Journal
COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE
Volume 208, Issue -, Pages -Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.cmpb.2021.106257
Keywords
Computational fluid dynamics; COVID-19; Flow resistance
Categories
Funding
- National Nature Sci-ence Foundation of China [61821002, 12072074, 11772093, 11972117, 11972118]
- Jiangsu science and technology development project [BE2017745]
- Fundamental Research Funds for the Central Universities
- National Demon-stration Center for Experimental Biomedical Engineering Education
- Funds for Young Zhishan Scholars (Southeast University, Nanjing, China)
Ask authors/readers for more resources
Analyzing the quantitative changes in respiratory functions for critically ill COVID-19 patients with mechanical ventilation revealed a correlation between airway changes and patient prognosis. The decrease in bronchial volume was significantly associated with survival rate, and changes in air flow resistance could serve as a non-invasive method for evaluating patient prognosis.
Objective: To evaluate the quantitative changes of respiratory functions for critically ill COVID-19 patients with mechanical ventilation, computational fluid dynamics (CFD) analysis was performed based on patient-specific three-dimensional airway geometry. Methods: 37 cases of critically ill patients with COVID-19 admitted to the ICU of Huangshi Traditional Chinese Medicine Hospital from February 1st to March 20th, 2020 were retrospectively analyzed. 5 patients whose clinical data met the specific criteria were finally cataloged into death group (2 patients) and survival group (3 patients). The patient-specific three-dimensional airways were reconstructed from the central airways down to the 4th-5th bifurcation of the tracheobronchial tree. The volume changes of bronchi were calculated during the disease progression according to the comparison of two CT scans. Additionally, the changes of air flow resistance were analyzed using numerical simulation of CFD. Results: Pearson correlation analysis demonstrated that there was negative correlation between the change of volume (AV) and the change of resistance (AR) for all COVID-19 patients (r = -0.7025). For total airway volume, an average decrease of -11.41 +/- 15.71% was observed in death group compared to an average increase of 1.86 +/- 10.80% in survival group (p = 0.0232). For air flow through airways in lower lobe, the resistance increases for death group by 10.97 +/- 77.66% and decreases for survival group by -45.49 +/- 42.04% (p = 0.0246). Conclusion: The variation of flow resistance in the airway could be used as a non-invasive functional evaluation for the prognosis and outcome of critically ill patients with COVID-19. The 'virtual' pulmonary function test by integrating follow-up CT scans with patient-derived CFD analysis could be a potentially powerful way in improving the efficiency of treatment for critically ill patients with COVID-19. (C) 2021 Elsevier B.V. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available