title: A mathematical model for carbon dioxide elimination: an insight for tuning mechanical ventilation.
abstract: OBJECTIVE
  The aim is to provide better understanding of carbon dioxide (CO2) elimination during ventilation for both the healthy and atelectatic condition, derived in a pressure-controlled mode. Therefore, we present a theoretical analysis of CO2 elimination of healthy and diseased lungs.
  
  
  METHODS
  Based on a single-compartment model, CO2 elimination is mathematically modeled and its contours were plotted as a function of temporal settings and driving pressure. The model was validated within some level of tolerance on an average of 4.9% using porcine dynamics.
  
  
  RESULTS
  CO2 elimination is affected by various factors, including driving pressure, temporal variables from mechanical ventilator settings, lung mechanics and metabolic rate.
  
  
  CONCLUSIONS
  During respiratory care, CO2 elimination is a key parameter for bedside monitoring, especially for patients with pulmonary disease. This parameter provides valuable insight into the status of an atelectatic lung and of cardiopulmonary pathophysiology. Therefore, control of CO2 elimination should be based on the fine tuning of the driving pressure and temporal ventilator settings. However, for critical condition of hypercapnia, airway resistance during inspiration and expiration should be additionally measured to determine the optimal percent inspiratory time (%TI) to maximize CO2 elimination for treating patients with hypercapnia.
authors.affiliation: Philips Chair for Medical Information Technology, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, 52074, Germany, pomprapa@hia.rwth-aachen.de.
authors.forename: Anake
authors.initials: A
authors.lastname: Pomprapa
authors.forename: David
authors.initials: D
authors.lastname: Schwaiberger
authors.forename: Burkhard
authors.initials: B
authors.lastname: Lachmann
authors.forename: Steffen
authors.initials: S
authors.lastname: Leonhardt
mesh_terms: D000403:Airway Resistance; D000818:Animals; D002138:Calibration; D002245:Carbon Dioxide / Q000378:metabolism*; D008954:Models, Biological; D001261:Pulmonary Atelectasis / Q000503:physiopathology; D012123:Pulmonary Ventilation / Q000502:physiology*; D012121:Respiration, Artificial / Q000379:methods* / Q000592:standards; D013552:Swine; D013990:Tidal Volume
chemical_list: D002245:Carbon Dioxide