CN114177451A - Control method of single breathing cycle pressure-volume double control mode of breathing machine - Google Patents

Control method of single breathing cycle pressure-volume double control mode of breathing machine Download PDF

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CN114177451A
CN114177451A CN202111650347.7A CN202111650347A CN114177451A CN 114177451 A CN114177451 A CN 114177451A CN 202111650347 A CN202111650347 A CN 202111650347A CN 114177451 A CN114177451 A CN 114177451A
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time
pressure
ventilation
control
real
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CN114177451B (en
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王家军
肖德鑫
成志标
唐超
王铁钢
张德成
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Hangzhou Dianzi University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003Accessories therefor, e.g. sensors, vibrators, negative pressure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022Control means therefor
    • A61M16/024Control means therefor including calculation means, e.g. using a processor

Abstract

The invention discloses a control method of a single breathing cycle pressure-volume double control mode of a breathing machine. And the conversion module is used for switching the pressure control mode to the capacity control mode when the real-time output capacity is larger than a set switching capacity value through detecting the output capacity. The lung simulation module is used for finally outputting the airway pressure, flow and real-time output capacity of the patient through simulating the parameters of the lung of the patient. The invention carries out the conversion of pressure control and volume control according to the real-time inspiratory capacity of the patient in a single period, can more quickly adjust the requirement of the patient, leads the control of the pressure and the volume of the breathing machine to be more flexible, can effectively reduce the breathing work of the patient, improves the treatment comfort and is closer to clinic.

Description

Control method of single breathing cycle pressure-volume double control mode of breathing machine
Technical Field
The invention belongs to the field of ventilation control of a breathing machine, and particularly relates to a control method of a single-breathing-cycle pressure-volume double-control mode of the breathing machine.
Background
The respirator is used as important medical equipment which can effectively replace or assist normal physiological breathing action of people, reduce artificial consumption in the breathing action of patients, increase lung ventilation and improve the breathing function, and is widely applied to the aspects of clinical medical treatment, household health care, emergency rescue and the like. Since the stability, safety and reliability of the ventilator and the accuracy of each control element are crucial to the respiratory therapy process, the research on ventilation control of the ventilator is a very important step in the design of the ventilator.
The breathing system has the characteristics of nonlinearity, time delay and large parameter dynamic range change, and the closed-loop control of the breathing machine is difficult to analyze and research by using the traditional method, so the control problem of the breathing machine is generally researched by using a modeling method. Many experts and scholars at home and abroad propose various ventilator ventilation mode control modes, which are finally classified into volume control ventilation, pressure control ventilation and mixed control ventilation according to different control targets, although the control modes are named differently due to patent protection or other reasons. The pressure control ventilation takes the airway pressure as a control target, and the inspiratory airway pressure is always kept at a set pressure level in the treatment process; the volume control ventilation takes the volume as a control target and carries out ventilation treatment on a patient at a constant flow rate according to a set tidal volume; hybrid controlled ventilation combines pressure control with volume control and uses different control regimes for ventilation therapy during different respiratory cycles. The control ventilation mode is single control or ventilation control in different breathing cycles, even in a mixed ventilation mode, the switching between pressure control and volume control in the same breathing cycle is difficult, so that the ventilation control of the breathing machine has certain time delay, the ventilation control can not be timely adjusted according to the change of the tidal volume of the patient, the breathing work of the patient is increased, and the comfort of the patient is reduced.
Therefore, the method has very important significance for the research of the ventilation control mode of the single breathing cycle of the respirator.
Disclosure of Invention
The invention aims to provide a control method of a single breathing cycle pressure-volume double control mode of a breathing machine aiming at the defects of the related technology of the ventilation mode of the current breathing machine.
The invention is realized by adopting the following technical scheme:
the simulation model of the invention consists of three parts, namely a ventilation control module, a conversion module and a lung simulation module. The ventilation control module comprises a pressure control module and a volume control module, wherein the pressure control module enables the airway pressure of a patient to be maintained at constant pressure through controlling the output pressure of the breathing machine, and the volume control module enables the output flow of the breathing machine to be maintained at constant flow through controlling the output flow of the breathing machine. The conversion module switches the pressure control mode and the volume control mode in a single breathing cycle by detecting the output volume of the ventilation control module. The simulated lung module comprises a PID control module and a lung model module, and is used for finally outputting the airway pressure and flow of the patient through simulating the parameters of compliance, air resistance, air pressure and the like of the lung of the patient, and the real-time output capacity is obtained after the output flow is integrated with time.
The control method based on the simulation model comprises the following specific processes:
the method comprises the following steps: after the breathing of the breathing machine is triggered, the pressure control is firstly carried out, and the breathing machine quickly reaches a set pressure value P0And continuously at a constant set pressure value P0Air supply is performed.
Step two: output volume V to the respirator in real time while supplying gasTReal-time detection is carried out, and real-time output capacity V is obtainedTAnd setting the switching capacity value V0And (3) comparison: if the capacity V is output in real timeTDoes not reach the set switch capacity value V0Then the real-time ventilation time T and the inspiration time T at the moment are determined0Comparing, if the real-time ventilation time T is equal to the inspiration time T0End of ventilation, indicating total inspirationThe process is pressure control ventilation; if the real-time ventilation time T does not reach the inspiration time T0Then continuing to control the pressure; if the capacity V is output in real timeTHas reached the set switching capacity value V0Then the capacity control is switched over by the conversion module.
Step three: for real-time ventilation pressure P in capacity control modeTDetecting if the real-time ventilation pressure P is presentTLess than the set pressure value P0Switching to pressure control again for ventilation, otherwise continuing volume control ventilation until ventilator output real-time ventilation time T equals inspiration time T0And ending the ventilation.
The invention has the beneficial effects that:
compared with other ventilator ventilation modes with single control or pressure control or volume control switching during different breathing cycles in the prior art, the ventilator single-breathing-cycle pressure-volume double-control mode provided by the invention can complete switching from the pressure control ventilation mode to the volume control ventilation mode in a single breathing cycle. Different from other mixed ventilation modes which are fixedly switched according to time periods, the invention carries out the conversion of the pressure control ventilation mode and the volume control ventilation mode according to the real-time inspiratory capacity of the patient in a single period, can more quickly adjust the control strategy of the inspiratory demand of the patient, and combines the advantages of the pressure control ventilation mode and the volume control ventilation mode, so that the control of the pressure and the volume of the respirator is more flexible, the breathing work of the patient can be effectively reduced, the treatment comfort is improved, and the respirator is closer to clinic.
Drawings
In order to more clearly illustrate the implementation process of the present invention, the following briefly introduces the implementation process and the drawings used in the description of the prior art, and the drawings in the following description are only part of the implementation part of the present invention based on simulation model, and for those skilled in the art, other drawings can be obtained according to the provided drawings without creative efforts.
FIG. 1 is a diagram of the overall structure of a simulation system;
FIG. 2 is a flow chart of the present invention;
FIG. 3 is a graph of Simulink simulation results.
Detailed Description
The technical solution of the present invention will be clearly and completely described below with reference to the accompanying drawings of the present invention, and it is obvious that the described implementation process is only an implementation part of the present invention based on a simulation model, and not a whole implementation process.
The overall structure diagram of the simulation system constructed by the invention shown in the attached figure 1 consists of a ventilation control module, a conversion module and a lung simulation module.
The ventilation control module includes a pressure control module and a volume control module. Wherein, the pressure control module controls the output pressure of the respirator to maintain the airway pressure of the patient at a constant set pressure value P after the respiration is triggered0(ii) a The volume control module controls the output flow of the respirator to maintain the output flow of the respirator at a constant flow after the ventilation control mode of the respirator is converted.
The conversion module is a conversion switch, and outputs the capacity V in real time through detecting the output capacityTGreater than a set switching capacity value V0Then, the pressure control mode and the capacity control mode are switched in a single breathing cycle.
The simulated lung module comprises a PID control module and a lung model module. The lung model module simulates parameters of compliance, air resistance, air pressure and the like of the lung of a patient; the PID control module feeds back the pressure value to the pressure P input into the lung model module in real time through the lung model moduleoutIs adjusted to finally output the airway pressure P of the patientTAnd flow rate QTThe output real-time output capacity V is obtained after the output flow is integrated with the timeT
Fig. 2 is a control flow diagram based on the simulation system design of fig. 1. The method is realized by the following main process steps:
the method comprises the following steps: after the breathing of the breathing machine is triggered, the breathing machine firstly enters a pressure control stage to control the pressure, and the breathing machine quickly reaches a set pressure value P0And continuously at a constant set pressure value P0Air supply is carried out;
step two: the respirator reaches the set pressure value P0Then, the conversion module outputs the volume V to the respirator in real time while supplying air at constant pressureTReal-time detection is carried out, and real-time output capacity V is obtainedTAnd setting the switching capacity value V0Comparing;
step three: if the real-time output volume V in the pressure control stageTDoes not reach the set switching capacity value V0Then the real-time ventilation time T and the inspiration time T at the moment are determined0Comparing;
step four: if the real-time ventilation time T is equal to the inspiration time T0If so, ending the ventilation, indicating that the whole inspiration process is pressure control ventilation;
step five: if the real-time ventilation time T is less than the inspiration time T0Then continuing to control the pressure;
step six: if the real-time output volume V in the pressure control stageTHas reached the set switching capacity V0Then the ventilation mode of the respirator is switched from pressure control to volume control according to the set flow value Q0Entering a capacity control stage;
step seven: after switching to capacity control, the real-time ventilation pressure P at the moment is adjustedTDetecting if the real-time ventilation pressure P is detectedTLess than the set pressure value P0Switching to pressure control again for ventilation;
step eight: if the real-time ventilation pressure PTGreater than or equal to the set pressure value P0Volume control ventilation is continued until the real-time ventilation time T equals the inspiration time T0And ending the ventilation.
FIG. 3 is a diagram of the simulation result of the simulation circuit built in Simulink according to the overall structure diagram shown in FIG. 1. In the built simulation circuit, a ventilation cycle is set to be 5s, taking the first ventilation cycle as an example, wherein the first 2s is an inspiration phase, namely a ventilator ventilation phase, and the last 3s is an expiration phase. Fig. 3 shows a pressure curve, a flow curve and a capacity curve from top to bottom. Wherein:
(1) in the pressure curve, the pressure rises rapidly to the set pressure value P after the breath is triggered0And maintained at the set pressure value P0Horizontally, the ventilation control mode is pressure control; when the real-time output volume V of the respirator is detectedTReach the set capacity value V0During the process, the ventilation mode of the respirator is converted from pressure control to volume control through a conversion module, and the pressure starts from a switching point to a set pressure value P0The level continues to rise until the real-time ventilation time T equals the inspiration time T0Ending ventilation;
(2) in the flow curve, the flow rises rapidly after the breath is triggered, and when the pressure reaches the set pressure value P0The time flow also reaches the maximum value QmaxThen the flow begins to drop, when the real-time output volume V of the ventilator is detectedTReach the set capacity value V0During the operation, the pressure control of the ventilation mode of the respirator is converted into the volume control through the conversion module, and the flow is maintained at the set flow value Q0Until the real-time ventilation time T equals the inspiration time T0Ending ventilation;
(3) in the volume curve, the volume rises rapidly after the breath is triggered, and when the pressure reaches the set pressure value P0Then, the volume increase is slowed down due to the flow reduction, and when the real-time output volume V of the breathing machine is detectedTReach the set capacity value V0The ventilation mode of the breathing machine is converted from pressure control to volume control through a conversion module, and the volume is then increased at a constant speed at a fixed speed until the real-time ventilation time T is equal to the inspiration time T0And ending the ventilation.
The control method of the invention specifically operates as follows:
firstly, according to the clinical practice and the conditions of different patients, the set pressure value P of the pressure control is determined0Capacity control set flow rate value Q0Tidal volume V of patient0And patient respiratory system breathing resistance, compliance, etc. The parameters are input into the single-breath-cycle pressure-volume double-control mode respirator based on the invention, and the respirator is started, and the respirator can automatically switch the control mode to ventilate the patient in the single-breath-cycle through the set parameters.

Claims (2)

1. A control method of a single breathing cycle pressure-volume double control mode of a breathing machine is characterized in that:
the established simulation model comprises a ventilation control module, a conversion module and a lung simulation module;
the ventilation control module comprises a pressure control module and a volume control module and is used for controlling the output pressure and the output flow of the respirator;
the conversion module switches the pressure control mode and the volume control mode in a single breathing cycle by detecting the output volume of the ventilation control module;
the lung simulation module is used for simulating parameters such as compliance, air resistance and air pressure of the lung of the patient, and finally outputting the airway pressure and flow of the patient and real-time output capacity;
the control method based on the simulation model comprises the following specific processes:
the method comprises the following steps: after the breathing of the breathing machine is triggered, the pressure control is firstly carried out, and the breathing machine quickly reaches a set pressure value P0And continuously at a constant set pressure value P0Air supply is carried out;
step two: output volume V to the respirator in real time while supplying gasTReal-time detection is carried out, and real-time output capacity V is obtainedTAnd setting the switching capacity value V0And (3) comparison:
if the capacity V is output in real timeTDoes not reach the set switch capacity value V0Then the real-time ventilation time T and the inspiration time T at the moment are determined0Comparing, if the real-time ventilation time T is equal to the inspiration time T0If so, ending the ventilation, indicating that the whole inspiration process is pressure control ventilation; if ventilation is performed in real timeThe time T does not reach the inspiration time T0Then continuing to control the pressure;
if the capacity V is output in real timeTHas reached the set switching capacity value V0Switching to capacity control through the conversion module;
step three: for real-time ventilation pressure P in capacity control modeTDetecting if the real-time ventilation pressure P is presentTLess than the set pressure value P0Switching to pressure control again for ventilation, otherwise continuing volume control ventilation until ventilator output real-time ventilation time T equals inspiration time T0And ending the ventilation.
2. The method of claim 1, wherein the method comprises the steps of:
the simulated lung module comprises a PID control module and a lung model module, and the PID control module is used for real-time inputting the pressure P of the lung model module to the pressure value fed back by the lung model moduleoutAnd (6) adjusting.
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Cited By (4)

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CN117059250A (en) * 2023-09-11 2023-11-14 巨翊科技(上海)有限公司 Method, system and prediction device for constructing respiratory flow prediction model
CN117045913A (en) * 2023-07-14 2023-11-14 南通大学附属医院 Mechanical ventilation mode intelligent switching method based on respiratory variable monitoring
CN117323525A (en) * 2023-12-01 2024-01-02 南京沪家医疗科技有限公司 Pressure control method and device of breathing machine
WO2024057241A1 (en) * 2022-09-14 2024-03-21 Fisher & Paykel Healthcare Limited A breathing assistance apparatus for providing resipratory therapy

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Publication number Priority date Publication date Assignee Title
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CN117323525B (en) * 2023-12-01 2024-02-23 南京沪家医疗科技有限公司 Pressure control method and device of breathing machine

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