CN111249588A - Expiratory pressure control method, device and equipment based on breathing machine and storage medium - Google Patents
Expiratory pressure control method, device and equipment based on breathing machine and storage medium Download PDFInfo
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- CN111249588A CN111249588A CN202010065374.7A CN202010065374A CN111249588A CN 111249588 A CN111249588 A CN 111249588A CN 202010065374 A CN202010065374 A CN 202010065374A CN 111249588 A CN111249588 A CN 111249588A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M16/0009—Accessories therefor, e.g. sensors, vibrators, negative pressure with sub-atmospheric pressure, e.g. during expiration
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3331—Pressure; Flow
Abstract
The embodiment of the invention discloses an expiratory pressure control method based on a breathing machine, which comprises the following steps: calculating a first compliance based on a maximum change in lung volume during a previous inhalation and a first pressure value overcoming lung elastic resistance; calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process; determining a first pressure dynamic curve based on the first compliance and the first airway resistance value; and controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve. The invention considers different first compliance and airway resistance values in each breathing process to determine different first pressure dynamic curves, controls the expiratory pressure to quickly discharge the gas in the lungs under the condition of not damaging the airway, and improves the ventilation efficiency. A ventilator-based expiratory pressure control device, apparatus and storage medium are also presented.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to an expiratory pressure control method, device, equipment and storage medium based on a breathing machine.
Background
The breathing machine is an artificial mechanical ventilation device and is used for assisting or controlling the breathing movement of a patient so as to achieve the effect of gas exchange in the lungs and be beneficial to the recovery of the breathing function. When a respirator is used for providing auxiliary ventilation for a patient, air needs to be forcibly introduced into the lung of the patient during inspiration, and after inspiration is finished, air in the lung of the patient needs to be led out.
Prior art ventilators utilize simple control logic (e.g., PID control or simple sliding mode control) to control the breathing pressure. However, during the assisted ventilation of the patient, the breathing parameters of the patient cannot be adjusted in real time by monitoring different compliance of the lungs of the patient and airway resistance values, which easily results in too high or too low airway pressure and ventilation. Too high airway pressure and ventilation easily cause respiratory barotrauma of a patient, and too low airway pressure and ventilation easily cause hypoventilation of the patient or the gas in the lung cannot be discharged at the fastest speed.
Thus, there is a need for a more effective and safe ventilation regimen.
Disclosure of Invention
In view of the above, it is necessary to provide a method, an apparatus, a computer device and a storage medium for controlling expiratory pressure based on a ventilator.
A ventilator-based expiratory pressure control method, the method comprising:
calculating a first compliance based on a maximum change in lung volume during a previous inhalation and a first pressure value overcoming lung elastic resistance;
calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process;
determining a first pressure dynamic curve based on the first compliance and the first airway resistance value;
and controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve.
In one embodiment, the method further comprises: determining whether the current exhalation process is a first exhalation process; in the case that the current exhalation process is not the first exhalation process, the step of calculating the first compliance according to the maximum change value of the lung volume in the last inhalation process and the first pressure value for overcoming the elastic resistance of the lung is executed; under the condition that the current exhalation process is the first exhalation process, calculating second compliance according to the maximum change value of the lung volume in the current inhalation process and a first pressure value for overcoming the elastic resistance of the lung; determining a second pressure dynamic curve according to the preset second airway resistance value and the second compliance; and controlling the expiratory pressure of the respirator according to the second pressure dynamic curve so as to enable the expiratory pressure to be matched with the second pressure dynamic curve.
In one embodiment, the step of controlling the expiratory pressure of the ventilator according to the first pressure dynamics further comprises: and controlling the expiratory pressure of the respirator through a preset control algorithm so as to enable the expiratory pressure to be greater than or equal to a pressure value corresponding to the first pressure dynamic curve.
In one embodiment, after the step of controlling the expiratory pressure of the ventilator by the preset control algorithm, the method further includes: acquiring an expiratory airflow value at a preset time stage in the current expiratory process; judging whether the expiratory airflow value is larger than zero or a preset partial flow value; and adjusting the control parameters in the preset control algorithm under the condition that the expiratory airflow value is greater than zero or a preset bias flow value.
In one embodiment, the step of calculating the first compliance based on the maximum change in lung volume during the previous inhalation and the first pressure value overcoming the elastic resistance of the lung comprises: and calculating first compliance according to the maximum change value of the lung volume in the last inspiration, the first pressure value and preset positive end expiratory pressure.
In one embodiment, after the step of calculating the first compliance according to the maximum lung volume change value during the last inhalation, the first pressure value and the preset positive end expiratory pressure, the method further comprises: acquiring the inspiration flow rate in the current inspiration process; calculating the first airway resistance based on the maximum change in lung volume during the previous inhalation, the airway pressure value during the current inhalation, the first compliance value, the inhalation flow rate, and the positive end expiratory pressure.
In one embodiment, the step of determining a first pressure dynamic curve based on the first compliance and the first airway resistance value further comprises: calculating an equilibrium time from the first compliance and the first airway resistance; acquiring a target change value of the tidal volume in the lung in the current expiration process within the balance time; and generating the first pressure dynamic curve according to the target change value.
A ventilator-based expiratory pressure control apparatus, the apparatus comprising:
the first calculation module is used for calculating first compliance according to the maximum change value of the lung volume in the last inhalation process and a first pressure value for overcoming the elastic resistance of the lung;
the second calculation module is used for calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process;
a generation module that determines a first pressure dynamic curve based on the first compliance and the first airway resistance value;
and the control module is used for controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve.
In one embodiment, the apparatus further comprises: the judging module is used for determining whether the current expiration process is the first expiration process; in the case that the current exhalation process is not the first exhalation process, the step of calculating the first compliance according to the maximum change value of the lung volume in the last inhalation process and the first pressure value for overcoming the elastic resistance of the lung is executed; the third calculation module is used for calculating second compliance according to the maximum change value of the lung volume in the current inhalation process and the first pressure value for overcoming the elastic resistance of the lung under the condition that the current exhalation process is the first exhalation process; the determining module is used for determining a second pressure dynamic curve according to the preset second airway resistance value and second compliance; and the matching module is used for controlling the expiratory pressure of the respirator according to the second pressure dynamic curve so as to enable the expiratory pressure to be matched with the second pressure dynamic curve.
In one embodiment, the control module comprises: and the control unit is used for controlling the expiratory pressure of the respirator through a preset control algorithm so as to enable the expiratory pressure to be greater than or equal to a pressure value corresponding to the first pressure dynamic curve.
In one embodiment, the control module comprises: the first acquisition unit is used for acquiring an expiratory airflow value at a preset time stage in the current expiratory process; the judging unit is used for judging whether the expiratory airflow value is larger than zero or a preset partial flow value; and the adjusting unit is used for adjusting the control parameters in the preset control algorithm under the condition that the expiratory airflow value is greater than zero or a preset bias flow value.
In one embodiment, the first calculation module comprises: and the first calculation unit is used for calculating first compliance according to the maximum change value of the lung volume in the last inhalation process, the first pressure value and preset positive end expiratory pressure.
In one embodiment, the second calculation module comprises: the second calculation unit is used for acquiring the inspiration flow rate in the current inspiration process; calculating the first airway resistance based on the maximum change in lung volume during the previous inhalation, the airway pressure value during the current inhalation, the first compliance value, the inhalation flow rate, and the positive end expiratory pressure.
In one embodiment, the generating module further comprises: a time generation unit for calculating an equilibrium time from the first compliance and the first airway resistance; the second acquisition unit is used for acquiring a target change value of the tidal volume in the lung in the current exhalation process within the balance time; and the generating unit is used for generating the first pressure dynamic curve according to the target change value.
A computer device comprising a memory and a processor, the memory storing a computer program that, when executed by the processor, causes the processor to perform the steps of:
calculating a first compliance based on a maximum change in lung volume during a previous inhalation and a first pressure value overcoming lung elastic resistance;
calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process;
determining a first pressure dynamic curve based on the first compliance and the first airway resistance value;
and controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve.
A computer-readable storage medium storing a computer program which, when executed by a processor, causes the processor to perform the steps of:
calculating a first compliance based on a maximum change in lung volume during a previous inhalation and a first pressure value overcoming lung elastic resistance;
calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process;
determining a first pressure dynamic curve based on the first compliance and the first airway resistance value;
and controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve.
By adopting the expiratory pressure control method, the device, the equipment and the storage medium based on the breathing machine, firstly, the first compliance is calculated according to the maximum change value of the lung volume in the last inspiration process and the first pressure value for overcoming the elastic resistance of the lung; then, calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process; then, determining a first pressure dynamic curve based on the first compliance and the first airway resistance value; finally, the expiratory pressure of the ventilator is controlled according to the first pressure dynamic curve so that the expiratory pressure matches the first pressure dynamic curve. According to the invention, the first pressure dynamic curve is obtained by calculating the first compliance of the lung and the airway resistance value, different first pressure dynamic curves are determined by considering different first compliance and airway resistance values in each breathing process, the expiratory pressure is controlled to quickly discharge the gas in the lung under the condition of not damaging the airway, and the ventilation efficiency is improved.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.
Wherein:
FIG. 1 is a flow diagram of a ventilator-based expiratory pressure control method in one embodiment;
FIG. 2 is a schematic representation of airway pressure during inspiration and expiration in one embodiment;
FIG. 3 is a schematic representation of inspiratory flow rate during inspiration in one embodiment;
FIG. 4 is a schematic illustration of a first pressure dynamics curve in one embodiment;
FIG. 5 is a flow diagram of a ventilator-based expiratory pressure control method in one embodiment;
FIG. 6 is a block diagram of a ventilator-based expiratory pressure control device in accordance with one embodiment;
FIG. 7 is a block diagram of a ventilator-based expiratory pressure control device in accordance with one embodiment;
FIG. 8 is a block diagram of a control module in one embodiment;
FIG. 9 is a block diagram of the structure of a generation module in one embodiment;
FIG. 10 is a block diagram of a computer device that implements the ventilator-based expiratory pressure control method described above in one embodiment.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
In one embodiment, a ventilator-based expiratory pressure control method is provided, which can analyze and process data such as a maximum lung volume change value and a first pressure value overcoming lung elastic resistance in an inspiration process and an expiration process to determine a control strategy of the expiratory pressure, so as to control the expiratory pressure of a ventilator. The method may be applied to ventilation modes of a ventilator, etc.
As shown in fig. 1, in one embodiment, the above-mentioned ventilator-based expiratory pressure control method specifically includes the following steps S102-S108. It should be noted that the implementation of steps S102-S108 is based on the expiratory pressure control during the expiration process not performed by using the ventilator for the first time.
Step S102, calculating a first compliance according to the maximum change value of the lung volume in the last inspiration process and a first pressure value overcoming the elastic resistance of the lung.
Specifically, in the current breathing process, an inhalation process and an exhalation process are included, and the related data are calculated based on the exhalation process and the inhalation process respectively. The inspiration process and the expiration process may be based on a Volume Controlled Ventilation (VCV) Ventilation mode of the ventilator. The specific inhalation process and exhalation process are shown in fig. 2, wherein the inhalation process includes an inhalation phase and a breath holding state, the inhalation phase needs to overcome airway resistance and lung elastic resistance, and the breath holding phase needs to overcome lung elastic resistance.
First, a first compliance is calculated according to a maximum change value of the lung volume during inhalation and a first pressure value overcoming the elastic resistance of the lung, and then a control strategy of the exhalation pressure is established according to the first compliance and the first airway resistance value during exhalation.
The maximum lung volume change value may refer to a change in lung volume from a positive end-expiratory pressure maintenance state to a breath-hold state of the lungs; the change value of the lung volume before and after ventilation can also be calculated by the inspiration volume of the lung, and the following formula is shown:
Volume＝∫Flowdt
wherein Volume is the maximum change value of the lung Volume in the last inspiration, Flow is the inspiration Flow rate, and the inspiration Flow rate refers to the ventilation speed of the auxiliary or controlled inspiration of a breathing machine. As shown in fig. 3, the inspiratory flow rate can be a rectangular square wave, and the calculation of the maximum change value of the lung volume is to integrate the inspiratory flow rate.
The first pressure value for overcoming the elastic resistance of the lung is the pressure value of the lung in the breath holding state after inspiration, and the pressure value of the lung in the breath holding state after inspiration can be obtained by measuring the airway pressure in the breath holding state.
The first compliance represents the ease with which the lungs are deformed under external pressure during non-first exhalations or during inhalation.
After obtaining the maximum change value of the lung volume and the first pressure value for overcoming the elastic resistance of the lung in the last inhalation process, the first compliance is calculated according to the maximum change value of the lung volume and the first pressure value for overcoming the elastic resistance of the lung in the last inhalation process.
In one embodiment, the first compliance is calculated based on the maximum change in lung volume during the previous inhalation, the first pressure value and a preset positive end expiratory pressure.
The preset positive end expiratory pressure is a certain positive pressure maintained in the respiratory tract at the end of respiration during assisted respiration or controlled respiration. The preset end-expiratory pressure can prevent the lungs of the patient from collapsing and shrinking during respiration, and a certain tidal volume is reserved in the lungs of the patient at the end of expiration to maintain the end-expiratory pressure.
Before calculating the first compliance, it is necessary to calculate a pressure change value Δ P corresponding to the maximum change value of the lung volume, that is, a difference value between the first pressure value and the pressure value in the positive end-of-breath pressure maintaining state is calculated, as shown in the following formula:
ΔP＝Pplate-PEEP
wherein Pplate is the pressure value of breath-hold state, PEEP is the positive end-respiratory pressure.
The first Compliance company is the ratio of the maximum change in lung volume to the corresponding change in pressure Δ P during the last exhalation, as shown in the following equation:
wherein Volume is the maximum change value of the lung Volume in the last inhalation process, and Δ P is the pressure change value.
And step S104, calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process.
Specifically, the airway pressure value during the current inhalation is the total airway pressure value during the auxiliary or control inhalation. The airway pressure value in the current inhalation process refers to a sum of the resistance of the airway, the elastic resistance of the lung and the positive airway end pressure, wherein the airway pressure value in the current inhalation process can be monitored by a breathing machine or other respiratory monitoring equipment.
After the first compliance during the last inhalation and the airway pressure value during the current inhalation are measured and calculated, a first airway resistance value may be calculated from the first compliance and the airway pressure value.
In one embodiment, an inspiratory flow rate during a current inspiration is obtained; calculating the first airway resistance based on the maximum change in lung volume during the previous inhalation, the airway pressure value during the current inhalation, the first compliance value, the inhalation flow rate, and the positive end expiratory pressure.
Specifically, the first airway resistance may be calculated using the following equation:
the method comprises the steps of obtaining a Flow rate, a Flow resistance and a PEEP (positive end expiratory pressure), wherein Paw is an airway pressure value in the current inhalation process, Volume is the maximum change value of the lung Volume in the previous inhalation process, the Compliance is first Compliance, the Flow is an inhalation Flow rate, R is a first airway resistance, and PEEP is positive end expiratory pressure.
Processing this equation, the calculation equation of the first airway resistance can also be expressed by the following equation:
step S106, determining a first pressure dynamic curve according to the first compliance and the first airway resistance value.
Specifically, the first pressure dynamic curve may be a curve of time variation of the target expiratory volume required to be reached when the breathing machine assists or controls expiration; which may be a time-varying curve of the retained tidal volume in the lungs upon ventilator assistance or control of exhalation.
A first pressure dynamic curve is determined based on the first compliance and the first airway resistance, the first pressure dynamic curve corresponding to the tidal volume in the lung based on time.
In one embodiment, an equilibrium time is calculated from the first compliance and the first airway resistance; acquiring a target change value of the tidal volume in the lung in the current expiration process within the balance time; and generating the first pressure dynamic curve according to the target change value.
Wherein, the equilibrium time is the time when the pressure of the proximal airway and the alveoli in the respiratory system reaches equilibrium, the tidal volume in the lung during the current exhalation process is the amount of retained gas in the lung, the target change value is the amount of tidal volume in the lung which is changed according to the equilibrium time, as shown in fig. 4, the first pressure dynamic curve can be a target value when the tidal volume is excluded from the body, and 63% of the tidal volume can be exhausted from the lung after an equilibrium time; after three equilibrium times, 95% of tidal volume can be discharged outside the lungs; after five equilibration times, 99% of the tidal volume was expelled from the lungs.
The equilibrium time may be calculated from the first compliance and the first airway resistance, as shown in the following equation:
TC＝Compliance×R
where TC is the equilibrium time, company is the first Compliance, and R is the first airway resistance.
And S108, controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve.
Specifically, the expiratory pressure of the breathing machine is controlled in the next expiratory process according to the first pressure dynamic curve. The expiratory pressure may be determined from the maximum change in lung volume during the previous procedure and the first compliance, and may be specified by the following equation:
wherein Pressure is expiratory Pressure, Volume is maximum lung Volume change value, and Compliance is first Compliance.
Controlling the expiratory pressure of the ventilator to be matched with the first pressure dynamic curve, wherein the tidal volume remaining in the lung under the action of the expiratory pressure is consistent with the first pressure dynamic curve, and the expiratory pressure needs to be equal to a pressure value corresponding to the first pressure dynamic curve, so that the expiratory speed is equal to the expiratory speed corresponding to the first pressure dynamic curve; the tidal volume remaining in the lung under the action of the expiratory pressure may also be smaller than the first pressure dynamic curve, wherein the expiratory pressure needs to be larger than the pressure value corresponding to the first pressure dynamic curve, so that the expiratory speed is larger than the expiratory speed corresponding to the first pressure dynamic curve.
In one embodiment, the expiratory pressure of the ventilator is controlled by a preset control algorithm, so that the expiratory pressure is greater than or equal to a pressure value corresponding to the first pressure dynamic curve.
The algorithm for controlling the expiratory pressure by the preset control algorithm may be a simple control logic, such as PID (proportional-integral-derivative) control or simple sliding mode control. The expiratory pressure is greater than or equal to the pressure value corresponding to the first pressure dynamic curve, so that the expiratory speed is greater than or equal to the expiratory speed corresponding to the first pressure dynamic curve, and the tidal volume in the lung can be rapidly exhausted from the body.
After the step of controlling the expiratory pressure of the ventilator by a preset control algorithm, it is necessary to determine whether the tidal volume discharge in the lung during the current expiration process reaches a preset condition.
In one embodiment, an expiratory airflow value is obtained at a preset time period during a current expiration; judging whether the expiratory airflow value is larger than zero or a preset partial flow value; and adjusting the control parameters in the preset control algorithm under the condition that the expiratory airflow value is greater than zero or a preset bias flow value.
The expiratory airflow value is the amount of tidal volume discharged from the lung in a preset time period during the current expiration process. The preset time period may be a certain time period at the end of the current exhalation process. The bias flow value is the air flow value of the air supply pipeline air flow given in the expiration process and is used for removing residual air in the pipeline. When the expiratory airflow value is greater than zero or the preset bias flow value indicates that the discharge of the tidal volume in the lung during the current expiration process has not reached the preset condition, the expiratory pressure needs to be adjusted. Adjusting the expiratory pressure requires adjusting a control parameter in a preset control algorithm, and the control parameter may be a KI parameter in PID control, that is, an integral adjustment coefficient, which is used to eliminate a residual error between the tidal volume during the expiration process and a target tidal volume. Over time, the integral increases as long as the target tidal volume is not reached. The integral value does not change again until the ventilator adjusts the expiratory pressure to the target tidal volume. Adjusting the KI parameter is simply to increase or decrease the rate of increase of the integral quantity so that the ventilator adjusts the expiratory pressure more quickly.
The steps S102 to S108 are to calculate the first pressure dynamic curve in the non-first inhalation process and the exhalation process, and then control the exhalation pressure, and for the first inhalation process and the exhalation process, the control of the exhalation pressure by the corresponding second dynamic curve is similar to the steps S102 to S108, but the calculation of the second pressure dynamic curve is different from the calculation of the first pressure dynamic curve.
Specifically, as shown in fig. 5, in one embodiment, step S101: determining whether the current exhalation process is a first exhalation process; in case the current exhalation process is not the first exhalation process, step S102 is performed: calculating a first compliance value according to the maximum change value of the lung volume in the last inhalation process and a first pressure value for overcoming the elastic resistance of the lung; in case the current exhalation process is the first exhalation process, step S103 is performed: calculating a second compliance according to the maximum change value of the lung volume in the current inhalation process and the first pressure value for overcoming the elastic resistance of the lung; step S105: determining a second pressure dynamic curve according to the preset second airway resistance value and the second compliance; step S107: and controlling the expiratory pressure of the respirator according to the second pressure dynamic curve so as to enable the expiratory pressure to be matched with the second pressure dynamic curve.
Wherein, the second compliance is the degree of difficulty of the lung deforming under the action of external pressure during the first expiration or during inspiration. Here, the maximum change value of the lung volume and the first pressure value against the elastic resistance of the lung during the current inhalation are calculated in the same manner as the maximum change value of the lung volume and the first pressure value against the elastic resistance of the lung during the previous inhalation.
The preset second airway resistance value is an empirically directly set airway resistance value. The method of determining the second pressure dynamic curve based on the preset second airway resistance value and the second compliance is the same as the method of determining the first pressure dynamic curve based on the first compliance and the first airway resistance value.
The method for controlling the expiratory pressure of the respirator according to the second pressure dynamic curve so as to enable the expiratory pressure to be matched with the second pressure dynamic curve is the same as the method for controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve.
As shown in fig. 6, in one embodiment, a ventilator-based expiratory pressure control apparatus is presented, the apparatus comprising:
a first calculation module 602, configured to calculate a first compliance according to a maximum lung volume change value during a previous inhalation and a first pressure value overcoming a lung elastic resistance;
a second calculation module 604, configured to calculate a first airway resistance value according to the first compliance and an airway pressure value in a current inhalation process;
a generating module 606 that determines a first pressure dynamic curve based on the first compliance and the first airway resistance value;
a control module 608, configured to control an expiratory pressure of the ventilator according to the first pressure dynamic curve, so that the expiratory pressure matches the first pressure dynamic curve.
As shown in fig. 7, in one embodiment, the apparatus further comprises: the judging module 601 is configured to determine whether a current exhalation process is a first exhalation process; in the case that the current exhalation process is not the first exhalation process, the step of calculating the first compliance according to the maximum change value of the lung volume in the last inhalation process and the first pressure value for overcoming the elastic resistance of the lung is executed; a third calculating module 603, configured to calculate a second compliance according to the maximum lung volume change value and the first pressure value overcoming the lung elastic resistance in the current inhalation process, when the current exhalation process is the first exhalation process; a determining module 605 for determining a second pressure dynamic curve according to the preset second airway resistance value and the second compliance; a matching module 607, configured to control the expiratory pressure of the ventilator according to the second pressure dynamic curve, so that the expiratory pressure matches the second pressure dynamic curve.
As shown in fig. 8, in one embodiment, the control module 608 includes: and the control unit is used for controlling the expiratory pressure of the respirator through a preset control algorithm so as to enable the expiratory pressure to be greater than or equal to a pressure value corresponding to the first pressure dynamic curve.
As shown in fig. 8, in one embodiment, the control module 608 includes: the first acquisition unit is used for acquiring an expiratory airflow value at a preset time stage in the current expiratory process; the judging unit is used for judging whether the expiratory airflow value is larger than zero or a preset partial flow value; and the adjusting unit is used for adjusting the control parameters in the preset control algorithm under the condition that the expiratory airflow value is greater than zero or a preset bias flow value.
In one embodiment, the first calculation module 602 includes: and the first calculation unit is used for calculating first compliance according to the maximum change value of the lung volume in the last inhalation process, the first pressure value and preset positive end expiratory pressure.
In one embodiment, the second calculation module 604 includes: the second calculation unit is used for acquiring the inspiration flow rate in the current inspiration process; calculating the first airway resistance based on the maximum change in lung volume during the previous inhalation, the airway pressure value during the current inhalation, the first compliance value, the inhalation flow rate, and the positive end expiratory pressure.
As shown in fig. 9, in one embodiment, the generating module 606 further includes: a time generation unit for calculating an equilibrium time from the first compliance and the first airway resistance; the second acquisition unit is used for acquiring a target change value of the tidal volume in the lung in the current exhalation process within the balance time; and the generating unit is used for generating the first pressure dynamic curve according to the target change value.
FIG. 10 is a diagram illustrating an internal structure of a computer device in one embodiment. The computer device may specifically be a terminal, and may also be a server. As shown in fig. 10, the computer device includes a processor, a memory, and a network interface connected by a system bus. Wherein the memory includes a non-volatile storage medium and an internal memory. The non-volatile storage medium of the computer device stores an operating system and may also store a computer program that, when executed by the processor, may cause the processor to implement a ventilator-based expiratory pressure control method. The internal memory may also have stored therein a computer program that, when executed by the processor, causes the processor to perform a ventilator-based expiratory pressure control method. Those skilled in the art will appreciate that the architecture shown in fig. 10 is merely a block diagram of some of the structures associated with the disclosed aspects and is not intended to limit the computing devices to which the disclosed aspects apply, as particular computing devices may include more or less components than those shown, or may combine certain components, or have a different arrangement of components.
In one embodiment, a computer device is proposed, comprising a memory and a processor, the memory storing a computer program which, when executed by the processor, causes the processor to perform the steps of: calculating a first compliance based on a maximum change in lung volume during a previous inhalation and a first pressure value overcoming lung elastic resistance; calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process; determining a first pressure dynamic curve based on the first compliance and the first airway resistance value; and controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve.
In one embodiment, the method further comprises: determining whether the current exhalation process is a first exhalation process; in the case that the current exhalation process is not the first exhalation process, the step of calculating the first compliance according to the maximum change value of the lung volume in the last inhalation process and the first pressure value for overcoming the elastic resistance of the lung is executed; under the condition that the current exhalation process is the first exhalation process, calculating second compliance according to the maximum change value of the lung volume in the current inhalation process and a first pressure value for overcoming the elastic resistance of the lung; determining a second pressure dynamic curve according to the preset second airway resistance value and the second compliance; and controlling the expiratory pressure of the respirator according to the second pressure dynamic curve so as to enable the expiratory pressure to be matched with the second pressure dynamic curve.
In one embodiment, the step of controlling the expiratory pressure of the ventilator according to the first pressure dynamics further comprises: and controlling the expiratory pressure of the respirator through a preset control algorithm so as to enable the expiratory pressure to be greater than or equal to a pressure value corresponding to the first pressure dynamic curve.
In one embodiment, after the step of controlling the expiratory pressure of the ventilator by the preset control algorithm, the method further includes: acquiring an expiratory airflow value at a preset time stage in the current expiratory process; judging whether the expiratory airflow value is larger than zero or a preset partial flow value; and adjusting the control parameters in the preset control algorithm under the condition that the expiratory airflow value is greater than zero or a preset bias flow value.
In one embodiment, the step of calculating the first compliance based on the maximum change in lung volume during the previous inhalation and the first pressure value overcoming the elastic resistance of the lung comprises: and calculating first compliance according to the maximum change value of the lung volume in the last inspiration, the first pressure value and preset positive end expiratory pressure.
In one embodiment, after the step of calculating the first compliance according to the maximum lung volume change value during the last inhalation, the first pressure value and the preset positive end expiratory pressure, the method further comprises: acquiring the inspiration flow rate in the current inspiration process; calculating the first airway resistance based on the maximum change in lung volume during the previous inhalation, the airway pressure value during the current inhalation, the first compliance value, the inhalation flow rate, and the positive end expiratory pressure.
In one embodiment, the step of determining a first pressure dynamic curve based on the first compliance and the first airway resistance value further comprises: calculating an equilibrium time from the first compliance and the first airway resistance; acquiring a target change value of the tidal volume in the lung in the current expiration process within the balance time; and generating the first pressure dynamic curve according to the target change value.
In one embodiment, a computer-readable storage medium is proposed, in which a computer program is stored which, when executed by a processor, causes the processor to carry out the steps of: calculating a first compliance based on a maximum change in lung volume during a previous inhalation and a first pressure value overcoming lung elastic resistance; calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process; determining a first pressure dynamic curve based on the first compliance and the first airway resistance value; and controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve.
In one embodiment, the method further comprises: determining whether the current exhalation process is a first exhalation process; in the case that the current exhalation process is not the first exhalation process, the step of calculating the first compliance according to the maximum change value of the lung volume in the last inhalation process and the first pressure value for overcoming the elastic resistance of the lung is executed; under the condition that the current exhalation process is the first exhalation process, calculating second compliance according to the maximum change value of the lung volume in the current inhalation process and a first pressure value for overcoming the elastic resistance of the lung; determining a second pressure dynamic curve according to the preset second airway resistance value and the second compliance; and controlling the expiratory pressure of the respirator according to the second pressure dynamic curve so as to enable the expiratory pressure to be matched with the second pressure dynamic curve.
In one embodiment, the step of controlling the expiratory pressure of the ventilator according to the first pressure dynamics further comprises: and controlling the expiratory pressure of the respirator through a preset control algorithm so as to enable the expiratory pressure to be greater than or equal to a pressure value corresponding to the first pressure dynamic curve.
In one embodiment, after the step of controlling the expiratory pressure of the ventilator by the preset control algorithm, the method further includes: acquiring an expiratory airflow value at a preset time stage in the current expiratory process; judging whether the expiratory airflow value is larger than zero or a preset partial flow value; and adjusting the control parameters in the preset control algorithm under the condition that the expiratory airflow value is greater than zero or a preset bias flow value.
In one embodiment, the step of calculating the first compliance based on the maximum change in lung volume during the previous inhalation and the first pressure value overcoming the elastic resistance of the lung comprises: and calculating first compliance according to the maximum change value of the lung volume in the last inspiration, the first pressure value and preset positive end expiratory pressure.
In one embodiment, after the step of calculating the first compliance according to the maximum lung volume change value during the last inhalation, the first pressure value and the preset positive end expiratory pressure, the method further comprises: acquiring the inspiration flow rate in the current inspiration process; calculating the first airway resistance based on the maximum change in lung volume during the previous inhalation, the airway pressure value during the current inhalation, the first compliance value, the inhalation flow rate, and the positive end expiratory pressure.
In one embodiment, the step of determining a first pressure dynamic curve based on the first compliance and the first airway resistance value further comprises: calculating an equilibrium time from the first compliance and the first airway resistance; acquiring a target change value of the tidal volume in the lung in the current expiration process within the balance time; and generating the first pressure dynamic curve according to the target change value.
By adopting the expiratory pressure control method, the device, the equipment and the storage medium based on the breathing machine, firstly, the first compliance is calculated according to the maximum change value of the lung volume in the last inspiration process and the first pressure value for overcoming the elastic resistance of the lung; then, calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process; then, determining a first pressure dynamic curve based on the first compliance and the first airway resistance value; finally, the expiratory pressure of the ventilator is controlled according to the first pressure dynamic curve so that the expiratory pressure matches the first pressure dynamic curve. According to the invention, the first pressure dynamic curve is obtained by calculating the first compliance of the lung and the airway resistance value, different first pressure dynamic curves are determined by considering different first compliance and airway resistance values in each breathing process, the expiratory pressure is controlled to quickly discharge the gas in the lung under the condition of not damaging the airway, and the ventilation efficiency is improved.
It will be understood by those skilled in the art that all or part of the processes of the methods of the embodiments described above can be implemented by a computer program, which can be stored in a non-volatile computer-readable storage medium, and can include the processes of the embodiments of the methods described above when the program is executed. Any reference to memory, storage, database, or other medium used in the embodiments provided herein may include non-volatile and/or volatile memory, among others. Non-volatile memory can include read-only memory (ROM), Programmable ROM (PROM), Electrically Programmable ROM (EPROM), Electrically Erasable Programmable ROM (EEPROM), or flash memory. Volatile memory can include Random Access Memory (RAM) or external cache memory. By way of illustration and not limitation, RAM is available in a variety of forms such as Static RAM (SRAM), Dynamic RAM (DRAM), Synchronous DRAM (SDRAM), Double Data Rate SDRAM (DDRSDRAM), Enhanced SDRAM (ESDRAM), Synchronous Link DRAM (SLDRAM), Rambus Direct RAM (RDRAM), direct bus dynamic RAM (DRDRAM), and memory bus dynamic RAM (RDRAM).
The technical features of the above embodiments can be arbitrarily combined, and for the sake of brevity, all possible combinations of the technical features in the above embodiments are not described, but should be considered as the scope of the present specification as long as there is no contradiction between the combinations of the technical features.
The above-mentioned embodiments only express several embodiments of the present application, and the description thereof is more specific and detailed, but not construed as limiting the scope of the present application. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the concept of the present application, which falls within the scope of protection of the present application. Therefore, the protection scope of the present patent shall be subject to the appended claims.
Claims (10)
1. A ventilator-based expiratory pressure control method, the method comprising:
calculating a first compliance based on a maximum change in lung volume during a previous inhalation and a first pressure value overcoming lung elastic resistance;
calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process;
determining a first pressure dynamic curve based on the first compliance and the first airway resistance value;
and controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve.
2. The method of claim 1, further comprising:
determining whether the current exhalation process is a first exhalation process;
in the case that the current exhalation process is not the first exhalation process, the step of calculating the first compliance according to the maximum change value of the lung volume in the last inhalation process and the first pressure value for overcoming the elastic resistance of the lung is executed;
under the condition that the current exhalation process is the first exhalation process, calculating second compliance according to the maximum change value of the lung volume in the current inhalation process and a first pressure value for overcoming the elastic resistance of the lung;
determining a second pressure dynamic curve according to the preset second airway resistance value and the second compliance;
and controlling the expiratory pressure of the respirator according to the second pressure dynamic curve so as to enable the expiratory pressure to be matched with the second pressure dynamic curve.
3. The method of claim 1, wherein the step of controlling an expiratory pressure of a ventilator in accordance with the first pressure dynamics profile further comprises:
and controlling the expiratory pressure of the respirator through a preset control algorithm so as to enable the expiratory pressure to be greater than or equal to a pressure value corresponding to the first pressure dynamic curve.
4. The method of claim 3, wherein the step of controlling the expiratory pressure of the ventilator by a preset control algorithm is followed by the step of:
acquiring an expiratory airflow value at a preset time stage in the current expiratory process;
judging whether the expiratory airflow value is larger than zero or a preset partial flow value;
and adjusting the control parameters in the preset control algorithm under the condition that the expiratory airflow value is greater than zero or a preset bias flow value.
5. The method of claim 1, wherein the step of calculating the first compliance based on the maximum change in lung volume during the previous inhalation and the first pressure value overcoming the elastic resistance of the lung comprises:
and calculating first compliance according to the maximum change value of the lung volume in the last inspiration, the first pressure value and preset positive end expiratory pressure.
6. The method of claim 5, wherein the step of calculating a first compliance from the maximum lung volume change during the previous inhalation, the first pressure value, and the preset positive end expiratory pressure is followed by the step of:
acquiring the inspiration flow rate in the current inspiration process;
calculating the first airway resistance based on the maximum change in lung volume during the previous inhalation, the airway pressure value during the current inhalation, the first compliance value, the inhalation flow rate, and the positive end expiratory pressure.
7. The method of claim 1, wherein the step of determining a first pressure dynamic curve based on the first compliance and the first airway resistance value further comprises:
calculating an equilibrium time from the first compliance and the first airway resistance;
acquiring a target change value of the tidal volume in the lung in the current expiration process within the balance time;
and generating the first pressure dynamic curve according to the target change value.
8. A ventilator-based expiratory pressure control device, the device comprising:
the first calculation module is used for calculating first compliance according to the maximum change value of the lung volume in the last inhalation process and a first pressure value for overcoming the elastic resistance of the lung;
the second calculation module is used for calculating a first airway resistance value according to the first compliance and the airway pressure value in the current inhalation process;
a generation module that determines a first pressure dynamic curve based on the first compliance and the first airway resistance value;
and the control module is used for controlling the expiratory pressure of the respirator according to the first pressure dynamic curve so as to enable the expiratory pressure to be matched with the first pressure dynamic curve.
9. A computer-readable storage medium, storing a computer program which, when executed by a processor, causes the processor to carry out the steps of the method according to any one of claims 1 to 7.
10. A computer device comprising a memory and a processor, the memory storing a computer program that, when executed by the processor, causes the processor to perform the steps of the method according to any one of claims 1 to 7.
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| CN202010065374.7A CN111249588A (en) | 2020-01-20 | 2020-01-20 | Expiratory pressure control method, device and equipment based on breathing machine and storage medium |
| PCT/CN2020/115335 WO2021147349A1 (en) | 2020-01-20 | 2020-09-15 | Ventilator-based expiratory pressure control method, apparatus and device, and storage medium |
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