Modeling Flow in a Compromised Pediatric Airway Breathing Air and Heliox

Authors

  • Mihai Mihaescu PhD,

    Corresponding author
    1. From the Department of Aerospace Engineering and Engineering Mechanics, University of Cincinnati, Ohio, U.S.A.
    • Mihai Mihaescu, PhD, University of Cincinnati, Department of Aerospace Engineering and Engineering Mechanics, 310 Rhodes Hall, ML 0070, Cincinnati, OH 45221-0070, U.S.A.
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  • Ephraim Gutmark PhD,

    1. From the Department of Aerospace Engineering and Engineering Mechanics, University of Cincinnati, Ohio, U.S.A.
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  • Shanmugam Murugappan PhD,

    1. From the Department of Aerospace Engineering and Engineering Mechanics, University of Cincinnati, Ohio, U.S.A.
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  • Ravindhra Elluru MD, PhD,

    1. Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Ohio, U.S.A.
    2. Division of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, Ohio, U.S.A.
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  • Aliza Cohen MA,

    1. Division of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, Ohio, U.S.A.
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  • J Paul Willging MD

    1. Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Ohio, U.S.A.
    2. Division of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, Ohio, U.S.A.
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Abstract

Objectives/Hypothesis: The aim of this study was to perform computer simulations of flow within an accurate model of a pediatric airway with subglottic stenosis. It is believed that the airflow characteristics in a stenotic airway are strongly related to the sensation of dyspnea.

Methodology: Computed tomography images through the respiratory tract of an infant with subglottic stenosis, were used to construct the three-dimensional geometry of the airway. By using computational fluid dynamics (CFD) modeling to capture airway flow patterns during inspiration and expiration, we obtained information pertaining to flow velocity, static airway wall pressure, pressure drop across the stenosis, and wall shear stress. These simulations were performed with both air and heliox.

Results: Unlike air, heliox maintained laminar flow through the stenosis. The calculated pressure drop over stenosis was lower for the heliox flow, in contrast to the airflow case. This lead to an approximately 40% decrease in airway resistance when using heliox, and presumably causes a decrease in the level of effort required for breathing.

Conclusions: CFD simulations offer a quantitative method of evaluating airway flow dynamics in patients with airway abnormalities. CFD modeling illustrated the flow features and quantified flow parameters within a pediatric airway with subglottic stenosis. Simulations with air and heliox conditions mirrored the known clinical benefits of heliox as compared with air. We anticipate that computer simulation models will ultimately allow a better understanding of changes in flow caused by specific medical and surgical interventions in patients with conditions associated with dyspnea.

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