NODES_Tincare_Z34_Conference_CMBBE2025_Borrelli

0D CARDIOPULMONARY MODEL FOR PEEP TITRATION IN MECHANICALLY VENTILATED ARDS PATIENTS Andrea Formaggio (1,2), Margherita De Luca (1,2), Giovanni Putame (1,2), Simone Borrelli (1,2), Alberto L. Audenino (1,2) and Mara Terzini (1,2) 1. Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino (Italy) 2. PolitoBIOMed Lab, Politecnico di Torino, Torino (Italy) 1. Introduction Patients with acute respiratory distress syndrome (ARDS) experience alveolar collapse, leading to reduced ventilation and blood oxygenation. Treatment with mechanical ventilation involves the use of positive endexpiratory pressure (PEEP) to recruit collapsed alveoli. The identification of an optimal PEEP level has remained a subject of debate in critical care for over 50 years [1]. This work proposes a 0D model to investigate the issue of PEEP titration by studying the impact of PEEP on the cardiopulmonary system of ARDS patients. 2. Materials and Methods The 0D cardiopulmonary model (Fig. 1) was implemented using Mathworks® Simulink. In the respiratory system model, alveoli are divided into aerated and collapsed, with the latter opening or closing based on pressure thresholds. In the circulatory system model, the lung is divided into three perfusion zones (zone 1: no perfusion, zone 2: partial perfusion, zone 3 complete perfusion) depending on alveolar pressure. Blood oxygenation is determined by using gas exchange equations. The model was tested on a dataset of 1000 synthetic patients statistically generated from ARDS patient input data reported in the literature [2]. Figure 1: 0D Cardiopulmonary model schematics. 3. Results A statistical validation of the 0D model was conducted by calculating the Wasserstein distance (W1) between the model and the reference outputs distributions. The W1 values obtained are reported in Fig. 2 for the outputs of the gas exchange equations (a), the respiratory system model (b), the circulatory system model (c), and the complete model (d). Figure 2: Outputs distributions comparison. 4. Discussion and Conclusions The developed 0D model integrates a novel alveolar recruitment and collapse mechanism, the simulation of lung capillary congestion, and gas exchange calculation. This approach offers high reliability and low computational cost, demonstrating potential clinical applicability for PEEP titration in ARDS patients. 5. References 1. Gattinoni L et al., Int Care Med; 48(6) (2022). 2. Dell’Anna AM et al., RESPNB; 298 (2022). Acknowledgements: NODES project (MUR – M4C2 1.5 of PNRR, grant agreement no. ECS00000036).