Critical illness and medical crises are a huge drain on our society. They consume a disproportionate part of medical budgets and are tremendously disruptive to patients and their families. Due to the unpredictable nature of these issues, the heterogeneity of patients and the time critical nature of events, recruitment to clinical studies is difficult, and the results disappointingly noisy and unhelpful. There has thus developed a pressing need for a novel method to answer questions of crucial importance to these most vulnerable of patients.
3. Computational modelling apnoea and high-flow upper airway oxygenation.
We are using our ICSM computer simulation to explore optimal rescue strategies using the Optiflow (a recent developed oxygen therapy device that delivers high-flow, humidified oxygen via nasal cannulae) in-silico obese subjects. This work is currently funded by the Fisher & Paykel Healthcare (New Zealand) and is staffed by 1 PhD student.
4. Apnoeic Oxygenation in healthy and respiratory disease: modelling investigations.
Using our computer simulator, we investigate the prolongation of apnoea - improving the high-risk period of anaesthetic induction, and optimising gas exchange. This work is currently staffed by 1 PhD student.
5. Development and validation of a computational simulator for paediatric and neonatal patients.
We are adapting our ICSM model to paediatric and neonatal pathophysiology in order to investigate mechanical ventilation strategies to reduce the risk of ventilator-associated lung injuries and to develop rescue ventilation strategies to hypoxic paediatric patients. This work is currently staffed by 1 PhD student and 2 research fellows.
M.Laviola, C.Niklas, A. Das, DG Bates and JG Hardman. Airway Rescue and the Effect of Oxygen Fraction: A Computational Modelling Study. British Journal of Anaesthesia, 2020. In press.
M. Laviola, C. Niklas, A. Das, D.G. Bates and J.G. Hardman, "High oxygen fraction during airway opening is key to effective airway rescue in obese subjects", in the proceedings of the 41st IEEE Engineering in Biology and Medical Conference, Berlin, 2019 https://ieeexplore.ieee.org/document/8857109
M. Laviola, D.G. Bates and J.G. Hardman, "Mathematical and Computational Modelling in Critical Illness". European Respiratory and Pulmonary Diseases. 5(1), 2019 https://www.touchrespiratory.com/mathematical-modelling-in-critical-illness/
M. Haque, T.E. Scott, A. Das, I. Cliff, D.G. Bates and J.G. Hardman. "Efficacy of continuous positive airway pressure (CPAP) in casualties suffering from primary blast lung injury: A modelling study", in the proceedings of the 41st IEEE Engineering in Biology and Medicine Conference, Berlin, 2019
S. Saffaran, A. Das, J.G Hardman, N. Yehya and D.G. Bates, "High-fidelity Computational Simulation to Refine Strategies for Lung-Protective Ventilation in Paediatric Acute Respiratory Distress Syndrome", Intensive Care Medicine, https://doi.org/10.1007/s00134-019-05559-4, 2019 http://link.springer.com/article/10.1007/s00134-019-05559-4
M. Laviola, A. Das, M. Chikhani, D.G. Batesand J.G Hardman, "Computer simulation clarifies mechanisms of carbon dioxide clearance during apnoea", British Journal of Anaesthesia, https://doi.org/10.1016/j.bja.2018.11.012, 2019 https://bjanaesthesia.org/article/s0007-0912(18)31301-1/fulltext
A. Das, L. Camporata, J.G. Hardman, and D.G. Bates, "What links ventilator driving pressure with survival in the acute respiratory distress syndrome? A computational study", Respiratory Research, 20:29, DOI:https://doi.org/10.1186/s12931-019-0990-5, 2019 https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-019-0990-5
M. Haque, A. Das, T.E. Scott, D.G. Bates and J.G. Hardman, "The primary blast lung injury simulator: A new computerised model", Journal of the Royal Army Medical Corrps, DOI: 10.1136/jramc-2018-000989, 2018 https://jramc.bmj.com/content/165/1/45.long
S. Saffaran, W. Wang, A. Das, W. Schmitt, J.G. Hardman, G. Weimann and D.G. Bates, "An inhaled sGC modulator can lower PH in COPD patients without deteriorating oxygenation", CPT Pharmacometrics & Systems Pharmacology, DOI: 10.1002/psp4.12308. 2018 https://ascpt.onlinelibrary.wiley.com/doi/full/10.1002/psp4.12308
M. Laviola, A. Das, M. Chikhani, D.G. Bates and J.G. Hardman "Investigating the effect of cardiac oscillations and deadspace gas mixing during apnea using computational simulation", in proceedings of the 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, JeJu Island, S. Korea, 2017 https://ieeexplore.ieee.org/document/8036831
S. Saffaran, A. Das, J.G. Hardman,N.Yehya and D.G. Bates, "Development and Validation of a Computational Simulator for Pediatric ARDS Patients", in proceedings of the 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, JeJu Island, S. Korea, 2017 https://ieeexplore.ieee.org/document/8037125
A. Das, M. Haque, M. Chikhani, O. Cole, W. Wang, J.G Hardman and D.G. Bates, "Hemodynamic effects of lung recruitment maneuvers in acute respiratory distress syndrome", BMC Pulmonary Medicine, 17:34, 2017 https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-017-0369-7
M. Chikhani, A. Das, M. Haque, W. Wang, D.G. Bates and J.G. Hardman, "High PEEP in ARDS evaluating the trade-off between improved oxygenation and decreased oxygen delivery", British Journal of Anaesthesia, 117 (5): 650--8, (2016) DOI: 10.1093/bja/aew314, 2016 https://www.sciencedirect.com/science/article/pii/s0007091217300247?via=ihub
A. Das, M. Haque, M. Chikhani, W. Wang, J.G. Hardman and D.G. Bates, "Creating Virtual ARDS Patients", in proceedings of the 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Orlando, 2016 https://ieeexplore.ieee.org/document/7591294
W. Wang, A Das, O. Cole, M. Chikhani, J.G. Hardman and D.G. Bates, "Computational simulation indicates that moderately high frequency ventilation can allow safe reduction of tidal volumes and airway pressures in ARDS patients", Intensive Care Medicine Experimental 3(1), 1-12, 2015 https://icm-experimental.springeropen.com/articles/10.1186/s40635-015-0068-8
A. Das, M. Haque, M. Chikhani, W. Wang, T. Ali, O. Cole, J.G. Hardman and D.G. Bates, "Development of an Integrated Model of Cardiovascular and Pulmonary Physiology for the Evaluation of Mechanical Ventilation Strategies", in Proceedings of the 37th IEEE Engineering in Medicine and Biology Conference, Milano, 2015 https://ieeexplore.ieee.org/document/7319592
A. Das, O. Cole, M. Chikhani, W. Wang, T. Ali, M. Haque, J.G. Hardman and D.G. Bates, "Evaluation of lung recruitment maneuvers in Acute Respiratory Distress Syndrome using computer simulation", Critical Care, 19:8, doi:10.1186/s13054-014-0723-62014, 2015. https://ccforum.biomedcentral.com/articles/10.1186/s13054-014-0723-6
W. Wang, A. Das, T. Ali, O. Cole, M. Chikhani, M. Haque, J.G. Hardman and D.G. Bates, "Can computer simulators accurately represent the pathophysiology of individual COPD patients?", Intensive Care Medicine EXperimental, 2:23, doi:10.1186/s40635-014-0023-02014, 2014. https://icm-experimental.springeropen.com/articles/10.1186/s40635-014-0023-0
A. Das, P.P. Menon, J. Hardman and D.G. Bates, "Optimization of Ventilation Settings for Pulmonary Disease States", IEEE Transactions on Biommedical Engineering, 60(6):1599-607,2013. https://ieeexplore.ieee.org/document/6410003
A. Das, Z. Gao, P.P. Menon, J. Hardman and D.G. Bates, "A Systems Engineering approach to validation of a pulmonary physiology simulator for clinical applications", Journal of The Royal Society Interface, doi:10.1098/rsif.2010.0224, 2011. https://royalsocietypublishing.org/doi/10.1098/rsif.2010.0224
A Das, S Saffaran, M Chikhani, T. E Scott, M. Laviola, N. Yehya, J. G Laffey, J. G Hardman and D. G. Bates. "In silico modelling of COVID-19 ARDS: pathophysiological insights and potential management implcatrions", to appear in Critical Care Explorations, 2020. //doi.org/10.1101/2020.07.21.20158659
J. Laffey, M. Chikhani, D. G. Bates and J. G Hardman "Supporting more than one patient with a single mechanical ventilator: useful last resort or unjustifiable risk?" British Journal of Anaesthesia, 125 (3), 2020 DOI:10.1016/j.bja.2020.05.029
A. Das, T. E Scott, M. Haque, D. G Bates and J. G Hardman, "Managament of primary blast lung injury: A comparison of airway pressure release versus low tiday volume ventilation", Intensive Care Medicine Experimental, 8 (1), 2020 DOI: 10.1186/s 40635-020-00314-2,2020
M. Laviola, C. Niklas, A. Das, D. G. Bates and J. G Hardman, "Airway Rescue and the Effect of Oxygen Fraction: A compututational study", British Journal of Anaesthesia, 125 (1), 2020 doi:10.1016/j.bja.2020.01.004