为急性呼吸窘迫综合征患者开发肺部计算模型

Chinmay Chavan, Asma Zainab, Debjyoti Banerjee
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摘要

急性呼吸窘迫综合征(ARDS)是一种继发于肺部直接或间接损伤、导致急性呼吸衰竭的疾病,死亡率很高。大多数 ARDS 患者都需要机械通气,这就像一把双刃剑。根据 ARDS 网络临床试验的建议,呼吸机诱发的肺损伤(VILI)被认为是继发于高吸气压力、吸气时周期性开放和呼气时塌陷。其他导致 VILI 的机制还包括异质通气。为了列举这些导致 VILI 的机制,本研究进行了一项计算流体动力学(CFD)研究,以探索从第三代到第六代分支的人体气管支气管气道模型中的流动模式和压力分布。作者对计算方法进行了验证,并对结果进行了分析,以获得主要和次要流动方向的速度曲线。研究调查了雷诺数(Re)从 100 到 2000 的不同流速对分支和分叉区压降的影响。确定次级流动模式对于理解三叉几何中不对称速度剖面的发展至关重要。观察到的层流状态下的压降和速度剖面模式为进一步开发数值模型以帮助治疗 ARDS 患者铺平了道路。
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Developing a Computational Model of Lungs for Patients With Acute Respiratory Distress Syndrome
Acute respiratory distress syndrome (ARDS) is a condition secondary to direct or indirect insult to lungs, leading to acute respiratory failure, and is associated with high mortality. Majority of the ARDS patients require mechanical ventilation, which acts as double-edged sword. Ventilator induced lung injury (VILI) is considered secondary to high inspiratory pressure and cyclical opening during inspiration, and collapse during expiration as suggested by ARDS network clinical trials. Other mechanism for VILI exist secondary to heterogeneous ventilation. To enumerate these mechanisms leading to VILI, a computational fluids dynamics (CFD) study was performed in this study to explore the flow patterns and the pressure distribution in a human tracheobronchial airway model from third to sixth generation branches. The authors validated the computational methodology and analyzed the results to obtain velocity profiles in the primary and secondary flow directions. The study investigated the role of various flow velocities corresponding to Reynolds number (Re) from 100 to 2000 on the pressure drops along branches and bifurcation zones. The identification of secondary flow patterns was critical in understanding the development of asymmetric velocity profiles in the triple bifurcation geometry. The observed patterns in pressure drops and velocity profiles over the laminar flow regime pave the path toward further development of a numerical model to aid treatment for patients with ARDS.
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