Computational fluid dynamics of small airway disease in chronic obstructive pulmonary disease

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Small airways (<2mm) are major sites of airflow obstruction in chronic obstructive pulmonary disease (COPD). This study aimed to quantify small airway disease impact (narrowing, occlusion, obliteration) on airflow parameters in smokers and end-stage COPD patients. Computational fluid dynamics (CFD) simulations of inspiratory airflow were performed in 3 lung groups: control non-used donor lungs (no smoking/emphysema), non-used donor lungs with smoking history and emphysema, and explanted end-stage COPD lungs. Each group included 4 lungs with 2 tissue cylinders. μCT-scanned airways were segmented into 3D models for CFD simulations to quantify pressure, resistance, and shear stress, benchmarked against simplified linear and Weibel models. CFD showed higher pressures in COPD vs. controls (p=0.0091) and smokers (p=0.015) (1.a), increased resistance (p=0.0057 vs. controls; p=0.0083 vs. smokers) (1.b) and 10-fold higher shear stress (p=0.010 vs. controls) (1.c). Narrowing and occlusion independently increased these parameters, validated through segmentation corrections. 3D models showed up to 7-fold higher pressure/resistance vs. simplified models for smokers and 72-fold for COPD (1.d) These findings show that increased airflow parameters can explain the association between small airway disease and airflow limitation in COPD. Also, they highlight limitations of theoretical models in accurately capturing small airway disease. erj;66/suppl_69/OA5484/F1 F1 F1

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