Estimation of lung recruitment characteristics using the static pressure-volume curve of lungs_Journal of Biomedical Engineering

Authors：

LIU Tianya ¹ , QIAO Huiting ¹ , XU Liqiang ¹ , LI Deyu ¹ ,  FAN Yubo ^1,2

1. Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P.R. China;
2. School of Medical Science and Engineering, Beihang University, Beijing 100083, P.R. China;

Corresponding author：

FAN Yubo, Email: yubofan@buaa.edu.cn

Keywords：

acute respiratory distress syndrome; mechanical ventilation; pressure-volume curve; lung recruitment

DOI：

10.7507/1001-5515.202008061

Video：

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Mechanical ventilation is an importmant life-sustaining treatment for patients with acute respiratory distress syndrome. Its clinical outcomes depend on patients’ characteristics of lung recruitment. Estimation of lung recruitment characteristics is valuable for the determination of ventilatory maneurvers and ventilator parameters. There is no easily-used, bedside method to assess lung recruitment characteristics. The present paper proposed a method to estimate lung recruitment characteristics from the static pressure-volume curve of lungs. The method was evaluated by comparing with published experimental data. Results of lung recruitment derived from the presented method were in high agreement with the published data, suggesting that the proposed method is capable to estimate lung recruitment characteristics. Since some advanced ventilators are capable to measure the static pressure-volume curve automatedly, the presented method is potential to be used at bedside, and it is helpful for clinicians to individualize ventilatory manuevers and the correpsonding ventilator parameters.

Citation： LIU Tianya, QIAO Huiting, XU Liqiang, LI Deyu, FAN Yubo. Estimation of lung recruitment characteristics using the static pressure-volume curve of lungs. Journal of Biomedical Engineering, 2021, 38(2): 326-332. doi: 10.7507/1001-5515.202008061 Copy

1.	国家卫生健康委办公厅. 关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知(国卫办医函﹝2020﹞184 号). (2020-03-03) [2021-03-10]. http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml.
2.	Pham T, Rubenfeld G D. Fifty years of research in ARDS. the epidemiology of acute respiratory distress syndrome. a 50th birthday review. Am J Respir Crit Care Med, 2017, 195(7): 860-870.
3.	Bellani G, Laffey J G, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA, 2016, 315(8): 788-800.
4.	Zhou Fei, Yu Ting, Du Ronghui, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 2020, 395(1229): 1054-1062.
5.	Yang Xiaobo, Yuan Yu, Xu Jiqian, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med, 2020, 8(5): 475-481.
6.	Fan E, Brodie D, Slutsky A S. Acute respiratory distress syndrome advances in diagnosis and treatment. JAMA, 2018, 319(7): 698-710.
7.	Schiller H J, Mccann Ⅱ U G, Carney D E, et al. Altered alveolar mechanics in the acutely injured lung. Crit Care Med, 2001, 29(5): 1049-1055.
8.	Slutsky A S, Ranieri V M. Ventilator-induced lung injury. N Engl J Med, 2013, 369(22): 2126-2136.
9.	Grasso S, Mascia L, Del Turco M, et al. Effects of recruiting maneuvers in patients with acute respiratory distress syndrome ventilated with protective ventilatory strategy. Anesthesiology, 2002, 96(4): 795-802.
10.	Briel M, Meade M, Mercat A, et al. Higher vs. lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA, 2010, 303(9): 865-873.
11.	Gattinoni L, Caironi P, Cressoni M, et al. Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med, 2006, 354(17): 1775-1786.
12.	Brower R G, Lanken P N, Macintyre N, et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med, 2004, 351(4): 327-336.
13.	Zheng Xi, Jiang Yijia, Jia Huimiao, et al. Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) versus low PEEP on patients with moderate-severe acute respiratory distress syndrome: a systematic review and meta-analysis of randomized controlled trials. Ther Adv Respir Dis, 2019, 13: 1753466619858228.
14.	Bouhemad B, Brisson H, Le-Guen M, et al. Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment. Am J Respir Crit Care Med, 2011, 183(3): 341-347.
15.	Gong B, Krueger-Ziolek S, Moeller K, et al. Electrical impedance tomography: functional lung imaging on its way to clinical practice?. Expert Rev Respir Med, 2015, 9(6): 721-737.
16.	Chiumello D, Marino A, Brioni M, et al. Lung recruitment assessed by respiratory mechanics and computed tomography in patients with acute respiratory distress syndrome. what is the relationship?. Am J Respir Crit Care Med, 2016, 193(11): 1254-1263.
17.	Chen L, Sorbo L D, Grieco D L, et al. Potential for lung recruitment estimated by the recruitment-to-inflation ratio in acute respiratory distress syndrome. Am J Respir Crit Care Med, 2020, 201(2): 178-187.
18.	Frazer D G, Lindsley W G, Mckinney W, et al. A model of the recruitment-derecruitment and volume of lung units in an excised lung as it is inflated-deflated between minimum and maximum lung volume. J Biomech Eng, 2013, 135(3): 34503.
19.	Sundaresan A, Yuta T, Hann C E, et al. A minimal model of lung mechanics and model-based markers for optimizing ventilator treatment in ARDS patients. Comput Methods Programs Biomed, 2009, 95(2): 166-180.
20.	Crotti S, Mascheroni D, Caironi P, et al. Recruitment and derecruitment during acute respiratory failure: a clinical study. Am J Respir Crit Care Med, 2001, 164(1): 131-140.
21.	Pelosi P, Goldner M, Mckibben A, et al. Recruitment and derecruitment during acute respiratory failure: an experimental study. Am J Respir Crit Care Med, 2001, 164(1): 122-130.
22.	Mertens M, Tabuchi A, Meissner S, et al. Alveolar dynamics in acute lung injury: heterogeneous distension rather than cyclic opening and collapse. Crit Care Med, 2009, 37(9): 2604-2611.
23.	Liu T, Wang Y, Liu X, et al. Effects of alveolar morphology on alveolar mechanics: an experimental study of mouse lung based on two-and three-dimensional imaging methods. J Mech Med Biol, 2019, 19(1): 1950027.
24.	Gattinoni L, Caironi P, Pelosi P, et al. What has computed tomography taught us about the acute respiratory distress syndrome?. Am J Respir Crit Care Med, 2001, 164(9): 1701-1711.
25.	Harris R S. Pressure-volume curves of the respiratory system. Respir Care, 2005, 50(1): 78-98; discussion 98-9.
26.	Chiumello D, Cressoni M, Chierichetti M, et al. Nitrogen washout/washin, helium dilution and computed tomography in the assessment of end expiratory lung volume. Crit Care, 2008, 12(6): R150.

1. 国家卫生健康委办公厅. 关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知(国卫办医函﹝2020﹞184 号). (2020-03-03) [2021-03-10]. http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml.
2. Pham T, Rubenfeld G D. Fifty years of research in ARDS. the epidemiology of acute respiratory distress syndrome. a 50th birthday review. Am J Respir Crit Care Med, 2017, 195(7): 860-870.
3. Bellani G, Laffey J G, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA, 2016, 315(8): 788-800.
4. Zhou Fei, Yu Ting, Du Ronghui, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 2020, 395(1229): 1054-1062.
5. Yang Xiaobo, Yuan Yu, Xu Jiqian, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med, 2020, 8(5): 475-481.
6. Fan E, Brodie D, Slutsky A S. Acute respiratory distress syndrome advances in diagnosis and treatment. JAMA, 2018, 319(7): 698-710.
7. Schiller H J, Mccann Ⅱ U G, Carney D E, et al. Altered alveolar mechanics in the acutely injured lung. Crit Care Med, 2001, 29(5): 1049-1055.
8. Slutsky A S, Ranieri V M. Ventilator-induced lung injury. N Engl J Med, 2013, 369(22): 2126-2136.
9. Grasso S, Mascia L, Del Turco M, et al. Effects of recruiting maneuvers in patients with acute respiratory distress syndrome ventilated with protective ventilatory strategy. Anesthesiology, 2002, 96(4): 795-802.
10. Briel M, Meade M, Mercat A, et al. Higher vs. lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA, 2010, 303(9): 865-873.
11. Gattinoni L, Caironi P, Cressoni M, et al. Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med, 2006, 354(17): 1775-1786.
12. Brower R G, Lanken P N, Macintyre N, et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med, 2004, 351(4): 327-336.
13. Zheng Xi, Jiang Yijia, Jia Huimiao, et al. Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) versus low PEEP on patients with moderate-severe acute respiratory distress syndrome: a systematic review and meta-analysis of randomized controlled trials. Ther Adv Respir Dis, 2019, 13: 1753466619858228.
14. Bouhemad B, Brisson H, Le-Guen M, et al. Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment. Am J Respir Crit Care Med, 2011, 183(3): 341-347.
15. Gong B, Krueger-Ziolek S, Moeller K, et al. Electrical impedance tomography: functional lung imaging on its way to clinical practice?. Expert Rev Respir Med, 2015, 9(6): 721-737.
16. Chiumello D, Marino A, Brioni M, et al. Lung recruitment assessed by respiratory mechanics and computed tomography in patients with acute respiratory distress syndrome. what is the relationship?. Am J Respir Crit Care Med, 2016, 193(11): 1254-1263.
17. Chen L, Sorbo L D, Grieco D L, et al. Potential for lung recruitment estimated by the recruitment-to-inflation ratio in acute respiratory distress syndrome. Am J Respir Crit Care Med, 2020, 201(2): 178-187.
18. Frazer D G, Lindsley W G, Mckinney W, et al. A model of the recruitment-derecruitment and volume of lung units in an excised lung as it is inflated-deflated between minimum and maximum lung volume. J Biomech Eng, 2013, 135(3): 34503.
19. Sundaresan A, Yuta T, Hann C E, et al. A minimal model of lung mechanics and model-based markers for optimizing ventilator treatment in ARDS patients. Comput Methods Programs Biomed, 2009, 95(2): 166-180.
20. Crotti S, Mascheroni D, Caironi P, et al. Recruitment and derecruitment during acute respiratory failure: a clinical study. Am J Respir Crit Care Med, 2001, 164(1): 131-140.
21. Pelosi P, Goldner M, Mckibben A, et al. Recruitment and derecruitment during acute respiratory failure: an experimental study. Am J Respir Crit Care Med, 2001, 164(1): 122-130.
22. Mertens M, Tabuchi A, Meissner S, et al. Alveolar dynamics in acute lung injury: heterogeneous distension rather than cyclic opening and collapse. Crit Care Med, 2009, 37(9): 2604-2611.
23. Liu T, Wang Y, Liu X, et al. Effects of alveolar morphology on alveolar mechanics: an experimental study of mouse lung based on two-and three-dimensional imaging methods. J Mech Med Biol, 2019, 19(1): 1950027.
24. Gattinoni L, Caironi P, Pelosi P, et al. What has computed tomography taught us about the acute respiratory distress syndrome?. Am J Respir Crit Care Med, 2001, 164(9): 1701-1711.
25. Harris R S. Pressure-volume curves of the respiratory system. Respir Care, 2005, 50(1): 78-98; discussion 98-9.
26. Chiumello D, Cressoni M, Chierichetti M, et al. Nitrogen washout/washin, helium dilution and computed tomography in the assessment of end expiratory lung volume. Crit Care, 2008, 12(6): R150.

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Estimation of lung recruitment characteristics using the static pressure-volume curve of lungs

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