Abstract
Mechanical ventilation of infants with congenital diaphragmatic hernia (CDH) often is a challenge due to different elastic-resistive properties of both lungs. The first step of therapy requires choosing between conventional mechanical ventilation (CMV) and high frequency ventilation (HFV). This study’s aim is to explore why CMV cannot always be applied in infants with ventilation inhomogeneity. The authors hypothesized that lung inhomogeneity is related to higher respiratory system impedance requiring higher respiratory pressure and work of breathing to obtain assumed minute ventilation. Real-time in vitro simulations using hybrid (numerical-physical) model of the respiratory system and a ventilator revealed the risk factors connected with inhomogeneous ventilation of lungs. The pressures and flows registered in the smaller, pinched lung exhibiting decreased compliance can reach dangerously high values and cause lung injury. Such effects were not observed with homogenous lungs as the same minute ventilation has been received at significantly lower pressure delivered to patient airway.
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Stankiewicz, B., Pałko, K.J., Darowski, M., Kozarski, M., Górczyńska, K. (2020). Challenges with Conventional Ventilation of Infants with Inhomogeneous Lungs. In: Korbicz, J., Maniewski, R., Patan, K., Kowal, M. (eds) Current Trends in Biomedical Engineering and Bioimages Analysis. PCBEE 2019. Advances in Intelligent Systems and Computing, vol 1033. Springer, Cham. https://doi.org/10.1007/978-3-030-29885-2_21
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DOI: https://doi.org/10.1007/978-3-030-29885-2_21
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