Mathematical modeling of lung mechanics and pressure-controlled ventilation design for barotrauma minimization: A numerical simulation study

Abstract

Mechanical ventilation represents a fundamental mode of therapy for severely ill patients who cannot breathe autonomously. At the same time, it has the potential of determining Ventilator-Induced Lung Injury (VILI) and further damaging the patient's respiratory system. In this work we present a model-based approach for pressure delivery optimization in the context of pressure-control mechanical ventilation, with the aim of maintaining oxygenation while minimizing barotrauma. A simple compartmental model of respiration describes both mechanical ventilation, alveolar oxygen exchange and blood oxygen transport. Model Predictive Control is used to optimize delivered air pressure at the mouth at each inspiration, optimizing a trade-off between oxygenation and barotrauma. Numerical simulations with different values of the trade-off parameter (Formula presented.) and in two emblematic pulmonary disease scenarios (ARDS and COPD) show the effectiveness of the proposed approach.