Whole-lung finite-element models for mechanical ventilation and respiratory research applications.

Mechanical ventilation has been a vital treatment for Covid-19 patients with respiratory failure. Lungs assisted with mechanical ventilators present a wide variability in their response that strongly depends on air-tissue interactions, which motivates the creation of simulation tools to enhance the design of ventilatory protocols. In this work, we aim to create anatomical computational models of the lungs that predict clinically-relevant respiratory variables. To this end, we formulate a continuum poromechanical framework that seamlessly accounts for the air-tissue interaction in the lung parenchyma. Based on this formulation, we construct anatomical finite-element models of the human lungs from computed-tomography images. We simulate the 3D response of lungs connected to mechanical ventilation, from which we recover physiological parameters of high clinical relevance. In particular, we provide a framework to estimate respiratory-system compliance and resistance from continuum lung dynamic simulations. We further study our computational framework in the simulation of the supersyringe method to construct pressure-volume curves. In addition, we run these simulations using several state-of-the-art lung tissue models to understand how the choice of constitutive models impacts the whole-organ mechanical response. We show that the proposed lung model predicts physiological variables, such as airway pressure, flow and volume, that capture many distinctive features observed in mechanical ventilation and the supersyringe method. We further conclude that some constitutive lung tissue models may not adequately capture the physiological behavior of lungs, as measured in terms of lung respiratory-system compliance. Our findings constitute a proof of concept that finite-element poromechanical models of the lungs can be predictive of clinically-relevant variables in respiratory medicine.