Flagship 1: Model-based diagnostics & therapeutics in pulmonary medicine

Summary

Our Flagship is creating a data-driven and validated ‘virtual lung’, as an enabling technology for patient-specific treatment in a range of areas. The virtual lung spans from the nasal and oral airways to the deepest smallest parts of the lung, connects to the circulatory system, exchanges respiratory gases, and interacts with models for central and peripheral respiratory control. A lean version of the model provides rapid analysis of breath-by-breath data at the bedside, and higher fidelity versions of the model provide deep analysis of patient response to treatment. Inclusion of imaging and pulmonary function data from hundreds of normal healthy subjects means that the model appropriately represents structure-function relationships over the full adult lifespan. The overall goal is to provide a comprehensive tool that can be used to predictively test interventional approaches and therapies, both well in advance and at the bedside, to develop and optimise new and current treatments for the individual, as well as to identify and stratify patients into risk groups and groups in need of more targeted, personalised therapies.

Team

Principal Investigators

University of Canterbury

University of Auckland

Associate Investigators

Christchurch City Hospital & University of Canterbury

  • Dr Geoff Shaw

Department of Mechanical Engineering, University of Canterbury

  • Dr Jennifer Dickson
  • Dr Paul Docherty

University of Auckland

Auckland Bioengineering Institute
  • Dr Haribalan Kumar
  • Dr Alys Clark
Department of Chemical & Materials Engineering
  • Dr Kelly Burrowes

Our work

1. Optimising mechanical ventilation

Patient-specific simulation of lung mechanics and gas exchange for titration of mechanical ventilation

2. Treatment planning

Patient-specific image and model-based assessment of respiratory system function pre and post-treatment, for planning surgical and other interventions

3. Pulmonary diagnostics

Linking 3D imaging to pulmonary function tests

Collaborators

Current collaborators

  • University of Canterbury (New Zealand)
  • University of Auckland (New Zealand)
  • Kalman Pandy County Hospital (Gyula, Hungary)
  • CHU de Liege (Belgium)
  • University of California (San Diego, USA)
  • University of Iowa (USA)
  • University of Liege (Belgium)
  • University of Monash (Malaysia)
  • Budapest University of Technology and Economics (Hungary)
  • Furtwangen University (Germany)
  • Auckland City Hospital (New Zealand)
  • Christchurch Hospital (New Zealand)

Future collaborators

We are looking to collaborate with clinicians and scientists with interest in testing and applying our technologies in a clinical or laboratory setting.

Publications

2017

  1. Automatic Construction of Subject-specific Human Airway Geometry Including Trifurcations Based on a CT-segmented Airway Skeleton and Surface
  2. Extrapolation of a Non-Linear Autoregressive Model of Pulmonary Mechanics
  3. Effective Sample Size Estimation for a Mechanical Ventilation Trial through Monte-Carlo Simulation: Length of Mechanical Ventilation and Ventilator Free Days
  4. Lobe Based Image Reconstruction in Electrical Impedance Tomography
  5. A Proof of Concept for Study of Acoustic Sensing of Lung Recruitment During Mechanical Ventilation
  6. Differences in Respiratory Mechanics Estimation with Respect to Manoeuvres and Mathematical Models

2016

  1. The Impact of Endoscopic Sinus Surgery on Paranasal Physiology in Simulated Sinus Cavities
  2. Regional Gas Transport in the Heterogeneous Lung during Oscillatory Ventilation
  3. Stochastic Modelling of Insulin Sensitivity for Out of Hospital Cardiac Arrest Patients Treated with Hypothermia
  4. Estimating the True Respiratory Mechanics during Asynchronous Pressure Controlled Ventilation
  5. Assessing Respiratory Mechanics Using Pressure Reconstruction Method in Mechanically Ventilated Spontaneous Breathing Patient
  6. Airflow in the Human Nasal Passage and Sinuses of Chronic Rhinosinusitis Subjects
  7. Simulation of Forced Expiration in a Biophysical Model, with Homogeneous and Clustered Bronchoconstriction
  8. Lung Injury and Respiratory Mechanics in Rugby Union
  9. Use of Basis Functions within a Non-linear Autoregressive Model of Pulmonary Mechanics
  10. Performance of Variations of the Dynamic Elastance Model in Lung Mechanics
  11. Virtual Patients and Virtual Cohorts: A New Way to Think about the Design and Implementation of Personalised ICU Treatments
  12. Respiratory Mechanics Assessment for Reverse-Triggered Breathing Cycles Using Pressure Reconstruction

2015

  1. Modeling of Pharyngeal Pressure during Adult Nasal High Flow Therapy
  2. A Numerical Study of Water Loss Rate Distributions in MDCT-based Human Airway Models
  3. Breathing Easier: Model-based Decision Support for Respiratory Care Looks Beyond Tomorrow
  4. Comparison of Generic and Subject-specific Models for Simulation of Pulmonary Perfusion and Forced Expiration
  5. Quantifying Normal Geometric Variation in Human Pulmonary Lobar Geometry from High Resolution Computed Tomography
  6. Feasibility of Titrating PEEP to Minimum Elastance for Mechanically Ventilated Patients
  7. Time-Varying Respiratory System Elastance: A Physiological Model for Patients Who Are Spontaneously Breathing

2014

  1. The Clinical Utilisation Of Respiratory Elastance Software (CURE Soft) - A Bedside Software For Real-time Respiratory Mechanics Monitoring And Mechanical Ventilation Management.