perfusion and volume in normal and diseased lungs
To simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation–perfusion ( V˙A/ Q˙) and ventilation–volume ( V˙A/VA) parameters must be selected correctly. Some diseases affect mainly the V˙A/ Q˙ distribution while others affect both V˙A/ Q˙ and V˙A/...
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Published in | British journal of anaesthesia : BJA Vol. 97; no. 5; pp. 718 - 731 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford
Elsevier Ltd
01.11.2006
Oxford University Press Oxford Publishing Limited (England) |
Subjects | |
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Abstract | To simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation–perfusion ( V˙A/ Q˙) and ventilation–volume ( V˙A/VA) parameters must be selected correctly. Some diseases affect mainly the V˙A/ Q˙ distribution while others affect both V˙A/ Q˙ and V˙A/VA distributions. Results from the multiple inert gas elimination technique (MIGET) and multiple breath nitrogen washout (MBNW) can be used to select V˙A/ Q˙ and V˙A/VA parameters, but no method exists for combining V˙A/ Q˙ and V˙A/VA parameters in a multicompartment lung model.
We define a tidally breathing lung model containing shunt and up to eight alveolar compartments. Quantitative and qualitative understanding of the diseases is used to reduce the number of model compartments to achieve a unique solution. The reduced model is fitted simultaneously to inert gas retentions calculated from published V˙A/ Q˙ distributions and normalized MBNWs obtained from similar subjects. Normal lungs and representative cases of emphysema and embolism are studied.
The normal, emphysematous and embolism models simplify to one, three and two alveolar compartments, respectively.
The models reproduce their respective MIGET and MBNW patient results well, and predict disease-specific steady-state and dynamic soluble and insoluble gas responses. |
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AbstractList | To simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation-perfusion (VA/Q) and ventilation-volume (VA/VA) parameters must be selected correctly. Some diseases affect mainly the VA/Q distribution while others affect both VA/Q and VA/VA distributions. Results from the multiple inert gas elimination technique (MIGET) and multiple breath nitrogen washout (MBNW) can be used to select VA/Q and VA/VA parameters, but no method exists for combining VA/Q and VA/VA parameters in a multicompartment lung model.
We define a tidally breathing lung model containing shunt and up to eight alveolar compartments. Quantitative and qualitative understanding of the diseases is used to reduce the number of model compartments to achieve a unique solution. The reduced model is fitted simultaneously to inert gas retentions calculated from published VA/Q distributions and normalized MBNWs obtained from similar subjects. Normal lungs and representative cases of emphysema and embolism are studied.
The normal, emphysematous and embolism models simplify to one, three and two alveolar compartments, respectively.
The models reproduce their respective MIGET and MBNW patient results well, and predict disease-specific steady-state and dynamic soluble and insoluble gas responses. Background. To simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation–perfusion (V˙A/Q˙) and ventilation–volume (V˙A/VA) parameters must be selected correctly. Some diseases affect mainly the V˙A/Q˙ distribution while others affect both V˙A/Q˙ and V˙A/VA distributions. Results from the multiple inert gas elimination technique (MIGET) and multiple breath nitrogen washout (MBNW) can be used to select V˙A/Q˙ and V˙A/VA parameters, but no method exists for combining V˙A/Q˙ and V˙A/VA parameters in a multicompartment lung model. Methods. We define a tidally breathing lung model containing shunt and up to eight alveolar compartments. Quantitative and qualitative understanding of the diseases is used to reduce the number of model compartments to achieve a unique solution. The reduced model is fitted simultaneously to inert gas retentions calculated from published V˙A/Q˙ distributions and normalized MBNWs obtained from similar subjects. Normal lungs and representative cases of emphysema and embolism are studied. Results. The normal, emphysematous and embolism models simplify to one, three and two alveolar compartments, respectively. Conclusions. The models reproduce their respective MIGET and MBNW patient results well, and predict disease-specific steady-state and dynamic soluble and insoluble gas responses. To simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation–perfusion ( V˙A/ Q˙) and ventilation–volume ( V˙A/VA) parameters must be selected correctly. Some diseases affect mainly the V˙A/ Q˙ distribution while others affect both V˙A/ Q˙ and V˙A/VA distributions. Results from the multiple inert gas elimination technique (MIGET) and multiple breath nitrogen washout (MBNW) can be used to select V˙A/ Q˙ and V˙A/VA parameters, but no method exists for combining V˙A/ Q˙ and V˙A/VA parameters in a multicompartment lung model. We define a tidally breathing lung model containing shunt and up to eight alveolar compartments. Quantitative and qualitative understanding of the diseases is used to reduce the number of model compartments to achieve a unique solution. The reduced model is fitted simultaneously to inert gas retentions calculated from published V˙A/ Q˙ distributions and normalized MBNWs obtained from similar subjects. Normal lungs and representative cases of emphysema and embolism are studied. The normal, emphysematous and embolism models simplify to one, three and two alveolar compartments, respectively. The models reproduce their respective MIGET and MBNW patient results well, and predict disease-specific steady-state and dynamic soluble and insoluble gas responses. BACKGROUND: To simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation-perfusion (VA/Q) and ventilation-volume (VA/VA) parameters must be selected correctly. Some diseases affect mainly the VA/Q distribution while others affect both VA/Q and VA/VA distributions. Results from the multiple inert gas elimination technique (MIGET) and multiple breath nitrogen washout (MBNW) can be used to select VA/Q and VA/VA parameters, but no method exists for combining VA/Q and VA/VA parameters in a multicompartment lung model. METHODS: We define a tidally breathing lung model containing shunt and up to eight alveolar compartments. Quantitative and qualitative understanding of the diseases is used to reduce the number of model compartments to achieve a unique solution. The reduced model is fitted simultaneously to inert gas retentions calculated from published VA/Q distributions and normalized MBNWs obtained from similar subjects. Normal lungs and representative cases of emphysema and embolism are studied. RESULTS: The normal, emphysematous and embolism models simplify to one, three and two alveolar compartments, respectively. CONCLUSIONS: The models reproduce their respective MIGET and MBNW patient results well, and predict disease-specific steady-state and dynamic soluble and insoluble gas responses. BACKGROUNDTo simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation-perfusion (VA/Q) and ventilation-volume (VA/VA) parameters must be selected correctly. Some diseases affect mainly the VA/Q distribution while others affect both VA/Q and VA/VA distributions. Results from the multiple inert gas elimination technique (MIGET) and multiple breath nitrogen washout (MBNW) can be used to select VA/Q and VA/VA parameters, but no method exists for combining VA/Q and VA/VA parameters in a multicompartment lung model.METHODSWe define a tidally breathing lung model containing shunt and up to eight alveolar compartments. Quantitative and qualitative understanding of the diseases is used to reduce the number of model compartments to achieve a unique solution. The reduced model is fitted simultaneously to inert gas retentions calculated from published VA/Q distributions and normalized MBNWs obtained from similar subjects. Normal lungs and representative cases of emphysema and embolism are studied.RESULTSThe normal, emphysematous and embolism models simplify to one, three and two alveolar compartments, respectively.CONCLUSIONSThe models reproduce their respective MIGET and MBNW patient results well, and predict disease-specific steady-state and dynamic soluble and insoluble gas responses. |
Author | Baker, A.B. Young, I.H. Crawford, A.B.H. Turner, M.J. Yem, J.S. |
Author_xml | – sequence: 1 givenname: J.S. surname: Yem fullname: Yem, J.S. organization: Department of Anaesthetics, The University of Sydney, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia – sequence: 2 givenname: M.J. surname: Turner fullname: Turner, M.J. email: mjturner@usyd.edu.au organization: Department of Anaesthetics, The University of Sydney, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia – sequence: 3 givenname: A.B. surname: Baker fullname: Baker, A.B. organization: Department of Anaesthetics, The University of Sydney, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia – sequence: 4 givenname: I.H. surname: Young fullname: Young, I.H. organization: Department of Respiratory Medicine, The University of Sydney, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia – sequence: 5 givenname: A.B.H. surname: Crawford fullname: Crawford, A.B.H. organization: Department of Respiratory Medicine, Westmead Hospital, Westmead, NSW 2145, Australia |
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Keywords | ventilation inhomogeneity modelling ventilation/perfusion distribution Short term Human Dynamic response Lung disease Nitrogen washout Shunt Respiratory disease Carbon dioxide Steady state Embolism Inert gas Lung volume Bronchus disease Anesthesia Obstructive pulmonary disease Gas exchange Emphysema |
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Snippet | To simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation–perfusion ( V˙A/ Q˙) and ventilation–volume (... Background. To simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation–perfusion (V˙A/Q˙) and... To simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation-perfusion (VA/Q) and ventilation-volume... BACKGROUND: To simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation-perfusion (VA/Q) and... BACKGROUNDTo simulate the short-term dynamics of soluble gas exchange (e.g. CO2 rebreathing), model structure, ventilation-perfusion (VA/Q) and... |
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SubjectTerms | Adult Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Breath Tests Humans Male Medical sciences modelling Models, Biological Pulmonary Alveoli - physiopathology Pulmonary Embolism - physiopathology Pulmonary Emphysema - physiopathology Pulmonary Gas Exchange Solubility ventilation inhomogeneity Ventilation-Perfusion Ratio ventilation/perfusion distribution |
Title | A tidally breathing model of ventilation, perfusion and volume in normal and diseased lungs |
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