CN111905162A - Airway secretion drainage device and drainage method - Google Patents

Abstract

The invention provides an airway secretion drainage device, which comprises: the suction control module controls the on and off of a connected drainage pipeline, and the drainage pipeline is connected to a patient; the communication module is communicated with the communication module of the breathing machine so that the drainage device and the breathing machine can carry out interaction of treatment information; an airway drainage management module that controls the suction control module, wherein the suction control module closes the drainage line during an inspiratory phase of the patient; and when the patient is pumped out, the suction control module opens the drainage pipeline to implement negative pressure drainage. The invention also correspondingly provides an airway secretion drainage method. The invention improves the effect of matching the breathing machine and the drainage device for drainage, eliminates the potential safety hazard and simultaneously reduces the complexity of the matched drainage pipeline.

Description

Airway secretion drainage device and drainage method

Technical Field

The invention relates to the technical field of auxiliary expectoration, in particular to an airway secretion drainage device and a drainage method.

Background

In normal persons, secretion in the airways is cleared mainly by two mechanisms of airway mucociliary movement and cough, but in intubated patients (namely invasive ventilation patients) depending on breathing machine support, the two airway secretion mechanisms of the patients are weakened to different degrees, and the patients are generally accompanied by primary airway morbidity (such as lung infection and chronic bronchial disease) which causes the increase of airway secretion (compared with the ordinary people), so the airway secretion management is particularly important for the patients with invasive ventilation. The conventional airway secretion management technology is mainly endotracheal sputum aspiration, and the conventional technology is very easy to cause many complications such as patient discomfort, blood oxygen decline and the like.

The existing system for realizing online airway sputum drainage by matching with a respirator is characterized in that a respirator and a synchronous drainage device are connected through a set of complex drainage matching pipeline, but the synchronous drainage device and the respirator are not communicated with each other through information. The synchronous drainage device and the breathing machine are separated, so that the matched drainage effect (with effectiveness defect) of the synchronous drainage device and the breathing machine is reduced, the operation fault (with safety defect) of the breathing machine is easily caused, and the complicated drainage matching pipeline also causes the management difficulty (with usability defect) of a user on the pipeline system.

Patent CN105343944 proposes an online airway drainage device capable of working with a breathing machine for simulating cough, which is also called a synchronous expectoration machine. The device utilizes a tee bend structure subassembly to connect breathing machine, negative pressure suction device (being synchronous expectoration machine promptly), patient, and under normal condition, the passageway between patient and the negative pressure suction device is in the off-state, does not influence the breathing machine and implements normal ventilation to the patient. Once the airway sputum drainage program is started, the negative pressure suction device judges the time (the rapid decrease of the inspiration peak value) when the breathing machine is switched from the inspiration phase to the expiration phase by using the sensor on the three-way structure, and at the moment when the switching time arrives, the balloon valve on the three-way structure is used for cutting off the normal ventilation channel of the breathing machine and the patient, and simultaneously, the negative pressure suction channel is rapidly opened to carry out negative pressure suction on the patient; after the negative pressure suction lasts for a short time, the system automatically restores the normal ventilation connection between the respirator and the airway of the patient, and the respirator inflates the patient. So, breathing machine and negative pressure suction device cooperate repeatedly, and the breathing machine is implemented to the patient and is aerifyd, and negative pressure suction device implements to bleed to the patient to reach the drainage effect that a simulation nature people coughed. The on-line drainage technology can avoid a plurality of complications caused by the traditional endotracheal sputum suction, and realize the effect of non-invasively removing the sputum of the trachea of the intubated patient.

The prior separated online drainage system matched with a breathing machine, namely a synchronous expectoration machine system, only uses a set of complex drainage matching pipelines to connect the breathing machine and the expectoration machine by air circuits, but does not communicate information between the expectoration machine and the breathing machine.

The synchronous expectoration machine does not communicate with the cooperating breathing machine, so the design of the separated system has a plurality of defects:

(1) the matching drainage effect (effectiveness defect) of the two is reduced: because the ventilator does not know when the expectoration machine performs cough treatment, the inspiratory capacity of the patient cannot be automatically increased before each cough like simulating the cough of a natural person, so that the gas entering the back of sputum in the deep part of the airway to generate enough push for the sputum cannot be sufficiently created, the ventilator does not limit the peak inspiratory flow, and the high inspiratory flow can generate the counterforce of blowing the sputum in the airway drawn by negative pressure back to the deep part of the airway again. Both small cough volumes and high ventilator reaction airflows are factors that contribute to the inefficient drainage of airway sputum.

(2) The ventilator is easy to cause safety alarm (safety defect): the breathing machine can not monitor the expiratory airflow of the patient when the expectoration machine sucks, the breathing machine can be triggered to give out an expiratory tidal volume low alarm, and in a more serious condition, the breathing machine can be triggered mistakenly in the expectoration machine suction period to give out a high-pressure alarm. Synchronizing ventilator alarms triggered by coughing requires attention and attention from the medical personnel, which increases and fatigues the medical personnel's care efforts.

(3) The system design concept that the expectoration machine and the breathing machine are respectively the same is a fundamental reason for the complex system of the matched pipeline of the synchronous expectoration machine, pressure and flow sampling pipes in the matched pipeline of the expectoration machine are designed for detecting when the breathing machine changes from inhalation to exhalation, and the sampling pipes have the risks of bending, breaking and being polluted by bacteria; the position of the three-way balloon valve in the matched pipeline is strict in placement requirement, otherwise, expectoration can not smoothly flow to the sputum collection cup. In summary, the complexity of the drainage kit increases the operational difficulty (ease of use deficiency) of managing the tubing by the user.

Disclosure of Invention

Aiming at the problems in the prior art, in order to overcome the defects of the existing online synchronous drainage system in the aspects of effectiveness, safety and usability, a more reasonable online drainage device and a drainage method are provided, and the online synchronous drainage device and the drainage method are a more reasonable system scheme.

The invention provides an airway secretion drainage device, which comprises: the suction control module controls the on and off of a connected drainage pipeline, and the drainage pipeline is connected to a patient; the communication module is communicated with the communication module of the breathing machine so that the drainage device and the breathing machine can carry out interaction of treatment information; an airway drainage management module that controls the suction control module, wherein the suction control module closes the drainage line during an inspiratory phase of the patient; and when the patient is pumped out, the suction control module opens the drainage pipeline to implement negative pressure drainage.

Optionally, after the inhalation phase begins, the airway management module closes the suction valve and regulates the negative pressure source pressure, and waits for the inhalation phase to end.

Optionally, when the inspiratory phase is finished, the airway-drainage management module receives inspiratory phase finishing information sent by the ventilator, and opens a suction valve in the suction control module to perform negative pressure drainage.

Optionally, at the end of the suction phase, the airway management module closes the suction valve in the suction control module and sends information of the end of the suction phase to the ventilator.

Optionally, the airway flow management module controls the suction control module based on ventilator-delivered therapy information, the therapy information comprising: inspiratory tidal volume, inspiratory flow, inspiratory peak pressure, inspiratory start information, and inspiratory end information.

The invention also provides an airway secretion drainage method, which comprises the following steps: providing an airway secretion drainage device, the drainage device being connected to the patient via a drainage line, the drainage device communicating with a ventilator; in the inspiration phase of the patient, the breathing machine works, and the drainage device closes the drainage pipeline; and in the air exhaust phase of the patient, the drainage device works, the drainage pipeline is opened, and negative pressure drainage is implemented.

Optionally, after the inhalation phase starts, the drainage device closes the suction valve to close the drainage pipeline, and adjusts the pressure of the negative pressure source to wait for the inhalation phase to end; when the end information of the inspiration phase sent by the respirator is received, the air suction phase starts, and the drainage device opens the drainage pipeline to start negative pressure drainage.

Optionally, after the inspiratory phase begins, the ventilator masks ventilator alarms due to negative pressure drainage, increases inspiratory tidal volume, and decreases inspiratory peak flow; and when the inspiration phase is finished, the breathing machine sends inspiration phase finishing information to the drainage device, closes the inspiration valve and closes the expiration control function.

Optionally, the airway flow management module controls the suction control module based on ventilator-delivered therapy information, the therapy information comprising: inspiratory tidal volume, inspiratory flow, inspiratory peak pressure, inspiratory start information, and inspiratory end information.

Optionally, the drainage device comprises: the suction control module controls the opening and closing of the drainage pipeline; the communication module is communicated with the communication module of the breathing machine so that the drainage device and the breathing machine can carry out interaction of treatment information; an airway-drainage management module that controls the suction control module having a suction valve for opening or closing the drainage line.

The beneficial effects of the invention include: the drainage device and the respirator are connected through a communication line, the drainage device and the respirator are provided with respective communication modules to realize information intercommunication of the drainage device and the respirator, and the drainage device and the respirator are also provided with respective airway drainage management modules to schedule and control a matching task in an airway drainage treatment process, so that the matching drainage effect of the drainage device and the respirator is improved, the potential safety hazard is eliminated, and the complexity of a drainage matching pipeline is reduced. The breathing machine and the drainage device can be simultaneously carried on a trolley, so that the occupied space of equipment in an ICU is greatly saved, and the unified control and management of the breathing machine and the drainage device by a user are facilitated.

(1) Because the breathing machine and the drainage device which are matched to realize airway sputum drainage are an information intercommunication whole, the breathing machine can improve the air supply tidal volume in the drainage treatment process and reduce the peak flow of inspiration to match the suction action of the negative pressure drainage device, thereby improving the drainage effect.

(2) The information of the breathing machine and the drainage device can be communicated, so that the breathing machine can completely know the drainage treatment information of the drainage device and can not send out an alarm in the matching drainage process, and thus, the fatigue of medical care personnel caused by unnecessary breathing machine alarm is avoided.

(3) The simplification of the matched drainage pipeline not only improves the safety of the system, but also reduces the operation difficulty of a user.

(4) The breathing machine and the drainage device are integrally carried, and the user can conveniently and uniformly control and manage the breathing machine and the drainage device.

Drawings

In order that the invention may be more readily understood, it will be described in more detail with reference to specific embodiments thereof that are illustrated in the accompanying drawings. These drawings depict only typical embodiments of the invention and are not therefore to be considered to limit the scope of the invention.

Fig. 1 is a working principle diagram of the externally-hung airway drainage system of the respirator.

Fig. 2 is a flow chart of the operation of the ventilator airway management module of the system of the present invention.

Fig. 3 is a flow chart of the operation of the airway management module of the drainage device of the system of the present invention.

FIG. 4 is a timing diagram of the operation of the drainage device and ventilator in the method of the present invention.

Detailed Description

Embodiments of the present invention will now be described with reference to the drawings, wherein like parts are designated by like reference numerals. The embodiments described below and the technical features of the embodiments may be combined with each other without conflict.

The invention is described below with reference to fig. 1. The ventilator is a dual limb ventilator capable of invasive ventilation. The dual-limb circuit of the ventilator, namely the inspiratory limb and the expiratory limb. The inspiration limb circuit is connected with an inspiration control module (inspiration valve) arranged in the breathing machine, the expiration limb circuit is connected with an expiration control module (expiration valve) arranged in the breathing machine, and the two limb circuits close to the patient end are converged through a Y-shaped tee joint.

The externally-hung drainage device comprises a suction control module, an airway drainage management module and a communication module. The suction control module comprises a suction port, the suction port is connected with a drainage pipeline, and the drainage pipeline is the same as a conventional breathing pipeline. A sputum collecting cup is arranged in the drainage pipeline and used for collecting airway secretions discharged from the drainage pipeline. The position of the sputum cup in the drainage line (whether near the patient, at the middle end, or near the drainage device) may be determined by the circumstances. The drainage pipeline is connected with a double-limb Y-shaped tee joint of the breathing machine and a patient intubation tube at the end close to the patient through another tee joint pipeline connecting piece.

The drainage device comprises a communication module used for communicating with the communication module of the breathing machine, and the direct communication mode of the two communication modules can be wired (RS232, USB and the like) or wireless (Bluetooth and the like). But is not limited to these standard interface modes, and other special communication modes and interface modes can be adopted.

The drainage device comprises an air passage drainage management module, and the air passage drainage management module is communicated with the communication module and the suction control module. The air passage drainage management module is used for scheduling and controlling the matched tasks in the air passage drainage treatment process. The airway drainage management module of the respirator is also used for scheduling and controlling the matching task in the airway drainage treatment process. The working process of the breathing machine and the drainage device needs to be matched with each other.

Specifically, the airway drainage management module of the ventilator can receive the treatment information of the drainage device sent by the communication module, and can also output the treatment information of the ventilator to the drainage device through the communication module. The therapy information of the ventilator may be information such as inspiratory tidal volume, inspiratory flow, inspiratory peak pressure, etc., or may be information such as inspiratory start and inspiratory end.

The airway drainage management module of the respirator can realize information intercommunication with the inspiration control module and the expiration control module of the respirator. An inspiratory control module of a ventilator includes a sensor, a valve element (e.g., an inspiratory valve), and an airflow source assembly. The ventilator exhalation control module includes a sensor, a valve element (e.g., exhalation valve), and an airflow source assembly.

The airway drainage management module of the drainage device can send the treatment information of the drainage device to the breathing machine through the communication module and can also receive the treatment information of the breathing machine reversely through the communication module. The treatment information of the drainage device can be information such as air suction amount, air suction peak flow, air suction peak pressure and the like, and can also be information such as air suction start and air suction end. The airway drainage management module and the suction control module of the drainage device can realize information intercommunication. The suction control module typically includes some sensor, valve components (including a suction valve) and an airflow source (e.g., a turbine that generates negative pressure) assembly.

Because the information can be communicated between the drainage device and the respirator, the drainage device does not need to utilize redundant pipeline sensor signals to guess when the respirator changes from inspiration to expiration to start suction action, because the treatment information of the respirator is completely transparent for the drainage device, the drainage device knows the time point (namely the end point of inspiration) when the respirator changes from inspiration to expiration in a communication mode, and the end point of inspiration of the respirator and the starting point of suction of the drainage device can be almost completely synchronized (certainly, a little communication delay exists). The synchronicity of the external drainage device and the respirator is not realized by a separated drainage device.

In addition, since conventional ICU dual-limb ventilators almost have built-in inspiratory valves for controlling inspiratory flow, the balloon valve employed by the split-drain to shut off the ventilator path during the aspiration period becomes unnecessary for the external-hanging type of drain. Therefore, compared with a separated drainage device, the externally-hung drainage device is not only not required to be provided with redundant pipeline sensor sampling pipes, but also is not required to be provided with a pipeline balloon valve, so that the matched drainage pipeline is greatly simplified.

The externally-hung drainage device has the advantages that the breathing machine can be matched with the action of the drainage device to make the change of breathing mode control and alarm response, so that the drainage effect and the safety of an integrated drainage system consisting of the breathing machine and the drainage device are improved.

Fig. 2 shows the task content of the airway management module of the ventilator. The ventilator needs to finish the equal air suction phase before each inspiration begins, and receives the treatment information of the drainage device. When the drainage treatment is started, the breathing machine receives the air suction phase finishing information sent by the drainage device, and the air suction phase starts.

Then, at the starting point of the inspiration phase, the respirator shields alarms such as low expiratory tidal volume, low expiratory minute ventilation, high breathing frequency and the like which are possibly sent out originally due to negative pressure suction. This is because the starting point of each inspiratory phase is usually the alarm information update point of the ventilator, and although the patient volume of the gas-pumping phase does not pass through the ventilator, the ventilator can completely know the expiratory volume of the patient of the induced-flow gas-pumping phase because the information of the ventilator and the induced-flow module can be communicated, and thus a false alarm may be generated.

The ventilator then controls inspiration: increasing inspiratory tidal volume and decreasing inspiratory peak flow. This is because, in order to cooperate with the drainage device to more effectively achieve airway sputum drainage, the ventilator will inflate the patient with a greater amount of air than it normally ventilates during the inspiratory phase, and will limit the peak flow of the inspiratory phase to prevent back-thrust from being generated to the airway sputum. During the breathing phase, which is controlled by the respirator, the suction valve of the drainage device is in the closed state, but the negative pressure source pressure in the drainage device is already set.

Then, when the inspiration phase is finished, the breathing machine sends information of finishing the inspiration phase to the drainage device. The ventilator sends out ventilator treatment information to the drainage device. After the drainage device receives the inspiration end information sent by the breathing machine, the suction valve is opened immediately to start the negative pressure air suction action.

Then, the respirator closes the inhalation valve, closes the exhalation control function, and waits for the end of the air-extraction phase of the drainage device. In the air extraction phase controlled by the drainage device, the inhalation valve of the respirator is in a closed state, and the exhalation valve of the respirator is also in a closed state.

Fig. 3 shows the workflow of the airway management module of the drainage device.

When the drainage treatment is started, the drainage device closes the suction valve, adjusts the pressure of the negative pressure source, and waits for the end of the inspiration phase of the respirator.

And when the end information of the inspiratory phase sent by the respirator is received, the suction valve is opened to implement airway negative pressure drainage.

And sending the pumping-out phase finishing information to the breathing machine when the pumping-out phase of the drainage device is finished.

The entire treatment process is described below with reference to the working sequence diagram of fig. 4.

When the drainage treatment is started, the suction valve of the drainage device is in a closed state, and the drainage pipeline is also in a closed state. The drainage device adjusts the pressure of the negative pressure source and waits for the end information of the inspiratory phase sent by the respirator.

The ventilator receives the information of the end of the air suction phase sent by the drainage device and enters the inspiration phase (time T0). In the inspiration phase, the patient inhales, and the respirator shields the alarm of the respirator caused by negative pressure drainage. And controlling the inspiration control module to open the inspiration valve, increase inspiration tidal volume and reduce inspiration peak flow. In the inspiration phase, the drainage device adjusts the negative pressure source pressure and waits for the end of the inspiration phase.

At the end of the inspiratory phase (time T1), the ventilator closes the inspiratory valve and the expiratory control function. The breathing machine sends out the end information of the inspiration phase to the drainage device.

After the drainage device receives the information of the end of the inspiration phase sent by the respirator, the suction phase starts (time T2). The drainage device opens the suction valve, enters the gas pumping phase, opens the drainage pipeline and implements the negative pressure drainage of the air passage. By the end of the gas extraction phase (time T3), the drainage device closes the suction valve and sends an extraction phase end message to the respirator, and the gas extraction phase is ended. The next cycle is started.

As can be seen from the figures 2-4, the breathing machine and the airway drainage management module of the external drainage module are independent and can form complementation.

In an exemplary embodiment of the invention, the drainage device and the ventilator are separate bodies, and the drainage device may also be integrated into the ventilator as a single body.

The above-described embodiments are merely preferred embodiments of the present invention, and general changes and substitutions by those skilled in the art within the technical scope of the present invention are included in the protection scope of the present invention.

Claims (10)

1. An airway secretion drainage device, comprising:

the suction control module controls the on and off of a connected drainage pipeline, and the drainage pipeline is connected to a patient;

the communication module is communicated with the communication module of the breathing machine so that the drainage device and the breathing machine can carry out interaction of treatment information;

an airway drainage management module that controls the suction control module, wherein the suction control module closes the drainage line during an inspiratory phase of the patient; and when the patient is pumped out, the suction control module opens the drainage pipeline to implement negative pressure drainage.

2. The airway secretion drainage device according to claim 1,

after the inspiratory phase begins, the airway-drainage management module closes the suction valve and regulates the negative pressure source pressure, and waits for the inspiratory phase to end.

3. The airway secretion drainage device according to claim 1,

and when the inspiration phase is finished, the airway drainage management module receives inspiration phase finishing information sent by the breathing machine, and opens a suction valve in the suction control module to implement negative pressure drainage.

4. The airway secretion drainage device according to claim 2,

when the air pumping phase is finished, the air passage drainage management module closes a pumping valve in the pumping control module and sends the information of the end of the air pumping phase to the respirator.

5. The airway secretion drainage device according to claim 1,

an airway diversion management module controls the suction control module based on ventilator-delivered therapy information, including: inspiratory tidal volume, inspiratory flow, inspiratory peak pressure, inspiratory start information, and inspiratory end information.

6. A method of airway secretion drainage, comprising:

providing an airway secretion drainage device, the drainage device being connected to the patient via a drainage line, the drainage device communicating with a ventilator;

in the inspiration phase of the patient, the breathing machine works, and the drainage device closes the drainage pipeline; and in the air exhaust phase of the patient, the drainage device works, the drainage pipeline is opened, and negative pressure drainage is implemented.

7. The method for draining airway secretions according to claim 6,

after the inhalation phase starts, the drainage device closes the suction valve to close the drainage pipeline, adjusts the pressure of the negative pressure source and waits for the termination of the inhalation phase;

when the end information of the inspiration phase sent by the respirator is received, the air suction phase starts, and the drainage device opens the drainage pipeline to start negative pressure drainage.

8. The method for draining airway secretions according to claim 7,

after the inspiratory phase begins, the respirator shields the alarm of the respirator caused by negative pressure drainage, increases inspiratory tidal volume and reduces inspiratory peak flow;

and when the inspiration phase is finished, the breathing machine sends inspiration phase finishing information to the drainage device, closes the inspiration valve and closes the expiration control function.

9. The method for draining airway secretions according to claim 6,

an airway diversion management module controls the suction control module based on ventilator-delivered therapy information, including: inspiratory tidal volume, inspiratory flow, inspiratory peak pressure, inspiratory start information, and inspiratory end information.

10. The method for draining airway secretions according to claim 6, wherein said drainage device comprises:

the suction control module controls the opening and closing of the drainage pipeline;

the communication module is communicated with the communication module of the breathing machine so that the drainage device and the breathing machine can carry out interaction of treatment information;

an airway-drainage management module that controls the suction control module having a suction valve for opening or closing the drainage line.

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