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This paper proposes a mathematical multiscale model for the mechanical ventilation of a network of occluded airways, where air is forced into the network at a fixed tidal volume, allowing investigation of optimal recruitment strategies. The temporal response is derived from mechanistic models of individual airway reopening, incorporating feedback on the airway pressure due to recruitment. The model accounts for stochastic variability in airway diameter and stiffness across and between generations. For weak heterogeneity, the network is completely ventilated via one or more avalanches of recruitment (with airways recruited in quick succession), each characterized by a transient decrease in the airway pressure; avalanches become more erratic for airways that are initially more flooded. However, the time taken for complete ventilation of the network increases significantly as the network becomes more heterogeneous, leading to increased stresses on airway walls. The model predicts that the most peripheral airways are most at risk of ventilation-induced damage. A positive-end-expiratory pressure reduces the total recruitment time but at the cost of larger stresses exerted on airway walls.<\/jats:p>","DOI":"10.1098\/rsif.2015.0523","type":"journal-article","created":{"date-parts":[[2015,9,30]],"date-time":"2015-09-30T17:49:13Z","timestamp":1443635353000},"page":"20150523","update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Patterns of recruitment and injury in a heterogeneous airway network model"],"prefix":"10.1098","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0971-8057","authenticated-orcid":false,"given":"Peter S.","family":"Stewart","sequence":"first","affiliation":[{"name":"School of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0172-6578","authenticated-orcid":false,"given":"Oliver E.","family":"Jensen","sequence":"additional","affiliation":[{"name":"School of Mathematics, University of Manchester, Manchester, M13 9PL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"175","published-online":{"date-parts":[[2015,10,6]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0034-5687(89)90059-5"},{"key":"e_1_3_6_3_2","article-title":"National vital statistics reports","volume":"61","author":"Murphy SL","year":"2013","journal-title":"Nat. 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