JPH03261482A - Monitor in high-frequency artificial respiration device - Google Patents

Abstract

PURPOSE:To constitute the device so that so state of the lungs in the course of high-frequency artificial respiration can be observed easily by providing an acceleration sensor attached to a position corresponding to the lungs on the body surface of a patient, and a display means for displaying the information obtained in accordance with an output from the acceleration sensor. CONSTITUTION:An acceleration sensor 82 is attached to the body surface of a position corresponding to the lungs of a patient 81. Output information from the acceleration sensor 82 passes through a processor 83, and is displayed on a display device 84. The display device 84 utilizes a cathode ray tube and has a first - a third display parts 84a-84c, and each signal inputted to each display part 84a-84c is inputted to a printer 85, and this printer 85 uses the time as a parameter, and records the contents corresponding to each display part 84a-84c. By using the acceleration sensor 82 so as to be dispersed and placed widely in accordance with the lungs of the patient 81, a state of the lungs at the time of executing high-frequency artificial respiration can be displayed by an image, while displaying the lungs, for instance, solidly.

Description

DETAILED DESCRIPTION OF THE INVENTION (Field of Industrial Application) The present invention relates to a monitoring device for a high frequency ventilator.

(Prior Art) In general, a ventilator has a breathing cycle similar to that of a healthy person, that is, about 15 to 20 breaths per minute.

On the other hand, recently, clinically, the respiratory cycle has been
It has now been demonstrated that high frequencies such as 30H2, or about 10 to 30 times per second, are extremely effective for treating certain types of lung diseases. This kind of high-frequency respirator is particularly effective because the gas in the breathing path connected to the patient's mouth is vibrated at high frequencies, increasing the gas diffusion effect and thereby increasing gas exchange with the patient's lungs. It is believed that this is because it is carried out.

In order to obtain such a fast breathing cycle, a breathing vibration generator for a ventilator has been developed and has already been put into practical use by the applicant.

(Problems to be Solved by the Invention) One problem with high-frequency ventilators is that it is difficult to easily determine from the outside whether artificial respiration is being performed normally for the patient. .

To explain this point in detail, in a general ventilator that allows the patient to breathe at the same breathing rate as a normal person, the patient's lungs expand and contract significantly as they breathe, so the lungs expand and contract due to this. The movement can be easily observed from the outside.

On the other hand, in high-frequency ventilators, the lungs themselves hardly make any movements such as expansion or contraction, so simply observing the movement of the lungs from the outside cannot tell whether artificial respiration is being performed normally for the patient. becomes difficult to judge immediately. Of course, pressure sensors, etc. are connected to the breathing path connected to the patient's mouth to manage artificial respiration, but this is only at the mouth stage, and the lungs themselves, which are connected to the back of the mouth, are observed. It's not a thing. In particular, if the patient turns over slightly, the so-called endotracheal tube that connects the breathing path of the ventilator and the lungs may become twisted, resulting in insufficient communication between the breathing path and the lungs. Become.

The present invention was made in consideration of the above circumstances, and
It is an object of the present invention to provide a monitoring device for a high-frequency ventilator that allows easy observation of the state of the lungs during high-frequency ventilation.

(Structure and operation of the invention) In order to achieve the above object, the present invention has the following structure. That is, a high-frequency ventilator that applies high-frequency exhalation vibrations to a patient includes an acceleration sensor attached to a position corresponding to the lungs on the patient's body surface, and information obtained according to the output from the acceleration sensor. and display means for displaying.

This is a configuration with the following.

In the present invention configured in this manner, the movement of the patient's lungs can be easily determined by viewing the display device that displays information based on the output of the acceleration sensor. That is,
Even if it is not possible to observe the movement of the lungs from outside the patient, the movement of the lungs can be determined by easily detecting this acceleration since the lungs are subject to high-frequency vibrations and therefore have large accelerations. . When the output of the acceleration sensor disappears, it is immediately determined that high-frequency artificial respiration is not being performed normally. If an abnormality is determined, it is possible to automatically activate an alarm or automatically stop a driving source that is a high frequency generation source of high frequency artificial respiration.

If you only want to know whether high-frequency artificial respiration is being performed normally, it is sufficient to display the output from the acceleration sensor as is on the display device, but the output from this sensor can be processed in various ways and displayed. By doing this, various movements of the lungs can be known. For example, by integrating the output from the acceleration sensor, the velocity of the lungs can be determined, and by further integrating the output, the position (amplitude) of the lungs can also be determined.

In particular, high-frequency artificial respiration has only just been developed and there are many unknowns, so based on the data obtained above, it will be possible to more optimally set the frequency, respiratory volume, etc. Become.

Of course, the number of acceleration sensors is not limited to one, and a plurality of acceleration sensors can be provided in a distributed manner, so that the state of each part of the lungs during high-frequency artificial respiration can be analyzed in more detail.

(Effects of the Invention) As described above, the present invention makes it possible to know the actual movement of the lungs when performing high-frequency artificial respiration, making it more preferable for performing high-frequency artificial respiration. .

(Example) Examples of the present invention will be described below based on the attached drawings. Note that an example of a monitoring device according to the present invention will be explained first, and then an example of high-frequency artificial respiration will be explained.

In FIG. 1O, 81 is a patient and 82 is an acceleration sensor. This acceleration sensor 82 is attached to the body surface of the patient 81 at a position corresponding to the lungs using a double-sided tube or an elastic band that covers the patient's chest.

As this acceleration sensor 82, for example, the American ICS
rMODEL 3031J manufactured by ENSORS can be used. This product is of the piezoresistance type and is extremely small and lightweight, with a thickness of several mm and less than 1 cm in each length and width. Outputs a proportional voltage.

The output information from the acceleration sensor 82 is processed by a processing device 83.
The image is then displayed on the 5 display device 84. In the embodiment, the display device 84 includes first to third display sections 84a to 84c using cathode ray tubes.

On the other hand, the processing device 83 includes a first integrator 83a and a second integrator 83b. The output from the acceleration sensor 82 that is input to the processing device 83 is input and displayed as is on the first display section 84a (acceleration display). The signal from the acceleration sensor 82 is integrated by the first integrator 83a, and the signal after this integration is input and displayed on the second display section 84b (speed display). The signal subjected to integration processing by the first integrator 83a is subjected to integration processing by the second second integrator 83b, and the signal after this integration processing is displayed on the third display section 84c (
position = amplitude display).

Each signal manually input to each of the display sections 84a to 84c is input to a printer 85, and this printer 85 records the contents corresponding to each of the display sections 848 to 84c using time as a parameter. This recording will be used for analysis after high-frequency ventilation is completed. Of course, printer 85
The content to be recorded on the storage medium is stored in the storage medium,
It can also be supplied later for analysis using a computer. In this case, by distributing the acceleration sensors 82 widely in correspondence with the lungs of the patient 81 and using them in the same manner as described above, the lungs can be displayed three-dimensionally while performing high-frequency artificial respiration. It becomes possible to display the state of the lungs as an image.

Next, the entire high-frequency artificial respiration will be explained with reference to FIGS. 1 to 9.

In FIG. 1, a respiratory system path A of a ventilator includes a common circuit 1, an inspiratory circuit 2, and an expiratory circuit 3.

One end of the common circuit 1 is airtightly connected to the patient's mouth, and an inhalation circuit 2 and an exhalation circuit 3 are connected to the other end of the common circuit 1. The intake circuit 2 is connected to an air tank 4 storing clean air to be supplied to the patient, and a known air flow meter 5 and a humidifier 6 are connected to the air tank 4 along the way. The exhalation circuit 3 is open to the atmosphere, and the degree of opening is adjusted by an electromagnetic opening adjustment valve 7.

A high frequency respiratory vibration generator B is connected to the respiratory system path A. Basically, the high frequency respiratory vibration generator B is as follows:
It includes a blower 11 as a pressure generation source and a rotary type switching valve 12. The positive pressure generated at the discharge port 11a of the blower 11 and the positive pressure generated at the suction port 11b are alternately applied to the vibration circuit 13 by the switching valve 12. This vibration circuit 13 includes each of the circuits 1 and 2.
．． 3 is connected to the respiratory system path A near each connection part of the vibration circuit 13, whereby the respiratory system path A, that is, the patient's lungs H, is forced to breathe at a breathing rate corresponding to the frequency of vibration in the vibration circuit 13. . In FIG. 1, 14 is a motor for driving the blower 11, and 15 is a motor for driving the switching valve 12.

The switching valve 12 is configured as shown in FIGS. 2 to 4, for example. First, the case 21 of the switching valve 12 has a main body case part 21A having a cylindrical communication space X with both ends open, and a pair of left and right flange case parts 21B and 2IC that close each end of the main body case part 21A. and an upper case 21D located on the main body case part 21A, and these case parts are integrated by screws 22. In such a case 21, a positive pressure boat Pl, a positive pressure boat P2, a pressurized boat P3, and an atmosphere release boat P4 are formed so as to open into the communication space X in the main body case portion 21A. The positive pressure boat Pl is connected to the discharge port 11a of the blower 11, the positive pressure boat P2 is connected to the suction port 11b of the blower 11, and the pressurized boat P3 is connected to the vibration circuit 13.

The arrangement of each boat is positive pressure boat PI and positive pressure boat P.
2 are located at each end in the axial direction of the switching valve 12 (a rotating shaft 23 to be described later), and a pressurized boat P3 and an atmosphere release boat P4 are located between the boats PI and P2.

Further, the positive pressure boat Pl, the positive pressure boat P2, and the atmosphere release boat P4 are each formed on the earthen wall of the case 21, while only the pressurized boat P3 is formed on the bottom wall of the case 21.

A rotary shaft 23 is rotatably supported by the pair of left and right flange case portions 21B and 2IC, and a rotor 25 is fixed to the rotary shaft 23 by a pin 24 so as to rotate together with the rotary shaft 23. This rotor 25 has a partition wall portion 25a having a circular cross section so as to define a positive pressure boat P1 and a positive pressure boat P2. More specifically, case 2
A communication space X in 1 is defined by a first minute side gap x1 on the left side with which the positive pressure boat P2 always communicates, and a second minute side gap x2 on the right side with which the positive pressure boat PI always communicates. .

The rotor 25 also has a pair of left and right valve bodies 25b and 25c extending from the outer peripheral edge of the partition wall 25a and spaced apart from each other in the axial direction of the rotating shaft 23. As shown in FIGS. 3 and 4, the pair of valve body portions are each formed into an arc shape extending approximately 180 degrees in the circumferential direction of the rotating shaft 23, and their phase relationship is 180 degrees apart. ing. That is, the pair of valve body parts 25b and 25
c is set to have a symmetrical shape with the center of the rotation axis 23 as the center.

The switching valve 12 configured as described above has a rotary shaft 23
That is, in accordance with the rotation of the rotor 25, the positive pressure boat PI is alternately communicated with the pressurized boat P3 and the atmosphere release boat P4, while the positive pressure boat P2 is also communicated with the pressurized boat P3 and the atmosphere release boat P4. are communicated alternately. That is, as shown in FIG. 2, the positive pressure photo Pl is
When the pressurized boat P3 is closed, it is communicated with the atmosphere release boat P4, and conversely, when the atmosphere release boat P4 is closed, it is communicated with the pressurized boat P3. Similarly, the positive pressure boat P2 is communicated with the atmosphere release boat P4 when the pressurized boat P3 is closed by the valve body portion 25b, and conversely, as shown in FIG.
When the atmosphere release boat P4 is closed, it is communicated with the pressurized boat P3. Then, both valve body parts 25b and 25
By setting the above-mentioned phase relationship with c, pressurized boat P3
(Atmospheric release boat P4) is alternately communicated with positive pressure boat PI and positive pressure boat -P2. Therefore, the appearance of the pressure change occurring in the pressurized boat P3 is that of vibration as shown in FIG.
It is said that

An electromagnetic variable throttle 31 and a regulating means 32 are connected to the vibration circuit 13 in this order from the switching valve 12 side.

As shown in FIG. 5, the regulating means 32 is composed of a case 33 having a predetermined capacity and a movable diaphragm 34 disposed within the case 33 and having sufficient airtightness. The capacity of the case 33 is such that the positive pressure is higher than the predetermined capacity or the positive pressure is connected to the respiratory system path A.
This is to prevent the movable diaphragm 34 from expanding more than necessary. The movable diaphragm 34 is intended to avoid direct contact between the air in the respiratory system tract A and the air from the high-frequency vibration generator B, and is placed inside the case 33 in a bag shape so as to be as thin (light) as possible. It is arranged to stretch. More specifically, case 33 is
A movable diaphragm 34 is provided between both case parts 33A and 33B as a divided structure into a main body case part 33A and a lid case part 33B.
Both 33A and 33B are fixed with screws 35 while sandwiching the opening edges of the two. Since the regulating means 32 is disposable for each patient, it is detachable from the vibration circuit I3, and therefore the case 33
A threaded groove 33a for attachment/detachment is formed at each end.

Referring again to FIG. 1, U is a control unit constructed using a microcomputer. This control unit U receives signals from the sensors 41, 42, 43 and the switches 44, 45, 46 manually. The sensor 41 is a flow sensor that is connected to the common circuit 1 and measures the actual respiratory rate of the patient. Sensors 42 and 43 are rotation sensors that detect the rotational state of the motor 14 for driving the blower 11 or the motor 15 for driving the switching valve 12. The switch 44 controls the respiratory rate (10
~30H2). The switch 45 controls the magnitude of the average pressure (
Steplessly set in the range from atmospheric pressure to slightly greater than atmospheric pressure)
is set. Switch 46 sets the respiratory volume to the patient. Further, the control unit U outputs the signal to the motors 14 and 15 (the drive circuit thereof), as well as the electromagnetic valve 7, the variable diaphragm 31, and the alarm 47 consisting of a lamp, a buzzer, and the like.

Next, the control contents of the control unit U will be explained with reference to the flowchart shown in FIG. Note that in the following explanation, S indicates a step.

First, the process starts when a start switch (not shown) is turned on, and the entire system is initialized at Sl. Next, the switching valve 12 (the motor 15) is activated in S2, and the blower 11 is activated in S3.
(the motor 14) is started. in this way,
By activating the switching valve 12 prior to activating the blower 11, it is possible to prevent positive pressure or only positive pressure from acting on the respiratory system path A from time to time. Therefore, in order to more reliably prevent such a situation, the process in S3 may be started after a predetermined period of time (for example, 2 seconds) has elapsed after the process in S2.

After S3, signals from each sensor or switch are read in S4. After that, after confirming that the blower 11 and the switching valve I2 are definitely being rotated based on the output status of the sensors 42 and 43 (S4 and S
5), each control in S7 to S9 is performed so that the values correspond to the set states of the switches 44 to 46. That is, controlling the rotational speed of the switching valve 12 in S7 (corresponding to the switch 44, controlling the breathing rate),
Control of the opening of the valve 7 in S8 (corresponding to the switch 45 and controlling the average pressure) and control of the variable restrictor 31 in S9 (corresponding to the switch 46, controlling the breathing volume - the magnitude of the amplitude shown in Fig. 6) control) is carried out.

After S9, it is determined in SIO whether or not a stop switch (not shown) has been turned on, and if the determination is No, the processes from S4 onwards are repeated. If the SIO determination is YES, the blower 11 is first stopped at Sll, and then the switching valve 12 is stopped at S12.

If the determination in S5 or S6 is No, it is assumed that an abnormality has occurred, and after activating the alarm 47 in S13, the process proceeds to S1.
1 and subsequent processes are performed.

FIG. 8 shows another embodiment of the high-frequency respirator, and the same components as those in the previous embodiment are given the same reference numerals, and redundant explanation thereof will be omitted.

In this embodiment, two blowers 11', a first blower 11-A and a second blower 11-B, are used. The first blower 11-A is dedicated to supplying positive pressure, and the suction port llb is always open to the atmosphere), and the second blower 11-B is dedicated to supplying positive pressure (discharge port 11a).
(is constantly released to the atmosphere).

Further, although the switching valve 12' has a common case 21' and a rotating shaft 23', the rotor has two rotors, a first rotor 25-A and a second rotor 25-B. Try to use what you have. This first rotor 25
-A is used exclusively for positive pressure supply control, and the second rotor 25
-B is dedicated to positive pressure supply control. That is, the rotor 25A (25-B) has a cylindrical shape with a bottom, and its release port is always connected to the positive pressure boat PI (positive pressure boat P2). A communication port 5l-A (51-B) extends approximately 180 degrees in the circumferential direction on the side wall of the rotor 25-A (25B).
As the rotor 25-A (25-B) rotates, the communication port 5l-A (51-B) connects to the atmosphere release boat P4-A (P4-B) formed in the case 21'. and pressurized boat P3-A (P3-B).

Of course, both pressurized boats P3-A and P3-B are ultimately connected to the vibration circuit 13, and both speed ports 51-A and 51-
B is formed 180 degrees apart in the circumferential direction of the rotating shaft 23'.

The advantage of using two blowers as in this embodiment is that both the positive pressure and the negative pressure are sufficiently large at least immediately before the supply to the vibration circuit 13 starts. This means that the respiratory vibration can rise and fall extremely quickly.

Here, the rotation shaft 2 of each rotor 25-A and 25-B is
3' may be provided separately and independently from each other and driven by separate motors. However, the rotation shaft 23' of each of the first and second rotors 25-A and 25-B is common, and as a result, the driving motor (not shown in FIG. 7)
By making them common, it is possible to reliably prevent the occurrence of a phase lag between the rotors 25-A and 25-B. From the same point of view, each of the first and second blowers 11-A
By making the drive shaft 52 and 11-B common and, as a result, the drive motor I4 common, it is possible to reliably prevent a situation in which only positive pressure or only positive pressure is applied to the vibration circuit 13. .

FIG. 9 shows yet another embodiment of the high frequency respirator. In this embodiment, the average pressure (see FIG. 6) is adjusted by changing the degree of opening of the discharge port 11a and suction port 11b of the blower 11 to the atmosphere.

First, in FIG. 9, the regulating valve 7 is connected to the blower 11.
1 is provided. This regulating valve 71 includes a casing 72,
A first passage 53 and a second passage formed in the casing 72
A passage 54 is provided.

The first passage 53 has three boats 53a, first to third.
, 53b, and 53c, and the first boat 53a is connected to the suction port 11b of the blower 11 via a communication path 61. Further, the second boat 53b is opened to the atmosphere, and its opening degree is adjusted by a valve body 55, which will be described later. Furthermore, the third boat 53c is open to the atmosphere via the aperture 56.

The second passage 54 is connected to the first and second boats 5.
4a and 54b. The first boat 54a has the communication path 6
2 to the outlet +1a of the blower 11. Further, the second boat 54b is opened to the atmosphere, and its opening degree is adjusted by the valve body 55.

The valve body 55 has a disk shape, and a valve stem 55a integrated with the valve body 55 is screwed into the casing 52.

Thereby, by manually operating and rotating the operating portion 55b formed on the valve stem 55a, the valve body 55 is displaced in the vertical direction in the figure. The second boat 53b of the first passage 53 faces the upper surface of the valve body 55, and the second boat 53b of the first passage 53 faces the upper surface of the valve body 55.
The second boat 54b of the passage faces the bottom surface of the valve body 55\
Ru.

In the above configuration, as the valve body 55 is displaced upward in the figure, the opening degree of the boat 53b becomes smaller while the opening degree of the boat 54b becomes larger. Conversely, when the valve body 55 is displaced downward in the figure, the opening degree of the boat 53b increases, while the opening degree of the boat 54b decreases.

As the opening degree of the boat 53b becomes smaller, the blower 1
1 increases the suction effect of the switching valve 12 on the positive pressure boat P2. This will lower the average pressure shown in Figure 6 (lower the trough of the pulsation). boat 53b
This means that the opening degree of the boat 54b becomes smaller.
The opening becomes larger. When the opening degree of the boat 54b increases, the action of the blower 11 to push air into the positive pressure boat Pl of the switching valve 12 becomes weaker, thereby lowering the average pressure (lowering the peak of pulsation).

As described above, by displacing the valve body 55 upward in the figure, the average pressure is reduced.

Of course, as is already clear from the explanation so far, the valve body 55
If you displace it downward in the figure, the average pressure will increase, contrary to the above case. Note that due to the action of the throttle 56, at least the minimum amount of atmospheric air is sucked through the suction port llb of the blower 11, so that the minimum value of the average pressure is set to a value slightly larger than atmospheric pressure.

Here, if the configuration is as shown in FIG. 9, it is also possible to eliminate the valve 7 shown in FIG. 1. However, this valve 7 is also provided, and the valve 7 is connected to the valve body 55 so as to reduce the difference in average pressure between the upstream side and the downstream side of the movable diaphragm 34 (see FIG. 5). It is preferable to link them.

Although the embodiments have been described above, the discharge pressure (discharge capacity) of the floor may be variable (for example, the motor 14 is controlled by an inverter).

Further, the variable diaphragm 31 may be provided in the circuit 13 on the downstream side of the regulating means 32 (on the breathing circuit 2.3 side). In this case, it is not necessary to disinfect the variable diaphragm 31 every time it is used, and the power of the blower 11 is transferred to the breathing circuit 2.
This is also preferable in terms of improving the efficiency of transmission to the third signal.

Furthermore, a thread path between the suction port 11b of the blower 11 and the boat P2 of the switching valve 12 may be communicated with the atmosphere via a variable throttle. In this case, by adjusting the opening of the variable throttle (0 to 100%), the average pressure of the boat p4 of the switching valve 12 (the pressure fluctuation of the boat P4 is pulsating as shown in Fig. 6) is adjusted. Sao,
It can be arbitrarily adjusted within the range from atmospheric pressure to a higher positive pressure.

[Brief explanation of drawings]

FIG. 1 is an overall system diagram showing an example of a high-frequency ventilator. FIG. 2 is a side sectional view showing an example of a rotary type switching valve. FIG. 3 is a sectional view taken along the line X3-X3 in FIG. 2. FIG. 4 is a sectional view taken along the line X4-X4 in FIG. 2. FIG. 5 is a side sectional view showing details of the regulating means connected to the vibration circuit. Figure 6 is a graph showing the state of respiratory vibration. FIG. 7 is a flowchart showing an example of controlling high-frequency artificial respiration. FIG. 8 and FIG. 9 are main part system diagrams showing other examples of high-frequency respirators. FIG. 10 is an overall system diagram showing an example of a monitoring device according to the present invention. 81: Patient 82: Acceleration sensor 83: Processing device 83a: First integrator 83b: Second integrator 84: Display device 84a: First display section 84b: Second display section 84c: Third display section 85: Printer No. 5 Figure j) Figure 6 (-) 1 2

Claims (1)

[Claims] (1) A high-frequency ventilator that applies high-frequency respiratory vibrations to a patient includes an acceleration sensor attached to a position corresponding to the lungs on the patient's body surface, and information obtained according to the output from the acceleration sensor. A monitoring device for a high-frequency respirator, comprising: a display means for displaying; and a monitoring device for a high-frequency respirator.