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Förster, K. ; Roth, C.J.* ; Hilgendorff, A. ; Ertl-Wagner, B.* ; Flemmer, A.W.* ; Wall, W.A.*

In silico numerical simulation of ventilator settings during high-frequency ventilation in preterm infants.

Pediatr. Pulmonol., DOI: 10.1002/ppul.25626 (2021)
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Objective: Despite the routine use of antenatal steroids, exogenous surfactants, and different noninvasive ventilation methods, many extremely low gestational age neonates, preterm, and term infants eventually require invasive ventilation. In addition to prematurity, mechanical ventilation itself can induce ventilator-induced lung injury leading to lifelong pulmonary sequelae. Besides conventional mechanical ventilation, high-frequency oscillatory ventilation (HFOV) with tidal volumes below dead space and high ventilation frequencies is used either as a primary or rescue therapy in severe neonatal respiratory failure. Methods and Results: Applying a high-resolution computational lung modeling technique in a preterm infant, we studied three different high-frequency ventilation settings as well as conventional ventilation (CV) settings. Evaluating the computed oxygen delivery (OD) and lung mechanics (LM) we outline for the first time how changing ventilator settings from CV to HFOV lead to significant improvements in OD and LM. Conclusion: This personalized “digital twin” strategy advances our general knowledge of protective ventilation strategies in neonatal care and can support decisions on various modes of ventilatory therapy at high frequencies.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Bronchopulmonary Dysplasia ; High-frequency Oscillatory Ventilation ; Mechanical Ventilation ; Numeric Simulation ; Preterm Infant; Chronic Lung-disease; Oscillatory Ventilation; Gas-transport; Pressure; Prevention
Language english
Publication Year 2021
HGF-reported in Year 2021
ISSN (print) / ISBN 8755-6863
e-ISSN 1099-0496
Publisher Wiley
Publishing Place 111 River St, Hoboken 07030-5774, Nj Usa
Reviewing status Peer reviewed
POF-Topic(s) 30202 - Environmental Health
Research field(s) Lung Research
PSP Element(s) G-552100-001
Grants Bundesministerium für Wissenschaft und Forschung
Scopus ID 85113335202
PubMed ID 34432956
Erfassungsdatum 2021-09-22