CN112057714B - Breathing machine - Google Patents
Breathing machine Download PDFInfo
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- CN112057714B CN112057714B CN202010996762.7A CN202010996762A CN112057714B CN 112057714 B CN112057714 B CN 112057714B CN 202010996762 A CN202010996762 A CN 202010996762A CN 112057714 B CN112057714 B CN 112057714B
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- supply flow
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- 230000029058 respiratory gaseous exchange Effects 0.000 title claims abstract description 20
- 230000001276 controlling effect Effects 0.000 claims abstract description 8
- 230000001105 regulatory effect Effects 0.000 claims abstract description 7
- 238000009423 ventilation Methods 0.000 claims description 11
- 238000012544 monitoring process Methods 0.000 claims description 7
- 238000007599 discharging Methods 0.000 claims 1
- 244000144985 peep Species 0.000 claims 1
- 238000000034 method Methods 0.000 abstract description 13
- 206010001052 Acute respiratory distress syndrome Diseases 0.000 abstract description 6
- 201000000028 adult respiratory distress syndrome Diseases 0.000 abstract description 6
- 210000004072 lung Anatomy 0.000 description 9
- 230000006378 damage Effects 0.000 description 6
- 230000002685 pulmonary effect Effects 0.000 description 6
- 230000004083 survival effect Effects 0.000 description 5
- 230000008859 change Effects 0.000 description 3
- 238000006213 oxygenation reaction Methods 0.000 description 3
- 210000003456 pulmonary alveoli Anatomy 0.000 description 3
- 206010021143 Hypoxia Diseases 0.000 description 2
- 206010037423 Pulmonary oedema Diseases 0.000 description 2
- 208000013616 Respiratory Distress Syndrome Diseases 0.000 description 2
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 230000007954 hypoxia Effects 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 238000010008 shearing Methods 0.000 description 2
- 206010061218 Inflammation Diseases 0.000 description 1
- 208000004852 Lung Injury Diseases 0.000 description 1
- 206010030113 Oedema Diseases 0.000 description 1
- 239000002202 Polyethylene glycol Substances 0.000 description 1
- 206010069363 Traumatic lung injury Diseases 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 230000004087 circulation Effects 0.000 description 1
- 208000035850 clinical syndrome Diseases 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- MTHSVFCYNBDYFN-UHFFFAOYSA-N diethylene glycol Chemical compound OCCOCCO MTHSVFCYNBDYFN-UHFFFAOYSA-N 0.000 description 1
- 230000004064 dysfunction Effects 0.000 description 1
- 230000002496 gastric effect Effects 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 230000004054 inflammatory process Effects 0.000 description 1
- 231100000515 lung injury Toxicity 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
- 230000004962 physiological condition Effects 0.000 description 1
- 229920001223 polyethylene glycol Polymers 0.000 description 1
- 238000004393 prognosis Methods 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 238000010992 reflux Methods 0.000 description 1
- 210000002345 respiratory system Anatomy 0.000 description 1
- 230000033764 rhythmic process Effects 0.000 description 1
- 230000002269 spontaneous effect Effects 0.000 description 1
- 239000000725 suspension Substances 0.000 description 1
- 230000008961 swelling Effects 0.000 description 1
- 230000001360 synchronised effect Effects 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
Classifications
-
- 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
-
- 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
-
- 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
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
- A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit
-
- 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
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
- A61M2016/0042—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the expiratory circuit
-
- 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
- A61M2205/3334—Measuring or controlling the flow rate
Abstract
The invention relates to the technical field of medical equipment, and discloses a breathing machine and a using method thereof, wherein the breathing machine comprises: the device comprises an expiration flow sensor, an air supply flow sensor and a plurality of pressure sensors, wherein the pressure sensors are used for measuring the air supply flow pressure and the expiration flow pressure and are arranged on an air supply pipe and an expiration pipe; the central processing unit is used for receiving the data of the air supply flow sensor and the expiratory flow sensor, comparing and integrating the data of the air supply flow and the expiratory flow, and controlling the pressure regulating equipment according to the integrated data and the data of the pressure sensors; the pressure adjusting device is used for adjusting the pressure of the air supply flow according to the instruction of the central processing unit and adjusting the pressure of the air supply flow; the air gun is used for conveying air flow with corresponding pressure according to the data of the pressure regulating equipment; an exhalation valve for controlling and exhausting an exhalation air flow; the breathing machine and the using method can improve the treatment success rate of ARDS patients.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to a breathing machine and a using method thereof.
Background
Acute respiratory distress syndrome (acute respiratory distress syndrom, ARDS) is a clinical syndrome which is caused by intrapulmonary and/or extrapulmonary causes and is characterized by refractory hypoxia, and the pathological basis is that a great deal of dorsal alveolar edema, collapse and alveolar diffuse dysfunction are caused by injury factors such as inflammatory reaction, so that intrapulmonary arteriovenous shunt is caused, a great deal of pulmonary arterial blood cannot be fully oxygenated into pulmonary arterial reflux to blood circulation, hypoxia is difficult to correct, and the death rate is high. Not only can damage respiratory system, but also can cause renal, gastrointestinal, central nervous and other functional failure.
The lung re-tensioning methods commonly used at present include: controlled lung inflation (SI) method, PEEP increment method, pressure Control (PCV) method, ventilation strategy includes: APRV, sigh/intermittent PEEP, prone ventilation, etc. The existing pulmonary re-tensioning causes damage due to excessive swelling of residual normal alveoli before re-tensioning while increasing PEEP (polyethylene glycol ether) to open collapsed alveoli, and moreover, the edema lung tissue of the transition zone between the normal alveoli and the collapsed alveoli is more easily damaged during pulmonary re-tensioning because the compliance difference of lung tissues at two sides is larger, the volume change difference is overlarge under the same pressure, larger shearing force is generated, and the tissue toughness is reduced due to the edema of the lung tissue at the part. Therefore, all current methods and ventilation strategies for pulmonary re-tensioning cannot improve survival rate nor improve various serious complications after survival. Aiming at the problems of low survival rate after treatment and more serious complications after treatment caused by shearing damage of the boundary area between the lung non-stretch area and the normal ventilation alveolus area in the prior art, the invention provides a ventilation mode of lung re-stretch which is more in line with physiological conditions so as to improve oxygenation, protect the infant lung, improve the treatment survival rate and improve the complications after treatment.
Disclosure of Invention
The invention provides a respirator and a using method thereof, which can improve the success rate of the treatment of ARDS patients. The invention provides a breathing machine, comprising:
the expiratory flow sensor is used for monitoring the flow of expiratory airflow and is arranged on an expiratory pipe;
the air supply flow sensor is used for monitoring the flow of the air supply flow and is arranged on the air supply pipe;
the pressure sensors are used for measuring the pressure of the air supply flow and the pressure of the air exhaust flow and are arranged on the air supply pipe and the air exhaust pipe;
the central processing unit is used for receiving the data of the air supply flow sensor and the expiratory flow sensor, comparing and integrating the data of the air supply flow and the expiratory flow, and controlling the pressure regulating equipment according to the integrated data and the data of the pressure sensors;
the pressure adjusting device is used for adjusting the pressure of the air supply flow according to the instruction of the central processing unit and adjusting the pressure of the air supply flow;
the air gun is used for conveying air flow with corresponding pressure according to the data of the pressure regulating equipment;
an exhalation valve for controlling and exhausting the flow of exhaled air.
A method of using a ventilator, comprising the steps of:
s1, setting a triggering condition of an air gun and the highest flow rate of air supply;
s2, using an air supply flow sensor, an expiration flow sensor and a plurality of pressure sensors to monitor the pressure of the air supply flow, the pressure of the expiration flow, the flow of the expiration flow and the flow of the air supply flow in real time;
s3, after the pressure of the air suction air flow reaches the triggering condition of the air gun, the air gun stops supplying air for 0.2 seconds after supplying air flow with the air supply flow rate of 120-180L/min;
s4, when the flow rate of the air supply flow is reduced to 95% of the maximum flow rate of the air supply flow, according to the pressure of the air supply flow at the moment, the air supply gun pauses the air supply for 0.2 seconds after providing the air flow with the air flow rate of 120-180L/min;
s5, when the air flow of the air supply falls to 95% of the highest flow rate of the air supply again, the air supply gun supplies air flow with the flow rate of 120-180L/min according to the pressure of the air supply flow at the moment;
s6, switching the respirator into an expiration mode, and exhaling through an expiration valve, wherein the air supply flow pressure when the air supply is paused for the first time in the step S3 is used as an end expiratory positive pressure PEEP value;
s7, executing S4-S6;
s8, after the step S7 is executed twice, ventilation is carried out in a pressure support breathing mode PSV according to the set air supply support pressure;
s9, after two minutes of interval, executing S3-S8 again.
The triggering conditions include: pressure of the air-feed stream.
Compared with the prior art, the invention has the beneficial effects that:
the invention can more accord with the physiological opening of the alveoli collapsed by ARDS, improve the pulmonary ventilation, reduce the lung injury, improve the prognosis, and reasonably increase PEEP according to the volume and pressure change relation of the newly opened alveoli, so as to prevent the alveoli from being excessively expanded or collapsed again. Improving the success rate of the treatment of ARDS patients.
Drawings
Fig. 1 is a schematic diagram of a control principle of a breathing machine according to the present invention.
Fig. 2 is a flow chart of a method for using a breathing machine according to the present invention.
Fig. 3 is a graph showing the trend of the airflow pressure over time according to the method of using a ventilator according to the present invention.
Reference numerals illustrate:
1-air gun, 2-air flow sensor, 3-pressure sensor, 4-pressure adjusting device, 5-CPU, 6-exhalation valve, 7-exhalation flow sensor.
Detailed Description
One embodiment of the present invention will be described in detail below with reference to fig. 1-3, but it should be understood that the scope of the present invention is not limited by the embodiment.
As shown in fig. 1, a ventilator according to an embodiment of the present invention includes: an expiratory flow sensor 7 for monitoring the flow rate of expiratory airflow, provided on the expiratory tube;
an air supply flow sensor 2 for monitoring the flow rate of the air supply flow, which is provided in the air supply pipe;
a plurality of pressure sensors 3 for measuring the pressure of the air supply flow and the pressure of the air exhaust flow, which are provided on the air supply pipe and the air exhaust pipe;
a central processing unit 5 for receiving data of the air supply flow sensor 2 and the air exhaust flow sensor 7, comparing and integrating the data of the air supply flow and the air exhaust flow, and controlling the pressure adjusting device according to the data of the integrating calculation and the data of the plurality of pressure sensors 3;
a pressure adjusting device 4 for adjusting the pressure of the air flow according to the instruction of the CPU 5;
an air gun 1 for delivering an air flow of a corresponding pressure according to data of a pressure adjusting device 4;
an exhalation valve 6 for controlling and exhausting the flow of exhaled air.
The using method comprises the following steps: after the inhalation effort of a patient reaches the triggering standard of the air gun 1, the breathing machine provides pressure support to realize high-speed air flow, the flow speed can reach 120L/min, when the air flow drops to 95% of the highest flow speed, the breathing machine provides pressure support to realize high-speed air flow in the air channel again according to the air channel resistance at the moment, the flow speed can reach 120L/min, when the air flow drops to 95% of the highest flow speed, the breathing machine pauses for a short time (0.2 seconds), the breathing machine provides pressure support to realize high-speed air flow in the air channel again according to the air channel resistance at the moment, the flow speed can reach 120L/min, the three times of overlapping the high-speed air supply and then switching to expiration, and the air channel internal pressure at the end of the first air supply is taken as a PEEP (positive end expiratory pressure positive end expiratory pressure) value after that; and then, four times of high-speed airflow superposition breathing (two superposition) are performed on the basis of the PEEP according to the principle, the PEEP value after superposition is not increased, the pressure support breathing mode (Pressure Support Ventilation, PSV for short) is given for ventilation according to the set support pressure after the backward air supply, and a cycle operation can be performed again two minutes after the adjustment of the respirator.
The first air supply is triggered by spontaneous breathing of a patient, and the breathing machine gives rapid short-time air supply according to a high-flow air supply strategy, because the air supply speed is high, the air entering the breathing machine can enter a collapsed alveolus with a relatively straight airway at the first time, the re-tensioning position is positioned at the back side, rather than preferentially entering a normal alveolus with better compliance, and the sequence of opening alveoli can be as follows: the sequence of collapsed alveoli- -interfacial alveoli- -normal alveoli- -is followed in turn. This air delivery avoids normal alveolar overexpansion and damage to the interface area due to shear forces.
When the air flow speed is reduced due to the increase of resistance after the air supply is carried out in a very short time, the time of suspension is extremely short (0.2 seconds), so that the phenomenon that the newly opened alveoli with smaller radius collapse again caused by Laplace law (P=2T/r) can be avoided, and the phenomenon that the alveolar filling sequence is carried out in the sequence from good to poor compliance due to the slow reduction of the flow speed (normal alveoli-boundary region alveoli-incompletely opened alveoli-collapsed alveoli) can be avoided. And air pressure injury caused by too fast rise of the airway pressure is avoided.
After a short time pause, the air supply pressure is regulated again according to the air passage pressure, so that the air supply flow reaches 120L/min again, superimposed air supply is carried out, the air supply flow is switched to an expiratory phase after three times of superimposition, the air passage pressure is released, and hypercarbonated blood is avoided; while PEEP is maintained at the airway pressure level at the first pause to avoid re-collapse of the collapsed alveoli just opened.
Five PSV modes of ventilation are thereafter administered, by which the just-opened collapsed alveolar interior surface active is evenly distributed. And after the five PSV synchronous periods, two superimposed high-flow-rate air supplies are given again, so that the purposes of excessive alveolar to normal alveoli in the boundary area and excessive alveolar to the boundary area in the incomplete opening alveoli are achieved. Two minutes of circulation in this rhythm brings the lungs to a new steady state after the PEEP has been raised.
And (3) carrying out a cycle of every two minutes according to the mode of the first two minutes, lifting PEEP once, closely monitoring the compliance change and oxygenation improvement condition of the lung, titrating to reach the optimal PEEP so as to reach the optimal oxygenation, and finally improving the survival rate of patients.
The foregoing disclosure is merely illustrative of some embodiments of the invention, but the embodiments are not limited thereto and variations within the scope of the invention will be apparent to those skilled in the art.
Claims (1)
1. A ventilator, comprising:
an expiratory flow sensor (7) for monitoring the flow of expiratory airflow, which is arranged on the expiratory tube;
an air supply flow sensor (2) for monitoring the flow rate of the air supply flow and arranged on the air supply pipe;
a plurality of pressure sensors (3) for measuring the pressure of the air supply flow and the pressure of the air exhaust flow, and arranged on the air supply pipe and the air exhaust pipe;
the central processing unit (5) is used for receiving the data of the air supply flow sensor (2) and the expiratory flow sensor (7), comparing and integrating the data of the air supply flow and the expiratory flow, and controlling the pressure regulating equipment according to the integrated data and the data of the pressure sensors (3);
the pressure adjusting device (4) is used for adjusting the pressure of the air supply flow according to the instruction of the central processing unit (5) and adjusting the pressure of the air supply flow;
an air gun (1) for delivering an air flow of a corresponding pressure according to the data of the pressure regulating device (4);
an exhalation valve (6) for controlling and discharging the flow of exhalation air;
s1, setting a triggering condition of an air gun (1) and the highest flow rate of air supply;
s2, using an air supply flow sensor (2), an expiration flow sensor (7) and a plurality of pressure sensors (3) to monitor the air supply flow pressure, the expiration flow pressure, the flow of the expiration flow and the flow of the air supply flow in real time;
s3, after the pressure of the air suction air flow reaches the triggering condition of the air gun (1), the air gun (1) supplies air flow with the air flow rate of 120-180L/min and then pauses air supply for 0.2 seconds;
s4, when the flow rate of the air supply flow is reduced to 95% of the maximum flow rate of the air supply flow, according to the pressure of the air supply flow at the moment, the air supply gun pauses the air supply for 0.2 seconds after providing the air flow with the air flow rate of 120-180L/min;
s5, when the air flow of the air supply falls to 95% of the highest flow rate of the air supply again, the air supply gun supplies air flow with the flow rate of 120-180L/min according to the pressure of the air supply flow at the moment;
s6, switching the respirator into an expiration mode, and exhaling through an expiration valve (6), wherein the air supply flow pressure when the air supply is stopped for the first time in the step S3 is used as an end expiratory positive pressure PEEP value;
s7, executing S4-S6;
s8, after the step S7 is executed twice, ventilation is carried out in a pressure support breathing mode PSV according to the set air supply support pressure;
s9, after two minutes of interval, executing S3-S8 again;
the triggering conditions include: pressure of the air-feed stream.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010996762.7A CN112057714B (en) | 2020-09-21 | 2020-09-21 | Breathing machine |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010996762.7A CN112057714B (en) | 2020-09-21 | 2020-09-21 | Breathing machine |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN112057714A CN112057714A (en) | 2020-12-11 |
| CN112057714B true CN112057714B (en) | 2023-11-10 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202010996762.7A Active CN112057714B (en) | 2020-09-21 | 2020-09-21 | Breathing machine |
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| Country | Link |
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| CN (1) | CN112057714B (en) |
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107519562A (en) * | 2017-02-10 | 2017-12-29 | 钱家杰 | Lung ventilator air-flow output control method |
| CN108348716A (en) * | 2015-10-30 | 2018-07-31 | 皇家飞利浦有限公司 | Respiratory training, monitoring and/or ancillary equipment |
Family Cites Families (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1579882A1 (en) * | 2004-03-26 | 2005-09-28 | Stephan Dr. Böhm | Non-invasive method and apparatus for optimizing the respiration for atelectatic lungs |
| WO2006012205A2 (en) * | 2004-06-24 | 2006-02-02 | Convergent Engineering, Inc. | METHOD AND APPARATUS FOR NON-INVASIVE PREDICTION OF INTRINSIC POSITIVE END-EXPIRATORY PRESSURE (PEEPi) IN PATIENTS RECEIVING VENTILATOR SUPPORT |
| EP3568183A1 (en) * | 2017-01-16 | 2019-11-20 | Koninklijke Philips N.V. | System and method for adaptive scheduling of pause maneuvers used for estimation of compliance and/or resistance during mechanical ventilation |
-
2020
- 2020-09-21 CN CN202010996762.7A patent/CN112057714B/en active Active
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108348716A (en) * | 2015-10-30 | 2018-07-31 | 皇家飞利浦有限公司 | Respiratory training, monitoring and/or ancillary equipment |
| CN107519562A (en) * | 2017-02-10 | 2017-12-29 | 钱家杰 | Lung ventilator air-flow output control method |
Non-Patent Citations (3)
| Title |
|---|
| ARDS机械通气治疗策略的研究进展;张可刚;《中国现代医生》;第49卷(第30期);20-22 * |
| 呼气末正压在治疗急性呼吸窘迫综合症中的应用及护理;徐仲璇;《护理研究》;第21卷(第7期);1887-1890 * |
| 急性呼吸窘迫综合征肺压力-容积曲线及其在通气设置中的应用;邵昕, 何奎华;《医学综述》;第16卷(第6期);915-918 * |
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| CN112057714A (en) | 2020-12-11 |
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