Proceedings of the 3rd International Conference on E-Health and Bioengineering - EHB 2011, 24th-26th November, 2011, Iai, Romania

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Design and Personification of the Mathematical Model of the Human Respiratory System
Martin Rozanek, Zuzana Horakova, Jan Suchomel, Petr Kudrna, Karel Roubik Czech Technical University in Prague, Faculty of biomedical engineering, Nam. Sitna 3105, 272 01, Kladno rozanek@fbmi.cvut.cz
Abstract- Design of a mathematical model of the respiratory system and its personification is described in this study. The aim of authors is to develop a model of the respiratory system that will respect anatomical structure of the bronchial tree including its asymmetry. Inclusion of airway asymmetry into the model allows more authentic description of the respiratory system. The model is designed using electro-acoustic analogy. The model has asymmetrical bronchial tree and five lobes with different compliance of alveoli. CT scans are used to personify the model according to the patients respiratory system. Respiratory diseases change respiratory mechanics and affect the efficiency of artificial lung ventilation. The novel model is designed to study the efficiency of artificial lung ventilation for individual changes of the respiratory mechanics at each patient. Keywords: Mathematical model, respiratory system, bronchial tree, artificial lung ventilation, computed tomography.

patient. In most of the cases it is impossible to use direct measurement, e.g. during exacerbation of asthma or chronic obstruction pulmonary disease (COPD), where the use of catheters can be cause of other problems. A catheter can also influence the measured value. The use of the mathematical models can be useful way how to observe the interactions between the respiratory system and different regimens of ALV. Design of the model and its personification is described in this study. II. METHODS

I.

INTRODUCTION

Patients are supported by artificial lung ventilation (ALV) in the cases when they have inadequate spontaneous breathing. It can be a consequence of some respiratory disease or the breathing can be intentionally inhibited. The patients undergoing ALV suffer still by high mortality reaching up to 40 % [1]. Therefore another research of ALV and its effects is required to increase the patients benefit. A lot of ventilatory regimens are used to oxygenate the patient when the spontaneous ventilation fails. Common type of ventilation is conventional ventilation (CV). The frequency of breathing is in range 12-18 breaths per minute and tidal volume is around 500 ml. It results in approximate minute volume 7.5 l. Other types of ALV are used mainly as rescue techniques when CV fails, e.g. high-frequency ventilation (HFV). High frequencies in range 5-20 Hz and small tidal volumes similar to anatomical dead space (160 ml for adults) are used during HFV. HFV usage results in different ventilatory pressures and flows during ALV and also in different intrapulmonary conditions. ALV is used often when the respiratory system is affected by pulmonary disease and the mechanical properties of the lungs are changed. It was also found out that mechanical parameters are changing in a very wide range even during the same disease [2, 3, 4]. Clinical studies show that changed respiratory mechanics can affect the efficiency of ALV. The lung is heterogeneous organ and the heterogeneity is emphasized when the lung suffers by a disease. Direct measurement of flow, pressure, etc. in the respiratory system is invasive and very uncomfortable for the

The model is based on the lung morphology described by Horsfield and Weibel. Horsfields description includes asymmetry of the bronchial tree and it is used to model the central airways. The airways are divided into the three zones, convection central, convection distal and respiratory airways and the asymmetry is modeled in the central airways only. It is mainly because of rapidly increasing complexity of the model with increasing number of generation modeled with asymmetry. Also the asymmetrical distribution of the alveolar compliance is applied in the model. A. Airways Electro-acoustic analogy is used to model the airways. Acoustic parameters describing the elementary airways are computed from its geometrical dimensions and the parameters are considered as electric. The airways are divided into the convection central, convection distal and respiratory airways containing alveoli. The geometrical dimensions of the convection central airways are summarized in Table I. The dimensions are taken from [5]. Approximately first five generations of the model of the bronchial tree is modeled according Horsfield.
TABLE I GEOMETRICAL DIMENSIONS OF THE CENTRAL AIRWAYS AND ITS DISTRIBUTION IN THE ASYMMETRICAL BRONCHIAL TREE [5]. DB1 STANDS AS DAUGHTER TUBE 1, DB2 AS DAUGHTER TUBE 2, D REPRESENTS DIAMETER OF AIRWAY IN MM AND L REPRESENTS LENGTH OF AIRWAY IN MM

Branch (B) 0 1 2 6

Order (O) 31 29 27 28

DB1 B1 B6 O26 O27

DB2 B10 B2 O23 O24

D [mm] 16,0 12,0 7,5 8,0

L [mm] 100,0 50,0 16,0 11,0

Proceedings of the 3rd International Conference on E-Health and Bioengineering - EHB 2011, 24th-26th November, 2011, Iai, Romania ___________________________________________________________________________________________________________________
10 11 13 14 15 Bronchi within lobes 30 27 29 25 28 27 26 25 24 23 22 21 20 19 B13 O26 B15 O24 O27 26 25 24 23 22 21 20 19 18 B11 O23 B14 O21 O24 23 22 21 20 19 18 17 16 15 11,1 7,3 8,9 5,2 6,4 7,0 6,67 5,85 5,35 4,27 3,49 3,47 3,09 2,88 22,0 15,6 26,0 21,0 8,0 9,7 11,27 11,25 9,7 10,81 9,53 8,57 9,88 7,96 alveolar compliance of each lobe is computed from total lung compliance and distribution of the lung volume among the lobes. Distribution of alveoli among the generations of airways in respiratory zone is taken from [6].
TABLE III LOBAR VOLUMES AS A PERCENTAGE OF TOTAL LUNG VOLUME IN THE MODEL AND REAL LUNG [5]

Lobe Right upper Right middle Right lower Left upper Left lower

Model 19 10 26 19 26

Lung 21 9 25 20 25

Weibels description of the lung morphology is used for modeling of convection distal and respiratory airways (from approximately sixth to last generation of the bronchial tree model). The geometrical dimensions of distal airways are summarized in Tab. 2. These airways are modeled with regular dichotomy simplifying the model structure. Between 22-25 generations of airways is contained in bronchial tree to reach the last generation of the alveolar space.
TABLE II GEOMETRICAL DIMENSIONS OF THE DISTAL AIRWAYS [6]. D STANDS AS DIAMETER OF AIRWAY IN MM AND L REPRESENTS LENGTH OF AIRWAY IN MM

Each alveolus is considered to have a constant compliance. Different compliance of each lobe is caused due to different volume of each lobe. The complete model of the human lung is received by joining together convection central, convection distal and respiratory airways with alveoli. C. Personification of the Model Images from examinations by computed tomography are used to modify the model parameters to fit each patient. Three-dimensional image of the lungs is reconstructed from CT slice images. The reconstructed lung of a patient is depicted in Fig. 1. The lung is reconstructed in software Phillips CT endoscopy where it is possible to fly through the bronchial tree. The software supplied with CT allows studying the structure of the bronchial tree. It allows investigating the elementary airways of the bronchial tree and evaluating of their geometrical dimensions. The geometrical dimensions of trachea are evaluated at the start and the process continues by assessing the geometrical dimensions of the airways in more distal parts of lung. The aim is to assess the length and diameter of the airways that were reconstructed from CT slices. It is possible to measure about 5-6 generations of the bronchial tree. Geometrical dimensions of most distal airways can be estimated according the dimensions of the proximal airways [7]. Airways in a few directions representing lung lobes are studied. When reaching the bifurcation of the airways a direction is chosen to investigate the airway condition in the appropriate lobe. The comparison of the geometrical dimensions of the airways received from CT images with the dimensions described by Horsfields morphological model is made. The model parameters are modified according to the comparisons of the airway geometrical dimensions of both: patients bronchial tree and morphological model of the human respiratory system. This approach is used to modify the model to fit the patients bronchial tree.

Order 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

D [mm] 3,5 2,8 2,3 1,86 1,54 1,30 1,09 0,95 0,82 0,74 0,66 0,60 0,54 0,50 0,47 0,45 0,43 0,41 0,41

L [mm] 10,7 9,0 7,6 6,4 5,4 4,6 3,9 3,3 2,7 2,3 2,0 1,65 1,41 1,17 0,99 0,83 0,70 0,59 0,50

B. Alveolar Space Presented model respects asymmetrical distribution of the alveolar compliance in the lung. The model has five lobes as real lung and their volume is summarized in Tab. 3. The

Proceedings of the 3rd International Conference on E-Health and Bioengineering - EHB 2011, 24th-26th November, 2011, Iai, Romania ___________________________________________________________________________________________________________________
[2] Gattinoni L., Pelosi P., Suter P.M., Pedoto A., Vercesi P., Lissoni A. Acute Respiratory Distress Syndrome Caused by Pulmonary and Extrapulmonary Disease Different Syndromes? Am J Respir Crit Care Med 1998;158:311. Pelosi P., DOnofrio D., Chiumello D., Paolo S., Chiara G., Capelozzi V.L., Barbas C.S.V., Chiaranda M., Gattinoni L.: Pulmonary and extrpulmonary acute respiratory distress syndrome are different. Eur Respir J, 2003, 22:Suppl 42, pp48-56. ISSN 0904-1850. Roubik K., Pachl J., Waldauf P., et al. Initial continuous distension pressure and effect of HFOV in extrapulmonary and pulmonary adult ARDS. Intensive Care Medicine 29: 303 Sep, 2003. Horsfield K., Cumming G. Morphology of the bronchial tree in man. J Appl Physiol, 1968, 24, pp 373-383. Weibel E.R. Morphometry of the human lung. Berlin: Springer-Verlag, 1963. Nakano Y., Wong J., de Jong P., et al. The prediction of small airway dimensions using computed tomography. Am. J. Respir. Crit. Care Med 2005; 171:142146.

[3]

[4] [5] [6] [7]

Fig. 1. Three-dimensional image of the lungs reconstructed from computed tomography examination. III. CONCLUSION

Unique model of the respiratory system is presented in the study. Model is designed according to the anatomical structure of the respiratory system including the asymmetry of the bronchial tree. Number of airway generations differs between 22 and 25 to reach the last generation of the bronchial tree. Also the asymmetrical distribution of alveolar compliance in the lung is considered in the model. The model design allows studying the effect of personal changes in the respiratory system upon the intrapulmonary conditions. Computed tomography is supposed to be used for personification of the model for each patient. The model allows study the efficiency of different types and regimens of ALV including HFV. Also the effect on changes in respiratory mechanics can be studied using designed model. The simplified versions of the model could be also included in the basic courses of medicine or bioengineering to allow better understanding of relationship between the geometrical parameters and mechanical parameters of lung. ACKNOWLEDGMENT This study has been supported by the research program No. MSM6840770012, SGS11/171/OHK4/3T/17 and grant GACR 102/08/H018. REFERENCES
[1] Ferguson N.D., Frutos-Vivar F., Esteban A.: Airway Pressures, Tidal Volumes, and Mortality in Patients With Acute Respiratory Distress Syndrome. Crit Care Med 33(1):21-30, Lippincott Williams & Wilkins, 2005.