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The following is a summary of “Modeling ventilation of patients with interstitial lung disease at rest and exercise: a bench study,” published in the November 2024 issue of Pulmonology by Artaud-Macari et al. 

Researchers conducted a retrospective study to personalize a mechanical simulator modeling healthy and interstitial lung disease (ILD) ventilation profiles and evaluate the effect of spontaneous breathing on respiratory mechanics at rest and during exercise.  

They modeled 1 healthy and 3 ILD profiles (rest and exercise) in a 2-compartment lung simulator (ASL 5000®) based on literature and patient data. The Measurements included tidal volume, end-expiratory lung volume, driving pressure, transpulmonary driving pressure, dynamic alveolar strain, mechanical power, and inspiratory flow time lag between compartments 1 and 2.  

The results showed that healthy and ILD models were validated, with maximum tidal volume differences of 5% (96 ml) and 6% (54 ml) at rest and exercise, respectively. Simulating lung inhomogeneity (compartment 1 compliance > compartment 2) increased tidal volume, end-expiratory lung volume, driving pressure, and mechanical power in compartment 1 while decreasing them in compartment 2. Conversely, driving transpulmonary pressure and dynamic alveolar strain increased in compartment 2 and decreased in compartment 1. The inspiratory flow time lag between compartments 1 and 2 correlated positively with compliance differences (r = 0.98, CI 95% (0.9106; 0.9962), P < 0.0001).  

Investigators concluded a mechanical simulator to model lung inhomogeneity and spontaneous breathing in patients with ILD and healthy ones, suggesting that lung inhomogeneity may contribute to increased lung vulnerability in ILD.  

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-03383-1