Biofluid Mechanics of the Pulmonary System

Effects of Surface Tension and Yield Stress on Mucus Plug Rupture: A Numerical Study

We study the effects of surface tension and yield stress on mucus plug rupture. A three-dimensional simplified configuration is employed to simulate mucus plug rupture in a collapsed lung airway of the tenth generation. The Herschel-Bulkley model is used to take into account the non-Newtonian viscoplastic fluid properties of mucus. Results show that the maximum wall shear stress greatly changes right prior to the rupture of the mucus plug. The surface tension influences mainly the late stage of the rupture process when the plug deforms greatly and the curvature of the mucus-air interface becomes significant. High surface tension increases the wall shear stress and the time needed to rupture since it produces a resistance to the rupture, as well as strong stress and velocity gradients across the mucus-air interface. The yield stress effects are pronounced mainly at the beginning. High yield stress makes the plug take a long time to yield and slows down the whole rupture process. When the effects induced by the surface tension and yield forces are comparable, dynamical quantities strongly depend on the ratio of the two forces. The pressure difference (the only driving in the study) contributes to wall shear stress much more than yield stress and surface tension per unit length. Wall shear stress is less sensitive to the variation in yield stress than that in surface tension. In general, wall shear stress can be effectively reduced by the smaller pressure difference and surface tension.

Engineered Airway Models to Study Liquid Plug Splitting at Bifurcations: Effects of Orientation and Airway Size

Delivery of biological fluids, such as surfactant solutions, into lungs is a major strategy to treat respiratory disorders including respiratory distress syndrome that is caused by insufficient or dysfunctional natural lung surfactant. The instilled solution forms liquid plugs in lung airways. The plugs propagate downstream in airways by inspired air or ventilation, continuously split at airway bifurcations to smaller daughter plugs, simultaneously lose mass from their trailing menisci, and eventually rupture. A uniform distribution of the instilled biofluid in lung airways is expected to increase the treatments success. The uniformity of distribution of instilled liquid in the lungs greatly depends on the splitting of liquid plugs between daughter airways, especially in the first few generations from which airways of different lobes of lungs emerge. To mechanistically understand this process, we developed a bioengineering approach to computationally design three-dimensional bifurcating airway models using morphometric data of human lungs, fabricate physical models, and examine dynamics of liquid plug splitting. We found that orientation of bifurcating airways has a major effect on the splitting of liquid plugs between daughter airways. Changing the relative gravitational orientation of daughter tubes with respect to the horizontal plane caused a more asymmetric splitting of liquid plugs. Increasing the propagation speed of plugs partially counteracted this effect. Using airway models of smaller dimensions reduced the asymmetry of plug splitting. This work provides a step toward developing delivery strategies for uniform distribution of therapeutic fluids in the lungs.

Surfactant-induced Marangoni transport of lipids and therapeutics within the lung

Understanding the fundamentals of surface transport on thin viscous films has important application in pulmonary drug delivery. The human lung contains a large-area interface between its complex fluid lining and inhaled air. Marangoni flows driven by surface tension gradients along this interface would promote enhanced distribution of inhaled therapeutics by carrying them from where they are deposited in the upper airways, along the fluid interface to deeper regions of the lung. Motivated by the potential to improve therapies for acute and chronic lung diseases, we review recent progress in modeling and experimental studies of Marangoni transport induced by the deposition of surfactant-containing microliter drops and liquid aerosols (picoliter drops) onto a fluid interface. The roles of key system variables are identified, including surfactant solubility, drop miscibility with the subphase, and the thickness, composition and surface properties of the subphase liquid. Of particular interest is the unanticipated but crucial role of aerosol processing to achieve Marangoni transport via phospholipid vesicle dispersions, which are likely candidates for a biocompatible delivery system. Progress in this field has the potential to not only improve outcomes in patients with chronic and acute lung diseases, but also to further our understanding of surface transport in complex systems.

The highs and lows of wheezing: A review of the most popular adventitious lung sound

Wheezing is the most widely reported adventitious lung sound in the English language. It is recognized by health professionals as well as by lay people, although often with a different meaning. Wheezing is an indicator of airway obstruction and therefore of interest particularly for the assessment of young children and in other situations where objective documentation of lung function is not generally available. This review summarizes our current understanding of mechanisms producing wheeze, its subjective perception and description, its objective measurement, and visualization, and its relevance in clinical practice.

Enabling Marangoni flow at air-liquid interfaces through deposition of aerosolized lipid dispersions

It has long been known that deposited drops of surfactant solution induce Marangoni flows at air-liquid interfaces. These surfactant drops create a surface tension gradient, which causes an outward flow at the fluid interface. We show that aqueous phospholipid dispersions may be used for this same purpose. In aqueous dispersions, phospholipids aggregate into vesicles that are not surface-active; therefore, drops of these dispersions do not initiate Marangoni flow. However, aerosolization of these dispersions disrupts the vesicles, allowing access to the surface-active monomers within. These lipid monomers do have the ability to induce Marangoni flow. We hypothesize that monomers released from broken vesicles adsorb on the surfaces of individual aerosol droplets and then create localized surface tension reduction upon droplet deposition. Deposition of lipid monomers via aerosolization produces surface tensions as low as 1mN/m on water. In addition, aerosolized lipid deposition also drives Marangoni flow on entangled polymer solution subphases with low initial surface tensions (∼34mN/m). The fact that aerosolization of phospholipids naturally found within pulmonary surfactant can drive Marangoni flows on low surface tension liquids suggests that aerosolized lipids may be used to promote uniform pulmonary drug delivery without the need for exogenous spreading agents.

Surfactant Driven Post-Deposition Spreading of Aerosols on Complex Aqueous Subphases. 1: High Deposition Flux Representative of Aerosol Delivery to Large Airways

BACKGROUND

Aerosol drug delivery is a viable option for treating diseased airways, but airway obstructions associated with diseases such as cystic fibrosis cause non-uniform drug distribution and limit efficacy. Marangoni stresses produced by surfactant addition to aerosol formulations may enhance delivery uniformity by post-deposition spreading of medications over the airway surface, improving access to poorly ventilated regions. We examine the roles of different variables affecting the maximum post-deposition spreading of a dye (drug mimic).

METHODS

Entangled aqueous solutions of either poly(acrylamide) (PA) or porcine gastric mucin (PGM) serve as airway surface liquid (ASL) mimicking subphases for in vitro models of aerosol deposition. Measured aerosol deposition fluxes indicate that the experimental delivery conditions are representative of aerosol delivery to the conducting airways. Post-deposition spreading beyond the locale of direct aerosol deposition is tracked by fluorescence microscopy. Aqueous aerosols formulated with either nonionic surfactant (tyloxapol) or fluorosurfactant (FS-3100) are compared with surfactant-free control aerosols.

RESULTS

Significant enhancement of post-deposition spreading is observed with surfactant solutions relative to surfactant-free control solutions, provided the surfactant solution surface tension is less than that of the subphase. Amongst the variables considered--surfactant concentration, aerosol flow-rate, total deposited volume, time of delivery, and total deposited surfactant mass--surfactant mass is the primary predictor of maximum spread distance. This dependence is also observed for solutions deposited as a single, microliter-scale drop with a volume comparable to the total volume of deposited aerosol.

CONCLUSIONS

Marangoni stress-assisted spreading after surfactant-laden aerosol deposition at high fluxes on a complex fluid subphase is capable of driving aerosol contents over significantly greater distances compared to surfactant-free controls. Total delivered surfactant mass is the primary determinant of the extent of spreading, suggesting a great potential to extend the reach of aerosolized medication in partially obstructed airways via a purely physical mechanism.

URINE FLOW DYNAMICS THROUGH THE URETHRA IN PATIENTS WITH BLADDER OUTLET OBSTRUCTION

Voiding dysfunction is a common disease among the elderly male population. However, few studies have elucidated the flow dynamics of the disease mechanism. We attempted to clarify the fluid dynamics of urine in the prostatic urethra (PU) in patients with bladder outlet obstruction (BOO), a common disease associated with voiding dysfunction. A model of normal PU and three phase models following the BOO progression were prepared using 3D CAD software tracing cystourethroscopic images. In fluid dynamics computation, the normal detrusor pressure was applied to the bladder side in each model. Results of fluid simulation were compared for flow trajectory line, fluid energy dynamics using Bernoulli's principle and pressure loss coefficient. In the BOO model, a large vortex was observed adjacent to the bladder outlet (BO) with increased hydraulic energy loss during the passage through the tract. In contrast, opening of the BO eliminated the vortex with reduction of hydraulic energy loss. These results corresponded with clinical data measured by catheterized pressure sensors inserted into the urethra, and those of urethral diameter measured by urethrography. Fluid dynamics simulation using CAD models can clarify the mechanism of voiding dysfunction in a less invasive and more acceptable way in patients with BOO.

Surface tension gradient driven spreading on aqueous mucin solutions: a possible route to enhanced pulmonary drug delivery

Surface tension gradient driven, or "Marangoni", flow can be used to move exogenous fluid, either surfactant dispersions or drug carrying formulations, through the lung. In this paper, we investigate the spreading of aqueous solutions of water-soluble surfactants over entangled, aqueous mucin solutions that mimic the airway surface liquid of the lung. We measure the movement of the formulation by incorporating dyes into the formulation while we measure surface flows of the mucin solution subphase using tracer particles. Surface tension forces and/or Marangoni stresses initiate a convective spreading flow over this rheologically complex subphase. As expected, when the concentration of surfactant is reduced until its surface tension is above that of the mucin solution, the convective spreading does not occur. The convective spreading front moves ahead of the drop containing the formulation. Convective spreading ends with the solution confined to a well-defined static area which must be governed by a surface tension balance. Further motion of the spread solution progresses by much slower diffusive processes. Spreading behaviors are qualitatively similar for formulations based on anionic, cationic, or nonionic surfactants, containing either hydrophilic or hydrophobic dyes, on mucin as well as on other entangled aqueous polymer solution subphases. This independence of qualitative spreading behaviors from the chemistry of the surfactant and subphase indicates that there is little chemical interaction between the formulation and the subphase during the spreading process. The spreading and final solution distributions are controlled by capillary and hydrodynamic phenomena and not by specific chemical interactions among the components of the system. It is suggested that capillary forces and Marangoni flows driven by soluble surfactants may thereby enhance the uniformity of drug delivery to diseased lungs.

The role of biofluid mechanics in the assessment of clinical and pathological observations: sixth International Bio-Fluid Mechanics Symposium and Workshop, March 28-30, 2008 Pasadena, California

Biofluid mechanics is increasingly applied in support of diagnosis and decision-making for treatment of clinical pathologies. Exploring the relationship between blood flow phenomena and pathophysiological observations is enhanced by continuing advances in the imaging modalities, measurement techniques, and capabilities of computational models. When combined with underlying physiological models, a powerful set of tools becomes available to address unmet clinical needs, predominantly in the direction of enhanced diagnosis, as well as assessment and prediction of treatment outcomes. This position paper presents an overview of current approaches and future developments along this theme that were discussed at the 5th International Biofluid Symposium and Workshop held at the California Institute of Technology in 2008. The introduction of novel mechanical biomarkers in device design and optimization, and applications in the characterization of more specific and focal conditions such as aneurysms, are at the center of attention. Further advances in integrative modeling, incorporating multiscale and multiphysics techniques are also discussed.

Recent advances and new opportunities in lung mechanobiology

Lung function is inextricably linked to mechanics. On short timescales every breath generates dynamic cycles of cell and matrix stretch, along with convection of fluids in the airways and vasculature. Perturbations such airway smooth muscle shortening or surfactant dysfunction rapidly alter respiratory mechanics, with profound influence on lung function. On longer timescales, lung development, maturation, and remodeling all strongly depend on cues from the mechanical environment. Thus mechanics has long played a central role in our developing understanding of lung biology and respiratory physiology. This concise review focuses on progress over the past 5 years in elucidating the molecular origins of lung mechanical behavior, and the cellular signaling events triggered by mechanical perturbations that contribute to lung development, homeostasis, and injury. Special emphasis is placed on the tools and approaches opening new avenues for investigation of lung behavior at integrative cellular and molecular scales. We conclude with a brief summary of selected opportunities and challenges that lie ahead for the lung mechanobiology research community.

Mechanical properties of the respiratory system derived from morphologic insight

This paper aims to provide the mechanical parameters of the respiratory airways (resistance, inertance, and compliance) from morphological insight, in order to facilitate the correlations of fractional-order models with pathologic changes. The approach consists of taking into account wall thickness, inner radius, tube length, and tissue structure for each airway level to combine them into a set of equations for modeling the pressure drop, flow, wall elasticity, and air velocity (axial and radial). Effects of pulmonary disease affecting the inner radius and elastic modulus of bronchial tree are discussed. A brief comparison with the circulatory system, which poses similarities with the respiratory system, is also given. The derived mechanical parameters can serve as elements in a transmission line equivalent, whose structure preserves the geometry of the human respiratory tree. The mechanical parameters derived in this paper offer the possibility to evaluate input impedance by altering the morphological parameters in relation to the pulmonary disease. In this way, we obtain a simple, yet accurate, model to simulate and understand specific effects in respiratory diseases; e.g., airway remodeling. The final scope of the research is to relate the variations in airway structure with disease to the values of fractional-order model parameters.

PIV measurements of the flow field just downstream of an oscillating collapsible tube

We probed the time-varying flow field immediately downstream of a flexible tube conveying an aqueous flow, during flow-induced oscillation of small amplitude, at time-averaged Reynolds numbers (Re) in the range 300-550. Velocity vector components in the plane of a laser sheet were measured by high-speed ("time-resolved") particle image velocimetry. The sheet was aligned alternately with both the major axis and the minor axis of the collapsing tube by rotating the pressure chamber in which the tube was mounted. The Womersley number of the oscillations was approximately 10. In the major-axis plane the flow fields were characterized by two jets that varied in lateral spacing. The rapid deceleration of flow at maximal collapse caused the jets momentarily to merge about one diameter into the downstream pipe, and strengthened and enlarged the existing retrograde flow lateral to each jet. Collapse also spread the jets maximally, allowing retrograde flow between them during the ascent from its minimum of the pressure at the end of the flexible tube. The minor-axis flow fields showed that the between-jet retrograde flow at this time extended all the way across the pipe. Whereas the retrograde flow lateral to the jets terminated within three diameters of the tube end at Re=335 at all times, it extended beyond three diameters at Re=525 for some 25% of the cycle including the time of maximal flow deceleration. Off-axis sheet positioning revealed the lateral jets to be crescent shaped. When the pressure outside the tube was increased, flattening the tube more, the jets retained a more consistent lateral position. These results illuminate the flows created by collapsible-tube oscillation in a laminar regime accessible to numerical modeling.