Respiratory failure & ventilation
Digital Twins of Acute Hypoxemic Respiratory Failure Patients Suggest a Mechanistic Basis for Success and Failure of Noninvasive Ventilation
Authors' conclusion
In digital twins of AHRF patients, successful NIV improved lung mechanics, lowering respiratory effort and indices associated with lung injury. NIV failed in patients for whom only low levels of positive inspiratory pressure support could be applied without risking patient self-inflicted lung injury due to excessive tidal volumes.
Study context
- Population
- Moderate-to-severe acute hypoxemic respiratory failure (AHRF) patients who failed high-flow nasal cannula (HFNC) therapy and then underwent a trial of noninvasive ventilation (NIV)individual patient data
- Participants
- 30 patients
- Comparison
- NIV success vs NIV failure
- Outcome
- Change in lung injury indices
- Follow-up
- 2 hours of the trial
Methodological detailsdigital twins based on mechanistic computational models of individual patients
- Digital twins based on mechanistic computational models of individual patients
Main finding
As reported in the abstract
| Group | Value | Change in total lung stress | Change in mechanical power | Change in total lung strain |
|---|---|---|---|---|
| Succeeded | mean −10.9 (SD 6.2) cm H2O | −10.9 (6.2) cm H2O | −13.4 (12.2) J/min | 0.02 (0.24) |
| Failed | mean −0.35 (SD 3.38) cm H2O | −0.35 (3.38) cm H2O | −1.0 (5.4) J/min | 0.16 (0.30) |
Value
Succeededmean −10.9 (SD 6.2) cm H2O
Failedmean −0.35 (SD 3.38) cm H2O
Change in total lung stress
Succeeded−10.9 (6.2) cm H2O
Failed−0.35 (3.38) cm H2O
Change in mechanical power
Succeeded−13.4 (12.2) J/min
Failed−1.0 (5.4) J/min
Change in total lung strain
Succeeded0.02 (0.24)
Failed0.16 (0.30)
Further findings
Intrinsic PEEP
Inspiratory pressure support
Tidal volume
Positive end-expiratory pressure (PEEP)
- PEEP produced by HFNC similar to that set during NIV
Effects of successful NIV on respiratory mechanics
- Increase in respiratory system compliance
- +25.0 (16.4) mL/cm H2O
- Lowered inspiratory muscle pressure
- −9.7 (9.6) cm H2O
- Reduced contribution of spontaneous breathing to total driving pressure
- 57.0%
Original publication
Digital Twins of Acute Hypoxemic Respiratory Failure Patients Suggest a Mechanistic Basis for Success and Failure of Noninvasive Ventilation. Crit Care Med. Published 29 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →