The dynamics of unsteady flow in the human large airways during a rapid inhalation were investigated using highly detailed large-scale computational fluid dynamics on a subject-specific geometry. The simulations were performed to resolve all the spatial and temporal scales of the flow, thanks to the use of massive computational resources. A highly parallel finite element code was used, running on two supercomputers, solving the transient incompressible Navier-Stokes equations on unstructured meshes. Given that the finest mesh contained 350 million elements, the study sets a precedent for large-scale simulations of the respiratory system, proposing an analysis strategy for mean flow, fluctuations and wall shear stresses on a rapid and short inhalation (a so-called sniff). The geometry used encompasses the exterior face and the airways from the nasal cavity, through the trachea and up to the third lung bifurcation; it was derived from a contrast-enhanced computed tomography (CT) scan of a 48-year-old male. The transient inflow produces complex flows over a wide range of Reynolds numbers (Re). Thanks to the high fidelity simulations, many features involving the flow transition were observed, with the level of turbulence clearly higher in the throat than in the nose. Spectral analysis revealed turbulent characteristics persisting downstream of the glottis, and were captured even with a medium mesh resolution. However a fine mesh resolution was found necessary in the nasal cavity to observe transitional features. This work indicates the potential of large-scale simulations to further understanding of airway physiological mechanics, which is essential to guide clinical diagnosis; better understanding of the flow also has implications for the design of interventions such as aerosol drug delivery.

Current approaches to model nasal airflow are reviewed in this study, and new findings presented. These new results make use of improvements to computational and experimental techniques and resources, which now allow key dynamical features to be investigated, and offer rational procedures to relate variations in anatomical form. Specifically, both replica and simplified airways of a single subject were investigated and compared with the replica airways of two other individuals with overtly differing geometries. Procedures to characterize and compare complex nasal airway geometry are first outlined. It is then shown that coupled computational and experimental studies, capable of obtaining highly resolved data, reveal internal flow structures in both intrinsically steady and unsteady situations. The results presented demonstrate that the intimate relation between nasal form and flow can be explored in greater detail than hitherto possible. By outlining means to compare complex airway geometries and demonstrating the effects of rational geometric simplification on the flow structure, this work offers a fresh approach to studies of how natural conduits guide and control flow. The concepts and tools address issues that are thus generic to flow studies in other physiological systems.

The wall shear stress (WSS) vector field provides a signature for near-wall convective transport, and can be scaled to obtain a first-order approximation of the near-wall fluid velocity. The near-wall flow field governs mass transfer problems in convection-dominated open flows with high Schmidt number, in which case a flux at the wall will lead to a thin concentration boundary layer. Such near-wall transport is of particular interest in cardiovascular flows whereby haemodynamics can initiate and progress biological events at the vessel wall. In this study we consider mass transfer processes in pulsatile blood flow of abdominal aortic aneurysms resulting from complex WSS patterns. Specifically, the Lagrangian surface transport of a species released at the vessel wall was advected in forward and backward time based on the near-wall velocity field. Exposure time and residence time measures were defined to quantify accumulation of trajectories, as well as the time required to escape the near-wall domain. The effect of diffusion and normal velocity was investigated. The trajectories induced by the WSS vector field were observed to form attracting and repelling coherent structures that delineated species distribution inside the boundary layer consistent with exposure and residence time measures. The results indicate that Lagrangian WSS structures can provide a template for near-wall transport.

Newtonian and generalized Newtonian mathematical models for blood flow are compared in two different reconstructions of an anatomically realistic geometry of a saccular aneurysm, obtained from rotational CTA and differing to within image resolution. The sensitivity of the flow field is sought with respect to geometry reconstruction procedure and mathematical model choice in numerical simulations. Taking as example a patient specific intracranial aneurysm located on an outer bend under steady state simulations, it is found that the sensitivity to geometry variability is greater, but comparable, to the one of the rheological model. These sensitivities are not quantifiable a priori. The flow field exhibits a wide range of shear stresses and slow recirculation regions that emphasize the need for careful choice of constitutive models for the blood. On the other hand, the complex geometrical shape of the vessels is found to be sensitive to small scale perturbations within medical imaging resolution. The sensitivity to mathematical modeling and geometry definition are important when performing numerical simulations from in vivo data, and should be taken into account when discussing patient specific studies since differences in wall shear stress range from 3% to 18%.

During a rapid inhalation, such as a sniff, the flow in the airways accelerates and decays quickly. The consequences for flow development and convective transport of an inhaled gas were investigated in a subject geometry extending from the nose to the bronchi. The progress of flow transition and the advance of an inhaled non-absorbed gas were determined using highly resolved simulations of a sniff 0.5 s long, 1 l s ⁻¹ peak flow, 364 ml inhaled volume. In the nose, the distribution of airflow evolved through three phases: (i) an initial transient of about 50 ms, roughly the filling time for a nasal volume, (ii) quasi-equilibrium over the majority of the inhalation, and (iii) a terminating phase. Flow transition commenced in the supraglottic region within 20 ms, resulting in large-amplitude fluctuations persisting throughout the inhalation; in the nose, fluctuations that arose nearer peak flow were of much reduced intensity and diminished in the flow decay phase. Measures of gas concentration showed non-uniform build-up and wash-out of the inhaled gas in the nose. At the carina, the form of the temporal concentration profile reflected both shear dispersion and airway filling defects owing to recirculation regions.