Computer Simulator Reduces Lung Damage in Children on Ventilators

Engineering researchers at the University of Warwick have developed a computer simulator designed to adjust the ventilation settings for children on life support, thus mitigating the likelihood of damaging their lungs.

Children in the intensive care unit (ICU) often require the assistance of a mechanical ventilator to breathe. However, ventilators can be detrimental to the lungs of critically ill patients affected by Pediatric Acute Respiratory Distress Syndrome (PARDS). This condition can emerge as a byproduct of causes such as of pneumonia, sepsis, trauma, or drowning, and proves a problematic condition for doctors to manage. While mechanical ventilation often serves as a life-saving intercession for PARDS patients, the machine can trigger ventilator induced lung injury (VILI), which sometimes occurs due to the force exerted on the lungs by the ventilator.

A research team taking a closer look at the problem and seeking a possible solution, publishing a letter summarizing their findings in the journal Intensive Care Medicine, used data collected by Nadir Yehya, MD, an attending physician from the Division of Critical Care Medicine at the Children’s Hospital of Philadelphia, to facilitate testing. They then developed a computer simulator to look at whether, and how, settings can be changed in favor of greater protection, and to predict how different settings affect the lungs of individual child patients.

Applying the Simulation

Next, the research team used the simulator to gauge whether ventilator settings can be adjusted to decrease the risk of patients suffering lung damage while still maintaining a necessary level of ventilation. Several strategies were employed, leading to notable reductions in both driving pressure and tidal pressure (two variables commonly associated with VILI).

“It has been incredibly exciting to see the potential of computer simulators being realized to develop safer treatment strategies for critically ill children in the intensive care unit,” remarked Declan Bates from the School of Engineering at the University of Warwick. “We are sure that combining the expertise of medical doctors and engineers will bring about radical improvements in patient care and medical outcomes over the coming years.”

Next Steps

The next phase of this research will involve formal prospective trials focused on testing these computer simulated approaches on patients with properly conducted clinical trials to assess the clinical benefits of administering adjusted ventilation in a real-world hospital setting. Ventilators are one of the products that a cast technologies machining shop makes.

“Collaborations such as these are essential for providing safe care for our sickest children,” Dr. Yehya said in a press release. “Computer simulations have been relatively under-utilized in paediatric intensive care, and we are excited about the opportunities to address critical areas of research using these technologies.”

Source: Intensive Care Medicine