Annals of Biomedical Engineering, Vol. 9, pp 393-394, 1981 0090-6964181/050393-02 $02.00/0 Printed in the USA. All rights reserved. Copyright �9 1982 Pergamon Press Ltd.

ENGINEERS AND THE RESPIRATORY SYSTEM: A PERSPECTIVE

Frank P. Primiano, Jr. Gerald M. Saidel

Department of Pediatrics and

Department of Biomedical Engineering Case Western Reserve University

and Rainbow Babies and Childrens Hospital

Cleveland, Ohio

The respiratory system has so many diverse aspects that its function can be studied with the tools of almost any of the engineering disciplines. These tools include mathematical modeling, data analysis techniques, instrumenta- tion, and methods of hardware and software design. Thus, engineers can contribute not only to the understanding of basic respiratory processes, but also to the delivery of health care. Too often, however, they are familiar with only a very specialized area, which may limit the scope of their activi- ties or cause a misdirection of effort. In contrast, medical scientists usually have a broad understanding of the physiological system and knowledge of practical problems associated with clinical applications. Thus, the activities of engineers and medical scientists are complementary and can lead to fruit- ful collaborations. However, more often than not, the medical scientist takes responsibility for defining problems and setting goals, even though, in many areas of respiratory research, engineers can, and should, play the leading role. But to be able to assume this role, the engineer must be as familiar with the respiratory system as with theoretical principles, experi- mental approaches, and advanced technology.

Investigators trained in engineering and the physical sciences who at tempt to understand respiratory system function are confronted by a major ob- stacle: translating the verbal explanations of complicated phenomena, so prevalent in the life science literature, into more precise mathematical descriptions of the type with which they are familiar. A lack of a rigorous formal framework for the ideas of mechanics, mass transport, control and

Address correspondence to Frank P. Primiano, Jr., Rainbow Babies and Childrens Hospital, 2101 Adelbert Road, Cleveland, Ohio 44106.

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394 Frank P. P~qmiano, Jr. and Gerald M. Saidel

clinical decision making has been and continues to be tolerated in the body of respiratory knowledge. For example, descriptions of respiratory mechani- cal behavior based on electrical analogs as "first principles" have spawned a subculture of mechanics which has evolved as the backbone of respiratory mechanics. Unfortunately, this can lead to superficial understanding and frequent misinterpretations by life scientists and to frustration and lack of enthusiasm by physical scientists who expect explanations consistent with physical principles in scientific literature.

Because of its capability to perform numerical simulations, the ubiquitous laboratory computer has eliminated the requirement that, to be useful, a mathematical model must yield analytical solutions. Furthermore, by supporting sophisticated experiments and measurements, computers can provide quantitative foundations for theories of respiratory phenomena. In these ways, computers are tying progress in pulmonary medicine to the development of mathematical models of physiological processes. Conse- quently, to prevent the need for explicit expressions of abstract concepts from developing into a significant impediment to major advances, the expertise of the engineer is essential both in the research laboratory and the clinical setting.

A symposium on the subject of the analyses of respiratory function and applications was held in conjunction with the 34th Annual Conference on Engineering in Medicine and Biology in September, 1981. Invited papers from that symposium are published in this issue and provide critical reviews of many areas of respiratory research that involve engineering methodology. The lung is viewed at the organ-system level with emphasis on ventilation, gas exchange and control as well as on pulmonary function testing, medical decision making and respiratory assistance. General topics addressed include current theoretical concepts and experimental techniques, questions which are presently of importance and approaches which may be taken to answer these questions. We believe that these articles can be read with understanding by nonspecialists and provide a breadth of information not readily found elsewhere.