MEGA: a computational framework to simulate the acute respiratory distress syndrome.

Summary

MEGA couples physiology and lung mechanics using patient CT data to simulate ARDS responses to prone positioning and PEEP changes. Outputs qualitatively matched literature and bedside measures but required calibration for quantitative accuracy.

Key Findings

• Developed a CT-based coupled physiomechanical ARDS simulation framework (MEGA).
• Simulated responses to prone positioning and PEEP increments with qualitative agreement to clinical/literature data.
• Observed quantitative discrepancies highlighting the need for model calibration before clinical deployment.

Clinical Implications

If calibrated and prospectively validated, such simulations could inform PEEP titration and proning decisions for individual patients, potentially reducing ventilator-induced lung injury.

Limitations

• Quantitative mismatches indicate under-calibration and lack of external validation
• Proof-of-concept without prospective clinical integration or outcome testing

Future Directions

Perform rigorous calibration with multicenter datasets, incorporate patient-specific recruitability and perfusion, and prospectively test decision-support integration.