Kronik Obstrüktif Akciğer Hastaları ile Sağlıklı Bireylerin Solunum İş Yükünün Termodinamik Analizi

Öz

Kronik Obstrüktif Akciğer Hastalığı (KOAH) sigara dumanı ve diğer zararlı partiküller nedeniyle akciğer enflamasyonu ve hava yolu limitasyonu ile karakterize bir hastalıktır. Dünya Sağlık Örgütü (DSÖ), yüksek morbidite ve mortaliteye sahip KOAH nedenli ölümlerin 2030 yılında üçüncü sırada olacağını öngörmektedir. Havayolu limitasyonu ve respiratuvar kasların yapısal ve fonksiyonel olarak değişmesi solunum kas kuvvetinde azalmaya neden olarak solunum iş yükünü arttırır. Respiratuvar kasların termodinamik analizi ile, iş veriminin azalmasına yol açan enerji kayıplarının ölçülmesi (entropi) ve maksimum yararlı işin (ekserji) yıkımı hesaplanabilmektedir. Bu çalışmada, KOAH hastaları ile sağlıklı bireylerin solunum kas işlerinin termodinamik analizle karşılaştırılması amaçlanmıştır. Respiratuvar kasların yaptığı işe termodinamiğin birinci ve ikinci kanunları uygulanmıştır. KOAH’ lı hastaların ve sağlıklı bireylerin respiratuvar kasları etrafında termodinamik analizler kütle, enerji, ekserji ve entropi balansları uygulanarak yapılmıştır. KOAH’lı hastalar ile sağlıklı bireylerin solunum iş yükünün termodinamik analizi sonucunda ekserji yıkımı sırasıyla 1.23x10^-2 kJ/min ile 6.01x10^-3 kJ/min olarak hesaplanmıştır. Entropi üretimi ise KOAH’lı bireylerde 4.12x10^-5 (kJ/K)/min iken sağlıklı bireylerde 2.02x10^-5 (kJ/K)/min olduğu görülmüştür. Enerji dengesi analizi sonuçlarına göre solunum işi için harcanan glikoz miktarları KOAH’lı ve sağlıklı bireyler için sırasıyla 0.32-0.16 mmol/min olarak hesaplanmıştır. Bu termodinamik analiz ile, KOAH hastası bireylerde respiratuvar kasların yaptığı iş yükünün artmasıyla ekserji yıkımı ve entropi üretiminin arttığı belirlenmiştir. Enerji dengesi analizlerinin sonuçlarına bakıldığında, solunum işi için KOAH hastası bir bireyin, sağlıklı bireye göre 2 kat daha fazla glikoz kullandığı görülmüştür. KOAH hastalarında entropi üretimi ve ekserji yıkımı sağlıklı bireylere göre yüksek olduğundan, bu hastalarda entropi artışının dokulardaki hasarla sonuçlanacağı ve sağlıklı yaşlanma üzerinde olumsuz etkileri olacağı düşünülmektedir.

Anahtar Kelimeler

• Gıda-Solunum Enerji Dönüşümü,Solunum Termodinamiği,Solunum Ekserji Yıkımı,Solunum Entropi Üretimi,Solunum İş Yükü Termodinamik Analizi,Kronik Obsrüktif Akciğer Hastalığı Termodinamik Analizi,KOAH

Thermodynamic Analysis of Work of Breathing of Healthy Individuals and Patients with Chronic Obstructive Pulmonary Disease

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a disease characterized by lung inflammation and airway limitation due to cigarette smoke and other harmful particles. World Health Organization (WHO) predicts that COPD with high morbidity and mortality will become the third leading cause of death worldwide by 2030. Airway limitation and structural and functional changes of respiratory muscles decrease respiratory muscle strength and increase work of breathing. By the thermodynamic analysis of the respiratory muscles, the measurement of energy losses (entropy) and the destruction of the maximum useful work (exergy) can be calculated. The aim of this study was to compare the work of respiratory muscles of patients with COPD and healthy individuals by thermodynamic analysis. Thermodynamic analyses were performed by applying the first and second laws of thermodynamics to the work done by respiratory muscles. Thermodynamic analyses of respiratory muscles of COPD patients and healthy individuals were performed by mass, energy, exergy and entropy balances. As a result of the thermodynamic analysis of the work of breathing of COPD patients and healthy subjects, exergy destruction was calculated as 1.23x10-2 kJ/min and 6.01x10-3 kJ/min respectively. Entropy generation was 4.12x10-5 (kJ/K)/min in individuals with COPD while 2.02x10-5 (kJ/K)/min in healthy individuals. According to the results of energy balance analysis, the amount of glucose consumed for work of breathing was calculated as 0.32-0.16 mmol/min for COPD and healthy subjects, respectively. With this thermodynamic analysis, it was determined that the exergy destruction and entropy generation increased with the increase of work of breathing in patients with COPD.

Keywords

• Food-respiration energy conversion,respiratory thermodynamics,respiratory exergy destruction,espiratory entropy generation,respiratory work of breathing thermodynamic analysis,Chronic Obstructive Pulmonary Disease thermodynamic analysis,COPD

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