CN101757707B - Method for controlling end-expiratory pressure and ventilator using same - Google Patents
Method for controlling end-expiratory pressure and ventilator using same Download PDFInfo
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- CN101757707B CN101757707B CN200810239300.XA CN200810239300A CN101757707B CN 101757707 B CN101757707 B CN 101757707B CN 200810239300 A CN200810239300 A CN 200810239300A CN 101757707 B CN101757707 B CN 101757707B
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- air pressure
- tidal air
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Abstract
The invention provides a method for controlling an end-expiratory pressure valve and a ventilator using the same. In the invention, the method for controlling the end-expiratory pressure comprises the following steps: the step of setting: setting the sizes of the openings of end-expiratory pressure valve in accordance with the predetermined end-expiratory pressure; the step of detecting: detecting the end-expiratory pressure; the step of comparing: comparing the end-expiratory pressure with the predetermined end-expiratory pressure; the step of adjusting: when the end-expiratory pressure is not equal to the predetermined end-expiratory pressure, changing the sizes of the openings of the end-expiratory pressure valve by the first predetermined value; and repeating the steps of detecting, comparing and adjusting until the end-expiratory pressure is consistent with the predetermined end-expiratory pressure. The effect of accurately controlling the end-expiratory pressure is achieved through the invention.
Description
Technical field
The present invention relates to electric electricing breathing machine field, more specifically, relate to the respirator of a kind of end-tidal air pressure control method and employing the method.
Background technology
Electric electricing breathing machine adopts straight moving end-tidal air pressure (positive end-expiratorypressure is called for short PEEP) valve to realize the control to PEEP.This control for PEEP is had higher requirement, and PEEP refers to and breathe and when assisted respiartion, the phase air flue of exhaling keeps malleation controlling, and by means of being contained in the devices such as the restriction air-flow flap valve held of exhaling, makes airway pressure higher than atmospheric pressure at the end eventually of exhaling.
For electric electricing breathing machine, owing to there is no continuous flow, if bad to the control of PEEP valve, not only can not maintain stable PEEP, and can affect the effect of breathing pattern.Carrying out PCV (pressure control ventilation, pressure controlled ventilation) when pattern control, due to the control curve linear relationship complexity of operation curve and the motor of piston, can change at the vapour lock and the compliance that add patient, the control of PCV breathing pattern is brought to very large difficulty, and the control that realizes PCV breathing pattern by the control of PEEP valve implements simple and reliable.
For the control of the PEEP of electric electricing breathing machine, owing to there is no continuous flow, PEEP is difficult to maintain.At present, some electric pulmotors adopt built-in miniature air pump to transfer PEEP control to continuous flow, obvious like this cost and the complexity of having increased are provided; Also the electric electricing breathing machine having adopts Direct Action Type outlet valve to realize maintaining of PEEP, adopts in this way, because machinery control diaphragm is not easy to keep balance, easily causes end-tidal shake, cannot reach the effect of accurate control patient's end-tidal air pressure.
Summary of the invention
In view of above one or more problems, the present invention proposes the respirator of a kind of end-tidal air pressure control method and employing the method, it can reach the effect of accurate control patient's end-tidal air pressure.
According to an aspect of the present invention, propose a kind of end-tidal air pressure control method, comprised the following steps: set step, set the openings of sizes of end-expiratory pressure valve according to end-tidal air pressure predetermined value; Measuring process, measures end-tidal air pressure; Comparison step, compares end-tidal air pressure and end-tidal air pressure predetermined value; Regulating step, in end-tidal air pressure and the inconsistent situation of end-tidal air pressure predetermined value, changes the first scheduled volume by the openings of sizes of end-expiratory pressure valve; And repeated measure step, comparison step and regulating step, until end-tidal air pressure is consistent with end-tidal air pressure predetermined value.
Wherein, set step and comprise the following steps: the controlling value of setting valve control module is set the openings of sizes of end-expiratory pressure valve, and wherein, valve control module is used for controlling end-expiratory pressure valve.Regulating step comprises the following steps: in end-tidal air pressure and the inconsistent situation of end-tidal air pressure predetermined value, controlling value is changed to the second scheduled volume.
This end-tidal air pressure control method can also comprise the following steps: the frequency n that presets repeated measure step, comparison step and regulating step; And after repeated measure step, comparison step and regulating step frequency n, stop repetition, and notify user to reset the second scheduled volume.End-tidal air pressure control method can also comprise the following steps: determine the curve linear relationship between end-tidal air pressure predetermined value and controlling value; And determine the controlling value corresponding to end-tidal air pressure predetermined value according to curve linear relationship and end-tidal air pressure predetermined value.Wherein, valve control module can be digital analog converter, and controlling value is the control current value I s of digital analog converter output.The end-tidal air pressure absolute value that refer to difference end-tidal air pressure and end-tidal air pressure predetermined value between consistent with end-tidal air pressure predetermined value is less than predetermined error allowed band.
End-tidal air pressure control method can also comprise the following steps: after end-tidal air pressure is consistent with end-tidal air pressure predetermined value, close end-expiratory pressure valve, the variation of monitoring end-tidal air pressure; In the situation that end-tidal air pressure exceedes end-tidal air pressure predetermined value predetermined difference value, open end-expiratory pressure valve, until end-tidal air pressure returns to end-tidal air pressure predetermined value; And close end-expiratory pressure valve.Wherein, predetermined difference value can be 3 centimeter water columns.
According to another aspect of the present invention, a kind of respirator that adopts said method has also been proposed.
In the present invention, utilize measurement, comparison and regulating step, can effectively control the last air pressure of breathing consistent with predetermined value.And, by repeated measure step, comparison step and regulating step, realized closed loop control, thereby can reach the effect of controlling more accurately end-tidal air pressure.In addition, by presetting number of repetition n, and respirator fault etc. break down or unexpected situation under, can avoid controlling pressure abnormity, thereby guarantee patient's safety.Moreover, by close end-expiratory pressure valve after end-tidal air pressure is consistent with end-tidal air pressure predetermined value, can maintain end-tidal air pressure and change not quite during certain.In addition, open end-expiratory pressure valve by exceed end-tidal air pressure predetermined value predetermined difference value at end-tidal air pressure in the situation that, in the situation that patient thinks initiatively to breathe, can effectively guarantee that patient's breathing is smooth and easy.
Accompanying drawing explanation
Accompanying drawing described herein is used to provide a further understanding of the present invention, forms the application's a part, and schematic description and description of the present invention is used for explaining the present invention, does not form inappropriate limitation of the present invention.In the accompanying drawings:
Fig. 1 is according to the flow chart of the end-tidal air pressure control method of exemplary embodiment of the present invention;
Fig. 2 is the flow chart that regulates according to an embodiment of the invention end-tidal air pressure by the controlling value (electric current) of control valve control module;
Fig. 3 is the output voltage values of digital analog converter (DAC) according to exemplary embodiment of the present invention and the corresponding relation figure of the PEEP value of actual measurement; And
Fig. 4 is according to the pressure at the electric electricing breathing machine interface of exemplary embodiment of the present invention and flow velocity waveform figure.
The specific embodiment
Below with reference to accompanying drawing, describe the specific embodiment of the present invention in detail.
Fig. 1 is according to the flow chart of the end-tidal air pressure control method of exemplary embodiment of the present invention.As shown in Figure 1, the method comprises the following steps:
Step S102, sets step, sets the openings of sizes of end-expiratory pressure valve according to end-tidal air pressure predetermined value;
Step S104, measuring process, measures end-tidal air pressure;
Step S106, comparison step, compares end-tidal air pressure and end-tidal air pressure predetermined value;
Step S108, regulating step, in end-tidal air pressure and the inconsistent situation of end-tidal air pressure predetermined value, changes the first scheduled volume by the openings of sizes of end-expiratory pressure valve; And
Repeated measure step 104 is to step 108, until end-tidal air pressure is consistent with end-tidal air pressure predetermined value.
Wherein, set step and comprise the following steps: the controlling value of setting valve control module is set the openings of sizes of end-expiratory pressure valve, and wherein, valve control module is used for controlling end-expiratory pressure valve.Regulating step comprises the following steps: in end-tidal air pressure and the inconsistent situation of end-tidal air pressure predetermined value, controlling value is changed to the second scheduled volume.
This end-tidal air pressure control method can also comprise the following steps: the frequency n that presets repeated measure step, comparison step and regulating step; And after repeated measure step, comparison step and regulating step frequency n, stop repetition, and notify user to reset the second scheduled volume.End-tidal air pressure control method can also comprise the following steps: determine the curve linear relationship between end-tidal air pressure predetermined value and controlling value; And determine the controlling value corresponding to end-tidal air pressure predetermined value according to curve linear relationship and end-tidal air pressure predetermined value.Wherein, valve control module can be digital analog converter, and controlling value is the control current value I s of digital analog converter output.The end-tidal air pressure absolute value that refer to difference end-tidal air pressure and end-tidal air pressure predetermined value between consistent with end-tidal air pressure predetermined value is less than predetermined error allowed band.
End-tidal air pressure control method can also comprise the following steps: after end-tidal air pressure is consistent with end-tidal air pressure predetermined value, close end-expiratory pressure valve, the variation of monitoring end-tidal air pressure; In the situation that end-tidal air pressure exceedes end-tidal air pressure predetermined value predetermined difference value, open end-expiratory pressure valve, until end-tidal air pressure returns to end-tidal air pressure predetermined value; And close end-expiratory pressure valve.Wherein, predetermined difference value can be 3 centimeter water columns.
Fig. 2 is the flow chart that regulates according to an embodiment of the invention the method for end-tidal air pressure by the controlling value (electric current) of control valve control module.As shown in Figure 2, the method comprises the following steps:
Step S202, sets and initializes fine setting frequency n, wherein n >=1; Calculate end-tidal air pressure and set value corresponding pressure transducer value Pj; Set fine setting error allowed band Pr;
Setup control current value I s on respirator; Set fine steps amount Ix;
Step S204, reads the pressure transducer value Pc of actual measurement; Calculate the absolute value Pabs of the difference of Pj and Pc;
Step S206, judges whether Pabs is greater than Pr, in the situation that Pabs is not more than Pr, turns back to step S204;
Step S208-S212, in the situation that Pabs is greater than Pr, judges whether Pj is greater than Pc, in the situation that Pj is greater than Pc, will controls current value I s and upwards finely tune Ix, in the situation that Pj is less than Pc, will controls current value I s and finely tune Ix downwards; And
Step S214-S218, subtracts 1 by fine setting frequency n, and judges whether n is greater than 0, in the situation that n is greater than 0, turns back to step S204, and in the situation that n is not more than 0, reminding user is verification Ix again.
According to exemplary embodiment of the present invention, in the time adopting digital analog converter (abbreviation DAC) conduct to be used for controlling the valve control module of PEEP valve, end-tidal air pressure control method comprises the following steps:
First, select the lung of fixing vapour lock and compliance, the pipeline of respirator connects, and finds out the corresponding relation of the PEEP value of digital analog converter output voltage values and actual measurement.Fig. 3 shows according to the corresponding relation of the PEEP value of the output voltage values of the DAC of exemplary embodiment of the present invention and actual measurement.
Secondly, according to PEEP and the matched curve of DAC output voltage values of measuring, the method for matched curve is method of least square, and this algorithm guarantees that all points all drop near curve.
Then,, in the time carrying out the control of PEEP, calculate the DAC output voltage predetermined value needing according to the curve linear relationship setting value and matching obtains.According to this DAC output voltage predetermined value and in this DAC the relation of the control electric current of output voltage and output, determine with this output voltage predetermined value corresponding to controlling current value I s.Between EEP, first set this control current value, obtained the actual value of current PEEP by PEEP monitoring facilities module, by comparing setting value and the actual value of PEEP, the fine setting (as shown in Figure 2) of PEEP control is carried out in judgement, by finely tuning several times, the actual value of PEEP and setting value are consistent, the PEEP of end-tidal controls and substantially completes like this.
Finally, after the actual value of PEEP and setting value are consistent, before upper once inspiratory cycle arrives, close PEEP valve, make whole system sealing, guarantee that PEEP can maintain setting value constant.And Real-Time Monitoring airway pressure, when airway pressure exceeds PEEP setting value 3cmH
2when O, show that patient has the desire of expiration, now should open PEEP valve, until reach the PEEP value of setting, then close PEEP valve, can maintain so stable PEEP value can not affect again patient's expiration.
The method of controlling according to the end-expiratory pressure valve to respirator of exemplary embodiment of the present invention has realized 0-30cmH
2the PEEP level of control of O, adopts close-loop control mode, even if different lungs also can reach identical level of control.Such as, setting PEEP value is 8cmH
2o, actual PEEP measured value can reach 7.9cmH
2o or 8.0cmH
2o.This method adopts different control modes under different breathing patterns, reached the perfect adaptation that realizes PEEP control and breathing pattern, and the method is simple to operate, easily realizes, and has good clinical experiment effect.
According to a further aspect in the invention, propose a kind of respirator, in this respirator, adopted above-mentioned end-tidal air pressure control method.
Fig. 4 is according to the pressure at the electric electricing breathing machine interface of exemplary embodiment of the present invention and flow velocity waveform figure.As shown in Figure 4, when PEEP setting value is 10cmH
2o, controlling value and setting value are consistent, and it is relatively good that end-tidal pressure waveform steadily shows that PEEP maintains.Wherein, Paw represents that patient airway pressure is with the variation relation of breathing cycle, and the peak value of pressure appears at air-breathing end and exhales and start moment, and the illustrated pressure platform phase belongs to end expiratory positive pressure and keeps the phase; The upper semiaxis of Flow represents inspiratory flow rate waveform, and lower semiaxis represents exhalation flow rate waveform.
In a word, the method of controlling according to the end-expiratory pressure valve to respirator of exemplary embodiment of the present invention can guarantee that with respirator the airway pressure of end-tidal is consistent with end-tidal air pressure setting value, adopt the control mode of closed loop to guarantee that replacing patient still can meet the demands, can improve patient's lung compliance, prevent that alveolar from withering, functional residual capacity is increased, and gas exchange area increases, and improves ventilation and oxygenate.In the present invention, by repeated measure step, comparison step and regulating step, reached the effect of accurate control end-tidal air pressure.In addition, by presetting number of repetition n, and respirator fault etc. break down or unexpected situation under, guaranteed patient's safety.Again, by close end-expiratory pressure valve after end-tidal air pressure is consistent with end-tidal air pressure predetermined value, maintained end-tidal air pressure and changed not quite during certain.Finally, open end-expiratory pressure valve by exceed end-tidal air pressure predetermined value predetermined difference value at end-tidal air pressure in the situation that, in the situation that patient thinks initiatively to breathe, guaranteed that patient's breathing is smooth and easy.
The foregoing is only the preferred embodiments of the present invention, be not limited to the present invention, for a person skilled in the art, the present invention can have various modifications and variations.Within the spirit and principles in the present invention all, any modification of doing, be equal to replacement, improvement etc., within all should being included in protection scope of the present invention.
Claims (10)
1. an end-tidal air pressure control method, is characterized in that, comprises the following steps:
Set step, set the openings of sizes of described end-expiratory pressure valve according to end-tidal air pressure predetermined value;
Measuring process, measures described end-tidal air pressure;
Comparison step, compares described end-tidal air pressure and described end-tidal air pressure predetermined value;
Regulating step, in described end-tidal air pressure and the inconsistent situation of described end-tidal air pressure predetermined value, changes the first scheduled volume by the described openings of sizes of described end-expiratory pressure valve; And
Repeat described measuring process, described comparison step and described regulating step, until described end-tidal air pressure is consistent with described end-tidal air pressure predetermined value.
2. method according to claim 1, is characterized in that, described setting step comprises the following steps:
The controlling value of setting valve control module is set the openings of sizes of described end-expiratory pressure valve, and wherein, described valve control module is used for controlling described end-expiratory pressure valve.
3. method according to claim 2, is characterized in that, described regulating step comprises the following steps:
In described end-tidal air pressure and the inconsistent situation of described end-tidal air pressure predetermined value, described controlling value is changed to the second scheduled volume.
4. method according to claim 3, is characterized in that, further comprising the steps of:
Preset the frequency n of measuring process described in repetition, described comparison step and described regulating step; And
After frequency n, stop repetition, and notify user to reset described the second scheduled volume repeating described in described measuring process, described comparison step and described regulating step.
5. method according to claim 4, is characterized in that, further comprising the steps of:
Determine the curve linear relationship between described end-tidal air pressure predetermined value and described controlling value; And
Determine the described controlling value corresponding to described end-tidal air pressure predetermined value according to described curve linear relationship and described end-tidal air pressure predetermined value.
6. method according to claim 4, is characterized in that, described valve control module is digital analog converter, and described controlling value is the control current value I s of described digital analog converter output.
7. method according to claim 1, is characterized in that, described end-tidal air pressure is consistent with described end-tidal air pressure predetermined value is that the absolute value of the difference between described end-tidal air pressure and described end-tidal air pressure predetermined value is less than predetermined error allowed band.
8. method according to claim 1, is characterized in that, further comprising the steps of:
After described end-tidal air pressure is consistent with described end-tidal air pressure predetermined value, close described end-expiratory pressure valve, monitor the variation of described end-tidal air pressure;
In the situation that described end-tidal air pressure exceedes described end-tidal air pressure predetermined value predetermined difference value, open described end-expiratory pressure valve, until described end-tidal air pressure returns to described end-tidal air pressure predetermined value; And
Close described end-expiratory pressure valve.
9. method according to claim 8, is characterized in that, described predetermined difference value is 3 centimeter water columns.
10. one kind adopts the respirator of the method described in any one in claim 1 to 9.
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| CN200810239300.XA CN101757707B (en) | 2008-12-08 | 2008-12-08 | Method for controlling end-expiratory pressure and ventilator using same |
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| CN200810239300.XA CN101757707B (en) | 2008-12-08 | 2008-12-08 | Method for controlling end-expiratory pressure and ventilator using same |
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| CN101757707B true CN101757707B (en) | 2014-06-11 |
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Families Citing this family (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102266631A (en) * | 2010-12-31 | 2011-12-07 | 北京谊安医疗系统股份有限公司 | Method and device for inspecting PEEP (positive end expiratory pressure) valve |
| CN103893865B (en) * | 2012-12-26 | 2017-05-31 | 北京谊安医疗系统股份有限公司 | A kind of method of lung ventilator turbine volume controlled ventilation |
| CN103893864B (en) * | 2012-12-26 | 2017-05-24 | 北京谊安医疗系统股份有限公司 | Turbine respirator pressure control ventilation method |
| CN103908726A (en) * | 2012-12-29 | 2014-07-09 | 北京谊安医疗系统股份有限公司 | Electric control breathing machine or anesthesia machine active exhalation valve based automatic calibration method |
| CN104874083A (en) * | 2014-02-28 | 2015-09-02 | 北京谊安医疗系统股份有限公司 | PEEP valve verification method |
| CN104001249B (en) * | 2014-06-13 | 2016-06-15 | 北京易世恒电子技术有限责任公司 | Breathe control method and the device of last malleation |
| CN104635777A (en) * | 2014-12-30 | 2015-05-20 | 河南西瑞医疗电子技术有限公司 | Precise pneumatic control method for voice coil motor |
| CN104841055B (en) * | 2015-04-21 | 2017-11-14 | 深圳市科曼医疗设备有限公司 | Control method, the device and system of lung ventilator PEEP valves |
| WO2017079860A1 (en) * | 2015-11-10 | 2017-05-18 | 石洪 | Method for respirator pressure control |
| JP6295477B1 (en) * | 2017-08-23 | 2018-03-20 | 弓場商事株式会社 | Expiratory pressure measuring instrument |
| CN110038200B (en) * | 2019-05-07 | 2022-03-11 | 濡新（北京）科技发展有限公司 | Expectoration device and method for limiting expectoration amount |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US6574201B1 (en) * | 1998-07-06 | 2003-06-03 | Siemens Aktiengesellschaft | Method and mobile radio telephone network for handling a packet data service |
| CN101310791A (en) * | 2007-12-29 | 2008-11-26 | 北京谊安医疗系统股份有限公司 | Expiratory valve system |
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- 2008-12-08 CN CN200810239300.XA patent/CN101757707B/en not_active Expired - Fee Related
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6574201B1 (en) * | 1998-07-06 | 2003-06-03 | Siemens Aktiengesellschaft | Method and mobile radio telephone network for handling a packet data service |
| CN101310791A (en) * | 2007-12-29 | 2008-11-26 | 北京谊安医疗系统股份有限公司 | Expiratory valve system |
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