title: A patient-specific airway branching model for mechanically ventilated patients.
abstract: BACKGROUND
  Respiratory mechanics models have the potential to guide mechanical ventilation. Airway branching models (ABMs) were developed from classical fluid mechanics models but do not provide accurate models of in vivo behaviour. Hence, the ABM was improved to include patient-specific parameters and better model observed behaviour (ABMps).
  
  
  METHODS
  The airway pressure drop of the ABMps was compared with the well-accepted dynostatic algorithm (DSA) in patients diagnosed with acute respiratory distress syndrome (ARDS). A scaling factor (α) was used to equate the area under the pressure curve (AUC) from the ABMps to the AUC of the DSA and was linked to patient state.
  
  
  RESULTS
  The ABMps recorded a median α value of 0.58 (IQR: 0.54-0.63; range: 0.45-0.66) for these ARDS patients. Significantly lower α values were found for individuals with chronic obstructive pulmonary disease (P < 0.001).
  
  
  CONCLUSIONS
  The ABMps model allows the estimation of airway pressure drop at each bronchial generation with patient-specific physiological measurements and can be generated from data measured at the bedside. The distribution of patient-specific α values indicates that the overall ABM can be readily improved to better match observed data and capture patient condition.
authors.affiliation: University of Canterbury, Christchurch 8041, New Zealand.
authors.forename: Nor Salwa
authors.identifier: 0000-0002-1545-0990
authors.initials: NS
authors.lastname: Damanhuri
authors.affiliation: University of Canterbury, Christchurch 8041, New Zealand.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Docherty
authors.affiliation: University of Canterbury, Christchurch 8041, New Zealand.
authors.forename: Yeong Shiong
authors.identifier: 0000-0003-3222-2006
authors.initials: YS
authors.lastname: Chiew
authors.affiliation: University of Canterbury, Christchurch 8041, New Zealand.
authors.forename: Erwin J
authors.initials: EJ
authors.lastname: van Drunen
authors.affiliation: University of Liège, 4000 Liège, Belgium.
authors.forename: Thomas
authors.initials: T
authors.lastname: Desaive
authors.affiliation: University of Canterbury, Christchurch 8041, New Zealand.
authors.forename: J Geoffrey
authors.initials: JG
authors.lastname: Chase
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009520:New Zealand; D012121:Respiration, Artificial / Q000379:methods* / Q000592:standards; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult