Predicting the Effects of Changing PEEP Using a Basis Function Method

Type of content
Conference Contributions - Published
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Publisher
Journal Title
Journal ISSN
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Language
Date
2017
Authors
Argus FJ
Sutherland CJ
Chakson J
McNearney E
Dickson JL
Redmond D
Kim K
Docherty PD
Chase, Geoff
Abstract

Current methods to optimise mechanical ventilation involve increasing positive end expiratory pressure (PEEP) in steps to maximize recruitment. If PEEP is too high, overdistension and damage occur. There is thus an inherent risk involved when increasing PEEP. This study predicts dynamic elastance and lung mechanics for higher PEEP using clinically relevant elastance basis functions, capturing distension, recruitment and constant stiffness, in a first order model of lung mechanics. The clinically relevant basis functions were used to fit elastance using a single compartment lung model for 10 patients undergoing recruitment maneuvers, where 2-4 PEEP levels were analysed, and then used to predict the elastance and pressure waveforms for PEEP level increases of 5 and 10 cmH2O. The mean error for the pressure fits from the clinically relevant basis functions was 2.06%. Mean error for pressure predictions with a PEEP level increase of 5 cmH2O was 3.8-5.5%. Mean error for PEEP level increases of 10 cmH2O was slightly higher, between 5.0 and 6.6%. Good pressure fits and predictions show these basis functions accurately fit and predict elastance and thus lung behavior at increased PEEP levels. Each clinically relevant basis function behaved as expected, however improvements to the identifiability of distension would further improve the overall accuracy.

Description
Citation
Argus FJ, Sutherland CJ, Chakson J, McNearney E, Dickson JL, Redmond D, Kim K, Docherty PD, Chase JG (2017). Predicting the Effects of Changing PEEP Using a Basis Function Method. Toulouse, France: IFAC 20th WC 2017. 09/07/2017-14/07/2017. IFAC-PapersOnLine.
Keywords
pressure, prediction, elastance, lung, recruitment, airway
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Fields of Research::40 - Engineering::4003 - Biomedical engineering::400303 - Biomechanical engineering
Fields of Research::32 - Biomedical and clinical sciences::3201 - Cardiovascular medicine and haematology::320103 - Respiratory diseases
Rights
Creative Commons Attribution Non-Commercial No Derivatives License