Model-based respiratory mechanics to titrate PEEP and monitor disease state for experimental ARDS subjects

• Published in: 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) Vol. 2013; pp. 5224 - 5227
• Main Authors: van Drunen, Erwin J., Chiew, Yeong Shiong, Chase, J. Geoffrey, Lambermont, Bernard, Janssen, Nathalie, Desaive, Thomas
• Format: Conference Proceeding Journal Article
• Language: English
• Published: United States IEEE 01.01.2013
• Subjects: Animals; Diseases; Lung - physiopathology; Lungs; Models, Biological; Monitoring; Positive-Pressure Respiration; Recruitment; Resistance; Respiratory Distress Syndrome, Adult - physiopathology; Respiratory Distress Syndrome, Adult - therapy; Respiratory Mechanics; Swine; Ventilation
• ISSN: 1094-687X; 1557-170X
• DOI: 10.1109/EMBC.2013.6610726

Modelling the respiratory mechanics of mechanically ventilated (MV) patients can provide useful information to guide MV therapy. Two model-based methods were evaluated based on data from three experimental acute respiratory distress syndrome (ARDS) induced piglets and validated against values available from ventilators. A single compartment lung model with integral-based parameter identification was found to be effective in capturing fundamental respiratory mechanics during inspiration. The trends matched clinical expectation and provided better resolution than clinically derived linear model metrics. An expiration time constant model also captured the same trend in respiratory elastance. However, the assumption of constant resistance and a slightly higher fitting error results in less insight than the single compartment model. Further research is required to confirm its application in titrating to optimal MV settings.