Critical Care |

Digital Modeling of the Physiologic Effects of a New High Frequency Focused-Pulsation (Percussion) Chest Wall Device FREE TO VIEW

Benjamin Mauroy; Samir Rachidi; Barrett Mitchell; Patrice Flaud; Dominique Pelca; Christian Fausser; Jacques Merckx; William Marshall, MBA
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Université de Nice-Sophia Antipolis, Nice, France

Chest. 2014;146(4_MeetingAbstracts):244A. doi:10.1378/chest.1991676
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SESSION TITLE: Critical Care Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The physiology of a new type of high frequency, focused-pulsation, chest wall therapy is described. It is characterized by high frequency focal pulsations (percussion), delivered in a flexible manner, compared to the more homogeneous pressure delivered by the “chest compression” devices.

METHODS: Mucociliary clearance and cough are the twomethods for mucus drainage in the bronchial tree. When affected by pathology, these methods can become ineffective. Therapeutic draining of mucus becomes crucial to avoid obstruction and/or infections. Numerical models to study the biomechanics of mucus expectoration in the lungs and mimic physical therapy have been created including the essential physics and physiology aspects: idealized geometry of the bronchial tree (multi-scale) and the thorax, their mechanics (elastic bronchi walls, tissues inhomogeneities), the fundamental rheological properties of mucus, and air mechanics. Given a force distribution on the thorax, the distribution of the internal pressures with a finite elements method is computed and modeled. Pressure distribution is described to a bronchial tree model to compute bronchi diameters, air flow, and mucus flow in bronchi.

RESULTS: A working digital model has been developed to evaluate the pressure induced in the lung airways by both types of high frequency chest wall devices . This presents new elements and key parameters of a theoretical and more detailed understanding of the action of mucus clearance, which was described, until now, with a purely empirical methodology in chest wall compression therapy and the new focused-pulsation (percussion) therapy. The effects of airflow on mucus motion in the bronchial tree for different scenarios have been investigated along with how normal ventilation and manual and mechanical physical therapies affect mucus motion in the bronchial tree. The model shows an airflow threshold under which mucus cannot be mobilized.

CONCLUSIONS: A biomechanical model of mucus expectoration has been developed demonstrating how normal ventilation and manual and mechanical physical therapies affect mucus motion in the bronchial tree and an airflow threshold under which mucus cannot be mobilized.

CLINICAL IMPLICATIONS: This model will aid development of optimal understanding of, and therapies for, improved pulmonary mucus clearance.

DISCLOSURE: Benjamin Mauroy: Grant monies (from industry related sources): annual grant The following authors have nothing to disclose: Samir Rachidi, Barrett Mitchell, Patrice Flaud, Dominique Pelca, Christian Fausser, Jacques Merckx, William Marshall

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