Numerical study of the airflow structures in an idealized mouth-throat under light and heavy breathing intensities using large eddy simulation

Engineering nanoliposomal tiotropium bromide embedded in a lactose-arginine carrier forming Trojan-particle dry powders for efficient pulmonary drug delivery: A combined approach of in vitro-3D printing and in silico-CFD modeling

Nanocarrier-based dry powders for lung disease treatment are crucial, with in vitro and in silico research being pivotal to their success. This study introduces a method for creating Tiotropium-bromide liposomal inhalation dry powder, termed "Trojan-particles," utilizing thin-film hydration and spray-drying with lactose-arginine carriers. Encapsulating tiotropium-bromide in nanoliposomes enhances lung treatment via liposomes' unique features. This formulation was examined through in vitro-3D-printing and in silico-CFD analysis. Nanoliposomes and powder were evaluated for physicochemical attributes, aerosolization, encapsulation-efficiency (EE%), and release. Both liposomes (90 nm) and powder particles (3 µm) were spherical. Liposomes had an EE% over 95 % and a zeta-potential of -28.3 mV. The optimal formulation was tested in vitro at 30, 60, and 90 L/min using a 3D-printed airway replica. CFD analysis evaluated particle deposition in steady and realistic inhalation with monodisperse and polydisperse particles. Based on realistic airway geometry, model utilized k-ω-SST turbulence model for the continuous phase and Lagrangian-DEM for the discrete phase, analyzed through ANSYS Fluent. The 20 %-arginine nanoliposomal-tiotropium formulation outperformed others due to arginine's dispersibility and therapeutic benefits, including nitric oxide conversion. The formulation competes with commercial dry powders due to its chemical, biochemical advantages, and Trojan-based physical traits, reducing exhalation risk. Simulation data aligned with experimental findings, showing that higher inhalation flows increase particle deposition in airways due to greater inertia and turbulence. At 60 L/min, the polydisperse model matched experimental data better than the monodisperse model. Alongside improving dry powder performance via a nanoliposomal formulation, this research highlights the development of a novel CFD method for their assessment.

Hypopharyngeal geometry impact on air-induced loads on the supraglottis

Exercise-induced laryngeal obstruction (EILO) describes paradoxical laryngeal closure during inspiration at high-intensity exercise. It is hypothesised that during intense activity, the air-induced loads on supraglottic walls overcome their internal stiffness, leading to the obstruction. Recent investigations have revealed that the air-induced loads on the supraglottic walls vary nonlinearly with increasing flow rate. It is, however, unclear whether certain geometric configurations of the hypopharynx and larynx may contribute to the predisposition to EILO. This study investigates the influence of hypopharyngeal and laryngeal geometry on upper respiratory tract airflow and air-induced forces. A computational fluid dynamics model is developed to study airflow through larynx. Four real, adult upper respiratory tracts with variable configurations are considered. Two steady, uniform inspiratory flow rates of 60 L/min and 180 L/min are considered. The analysis shows that geometries with a space lateral to the epiglottis (EpiS) and piriform fossae (PF) directs the hypopharyngeal and supraglottic pressure field to remain positive and increase with the flow rate. In geometries with EpiS and PF, pressure differential occurs around the aryepiglottic fold producing a net inward force over the region. The three-fold increase in flow rate induces near ten-fold increases in force over the region which may facilitate the closure. It is concluded that hypopharyngeal anatomy, particularly the piriform fossae, play a significant role in the obstruction of the supraglottic airway and should be considered in research and clinical assessment of EILO.

Assessing airflow unsteadiness in the human respiratory tract under different expiration conditions

To enhance the understanding of airflow characteristics in the human respiratory system, the expiratory airflow in a human respiratory tract model was simulated using large eddy simulation and dynamic mesh under different expiration conditions aligned with clinically measured data. The airflow unsteadiness was quantitatively assessed using power spectral density (PSD) and spectral entropy (SE). The following findings were obtained: (1) The airflow is highly turbulent in the mouth-pharynx region during expiration, with its dynamic characteristics being influenced by both the transient expiration flow pattern at mouth piece and the glottis motion. (2) PSD analysis reveals that the expiratory airflow is very unsteady, exhibiting a broad-band attenuation spectrum in the pharynx-trachea region. When only transient expiration or glottis motion is considered, the PSD spectrum changes slightly. When both are ignored, however, the change is significant, with the peak frequency reduced to 10% of the real expiration condition. (3) SE analysis indicates that the airflow transitions into turbulence in the trachea, and there may be multiple transitions in the region of soft palate. The transient expiration or glottis motion alone increases turbulence intensity by 2%-15%, while ignoring both reduces turbulence intensity by 10%-20%. This study implies that turbulence characteristics can be significantly different under different expiratory conditions, and therefore it is necessary to determine the expiratory flow characteristics using clinically measured expiratory data.

Airflow through the supraglottis during inspiration

Exercise-induced laryngeal obstruction is a paradoxical laryngeal closure during inspiration at high-intensity exercise, with supraglottic closure being most common. This study develops a model based on the computational fluid dynamics to investigate airflow velocity and pressure and the air-induced loads on the supraglottis at various inspiratory flow rates. It is found that at high flow rates, positive wall pressure is formed in the hypopharynx localise towards its lower region, while posterior supraglottic wall pressures shift from positive to negative. These findings suggest that high inspiratory flow rates may increase supraglottic pressure differentials, ultimately contributing in the collapse.

Effects of airway deformation and alveolar pores on particle deposition in the lungs

The distal lung (G14-G23), which are composed of alveoli and bronchi, are responsible for almost all gas exchange and micro- and nanoparticle deposition in the lungs. In the existing research using computational fluid dynamics, the geometric modeling accuracy of the bronchial bifurcation structure is given priority, and then the alveoli are attached to bronchi as discrete spherical crowns. This method ignores the correlation between alveoli. In fact, the alveoli have a tessellated distribution, and adjacent alveoli are connected by several alveolar pores. Due to the huge number of alveoli, this seemingly small difference will be greatly amplified, which may lead to a large deviation in the prediction of the overall flow. Accordingly, the objective of this study is to construct a two-dimensional distal lung model including the bronchi, acini, and alveolar pores by using the methods of regular hexagonal tessellational subdivision, fusion, and coordinate transformation. A moving boundary is introduced to simulate the process of airflow and particle deposition in the distal lung, and the effects of bronchial deformation, respiratory frequency, and alveolar pores are obtained. The results show that there are significant differences in intrapulmonary flow patterns with and without alveolar pores. Alveolar pores can establish bypass ventilation downstream of a blockage, thus providing a pathway for particles to enter the airways downstream of the blockage. Changing the respiratory frequency and the amplitude of bronchial deformation will change the relative velocity between particles and moving wall, which, in turn, will change the particle deposition efficiency in the distal lung. To summarize this study, a geometric modeling method for the distal lung with alveolar pores is established, and the important roles of detailed characteristics of the distal lung are revealed. The findings of this study provide a reasonable hydrodynamic mechanism for the prevention of related respiratory diseases.

Effects of face shield on an emitter during a cough process: A large-eddy simulation study

Face shield is a common personal protection equipment for pandemic. In the present work, three-dimensional computational fluid dynamic (CFD) method is used to simulate a cough jet from an emitter who wears a face shield. A realistic manikin model with a simplified mouth cavity is employed. A large eddy simulation with a dynamic structure subgrid scale model is applied to model the turbulence. An Eulerian-Lagrangian approach is adopted to model the two-phase flows, with which the droplets are represented by a cloud of particles. The droplet breakup, evaporation, dispersion, drag force, and wall impingement are considered in this model. An inlet velocity profile that is based on a variable mouth opening area is considered. Special attentions have been put the vortex structure and droplet re-distribution induced by the face shield. It is found that the multiple vortices are formed when the cough jet impinges on the face shield. Some droplets move backward and others move downward after the impinging. It is also found that a small modification of the face shield significantly modifies the flow field and droplet distribution. We conclude that face shield significantly reduces the risk factor in the front of the emitter, meanwhile the risk factor in the back of the emitter increases. When the receiver standing in front of the emitter is shorter than the emitter, the risk is still very high. More attentions should be paid on the design of the face field, clothes cleaning and floor cleaning of the emitters with face shields. Based on the predicted droplet trajectory, a conceptual model for droplet flux is proposed for the scenario with the face shield.

LES study on the impact of airway deformation on the airflow structures in the idealized mouth–throat model

To investigate the impacts of upper airway deformation on the airflow structures, the airflow fields in the trachea are simulated using three geometrical models considering three different levels of airway deformations. Structured grids are used to create the high-quality grids. Large eddy simulation with the Smagorinsky sub-grid model is adopted to solve the three-dimensional in-compressible Navier–Stokes equations using the solver pisoFoam in the open-source CFD software OpenFOAM. The numerical results demonstrate that the airway deformation influences the main airflow structures depending on the deformation level. Particularly, it slightly impacts on the laryngeal jet such as the profile and the strength of laryngeal jet. The strength of the laryngeal jet increases slightly for the heavy deformation. In contrast, it impacts on the recirculation zone, secondary vortices, and turbulent kinetic energy more obviously. The increasing airway deformation will produce stronger secondary flow, smaller recirculation zone, and weaker turbulent kinetic energy. The turbulence intensity distribution varies as well. The obviously impacted flow region is mainly within the region of one to six tracheal diameters downstream the glottis.

Role of CFD based in silico modelling in establishing an in vitro-in vivo correlation of aerosol deposition in the respiratory tract

Effective evaluation and prediction of aerosol transport deposition in the human respiratory tracts are critical to aerosol drug delivery and evaluation of inhalation products. Establishment of an in vitro-in vivo correlation (IVIVC) requires the understanding of flow and aerosol behaviour and underlying mechanisms at the microscopic scale. The achievement of the aim can be facilitated via computational fluid dynamics (CFD) based in silico modelling which treats the aerosol delivery as a two-phase flow. CFD modelling research, in particular coupling with discrete phase model (DPM) and discrete element method (DEM) approaches, has been rapidly developed in the past two decades. This paper reviews the recent development in this area. The paper covers the following aspects: geometric models of the respiratory tract, CFD turbulence models for gas phase and its coupling with DPM/DEM for aerosols, and CFD investigation of the effects of key factors associated with geometric variations, flow and powder characteristics. The review showed that in silico study based on CFD models can effectively evaluate and predict aerosol deposition pattern in human respiratory tracts. The review concludes with recommendations on future research to improve in silico prediction to achieve better IVIVC.

Studying airflow structures in periodic cylindrical hills of human tracheal cartilaginous rings

The objective of this study is to assess tracheobronchial flow features with the cartilaginous rings during a light exercising. Tracheobronchial is part of human's body airway system that carries oxygen-rich air to human's lungs as well as takes carbon dioxide out of the human's lungs. Consequently, evaluation of the flow structures in tracheobronchial is important to support diagnosis of tracheal disorders. Computational Fluid Dynamics (CFD) allows evaluating effectiveness of tracheal cartilage rings in human body under different configurations. This study utilizes Large Eddy Simulation (LES) to model an anatomically-based human large conducting airway model with and without cartilaginous rings at the breathing conditions at Reynolds number of 5,176 in trachea region. It is observed that small recirculating areas shaped between rings cavities. While these recirculating areas are decaying, similar to periodic 2D-hills, the cartilaginous rings contribute to the construction of a vortical flow structure in the main flow. The separated vortically-shaped zone creates a wake in the flow and passes inside of the next ring cavity and disturb its boundary layer. At last, the small recirculation flow impinges onto tracheal wall. The outcome of this impinge flow is a latitudinal rotating flow perpendicular to the main flow in a cavity between the two cartilaginous rings crest which appear and disappear within a hundredth of a second. Kelvin-Helmholtz instability is observed in trachea caused by shear flow created behind of interaction between these flow structures near to tracheal wavy wall and main flow. A comparison of the results between a smooth wall model named simplified model and a rough wall model named modified model shows that these structures do not exist in simplified model, which is common in modeling tracheobronchial flow. This study proposes to consider macro surface roughness to account for the separating and rotating instantaneous flow structures. Finally, solving trachea airflow with its cartilages can become one of major issues in measuring the validity and capability of solving flow in developing types of sub-grid scale models as a turbulence studies benchmark.

Health effects of physical activity as predicted by particle deposition in the human respiratory tract

Although health benefits of physical activity are well known, the risk of physical activity in polluted air is unclear. Our objective is to investigate health effects resulting from physical activity in polluted air by looking at particle deposition in human tracheobronchial (TB) airways. Airflow and particle deposition in TB airways were investigated using a computational fluid dynamics (CFD) method. We chose three regional airways: upper (G3-G5), central (G9-G11) and lower (G14-G16). Physical activity was described by breathing rate at the mouth, for three levels of activity: sedentary (15 l/min), moderate (30 l/min) and intense (60 l/min). We found that particle deposition was strongly affected by physical activity. Particles are deposited in greater number in the lower airways (G14-G16) during sedentary activity, more in the upper airways (G3-G5) during intense activity, and uniformly in the airways during moderate activity. The difference in the deposition pattern was due to the reason that physical activity increased the airflow which increased inertial impaction. Our modeling of particle deposition in the human respiratory airways shows that there are different health effects for different activity levels: sedentary activity leads to chronic health effects, intense activity results in acute effects, and moderate activity minimizes the adverse health effects of physical activity in polluted air.

Analysis of the volume of fluid (VOF) method for the simulation of the mucus clearance process with CFD

The clearance of mucus through coughing is a complex, multiphase process, which is affected principally by mucus viscosity and airflow velocity; however, it is also critically affected by the thickness of the two layers of mucus-the serous and gel layers-and oscillation level. The present study examines the effects of the latter parameters more closely. To do so, the mucus clearance process is simulated with a transient 3D volume of fluid (VOF) multiphase model in ANSYS Fluent. The model includes mucus' bilayer properties and a wide range of boundary conditions were tested. The model was analysed in both a straight tube and a realistic trachea. Ultimately, the model was able to both capture air-mucus interface wave evolution and predict the overall behaviour of the clearance process. The results were consistent with experimental clearance data and numerical airflow simulations, which indicates our methodology is appropriate for future studies. Ultimately, the mere presence of the serous layer was found to increase mucus clearance by more than 15 percent. An oscillating flow enhanced clearance by up to 5 percent. Interestingly, interface wave steepness was found to be inversely correlated with mucus thickness, but directly with mucus velocity, which suggests it will be an interesting parameter for further study.