Relation of Respiratory System Elastance and Expiratory Time Constant: Are They From the Same Lung?

摘要

Modeling the respiratory system can aid clinical decision making during mechanical ventilation (MV) in the intensive care. However, most lung models only use airway pressure and flow data during inspiration phase of the breathing, and the data from expiration are often neglected. In this study, we hypothesized that the airway pressure and flow data during expiration have equal important information as the inspiratory data for respiratory mechanics modeling. In particular, expiratory time constant parameter, K, can provide unique information and relation with respiratory system elastance in MV patients. Two different respiratory models were investigated, with one model focusing on data from inspiratory cycle (Single compartment model) and the other focusing on expiratory cycle (Time constant model). The expiratory time constant model and single compartment model were evaluated based on 22 retrospective datasets of acute respiratory distress syndrome (ARDS) patients from two different cohorts. The expiration time constant model captured a moderate correlation with the lung elastance with R~2 = 0.568 in Cohort 1 and weak correlation with R~2 = 0.184 in Cohort 2, resulting in an overall of R~2 = 0.435. Significant variations in lung resistance may lead to a poor correlation between K and lung elastance, E_(lung). Thus, the application of K as a surrogate to the respiratory elastance warrants further investigation.