Dynamic model of the influence of gravity, ventilation with positive and negative pressure on ventilation-perfusion ratio in lungs

The concept of gravitational influence on ventilation and blood flow in lungs is well known. Dr. John West presented this concept in 1964. However, this concept does not fully explain some clinical features of pulmonary dysfunction. In addition, recent studies demonstrated a less important role of gravity in changing the regional distribution of blood flow (approximately 25%) than structural features of respiratory tract and blood vessels. We present a theoretical model designed to better understand the effects of different ventilation methods on pulmonary perfusion. The objective of this report is to discuss our theory with specialists in respiratory physiology and respiratory support, as well as to get your opinion. This is very important for us, since our theoretical model is based on a slightly different vision of perfusion and ventilation in lungs. We are particularly interested in your views on the issue of cuirass ventilation and combination of cuirass ventilation with positive pressure ventilation. We found no available literature data on such an approach to describing the relationship between ventilation and perfusion in lungs. We will be grateful for any information and especially your professional opinion. We are ready for cooperation in any form (from theoretical discussion to joint work). We are aware that certain our assumptions require verification. Additional research of cuirass ventilation and development of new types of ventilators are necessary. Perhaps, the combination of cuirass ventilation and positive pressure ventilation opens up great prospects in the treatment of severe pulmonary diseases. We hope that our dynamic model will be useful for understanding the processes of ventilation and perfusion in lungs and, possibly, for predicting the results of any methods of respiratory support.