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Fluid flow and particle transport in mechanically ventilated airways. Part II: particle transport

机译:机械通风的气道中的流体流动和颗粒传输。第二部分:颗粒运输

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The flow mechanisms that play a role on aerosol deposition were identified and presented in a companion paper (Timothy et al. in Med Biol Eng Comput. doi:10.1007/s11517-015-1407-3, 2015). In the current paper, the effects of invasive conventional mechanical ventilation waveforms and endotracheal tube (ETT) on the aerosol transport were investigated. In addition to the enhanced deposition seen at the carinas of the airway bifurcations, enhanced deposition was also seen in the right main bronchus due to impaction and turbulent dispersion resulting from the fluid structures created by jet caused by the ETT. The orientation of the ETT toward right bronchus resulted in a substantial deposition inside right lung compared to left lung. The deposition inside right lung was similar to 12-fold higher than left lung for all considered cases, except for the case of using pressure-controlled sinusoidal waveform where a reduction of this ratio by similar to 50 % was found. The total deposition during pressure constant, volume ramp, and ascending ramp waveforms was similar and similar to 1.44 times higher than deposition fraction when using pressure sinusoidal waveform. Varying respiratory waveform demonstrated a significant role on the deposition enhancement factors and give evidence of drug aerosol concentrations in key deposition sites, which may be significant for drugs with negative side effects in high concentrations. These observations are thought to be important for ventilation treatment strategy.
机译:确定了在气溶胶沉积中起作用的流动机制,并在随附的论文中进行了介绍(Timothy等人在Med Biol Eng Comput。doi:10.1007 / s11517-015-1407-3,2015)。在本文中,研究了有创常规机械通气波形和气管导管对气溶胶传输的影响。除了气道分叉隆起处的沉积增加外,由于ETT引起的射流产生的流体结构引起的冲击和湍流分散,在右主支气管中也发现了增强的沉积。与左肺相比,ETT朝向右支气管的方向导致右肺内部大量沉积。在所有考虑的病例中,除使用压力控制正弦波形的情况外,右肺内部的沉积均比左肺高12倍,发现该比例降低了约50%。使用压力正弦波形时,压力常数,体积斜率和上升斜率波形期间的总沉积量相似,并且比沉积分数高1.44倍。呼吸波形的变化显示了对沉积增强因子的重要作用,并提供了关键沉积部位药物气溶胶浓度的证据,这对于高浓度具有负面副作用的药物可能是重要的。这些观察结果被认为对通气治疗策略很重要。

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