Patient asynchrony modelling during controlled mechanical ventilation therapy

Arunachalam, Ganesaramachandran and Chiew, Yeong Shiong and Tan, Chee Pin and Md Ralib, Azrina and Mat Nor, Mohd Basri (2020) Patient asynchrony modelling during controlled mechanical ventilation therapy. Computer Methods and Programs in Biomedicine, 183. pp. 1-12. ISSN 0169-2607 E-ISSN 1872-7565

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Abstract

Background and objective: Mechanical ventilation therapy of respiratory failure patients can be guided by monitoring patient-specific respiratory mechanics. However, the patient’s spontaneous breathing effort during controlled ventilation changes airway pressure waveform and thus affects the model-based identification of patient-specific respiratory mechanics parameters. This study develops a model to estimate respiratory mechanics in the presence of patient effort. Methods: Gaussian effort model (GEM) is a derivative of the single-compartment model with basis function. GEM model uses a linear combination of basis functions to model the nonlinear pressure waveform of spontaneous breathing patients. The GEM model estimates respiratory mechanics such as Elastance and Resistance along with the magnitudes of basis functions, which accounts for patient inspiratory effort. Results and discussion: The GEM model was tested using both simulated data and a retrospective observational clinical trial patient data. GEM model fitting to the original airway pressure waveform is better than any existing models when reverse triggering asynchrony is present. The fitting error of GEM model was less than 10% for both simulated data and clinical trial patient data. Conclusion: GEM can capture the respiratory mechanics in the presence of patient effect in volume control ventilation mode and also can be used to assess patient-ventilator interaction. This model determines basis functions magnitudes, which can be used to simulate any waveform of patient effort pressure for future studies. The estimation of parameter identification GEM model can further be improved by constraining the parameters within a physiologically plausible range during least-square nonlinear regression.

Item Type:	Article (Journal)
Additional Information:	3934/76234
Uncontrolled Keywords:	Asynchrony, mechanical ventilation, Gaussian effort model
Subjects:	R Medicine > R Medicine (General) R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	17 Dec 2019 09:20
Last Modified:	11 Nov 2020 16:30
URI:	http://irep.iium.edu.my/id/eprint/76234

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