CN115364318A - 手动式机械通气设备的自动控制系统 - Google Patents

手动式机械通气设备的自动控制系统 Download PDF

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CN115364318A
CN115364318A CN202210554115.XA CN202210554115A CN115364318A CN 115364318 A CN115364318 A CN 115364318A CN 202210554115 A CN202210554115 A CN 202210554115A CN 115364318 A CN115364318 A CN 115364318A
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control system
controller
mechanical ventilation
sensor
patient
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保罗·罗马戈萨·卡拉塔尤德
保罗·萨萨内达斯·米列特
米格尔·弗朗西斯科·佩雷斯·普拉纳斯
卡里姆·博法雷斯·博法雷斯
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Gpa Medical Co ltd
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Abstract

一种手动式机械通气设备(1)的自动控制系统，包括伺服电机、致动器和步进气缸(4)，其适于响应于控制器(6)发出的信号压缩机械通气设备(1)。控制器(6)还与至少一个流量传感器(2)和至少一个压力传感器(3)连接，并具有人机界面(5)，用于插入患者要接收的压力和氧气流量输出值。

Description

手动式机械通气设备的自动控制系统
技术领域
本发明涉及医疗领域，更具体地，涉及呼吸支持设备领域。
背景技术
医院的生命保障呼吸设备包括呼吸器或机械呼吸机，用于补充肺通气。
在医院不堪重负的情况下，例如，有流行病或大流行病，需要弥补呼吸器的缺乏。
出于这个原因，最近人们开发了几种医疗设备，用于紧急情况下的机械通气。其中许多产品基于手持式呼吸器(hand-held ventilator，也以其广泛使用的品牌名称
Figure BDA0003654215700000011
(来自“Airway Mask Bag Unit”)而闻名)的自动化。复苏器(resuscitator)或手动式呼吸器(manual respirator)由通过一组阀门与面罩相连的充气式气囊组成。当正确佩戴面罩并手动压缩腔室时，该设备会使空气进入患者的肺部。当手动压缩停止时，腔室会通过另一端用大气空气或富氧空气自动充气，同时允许肺部通过阀门组件向环境中排气。手动式呼吸器是一种用于医疗车辆和医院临时情况的设备。然而，它们在短时间内受到限制，因为它们必须来由医护人员手动操作。此外，所需的手动操作意味着不会提供持续通气，因为难以主观评估诸如每分钟的呼吸次数、施用的总容量和吸气/呼气比等参数。
因此，在全球性大流行病期间，迫切需要改进用于紧急机械通气的医疗设备的性能，以使在患者体内产生的通气更接近于由先进的医用呼吸机提供的通气。
发明内容
本发明的目的在于提供一种用于手动式呼吸机的控制系统，该控制系统允许比现有技术中的设备更有效、更准确地控制自动通气，使从业者能够根据患者的需要调整氧气流量和施加的压力。
为此，本发明包括一种用于基于呼吸过程的自动化来控制由手持式呼吸机在患者体内产生的通气的系统。为此，该系统配备有带有伺服电机的线性致动器，其调节呼吸机的压缩并由可编程逻辑控制器进行控制，该可编程逻辑控制器接收来自至少一个压力传感器和至少一个流量传感器的数据。该系统还设有用于输入压力和流量输出值的界面。基于这些输出值和传感器读数，上述控制器作用于上述致动器。这些组件可通过Profinet网络相互连接，并有利地配备有不间断电源(uninterruptible power supply)。就在患者连接之前的单向阀、PEEP阀和加湿和/或抗菌过滤器可以可选地位于患者侧的插孔(socket)中。
本发明旨在用于需要机械通气或心跳呼吸停止的患者。它的使用限于有创机械通气(invasive mechanical ventilation)技术合格的医务人员。
附图简要说明
图1是本发明的系统的示意图；
图2是由本发明的系统控制的机械通气的呼吸周期和吹气周期的曲线图；
图3是应用于现有呼吸机的上述控制系统的特定实施方式。
具体实施方式
根据本发明的用于手持式呼吸机的控制系统的一实施方式如图1所示。该系统具有手持式呼吸机的进气口和手持式呼吸机的出气口。该控制系统配备有至少一个流量传感器和至少一个压力传感器。来自这些传感器的信号进入可编程逻辑控制器，该控制器根据从业者基于传感器读数通过人机界面输入系统的所需最终参数控制致动器，该致动器压缩通气设备。
软件须控制以下组件并与之通信：
-可编程逻辑控制器(Programmable Logic Controller，PLC)
-界面
-致动器
-压力传感器
-流量传感器
-不间断电源(UPS)。
流量传感器报告并监测在给定时间内吹入患者体内的气体体积。压力传感器控制施加于患者的压力范围。该设备通过调节致动器施加在手持式呼吸机上的速度、压力和冲程来控制施加给患者的通气。
使用界面屏幕，临床医生验证和修改呼吸机的操作。
图1示出了根据本发明的基于手持式呼吸机(1)的自动化的机械通气控制系统的一实施方式。该系统包括流量传感器(2)和压力传感器(3)。呼吸机袋(ventilator bag)的压缩由伺服电机、致动器(4)和步进气缸(stepper cylinder)完成。该系统具有具有显示器的人机界面(5)或HMI，其显示器允许根据医生为患者输入必要的参数并读取传感器提供的信息。应使用不间断电源(UPS)，以在没有外部电源的情况下保持设备运行。
该系统的基本元件是：
(1)手持式呼吸器
(2)流量传感器
(3)压力传感器
(4)伺服电机、致动器和步进气缸。
(5)人机界面
(6)控制器
(7)交换机(switch)
(8)不间断(连续)供电系统
自动驱动部分允许通过与气缸相关联的伺服电机和致动器逐步平移气缸。步进气缸的运动反过来允许手持式呼吸机被压缩以向患者输送空气。
该系统可包括将手持式呼吸机保持在正确位置以进行操作的元件。这样的元件可包括，例如，一组弹性带(elastic bands)。
该系统具有流量传感器来报告和监测吹入患者体内的气体的体积。通过测量流量和时间来计算吹入的体积。
该系统还将具有压力传感器来监测施加到患者身上的压力范围。
为了控制步进气缸，伺服电机致动器直接与控制器通信，控制器管理步进气缸的位移。
为了统一所有装置的通信，优选使用Profinet网络和交换机(switch)。交换机不会干扰其他装置，因为它执行被动链接功能(passive link function)以链接装置之间的帧/数据包。Profinet工业网络基于TCP/IP通信，但适用于与工业设备(如PLC、HMI、伺服驱动器等)交换数据，其中数据包交换以快速且确定的方式完成以保证服务的质量。
图2示出了充气周期的曲线图。这些周期取决于系统的操作模式：
-容量控制(Volume Control)：用于服用了镇静剂的患者的强制通气模式，其中，潮气量(tidal volume)由“充气”参数设置，呼吸周期由呼吸频率和吸气-呼气(I:E)比率控制。
-容量辅助控制(Volume Assisted Control)：撤机初始阶段的通气支持模式(ventilatory support mode)(称为撤机(weaning))，其中，患者有设置通气或换气频率的可能。医生使用“充气”参数设置潮气量、设置基线呼吸频率和I:E比、以及吸气灵敏度(患者打开呼吸机吸气阀必须做出的努力)以开始呼吸循环。
-容量辅助(Volume Assisted)：撤机的通气支持模式或撤机，其中，患者设置通气频率。医生使用“吹气”参数输入潮气量、设置呼吸周期开始时的吸气时间和吸气灵敏度。此外，可以设置“呼吸暂停时间(apnoea time)”，如果超过该时间，设备将切换到容量控制(Volume Control)模式。
该系统使用以下控制参数工作：
-手持式呼吸机施加的体积关于手持式呼吸机的最大体积的充气百分比(％)。
-实际呼吸频率，单位：rpm
-吸气：呼气比率(Inspiration:Expiration Ratio，I:E比率)
-呼气末正压(Positive end-expiratorypressure，PEEP)，单位：cmH2O
-容量辅助模式的充气时间，单位：秒
-容量控制辅助和容量辅助模式的吸气灵敏度(Inspiratory sensitivity)
上述系统从机械通气设备接收以下监测参数：
-最大或峰值压力，单位：cmH2O
-稳定阶段压力(Plateau pressure)，单位：cmH2O
-最小压力，单位：cmH2O
-实际呼吸频率，单位：rpm
-比率I:E
传感器获取的信息可以用曲线图(graph)的形式表示：
-压力，单位：cmH2O
-吸气流量，单位：L/min
-潮气量(Tidal volume)，单位：mL
上述系统会在不同情况下发出警报警告：
-最大和最小潮气量，单位：mL
-最大和最小呼吸压力，单位：cmH2O
-最小和最大实际呼吸频率，单位：rpm
-电源断开
除了前面提到的要素之外，图3还示出了上述系统的一些可选要素。单向阀(9)、PEEP阀(10)和加湿和/或抗菌过滤器(11)可以在就在患者连接之前的患者侧管子(tubing)上找到。
鉴于上述说明及附图，本领域的技术人员将理解的是，本发明已经根据其一些优选实施方式进行了描述，但是在不超出所要求保护的本发明的主题的情况下，所述优选实施方式中可以引入多种变化。

Claims (5)

1.一种手动式机械通气设备(1)的自动控制系统，其特征在于，所述控制系统包括控制器(6)、及伺服电机、致动器和步进气缸(4)，所述伺服电机、致动器和步进气缸(4)适于响应于所述控制器(6)发出的信号压缩所述机械通气设备(1)；其中，所述控制器(6)与所述伺服电机连接，并与至少一个流量传感器(2)和至少一个压力传感器(3)连接，并且，所述控制器(6)具有人机界面(5)用于插入要由患者接收的压力和氧气流量输出值，其中，所述控制器(6)适于基于传感器输入和输入所述人机界面(5)的输出值来修改所述机械通气设备(2)接收的压缩。
2.根据权利要求1所述的控制系统，其特征在于，所述控制器(6)和所述传感器通过Profinet网络和交换机(7)连接。
3.根据权利要求1所述的控制系统，其特征在于，其还包括连续供电系统(8)。
4.根据权利要求1所述的控制系统，其特征在于，所述人机界面适于提供传感器读数。
5.根据权利要求1所述的控制系统，其特征在于，其进一步在患者侧设置有抗菌过滤器(11)。
CN202210554115.XA 2021-05-20 2022-05-20 手动式机械通气设备的自动控制系统 Pending CN115364318A (zh)

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