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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 [18] (Table 9).
  • Compliance: Taken from Arnal et al [18] (Table 3).
  • Dead space: Standard healthy values taken from the Kacmarek et al Fundamentals of Respiratory Care page 63 [191].
  • Shunt: Standard healthy values taken from the Kacmarek et al Fundamentals of Respiratory Care page 68 [191].
  • Ventilator Settings: All ventilator settings were takeng from Arnal et al [18] (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 [18] 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 [191].

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 [18] 10.3 2.75%   Rinsp
ExpiratoryRespiratoryResistance(cmH2O_s/L) EqualTo 10 [18] 10.3 2.75%   Rexp
RespiratoryCompliance(mL/cmH2O) EqualTo 54 [238] 54.0 0.02%   C
PhysiologicDeadSpaceTidalVolumeRatio [0.200,0.400] [191] 0.288 0.00%   VD/VT
ClinicalShuntFraction LessThan 0.05 [191] 0.0287   -42.69% QS/QT (determined from blood gas values)
MechanicalVentilator-TidalVolume(mL) EqualTo 444 [18] 432 -2.60%   VT (measured)
BloodPH [7.35,7.45] [191] 7.43 0.00%   pH
Aorta-Oxygen-PartialPressure(mmHg) GreaterThan 75 [191] 119   58.05% PaO2
Aorta-CarbonDioxide-PartialPressure(mmHg) LessThan 45 [191] 35.7   -20.71% PaCO2
OxygenSaturation GreaterThan 0.95 [191] 0.988   4.05% SpO2
HorowitzIndex(mmHg) [400,500] [191] 457 0.00%   PaO2/FiO2
HorowitzIndex(mmHg) GreaterThan 300 [119] 457   52.37% 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) 54.0
ClinicalPhysiologicDeadSpaceTidalVolumeRatio 0.344
ClinicalShuntFraction 0.0287
MechanicalVentilator-TidalVolume(L) 0.432
BloodPH 7.43
Aorta-Oxygen-PartialPressure(mmHg) 119
Aorta-CarbonDioxide-PartialPressure(mmHg) 35.7
Aorta-Bicarbonate-Molarity(mEq/L) 25.8
OxygenSaturation 0.988
HorowitzIndex(mmHg) 457
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) 70.6
SystolicArterialPressure(mmHg) 114
DiastolicArterialPressure(mmHg) 73.3
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) 33.5
MechanicalVentilator-EndTidalOxygenPressure(mmHg) 159
MechanicalVentilator-ExpiratoryTidalVolume(L) 0.432
MechanicalVentilator-InspiratoryExpiratoryRatio 0.580
MechanicalVentilator-InspiratoryTidalVolume(L) 0.432
MechanicalVentilator-PeakExpiratoryFlow(L/s) 0.651
MechanicalVentilator-LeakFraction 1.30e-13
MechanicalVentilator-IntrinsicPositiveEndExpiratoryPressure(cmH2O) 0.133
MechanicalVentilator-ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5.00
MechanicalVentilator-TotalPositiveEndExpiratoryPressure(cmH2O) 5.13
PhysiologicDeadSpaceTidalVolumeRatio 0.288
PhysiologicShuntFraction 0.0321
TotalRespiratoryModelInspiratoryResistance(cmH2O_s/L) 10.3
TotalRespiratoryModelExpiratoryResistance(cmH2O_s/L) 10.3
TotalRespiratoryModelCompliance(mL/cmH2O) 62.4
ExtrinsicPositiveEndExpiratoryPressure(cmH2O) 5.00
TotalPositiveEndExpiratoryPressure(cmH2O) 5.13
EndTidalCarbonDioxidePressure(mmHg) 34.3
PhysiologicDeadSpace(mL) 121
AlveolarArterialGradient(mmHg) 39.4
AlveolarDeadSpace(mL) 1.00
AnatomicDeadSpace(mL) 120
ChestWallCompliance(L/cmH2O) 0.141
FractionOfInspiredOxygen 0.259
LungCompliance(L/cmH2O) 0.0900
VentilationPerfusionRatio 0.980
HeartStrokeVolume(mL) 78.2
HeartEjectionFraction 0.573
BloodVolume(L) 4.14
MeanArterialPressure(mmHg) 95.3
PulsePressure(mmHg) 41.1
CardiacOutput(L/min) 5.53
CarbonDioxideSaturation 0.0272
RespiratoryExchangeRatio 0.815
SystemicVascularResistance(mmHg_s/mL) 0.984
OxygenConsumptionRate(mL/min) 198
CarbonDioxideProductionRate(mL/min) 161
Patient-AlveoliSurfaceArea(m^2) 54.5
Patient-ExpiratoryReserveVolume(L) 0.734
Patient-FunctionalResidualCapacity(L) 1.57
Patient-InspiratoryCapacity(L) 2.62
Patient-InspiratoryReserveVolume(L) 2.21
Patient-ResidualVolume(L) 0.839
Patient-TidalVolumeBaseline(L) 0.406
Patient-TotalLungCapacity(L) 4.19
Patient-VitalCapacity(L) 3.35

Scenario Output Plots


Figure 2. Select outputs from the scenario.


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