A tidally breathing model of ventilation, perfusion and volume in normal and diseased lungs

British Journal of Anaesthesia

Volumn 97, Issue 5, 2006, Pages 718-731

  Yem, J S ^a   Turner, M J ^a   Baker, A B ^a   Young, I H ^a   Crawford, A B H ^b  

^a ROYAL PRINCE ALFRED HOSPITAL   (Australia)

^b WESTMEAD HOSPITAL   (Australia)

Author keywords

Modelling; Ventilation inhomogeneity; Ventilation perfusion distribution

Indexed keywords

INERT GAS;

ADULT; AGED; ARTICLE; CONTROLLED STUDY; FEMALE; HUMAN; LUNG ALVEOLUS; LUNG DISEASE; LUNG EMBOLISM; LUNG EMPHYSEMA; LUNG GAS EXCHANGE; LUNG PERFUSION; LUNG VENTILATION; LUNG VOLUME; MALE; PREDICTION; PRIORITY JOURNAL; QUALITATIVE ANALYSIS; QUANTITATIVE ANALYSIS; STEADY STATE;

EID: 33750133032     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1093/bja/ael216     Document Type: Article

References (65)

1. Gedeon A, Forslund L, Hedenstierna G, Romano E. A new method for noninvasive bedside determination of pulmonary blood flow. Med Biol Eng Comput 1980; 18: 411-8
2. Binder J, Parkin W. Non-invasive cardiac output determination: A comparison of a new partial rebreathing technique with thermodilution. Anaesth Intens Care 2001; 29: 19-23
3. Botero M, Lobato EB. Advances in noninvasive cardiac output monitoring: an update. J Cardiothorac Vasc Anesth 2001, 15: 631-40
4. Arieli R, Farhi LE. Gas exchange in tidally ventilated and non-steadily perfused lung model. Respir Physiol 1985; 60: 295-309
5. Whiteley JP, Gavaghan DJ, Hahn CE. A tidal breathing model for the multiple inert gas elimination technique. J Appl Physiol 1999; 87: 161-9
6. Peyton PJ, Robinson GJ, Thompson B. Ventilation-perfusion inhomogeneity increases gas uptake: Theoretical modeling of gas exchange. J Appl Physiol 2001; 91: 3-9
7. Peyton PJ, Robinson GJ, Thompson B. Ventilation-perfusion inhomogeneity increases gas uptake in anesthesia: Computer modeling of gas exchange. J Appl Physiol 2001; 91: 10-16
8. 2O on oxygenation: Physiological modeling of gas exchange. J Appl Physiol 2001; 91: 17-25
9. Wagner PD, Saltzman HA, West JB. Measurement of continuous distributions of ventilation-perfusion ratios: Theory. J Appl Physiol 1974; 36: 588-99
10. Young IH, Wagner PD. Solubility of inert gases in homogenates of canine lung tissue. J Appl Physiol 1979; 46: 1207-10
11. West JB, Wagner PD. Pulmonary gas exchange. In: West JB, ed. Bioengineering Aspects of the Lung. New York: Marcel Dekker, 1977; 361-454
12. Wagner PD, Laravuso RB, Goldzimmer E, Naumann PF, West JB. Distribution of ventilation-perfusion ratios in dogs with normal and abnormal lungs. J Appl Physiol 1975; 38: 1099-109
13. Evans JW, Wagner PD. Limits on VA/Q distributions from analysis of experimental inert gas elimination. J Appl Physiol 1977; 42: 889-98
14. West JB, Wagner PD. Ventilation-perfusion relationships. In: Crystal RG, West JB, eds. The Lung: Scientific Foundations. New York: Raven Press, 1991; 1289-305
15. Roca J, Wagner PD. Contribution of multiple inert gas elimination technique to pulmonary medicine. I. Principles and information content of the multiple inert gas elimination technique. Thorax 1994; 49: 815-24
16. Agusti AG, Barbera JA. Contribution of multiple inert gas elimination technique to pulmonary medicine. 2. Chronic pulmonary diseases: Chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis. Thorax 1994; 49: 924-32
17. Melot C. Contribution of multiple inert gas elimination technique to pulmonary medicine. 5. Ventilation-perfusion relationships in acute respiratory failure. Thorax 1994; 49: 1251-8
18. Lee ASTI, Patterson RW, Kaufman RD. Relationships among ventilation-perfusion distribution, multiple inert gas methodology and metabolic blood-gas tensions. Br J Anaesth 1987; 59: 1579-98
19. Mertens P. A simple model of VA/Q distribution for analysis of inert gas elimination data. J Appl Physiol 1983; 55: 562-8
20. Loeppky JA, Caprihan A, Altobelli SA, Icenogle MV, Scotto P, Vidal Melo MF. Validation of a two-compartment model of ventilation/perfusion distribution. Respir Physiol Neurobiol 2006; 151: 74-92
21. Wgner PD. Information content of the multibreath nitrogen washout. J Appl Physiol 1979; 46: 579-87
22. Lewis S, Evans J. Jalowayski A. Continuous distributions of specific ventilation recovered from inert gas washout. J Appl Physiol 1978; 44: 416-23
23. Crawford AB, Cotton DJ, Paiva M, Engel LA. Effect of lung volume on ventilation distribution. J Appl Physiol 1989; 66: 2502-10
24. Nye R. Theoretial limits to measurement of uneven ventilation. J Appl Physiol 1961; 16: 1115-23
25. Kapitan K. Information content of the multibreath nitrogen washout: effects of experimental error. J Appl Physiol 1990; 68: 1621-7
26. Evans JW, Cantor DG, Norman JR. The dead space in a compartmental lung model. Bull Math Biophys 1967; 29: 711-8
27. Whiteley JP, Gavaghan DJ, Hahn CE. A tidal breathing model of the inert gas sinewave technique for inhomogeneous lungs. Respir Physiol 2001; 124: 65-83
28. Fortune JB, Wagner PD. Effects of common dead space on inert gas exchange in mathematical models of the lung. J Appl Physiol 1979; 47: 896-906
29. Yem J, Tang Y, Turner MJ, Baker AB. Sources of error in non-invasive pulmonary blood flow measurements by partial re-breathing: A computer study. Anesthesiology 2003; 98: 881-7
30. Nunn J. Applied Respiratory Physiology with Special Reference to Anaesthesia, 1st Edn. Oxford: Butterworth, 1969; 241-3
31. Tang Y, Turner MJ, Baker AB. Effects of alveolar dead-space, shunt and V/ Q distribution on respiratory dead-space measurements. Br J Anaesth 2005; 95: 538-48
32. Tang Y, Turner MJ, Baker AB. Effects of lung time constant, gas analyser delay and rise time on measurement of respiratory dead space. Physiol Meas 2005; 26: 1103-14
33. Tang Y, Turner MJ, Baker AB. A new equal area method for calculating and representing physiological, anatomical and alveolar dead spaces. Anesthesiology 2006; 104: 696-700
34. Olszowka AJ, Farhi LE. A system of digital computer subroutines for blood gas calculations. Respir Physiol 1968; 4: 270-80
35. Cotes JE, Leathart GL. Lung Function: Assessment and Application in Medicine, 5th Edn. Oxford: Blackwell, 1993
36. Morris MJ, Lane DJ. Tidal expiratory flow patterns in airflow obstruction. Thorax 1981; 36: 135-42
37. Davis NR, Mapleson WW. A physiological model for the distribution of injected agents, with special reference to pethidine. Br J Anaesth 1993; 70: 248-58
38. Wagner PD, Dantzker DR, Dueck R, Clausen JL, West JB. Ventilation-perfusion inequality in chronic obstructive pulmonary disease. J Clin Invest 1977, 59: 203-16
39. West J. Ventitation/Blood Flow and Gas Exchange, 3rd Edn. Oxford: Blackwell, 1977
40. Roca J, Rodriguez-Roisin R, Wagner PD. Pulmonary and Peripheral Gas Exchange in Health and Disease. New York: Marcel Dekker, 2000
41. Altemeier WA, Robertson HT, McKinney S, Glenny RW. Pulmonary embolization causes hypoxemia by redistributing regional blood flow without changing ventilation. J Appl Physiol 1998; 85: 2337-43
42. Tsang JY, Frazer D, Hlastala MP. Ventilation heterogeneity does not change following pulmonary microembolism. J Appl Physiol 2000; 98: 705-12
43. Saidel G, Salmon R, Chester E. Moment analysis of multibreath lung washout. J Appl Physiol 1975: 38: 328-34
44. Habib RH, Lutchen KR. Moment analysis of a multibreath nitrogen washout based on an alveolar gas dilution number. Am Rev Respir Dis 1991; 144: 513-9
45. Kuwabara S, Duncalf D. Effect of anatomic shunt on physiologic deadspace-to-tidal volume ratio - a new equation. Anesthesiology 1969; 31: 575-7
46. 2. J Clin Invest 1974; 54: 54-68
47. Melot C, Naeije P. Rothschild T, Mertens P, Mols P, Hallemans R. Improvement in ventilation-perfusion matching by almitrine in COPD. Chest 1983; 83: 528-33
48. D'Alonzo GE, Bower JS, DeHart P, Dantzker DR. The mechanisms of abnormal gas exchange in acute massive pulmonary embolism. Am Rev Respir Dis 1983; 128: 170-2
49. Zheng J, Leawoods JC, Nolte M, et al. Combined MR proton lung perfusion/ angiography and helium ventilation: Potential for detecting pulmonary emboli and ventilation defects. Magn Reson Med 2002; 47: 433-8
50. Whiteley JP, Turner MJ, Baker AB, Gavaghan DJ, Hahn CE. The effects of ventilation pattern on carbon dioxide transfer in three computer models of the airways. Respir Physiol Neurobiol 2002; 131: 269-84
51. Verbanck S, Pavia M. Model simulations of gas mixing and ventilation distribution in the human lung. J Appl Physiol 1990; 69: 2269-79
52. Tawhai MH, Hunter PJ. Multibreath washout analysis: Modeling the influence of conducting airway asymmetry. Respir Physiol 2001; 127: 249-58
53. Prella M, Feihl F, Domenighetti G. Effects of short-term pressure-controlled ventilation on gas exchange, airway pressures, and gas distribution in patients with acute lung injury/ARDS: Comparison with volume-controlled ventilation. Chest 2002; 122: 1382-8
54. Cotran RS, Kumar V, Robbins SL. The respiratory system. Pathologic Basis of Disease, 4th Edn. Philadelphia: WB Saunders, 1989;755-804
55. Crawford AB, Paiva M, Engel LA. Uneven ventilation. In: Crystal RG, West JB, eds. The Lung: Scientific Foundations. New York: Raven Press, 1991; 1031-41
56. Manier G, Castaing Y. Contribution of multiple inert gas elimination technique to pulmonary medicine. 4. Gas exchange abnormalities in pulmonary vascular and cardiac disease. Thorax 1994; 49: 1169-74
57. Eriksson L, Wollmer P, Olsson CG, et al. Diagnosis of pulmonary embolism based upon alveolar dead space analysis. Chest 1989; 96: 357-62
58. Feihl F, Eckert P, Brimioulle S, et al. Permissive hypercapnia impairs pulmonary gas exchange in the acute respiratory distress syndrome. Am J Respir Crit Care Med 2000; 162: 209-15
59. Turato G, Zuin R, Miniati M, et al. Airway inflammation in severe chronic obstructive pulmonary disease: Relationship with lung function and radiologic emphysema. Am J Respir Crit Care Med 2002; 166: 105-10
60. Hahn CE, Farmery AD. Gas exchange modelling: No more gills, please. Br J Anaesthesia 2003; 91: 2-15
61. Wagner PD, West JB. Ventilation-perfusion relationships. In: West JB, ed. Pulmonary Gas Exchange, Ventilation, Blood Flow, and Diffusion. New York: Academic Press, 1980; 219-62
62. Yem JS, Turner MJ, Baker AB. Sources of error in partial rebreathing pulmonary blood flow measurements in lungs with emphysema and pulmonary embolism. Br J Anaesth 2006; 97: 732-41
63. Nunn J. Applied Respiratory Physiology, 4th Edn. Oxford: Butterworth-Heinemann, 1993; 240
64. Weibel ER. Morphometry of the Human Lung. Heidelberg: Springer, 1963; 110-43
65. Farhi LE. Elimination of inert gas by the lung. Respir Physiol 1967; 3: 1-11