AN INTEGRATED PHYSIOLOGICAL MODEL OF THE LUNG MECHANICS AND GAS EXCHANGE USING ELECTRICAL IMPEDANCE TOMOGRAPHY IN THE ANALYSIS OF VENTILATION STRATEGIES IN ARDS PATIENTS

M. Denaï, M. Mahfouf, A. Wang, D. A. Linkens, G. H. Mills

2010

Abstract

Thoracic Electrical Impedance Tomography (EIT) is a non-invasive technique which attempts to reconstruct a cross-sectional image of the internal spatial distribution of conductivity from electrical measurements made by injecting small alternating currents via an electrode array placed on the surface of the thorax. Because air is highly resistive to electric currents whereas fluids and blood are good conductors, it is possible to detect changes in lungs air content with EIT enabling the assessment of ventilation distribution. This paper presents a physiological model which integrates a previously developed gas exchange model with a model of the lung mechanics. This model is combined with a two-dimensional (2D) finite element mesh of the thorax to simulate EIT image reconstruction in patients with acute Respiratory Distress Syndrome (ARDS) under mechanical ventilation. The model was able to track lung ventilation distribution under various simulated ARDS conditions and ventilator settings.

References

  1. Adler, A. and Lionheart, W.R.B., 2006. Uses and abuses of EIDORS: an extensible software base for EIT, Physiology Measurement, 27, S25-S42. (Available: http://eidors3d.sourceforge.net/).
  2. Brown, B.H., Barber, D.C. and Seager, A.D., 1985. Applied potential tomography: possible clinical applications, Clin Phys Physiol Mea., 6, 109-121.
  3. Crotti, S., Mascheroni, D., Caironi, P., Pelosi, P., Ronsoni, G., Mondino, G.M., Marini, J.J. and Gattinoni, L., 2001. Recruitment and derecruitment during acute respiratory distress syndrome, Am J Respir Crit Care Med, 164, 131-140.
  4. Frerichs, I., 2000. Electrical impedance tomography (EIT) in applications related to lung and ventilation: A review of experimental and clinical activities, Physiol Meas, 21, R1-R21.
  5. Hickling, K.G., 2001. Best compliance during a decremental, but not incremental, positive endexpiratory pressure trial is related to open-lung positive end-expiratory pressure: A mathematical model of acute respiratory distress syndrome lungs. Am J of Respir Crit Care Med, 163, 69-77.
  6. Markhorst, D.G., van Genderingen, H.R. and van Vught, A.J., 2004. Static pressure-volume curve characteristics are moderate estimators of optimal airway pressures in a mathematical model of (primary/pulmonary) acute respiratory distress syndrome,” Intens Care Med, 30, 2086-2093.
  7. Panoutsos, G., Mahfouf, M., Brown, B.H. and Mills, G.H., 2007. Electrical impedance tomography (EIT) in pulmonary measurement: a review of applications and research,” Proceedings of the 5th IASTED International Conference: biomedical engineering, Innsbruck, Austria, 221-230.
  8. Putensen, C., Wrigge, H., and Weiler, N., 2007. Electrical impedance tomography guided ventilation therapy, Current Opinion in Critical Care, 13(3), 344-350.
  9. Salazar, E. and Knowles, J.H., 1964. Analysis of the pressure-volume characteristics of the lungs, J of Appl Physiol, 19, 97-104.
  10. Smith, B.W., Rees, S., Tvorup, J., Christensen, C.G. and Andreassen, S., 2005. Modelling the influence of the pulmonary pressure-volume curve on gas exchange, Proceedings of the 27th IEEE Annual Conf on Engineering in Medicine and Biology, Shangai, China.
  11. Smulders, L.A. and van Oosterom, A., 1992. Application of electrical impedance tomography to the determination of lung volume, Clin Phys Physiol Meas, 13, 167-170.
  12. Soni, N.K., Paulsen, K.D., Dehghani, H. and Hartov, A., 2006. A 3-D reconstruction algorithm for EIT planner electrode arrays, IEEE Trans. Medical Imaging, 25(1), 55-61.
  13. Tremblay, L.N. and Slutsky, A.S., 2006. Ventilatorinduced lung injury: from the bench to the bedside, Intensive Care Med, 32, 24-33.
  14. Victorino, J.A., Borges, J.B., Okamoto, V.N., Matos, G.F.J, Tucci, M.R., Caramez, M.P.R., Tanaka, H., Sipmann, F.S., Santos, D.C.B., Barbas, C.S.V., Carvalho, C.R.R. and Amato, M.B.P., 2004. Imbalances in regional lung ventilation: A validation study on electrical impedance tomography, Am J Respir Crit Care Med, 169, 791-800.
  15. Wang A., Mahfouf M. and Mills G.H.., 2006. A continuously updated hybrid blood gas model for ventilated patients. The 6th IFAC Symposium on Modelling and Control in Biomedical Systems, Reims, France.
  16. Wang A., Panoutsos, G., Mahfouf M. and Mills G.H., 2007. An improved blood gas intelligent model for mechanically ventilated patients in the intensive care unit. The 5th IASTED International Conference on Biomedical Engineering, Innsbruck, Austria.
  17. Workman, J.M., Penman, W.B., Bromberger-Barnea, B., Perut, S. and Riley, R.L., 1965. Alveolar dead space, alveolar shunt, and transpulmonary pressure. Journal of Applied Physiology, 20, 816-824.
  18. Yuta, Y., Chase, J.G., Shaw, G.M. and Hann, C., 2004. Dynamic models of ARDS lung mechanics for optimal patient ventilation, Proceedings of the 26th Annual International Conference: of the IEEE EMBS San Francisco, USA, 861-864.
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Paper Citation


in Harvard Style

Denaï M., Mahfouf M., Wang A., A. Linkens D. and H. Mills G. (2010). AN INTEGRATED PHYSIOLOGICAL MODEL OF THE LUNG MECHANICS AND GAS EXCHANGE USING ELECTRICAL IMPEDANCE TOMOGRAPHY IN THE ANALYSIS OF VENTILATION STRATEGIES IN ARDS PATIENTS . In Proceedings of the Third International Conference on Bio-inspired Systems and Signal Processing - Volume 1: BIOSIGNALS, (BIOSTEC 2010) ISBN 978-989-674-018-4, pages 208-213. DOI: 10.5220/0002709502080213


in Bibtex Style

@conference{biosignals10,
author={M. Denaï and M. Mahfouf and A. Wang and D. A. Linkens and G. H. Mills},
title={AN INTEGRATED PHYSIOLOGICAL MODEL OF THE LUNG MECHANICS AND GAS EXCHANGE USING ELECTRICAL IMPEDANCE TOMOGRAPHY IN THE ANALYSIS OF VENTILATION STRATEGIES IN ARDS PATIENTS},
booktitle={Proceedings of the Third International Conference on Bio-inspired Systems and Signal Processing - Volume 1: BIOSIGNALS, (BIOSTEC 2010)},
year={2010},
pages={208-213},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0002709502080213},
isbn={978-989-674-018-4},
}


in EndNote Style

TY - CONF
JO - Proceedings of the Third International Conference on Bio-inspired Systems and Signal Processing - Volume 1: BIOSIGNALS, (BIOSTEC 2010)
TI - AN INTEGRATED PHYSIOLOGICAL MODEL OF THE LUNG MECHANICS AND GAS EXCHANGE USING ELECTRICAL IMPEDANCE TOMOGRAPHY IN THE ANALYSIS OF VENTILATION STRATEGIES IN ARDS PATIENTS
SN - 978-989-674-018-4
AU - Denaï M.
AU - Mahfouf M.
AU - Wang A.
AU - A. Linkens D.
AU - H. Mills G.
PY - 2010
SP - 208
EP - 213
DO - 10.5220/0002709502080213