Mild ARDS with Progressive Fall in Oxygenation

Description

A 22 year-old patient was involved in a motor vehicle crash with rollover and ejection from the vehicle. He suffered multiple rib fractures, a right femur fracture, multiple lacerations and pulmonary contusion. He underwent internal fixation of the femur fracture, received 4 units of whole blood, had a chest tube placed for a small hemothorax and returned from the operating room on mechanical ventilation. The patient is sedated and is not currently triggering the ventilator. Intraoperatively 3 L of crystalloids were administered. The patient is 6'2'' tall, weighs 200 lbs and has no known comorbidities or allergies. Chest radiograph demonstrates bi-basilar early consolidation, presence of the chest tube and pulmonary contusion.

Figure 1. Chest radiograph demonstrates bi-basilar early consolidation, presence of the chest tube and pulmonary contusion.

Segment Validation

Segment 1

Learning Objectives:

Identify severity of ARDS
Recognize acceptable ventilator settings

Recommended Actions:

None

Ventilator settings are (VT Target = 7.1 mL/kg (ideal)):

Mode	VT (L)	PIP (cmH2O)	Flow (L/min)	I:E	TI (s)	RR (bpm)	PEEP (cmH2O)	FiO2
VC-AC	0.584	NA	60	NA	0.62	24	5	0.4

Ventilator alarm settings are:

High PIP = 38 cmH2O (~10 cmH2O above the initial value or a max of 40 cmH2O)
Low MVe = 10.4 L/min (~25% below the initial value)
Low VT = 438 mL (~25% below the initial value)
High RR = 34 bpm (~10 bpm above the initial value or a max of 40 bpm)

Table 1. Data request validation results for Segment 1.

Property Name	Validation	Engine Value	Percent Error	Notes
MechanicalVentilator-TidalVolume(mL)	EqualTo 584	578	0.986%	VT (measured)
InspiratoryRespiratoryResistance(cmH2O_s/L)	EqualTo 12 [17]	11.6	3.17%	Rinsp for mild ARDS
ExpiratoryRespiratoryResistance(cmH2O_s/L)	EqualTo 12 [17]	11.6	3.17%	Rexp for mild ARDS
RespiratoryCompliance(mL/cmH2O)	EqualTo 50 [304]	50.2	0.385%	C requested by SME for mild ARDS
PhysiologicDeadSpaceTidalVolumeRatio	EqualTo 0.54 [229]	0.515	4.72%	VD/VT for mild ARDS
ClinicalShuntFraction	[0.200,0.400] [221]	0.191	4.44%	QS/QT for mild ARDS (determined from blood gas values)
HorowitzIndex(mmHg)	[200,300] [115]	198	1.22%	PaO2/FiO2 for mild ARDS

Figure 2. Vitals and ventilator monitors for Segment 1.

Table 2. Data requests for Segment 1.

Property Name	Engine Value
Patient-Height(in)	74.0
Patient-IdealBodyWeight(kg)	82.2
InspiratoryRespiratoryResistance(cmH2O_s/L)	11.6
ExpiratoryRespiratoryResistance(cmH2O_s/L)	11.6
RespiratoryCompliance(mL/cmH2O)	50.2
ClinicalPhysiologicDeadSpaceTidalVolumeRatio	0.491
ClinicalShuntFraction	0.191
MechanicalVentilator-TidalVolume(L)	0.578
BloodPH	7.39
Aorta-Oxygen-PartialPressure(mmHg)	79.0
Aorta-CarbonDioxide-PartialPressure(mmHg)	42.7
Aorta-Bicarbonate-Molarity(mEq/L)	26.0
OxygenSaturation	0.961
HorowitzIndex(mmHg)	198
IntrinsicPositiveEndExpiratoryPressure(cmH2O)	0.503
MechanicalVentilator-RespirationRate(1/min)	24.0
MechanicalVentilator-MeanAirwayPressure(cmH2O)	9.37
MechanicalVentilator-PeakInspiratoryPressure(cmH2O)	28.1
MechanicalVentilator-PlateauPressure(cmH2O)	17.0
HeartRate(1/min)	71.7
SystolicArterialPressure(mmHg)	114
DiastolicArterialPressure(mmHg)	74.1
MechanicalVentilator-TotalPulmonaryVentilation(L/min)	13.9
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L)	11.6
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L)	11.6
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O)	50.0
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O)	25.1
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg)	30.4
MechanicalVentilator-EndTidalOxygenPressure(mmHg)	270
MechanicalVentilator-ExpiratoryTidalVolume(L)	0.578
MechanicalVentilator-InspiratoryExpiratoryRatio	0.330
MechanicalVentilator-InspiratoryTidalVolume(L)	0.578
MechanicalVentilator-PeakExpiratoryFlow(L/s)	0.843
MechanicalVentilator-LeakFraction	1.12e-13
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O)	0.456
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O)	5.00
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O)	5.46
PhysiologicDeadSpaceTidalVolumeRatio	0.515
PhysiologicShuntFraction	0.194
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L)	11.6
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L)	11.6
TotalRespiratoryModelCompliance(mL/cmH2O)	60.5
ExtrinsicPositiveEndExpiratoryPressure(cmH2O)	5.00
TotalPositiveEndExpiratoryPressure(cmH2O)	5.51
EndTidalCarbonDioxidePressure(mmHg)	32.4
PhysiologicDeadSpace(mL)	296
AlveolarArterialGradient(mmHg)	188
AlveolarDeadSpace(mL)	132
AnatomicDeadSpace(mL)	164
ChestWallCompliance(L/cmH2O)	0.146
FractionOfInspiredOxygen	0.400
LungCompliance(L/cmH2O)	0.0790
VentilationPerfusionRatio	2.42
HeartStrokeVolume(mL)	82.1
HeartEjectionFraction	0.562
BloodVolume(L)	6.51
MeanArterialPressure(mmHg)	95.4
PulsePressure(mmHg)	39.8
CardiacOutput(L/min)	5.89
CarbonDioxideSaturation	0.0353
RespiratoryExchangeRatio	0.812
SystemicVascularResistance(mmHg_s/mL)	0.924
OxygenConsumptionRate(mL/min)	290
CarbonDioxideProductionRate(mL/min)	235
Patient-AlveoliSurfaceArea(m^2)	37.3
Patient-ExpiratoryReserveVolume(L)	0.984
Patient-FunctionalResidualCapacity(L)	1.85
Patient-InspiratoryCapacity(L)	3.52
Patient-InspiratoryReserveVolume(L)	2.94
Patient-ResidualVolume(L)	0.863
Patient-TidalVolumeBaseline(L)	0.580
Patient-TotalLungCapacity(L)	5.36
Patient-VitalCapacity(L)	4.50

Segment 2

The patient is loaded in the aircraft for transport to trauma center care. Twenty minutes into the transport, SpO2 falls and both PIP and Pplat are increased. The patient is triggering the ventilator.

Learning Objectives:

Recognize worsening ARDS
Adjust vent settings for safety

Recommended Actions:

Increase FiO2 to 0.5
Decrease VT to 490 mL to get acceptable DP

Table 3. Data request validation results for Segment 2.

Property Name	Validation	Engine Value	Percent Error	Percent Change	Notes
MechanicalVentilator-TidalVolume(mL)	EqualTo 567	585	3.07%		VT (measured)
InspiratoryRespiratoryResistance(cmH2O_s/L)	EqualTo 12 [17]	12.4	3.08%		Rinsp for moderate ARDS
ExpiratoryRespiratoryResistance(cmH2O_s/L)	EqualTo 12 [17]	12.4	3.08%		Rexp for moderate ARDS
RespiratoryCompliance(mL/cmH2O)	EqualTo 40 [304]	39.4	1.47%		C requested by SME for moderate ARDS
PhysiologicDeadSpaceTidalVolumeRatio	EqualTo 0.57 [229]	0.553	3.02%		VD/VT for moderate ARDS
ClinicalShuntFraction	[0.300,0.500] [221]	0.347	0.00%		QS/QT for moderate ARDS (determined from blood gas values)
HorowitzIndex(mmHg)	[100,200] [115]	138	0.00%		PaO2/FiO2 for moderate ARDS
MechanicalVentilator-PeakInspiratoryPressure(cmH2O)	GreaterThan Segment1 (28.1) [304]	26.3		-6.23%	PIP
MechanicalVentilator-PlateauPressure(cmH2O)	GreaterThan Segment1 (17.0) [304]	20.5		20.8%	Pplat
OxygenSaturation	LessThan Segment1 (0.961) [304] [308]	0.903		-6.05%	SpO2

Figure 3. Vitals and ventilator monitors for Segment 2.

Table 4. Data requests for Segment 2.

Property Name	Engine Value
Patient-Height(in)	74.0
Patient-IdealBodyWeight(kg)	82.2
InspiratoryRespiratoryResistance(cmH2O_s/L)	12.4
ExpiratoryRespiratoryResistance(cmH2O_s/L)	12.4
RespiratoryCompliance(mL/cmH2O)	39.4
ClinicalPhysiologicDeadSpaceTidalVolumeRatio	0.570
ClinicalShuntFraction	0.347
MechanicalVentilator-TidalVolume(L)	0.585
BloodPH	7.38
Aorta-Oxygen-PartialPressure(mmHg)	55.4
Aorta-CarbonDioxide-PartialPressure(mmHg)	43.2
Aorta-Bicarbonate-Molarity(mEq/L)	26.0
OxygenSaturation	0.903
HorowitzIndex(mmHg)	138
IntrinsicPositiveEndExpiratoryPressure(cmH2O)	0.0651
MechanicalVentilator-RespirationRate(1/min)	26.8
MechanicalVentilator-MeanAirwayPressure(cmH2O)	9.03
MechanicalVentilator-PeakInspiratoryPressure(cmH2O)	26.3
MechanicalVentilator-PlateauPressure(cmH2O)	20.5
HeartRate(1/min)	111
SystolicArterialPressure(mmHg)	110
DiastolicArterialPressure(mmHg)	81.6
MechanicalVentilator-TotalPulmonaryVentilation(L/min)	15.7
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L)	12.4
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L)	12.4
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O)	38.9
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O)	27.4
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg)	27.4
MechanicalVentilator-EndTidalOxygenPressure(mmHg)	275
MechanicalVentilator-ExpiratoryTidalVolume(L)	0.585
MechanicalVentilator-InspiratoryExpiratoryRatio	0.383
MechanicalVentilator-InspiratoryTidalVolume(L)	0.585
MechanicalVentilator-PeakExpiratoryFlow(L/s)	0.772
MechanicalVentilator-LeakFraction	1.94e-05
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O)	0.518
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O)	5.00
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O)	5.52
PhysiologicDeadSpaceTidalVolumeRatio	0.553
PhysiologicShuntFraction	0.351
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L)	12.4
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L)	12.4
TotalRespiratoryModelCompliance(mL/cmH2O)	44.8
ExtrinsicPositiveEndExpiratoryPressure(cmH2O)	5.00
TotalPositiveEndExpiratoryPressure(cmH2O)	5.07
EndTidalCarbonDioxidePressure(mmHg)	29.4
PhysiologicDeadSpace(mL)	318
AlveolarArterialGradient(mmHg)	210
AlveolarDeadSpace(mL)	154
AnatomicDeadSpace(mL)	164
ChestWallCompliance(L/cmH2O)	0.131
FractionOfInspiredOxygen	0.400
LungCompliance(L/cmH2O)	0.0592
VentilationPerfusionRatio	2.53
HeartStrokeVolume(mL)	57.1
HeartEjectionFraction	0.465
BloodVolume(L)	6.52
MeanArterialPressure(mmHg)	95.9
PulsePressure(mmHg)	28.0
CardiacOutput(L/min)	6.34
CarbonDioxideSaturation	0.0650
RespiratoryExchangeRatio	0.809
SystemicVascularResistance(mmHg_s/mL)	0.862
OxygenConsumptionRate(mL/min)	280
CarbonDioxideProductionRate(mL/min)	227
Patient-AlveoliSurfaceArea(m^2)	14.9
Patient-ExpiratoryReserveVolume(L)	0.943
Patient-FunctionalResidualCapacity(L)	1.39
Patient-InspiratoryCapacity(L)	3.37
Patient-InspiratoryReserveVolume(L)	2.79
Patient-ResidualVolume(L)	0.444
Patient-TidalVolumeBaseline(L)	0.580
Patient-TotalLungCapacity(L)	4.75
Patient-VitalCapacity(L)	4.31

Segment 3

Patient transport continues.

Learning Objectives:

Recognize need to increase PEEP to keep on PEEP matrix

Recommended Actions:

Increase PEEP to 10 to keep on PEEP matrix

Ventilator settings are updated to:

FiO2: 0.4 -> 0.5
VT: 567 -> 490 mL
Flow: 59 -> 50 L/min

Table 5. Data request validation results for Segment 3.

Property Name	Validation	Engine Value	Percent Error	Percent Change	Notes
MechanicalVentilator-TidalVolume(mL)	EqualTo 490	488	0.462%		VT (measured)
Aorta-Oxygen-PartialPressure(mmHg)	GreaterThan Segment2 (55.4) [304] [308]	57.6		4.02%	PaO2
ClinicalShuntFraction	EqualTo Segment2 (0.347) [304] [308]	0.348	0.394%		QS/QT

Figure 4. Vitals and ventilator monitors for Segment 3.

Table 6. Data requests for Segment 3.

Property Name	Engine Value
Patient-Height(in)	74.0
Patient-IdealBodyWeight(kg)	82.2
InspiratoryRespiratoryResistance(cmH2O_s/L)	12.4
ExpiratoryRespiratoryResistance(cmH2O_s/L)	12.4
RespiratoryCompliance(mL/cmH2O)	38.4
ClinicalPhysiologicDeadSpaceTidalVolumeRatio	0.556
ClinicalShuntFraction	0.348
MechanicalVentilator-TidalVolume(L)	0.488
BloodPH	7.38
Aorta-Oxygen-PartialPressure(mmHg)	57.6
Aorta-CarbonDioxide-PartialPressure(mmHg)	43.7
Aorta-Bicarbonate-Molarity(mEq/L)	26.1
OxygenSaturation	0.911
HorowitzIndex(mmHg)	115
IntrinsicPositiveEndExpiratoryPressure(cmH2O)	0.0690
MechanicalVentilator-RespirationRate(1/min)	30.6
MechanicalVentilator-MeanAirwayPressure(cmH2O)	9.13
MechanicalVentilator-PeakInspiratoryPressure(cmH2O)	24.8
MechanicalVentilator-PlateauPressure(cmH2O)	18.5
HeartRate(1/min)	102
SystolicArterialPressure(mmHg)	111
DiastolicArterialPressure(mmHg)	80.2
MechanicalVentilator-TotalPulmonaryVentilation(L/min)	14.9
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L)	12.4
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L)	12.4
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O)	38.3
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O)	24.6
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg)	28.1
MechanicalVentilator-EndTidalOxygenPressure(mmHg)	350
MechanicalVentilator-ExpiratoryTidalVolume(L)	0.488
MechanicalVentilator-InspiratoryExpiratoryRatio	0.463
MechanicalVentilator-InspiratoryTidalVolume(L)	0.488
MechanicalVentilator-PeakExpiratoryFlow(L/s)	0.770
MechanicalVentilator-LeakFraction	3.82e-06
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O)	0.755
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O)	5.00
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O)	5.75
PhysiologicDeadSpaceTidalVolumeRatio	0.553
PhysiologicShuntFraction	0.354
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L)	12.4
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L)	12.4
TotalRespiratoryModelCompliance(mL/cmH2O)	44.8
ExtrinsicPositiveEndExpiratoryPressure(cmH2O)	5.00
TotalPositiveEndExpiratoryPressure(cmH2O)	5.07
EndTidalCarbonDioxidePressure(mmHg)	31.0
PhysiologicDeadSpace(mL)	318
AlveolarArterialGradient(mmHg)	278
AlveolarDeadSpace(mL)	154
AnatomicDeadSpace(mL)	164
ChestWallCompliance(L/cmH2O)	0.128
FractionOfInspiredOxygen	0.500
LungCompliance(L/cmH2O)	0.0590
VentilationPerfusionRatio	2.41
HeartStrokeVolume(mL)	62.5
HeartEjectionFraction	0.490
BloodVolume(L)	6.53
MeanArterialPressure(mmHg)	95.8
PulsePressure(mmHg)	30.3
CardiacOutput(L/min)	6.35
CarbonDioxideSaturation	0.0950
RespiratoryExchangeRatio	0.810
SystemicVascularResistance(mmHg_s/mL)	0.860
OxygenConsumptionRate(mL/min)	282
CarbonDioxideProductionRate(mL/min)	228
Patient-AlveoliSurfaceArea(m^2)	14.9
Patient-ExpiratoryReserveVolume(L)	0.943
Patient-FunctionalResidualCapacity(L)	1.39
Patient-InspiratoryCapacity(L)	3.37
Patient-InspiratoryReserveVolume(L)	2.79
Patient-ResidualVolume(L)	0.444
Patient-TidalVolumeBaseline(L)	0.580
Patient-TotalLungCapacity(L)	4.75
Patient-VitalCapacity(L)	4.31

Segment 4

Patient transport has ended.

Learning Objectives:

Recognize improvement due to change in vent settings
Consider changing mode to address work shifting

Recommended Actions:

None

Ventilator settings are updated to:

PEEP: 5 -> 10 cmH2O

Table 7. Data request validation results for Segment 4.

Property Name	Validation	Engine Value	Percent Error	Percent Change	Notes
MechanicalVentilator-TidalVolume(mL)	EqualTo 490	488	0.336%		VT (measured)
RespiratoryCompliance(mL/cmH2O)	GreaterThan Segment3 (38.4) [229]	42.2		9.84%	C
Aorta-CarbonDioxide-PartialPressure(mmHg)	EqualTo Segment3 (43.7) [254]	46.6	6.53%		PaCO2
Aorta-Oxygen-PartialPressure(mmHg)	GreaterThan Segment3 (57.6) [185]	66.2		14.9%	PaO2
HorowitzIndex(mmHg)	GreaterThan Segment3 (115) [185]	132		14.9%	PaO2/FiO2
ClinicalShuntFraction	LessThan Segment3 (0.348) [185]	0.284		-18.4%	QS/QT (determined from blood gas values)

Figure 5. Vitals and ventilator monitors for Segment 4.

Table 8. Data requests for Segment 4.

Property Name	Engine Value
Patient-Height(in)	74.0
Patient-IdealBodyWeight(kg)	82.2
InspiratoryRespiratoryResistance(cmH2O_s/L)	12.4
ExpiratoryRespiratoryResistance(cmH2O_s/L)	12.4
RespiratoryCompliance(mL/cmH2O)	42.2
ClinicalPhysiologicDeadSpaceTidalVolumeRatio	0.543
ClinicalShuntFraction	0.284
MechanicalVentilator-TidalVolume(L)	0.488
BloodPH	7.35
Aorta-Oxygen-PartialPressure(mmHg)	66.2
Aorta-CarbonDioxide-PartialPressure(mmHg)	46.6
Aorta-Bicarbonate-Molarity(mEq/L)	26.2
OxygenSaturation	0.931
HorowitzIndex(mmHg)	132
IntrinsicPositiveEndExpiratoryPressure(cmH2O)	0.374
MechanicalVentilator-RespirationRate(1/min)	28.8
MechanicalVentilator-MeanAirwayPressure(cmH2O)	13.3
MechanicalVentilator-PeakInspiratoryPressure(cmH2O)	27.1
MechanicalVentilator-PlateauPressure(cmH2O)	22.3
HeartRate(1/min)	75.9
SystolicArterialPressure(mmHg)	114
DiastolicArterialPressure(mmHg)	75.1
MechanicalVentilator-TotalPulmonaryVentilation(L/min)	14.1
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L)	12.4
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L)	12.4
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O)	42.0
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O)	28.6
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg)	31.2
MechanicalVentilator-EndTidalOxygenPressure(mmHg)	348
MechanicalVentilator-ExpiratoryTidalVolume(L)	0.488
MechanicalVentilator-InspiratoryExpiratoryRatio	0.425
MechanicalVentilator-InspiratoryTidalVolume(L)	0.488
MechanicalVentilator-PeakExpiratoryFlow(L/s)	0.690
MechanicalVentilator-LeakFraction	0.00
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O)	0.700
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O)	10.0
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O)	10.7
PhysiologicDeadSpaceTidalVolumeRatio	0.553
PhysiologicShuntFraction	0.290
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L)	12.4
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L)	12.4
TotalRespiratoryModelCompliance(mL/cmH2O)	46.0
ExtrinsicPositiveEndExpiratoryPressure(cmH2O)	10.0
TotalPositiveEndExpiratoryPressure(cmH2O)	10.4
EndTidalCarbonDioxidePressure(mmHg)	34.4
PhysiologicDeadSpace(mL)	318
AlveolarArterialGradient(mmHg)	268
AlveolarDeadSpace(mL)	154
AnatomicDeadSpace(mL)	164
ChestWallCompliance(L/cmH2O)	0.159
FractionOfInspiredOxygen	0.499
LungCompliance(L/cmH2O)	0.0592
VentilationPerfusionRatio	2.38
HeartStrokeVolume(mL)	79.8
HeartEjectionFraction	0.553
BloodVolume(L)	6.58
MeanArterialPressure(mmHg)	95.7
PulsePressure(mmHg)	38.6
CardiacOutput(L/min)	6.06
CarbonDioxideSaturation	0.234
RespiratoryExchangeRatio	0.813
SystemicVascularResistance(mmHg_s/mL)	0.899
OxygenConsumptionRate(mL/min)	289
CarbonDioxideProductionRate(mL/min)	235
Patient-AlveoliSurfaceArea(m^2)	14.9
Patient-ExpiratoryReserveVolume(L)	0.943
Patient-FunctionalResidualCapacity(L)	1.39
Patient-InspiratoryCapacity(L)	3.37
Patient-InspiratoryReserveVolume(L)	2.79
Patient-ResidualVolume(L)	0.444
Patient-TidalVolumeBaseline(L)	0.580
Patient-TotalLungCapacity(L)	4.75
Patient-VitalCapacity(L)	4.31

Scenario Output Plots

Figure 6. Select outputs from the scenario.