title: Microscale distribution and dynamic surface tension of pulmonary surfactant normalize the recruitment of asymmetric bifurcating airways.
abstract: We investigate the influence of bifurcation geometry, asymmetry of daughter airways, surfactant distribution, and physicochemical properties on the uniformity of airway recruitment of asymmetric bifurcating airways. To do so, we developed microfluidic idealized in vitro models of bifurcating airways, through which we can independently evaluate the impact of carina location and daughter airway width and length. We explore the uniformity of recruitment and its relationship to the dynamic surface tension of the lining fluid and relate this behavior to the hydraulic (PHyd) and capillary (PCap) pressure drops. These studies demonstrate the extraordinary importance of PCapin stabilizing reopening, even in highly asymmetric systems. The dynamic surface tension of pulmonary surfactant is integral to this stability because it modulates PCapin a velocity-dependent manner. Furthermore, the surfactant distribution at the propagating interface can have a very large influence on recruitment stability by focusing surfactant preferentially to specific daughter airways. This implies that modification of the surfactant distribution through novel modes of ventilation could be useful in inducing uniformly recruited lungs, aiding in gas exchange, and reducing ventilator-induced lung injury.NEW & NOTEWORTHYThe dynamic surface tension of pulmonary surfactant is integral to the uniformity of asymmetric bifurcation airway recruitments because it modulates capillary pressure drop in a velocity-dependent manner. Also, the surfactant distribution at the propagating interface can have a very large influence on recruitment stability by focusing surfactant preferentially to specific daughter airways. This implies that modification of the surfactant distribution through novel modes of ventilation could be useful in inducing uniformly recruited lungs, reducing ventilator-induced lung injury.
authors.affiliation: Department of Biomedical Engineering, Tulane University, New Orleans, Louisiana.
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Yamaguchi
authors.affiliation: Department of Biomedical Engineering, Tulane University, New Orleans, Louisiana.
authors.forename: Liam P
authors.initials: LP
authors.lastname: Nolan
authors.affiliation: Department of Biomedical Engineering, Tulane University, New Orleans, Louisiana dpg@tulane.edu.
authors.forename: Donald P
authors.initials: DP
authors.lastname: Gaver
mesh_terms: D008168:Lung / Q000378:metabolism*; D008954:Models, Biological; D011312:Pressure; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D011663:Pulmonary Surfactants / Q000378:metabolism*; D012119:Respiration; D015656:Respiratory Mechanics / Q000502:physiology*; D013500:Surface Tension; D055397:Ventilator-Induced Lung Injury / Q000378:metabolism / Q000503:physiopathology
chemical_list: D011663:Pulmonary Surfactants
keywords: ARDS; VILI; lung; respiratory airways; surfactant