MechanicalVentilator-Healthy

MechanicalVentilatorHealthy

Description

A healthy male patient with a predicted body weight of 60 kg is mechanically ventilated. These are the data sources:

  • Resistance: Inspiratory resistance (Rinsp) is assumed equal to expiratory resistance (Rexp), taken from Arnal et al [1] (Table 9).
  • Compliance: Taken from Arnal et al arnal2018parameters (Table 3).
  • Dead space: Standard healthy values taken from the Kacmarek et al Fundamentals of Respiratory Care page 63 [5].
  • Shunt: Standard healthy values taken from the Kacmarek et al Fundamentals of Respiratory Care page 68 [5].
  • Ventilator Settings: All ventilator settings were takeng from Arnal et al [1] (Table 2) for a male patient aged 73 years and predicted body weight of 60 kg. Note that the mode for simulation is PC-CMV, which is equivalent to the mode used by Arnal et alv [1] for passive pateints. Equivalent settings for tidal volume, rate, and inspiratory time can be used for volume control simulations.
  • Blood Gas Values: Standard healthy values taken from the Kacmarek et al Fundamentals of Respiratory Care [5].

Segment Validation

Segment 1

Ventilator settings are (VT Target = 7.4 mL/kg (ideal)):

Mode VT (mL) PIP (cmH2O) Flow (L/min) I:E TI (s) RR (bpm) PEEP (cmH2O) FiO2
PC-CMV 444 Adjust NA 0.6 1.3 17 5 0.26
Table 1. Data request validation results for Segment 1.
Property Name Validation Engine Value Percent Error Percent Change Notes
InspiratoryRespiratoryResistance(cmH2O_s/L) EqualTo 10 [1] 10.28 2.7%   Rinsp
ExpiratoryRespiratoryResistance(cmH2O_s/L) EqualTo 10 [1] 10.27 2.7%   Rexp
RespiratoryCompliance(mL/cmH2O) EqualTo 54 [8] 52.59 2.6%   C
PhysiologicDeadSpaceTidalVolumeRatio [0.2,0.4] [5] 0.2881 0.0%   VD/VT
ShuntFraction LessThan 0.05 [5] 0.0265   -47.0% QS/QT
MechanicalVentilator-TidalVolume(mL) EqualTo 444 [1] 432.5 2.6%   VT (measured)
BloodPH [7.35,7.45] [5] 7.397 0.0%   pH
Aorta-Oxygen-PartialPressure(mmHg) GreaterThan 75 [5] 118.6   58.2% PaO2
Aorta-CarbonDioxide-PartialPressure(mmHg) LessThan 45 [5] 41.68   -7.4% PaCO2
OxygenSaturation GreaterThan 0.95 [5] 0.9871   3.9% SpO2
HorowitzIndex(mmHg) [400,500] [5] 457.3 0.0%   PaO2/FiO2
HorowitzIndex(mmHg) GreaterThan 300 [3] 457.3   52.4% PaO2/FiO2


Figure 1. Vitals and ventilator monitors for Segment 1.


Table 2. Data requests for Segment 1.
Property Name Engine Value
Patient-Height(in) 64.3
Patient-IdealBodyWeight(kg) 60
InspiratoryRespiratoryResistance(cmH2O_s/L) 10.3
ExpiratoryRespiratoryResistance(cmH2O_s/L) 10.3
RespiratoryCompliance(mL/cmH2O) 52.6
PhysiologicDeadSpaceTidalVolumeRatio 0.288
ShuntFraction 0.0265
MechanicalVentilator-TidalVolume(L) 0.432
BloodPH 7.4
Aorta-Oxygen-PartialPressure(mmHg) 119
Aorta-CarbonDioxide-PartialPressure(mmHg) 41.7
Aorta-Bicarbonate-Molarity(mEq/L) 26
OxygenSaturation 0.987
HorowitzIndex(mmHg) 457
IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.129
MechanicalVentilator-RespirationRate(1/min) 16.9
MechanicalVentilator-MeanAirwayPressure(cmH2O) 8.25
MechanicalVentilator-PeakInspiratoryPressure(cmH2O) 14
MechanicalVentilator-PlateauPressure(cmH2O) 13.4
HeartRate(1/min) 70.7
SystolicArterialPressure(mmHg) 115
DiastolicArterialPressure(mmHg) 72.8
MechanicalVentilator-TotalPulmonaryVentilation(L/min) 7.33
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L) 10.3
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L) 10.3
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O) 52.2
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O) 48.1
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg) 36.6
MechanicalVentilator-EndTidalOxygenPressure(mmHg) 156
MechanicalVentilator-ExpiratoryTidalVolume(L) 0.432
MechanicalVentilator-InspiratoryExpiratoryRatio 0.58
MechanicalVentilator-InspiratoryTidalVolume(L) 0.432
MechanicalVentilator-PeakExpiratoryFlow(L/s) 0.651
MechanicalVentilator-LeakFraction 0
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.127
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O) 5.13
ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5
TotalPositiveEndExpiratoryPressure(cmH2O) 5.13
EndTidalCarbonDioxidePressure(mmHg) 38.3
PhysiologicDeadSpace(mL) 121
AlveolarArterialGradient(mmHg) 33
AlveolarDeadSpace(mL) 1
AnatomicDeadSpace(mL) 120
ChestWallCompliance(L/cmH2O) 0.13
FractionOfInspiredOxygen 0.259
LungCompliance(L/cmH2O) 0.09
VentilationPerfusionRatio 1.36
HeartStrokeVolume(mL) 79.3
HeartEjectionFraction 0.575
BloodVolume(L) 4.14
MeanArterialPressure(mmHg) 95.6
PulsePressure(mmHg) 42
CardiacOutput(L/min) 5.6
CarbonDioxideSaturation 0.028
RespiratoryExchangeRatio 0.829
SystemicVascularResistance(mmHg_s/mL) 0.974
OxygenConsumptionRate(mL/min) 198
CarbonDioxideProductionRate(mL/min) 164
Patient-AlveoliSurfaceArea(m^2) 54.5
Patient-ExpiratoryReserveVolume(L) 0.734
Patient-FunctionalResidualCapacity(L) 1.57
Patient-InspiratoryCapacity(L) 2.62
Patient-InspiratoryReserveVolume(L) 2.19
Patient-ResidualVolume(L) 0.839
Patient-TidalVolumeBaseline(L) 0.435
Patient-TotalLungCapacity(L) 4.19
Patient-VitalCapacity(L) 3.35

Scenario Output Plots


Figure 2. Select outputs from the scenario.