Identification of asynchronous effect via pressure-volume loop reconstruction in mechanically ventilated breathing waveforms

Zhou, C.; Geoffrey Chase, J.; Sun, Q.; Knopp, J.; Tawhai, M.H.; Desaive, Thomas; Möller, K.; Shaw, G.M.; Chiew, Y.S.; Benyo, B.

doi:10.1016/j.ifacol.2021.10.253

Paper published in a journal (Scientific congresses and symposiums)

Identification of asynchronous effect via pressure-volume loop reconstruction in mechanically ventilated breathing waveforms

Zhou, C.; Geoffrey Chase, J.; Sun, Q. et al.

2021 • In IFAC-PapersOnLine, 54 (15), p. 186 - 191

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/334223

DOI
10.1016/j.ifacol.2021.10.253

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Keywords :

Asynchrony; Hysteresis loop model; Hysteretic lung mechanics; Mechanical ventilation; Virtual patient; Biological organs; Energy dissipation; Hysteresis loops; Mean square error; Ventilation; Breathing cycle; Hysteretic lung mechanic; Loop models; Lung mechanics; Pressure volumes; Virtual patients; Waveforms; Hysteresis

Abstract :

[en] Patient-specific lung-mechanics during mechanical ventilation (MV) can be modelled via using fully ventilated/controlled waveforms. However, patient asynchrony due to spontaneous breathing (SB) effort commonly exists in patients on full MV support, leading to variability in breathing waveforms and reducing the accuracy of identified, model-based, and patient-specific lung mechanics. This study aims to extract ventilated breathing waveforms from affected asynchronous breathing cycles using an automated virtual patient model-based approach. In particular, change of lung elastance over a pressure-volume (PV) loop is identified using hysteresis loop analysis (HLA) to detect the occurrence of asynchrony, as well as its type and pattern. The identified HLA parameters are then combined with a nonlinear mechanics hysteresis loop model (HLM) to extract and replicate the ventilated waveforms from the coupled asynchronous breaths. The magnitude of asynchrony can then be quantified using an energy dissipation metric, Easyn, comparing the area difference of PV loops between model-reconstructed and original breathing cycles. A proof-of-concept study is conducted using clinical data from 2700 breathing cycles of two patients exhibiting asynchrony during MV. The reconstruction root mean square errors are within 5-10% of the clinical data for 90% of the cycles, indicating good and robust reconstruction accuracy. Estimation of Easyn shows significant asynchrony magnitude for Patient 1 with Easyn greater than 10% for over 50% breaths, while asynchrony occurrence for Patient 2 is lower with 90% breaths at Easyn < 10%, which is a minimal asynchrony magnitude. These results match direct observation, thus validating the ability of the virtual patient model and methods presented to be used for a real-time monitoring of asynchrony with different types and magnitudes, which in turn would justify prospective clinical tests. © 2021 The Authors.

Disciplines :

Anesthesia & intensive care

Author, co-author :

Zhou, C.; School of Civil Aviation, Taicang Yangzte River Delta Research Institute, Northwestern Polytechnical University, China, Dept of Mechanical Engineering, Dept of Mechanical Eng, Centre for Bio-Engineering, University of Canterbury, Christchurch, New Zealand

Geoffrey Chase, J.; Dept of Mechanical Engineering, Dept of Mechanical Eng, Centre for Bio-Engineering, University of Canterbury, Christchurch, New Zealand

Sun, Q.; Dept of Mechanical Engineering, Dept of Mechanical Eng, Centre for Bio-Engineering, University of Canterbury, Christchurch, New Zealand

Knopp, J.; Dept of Mechanical Engineering, Dept of Mechanical Eng, Centre for Bio-Engineering, University of Canterbury, Christchurch, New Zealand

Tawhai, M.H.; Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand

Desaive, Thomas ; Université de Liège - ULiège > Département d'astrophysique, géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles

Möller, K.; Institute for Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany

Shaw, G.M.; Dept of Intensive Care, Christchurch Hospital, Christchurch, New Zealand

Chiew, Y.S.; School of Engineering, Monash University, Subang Jaya, Malaysia

Benyo, B.; Dept of Control Engineering and Information Technology, Budapest University of Technology and Economics, Budapest, Hungary

Language :

English

Title :

Identification of asynchronous effect via pressure-volume loop reconstruction in mechanically ventilated breathing waveforms

Publication date :

2021

Event name :

11th IFAC Symposium on Biological and Medical Systems BMS 2021

Event date :

19 September 2021 through 22 September 2021

By request :

Yes

Audience :

International

Journal title :

IFAC-PapersOnLine

ISSN :

2405-8971

eISSN :

2405-8963

Publisher :

Elsevier

Volume :

Issue :

Pages :

186 - 191

Peer review/Selection committee :

Peer Reviewed verified by ORBi

Funding text :

The authors acknowledge support from the NZ Tertiary Education Commission (TEC) fund MedTech CoRE (Centre of Research Excellence; #3705718) and the NZ National Science Challenge 7, Science for Technology and Innovation (2019-S3-CRS). The authors also acknowledge support from the EU H2020 R&I programme (MSCA -RISE-2019 call) under grant agreement #872488 — DCPM. The support from the Taicang Yangtze River Delta Research Institute of Northwestern Polytechnical University is also acknowledged.

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