Theoretical analysis of factors influencing recovery of ventilation distributions from inert gas washout data.
A method is presented that allows to calculate distributions of ventilation from measured time courses of inert gas washout. In the mathematical description of the washout process a discontinuous algorithm is applied: For each individual breath inspiratory and expiratory tidal volumes, endexpiratory alveolar volume, and dead space inspiration are taken into account. Furthermore, volume reduction of the alveolar gas according to the gas exchange ratio is considered. Commonly in ventilation analysis, the specific ventilation serves as abscissa of the density of the ventilation distribution. As at a given location the specific ventilation changes with varying tidal volumes even if the distribution pattern of the ventilation amongst the lung remains unchanged, the normalized specific ventilation is newly introduced instead. This quantity is defined to be the ratio of regional alveolar ventilation and regional endexpiratory alveolar volume divided by the total alveolar ventilation. The normalized specific ventilation reflects the distribution of the ventilation independently of variations in tidal volume and respiratory frequency. Furthermore, it allows direct comparison of ventilation distributions that are determined at varying alveolar ventilations. Ventilation distributions are approximated by the transformed beta distribution which is parameterized by its mean, variance, and skewness. In order to evaluate simplifications introduced in former studies and to quantify their effects on the resulting ventilation distributions, washout time courses are generated in a computer simulation from the comprehensive discontinuous algorithm and are used to recover ventilation distributions by means of accordingly simplified algorithms. Furthermore, the influence of errors that may occur in the measurement of tidal volumes are assessed. The results of these studies are summarized as follows: Serious errors are introduced in the recovered distributions if ventilation is modelled as a continuous process and if physiological variations in tidal volumes or endexpiratory alveolar volumes or dead space inspiration are neglected. Modelling the entire dead space as common dead space or as local dead space only, entails significant errors as well. Statistical errors of 2% in the measured volumes practically do not have any impacts on the recovered distributions whereas systematic errors significantly deteriorate the results. In conclusion, in ventilation analysis it is essential to apply a discontinuous description of the inert gas washout process that accounts for dead space inspiration and variations in the above mentioned quantities. In addition it is important to obtain all measured values with the highest achievable precision.
Meyer
D
D
Physiologisches Institut, Universität Mainz, West Germany.
Groebe
K
K
Thews
G
G
D003198:Computer Simulation; D006801:Humans; D008954:Models, Biological; D005741:Noble Gases; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012119:Respiration / Q000502:physiology*; D012126:Respiratory Dead Space / Q000502:physiology
D005741:Noble Gases