Mathematical modeling of extracorporeal CO2 removal therapy

Abstract

The Extracorporeal CO 2 removal device (ECCO 2 RD) is used in clinics to treat patients suffering from respiratory failures like acute respiratory distress syndrome (ARDS) or chronic obstructive pulmonary disease (COPD). The aim of this device is to decarboxylate blood externally with low blood flow. A mathematical model is proposed to describe protective ventilation, ARDS and an extracorporeal CO 2 removal therapy (ECCO 2 RT). The simulations are compared with experimental data carried out on 10 pigs. The results show a good agreement between the mathematical simulations and the experimental data, which provides a nice validation of the model. This model is thus able to predict the decrease of PCO 2 during ECCO 2 RT for different blood flows across the extracorporeal lung support.

Extracorporeal carbon dioxide removal requirements for ultraprotective mechanical ventilation: Mathematical model predictions

“…Third, the current model provides a comprehensive description of CO 2 , O 2 , and acid‐base chemistry; thus, it is more general and applicable to a greater variety of clinical conditions. We believe our model and the previous model are complementary and applicable to different study objectives.…”

“…This theoretical effort extends a previously published mathematical model of CO 2 and O 2 chemistry and whole‐body storage and transport to provide estimates of the ECCO 2 R rate requirements for mechanically ventilated ARDS patients treated with low tidal volumes. Others have recently developed an alternative mathematical model to predict changes in PaCO 2 as a function of treatment time and the blood flow rate for one specific ECCO 2 R device and compared their model predictions with empirical data from preclinical studies in a porcine model. The current mathematical model is comparable to this latter model in overall design but differs in three major ways.…”

“…The previous model was developed to explain time‐dependent changes in PaCO 2 after abrupt, transient changes in the ECCO 2 R rate as well as time‐dependent changes in temperature and metabolic rate during the preclinical experiments. Those time‐dependent model elements were necessary to explain the data from their porcine experiments but are not relevant to the approximate steady state conditions when treating mechanically ventilated ARDS patients over the period of hours or days in the intensive care unit. Third, the current model provides a comprehensive description of CO 2 , O 2 , and acid‐base chemistry; thus, it is more general and applicable to a greater variety of clinical conditions.…”