Assessing Changes in Airflow and Energy Loss in a Progressive Tracheal Compression Before and After Surgical Correction

Ann Biomed Eng. 2020 Feb;48(2):822-833. doi: 10.1007/s10439-019-02410-1. Epub 2019 Dec 2.

Abstract

The energy needed to drive airflow through the trachea normally constitutes a minor component of the work of breathing. However, with progressive tracheal compression, patient subjective symptoms can include severe breathing difficulties. Many patients suffer multiple respiratory co-morbidities and so it is important to assess compression effects when evaluating the need for surgery. This work describes the use of computational prediction to determine airflow resistance in compressed tracheal geometries reconstructed from a series of CT scans. Using energy flux analysis, the regions that contribute the most to airway resistance during inhalation are identified. The principal such region is where flow emerging from the zone of maximum constriction undergoes breakup and turbulent mixing. Secondary regions are also found below the tongue base and around the glottis, with overall airway resistance scaling nearly quadratically with flow rate. Since the anatomical extent of the imaged airway varied between scans-as commonly occurs with clinical data and when assessing reported differences between research studies-the effect of sub-glottic inflow truncation is considered. Analysis shows truncation alters the location of jet breakup and weakly influences the pattern of pressure recovery. Tests also show that placing a simple artificial glottis in the inflow to a truncated model can replicate patterns of energy loss in more extensive models, suggesting a means to assess sensitivity to domain truncation in tracheal airflow simulations.

Keywords: Airway CFD; Airway Resistance; Compressed Trachea; Flow Energy Loss; Inflow Truncation; Tracheal Airflow.

Publication types

  • Clinical Trial

MeSH terms

  • Airway Resistance*
  • Computer Simulation*
  • Female
  • Humans
  • Male
  • Models, Biological*
  • Pulmonary Ventilation*
  • Respiratory Mechanics*
  • Tomography, X-Ray Computed*
  • Trachea* / diagnostic imaging
  • Trachea* / physiopathology
  • Trachea* / surgery