inst/doc/NeonatalVentilation.R

In physiology: Calculate physiologic characteristics of awake and anesthetized adults, children and infants

## ----setup, include=FALSE------------------------------------------------
knitr::opts_chunk$set(echo = TRUE)

## ----calc, echo = T, warn = FALSE, message = FALSE-----------------------
library(physiology)
library(childsds)
library(dplyr)
library(magrittr)
# units of ml per cmH20
min_compliance <- 0.5
max_compliance <- 1.5
# unit cmH20
driving_pressure <- 15
insp_tube_vol_diff <- driving_pressure * (max_compliance - min_compliance)

## ----getmedianweights, message = FALSE-----------------------------------
dat <- as_tibble(
  childsds::make_percentile_tab(
    childsds::who.ref, 
    item = "weight",
    perc = 50,
    stack = TRUE, 
    sex = "sex"))
dat <- dplyr::filter(dat, sex == "female", age <= 1) %>%
  dplyr::rename(weight = value) %>% 
  dplyr::select(age, weight)

## ----deadspacecalc-------------------------------------------------------
dat <- dat %>%
  mutate(tidal_volume = 7 * weight) %>% 
  mutate(error_fraction = insp_tube_vol_diff / tidal_volume)

plot(dat[c("weight", "error_fraction")], 
     type = "l",
     xlab = "Weight, kg",
     ylab = "Error in tidal volume delivery as fraction of delivered")

## ----cleft---------------------------------------------------------------
cleft_repair_deadspace <- 
  deadspace_equipment_ml(humidifier = "infant",
                         elbow = FALSE, 
                         flexible = "extended")
cleft_repair_deadspace2 <- 
  deadspace_equipment_ml(humidifier = "infant",
                         elbow = FALSE, 
                         flexible = "none")

## ----plotclefterr--------------------------------------------------------
dat$equip_err_frac <- cleft_repair_deadspace / dat$tidal_volume
dat$equip_err_frac2 <- cleft_repair_deadspace2 / dat$tidal_volume
dat$months <- dat$age * 12
plot(dat$months, dat$equip_err_frac, 
     axes = FALSE,
     type = "l",
     ylim = c(0, 2),
     main = "Effect of optional equipment deadspace in infants",
     sub = "Age, months (top axis), Weight, kg (bottom axis)",
     xlab = "",
     ylab = "Equipment deadspace as fraction of expected tidal volume")
axis(2, seq(0, 2, 0.5))
axis(1, at = 0:12, line = 0)
lines(dat$months, dat$equip_err_frac2, lty = 2)
wts <- seq(floor(min(dat$weight)), ceiling(max(dat$weight)))
points(dat$months, rep_len(0, length(dat$months)), type = "n")
axis(1, at = seq(0, 12, 12/6), labels = wts, line = 2)
legend("topright", c("typical", "better"), lty = c(1, 2))