Positive end expiratory pressure and expiratory flow limitation: A model study

Acta Biotheoretica 49 (4):277-290 (2001)

Abstract
Patients suffering from chronic obstructive pulmonary diseases, frequently exhibit expiratory airflow limitation. We propose a mathematical model describing the mechanical behavior of the ventilated respiratory system. This model has to simulate applied positive end-expiratory pressure effects during expiration, a process used by clinicians to improve airflow. The proposed model consists of a nonlinear two-compartment system. One of the compartments represents the collapsible airways and mimics its dynamic compression, the other represents the lung and chest wall compartment. For all clinical conditions tested, the mathematical model simulates the removal of expiratory airflow limitation at PEEP lower than 70–80% of intrinsic end-expiratory pressure, i.e. the end-expiratory alveolar pressure without PEEP. It also shows the presence of an optimal PEEP. The optimal PEEP contributes to decrease PAet from 7.4 ± 0.9 to 5.4 ± 0.9 hPa. This simplistic mathematical model gives a plausible explanation of the expiratory airflow limitation removal with PEEP and a rationale to the practice of PEEP application to airflow limited patients
Keywords Philosophy   Philosophy of Biology   Evolutionary Biology
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Reprint years 2004
DOI 10.1023/A:1014278526603
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