A multi-scale model of gas transport in the lung to study heterogeneous lung ventilation during the multiple-breath washout test.

Hasler, David; Anagnostopoulou, Pinelopi; Nyilas, Sylvia Meryl; Latzin, Philipp; Schittny, Johannes; Obrist, Dominik (2019). A multi-scale model of gas transport in the lung to study heterogeneous lung ventilation during the multiple-breath washout test. PLoS computational biology, 15(6), e1007079. Public Library of Science 10.1371/journal.pcbi.1007079

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The multiple-breath washout (MBW) is a lung function test that measures the degree of ventilation inhomogeneity (VI). The test is used to identify small airway impairment in patients with lung diseases like cystic fibrosis. However, the physical and physiological factors that influence the test outcomes and differentiate health from disease are not well understood. Computational models have been used to better understand the interaction between anatomical structure and physiological properties of the lung, but none of them has dealt in depth with the tracer gas washout test in a whole. Thus, our aim was to create a lung model that simulates the entire MBW and investigate the role of lung morphology and tissue mechanics on the tracer gas washout procedure. To this end, we developed a multi-scale lung model to simulate the inert gas transport in airways of all size. We then applied systematically different modifications to geometrical and mechanical properties of the lung model (compliance, residual airway volume and flow resistance) which have been associated with VI. The modifications were applied to distinct parts of the model, and their effects on the gas distribution within the lung and on the gas concentration profile were assessed. We found that variability in compliance and residual volume of the airways, as well as the spatial distribution of this variability in the lung had a direct influence on gas distribution among airways and on the MBW pattern (washout duration, characteristic concentration profile during each expiration), while the effects of variable flow resistance were negligible. Based on these findings, it is possible to classify different types of inhomogeneities in the lung and relate them to specific features of the MBW pattern, which builds the basis for a more detailed association of lung function and structure.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Anatomy

UniBE Contributor:

Nyilas, Sylvia Meryl; Latzin, Philipp and Schittny, Johannes

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1553-734X

Publisher:

Public Library of Science

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

05 Aug 2019 16:47

Last Modified:

22 Oct 2019 16:46

Publisher DOI:

10.1371/journal.pcbi.1007079

PubMed ID:

31206515

BORIS DOI:

10.7892/boris.131496

URI:

https://boris.unibe.ch/id/eprint/131496

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