RICERCA ITALIANA     

Bioengineering of the Respiratory System

Università degli Studi di Bologna

Abstract

The quantitative evaluation of pulmonary mechanics, in patients undergoing mechanical ventilation, has a well recognised importance. In fact, in order to know the state of the patient and to estimate the therapeutic treatment adequacy, it is required to determine the value of parameters characterising the total respiratory functionality.
In this regard, the present research program aims at the development of theories, methods, and algorithms able to improve the knowledge of the physiopathological mechanisms of the respiratory functions and to help monitoring of the main viscoelastic properties of the respiratory mechanics in artificially ventilated patients. In particular, models previously developed will be improved so that they explicitly include physiopathological changes connected with COPD (Chronic Obstructive Pulmonary Disease), a pathology with a relevant socio-economical impact, since it represents the fourth leading cause of death in the Western countries. Therefore we intend to realize a simulation tool able to help the understanding of mechanisms producing expiratory flow limitation and the studying of its progression during the evolution of an obstructive disease. Moreover we intend to develop parameter estimation techniques for monitoring the patient status and optimizing the respiratory treatment.
The project is the natural continuation of a research activity already financed by MIUR in two previous periods 2000-2002 and 2002-2004, and it is >>>

Principal Investigator

Guido AVANZOLINI Università degli Studi di BOLOGNA

Research Objectives

The advance in basic knowledge on the respiratory system is generally recognized to be fundamental in order to improve the processes of diagnosis, surveillance and therapy. In particular, respiratory mechanics parameters in intensive care patients under assisted ventilation are components of so-called risk indices on which therapy and prognosis are based.
The present research program is the natural continuation of a research activity characterized by a strong international impact and already financed in the period 2002-2004 in the PRIN context. The main goal is the development of theories, methods, and algorithms suitable to improve the quantitative knowledge of the lung mechanics in patients affected by COPD (Chronic Obstructive Pulmonary Disease), with two precise purposes:
(A) to elucidate the mechanisms producing expiratory flow limitation and its progression during the evolution of an obstructive disease;
(B) to develop parameter estimation techniques for monitoring the patient status and optimizing the respiratory treatment.

More details on the intermediate objectives of part (A) and (B) are given at the end of this section.

COPD patients progressively develop pulmonary airflow limitation, which is not completely reversible. Expiratory flow limitation (EFL) leads to dynamic hyperinflation of the lungs and positive intrinsic end-expiratory pressure (PEEPi) which may require respiratory assistance. In this >>>

Timescale

24 months

National and international background

The two Units involved in the program have a consolidated experience in the proposed research themes, as illustrated in Models B. In particular, the above experience is documented by a number of international publications, reporting results that constitute a solid scientific background for the present program. Moreover, the same units have already worked in close cooperation in research projects concerning the "Bioengineering of the respiratory system", also in the PRIN, showing the ability to effectively coordinate their work and to take advantage of the different competencies and available resources to pursue a common goal.
The know-how possessed by the two Units is largely complementary, therefore we stress that the scientific collaboration of the two research units taking part in the project is indispensable for achieving the final objective. In particular, the Unit of Bologna will be the main reference for developing inverse mathematical models of respiratory mechanics, aimed at parameter identification. The Unit of Siena will constitute the main clinical reference, being a mixed group of Clinicians and Bioengineers working in a University Medical Department. Moreover, this Unit will work on the development of the simulation models of respiratory mechanics, in close cooperation with the Unit of Bologna.
In the last forty years, researches in the field of respiratory mechanics have led to significant improvements for comprehension, diagnosis and treatment >>>