Patterns in pharyngeal airflow associated with sleep-disordered breathing.
Patterns in pharyngeal airflow associated with sleep-disordered breathing.
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DOI：
10.1016/j.sleep.2011.08.004
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发表时间：
2011-12
期刊：
影响因子：
4.8
通讯作者：
Gutmark E
中科院分区：
文献类型：
--
作者：
Powell NB;Mihaescu M;Mylavarapu G;Weaver EM;Guilleminault C;Gutmark E
建立一种无创方法来识别睡眠呼吸障碍患者咽部气流特征的可行性。研究了四名接受手术或使用气道正压通气装置的睡眠呼吸障碍患者和四名正常健康对照者。三维CT成像和计算流体动力学建模与标准的稳态数值公式被用来表征正常人和治疗前和治疗后的患者的咽部气流行为。在一名患者中使用非定常方法进行动态血流模拟。最小横截面积阻塞部位下方的治疗前咽部气道显示气流分离。这产生了再循环气流区域和增强的湍流区域，在这些区域中形成了涡流。这种相互作用引起气流变量的大幅波动，并增加了作用在咽壁上的气动力。在后处理时，在相同的体积流量下，气流场的不稳定性消失，气流特性得到改善。吸气期间的平均最大气流速度从治疗前的18.3 ± 5.7米/秒降至治疗后的6.3 ± 4.5米/秒（p = 0.002），导致最大壁面剪切应力从治疗前的4.8 ± 1.7帕斯卡降至治疗后的0.9 ± 1.0帕斯卡（p = 0.01）。气道阻力从治疗前的4.3 ± 1.4帕斯卡/升/分钟改善至治疗后的0.7 ± 0.7帕斯卡/升/分钟（p = 0.004）。治疗后气流特征与正常对照无差异（所有p ≥ 0.39）。这项研究表明，咽部气流变量可能来自CT成像和计算流体动力学建模，导致高质量的可视化的气流特征的轴向速度，静压和壁面切应力，在睡眠呼吸障碍。
To establish the feasibility of a noninvasive method to identify pharyngeal airflow characteristics in sleep-disordered breathing. Four patients with sleep-disordered breathing who underwent surgery or used positive airway pressure devices and four normal healthy controls were studied. Three-dimensional CT imaging and computational fluid dynamics modeling with standard steady-state numerical formulation were used to characterize pharyngeal airflow behavior in normals and pre-and post-treatment in patients. Dynamic flow simulations using an unsteady approach were performed in one patient. The pre-treatment pharyngeal airway below the minimum cross-sectional area obstruction site showed airflow separation. This generated recirculation airflow regions and enhanced turbulence zones where vortices developed. This interaction induced large fluctuations in airflow variables and increased aerodynamic forces acting on the pharyngeal wall. At post-treatment, for the same volumetric flow rate, airflow field instabilities vanished and airflow characteristics improved. Mean maximum airflow velocity during inspiration reduced from 18.3±5.7 meters/second pre-treatment to 6.3±4.5 meters/second post-treatment (p=0.002), leading to a reduction in maximum wall shear stress from 4.8±1.7 Pascals pre-treatment to 0.9±1.0 Pascals post-treatment (p=0.01). The airway resistance improved from 4.3±1.4 Pascals/Liter/minute at pre-treatment to 0.7±0.7 Pascals/Liter/minute at post-treatment (p=0.004). Post-treatment airflow characteristics were not different from normal controls (all p≥0.39). This study demonstrates that pharyngeal airflow variables may be derived from CT imaging and computational fluid dynamics modeling, resulting in high quality visualizations of airflow characteristics of axial velocity, static pressure and wall shear stress, in sleep-disordered breathing.
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影响因子：
2.6
作者：
Mihaescu, Mihai;Gutmark, Ephraim;Willging, J. Paul
通讯作者：
Willging, J. Paul
影响因子：
1.4
作者：
Mihaescu, Mihal;Murugappan, Shanmugam;Kalra, Maninder
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Kalra, Maninder
影响因子：
2.6
作者：
Huang, Yaqi;White, David P.;Malhotra, Atul
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Malhotra, Atul
DOI：
10.1164/ajrccm.157.2.96-06049
发表时间：
1998-02-01
影响因子：
24.7
作者：
Friberg, D;Ansved, T;Svanborg, E
通讯作者：
Svanborg, E
影响因子：
3.6
作者：
Balint, TS;Lucey, AD
通讯作者：
Lucey, AD