title: Modeling flow in a compromised pediatric airway breathing air and heliox.
abstract: OBJECTIVE
  The aim of this study was to perform computer simulations of flow within an accurate model of a pediatric airway with subglottic stenosis. It is believed that the airflow characteristics in a stenotic airway are strongly related to the sensation of dyspnea.
  
  
  METHODS
  Computed tomography images through the respiratory tract of an infant with subglottic stenosis, were used to construct the three-dimensional geometry of the airway. By using computational fluid dynamics (CFD) modeling to capture airway flow patterns during inspiration and expiration, we obtained information pertaining to flow velocity, static airway wall pressure, pressure drop across the stenosis, and wall shear stress. These simulations were performed with both air and heliox.
  
  
  RESULTS
  Unlike air, heliox maintained laminar flow through the stenosis. The calculated pressure drop over stenosis was lower for the heliox flow, in contrast to the airflow case. This lead to an approximately 40% decrease in airway resistance when using heliox, and presumably causes a decrease in the level of effort required for breathing.
  
  
  CONCLUSIONS
  CFD simulations offer a quantitative method of evaluating airway flow dynamics in patients with airway abnormalities. CFD modeling illustrated the flow features and quantified flow parameters within a pediatric airway with subglottic stenosis. Simulations with air and heliox conditions mirrored the known clinical benefits of heliox as compared with air. We anticipate that computer simulation models will ultimately allow a better understanding of changes in flow caused by specific medical and surgical interventions in patients with conditions associated with dyspnea.
authors.affiliation: Department of Aerospace Engineering and Engineering Mechanics, University of Cincinnati, Cincinnati, OH 45221-0070, USA. mihai.mihaescu@uc.edu
authors.forename: Mihai
authors.initials: M
authors.lastname: Mihaescu
authors.forename: Ephraim
authors.initials: E
authors.lastname: Gutmark
authors.forename: Shanmugam
authors.initials: S
authors.lastname: Murugappan
authors.forename: Ravindhra
authors.initials: R
authors.lastname: Elluru
authors.forename: Aliza
authors.initials: A
authors.lastname: Cohen
authors.forename: J Paul
authors.initials: JP
authors.lastname: Willging
mesh_terms: D000399:Air Pressure; D000403:Airway Resistance / Q000502:physiology; D003198:Computer Simulation; D006371:Helium / Q000008:administration & dosage*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D007829:Laryngostenosis / Q000151:congenital / Q000503:physiopathology* / Q000628:therapy; D008962:Models, Theoretical; D010100:Oxygen / Q000008:administration & dosage*; D012123:Pulmonary Ventilation / Q000502:physiology*; D012984:Software; D014057:Tomography, X-Ray Computed
chemical_list: D006371:Helium; C038949:heliox; D010100:Oxygen