ORIGINAL RESEARCH article
Front. Physiol.
Sec. Respiratory Physiology and Pathophysiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1612501
This article is part of the Research TopicTranslating Biomechanics of the Human Airways for Classification, Diagnosis and Treatment of Pulmonary DiseasesView all articles
A Feedback-Driven Ventilation Model for Assessing Airway Secretions in Mechanically Ventilated Patients
Provisionally accepted
- 1Department of Mathematics, Faculty of Mathematical and Physical Sciences, University College London, London, England, United Kingdom
- 2Department of Mechanical Engineering, Faculty of Engineering Sciences, University College London, London, England, United Kingdom
- 3University College London Hospitals NHS Foundation Trust, London, United Kingdom
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
A mechanistic compartmental model with a feedback-driven simulation framework is developed to investigate the impact of airway secretion accumulation and its removal on the respiratory dynamics of mechanically ventilated patients. The model simulates pressure support ventilation by incorporating airway resistances, lung and chest wall compliances, and patient effort via a dynamic respiratory muscle pressure term, enabling realistic modelling of patient-ventilator interaction. The resulting simulations reveal characteristic waveform changes, such as reduced inspiratory flow and prolonged expiration associated with secretion accumulation. The waveform features identified as sensitive to these changes were extracted from ventilator recordings of 35 patients before and after airway clearance. The Wasserstein distance metric was used to quantify pre/post-suction shifts in feature distributions, which, when combined with unsupervised clustering, revealed distinct patient groups corresponding to low, medium, and high secretion levels. Finally, we introduce a model-informed secretion index to enable non-invasive and continuous monitoring of secretion accumulation. This approach demonstrates the potential of physiology-informed modelling for real-time assessment of secretion accumulation and supports personalised respiratory care in the ICU.
Keywords: mechanical ventilation, Airway clearance, Secretion management, compartmental model, Ventilator waveforms
Received: 15 Apr 2025; Accepted: 23 May 2025.
Copyright: © 2025 Anand, Teixeira Cabeliera, Black, Diaz and Ovenden. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Nicholas Ovenden, Department of Mathematics, Faculty of Mathematical and Physical Sciences, University College London, London, WC1H 0AY, England, United Kingdom
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.