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En Route Care Scenario 1 - NoSpontaneous

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.

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 Percent Change Notes
MechanicalVentilator-TidalVolume(mL) EqualTo 584 578 -0.98%   VT (measured)
InspiratoryRespiratoryResistance(cmH2O_s/L) EqualTo 12 [18] 11.6 -3.12%   Rinsp for mild ARDS
ExpiratoryRespiratoryResistance(cmH2O_s/L) EqualTo 12 [18] 11.6 -3.12%   Rexp for mild ARDS
RespiratoryCompliance(mL/cmH2O) EqualTo 50 [316] 50.8 1.67%   C requested by SME for mild ARDS
PhysiologicDeadSpaceTidalVolumeRatio EqualTo 0.54 [238] 0.515 -4.61%   VD/VT for mild ARDS
ClinicalShuntFraction [0.200,0.400] [229] 0.216 0.00%   QS/QT for mild ARDS (determined from blood gas values)
HorowitzIndex(mmHg) [200,300] [119] 185 -7.60%   PaO2/FiO2 for mild ARDS



Figure 1. 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) 50.8
ClinicalPhysiologicDeadSpaceTidalVolumeRatio 0.432
ClinicalShuntFraction 0.216
MechanicalVentilator-TidalVolume(L) 0.578
BloodPH 7.38
Aorta-Oxygen-PartialPressure(mmHg) 73.9
Aorta-CarbonDioxide-PartialPressure(mmHg) 40.9
Aorta-Bicarbonate-Molarity(mEq/L) 26.1
OxygenSaturation 0.953
HorowitzIndex(mmHg) 185
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) 73.5
SystolicArterialPressure(mmHg) 114
DiastolicArterialPressure(mmHg) 73.9
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) 30.5
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 0.00
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.456
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5.00
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O) 5.46
PhysiologicDeadSpaceTidalVolumeRatio 0.515
PhysiologicShuntFraction 0.218
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L) 11.6
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L) 11.6
TotalRespiratoryModelCompliance(mL/cmH2O) 58.2
ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5.00
TotalPositiveEndExpiratoryPressure(cmH2O) 5.51
EndTidalCarbonDioxidePressure(mmHg) 32.5
PhysiologicDeadSpace(mL) 296
AlveolarArterialGradient(mmHg) 194
AlveolarDeadSpace(mL) 132
AnatomicDeadSpace(mL) 164
ChestWallCompliance(L/cmH2O) 0.151
FractionOfInspiredOxygen 0.400
LungCompliance(L/cmH2O) 0.0790
VentilationPerfusionRatio 1.18
HeartStrokeVolume(mL) 80.4
HeartEjectionFraction 0.555
BloodVolume(L) 6.50
MeanArterialPressure(mmHg) 95.2
PulsePressure(mmHg) 40.0
CardiacOutput(L/min) 5.91
CarbonDioxideSaturation 0.0258
RespiratoryExchangeRatio 0.799
SystemicVascularResistance(mmHg_s/mL) 0.919
OxygenConsumptionRate(mL/min) 291
CarbonDioxideProductionRate(mL/min) 232
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) 0.578
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.

Learning Objectives:

  • Recognize worsening ARDS
  • Adjust vent settings for safety

Recommended Actions:

  • Increase FiO2 to 0.5
  • Decrease VT to get acceptable DeltaP
  • Increase RR to get same MVe
Table 3. Data request validation results for Segment 2.
Property Name Validation Engine Value Percent Error Percent Change Notes
MechanicalVentilator-TidalVolume(mL) EqualTo 567 579 2.11%   VT (measured)
InspiratoryRespiratoryResistance(cmH2O_s/L) EqualTo 12 [18] 12.4 3.13%   Rinsp for moderate ARDS
ExpiratoryRespiratoryResistance(cmH2O_s/L) EqualTo 12 [18] 12.4 3.13%   Rexp for moderate ARDS
RespiratoryCompliance(mL/cmH2O) EqualTo 40 [316] 39.7 -0.85%   C requested by SME for moderate ARDS
PhysiologicDeadSpaceTidalVolumeRatio EqualTo 0.57 [238] 0.553 -2.97%   VD/VT for moderate ARDS
ClinicalShuntFraction [0.300,0.500] [229] 0.379 0.00%   QS/QT for moderate ARDS (determined from blood gas values)
HorowitzIndex(mmHg) [100,200] [119] 133 0.00%   PaO2/FiO2 for moderate ARDS
MechanicalVentilator-PeakInspiratoryPressure(cmH2O) GreaterThan Segment1 (28.1) [316] 31.7   12.97% PIP
MechanicalVentilator-PlateauPressure(cmH2O) GreaterThan Segment1 (17.0) [316] 20.2   18.69% Pplat
OxygenSaturation LessThan Segment1 (0.953) [316] [320] 0.888   -6.86% SpO2



Figure 2. 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) 39.7
ClinicalPhysiologicDeadSpaceTidalVolumeRatio 0.478
ClinicalShuntFraction 0.379
MechanicalVentilator-TidalVolume(L) 0.579
BloodPH 7.36
Aorta-Oxygen-PartialPressure(mmHg) 53.1
Aorta-CarbonDioxide-PartialPressure(mmHg) 43.2
Aorta-Bicarbonate-Molarity(mEq/L) 26.2
OxygenSaturation 0.888
HorowitzIndex(mmHg) 133
IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.321
MechanicalVentilator-RespirationRate(1/min) 24.0
MechanicalVentilator-MeanAirwayPressure(cmH2O) 9.91
MechanicalVentilator-PeakInspiratoryPressure(cmH2O) 31.7
MechanicalVentilator-PlateauPressure(cmH2O) 20.2
HeartRate(1/min) 128
SystolicArterialPressure(mmHg) 109
DiastolicArterialPressure(mmHg) 83.1
MechanicalVentilator-TotalPulmonaryVentilation(L/min) 13.9
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L) 12.4
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L) 12.4
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O) 38.9
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O) 21.7
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg) 28.8
MechanicalVentilator-EndTidalOxygenPressure(mmHg) 272
MechanicalVentilator-ExpiratoryTidalVolume(L) 0.579
MechanicalVentilator-InspiratoryExpiratoryRatio 0.330
MechanicalVentilator-InspiratoryTidalVolume(L) 0.579
MechanicalVentilator-PeakExpiratoryFlow(L/s) 0.969
MechanicalVentilator-LeakFraction 1.88e-14
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.299
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5.00
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O) 5.30
PhysiologicDeadSpaceTidalVolumeRatio 0.553
PhysiologicShuntFraction 0.381
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L) 12.4
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L) 12.4
TotalRespiratoryModelCompliance(mL/cmH2O) 45.8
ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5.00
TotalPositiveEndExpiratoryPressure(cmH2O) 5.32
EndTidalCarbonDioxidePressure(mmHg) 31.0
PhysiologicDeadSpace(mL) 318
AlveolarArterialGradient(mmHg) 215
AlveolarDeadSpace(mL) 154
AnatomicDeadSpace(mL) 164
ChestWallCompliance(L/cmH2O) 0.126
FractionOfInspiredOxygen 0.400
LungCompliance(L/cmH2O) 0.0594
VentilationPerfusionRatio 1.01
HeartStrokeVolume(mL) 49.7
HeartEjectionFraction 0.425
BloodVolume(L) 6.51
MeanArterialPressure(mmHg) 96.2
PulsePressure(mmHg) 26.1
CardiacOutput(L/min) 6.35
CarbonDioxideSaturation 0.0590
RespiratoryExchangeRatio 0.795
SystemicVascularResistance(mmHg_s/mL) 0.863
OxygenConsumptionRate(mL/min) 280
CarbonDioxideProductionRate(mL/min) 223
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) 0.578
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 8 cmH2O to keep on low PEEP table

Ventilator settings are updated to:

  • FiO2: 0.4 -> 0.5
  • RR: 24 -> 28 bpm
  • VT: 584 -> 490 mL
  • Flow: 60 -> 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 490 482 -1.73%   VT (measured)
Aorta-Oxygen-PartialPressure(mmHg) GreaterThan Segment2 (53.1) [316] [320] 55.0   3.64% PaO2
ClinicalShuntFraction EqualTo Segment2 (0.379) [316] [320] 0.382 0.82%   QS/QT



Figure 3. 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) 39.7
ClinicalPhysiologicDeadSpaceTidalVolumeRatio 0.436
ClinicalShuntFraction 0.382
MechanicalVentilator-TidalVolume(L) 0.482
BloodPH 7.35
Aorta-Oxygen-PartialPressure(mmHg) 55.0
Aorta-CarbonDioxide-PartialPressure(mmHg) 44.1
Aorta-Bicarbonate-Molarity(mEq/L) 26.2
OxygenSaturation 0.895
HorowitzIndex(mmHg) 110
IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.560
MechanicalVentilator-RespirationRate(1/min) 27.8
MechanicalVentilator-MeanAirwayPressure(cmH2O) 9.82
MechanicalVentilator-PeakInspiratoryPressure(cmH2O) 27.7
MechanicalVentilator-PlateauPressure(cmH2O) 17.8
HeartRate(1/min) 121
SystolicArterialPressure(mmHg) 109
DiastolicArterialPressure(mmHg) 81.9
MechanicalVentilator-TotalPulmonaryVentilation(L/min) 13.4
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L) 12.4
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L) 12.4
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O) 39.1
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O) 21.2
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg) 31.8
MechanicalVentilator-EndTidalOxygenPressure(mmHg) 344
MechanicalVentilator-ExpiratoryTidalVolume(L) 0.482
MechanicalVentilator-InspiratoryExpiratoryRatio 0.403
MechanicalVentilator-InspiratoryTidalVolume(L) 0.482
MechanicalVentilator-PeakExpiratoryFlow(L/s) 0.834
MechanicalVentilator-LeakFraction 3.94e-14
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.510
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5.00
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O) 5.51
PhysiologicDeadSpaceTidalVolumeRatio 0.553
PhysiologicShuntFraction 0.384
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L) 12.4
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L) 12.4
TotalRespiratoryModelCompliance(mL/cmH2O) 46.2
ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5.00
TotalPositiveEndExpiratoryPressure(cmH2O) 5.56
EndTidalCarbonDioxidePressure(mmHg) 35.6
PhysiologicDeadSpace(mL) 318
AlveolarArterialGradient(mmHg) 283
AlveolarDeadSpace(mL) 154
AnatomicDeadSpace(mL) 164
ChestWallCompliance(L/cmH2O) 0.126
FractionOfInspiredOxygen 0.499
LungCompliance(L/cmH2O) 0.0594
VentilationPerfusionRatio 0.725
HeartStrokeVolume(mL) 53.4
HeartEjectionFraction 0.446
BloodVolume(L) 6.52
MeanArterialPressure(mmHg) 95.8
PulsePressure(mmHg) 27.5
CardiacOutput(L/min) 6.45
CarbonDioxideSaturation 0.109
RespiratoryExchangeRatio 0.796
SystemicVascularResistance(mmHg_s/mL) 0.846
OxygenConsumptionRate(mL/min) 282
CarbonDioxideProductionRate(mL/min) 224
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) 0.578
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

Recommended Actions:

  • None

Ventilator settings are updated to:

  • PEEP: 5 -> 8 cmH2O
Table 7. Data request validation results for Segment 4.
Property Name Validation Engine Value Percent Error Percent Change Notes
MechanicalVentilator-TidalVolume(mL) EqualTo 490 481 -1.78%   VT (measured)
RespiratoryCompliance(mL/cmH2O) GreaterThan Segment3 (39.7) [238] 41.4   4.42% C
Aorta-CarbonDioxide-PartialPressure(mmHg) EqualTo Segment3 (44.1) [264] 45.5 3.18%   PaCO2
Aorta-Oxygen-PartialPressure(mmHg) GreaterThan Segment3 (55.0) [193] 58.9   7.04% PaO2
HorowitzIndex(mmHg) GreaterThan Segment3 (110) [193] 118   7.05% PaO2/FiO2
ClinicalShuntFraction LessThan Segment3 (0.382) [193] 0.349   -8.75% QS/QT (determined from blood gas values)



Figure 4. 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) 41.4
ClinicalPhysiologicDeadSpaceTidalVolumeRatio 0.430
ClinicalShuntFraction 0.349
MechanicalVentilator-TidalVolume(L) 0.481
BloodPH 7.33
Aorta-Oxygen-PartialPressure(mmHg) 58.9
Aorta-CarbonDioxide-PartialPressure(mmHg) 45.5
Aorta-Bicarbonate-Molarity(mEq/L) 26.3
OxygenSaturation 0.909
HorowitzIndex(mmHg) 118
IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.631
MechanicalVentilator-RespirationRate(1/min) 27.8
MechanicalVentilator-MeanAirwayPressure(cmH2O) 12.8
MechanicalVentilator-PeakInspiratoryPressure(cmH2O) 30.3
MechanicalVentilator-PlateauPressure(cmH2O) 20.3
HeartRate(1/min) 105
SystolicArterialPressure(mmHg) 111
DiastolicArterialPressure(mmHg) 80.0
MechanicalVentilator-TotalPulmonaryVentilation(L/min) 13.4
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L) 12.4
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L) 12.4
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O) 41.1
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O) 21.6
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg) 33.4
MechanicalVentilator-EndTidalOxygenPressure(mmHg) 345
MechanicalVentilator-ExpiratoryTidalVolume(L) 0.481
MechanicalVentilator-InspiratoryExpiratoryRatio 0.403
MechanicalVentilator-InspiratoryTidalVolume(L) 0.481
MechanicalVentilator-PeakExpiratoryFlow(L/s) 0.808
MechanicalVentilator-LeakFraction 0.00
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.566
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 8.00
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O) 8.57
PhysiologicDeadSpaceTidalVolumeRatio 0.553
PhysiologicShuntFraction 0.352
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L) 12.4
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L) 12.4
TotalRespiratoryModelCompliance(mL/cmH2O) 47.7
ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 8.01
TotalPositiveEndExpiratoryPressure(cmH2O) 8.64
EndTidalCarbonDioxidePressure(mmHg) 37.4
PhysiologicDeadSpace(mL) 318
AlveolarArterialGradient(mmHg) 281
AlveolarDeadSpace(mL) 154
AnatomicDeadSpace(mL) 164
ChestWallCompliance(L/cmH2O) 0.143
FractionOfInspiredOxygen 0.499
LungCompliance(L/cmH2O) 0.0594
VentilationPerfusionRatio 0.735
HeartStrokeVolume(mL) 60.7
HeartEjectionFraction 0.482
BloodVolume(L) 6.50
MeanArterialPressure(mmHg) 95.6
PulsePressure(mmHg) 30.5
CardiacOutput(L/min) 6.36
CarbonDioxideSaturation 0.174
RespiratoryExchangeRatio 0.799
SystemicVascularResistance(mmHg_s/mL) 0.858
OxygenConsumptionRate(mL/min) 285
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) 0.578
Patient-TotalLungCapacity(L) 4.75
Patient-VitalCapacity(L) 4.31

Scenario Output Plots


Figure 5. Select outputs from the scenario.


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