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 [1] (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 [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 (10.0) [1] 10.3 2.71%   Rinsp
ExpiratoryRespiratoryResistance(cmH2O_s/L) EqualTo (10.0) [1] 10.3 2.71%   Rexp
RespiratoryCompliance(mL/cmH2O) EqualTo (54.0) [8] 53.1 1.74%   C
PhysiologicDeadSpaceTidalVolumeRatio [0.200,0.400] [5] 0.288 0.00%   VD/VT
ShuntFraction LessThan (0.0500) [5] 0.0261   -47.9% QS/QT
MechanicalVentilator-TidalVolume(mL) EqualTo (444) [1] 432 2.63%   VT (measured)
BloodPH [7.35,7.45] [5] 7.40 0.00%   pH
Aorta-Oxygen-PartialPressure(mmHg) GreaterThan (75.0) [5] 119   58.3% PaO2
Aorta-CarbonDioxide-PartialPressure(mmHg) LessThan (45.0) [5] 41.7   -7.37% PaCO2
OxygenSaturation GreaterThan (0.950) [5] 0.987   3.91% SpO2
HorowitzIndex(mmHg) [400,500] [5] 458 0.00%   PaO2/FiO2
HorowitzIndex(mmHg) GreaterThan (300) [3] 458   52.6% 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) 60.0
InspiratoryRespiratoryResistance(cmH2O_s/L) 10.3
ExpiratoryRespiratoryResistance(cmH2O_s/L) 10.3
RespiratoryCompliance(mL/cmH2O) 53.1
ApparentPhysiologicDeadSpaceTidalVolumeRatio 0.408
ApparentShuntFraction 0.0952
MechanicalVentilator-TidalVolume(L) 0.432
BloodPH 7.40
Aorta-Oxygen-PartialPressure(mmHg) 119
Aorta-CarbonDioxide-PartialPressure(mmHg) 41.7
Aorta-Bicarbonate-Molarity(mEq/L) 26.0
OxygenSaturation 0.987
HorowitzIndex(mmHg) 458
IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.129
MechanicalVentilator-RespirationRate(1/min) 16.9
MechanicalVentilator-MeanAirwayPressure(cmH2O) 8.25
MechanicalVentilator-PeakInspiratoryPressure(cmH2O) 14.0
MechanicalVentilator-PlateauPressure(cmH2O) 13.3
HeartRate(1/min) 70.5
SystolicArterialPressure(mmHg) 114
DiastolicArterialPressure(mmHg) 72.2
MechanicalVentilator-TotalPulmonaryVentilation(L/min) 7.33
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L) 10.3
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L) 10.3
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O) 53.0
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O) 48.1
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg) 36.6
MechanicalVentilator-EndTidalOxygenPressure(mmHg) 156
MechanicalVentilator-ExpiratoryTidalVolume(L) 0.432
MechanicalVentilator-InspiratoryExpiratoryRatio 0.580
MechanicalVentilator-InspiratoryTidalVolume(L) 0.432
MechanicalVentilator-PeakExpiratoryFlow(L/s) 0.651
MechanicalVentilator-LeakFraction 0.00
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.133
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5.00
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O) 5.13
PhysiologicDeadSpaceTidalVolumeRatio 0.288
ShuntFraction 0.0261
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L) 10.3
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L) 10.3
TotalRespiratoryModelCompliance(mL/cmH2O) 65.3
ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5.00
TotalPositiveEndExpiratoryPressure(cmH2O) 5.13
EndTidalCarbonDioxidePressure(mmHg) 38.3
PhysiologicDeadSpace(mL) 121
AlveolarArterialGradient(mmHg) 33.1
AlveolarDeadSpace(mL) 1.00
AnatomicDeadSpace(mL) 120
ChestWallCompliance(L/cmH2O) 0.135
FractionOfInspiredOxygen 0.259
LungCompliance(L/cmH2O) 0.0900
VentilationPerfusionRatio 1.34
HeartStrokeVolume(mL) 79.3
HeartEjectionFraction 0.577
BloodVolume(L) 4.14
MeanArterialPressure(mmHg) 94.6
PulsePressure(mmHg) 41.7
CardiacOutput(L/min) 5.60
CarbonDioxideSaturation 0.0279
RespiratoryExchangeRatio 0.829
SystemicVascularResistance(mmHg_s/mL) 0.964
OxygenConsumptionRate(mL/min) 197
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.