Patterns of recruitment and injury in a heterogeneous airway network model

Stewart, P. S. and Jensen, O. E. (2015) Patterns of recruitment and injury in a heterogeneous airway network model. Journal of the Royal Society: Interface, 12, 20150523. (doi: 10.1098/rsif.2015.0523)

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In respiratory distress, lung airways become flooded with liquid and may collapse due to surface-tension forces acting on air-liquid interfaces, inhibiting gas exchange. This pa- per proposes a mathematical multiscale model for the mechanical ventilation of a network of occluded airways, where air is forced into the network at a fixed tidal volume, allowing investigation of optimal recruitment strategies. The temporal response is derived from mechanistic models of individual airway reopening, incorporating feedback on the airway pressure due to recruitment. The model accounts for stochastic variability in airway di- ameter and stiffness across and between generations. For weak heterogeneity, the network is completely ventilated via one or more avalanches of recruitment (with airways recruited in quick succession), each characterised by a transient decrease in the airway pressure; avalanches become more erratic for airways that are initially more flooded. However, the time taken for complete ventilation of the network increases significantly as the network becomes more heterogeneous, leading to increased stresses on airway walls. The model predicts that the most peripheral airways are most at risk of ventilation-induced damage. A positive-end-expiratory pressure (PEEP) reduces the total recruitment time but at the cost of larger stresses exerted on airway walls.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Stewart, Professor Peter
Authors: Stewart, P. S., and Jensen, O. E.
College/School:College of Science and Engineering > School of Mathematics and Statistics > Mathematics
Journal Name:Journal of the Royal Society: Interface
Publisher:The Royal Society
ISSN (Online):1742-5662
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in J. R. Soc. Interface 12: 20150523
Publisher Policy:Reproduced under a Creative Commons licence
Data DOI:10.5525/gla.researchdata.187

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