Minimal model quantification of pulmonary gas exchange in intensive care patients.
Mathematical models are required to describe pulmonary gas exchange. The challenge remains to find models which are complex enough to describe physiology and simple enough for clinical practice. This study aimed at finding the necessary 'minimal' modeling complexity to represent the gas exchange of both oxygen and carbon dioxide. Three models of varying complexity were compared for their ability to fit measured data from intensive care patients and to provide adequate description of patients' gas exchange abnormalities. Pairwise F-tests showed that a two parameter model provided superior fit to patient data compared to a shunt only model (p<0.001), and that a three parameter model provided superior fit compared to the two parameter model (p<0.1). The three parameter model describes larger ranges of ventilation to perfusion ratios than the two parameter model, and is identifiable from data routinely available in clinical practice.
Center for Model-based Medical Decision Support, Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, E4-204, DK-9220 Aalborg East, Denmark. dank@hst.aau.dk
Dan S
DS
Karbing
Søren
S
Kjærgaard
Steen
S
Andreassen
Kurt
K
Espersen
Stephen E
SE
Rees
D002245:Carbon Dioxide / Q000378:metabolism*; D003198:Computer Simulation; D003422:Critical Care / Q000379:methods*; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008954:Models, Biological; D015233:Models, Statistical; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D010100:Oxygen / Q000378:metabolism*; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D015203:Reproducibility of Results; D012119:Respiration; D012121:Respiration, Artificial / Q000295:instrumentation*; D012129:Respiratory Function Tests / Q000295:instrumentation; D012131:Respiratory Insufficiency / Q000473:pathology; D012680:Sensitivity and Specificity; D014692:Ventilation-Perfusion Ratio / Q000502:physiology
D002245:Carbon Dioxide; D010100:Oxygen