CN103830783B - A kind of Cardiopulmonary bypass decision system - Google Patents

Abstract

A kind of Cardiopulmonary bypass decision system, belongs to biomedical engineering technology field, mainly comprises decision-making module and detection module.Decision-making module, according to the data of detection module acquisition and processing, comprises output pressure and the blood flow of parameters of left ventricular function and oxygen supply index and outer circulation filling system, calculates perfusion subsidiary index number.This perfusion subsidiary index number represents the ratio of the acting of external counterpulsation system and patient's heart perfusion acting, and perfusion subsidiary index number value is higher, and the energy that external counterpulsation system provides for patient is higher.Decision-making module judges according to the parameters of left ventricular function of acquisition module collection and oxygen supply index, makes a policy: if index is within normal range, then pouring into subsidiary index number is recommendation, namely with reference to decision value; If index is outside normal range, then make warning.The reference decision value that doctor or control system propose according to decision-making module, selects to perform.By with reference to control agent outer filling flow based on decision value, the psychological need of patient can be adapted to, reduce complication.

Description

A kind of Cardiopulmonary bypass decision system

Technical field

The present invention relates to a kind of Cardiopulmonary bypass decision system, belong to biomedical engineering field.

Background technology

Cardiopulmonary bypass 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 provides leave described aortal aspiration flow to draw flow velocity whereby.Can simultaneously and optionally control described target perfusion flow velocity and described absorption flow velocity, but the physiological parameter of patient is not taken into account by this flow-control.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 monitor and forecast 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 controlling irrigation flow according to physiological parameter yet.

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

A kind of Low perfusion measurement method of blood oxygen saturation CN103027690A based on auto-correlation modeling of the Central China University of Science and Technology, although devise a kind of method measuring blood perfusion index, but this index only reflects the pulsating nature of blood flow, the ratio relation of external counterpulsation flow and patient self heart perfusion cannot be represented, foundation cannot be provided for control agent outer filling flow.

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

Summary of the invention

In order to according to the physiological parameter control agent outer filling flow of patient, complication can be reduced, the invention provides a kind of Cardiopulmonary bypass decision system, make groundwater increment maintain the scope of applicable patient's states.

To achieve these goals, this invention takes following technical scheme:

A kind of Cardiopulmonary bypass decision system, system comprises detection module and decision-making module, the described physiological data of detection module circle collection patient and the parameter of external counterpulsation system, the physiological data of patient 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 the waveform of arterial pressure respectively, the waveform of blood flow volume, the outlet pressure waveform of Cardiopulmonary bypass blood pump, the waveform of the perfusion blood flow of Cardiopulmonary bypass blood pump, above-mentioned data shown simultaneously and deliver to described decision-making module, described decision-making module is according to formula

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

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

In formula, the acting relation of PAI (ω)---Cardiopulmonary bypass and heart perfusion,

P _pthe outlet pressure waveform of (t)---Cardiopulmonary bypass blood pump,

F _pthe waveform of the perfusion blood flow of (t)---Cardiopulmonary bypass blood pump,

P _apthe waveform of (t)---arterial pressure,

F _apthe waveform of (t)---blood flow volume,

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

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

With condition below for foundation can obtain 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 calculated according to formula 118.1-(0.57 × age);

3) heart stroke is 4 ~ 7L/min or heart stroke 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 Cardiopulmonary bypass decision system can formulate perfusion decision-making, based on this control agent outer filling flow according to the physiological parameter of patient, adapt to the psychological need of patient, reduce complication.

Accompanying drawing explanation

Fig. 1 is the structural representation of a kind of Cardiopulmonary bypass decision system of the present invention.

Detailed description of the invention

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

Cardiopulmonary bypass flow decision system comprises detection module and decision-making module, and structured flowchart as shown in Figure 1.Detection module gathers the physiological data of patient 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, the heart stroke of patient, heart rate, blood pressure, blood oxygen saturation can adopt conventional sense means to obtain, and as Doppler flow 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 that chip CD4051 is formed) to form, multi-channel data acquisition module successively by each road signals collecting to computer, and circle collection.Computer fitting goes out the waveform of arterial pressure and blood flow, and the waveform of Cardiopulmonary bypass 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 Cardiopulmonary bypass and heart perfusion, introduce perfusion subsidiary index number PAI (ω), describe therebetween do the distribution of work.The algorithm routine of calculating PAI (ω) is installed, by formula in decision-making module

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

In formula, P _pthe outlet pressure waveform of (t)---Cardiopulmonary bypass blood pump,

F _pthe waveform of the perfusion blood flow of (t)---Cardiopulmonary bypass blood pump,

P _apthe waveform of (t)---arterial pressure,

F _apthe waveform of (t)---blood flow volume,

T _c---cardiac cycle.

Because the waveform of outlet pressure and blood flow is that Cardiopulmonary bypass system produces, can regulates, be obtained by described detection module, thus PAI (ω) is a personalized decision factor with physiological parameter change.PAI (ω) can the acting relation of assess cardiac and external counterpulsation system, describe therebetween do the distribution of work, unit is " % ", and its normal range is in 0%-100%.As PAI (ω) <100%, it is auxiliary that external counterpulsation system is in part.As PAI (ω)=100%, external counterpulsation system is in completely auxiliary.PAI (ω) value is higher, and the energy that external counterpulsation system provides for patient is higher.

The physiological data that decision-making module gathers according to detection module as heart stroke, heart rate, blood pressure, blood oxygen saturation, computing reference decision-making, i.e. PAI (ω).When these physiological datas are in normal value, PAI (ω) is with reference to decision value PAI, and 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 then 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 heartbeat frequency range is divided at 60-100/, and on average at about 75/ point, heart rate normal value is according to following formulae discovery: 118.1-(0.57 × age); The normal value of heart stroke is 4 ~ 7L/min, and heart stroke meansigma methods is 4 ~ 6.5L/min; Blood pressure systolic pressure≤140mmHg (18.6kPa), diastolic pressure≤90mmHg (12kPa).

Claims (2)

1. a Cardiopulmonary bypass decision system, system comprises detection module and decision-making module, it is characterized in that: the described physiological data of detection module circle collection patient and the parameter of external counterpulsation system, the physiological data of patient 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 the waveform of arterial pressure respectively, the waveform of blood flow volume, the outlet pressure waveform of Cardiopulmonary bypass blood pump, the waveform of the perfusion blood flow of Cardiopulmonary bypass blood pump, simultaneously by the physiological data of above-mentioned all patients, the parameter of external counterpulsation system, and detection module matching waveform out shows and delivers to described decision-making module, described decision-making module is according to formula

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

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

In formula, the acting relation of PAI (ω)---Cardiopulmonary bypass and heart perfusion,

P _pthe outlet pressure waveform of (t)---Cardiopulmonary bypass blood pump,

F _pthe waveform of the perfusion blood flow of (t)---Cardiopulmonary bypass blood pump,

P _apthe waveform of (t)---arterial pressure,

F _apthe waveform of (t)---blood flow volume,

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

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

2. a kind of Cardiopulmonary bypass decision system as claimed in claim 1, is characterized in that: the described foundation with reference to decision-making PAI is,

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

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

3) heart stroke is 4 ~ 7L/min, and heart stroke meansigma methods is 4 ~ 6.5L/min;

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