Device for simulation of restrictive pathologies in healthy subjects with non-invasive mechanical ventilation
Keywords:respiratory mechanics, thoracic compliance, restrictive diseases, control systems
The respiratory mechanics assessment in patients with mechanical ventilation allows to adjust the treatment in intensive care units related to the ventilatory mode and parameters of mechanical ventilator settings. However, to estimate the compliance and respiratory resistance in spontaneous ventilation is only possible with obstructive maneuvers or invasive techniques. One of the most important limitations to develop new techniques for respiratory mechanics estimation is the non-stationary characteristic of the system and the variability of parameters according to the variability of the breathing pattern. The aim of this article is to present and evaluate a device that allows artificially modify the thoracic compliance of a healthy subject, which will make possible to register in the future a useful database for the development of techniques for estimating ventilatory mechanics. The device was formed by a cuirass, a pump and a controller that allows to vary the pressure inside the cuirass, which was placed in the chest and abdomen of the volunteers to change compliance in a controlled manner. 5 volunteers participated in the performance test of the device, achieving percentage changes of 34.5 ± 9.4% respecting their resting value for a pressure of 10 cmH2O and changes of 46.8 ± 5.7% for the maximum pressure of 20 cmH2O. It was possible to design a device that allowed to artificially modify thoracic compliance in a comparable way for any healthy subject.
J. H. Bates, Lung Mechanics. An Inverse Modeling Approach, 1 st ed. New York, USA: Cambridge University Press, 2009.
J. W. Kreit, ”Mecánica del Sistema Respiratorio,” in Tratado de medicina crítica y terapia intensiva, 4 th ed., W. C. Schoemaker (ed). Madrid, España: Médica Panamericana, 2002, pp. 1164-1176.
T. Troosters, R. Gosselink, and M. Decramer, ”Respiratory muscle assessment,” in Lung Function Testing: European Respiratory Monograph, vol.10, R. Gosselink and H. Stam (ed). Wakefield, UK: European Respiratory Society Journals, 2005, pp. 57-71.
A. Carlucci, L. Pisani, P. Ceriana, A. Malovini, and S. Nava, ”Patient-ventilator asynchronies: may the respiratory mechanics play a role?,” Critical Care, vol. 17, no. 2, pp. R54, 2013.
A. Lomas and L. Jara, ”Manejo respiratorio perioperatorio del paciente obeso,” Rev. Esp. Patol. Torac., vol. 25, no. 3, pp. 201-208, 2013.
Ministerio de Salud y Protección Social, Análisis de Situación de Salud (ASIS), Ministerio de Salud y Protección Social, Bogotá, Colombia, 2016.
OMS: Organización mundial de la salud, Obesidad y Sobrepeso, 2015. [Online]. Available: http://www.who.int/mediacentre/factsheets/fs311/es/. Accessed on: Mar. 28, 2017.
C. E. Battle, H. Hutchings, and P. A. Evans, ”Risk factors that predict mortality in patients with blunt chest wall trauma: A systematic review and meta-analysis,” Injury, vol. 43, no. 1, pp. 8-17, 2012.
M. F. Undirraga, D. P. Rodríguez, and P. D. Lazo, ”Trauma de tórax,” Rev. Médica Clínica Las Condes, vol. 22, no. 5, pp. 617-622, 2011.
J. D. Charry et al., ”Índice de shock como factor predictor de mortalidad en el paciente con trauma penetrante de tórax,” Rev. Colomb. Cirugía, vol. 30, pp. 24-28, 2015.
M. Eberlein, G. A. Schmidt, and R. G. Brower, ”Chest Wall Strapping. An Old Physiology Experiment with New Relevance to Small Airways Diseases,” Ann. Am. Thorac. Soc., vol. 11, no. 8, pp. 1258-1266, 2014.
D. G. Chapman, N. Berend, K. R. Horlyck, G. G. King, and C. M. Salome, ”Does increased baseline ventilation heterogeneity following chest wall strapping predispose to airway hyperresponsiveness?,” J. Appl. Physiol., vol. 113, no. 1, pp. 25-30, 2012.
C. T. Mendonca, M. R. Schaeffer, P. Riley, and D. Jensen, ”Physiological mechanisms of dyspnea during exercise with external thoracic restriction: role of increased neural respiratory drive,” J. Appl. Physiol., vol. 116, no. 5, pp. 570-581, 2014.
I. C. Muñoz and A. M. Hernández, ”Noninvasive approach to estimate ventilatory mechanics in spontaneous breathing with different PEEP and pressure support values: validation with mechanical simulation,” in VII Latin American Congress on Biomedical Engineering CLAIB, Bucaramanga, Colombia, 2016, pp. 241-244.
E. García, L. Amado, and G. M. Albaiceta, ”Monitorization of respiratory mechanics in the ventilated patient,” Med. Intensiva (English Ed.), vol. 38, no. 1, pp. 49-55, 2014.
How to Cite
Copyright (c) 2018 Revista Facultad de Ingeniería Universidad de Antioquia
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Revista Facultad de Ingeniería, Universidad de Antioquia is licensed under the Creative Commons Attribution BY-NC-SA 4.0 license. https://creativecommons.org/licenses/by-nc-sa/4.0/deed.en
You are free to:
Share — copy and redistribute the material in any medium or format
Adapt — remix, transform, and build upon the material
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
The material published in the journal can be distributed, copied and exhibited by third parties if the respective credits are given to the journal. No commercial benefit can be obtained and derivative works must be under the same license terms as the original work.