Patient-specific modeling; Critical care; Extracorporeal lung support
Abstract :
[en] The extracorporeal CO2 removal device (ECCO2RD) is used in clinics to treat patients suffering from respiratory failures like acute respiratory distress syn- drome (ARDS) or chronic obstructive pulmonary disease (COPD). The aim of this device is to decarboxylate blood externally with low blood flow. A mathematical model is proposed to describe protective ventilation, ARDS, and an extracorporeal CO2 removal therapy (ECCO2RT). The sim- ulations are compared with experimental data carried out on ten pigs. The results show a good agreement between the mathematical simulations and the experimental data, which provides a nice validation of the model. This model is thus able to predict the decrease of PCO2 during ECCO2RT for different blood flows across the extracorporeal lung support.
Disciplines :
Engineering, computing & technology: Multidisciplinary, general & others
Author, co-author :
Habran, Simon ; Université de Liège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
Desaive, Thomas ; Université de Liège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
MORIMONT, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Frais communs médecine - Pool assistants
LAMBERMONT, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Frais communs médecine - Pool assistants
Dauby, Pierre ; Université de Liège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
Language :
English
Title :
Mathematical modeling of extracorporeal CO2 removal therapy. A validation carried out on ten pigs
Abrams D, Roncon-Albuquerque R Jr, Brodie D (2015) What’s new in extracorporeal carbon dioxide removal for COPD? Intens Care Med 41(5):906
Anzueto A, Gattinoni L (2016) Prone position in ARDS. Acute Respir Distress Syndr 233:313
Batzel JJ, Kappel F, Scneditz D, Tran HT (2007) Cardiovascular and respiratory systems: modeling, analysis, and control, vol 34. SIAM
Bein T, Weber-Carstens S, Goldmann A, Müller T, Staudinger T, Brederlau J, Muellenbach R, Dembinski R, Graf BM, Wewalka M et al (2013) Lower tidal volume strategy (3 ml/kg) combined with extracorporeal CO2 removal versus “conventional” protective ventilation (6 ml/kg) in severe ARDS. Intens Care Med 39(5):847–856
Ben-Tal A (2006) Simplified models for gas exchange in the human lungs. J Theor Biol 238(2):474–495. doi:10.1016/j.jtbi.2005.06.005. http://www.sciencedirect.com/science/article/pii/S0022519305002390
Brendle C, Hackmack KF, Kühn J, Wardeh M, Janisch T, Kopp R, Rossaint R, Stollenwerk A, Kowalewski S, Misgeld B et al (2017) Continuous gas transfer monitoring during extracorporeal membrane oxygenation. Biomed Signal Process Control 31:321–330
Burney PG, Patel J, Newson R, Minelli C, Naghavi M (2015) Global and regional trends in COPD mortality, 1990–2010. Euro Resp J 45(5):1239–1247
Enger TB, Philipp A, Videm V, Lubnow M, Wahba A, Fischer M, Schmid C, Bein T, Müller T (2014) Prediction of mortality in adult patients with severe acute lung failure receiving veno-venous extracorporeal membrane oxygenation: a prospective observational study. Crit Care 18(2):R67
Fanelli V, Ranieri MV, Mancebo J, Moerer O, Quintel M, Morley S, Moran I, Parrilla F, Costamagna A, Gaudiosi M et al (2016) Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress syndrome. Crit Care 20 (1):36
Ferguson N, Fan E, Camporota L, Antonelli M, Anzueto A, Beale R, Brochard L, Brower R, Esteban A, Gattinoni L, Rhodes A, Slutsky A, Vincent JL, Rubenfeld G, Thompson BT, Ranieri VM (2012) The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material. Intens Care Med 38(10):1573–1582. doi:10.1007/s00134-012-2682-1
Gnaiger E (1983) Calculation of energetic and biochemical equivalents of respiratory oxygen consumption. In: Polarographic oxygen sensors. Springer, pp 337–345
Grodins FS, Buell J, Bart AJ (1967) Mathematical analysis and digital simulation of the respiratory control system. Tech. rep. DTIC Document
Guyton CA, Hall EJ (2006) Textbook of medical physiology, 11th edn. Elsevier
Hinski ST (2014) Respiratory care clinical competency lab manual (chapter 23). Elsevier Health Sciences
Karagiannidis C, Kampe KA, Sipmann FS, Larsson A, Hedenstierna G, Windisch W, Mueller T (2014) Veno-venous extracorporeal CO2 removal for the treatment of severe respiratory acidosis: pathophysiological and technical considerations. Crit Care 18(3):R124
Karbing DS, Kjaergaard S, Andreassen S, Espersen K, Rees SE (2011) Minimal model quantification of pulmonary gas exchange in intensive care patients. Med Eng Phys 33(2):240–8. doi:10.1016/j.medengphy.2010.10.007. http://www.ncbi.nlm.nih.gov/pubmed/21050794
Karbing DS, Kjærgaard S, Smith BW, Allerød C, Espersen K, Andreassen S, Rees SE (2008) Decision support of inspired oxygen fraction using a model of oxygen transport. IFAC Proc 41(2):8080–8084
Klinzing S, Wenger U, Steiger P, Starck CT, Wilhelm M, Schuepbach RA, Maggiorini M (2015) External validation of scores proposed for estimation of survival probability of patients with severe adult respiratory distress syndrome undergoing extracorporeal membrane oxygenation therapy: a retrospective study. Crit Care 19 (1):142
Linares OA, Schiesser WE, Fudin J, Pham TC, Bettinger JJ, Mathew RO, Daly AL (2015) In silico ordinary differential equation/partial differential equation hemodialysis model estimates methadone removal during dialysis. J Pain Res 8:417
Messai E, Bouguerra A, Harmelin G, Di Lascio G, Bonizzoli M, Bonacchi M (2016) A numerical model of blood oxygenation during veno-venous ECMO: analysis of the interplay between blood oxygenation and its delivery parameters. J Clin Monitor Comput 30(3):327–332
Michael J, Murray DC (2008) Cardiopulmonary bypass: principles and practice (chapter 33). Lippincott Williams & Wilkins
Misgeld BJE (2006) Automatic control of the heart-lung machine. Ruhr-Universität Bochum, Diss
Morimont P, Batchinsky A, Lambermont B (2015) Update on the role of extracorporeal CO2 removal as an adjunct to mechanical ventilation in ards. Crit Care 19(1):1
Morimont P, Guiot J, Desaive T, Tchana-Sato V, Janssen N, Hella D, Blaffart F, Defraigne J, Lambermont B (2015) Veno-venous extracorporeal CO2 removal improves pulmonary hemodynamics in a porcine ARDS model. Acta Anaesthesiol Scand 59(4):448–456
Péronnet F., Massicotte D et al (1991) Table of nonprotein respiratory quotient: an update. Can J Sport Sci 16(1):23–29
Pironet A, Dauby PC, Morimont P, Janssen N, Chase JG, Davidson S, Desaive T (2016) Model-based decision support algorithm to guide fluid resuscitation. IFAC-PapersOnLine 49(5):224–229
Potkay JA (2014) The promise of microfluidic artificial lungs. Lab Chip 14:4122–4138. doi:10.1039/C4LC00828F
Ragaller M, Richter T (2010) Acute lung injury and acute respiratory distress syndrome. J Emerge Trauma Shock 3(1):43–51. doi:10.4103/0974-2700.58663. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823143/
Rees SE, Kjærgaard S, Thorgaard P, Malczynski J, Toft E, Andreassen S (2002) The automatic lung parameter estimator (ALPE,) system: non-invasive estimation of pulmonary gas exchange parameters in 10-15 minutes. J Clin Monit Comput 17(1):43–52
Rees SE, Klæstrup E, Handy J, Andreassen S, Kristensen SR (2010) Mathematical modelling of the acid–base chemistry and oxygenation of blood: a mass balance, mass action approach including plasma and red blood cells. Eur J Appl Physiol 108(3):483–494
Sawheny E, Ellis AL, Kinasewitz GT (2013) Iloprost improves gas exchange in patients with pulmonary hypertension and ARDS. Chest 144(1):55–62. doi:10.1378/chest.12-2296. http://www.sciencedirect.com/science/article/pii/S001236921360450X
Sklar MC, Beloncle F, Katsios CM, Brochard L, Friedrich JO (2015) Extracorporeal carbon dioxide removal in patients with chronic obstructive pulmonary disease: a systematic review. Intens Care Med 41 (10):1752–1762
Terragni P, Maiolo G, Ranieri VM (2012) Role and potentials of low-flow CO2 removal system in mechanical ventilation. Current Opin Crit Care 18(1):93–98
Thom TJ (1989) International comparisons in COPD mortality. Am Rev Respir Dis 140(3 Pt 2):S27–34
Trueb T, Cherniack N, D’souza A, Fishman A (1971) A mathematical model of the controlled plant of the respiratory system. Biophys J 11(10):810–834
Walter M, Weyer S, Stollenwerk A, Kopp R, Arens J, Leonhardt S (2010) A physiological model for extracorporeal oxygenation controller design. Conf Proc IEEE Eng Med Biol Soc 1:434–437
XENIOS (2016) ila activve minilung petite kit. http://www.xenios-ag.com/novalung-products/minilung-petite-kit/