CN103830783A - Extracorporeal circulation perfusion policy making system - Google Patents

Abstract

The invention relates to an extracorporeal circulation perfusion policy making system and belongs to the technical field of biomedical engineering. The extracorporeal circulation perfusion policy making system comprises a policy making module and a detecting module. The policy making module calculates a perfusion subsidiary index according to data acquired and processed by the detecting module, and the date include a cardiac function index, an oxygen supply index, and output pressure and blood flow of a extracorporeal circulation perfusion system. The perfusion subsidiary index stands for the ratio of acting of the extracorporeal perfusion system and acting of perfusion of the heart of a patient, and the higher the perfusion subsidiary index is, the higher the energy the extracorporeal perfusion system provides for the patient is. The policy making module judges to make policy according to the cardiac function index and the oxygen supply index of the acquiring module. If the indexes are within a normal limit, the perfusion subsidiary index is a recommended value, namely a reference policy making value; if the indexes are out of the normal limit, an alarm is sent. A doctor may control the system to implement according to the reference policy making value provided by the policy making module. The extracorporeal perfusion flow is adjusted on the basis of the reference policy making value, which can adapt to physiological needs of patients and complications can be reduced.

Description

A kind of extracorporeal circulation perfusion decision system

Technical field

The present invention relates to a kind of extracorporeal circulation perfusion decision system, belong to biomedical engineering field.

Background technology

Extracorporeal circulation filling system is supplementary means conventional in surgical operation.In the world, the arterial set of Ka Diou Jiade medical science company, system and method CN201080025371.5, adopting a kind of aspiration chamber to arrange whereby provides and leaves described aortal aspiration flow with absorption flow velocity.Can and optionally control described target perfusion flow velocity and described absorption flow velocity, but this flow-control is not taken into account patient's physiological parameter simultaneously.The extracorporeal circulation of medical fluid and the system CN200710093658.1 of perfusion in the monitoring cardiorespiratory bypass process of Lande Co., Ltd., the blood circulation loop of monitoring and control blood pump, but its monitoring parameter does not feed back to the control of perfusion blood pump.Domestic, a kind of extracorporeal circulation overall perfusion system CN201220067806.9 of the Fourth Military Medical University of P.L.A, does not realize according to physiological parameter control irrigation flow yet.

The irrigation flow of current external counterpulsation system is to rely on doctors experience control, and be not coupled patient's physiological parameter of irrigation flow changes and considers, and therefore has the danger of perfusion or hypoperfusion.

A kind of low perfusion measurement method of blood oxygen saturation CN103027690A based on self correlation modeling of the Central China University of Science and Technology, although designed a kind of method of measuring blood perfusion index, but this index has only reflected the pulsating nature of blood flow, cannot represent the ratio relation of external counterpulsation flow and patient self heart perfusion, cannot provide foundation for control agent outer filling flow.

In filling process, physiological parameter is as heart stroke, heart rate, and the flow of blood pressure etc. and external counterpulsation is relevant in real time, and these parameters can be rotated the changes in flow rate causing and change along with blood pump.In the decision-making of control blood pump, these parameters are also important influence factors.

Summary of the invention

In order, according to patient's physiological parameter control agent outer filling flow, to reduce complication, the invention provides a kind of extracorporeal circulation perfusion decision system, make groundwater increment maintain the scope that is applicable to patient's states.

To achieve these goals, the present invention has taked following technical scheme:

A kind of extracorporeal circulation perfusion decision system, system comprises detection module and decision-making module, described detection module circle collection patient's physiological data and the parameter of external counterpulsation system, patient's physiological data comprises heart stroke, heart rate, blood pressure, Svo2 and arterial oxygen saturation, the parameter of external counterpulsation system comprises output pressure and flow, and detection module is by heart stroke wherein, blood pressure, output pressure, flow fits to respectively the waveform of arterial pressure, the waveform of blood flow volume, the outlet pressure waveform of extracorporeal circulation perfusion blood pump, the waveform of the perfusion blood flow of extracorporeal circulation perfusion blood pump, out by above-mentioned data show and deliver to described decision-making module simultaneously, described decision-making module is according to formula

$\mathrm{PAI}\left(\mathrm{\ω}\right)=\frac{1}{T_c}{\∫}_0^{T_c}\left(\frac{P_p\left(t\right)F_p\left(t\right)}{P_{\mathrm{ap}}\left(t\right)F_{\mathrm{ap}}\left(t\right)}\right)\mathrm{dt}$

Obtain with reference to decision-making PAI, and show with reference to decision-making PAI, or export to external counterpulsation system simultaneously;

In formula, PAI(ω)---the acting relation of extracorporeal circulation perfusion and heart perfusion,

P _p(t)---the outlet pressure waveform of extracorporeal circulation perfusion blood pump,

F _p(t)---the waveform of the perfusion blood flow of extracorporeal circulation perfusion blood pump,

P _ap(t)---the waveform of arterial pressure,

F _ap(t)---the waveform of blood flow volume,

T _c---cardiac cycle, is obtained by heart rate;

Described Svo2 and arterial oxygen saturation are as differentiating PAI(ω) whether be the foundation with reference to decision-making PAI, if arterial oxygen saturation >90%, Svo2 maintains between 64～88%, PAI(ω) be recommendation, output is with reference to decision-making PAI.

Taking condition below as according to obtaining the described optimum with reference to decision-making PAI:

1) arterial oxygen saturation >90%, Svo2 maintains between 64～88%;

2) heart rate is near the value of calculating according to formula 118.1-(0.57 × age);

3) cardiac output is 4～7L/min, and meansigma methods is 4～6.5L/min;

4) blood pressure systolic pressure≤140mmHg (18.6kPa), diastolic pressure≤90mmHg (12kPa).

Beneficial effect of the present invention is: utilize extracorporeal circulation perfusion decision system to formulate perfusion decision-making according to patient's physiological parameter, and control agent outer filling flow based on this, adaptation patient's psychological need, reduces complication.

Brief description of the drawings

Fig. 1 is the structural representation of a kind of extracorporeal circulation perfusion of the present invention decision system.

Detailed description of the invention

Below in conjunction with accompanying drawing 1, concrete formation of the present invention is elaborated.

Extracorporeal circulation irrigation flow decision system comprises detection module and decision-making module, and structured flowchart as shown in Figure 1.Detection module gathers patient's physiological data and the parameter of external counterpulsation system, and data are passed to described decision-making module.Physiological data comprises Cardiac Function of Patients index, as heart stroke, heart rate, blood pressure and oxygen supply index (comprising Svo2 and arterial oxygen saturation).The parameter of external counterpulsation system comprises output pressure and flow.Decision-making module receives the data of detection module and calculates, and draws with reference to decision-making PAI.

Wherein, patient's heart stroke, heart rate, blood pressure, blood oxygen saturation can adopt conventional sense means to obtain, and as doppler flow quantity sensor detects heart stroke, two have wound pressure transducer to detect blood pressure, and electrocardioelectrode detects heart rate, and photoelectric sensor detects blood oxygen saturation.

Detection module adopts computer and multiple signals selected on-off circuit (as the multiple signals selected on-off circuit of chip CD4051 formation) to form, and multi-channel data acquisition module successively Jiang Ge road signals collecting arrives computer, and circle collection.Computer fitting goes out the waveform of arterial pressure and blood flow, and the waveform of extracorporeal circulation perfusion blood pump outlet pressure and flow.

Decision-making module can adopt simple single-chip microcomputer and peripheral circuit thereof to form.By coding, obtain with reference to decision-making PAI.Its principle is as follows:

For evaluating the acting relation of extracorporeal circulation perfusion and heart perfusion, introduce perfusion subsidiary index number PAI(ω), the distribution of work of doing between the two is described.Calculating PAI(ω has been installed in decision-making module) algorithm routine, by formula

$\mathrm{PAI}\left(\mathrm{\ω}\right)=\frac{1}{T_c}{\∫}_0^{T_c}\left(\frac{P_p\left(t\right)F_p\left(t\right)}{P_{\mathrm{ap}}\left(t\right)F_{\mathrm{ap}}\left(t\right)}\right)\mathrm{dt}$ Obtain;

In formula, P _p(t)---the outlet pressure waveform of extracorporeal circulation perfusion blood pump,

F _p(t)---the waveform of the perfusion blood flow of extracorporeal circulation perfusion blood pump,

P _ap(t)---the waveform of arterial pressure,

F _ap(t)---the waveform of blood flow volume,

T _c---cardiac cycle.

Because the waveform of outlet pressure and blood flow is that extracorporeal circulation filling system produces, can regulate, obtained by described detection module, thereby PAI(ω) be a personalized decision factor changing with physiological parameter.PAI(ω) can assess cardiac and the acting relation of external counterpulsation system, the distribution of work of doing between the two is described, unit is " % ", its normal range is in 0%-100%.As PAI(ω) when <100%, external counterpulsation system is auxiliary in part.As PAI(ω)=100%, external counterpulsation system is in completely auxiliary.PAI(ω) value higher, external counterpulsation system for the energy that patient provides higher.

Decision-making module according to detection module gather physiological data as heart stroke, heart rate, blood pressure, blood oxygen saturation, computing reference decision-making, i.e. PAI(ω).When these physiological datas are during in normal value, PAI(ω) be with reference to decision value PAI, doctor or control system can regulate groundwater increment with reference to decision value PAI.If physiological data is not within normal range, decision-making module gives a warning.The normal value of the physiological parameter of decision-making module PAI reference is as follows: arterial oxygen saturation >90%, and Svo2 maintains between 64～88%; Normal palmic rate scope is divided at 60-100/, and on average 75/ point of left and right, heart rate normal value is calculated according to following formula: 118.1-(0.57 × age); Kinemic normal value is 4～7L/min, and meansigma methods is 4～6.5L/min; Blood pressure systolic pressure≤140mmHg (18.6kPa), diastolic pressure≤90mmHg (12kPa).

Claims (2)

1. an extracorporeal circulation perfusion decision system, system comprises detection module and decision-making module, it is characterized in that: described detection module circle collection patient's physiological data and the parameter of external counterpulsation system, patient's physiological data comprises heart stroke, heart rate, blood pressure, Svo2 and arterial oxygen saturation, the parameter of external counterpulsation system comprises output pressure and flow, and detection module is by heart stroke wherein, blood pressure, output pressure, flow fits to respectively the waveform of arterial pressure, the waveform of blood flow volume, the outlet pressure waveform of extracorporeal circulation perfusion blood pump, the waveform of the perfusion blood flow of extracorporeal circulation perfusion blood pump, out by above-mentioned data show and deliver to described decision-making module simultaneously, described decision-making module is according to formula

$\mathrm{PAI}\left(\mathrm{\&omega;}\right)=\frac{1}{T_c}{\&Integral;}_0^{T_c}\left(\frac{P_p\left(t\right)F_p\left(t\right)}{P_{\mathrm{ap}}\left(t\right)F_{\mathrm{ap}}\left(t\right)}\right)\mathrm{dt}$

Obtain with reference to decision-making PAI, and show with reference to decision-making PAI, or export to external counterpulsation system simultaneously;

In formula, PAI(ω)---the acting relation of extracorporeal circulation perfusion and heart perfusion,

P _p(t)---the outlet pressure waveform of extracorporeal circulation perfusion blood pump,

Fp ₍t)---the waveform of the perfusion blood flow of extracorporeal circulation perfusion blood pump,

P _ap(t)---the waveform of arterial pressure,

F _ap(t)---the waveform of blood flow volume,

T _c---cardiac cycle, is obtained by heart rate;

Described Svo2 and arterial oxygen saturation are as differentiating PAI(ω) whether be the foundation with reference to decision-making PAI, if arterial oxygen saturation >90%, Svo2 maintains between 64～88%, PAI(ω) be recommendation, output is with reference to decision-making PAI.

2. a kind of extracorporeal circulation perfusion decision system as claimed in claim 1, is characterized in that: described with reference to decision-making PAI according to being,

1) arterial oxygen saturation >90%, Svo2 maintains between 64～88%;

2) heart rate is near the value of calculating according to formula 118.1-(0.57 × age);

3) cardiac output is 4～7L/min, and meansigma methods is 4～6.5L/min;

4) blood pressure systolic pressure≤140mmHg (18.6kPa), diastolic pressure≤90mmHg (12kPa).

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