A patient-specific non-uniform pressure outlet boundary condition was developed and used in unsteady simulations of cyclic breathing in a large-scale model of the lung airway from the oronasal opening to the terminal bronchioles. The computational domain is a reduced-geometry model, in which some airway branches in each generation were truncated, and only selected paths were retained to the terminal generation. To characterize pressure change through airway tree extending from the truncated outlets to pulmonary zone, virtual airways represented by extended volume mesh zones were constructed in order to apply a zero-dimensional airway resistance model. The airway resistances were prescribed based on a precursor steady simulation under constant ventilation condition. The virtual airways accommodate the use of patient-specific alveolar pressure conditions. Furthermore, the time-dependent alveolar pressure profile was composed with the physiologically accurate pleural pressure predicted by the whole-body simulation software HumMod, and the transpulmonary pressure evaluated based on lung compliance and local air volume change. To investigate airway flow patterns of healthy and diseased lungs, unsteady breathing simulations were conducted with varying lung compliances accounting for healthy lungs, and lungs with emphysema or interstitial fibrosis. Results show that the simulations using this patient-specific pressure boundary condition are capable of reproducing physiologically realistic flow patterns corresponding to abnormal pulmonary compliance in diseased lungs, such as the hyperventilation in lungs with emphysema, and the demand of more mechanic work for breathing in lungs with fibrosis.

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