JPS61176348A - Breast external reduced pressure type artificial respirator - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed Description of the Invention] (Field of Industrial Application) The present invention is capable of increasing lung capacity and providing respiratory support without endotracheal intubation for conscious patients such as weaning patients, postoperative patients, and myasthenic patients. (Conventional technology) Many attempts have been made to develop artificial respiration devices that mechanically assist patients with decreased respiratory function. It is being The development of this artificial respirator has been approached from two perspectives: an external type based on changes and movements of extrathoracic negative pressure, and an internal type based on positive intratracheal pressure. However, the external type is largely abandoned because it cannot synchronize with the patient's spontaneous breathing, resulting in significantly lower efficiency of artificial respiration, and because the patient's body is inside the housing, it is not possible to manage the patient adequately. Currently, intracorporeal ventilation, that is, intratracheal positive pressure ventilation, is mainly used.

(Problem to be solved by the invention) However, since intratracheal positive pressure artificial respiration involves intubating a tube into the trachea, it is superior in terms of securing the airway of unconscious patients and suctioning secretions in the trachea. The presence of an endotracheal tube can be extremely painful for patients who suffer from tracheal trachea, which sometimes requires large doses of sedatives and muscle relaxants, and the presence of an endotracheal tube can increase secretions and cause infection In addition to this, problems such as inability to take oral intake or to speak were common.

(Means for Solving the Problems) The present inventors believe that the above-mentioned problems are essentially unavoidable in the in-body type in which a tube is inserted into the trachea, but the in-vitro type eliminates these problems. Focusing on the fact that these problems can be solved all at once, we have arrived at the present invention as a result of intensive studies to improve the efficiency of artificial respiration using this extracorporeal device.

That is, the present invention provides an extrathoracic negative pressure artificial respiration device in which the outside of a rigid shell surrounding the thorax is covered with an airtight jacket, and a suction pump is connected to an inlet port provided in the rigid shell via an inlet pipe. An intake valve is provided in the intake valve, and a bypass valve opened to the atmosphere is connected to a branch pipe provided in a circuit connecting the intake valve and the intake pump, and each of the above-mentioned valves is controlled to open and close in conjunction with a spontaneous breathing detection means. This is an extrathoracic negative pressure artificial respiration device characterized by being configured as follows.

Next, one embodiment of the device of the present invention will be described with reference to the drawings.

FIG. 1 is an explanatory diagram showing the overall configuration of the device of the present invention.
This device includes a rigid shell 30 that surrounds the thorax, an airtight jacket 31 that covers the outside of the rigid shell and makes the inside of the rigid shell airtight by making the inside of the rigid shell airtight by making the inside of the rigid shell airtight by attaching it to the living body at the neck, upper arms, and abdomen using tape or the like. An intake valve 11 and a bypass valve 13 connected to an intake pump 10 for intermittently creating pressure relief inside
and a control device 32 that operates the two valves in conjunction with the patient's spontaneous breathing. 12 is a pressure regulating valve.

As shown in FIG. 2, the rigid shell 30 surrounding the thorax has a semi-circular shape and is provided with an intake port 33 at the top. This rigid shell is lightweight and does not deform even when a pressure of 0.0519/cd G is removed.1 Usually, a plastic molded product as shown in FIG. 2 can be used. Alternatively, it may be formed of a plastic mesh or a pipe. This rigid shell must provide a suitable space between it and the patient's thorax to allow for expansion of the thorax. It is usually preferable to create a shell of an optimal size to suit the patient.

As shown in FIG. 3, 31 is made of a sheet with excellent airtightness such as a sheet based on vinyl cloth or non-woven fabric.The neck A, the upper arm B and the abdomen C are hook-and-loop fasteners 34 (A),
34 (C) and 34 (C) to wrap it around the human body and seal it. The front part of the Maroku jacket is temporarily fastened with a hook-and-loop fastener 34 (D') and a wide hook-and-loop fastener P for permanent fastening.After temporarily fastening with the temporary fastener,
Sealing performance is improved by folding the wide hook-and-loop fastener twice. 35 is an opening through which the intake port 33 of the rigid shell is inserted. By using such a hook-and-loop fastener, the sealing of the opening can be improved, and the jacket can be easily put on and taken off by the patient alone. FIG. 4 shows a state in which the outside of the rigid shell 30 surrounding the thorax is covered with an airtight jacket 31, and the neck, upper arms, and abdomen are brought into close contact with the living body using hook-and-loop fasteners, making the inside of the rigid shell airtight.

In order to create intermittent pressure relief within the rigid shell, an inlet 33 provided in the rigid shell 30 is connected via an inlet pipe 36 to a suction pump 10 which is in continuous operation. Sixth, the intake pipe 36 is provided with an intake valve 11, and a branch pipe 37 provided in a circuit connecting the intake valve 11 and the suction pump 10 is connected to a bypass valve 13 open to the atmosphere. When the patient inhales, the intake valve 11 is opened and the bypass valve 13 is closed. On the other hand, during exhalation, the intake valve is closed and the bypass valve 13 is opened. These two valves are controlled in conjunction with the patient's spontaneous breathing detection means. The patient's spontaneous breathing detection means is a signal that changes depending on the patient's spontaneous breathing.

For example, it is possible to detect airway pressure, airway flow rate, nose-orifice temperature, or diaphragm muscle discharge signals generated during spontaneous breathing, and use these signals as actuation signals for the two valves. Among these, the method of detecting the temperature inside the elevator is preferably used because the sensor can be easily attached to the living body and does not cause pain to the patient.

Ru. FIG. 5 is a block diagram showing a method of detecting temperature changes within the nose and mouth and transmitting a patient's exhalation end point (inhalation start) signal, and FIG. 6 is a timing chart thereof.

In FIG. 5, 1 is a sensor for detecting the temperature inside the nose and mouth, and this sensor can be a commonly used temperature detection means such as a thermistor, semiconductor sensor, or thermocouple. Sensor l that indicates temperature changes due to patient's inhalation and exhalation
The output signal becomes a sine wave-shaped signal when time is plotted on the horizontal axis. This signal is amplified by an amplifier 2 and input to the next respiratory synchronization circuit 3. This respiration synchronization circuit 3 is constructed just before the end point of expiration. The delay circuit outputs the amplified signal after delaying it for a certain period of time, typically 0.3 seconds or less, and this signal [phase] is input to the next comparison circuit 26. The comparator circuit 26 compares the signal delayed for a certain period of time with the signal ■ which is obtained by cutting the valley part of the original waveform of the sine wave shape using a bias voltage in order to eliminate the detection signal of the end point of inspiration, and compares these two signals ■
When and @ match (comparison point), a signal θ indicating the exhalation end point is transmitted. Since the signal emitted from the comparator circuit has an extremely short pulse width, it is difficult to follow this signal as an activation signal to the artificial respirator. Therefore, in order to follow this signal as an activation signal to the artificial respirator, the pulse generator 27 generates a predetermined pulse width (
T1). This respiration synchronization pulse [phase] can be reliably followed as an activation signal for the artificial respiration device. Further, the output signal may have a multi-waveform disturbance depending on the condition of the patient or the mounting condition of the sensor. In order to prevent erroneous generation of the respiratory synchronization pulse O due to this waveform disturbance, it is preferable to provide a dead time T2 to the pulse generator 27 using another pulse generator 28. This dead time T
Even if pulse O occurs within 2, this signal will not be output. The above dead time T2 is 1 of the normal exhalation/inspiration cycle.
/2 or less and T2 (T2).The comparison input signal of the comparison circuit 26 is a signal @ which is the original waveform delayed by a certain period of time, and a signal (■) which is the signal where the valley part of the original waveform is cut, in other words. Since the same signal is used, the delay time can be set arbitrarily.

In other words, the point at which these signals match can be arbitrarily controlled. Therefore, by setting the comparator point υ before the peak of the original waveform, the respiratory synchronization pulse @ can be sent earlier than the patient's spontaneous breathing, covering the delay in the operation of the device and completely synchronizing the artificial respiration device with spontaneous breathing.・Can be extended.

The intake valve 11 and the bypass valve 1 are synchronized with the patient's spontaneous breathing.
The control device 32 for operating the pump 3 is provided with a sensor 4 for detecting the pressure inside the rigid shell in order to prevent accidents such as damage to the jacket when the intake pipe is removed, as well as the above-mentioned means for detecting spontaneous breathing of the patient. 6 (A) should be a pressure indicator! 6(B) is a driver for driving the pressure indicator. The signal of this pressure sensor is amplified by an amplifier 5,
Next, an A/D converter 6 converts the pressure analog signal into a digital signal. 7 is a time setting volume for setting the pressure proof time inside the rigid shell, 8 is a timer for generating a time-up signal when the time set by the time setting volume is reached, and 9 is a timer inside the jacket. This is a digital switch that issues an alarm if the pressure does not reach the pressure set by this switch.

Signals from the respiration synchronization circuit 3 and A/D converter 6 are input to a digital calculator 14. This digital arithmetic unit 14 is composed of an interface 15 and an arithmetic unit 16.

The interface 15 inputs data from the ~0 converter 6 to υ, inputs respiration and synchronization timing signals from the respiratory synchronization circuit 3, inputs a time-up signal from the timer circuit 8, or outputs data to the display 6 (~, and outputs data to the timer circuit 8. It has a function of inputting and outputting data to and from the digital computing unit 14, such as outputting a start signal to the intake valve and bypass valve.

The arithmetic circuit 16 includes a ROM 17 containing a program, a RAMI 8 for temporarily storing data, and a C for arithmetic processing.
, P, and U l 9.

Next, the operation of the apparatus of the present invention will be explained with reference to FIG.

FIG. 7 is a flowchart showing the processing within the digital arithmetic unit 16, and P1 to P21 in the figure indicate each step of the flowchart. The process flow can be roughly divided into automatic processing in which inhalation and stopping are performed according to a respiratory synchronization signal, and manual processing in which inhalation and stopping are performed in accordance with predetermined inspiratory time and stop time, regardless of this. First, automatic processing will be explained.

Start at Pl, initialize input and output at P2, wait at P3, and check whether processing is automatic at P4. If the process is automatic, the presence or absence of a respiratory synchronization signal is checked at Ps, and if a respiratory synchronization signal is present, the intake valve 11 is operated to open the bypass valve 13 and closed. If there is no respiratory synchronization signal, wait 10 hours at Pl3, and if there is no respiratory synchronization signal during this time, move to manual processing,
If there is a signal within the time To, it is further checked whether this signal is a respiratory synchronization signal. If a respiration synchronization signal exists, the same procedure is used to open the intake valve at Ps, close the bypass valve at P7, maintain this state if it is within T1 hour at Plo, and close the intake valve at pH when the Tr wait time is reached. Close, P
The bypass valve is opened at l2. Then, return to Ps again.

Next, manual processing will be explained. It is checked at PI4 whether or not it is manual processing, and if it is not manual processing, it waits, and if it is manual processing, the intake valve is opened at PI5, and the bypass valve is closed at PI3. If Ply is within T1 time, this state is maintained, and when T1 time is reached, the intake valve is closed at Pl8, and the bypass valve is opened at Plg. If a respiratory synchronization signal is detected during automatic P2O, the process will proceed to automatic processing, otherwise P2O will be activated.
If it does not reach 12 hours at 21, keep Pl8゜Pl9,
At 12 hours, return to Pl5.

Note that at Ps, if the pressure inside the rigid shell does not reach the value set by the digital switch 9 during intake, a buzzer will sound at Ps. In other words, the piping system, including the jacket, is checked for leakage abnormalities.

(Effects of the Invention) As described above, the present invention not only eliminates the need for a painful endotracheal tube unlike conventional intratracheal positive pressure artificial respiration, but also eliminates the risk of infection, oral intake, and inability to speak. It eliminates many of the drawbacks of artificial respiration, and achieves the same effect as artificial respiration. And a jacket.

It can be used easily and safely by simply attaching the rigid shell and connecting it to the device with a flexible tube, making it extremely useful as an auxiliary breathing device for the human body as it can also be used for home therapy outside of hospitals. Out.

Furthermore, by assembling the above-mentioned control circuit, the following effects are also achieved.

(1) Inhalation/stopping is performed in synchronization with the spontaneous respiration of the living body, so there is no stress on the living body. Furthermore, even if the synchronization is disrupted due to respiratory failure or the like, it is safe because it is automatically and manually processed.

(2) The pressure inside the jacket can be monitored and adjusted to any desired pressure. In the unlikely event that a leak occurs in the piping system, including the jacket (the jacket is torn, the piping is disconnected), an alarm will be issued and you will be notified.

(3) The intake/stop cycle can be set accurately.

[Brief explanation of drawings]

FIG. 1 is an explanatory diagram showing the overall configuration of the device of the present invention,
FIG. 2 is a perspective view of the rigid shell. Fig. 3 is a front view of the airtight jacket, Fig. 4 is a cross-sectional view showing the airtight jacket covering the rigid shell surrounding the thorax, and Fig. 5 is a FIG. 6 is a block diagram of an electric circuit that transmits this signal to the respiratory apparatus, FIG. 6 is a timing chart thereof, and FIG. 7 is a flowchart showing processing within the digital arithmetic unit.

Claims (1)

[Claims] 1. In an extrathoracic negative pressure artificial respiration device in which the outside of a rigid shell surrounding the thorax is covered with an airtight jacket, and the inlet port provided in the rigid shell is connected to a suction pump via an inlet pipe, An intake valve is provided, and a bypass valve opened to the atmosphere is connected to a branch pipe provided in a circuit connecting the intake valve and the intake pump, and each of the valves is controlled to open and close in conjunction with a spontaneous breathing detection means. Extrathoracic negative pressure artificial respiration device characterized by comprising: