NDLI: Positive End Expiratory Pressure and Expiratory Flow Limitation: A Model Study

Content Provider	Springer Nature Link
Author	Khirani, S. Biot, L. Eberhard, A. Baconnier, P.
Copyright Year	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 (PEEP) 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 (n=16), the mathematical model simulates the removal of expiratory airflow limitation at PEEP lower than 70–80% of intrinsic end-expiratory pressure (PEEPi), i.e. the end-expiratory alveolar pressure (PAet) without PEEP. It also shows the presence of an optimal PEEP. The optimal PEEP contributes to decrease PAet from 7.4 ± 0.9 (SD) to 5.4 ± 0.9 hPa (p < 0.0001; mild flow limitation) and from 11.8 ± 1.1 to 7.8 ± 0.7 hPa (p < 0.0001; severe flow limitation). Resistance of the collapsible compartment is decreased from 53 ± 7 to 8.2 ± 5.9 hPa.L−1.s (p < 0.0001; mild flow limitation) and from 80 ± 11 to 6.9 ± 5.4 hPa.L−1.s (p < 0.0001; severe flow limitation). 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.
Starting Page	277
Ending Page	290
Page Count	14
File Format	PDF
ISSN	00015342
Journal	Acta Biotheoretica
Volume Number	49
Issue Number	4
e-ISSN	15728358
Language	English
Publisher	Kluwer Academic Publishers
Publisher Date	2001-01-01
Publisher Place	Dordrecht
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Philosophy of Biology Evolutionary Biology
Content Type	Text
Resource Type	Article
Subject	Philosophy Applied Mathematics Medicine Biochemistry, Genetics and Molecular Biology Environmental Science Agricultural and Biological Sciences

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