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MEDICAL DEVICESFOR RESPIRATORY

DYSFUNCTION:PRINCIPLES AND MODELINg OF

CONTINUOUS POSITIVEAIRwAY PRESSURE (CPAP)

Author Contributin Author

Ahmed M. Al-JumailyInstitute of BiomedicalTechnoloiesAuckland University

of Technoloy

Prasika I. ReddyInstitute of BiomedicalTechnoloiesAuckland University

of Technoloy

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2012, ASME, 3 Pa Aenue, Ne Y, NY 10016, USA (.asme.)

A is esee. Pine in e Unie Saes Ameica. Excep as pemie une

e Unie Saes Cpyi Ac 1976, n pa is puicain may e ep-

uce isiue in any m y any means, se in a aaase eieasysem, iu e pi ien pemissin e puise.

INorMAtIoN CoNtAINEd IN thIS work hAS bEEN obtAINEd bY thE

AMErICAN SoCIEtY o MEChANICAl ENgINEErS roM SoUrCES bE-

lIEvEd to bE rElIAblE. howEvEr, NEIthEr ASME Nor ItS AUthorS

or EdItorS gUArANtEE thE ACCUrACY or CoMPlEtENESS o ANY

INorMAtIoN PUblIShEd IN thIS work. NEIthEr ASME Nor ItS AU-

thorS ANd EdItorS ShAll bE rESPoNSIblE or ANY ErrorS, oMIS-

SIoNS, or dAMAgES ArISINg oUt o thE USE o thIS INorMAtIoN.

thE work IS PUblIShEd wIth thE UNdErStANdINg thAt ASME

ANd ItS AUthorS ANd EdItorS ArE SUPPlYINg INorMAtIoN bUt

ArE Not AttEMPtINg to rENdEr ENgINEErINg or othEr ProES-

SIoNAl SErvICES. I SUCh ENgINEErINg or ProESSIoNAl SErvICES

ArE rEqUIrEd, thE ASSIStANCE o AN APProPrIAtE ProESSIoNAl

ShoUld bE SoUght.

ASME sa n e espnsie saemens pinins aance in papes . . .

pine in is puicains (b7.1.3). Saemen m e byas.

auizain pcpy maeia inena pesna use une se ci-

cumsances n ain iin e ai use pisins e Cpyi Ac, cnac eCpyi Ceaance Cene (CCC), 222 rse die, danes, MA 01923, e:

978-750-8400, .cpyi.cm.

reuess specia pemissin u epucin su e aesse e ASME

Puisin depamen, sumie nine a: p://.asme./Puicains/

bs/Aminisain/Pemissins.cm

ASME Pess s ae aaiae a specia uaniy iscuns use as pemiums

use in cpae ainin pams. me inmain, cnac Specia Saes

a incena@asme.

liay Cness Caain-in-Puicain daa

A-Jumaiy, Ame.

Meica eices espiay ysuncin : pincipes an mein

cninuus psiie aiay pessue (CPAP) eices / Ame M. A-Jumaiy ;

cniuin au, Pasia I. rey.

p. ; cm.

Incues iiapica eeences.

ISbN 978-0-7918-5977-3

I. rey, Pasia I. II. tie.

[dNlM: 1. Cninuus Psiie Aiay Pessue--insumenain. 2. bimeica

Enineein--mes. 3. respiain dises--eapy. 4. Seep Apnea,

osucie--eapy. w 145]

616.200284--c23

2011035639

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TABLE OF CONTENTS

Au e Au ix

Peace x

Aus Inucin xiii

Introduction 1

Chapter1:ModelingConcepts 3

1.1 Maemaica Mein 3

1.2 taaie Mes 5

1.3 Paamee/Me reuiemens 7

1.4 Mein Pceue 8

1.5 Csue 13

Part1:ObstructiveSleepApnea(OSA) 15

Chapter2:ObstructiveSleepApnea:BasicPrinciples

andCurrentTreatments 17

2.1 osucie Seep Apnea (oSA) 17

2.2 diansis 19

2.3 Cinica Manaemen an teamen oSA 20

2.3.1 oa deices 20

2.3.2 Suica teamen 21

2.3.3 CPAP teapy 22

2.4 Csue 25

reeences 25

iii

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Chapter3:ModelingoContinuousPositiveAirway

Pressure(CPAP) 29

3.1 Pincipes opeain an Sysem Cmpnens 293.2 lumpe Paamee Mein Cmpnens 30

3.2.1 Ai deiey Uni 31

3.2.2 Cnnecin duc 31

3.2.3 resei 32

3.2.4 deiey tue 33

3.2.5 Mas 37

3.3 Simuin Me 39

3.4 Me vaiain 413.5 Me Uiiy 44

3.5.1 Cmpess Anaysis 45

3.5.2 Sysem Me Summay 47

3.5.3 Simuain resus 49

3.6 reese 54

3.6.1 tansp deay 56

3.6.2 Eec diecin n Ai Ppeies 56

3.6.3 Exae Ai re-eain 573.6.4 Mein oucmes 59

3.7 Csue 63

reeences 63

Chapter4:ModelingCPAPHumidifcation 65

4.1 te Nee humiicain 65

4.2 types humiies 66

4.2.1 heae humiies 67

4.2.2 Passie humiies 69

4.2.3 hyscpic Cnense humiies 69

4.3 Mein i humiicain 71

4.4 Ai deiey Uni 72

4.5 humiicain Pcess 74

4.6 Mass tanse 76

4.7 humiie hea tanse 79

4.7.1 heae Pae 79

4.7.2 wae resei 82

4.7.3 Ai Came 86

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4.8 heae Ai deiey tue (hAdt) 89

4.9 Ineace 93

4.9.1 exie tue 94

4.9.2 Nasa Mas 95

4.10 Simuin Me 99

4.11 Csue 100

reeences 100

Chapter5:ControlSystemsorCPAP 103

5.1 Aaiae Cn Scemes 1035.2 Maemaica Mein 106

5.2.1 Pysica Sysem 106

5.2.2 Pessue tansuce 107

5.2.3 Cne 108

5.2.4 beain 108

5.3 Simuin Me 108

5.3.1 Me Cmpnens 108

5.3.2 open lp respnse 1095.4 Apppiae Cn Sceme 111

5.4.1 time Cnsan Cmpensain 112

5.4.2 time deay Cmpensain 114

5.5 Cne tunin 116

5.5.1 reacin Cue Me 117

5.5.2 Cninuus Cycin Me 117

5.6 Senss 119

5.7 Csue 122reeences 123

Chapter6:MaskDesign 125

6.1 basic Pincipes Cnensain an Can dixie 125

6.2 Maemaica Mes deemine desin Paamees 128

6.2.1 ui Mein 128

6.2.2 desin Cnsieains Pessue an Aea Eecs 131

6.3 Mein Cnensain 132

6.3.1 Cnensain Pysics 132

6.3.2 Cacuain cnensain ae 133

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6.4 Cmpuaina ui dynamic (Cd) Simuains 137

6.5 Csue 139

reeences 139

Part2:RespiratoryDistressSyndrome(RDS) 141

Chapter7:BasicPrinciplesandCurrentTreatments 143

7.1 respiay disess Synme (rdS) 143

7.1.1 Papysiy 144

7.1.2 Suacan teapies 145

7.1.3 taiina veniain teapies 145

7.2 veniain tecniues usin Pessue osciains 147

7.2.1 hi euency veniain (hv) 147

7.2.2 biicay vaiae veniain (bvv) 150

7.2.3 Cninuus Psiie Aiay Pessue (CPAP)

i Pessue osciains 150

7.3 Csue 152

reeences 152

Chapter8:ModelingoBubbleCPAP 155

8.1 Pincipes opeain an Sysem Cmpnens 155

8.1.1 humiicain Came 156

8.1.2 Sine-heae beain Cicui 156

8.1.3 Pessue Mani 1578.1.4 CPAP genea 157

8.1.5 Paien Ineace - Nasa tuin, Nasa Pns,

an Inan bnne 158

8.2 lumpe Paamee Mein Cmpnens 158

8.2.1 humiicain Came 159

8.2.2 te Inspiay line 160

8.2.3 Paien Ineace 162

8.2.4 Expiay line 1638.2.5 te CPAP genea 166

8.2.6 Simpie lun Me 166

8.2.7 Cmpee Sysem Simuain Me 167

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8.3 Me vaiain 168

8.4 Me Uiiy 169

8.4.1 Eec desin Paamees n Pessue

tansmissin 169

8.4.2 Ineacin i Nenaa lun 170

8.5 Csue 170

reeences 171

Chapter9:ModelingDeviceInteractionwiththe

NeonatalLung 1739.1 respiay Sysem Sucue an uncin 173

9.1.1 Anamy 173

9.1.2 Inspiain, Expiain, an e respiay

Musces 177

9.1.3 respiay vumes an Capaciies 179

9.2 respiay Mecanics 180

9.2.1 Aiay resisance 180

9.2.2 Cmpiance 1819.2.3 Impeance 182

9.2.4 Aea Suace tensin 182

9.2.5 w bea 185

9.3 Mein respiay Sysem dynamics 186

9.3.1 Mpmeic Mes 186

9.3.2 Mecanica Mes 187

9.3.3 Summay 189

9.4 Me deepmen 1909.4.1 Me Assumpins 191

9.4.2 Me deiain 194

9.4.3 Mass rae Expessins 195

9.4.4 le dynamics 196

9.4.5 te Peua Cmpamen an Ces wa 198

9.5 Simuin Me 200

9.6 Me vaiain 204

9.7 Peicins Pessue osciain tansmissintu e tacencia tee 207

9.8 Csue 209

reeences 209

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AppendixA:CPAPAirDelivery 211

A.1 Psiie type Ai Cmpesss 211

A.2 Nn-Psiie type Ai Cmpesss 211reeences 214

AppendixB:SensorsUsedinCPAP 215

b.1 diia Ppee Anemmee 215

b.2 Eecmaneic Mee 216

b.3 lase dppe Anemmey (ldA) 216

b.4 h wie/im Anemmee 217

b.5 Uasnic Anemmee 219

b.6 Summay 219

reeences 221

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ABOUT THE AUTHOR

Pess Ame A-Jumaiy s a P.d. an M.Sc. m oi Sae

Uniesiy, Cumus, oh, an a b.Sc. m e Uniesiy baa,

Ia (a in Mecanica Enineein). he as 33 yeas eacin an

eseac expeience a Ameican uniesiies, u Mie Easen

uniesiies, an e Aucan Uniesiy tecny (AUt). he isa e meme e Ameican Sciey Mecanica Eninees, as

e as a meme e Acusica Sciey Ameica, Ameican Eni-

neein Eucain, Inenaina Sciey opica Enineein, Inena-

ina Insiue Acusics an viain, an Insiue Pessina

Eninees Ne Zeaan. he is as a eisee pessina eninee.

he as supeise me an 90 psauae suens in imecanics,

mecanica iains, acusics, sma pymes, meica eices, an

sysem ynamics an cn. he as puise me an 250 papes

in inenaina junas an cneence pceeins, an as ace as

a eiee seea inenaina junas. As, e as eie

ASME s n iain an acusics in imeica appicains. As

e iec e Enineein reseac Insiue an en e Insiue

bimeica tecnies AUt e as 12 yeas, e as es-

aise ey sn inusia eseac ins i many maj meica

eice cmpanies in Ne Zeaan an e Unie Saes. A-Jumaiys

pespecie acaemic enineein eseac is a inusia eseac is

a mus minimize e ap eeen acaemia an e inusy.

ix

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x

PREFACE

tis inuces e eae e asic pincipes peain, e-

epmen, an mein psiie aiay pessue eapy eices

i an empasis n Cninuus Psiie Aiay Pessue (CPAP) e-

ices. I incues upae ieaue eies n e sae e a ese

eices, incuin uncinaiy an mein. te eaaes n

e ms peaen espiay ysuncins, osucie Seep

Apnea (oSA) an respiay disess Synme (rdS), i an em-

pasis n e use CPAP sysems manae ese espiay ises.

I efecs me an 10 yeas eepmen, esin, mein, an

impemen usin eecmecanica enineein pincipes see e

meica cmmuniy.

te cnsiss an inucy cape an secins. Eac

ne e capes in ese secins is esine e a san-ane cap-

e a can peniay e use in an enineein mein cuse. teinucy cape pesens sme mein cnceps an ei ps an

cns, i empasis n meica eapy eice appicains. te cape

as inuces a ne cncep taaie Mes, ic can e use

assess meica eice pemance as ese eices ae appie uin

a eapy pcess.

Secin one cnsiss six capes, ic cus n CPAP eices

oSA eamen. te s cape in is secin, i.e., Cape 2 in e

, ces asic pincipes an cuen eamens oSA. I pesens

eniins an an eie oSA an e eae ieaue, as e aseaaes n aius mes eamen. Cape 3 emnsaes

mein ecniues can e appie peic e pemance a p-

ype CPAP sysem. te sysem is escie in ems enin eua-

ins e iniiua cmpnens usin a umpe paamee appac,

an en mee in Simuin iin e Maa eninmen. te

manne in ic e enin euains can e eaie u e use

c iaams iin Simuin is emnsae. dynamic esin

e pupse me eicain is en iusae e eae. An

exampe suc a me can en e use ue puc ee-

pmen is ien y usin i eauae e specicains an impe

ai eiey uni. te nee mein umiicain an e ypes

umiies usin a umpe paamee appac i me aiain

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is pesene in Cape 4. wie Cape 5 ces e eepmen a

cn sceme enae e euain a cnsan nasa mas pessue

uin CPAP eapy uu a paiens eain cyce, Cape 6

pesens a ie eie e ieen ypes mass use in CPAPeiey an an inucin e impance cnin can i-

xie an cnensain ees in e mas. tis cape as ss

fui mecanics an emynamics can e use me f an cn-

ensain in a ypica nasa mas. A cmpuain fui ynamics (Cd)

appac mein cnensain in e mas is as escie en

ee is a nee ae in accun emeic cmpexiy, f iecin,

an empeaue isiuin.

Secin t cnsiss ee capes n rdS. te s cape is

Cape 7 in e . I pies an inucin an eie rdS,an escies aiina suacan an eniain eapies, an i

me cuen ecniues a use pessue sciains. In paicua, e

bue CPAP sysem is eaae n, an i cinica suies m

e ieaue a uine e enes is use ea rdS. Cape 8

pies a escipin e aius cmpnens a bue CPAP sys-

em, ee emain n a umpe paamee mein appac, ee

asic as pysics an empiica eainsips ae appie eneae

maemaica mes iniiua cmpnens. I as pesens a e-

scipin ceae an ea cmpuaina me e sysem in

Simuin iin e Maa eninmen. te pcess aiain

e me i expeimena aa is eaae n i e aim puc-

in a me a can e use cinica an enineein ias. te as

cape, Cape 9, pies an inucin e sucue, uncin, an

mecanics e espiay sysem ee pceein iscuss exis-

in mes in e ieaue a ae een eepe anse a aiey

uesins n espiay pemance. te pceue eepin

a aiae umpe paamee maemaica me a nn-inea i-

ica sysem suc as e un is escie, an is impemenain in

e Simuin eninmen is as eaae n. Usin e taaieMes cncep inuce in Cape 1, e manne in ic suc a

me can e ineae i a me a espiay eice eemine

e eec eice peain n espiay pemance is iusae.

te cnen an ma is ae een esine ene a

aiey auiences, incuin:

1. Acaemic eucas eacin uppe-ee auae cuses in bi-

meica Enineein.

2. gauae an uneauae suens in imeica, eecica, an

mecanica enineein anin ean au mein eapeuic

eices an ecniues an se mes can e use assess

e pemance ese eices.

Preface xi

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3. reseaces ineese in eanin eean sinican pincipes, e-

y, mein, expeimena, an cinica appicains imeica

sysems.

4. Meica paciines ae ine in usin eapeuic ec-niues.

5. Inusia pessinas isin unesan e unamenas an

appicains un eapy eices i a cus n CPAP eices.

6. Meica eice manuacuin cmpanies ineese in expeien p-

ceues eice anayses an eepmen.

tis pesens e-esaise mein mes as appie

meica eices. te aus main cniuins ae een e ays

in ic ese mes ae ne-une uses eae meica e-apy eices. I am us inee e aus an psauae suens

se s ee eane (i apppiae eeences e iina

puicains) is e eepe.

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xiii

AUTHORS

INTRODUCTION

Appicains enineein pincipes eapy eices ae n aai-

ae une ne umea; ey ae scaee in aius eseac aices

an imie capes. tis maes i icu e eae access

un eapy eices in ne eay-mae ume. t aciee is a,

is pies upae maeia n e sujec: I ies e asic

pincipes ese eices an expains enineein mein is

use impe, eep, an pimize ese eices.

tis ies e ap eeen acaemia an e inusy in e

aea imeica eices an meies. I cmpies expeimena,

eeica, an cmpuaina mes appie e meica eices

une ne . tis is e s a ins ee enineein

pincipes as appie lun teapy deices. Inmain m ecassm an e inusy ae u ee e expanin e

imeica eices.

tis summaizes me an 10 yeas eseac an eep-

men a I ae cnuce i my psauae suens. Eac cape

sans ane an summaizes a cmpee pjec, ic is ue e-

aie in e esis cie as e main eeence a cape. In is

ay, I u ie acnee e cniuins a suens se

eses ae use as e main eeence maeias is . I u as

ie acnee e e my suen an ceaue, c-aud. Pasia I. rey, as epe in puin ee pas e .

ue, I u ie exen my ans my suen an assisan Mea

Mau epin eise pas e , as e as an ex-ceaue

an ien dai d e na p-eain e .

te au pes a e eaes i n is a auae asse

in eepin emsees aeas e aes ecniues in e enecia

sysem mein appac appicains un suppie eices. tis

i appea n ny e eseaces, u as paciines,

ecues, an suens enineein an meicine as e as meicaeice inusy pesnne.

te aus is is a is i inees an iniue is ea-

es pme ue useu mein appicains meica eices,

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an ene se mein ecniues as s cmpue simuains,

ic can e e ase a viua la es e pemance se

eices. tis is a ey peu an ecnmic appac impin

an eepin se eices. I i minimize e ia-an-epcesses a ae cueny use y many inusies an euce e is

csy esin canes.

Ame A-Jumaiy

Insiue bimeica tecnies

Aucan Uniesiy tecny

Aucan, Ne Zeaan

xiv Authors Introduction