Journal
ANNALS OF BIOMEDICAL ENGINEERING
Volume 38, Issue 3, Pages 1017-1030Publisher
SPRINGER
DOI: 10.1007/s10439-009-9884-x
Keywords
Mathematical model; Bronchial circulation; Alveolar heterogeneity; Ventilation; Perfusion
Categories
Funding
- National Institute for Biomedical Imaging and Bioengineering [T32 EB001650, BE 001973]
- National Heart, Lung, and Blood Institute Grants [HL 64368, HL073598]
- National Science Foundation [04-607/NIH]
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The multiple inert gas elimination technique (MIGET) provides a method for estimating alveolar gas exchange efficiency. Six soluble inert gases are infused into a peripheral vein. Measurements of these gases in breath, arterial blood, and venous blood are interpreted using a mathematical model of alveolar gas exchange (MIGET model) that neglects airway gas exchange. A mathematical model describing airway and alveolar gas exchange predicts that two of these gases, ether and acetone, exchange primarily within the airways. To determine the effect of airway gas exchange on the MIGET, we selected two additional gases, toluene and m-dichlorobenzene, that have the same blood solubility as ether and acetone and minimize airway gas exchange via their low water solubility. The airway-alveolar gas exchange model simulated the exchange of toluene, m-dichlorobenzene, and the six MIGET gases under multiple conditions of alveolar ventilation-to-perfusion, (V) over dot(A)/(Q) over dot, heterogeneity. We increased the importance of airway gas exchange by changing bronchial blood flow, (Q) over dot(br). From these simulations, we calculated the excretion and retention of the eight inert gases and divided the results into two groups: (1) the standard MIGET gases which included acetone and ether and (2) the modified MIGET gases which included toluene and m-dichlorobenzene. The MIGET mathematical model predicted distributions of ventilation and perfusion for each grouping of gases and multiple perturbations of (V) over dot(A)/(Q) over dot and (Q) over dot(br). Using the modified MIGET gases, MIGET predicted a smaller dead space fraction, greater mean (V) over dot(A), greater log(SDVA), and more closely matched the imposed (V) over dot(A) distribution than that using the standard MIGET gases. Perfusion distributions were relatively unaffected.
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