Identification of a non-linear model as a new method to detect expiratory airflow limitation in mechanically ventilated patients
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Acta Biotheoretica 52 (4):241-254 (2004)
Expiratory flow limitation (EFL) can occur in mechanically ventilated patients with chronic obstructive pulmonary disease and other disorders. It leads to dynamic hyperinflation with ensuing deleterious consequences. Detecting EFL is thus clinically relevant. Easily applicable methods however lack this detection being routinely made in intensive care. Using a simple mathematical model, we propose a new method to detect EFL that does not require any intervention or modification of the ongoing therapeutic. The model consists in a monoalveolar representation of the respiratory system, including a collapsible airway that is submitted to periodic changes in pressure at the airway opening: EFL provokes a sharp expiratory increase in the resistance Rc of the collapsible airway. The model parameters were identified via the Levenberg-Marquardt method by fitting simulated data on the airway pressure and the flow signals recorded in 10 mechanically ventilated patients. A sensitivity study demonstrated that only 8/11 parameters needed to be identified, the remaining three being given reasonable physiological values. Flow-volume curves built at different levels of positive expiratory pressure, PEEP, during PEEP trials (stepwise increases in positive end-expiratory pressure to optimize ventilator settings) have shown evidence of EFL in three cases. This was concordant with parameter identification (high Rc during expiration for EFL patients). We conclude from these preliminary results that our model is a potential tool for the non-invasive detection of EFL in mechanically ventilated patients.
|Keywords||Philosophy Philosophy of Biology Evolutionary Biology|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Tony Hope, John Mcmillan & Elaine Hill (2010). Intensive Care Triage: Priority Should Be Independent of Whether Patients Are Already Receiving Intensive Care. Bioethics 26 (5):259-266.
Pierre F. Baconnier, Catherine Marey & Ahmed Ménaouar (1997). Simulation of Pulmonay Damages Induced by Inhaled CL2 on the Bronchial Tree. Acta Biotheoretica 45 (3-4):237-250.
Gila Benchetrit (unknown). A Simple Dynamic Model of Respiratory Pump. Acta Biotheoretica.
Etienne Roux, Penelope J. Noble, Jean-Marc Hyvelin & Denis Noble (2001). Modelling of Ca2+-Activated Chloride Current in Tracheal Smooth Muscle Cells. Acta Biotheoretica 49 (4):291-300.
Joachim Widder (2004). The Origins of Medical Evidence: Communication and Experimentation. Medicine, Health Care and Philosophy 7 (1):99-104.
C. Vauge, B. Carbonne, E. Papiernik & F. Ferré (2000). A Mathematical Model of Uterine Dynamics and its Application to Human Parturition. Acta Biotheoretica 48 (2):95-105.
C. P. Bhunu, W. Garira & G. Magombedze (2009). Mathematical Analysis of a Two Strain Hiv/Aids Model with Antiretroviral Treatment. Acta Biotheoretica 57 (3):361-381.
Antoine Baumann, Frederique Claudot, Gerard Audibert, Paul-Michel Mertes & Louis Puybasset (2011). The Ethical and Legal Aspects of Palliative Sedation in Severely Brain Injured Patients: A French Perspective. Philosophy, Ethics, and Humanities in Medicine 6 (1):4-.
Christian Vauge, Thérèse-Marie Mignot, Brigitte Paris, Michelle Breuiller-Fouché, Charles Chapron, Michel Attoui & Françoise Ferré (2003). A Mathematical Model for the Spontaneous Contractions of the Isolated Uterine Smooth Muscle From Patients Receiving Progestin Treatment. Acta Biotheoretica 51 (1):19-34.
S. Khirani, L. Biot, A. Eberhard & P. Baconnier (2001). Positive End Expiratory Pressure and Expiratory Flow Limitation: A Model Study. Acta Biotheoretica 49 (4):277-290.
Added to index2009-01-28
Total downloads4 ( #383,052 of 1,699,818 )
Recent downloads (6 months)2 ( #269,935 of 1,699,818 )
How can I increase my downloads?