MechanicalVentilator-Recruitment
MechanicalVentilatorRecruitment
Description
A standard patient is mechanically ventilated with moderate ARDS. The PEEP is increased to test the effects of improved lung recruitment. Ventilator setting and expected values were largely determined from Karbing et al [6] Table 2.
Segment Validation
Segment 1
Diagnosis: ARDS
Ventilator settings are set for TV = 6.9 mL/kg (ideal) and I:E = 0.5:
Mode | VT (mL) | PIP (cmH2O) | Flow (L/min) | I:E | TI (s) | RR (bpm) | PEEP (cmH2O) | FiO2 |
---|---|---|---|---|---|---|---|---|
PC-CMV | 520 | Adjust | NA | NA | 0.87 | 23 | 5 | 0.5 |
Property Name | Validation | Engine Value | Percent Error | Percent Change | Notes |
---|---|---|---|---|---|
MechanicalVentilator-TidalVolume(mL) | EqualTo (520) [6] | 528 | 1.54% | VT (measured) | |
HorowitzIndex(mmHg) | [72.0,188] [6] | 172 | 0.00% | PaO2/FiO2 (130 +/- 58) | |
ApparentShuntFraction | [0.180,0.480] [6] | 0.253 | 0.00% | QS/QT (determined from blood gas values) (0.33 +/- 0.15) |
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Property Name | Engine Value |
---|---|
Patient-Height(in) | 71.0 |
Patient-IdealBodyWeight(kg) | 75.3 |
InspiratoryRespiratoryResistance(cmH2O_s/L) | 11.9 |
ExpiratoryRespiratoryResistance(cmH2O_s/L) | 11.9 |
RespiratoryCompliance(mL/cmH2O) | 36.9 |
ApparentPhysiologicDeadSpaceTidalVolumeRatio | 0.519 |
ApparentShuntFraction | 0.253 |
MechanicalVentilator-TidalVolume(L) | 0.528 |
BloodPH | 7.39 |
Aorta-Oxygen-PartialPressure(mmHg) | 86.1 |
Aorta-CarbonDioxide-PartialPressure(mmHg) | 43.0 |
Aorta-Bicarbonate-Molarity(mEq/L) | 26.0 |
OxygenSaturation | 0.969 |
HorowitzIndex(mmHg) | 172 |
IntrinsicPositiveEndExpiratoryPressure(cmH2O) | 0.254 |
MechanicalVentilator-RespirationRate(1/min) | 22.9 |
MechanicalVentilator-MeanAirwayPressure(cmH2O) | 10.6 |
MechanicalVentilator-PeakInspiratoryPressure(cmH2O) | 22.0 |
MechanicalVentilator-PlateauPressure(cmH2O) | 19.9 |
HeartRate(1/min) | 69.9 |
SystolicArterialPressure(mmHg) | 115 |
DiastolicArterialPressure(mmHg) | 73.0 |
MechanicalVentilator-TotalPulmonaryVentilation(L/min) | 12.1 |
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L) | 11.9 |
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L) | 11.9 |
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O) | 36.1 |
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O) | 31.1 |
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg) | 30.9 |
MechanicalVentilator-EndTidalOxygenPressure(mmHg) | 347 |
MechanicalVentilator-ExpiratoryTidalVolume(L) | 0.528 |
MechanicalVentilator-InspiratoryExpiratoryRatio | 0.506 |
MechanicalVentilator-InspiratoryTidalVolume(L) | 0.528 |
MechanicalVentilator-PeakExpiratoryFlow(L/s) | 0.977 |
MechanicalVentilator-LeakFraction | 8.70e-14 |
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O) | 0.254 |
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O) | 5.00 |
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O) | 5.25 |
PhysiologicDeadSpaceTidalVolumeRatio | 0.528 |
ShuntFraction | 0.224 |
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L) | 11.9 |
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L) | 11.9 |
TotalRespiratoryModelCompliance(mL/cmH2O) | 42.4 |
ExtrinsicPositiveEndExpiratoryPressure(cmH2O) | 5.00 |
TotalPositiveEndExpiratoryPressure(cmH2O) | 5.26 |
EndTidalCarbonDioxidePressure(mmHg) | 33.1 |
PhysiologicDeadSpace(mL) | 278 |
AlveolarArterialGradient(mmHg) | 252 |
AlveolarDeadSpace(mL) | 128 |
AnatomicDeadSpace(mL) | 151 |
ChestWallCompliance(L/cmH2O) | 0.117 |
FractionOfInspiredOxygen | 0.500 |
LungCompliance(L/cmH2O) | 0.0555 |
VentilationPerfusionRatio | 2.67 |
HeartStrokeVolume(mL) | 83.5 |
HeartEjectionFraction | 0.573 |
BloodVolume(L) | 5.51 |
MeanArterialPressure(mmHg) | 95.4 |
PulsePressure(mmHg) | 42.1 |
CardiacOutput(L/min) | 5.84 |
CarbonDioxideSaturation | 0.0516 |
RespiratoryExchangeRatio | 0.820 |
SystemicVascularResistance(mmHg_s/mL) | 0.932 |
OxygenConsumptionRate(mL/min) | 251 |
CarbonDioxideProductionRate(mL/min) | 205 |
Patient-AlveoliSurfaceArea(m^2) | 27.3 |
Patient-ExpiratoryReserveVolume(L) | 0.855 |
Patient-FunctionalResidualCapacity(L) | 1.48 |
Patient-InspiratoryCapacity(L) | 3.06 |
Patient-InspiratoryReserveVolume(L) | 2.52 |
Patient-ResidualVolume(L) | 0.624 |
Patient-TidalVolumeBaseline(L) | 0.535 |
Patient-TotalLungCapacity(L) | 4.54 |
Patient-VitalCapacity(L) | 3.91 |
Segment 2
PEEP is increased for improved recruitment with PIP set to maintain target TV:
Mode | VT (mL) | PIP (cmH2O) | Flow (L/min) | I:E | TI (s) | RR (bpm) | PEEP (cmH2O) | FiO2 |
---|---|---|---|---|---|---|---|---|
PC-CMV | 520 | Adjust | NA | NA | 0.87 | 23 | 18 | 0.5 |
Property Name | Validation | Engine Value | Percent Error | Percent Change | Notes |
---|---|---|---|---|---|
MechanicalVentilator-TidalVolume(mL) | EqualTo (520) [6] | 538 | 3.44% | VT (measured) | |
Aorta-CarbonDioxide-PartialPressure(mmHg) | EqualTo Segment 1 (43.0) [9] | 42.7 | 0.517% | PaCO2 | |
Aorta-Oxygen-PartialPressure(mmHg) | GreaterThan (1.00) [6] | 195 | 1.94e+04% | PaO2 | |
HorowitzIndex(mmHg) | [138,302] [6] | 389 | 25.3% | PaO2/FiO2 (220 +/- 82) | |
HorowitzIndex(mmHg) | GreaterThan (1.00) [6] | 389 | 3.88e+04% | PaO2/FiO2 | |
ApparentShuntFraction | [0.0800,0.360] [6] | 0.106 | 0.00% | QS/QT (determined from blood gas values) (0.22 +/- 0.14) | |
ApparentShuntFraction | LessThan (1.00) [6] | 0.106 | -89.4% | QS/QT (determined from blood gas values) |
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Property Name | Engine Value |
---|---|
Patient-Height(in) | 71.0 |
Patient-IdealBodyWeight(kg) | 75.3 |
InspiratoryRespiratoryResistance(cmH2O_s/L) | 11.9 |
ExpiratoryRespiratoryResistance(cmH2O_s/L) | 11.9 |
RespiratoryCompliance(mL/cmH2O) | 43.6 |
ApparentPhysiologicDeadSpaceTidalVolumeRatio | 0.504 |
ApparentShuntFraction | 0.106 |
MechanicalVentilator-TidalVolume(L) | 0.538 |
BloodPH | 7.39 |
Aorta-Oxygen-PartialPressure(mmHg) | 195 |
Aorta-CarbonDioxide-PartialPressure(mmHg) | 42.7 |
Aorta-Bicarbonate-Molarity(mEq/L) | 26.0 |
OxygenSaturation | 0.996 |
HorowitzIndex(mmHg) | 389 |
IntrinsicPositiveEndExpiratoryPressure(cmH2O) | 0.458 |
MechanicalVentilator-RespirationRate(1/min) | 22.9 |
MechanicalVentilator-MeanAirwayPressure(cmH2O) | 23.3 |
MechanicalVentilator-PeakInspiratoryPressure(cmH2O) | 34.0 |
MechanicalVentilator-PlateauPressure(cmH2O) | 30.9 |
HeartRate(1/min) | 64.1 |
SystolicArterialPressure(mmHg) | 116 |
DiastolicArterialPressure(mmHg) | 71.5 |
MechanicalVentilator-TotalPulmonaryVentilation(L/min) | 12.3 |
MechanicalVentilator-InspiratoryResistance(cmH2O_s/L) | 11.9 |
MechanicalVentilator-ExpiratoryResistance(cmH2O_s/L) | 11.9 |
MechanicalVentilator-StaticRespiratoryCompliance(mL/cmH2O) | 43.3 |
MechanicalVentilator-DynamicRespiratoryCompliance(mL/cmH2O) | 33.7 |
MechanicalVentilator-EndTidalCarbonDioxidePressure(mmHg) | 32.5 |
MechanicalVentilator-EndTidalOxygenPressure(mmHg) | 350 |
MechanicalVentilator-ExpiratoryTidalVolume(L) | 0.538 |
MechanicalVentilator-InspiratoryExpiratoryRatio | 0.506 |
MechanicalVentilator-InspiratoryTidalVolume(L) | 0.538 |
MechanicalVentilator-PeakExpiratoryFlow(L/s) | 0.885 |
MechanicalVentilator-LeakFraction | 1.03e-15 |
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O) | 0.421 |
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O) | 18.0 |
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O) | 18.4 |
PhysiologicDeadSpaceTidalVolumeRatio | 0.528 |
ShuntFraction | 0.0718 |
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L) | 11.9 |
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L) | 11.9 |
TotalRespiratoryModelCompliance(mL/cmH2O) | 45.3 |
ExtrinsicPositiveEndExpiratoryPressure(cmH2O) | 18.0 |
TotalPositiveEndExpiratoryPressure(cmH2O) | 18.5 |
EndTidalCarbonDioxidePressure(mmHg) | 34.8 |
PhysiologicDeadSpace(mL) | 278 |
AlveolarArterialGradient(mmHg) | 148 |
AlveolarDeadSpace(mL) | 128 |
AnatomicDeadSpace(mL) | 151 |
ChestWallCompliance(L/cmH2O) | 0.209 |
FractionOfInspiredOxygen | 0.500 |
LungCompliance(L/cmH2O) | 0.0555 |
VentilationPerfusionRatio | 2.35 |
HeartStrokeVolume(mL) | 88.6 |
HeartEjectionFraction | 0.589 |
BloodVolume(L) | 5.54 |
MeanArterialPressure(mmHg) | 95.3 |
PulsePressure(mmHg) | 44.5 |
CardiacOutput(L/min) | 5.68 |
CarbonDioxideSaturation | 0.0367 |
RespiratoryExchangeRatio | 0.825 |
SystemicVascularResistance(mmHg_s/mL) | 0.957 |
OxygenConsumptionRate(mL/min) | 259 |
CarbonDioxideProductionRate(mL/min) | 214 |
Patient-AlveoliSurfaceArea(m^2) | 27.3 |
Patient-ExpiratoryReserveVolume(L) | 0.855 |
Patient-FunctionalResidualCapacity(L) | 1.48 |
Patient-InspiratoryCapacity(L) | 3.06 |
Patient-InspiratoryReserveVolume(L) | 2.52 |
Patient-ResidualVolume(L) | 0.624 |
Patient-TidalVolumeBaseline(L) | 0.535 |
Patient-TotalLungCapacity(L) | 4.54 |
Patient-VitalCapacity(L) | 3.91 |
Scenario Output Plots
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