title: A computer model of the artificially ventilated human respiratory system in adult intensive care.
abstract: A multi-technique approach to modelling artificially ventilated patients on the adult general intensive care unit (ICU) is proposed. Compartmental modelling techniques were used to describe the mechanical ventilator and the flexible hoses that connect it to the patient. 3D CFD techniques were used to model flow in the major airways and a Windkessel style balloon model was used to model the mechanical properties of the lungs. A multi-compartment model of the lung based on bifurcating tree structures representing the conducting airways and pulmonary circulation allowed lung disease to be modelled in terms of altered V/Q ratios within a lognormal distribution of values and it is from these that gas exchange was determined. A compartmental modelling tool, Bathfp, was used to integrate the different modelling techniques into a single model. The values of key parameters in the model could be obtained from measurements on patients in an ICU whilst a sensitivity analysis showed that the model was insensitive to the value of other parameters within it. Measured and modelled values for arterial blood gases and airflow parameters are compared for 46 ventilator settings obtained from 6 ventilator dependent patients. The results show correlation coefficients of 0.88 and 0.85 for the arterial partial pressures of the O(2) and CO(2), respectively (p<0.01) and of 0.99 and 0.96 for upper airway pressure and tidal volume, respectively (p<0.01). The difference between measured and modelled values was large in physiological terms, suggesting that some optimisation of the model is required.
authors.affiliation: Department of Physics, University of Warwick, Coventry CV4 7AL, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Wilson
authors.forename: C M
authors.initials: CM
authors.lastname: Murphy
authors.forename: B S
authors.initials: BS
authors.lastname: Brook
authors.forename: D
authors.initials: D
authors.lastname: Breen
authors.forename: A W
authors.initials: AW
authors.lastname: Miles
authors.forename: D G
authors.initials: DG
authors.lastname: Tilley
mesh_terms: D003198:Computer Simulation; D003422:Critical Care; D004867:Equipment Design; D006801:Humans; D008168:Lung / Q000502:physiology; D008297:Male; D008962:Models, Theoretical; D010477:Perfusion; D011659:Pulmonary Gas Exchange; D012123:Pulmonary Ventilation; D012119:Respiration; D012121:Respiration, Artificial / Q000379:methods; D013990:Tidal Volume / Q000502:physiology; D014132:Trachea / Q000502:physiology