CN115970109A - Respiratory ventilation prediction preprocessing method, respirator, controller and storage medium - Google Patents
Respiratory ventilation prediction preprocessing method, respirator, controller and storage medium Download PDFInfo
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Abstract
The invention discloses a respiratory ventilation prediction preprocessing method, a breathing machine, a controller and a storage medium, wherein the method comprises the following steps: dividing respiratory phases, wherein the flow mean value is more than + e1 and is divided into an inspiratory phase, the flow mean value is less than-e 1 and is divided into an expiratory phase, and the flow mean value is divided into a holding phase when the flow mean value is in an interval of [ -e1, + e1 ]; the respiratory state prediction result comprises predicted expiration at the end of inspiration, predicted secondary inspiration, predicted inspiration at the end of expiration and predicted secondary expiration; preprocessing is performed for different predicted respiratory states. The scheme can carry out different fine breathing pretreatments according to different breathing states accurately predicted so as to improve the comfort of a patient, can effectively reduce inspiration error triggering caused by unstable control at the end of expiration, inspiration difficulty caused by slow switching of inspiration control lag and expiration difficulty caused by untimely pressure release at the end of inspiration, and relieves inspiration difficulty during secondary inspiration.
Description
Technical Field
The invention relates to the technical field of respiratory measurement, prediction and control, in particular to a respiratory ventilation prediction preprocessing method, a breathing machine, a controller and a storage medium.
Background
The breathing phase control is an important performance of the breathing machine, and it is a common practice to obtain breathing characteristic information related to a patient by detecting a change in a breathing airflow, and control the breathing machine to follow the spontaneous breathing of the patient according to the breathing characteristic information, so that the patient feels smooth and comfortable in breathing. Generally, the respiratory phase includes an expiratory phase and an inspiratory phase, where the expiratory phase refers to a time phase set by the ventilator to complete an expiratory process, and the inspiratory phase refers to a time phase set by the ventilator to complete an inspiratory process. The relationship between the respiratory phase and the flow during the respiratory cycle can be seen schematically in fig. 1.
The breathing control that current scheme was carried out adopts the flow value to exceed the preset threshold value of flow benchmark value, judges to get into the expiration state of breathing in to this carries out single-point switching, and this kind of control mode has control lag, thereby can lead to breathing in the difficulty in the initial stage of breathing in, expiration difficulty in the initial stage of breathing out, and the last period of breathing out is shaken easily and is triggered by mistake and breathes in. If the conditions of secondary inspiration and secondary expiration exist, the control strategy cannot be adjusted in a rapid self-adaptive mode. The secondary inspiration refers to the condition that inspiration is performed again after the short stop after inspiration is finished; the secondary expiration refers to the situation that expiration is carried out again after short-term retention after expiration is finished, the period of secondary inspiration and secondary expiration is short, the occurrence is sudden, and the problem cannot be well solved by the conventional scheme.
As shown in fig. 2, it is a graph of the flow change of the patient during breathing. In fact, respiratory waveforms of different people are all inconsistent, and a certain pause time is often generated after inspiration or expiration is finished, in the prior art, the pause time, i.e., the region between + e1 to-e 1, is divided into inspiration or expiration control, which may cause a certain problem of false triggering and control delay, and then the false triggering and control delay shown in the solid line circle and the dotted line circle in fig. 3 may be generated, which is worse than that in the image, and in this case, the user experience is worse.
Therefore, how to develop a method and related technology capable of effectively reducing the inhalation mistrigger caused by unstable control at the end of expiration, the inhalation difficulty caused by slow switch of delay of inhalation control, the exhalation difficulty caused by untimely pressure release at the end of inspiration, and the inhalation difficulty during the second inhalation becomes the subject to be researched and solved by the invention.
Disclosure of Invention
The invention aims to provide a respiratory ventilation prediction preprocessing method, a breathing machine, a controller and a storage medium.
In order to achieve the above object, a first aspect of the present invention provides a respiratory ventilation prediction preprocessing method, which includes:
in the breathing phase control of a breathing machine, setting an upper threshold value + e1 and a lower threshold value-e 1 aiming at the flow average value of the breathing machine; the breathing phase control comprises a normal breathing control parameter for breathing control;
dividing respiratory phases, wherein the respiratory phases are divided into inspiratory phases when the flow mean value is more than + e1, the respiratory phases are divided into expiratory phases when the flow mean value is less than-e 1, and the respiratory phases are divided into holding phases when the flow mean value is in an interval of [ -e1, + e1 ];
carrying out flow sampling at a sampling frequency t; calculating the flow slope of two adjacent flow sampling points;
calculating the flow in the inspiration period to obtain inspiration tidal volume; calculating the flow in the expiratory phase period to obtain the expiratory tidal volume;
after entering a holding phase, predicting the respiratory state according to the flow slope and tidal volume data in continuous sampling; the respiratory state prediction result comprises predicted expiration at the end of inspiration, predicted secondary inspiration, predicted inspiration at the end of expiration and predicted secondary expiration;
for different predicted respiratory states, the following pre-processing is performed:
pretreatment of the gas absorption powder:
if exhalation is predicted: adjusting the normal breathing control parameter to a first breathing control parameter different from the normal breathing control parameter, wherein the first breathing control parameter takes effect when exiting the holding phase and entering the expiration phase, and the first breathing control parameter takes effect after a period of time, and the first breathing control parameter is stopped when taking effect, and the first breathing control parameter is recovered to the original normal breathing control parameter;
if a second inspiration is predicted: adjusting the normal breathing control parameter to a second breathing control parameter different from the normal breathing control parameter, wherein the second breathing control parameter takes effect when exiting the holding phase and entering the inspiration phase, and the second breathing control parameter takes effect after a period of time, and the second breathing control parameter stops taking effect, and the second breathing control parameter is recovered to the original normal breathing control parameter;
pretreatment of end-tidal gas:
if inhalation is predicted: adjusting the normal breathing control parameter to a third breathing control parameter different from the normal breathing control parameter, wherein the third breathing control parameter takes effect when exiting the holding phase and entering the inspiration phase, and the time for taking effect of the third breathing control parameter stops after a period of time, and the third breathing control parameter is recovered to the original normal breathing control parameter;
predicting secondary expiration: and adjusting the normal breathing control parameter to a fourth breathing control parameter different from the normal breathing control parameter, wherein the fourth breathing control parameter takes effect when the fourth breathing control parameter exits from the holding phase and enters into the breathing phase, and the effective time of the fourth breathing control parameter stops after a period of time, and the fourth breathing control parameter is restored to the original normal breathing control parameter.
A second aspect of the present invention provides a ventilator, which has an air path module, a detection module, and a controller; wherein the content of the first and second substances,
a pneumatic circuit module configured to generate a flow of breathable gas for breathing, the flow of breathable gas employing respiratory phase control to adjust normal respiratory control parameters;
a detection module configured at least for sampling traffic at a sampling frequency t;
a controller configured to use a normal breathing control parameter, a first breathing control parameter, a second breathing control parameter, a third breathing control parameter, or a fourth breathing control parameter for respiratory phase control to vary a flow of breathable gas in the airway module.
A third aspect of the invention proposes a controller comprising a storage medium, a processor and a control program stored on the storage medium and executable on the processor, the processor implementing the steps of the method according to the first aspect when executing the control program.
A fourth aspect of the invention proposes a storage medium having stored thereon a control program which, when executed by a processor, causes the processor to carry out the steps of the method according to the first aspect.
The invention is explained below:
1. by implementing the technical scheme of the invention, aiming at the problems of inspiration difficulty caused by inspiration false triggering and slow switching of inspiration control lag due to unstable control at the end of the conventional expiration, expiration difficulty caused by untimely pressure release at the end of inspiration and difficulty in inspiration when relieving secondary inspiration, a third state except an inspiration phase and an expiration phase is particularly provided on the division of a breathing phase controlled by the breathing phase, the phase is kept, a breathing control mode is increased by using the division mode of the breathing phase, and the core is the breathing prediction and pretreatment of the phase; when the respiration prediction is carried out, the respiration state prediction is carried out by using the flow slope and tidal volume data in continuous sampling, joint judgment is carried out by adopting a plurality of K values in the continuous sampling, and the respiration state is predicted when a plurality of continuous flow slopes are all larger than or smaller than related values, so that the judgment error is reduced; meanwhile, airflow jitter may exist in-e 1- + e1, so that even if a plurality of continuous flow slopes are in one interval, the possibility of respiratory error prediction still exists, and therefore a mode of combined judgment of tidal volume and flow slopes is introduced to further avoid judgment errors; when the breathing pretreatment control is carried out, different fine breathing pretreatment is carried out according to different breathing states which are accurately predicted, so that the breathing control can be effectively, timely and accurately carried out, the comfort of a patient is improved, the breathing difficulty caused by inspiration false triggering due to unstable control at the end of expiration, slow switching of inspiration control lag and untimely pressure release at the end of inspiration can be effectively reduced, and the inspiration difficulty during secondary inspiration is relieved.
2. In the first aspect of the foregoing technical solution, a flow slope K = (current sampling point flow-previous sampling point flow)/sampling frequency;
a slope threshold K1 and a slope threshold K2 at the end of inspiration, a slope threshold K3 and a slope threshold K4 at the end of expiration and a predicted tidal volume TV are set in the respirator;
and predicting and preprocessing the respiratory state according to the slope threshold K1 and the slope threshold K2 at the end of inspiration, the slope threshold K3 and the slope threshold K4 at the end of expiration, the flow slope K, the predicted tidal volume TV, the inspiration tidal volume TV1 and the expiration tidal volume TV2.
3. In the first aspect of the above technical solution, the step of predicting the respiratory state based on the flow slope and tidal volume data in the continuous sampling includes the following steps:
gas absorption powder:
predicting exhalation if K is less than K1 and TV1> N1 × TV;
predicting a second inspiration if K is greater than K2 and TV1< N1 × TV;
end-tidal:
predicting inspiration if K is greater than K3 and TV2> N2 TV1;
predicting secondary exhalation if K is less than K4 and TV2< N2 TV1;
wherein N1 is the percentage of the tidal volume of the user under normal breathing to the predicted tidal volume, and N2 is the percentage of the tidal volume of the user under normal breathing to the predicted tidal volume after error correction.
4. In a first aspect of the above technical solution, the breathing phase control of the ventilator is in a form of controlling PWM (pulse width modulation), PWM1= PWM2+ (F1-Fave) × a;
wherein PWM1 is a PWM value which is actually issued, PWM2 is a PWM value of output pressure under standard connection, F1 is a real-time flow value, fave is an average flow within a period of time T, and a normal breathing control parameter is a normal breathing control coefficient a.
5. In the first aspect of the above technical solution, in the control process of the end of inspiration:
adjusting the parameter of the predicted exhalation by adjusting the normal breathing control coefficient a to a first breathing control coefficient A1, wherein A1= a (TV 1/(N1 TV)); when the first breathing control coefficient A1 of expiration lasts for a period of time until the expiratory tidal volume TV2>50% tv1, the first breathing control coefficient A1 comes into effect for a time that ceases, reverting to the normal breathing control coefficient a;
the parameter adjustment mode of the prediction second inspiration is that the normal respiration control coefficient a is adjusted to a second respiration control coefficient A2, wherein A2= a (N1 TV-TV 1)/(N1 TV), when the second respiration control coefficient A2 of the second inspiration lasts for a period of time till the tidal volume TV3 of the second inspiration is more than 50% (TV-TV 1), the effective time of the second respiration control coefficient A2 stops, and the second respiration control coefficient a is recovered to the normal respiration control coefficient a; the tidal volume of second inspiration TV3 is equal to the tidal volume of inspiration TV1;
during end-tidal control:
adjusting the parameter of the predicted inspiration in a manner that adjusts the normal breathing control coefficient a to a third breathing control coefficient A3, wherein A3= a (1 + (TV-TV 1)/TV); when the inspiratory third breathing control coefficient A3 continues for a period of time until the inspiratory tidal volume TV1>50% TV, the third breathing control coefficient A3 becomes effective, ceasing, and reverting to the normal breathing control coefficient a;
the parameter adjustment mode of the secondary expiration prediction is to adjust the normal respiration control coefficient a to a fourth expiration control coefficient A4, wherein A4= a (1 + (TV 2-TV 1)/TV 1); when the fourth breath control coefficient A4 of the secondary expiration lasts for a period of time until the tidal volume TV4 of the secondary expiration is more than 50% (TV 1-TV 2), the effective time of the fourth breath control coefficient A4 stops, and the control coefficient a is restored to the normal breath control coefficient a; the tidal volume of secondary expiration TV4 is identical to tidal volume of expiratory expiration TV2.
6. In the first aspect of the above technical solution, the flow of the inspiratory phase is integrated to obtain an inspiratory tidal volume TV1, TV1= (Fa-Fave) × t + (Fb-Fave) × t + (Fx-Fave) × t, where Fa-Fx in the formula refers to each flow sampling value in the period of the inspiratory phase; TV3= TV1;
performing integral calculation on the flow of the expiratory phase to obtain an expiratory tidal volume TV2, wherein TV2= (Fa-Fave) × t + (Fb-Fave) × t + - + (Fx-Fave) × t, and Fa-Fx in the formula refer to each flow sampling value in the period of the expiratory phase; TV4= TV2.
7. In a second aspect of the above solution, the controller is configured to perform the following method steps: the controller is configured to perform the following method steps:
for different predicted respiratory states, the following preprocessing controls are performed:
pretreatment control of the gas absorption powder:
if exhalation is predicted: adjusting the normal breathing control parameter of the gas circuit module to be a first breathing control parameter different from the normal breathing control parameter, wherein the first breathing control parameter takes effect when exiting from a holding phase and entering into an expiration phase, and the first breathing control parameter takes effect after a period of time, stops taking effect, and recovers to the original normal breathing control parameter;
if a second inspiration is predicted: adjusting the normal breathing control parameter of the gas circuit module to be a second breathing control parameter different from the normal breathing control parameter, wherein the second breathing control parameter takes effect when exiting from the holding phase and entering into the inspiration phase, and the second breathing control parameter takes effect after a period of time, stops taking effect, and recovers to the original normal breathing control parameter;
pretreatment control of the gas absorption powder:
if inhalation is predicted: adjusting the normal respiration control parameter of the gas circuit module to a third respiration control parameter different from the normal respiration control parameter, wherein the third respiration control parameter takes effect when exiting from the holding phase and entering into the inspiration phase, and the time for taking the third respiration control parameter into effect stops after a period of time, and the third respiration control parameter is recovered to the original normal respiration control parameter;
predicting secondary expiration: and adjusting the normal breathing control parameter of the gas circuit module to a fourth breathing control parameter different from the normal breathing control parameter, wherein the fourth breathing control parameter takes effect when exiting the holding phase and entering the breathing phase, and the fourth breathing control parameter stops taking effect after a period of time, and the fourth breathing control parameter is recovered to the original normal breathing control parameter.
8. In the technical scheme of the invention, thresholds, + e1 and-e 1 are set up above and below the flow average value, the selection mode of the thresholds can adopt a dynamic threshold method, and the specific method refers to a breathing phase control method of a breathing machine based on the dynamic threshold in patent CN 114209940A.
9. In the technical scheme of the invention, the normal breathing control parameter comprises a normal breathing control coefficient a, and can be related to breathing airflow pressure, flow, valve opening and closing degree and the like related to breathing control.
10. In the present invention, unless otherwise explicitly stated or limited, the terms "mounted," "connected," "fixed," and the like are to be construed broadly, e.g., as being permanently connected, detachably connected, or integral; they may be mechanically coupled, directly coupled, indirectly coupled through intervening media, coupled between two elements, or coupled in any other manner that does not materially affect the operation of the device, unless otherwise specifically limited. The specific meaning of the above terms in the present application can be understood by those of ordinary skill in the art as the case may be.
11. In the present invention, the terms "center", "upper", "lower", "axial", "bottom", "inner", "outer", etc. indicate orientations or positional relationships based on the orientations or positional arrangements shown in the drawings, and are only for convenience in describing the present application and simplifying the description, but do not indicate or imply that the referred device or element must have a specific orientation, be constructed in a specific orientation, and be operated, and thus, should not be construed as limiting the present application.
12. Furthermore, the terms "first", "second", etc. are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include at least one such feature. In the description of the present application, "plurality" means at least two, e.g., two, three, etc., unless explicitly specified otherwise.
Due to the application of the scheme, compared with the prior art, the invention has the following advantages and effects:
aiming at the problems of inspiration difficulty caused by inspiration error triggering and slow switching of inspiration control lag due to unstable control at the end of expiration, expiration difficulty caused by untimely pressure release at the end of inspiration and difficulty in expiration when relieving inspiration during secondary inspiration, the invention particularly provides a third state except an inspiration phase and an expiration phase on the division of a breathing phase controlled by the breathing phase, keeps the phase, increases a breathing control mode by the division of the breathing phase, and has the core of keeping the breathing prediction and pretreatment of the phase; when the respiration prediction is carried out, the respiration state prediction is carried out by using the flow slope and tidal volume data in continuous sampling, joint judgment is carried out by adopting a plurality of K values in the continuous sampling, and the respiration state is predicted when a plurality of continuous flow slopes are all larger than or smaller than related values, so that the judgment error is reduced; meanwhile, airflow jitter may exist in-e 1- + e1, so that even if a plurality of continuous flow slopes are in one interval, the possibility of respiratory error prediction still exists, and therefore a mode of combined judgment of tidal volume and flow slopes is introduced to further avoid judgment errors; when the breathing pretreatment control is carried out, different fine breathing pretreatment is carried out according to different breathing states which are accurately predicted, the breathing control can be effectively, timely and accurately carried out, so that the comfort of a patient is improved, the breathing difficulty caused by inspiration error triggering caused by unstable control at the end of expiration, slow switching of inspiration control lag and untimely pressure release at the end of inspiration can be effectively reduced, and the difficulty in inspiration during secondary inspiration is relieved.
Drawings
FIG. 1 is a schematic diagram of the relationship between the respiratory phase and the flow rate during a respiratory cycle in a prior art solution;
FIG. 2 is a graph of the change in flow as a patient breathes;
FIG. 3 is a waveform diagram illustrating the false triggering and control hysteresis of a prior art solution for patient breathing;
FIG. 4 is a schematic diagram of the breathing phase division according to an embodiment of the present invention;
FIG. 5 is a graph of respiratory waveforms (one) before and after an intervention in accordance with aspects of the present invention;
fig. 6 is a diagram of respiratory waveforms before and after an intervention in accordance with the teachings of the present invention.
Detailed Description
In order to make the aforementioned objects, features and advantages of the present application more comprehensible, embodiments accompanying figures are described in detail below. In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present application. This application is capable of embodiments in many different forms than those described herein and that modifications may be made by one skilled in the art without departing from the spirit and scope of the application and it is therefore not intended to be limited to the specific embodiments disclosed below.
Example one
In one embodiment of the present invention, a respiratory ventilation prediction preprocessing method for a ventilator is provided, the method including:
in the breathing phase control of the breathing machine, setting an upper threshold value + e1 and a lower threshold value-e 1 aiming at the flow average value of the breathing machine; the breathing phase control comprises a normal breathing control parameter for breathing control;
dividing respiratory phases, wherein the respiratory phases are divided into inspiratory phases when the flow mean value is more than + e1, the respiratory phases are divided into expiratory phases when the flow mean value is less than-e 1, and the respiratory phases are divided into holding phases when the flow mean value is in an interval of [ -e1, + e1 ];
carrying out flow sampling at a sampling frequency t; calculating the flow slope K of two adjacent flow sampling points, wherein the flow slope K = (the flow of the current sampling point-the flow of the previous sampling point)/the sampling frequency;
calculating the flow in the inspiration period to obtain inspiration tidal volume; calculating the flow in the expiratory phase period to obtain the expiratory tidal volume;
after entering a holding phase, predicting the respiratory state according to the flow slope and tidal volume data in continuous sampling; the respiratory state prediction result comprises predicted expiration at the end of inspiration, predicted secondary inspiration, predicted inspiration at the end of expiration and predicted secondary expiration;
for different predicted respiratory states, the following preprocessing is performed:
pretreatment of the gas absorption powder:
if exhalation is predicted: adjusting the normal breathing control parameter to a first breathing control parameter different from the normal breathing control parameter, wherein the first breathing control parameter takes effect when exiting from a holding phase and entering into an expiration phase, and the first breathing control parameter takes effect after a period of time, and the first breathing control parameter is stopped taking effect, and the first breathing control parameter is recovered to the original normal breathing control parameter;
if a second inspiration is predicted: adjusting the normal breathing control parameter to a second breathing control parameter different from the normal breathing control parameter, wherein the second breathing control parameter takes effect when the second breathing control parameter exits from a holding phase and enters an inspiration phase, and the second breathing control parameter takes effect after a period of time, stops taking effect, and returns to the original normal breathing control parameter;
pretreatment of end-tidal gas:
if inhalation is predicted: adjusting the normal breathing control parameter to a third breathing control parameter different from the normal breathing control parameter, wherein the third breathing control parameter takes effect when the third breathing control parameter exits from a holding phase and enters an inspiration phase, and the taking-effect time of the third breathing control parameter stops after a period of time, and the original normal breathing control parameter is recovered;
predicting secondary expiration: and adjusting the normal breathing control parameter to a fourth breathing control parameter different from the normal breathing control parameter, wherein the fourth breathing control parameter takes effect when exiting the holding phase and entering the breathing phase, and the taking effect time of the fourth breathing control parameter stops after a period of time, and the fourth breathing control parameter is recovered to the original normal breathing control parameter.
In an embodiment of the invention, the breathing phase control of the ventilator takes the form of controlling PWM, PWM1= PWM2+ (F1-Fave) × a;
wherein PWM1 is a PWM value which is actually issued, PWM2 is a PWM value of output pressure under standard connection, F1 is a real-time flow value, fave is an average flow within a period of time T, and a normal breathing control parameter is a normal breathing control coefficient a.
In the first embodiment, the ventilator is set with the slope threshold K1 and the slope threshold K2 at the end of inspiration, the slope threshold K3 and the slope threshold K4 at the end of expiration, and the predicted tidal volume TV; and predicting and preprocessing the respiratory state according to the slope threshold K1 and the slope threshold K2 at the end of inspiration, the slope threshold K3 and the slope threshold K4 at the end of expiration, the flow slope K, the predicted tidal volume TV, the inspiration tidal volume TV1 and the expiration tidal volume TV2.
In the first embodiment, after the hold phase is entered, the respiratory state is predicted according to the flow slope and tidal volume data in the continuous sampling; the respiratory state prediction result comprises the predicted expiration of the end of inspiration, the predicted secondary inspiration, the predicted inspiration of the end of expiration and the predicted secondary expiration. The step of predicting breathing includes the following judgment and prediction:
gas absorption powder:
predicting exhalation if K is less than K1 and TV1> N1 × TV;
predicting a second inspiration if K is greater than K2 and TV1< N1 × TV;
end-tidal:
predicting inspiration if K is greater than K3 and TV2> N2 TV1;
predicting secondary exhalation if K is less than K4 and TV2< N2 TV1;
wherein N1 is the percentage of the tidal volume of the user under normal breathing to the predicted tidal volume, and N2 is the percentage of the tidal volume of the user under normal breathing to the predicted tidal volume after error correction.
In the first embodiment, during the control of the end of inspiration:
adjusting the parameter of the predicted exhalation by adjusting the normal breathing control coefficient a to a first breathing control coefficient A1, wherein A1= a (TV 1/(N1 TV)); when the first breathing control coefficient A1 of expiration lasts for a period of time until the expiratory tidal volume TV2>50% tv1, the first breathing control coefficient A1 comes into effect for a time that ceases, reverting to the normal breathing control coefficient a;
the parameter adjustment mode of the prediction second inspiration is that the normal respiration control coefficient a is adjusted to a second respiration control coefficient A2, wherein A2= a (N1 TV-TV 1)/(N1 TV), when the second respiration control coefficient A2 of the second inspiration lasts for a period of time till the tidal volume TV3 of the second inspiration is more than 50% (TV-TV 1), the effective time of the second respiration control coefficient A2 stops, and the second respiration control coefficient a is recovered to the normal respiration control coefficient a; the second inspiratory tidal volume TV3 is equal to the inspiratory tidal volume TV1;
during end-tidal control:
adjusting the parameter of the predicted inspiration in a manner that adjusts the normal breathing control coefficient a to a third breathing control coefficient A3, wherein A3= a (1 + (TV-TV 1)/TV); when the inspiratory third breathing control coefficient A3 continues for a period of time until the inspiratory tidal volume TV1>50% TV, the third breathing control coefficient A3 becomes effective, ceasing, and reverting to the normal breathing control coefficient a;
the parameter adjustment mode of the secondary expiration prediction is to adjust the normal respiration control coefficient a to a fourth expiration control coefficient A4, wherein A4= a (1 + (TV 2-TV 1)/TV 1); when the fourth breath control coefficient A4 of the secondary expiration lasts for a period of time until the tidal volume TV4 of the secondary expiration is more than 50% (TV 1-TV 2), the effective time of the fourth breath control coefficient A4 stops, and the control coefficient a is restored to the normal breath control coefficient a; the quadratic expiratory tidal volume TV4 is identical to the expiratory tidal volume TV2.
The following description will proceed with reference being made to one of the preferred embodiments.
In the preferred embodiment of the invention, a division mode of breathing phase of a breathing process is provided, a third state except an inspiratory phase and an expiratory phase is provided, a holding phase is provided, a breathing control mode is added by the division mode of the breathing phase, and the core is the prediction and pretreatment of the breathing state of the holding phase.
The interval division mode is as follows:
the selection mode of the upper threshold + e1 and the lower threshold-e 1 above and below the flow average value, and the selection mode of the upper threshold + e1 and the lower threshold-e 1 can adopt a dynamic threshold method, and the specific method can refer to a published patent CN114209940A breathing phase control method of a breathing machine based on the dynamic threshold.
Referring to fig. 4, the breathing phase interval is divided: the inspiratory phase flow F is greater than + e1, the holding phase flow F is [ -e1, + e1], the expiratory phase flow F is less than-e 1, the original inspiratory and expiratory control mode is PWM1= PWM2+ (F1-Fave) × a remains unchanged, and the increased holding phase is now described.
And keeping the phase entering condition, wherein the flow rate is in an interval of [ -e1, + e1 ]. Within the hold phase, a respiratory state prediction is made, the predicted subsequent breaths of this phase exist: expiration and secondary inspiration of inspiration and expiration, and corresponding breathing machine states respectively: the pressure needs to be released and increased in advance; and end-tidal inspiration, secondary expiration.
The method for predicting the suction state comprises the following steps: the flow sampling frequency is temporarily set to be 2ms once, namely t =2ms, and after entering the hold phase, the respiration prediction is carried out by adopting a mode of combining the flow slope and the tidal volume.
Recording sampling values, calculating a slope K = (Fa-Fb)/t by collecting the flow Fa and Fb of two adjacent flow sampling points, considering that expiration is about to occur when the slope K is smaller than an end-inspiration threshold K1 or smaller than an end-expiration threshold K4, considering that inspiration is about to occur when K is larger than an end-inspiration threshold K2 or larger than an end-expiration threshold K3, and considering that inspiration is about to occur in order to reduce K judgment errors by jointly judging a plurality of calculated continuous K values in continuous sampling, for example, KA, KB and KC are three continuous slopes calculated by continuous sampling, and expiration is predicted when KA, KB and KC are smaller than the end-inspiration threshold K1, wherein the thresholds K1, K2, K3 and K4 are testing empirical values.
However, due to the fact that airflow jitter may exist in-e 1 to + e1, even if a plurality of continuous K's are in one of the intervals, the possibility of respiratory error prediction still exists, and therefore the tidal volume and the flow slope are combined for judgment, the flow of the inhalation phase and the exhalation phase is subjected to integral calculation to obtain the tidal volumes TV1 and TV2 in the inhalation phase and the exhalation phase, the calculated inhalation tidal volume TV1 and exhalation tidal volume TV2 are compared with the N1 of the predicted tidal volume TV to predict the respiratory state, and the end-exhalation TV2 is compared with the N2 (percentage) of the TV1 to predict the respiratory state.
N1, which is temporarily 85%, and the value of N1 is measured according to a large amount of experimental data to obtain the percentage of the tidal volume of different people under normal breathing and the predicted tidal volume (weight: 8 to 10 ml/kg));
n2 is tentatively 90%, theoretically TV1= TV2, but in practice 5% error is reserved due to sampling errors, respiratory dead space, etc.
Inspiratory tidal volume TV1, inspiratory flow integral calculation: TV1= (Fa-Fave) × 2ms + (Fb-Fave) × 2ms + - + (Fx-Fave) × 2ms;
the second inspiratory tidal volume TV3 is calculated in the same manner as TV1, TV3= (Fa-Fave) × 2ms + (Fb-Fave) × 2ms + (Fx-Fave) × 2ms;
expiratory tidal volume TV2, expiratory flow integral calculation: TV2= (Fa-Fave) × 2ms + (Fb-Fave) × 2ms + - + (Fx-Fave) × 2ms;
the secondary expiratory tidal volume TV4 is calculated in the same manner as TV2, TV4= (Fa-Fave) × 2ms + (Fb-Fave) × 2ms + (Fx-Fave) × 2ms;
Fa-Fx refer to the flow of each sample in inspiration or expiration.
The predicted tidal volume calculation method comprises the following steps: adding weight input function on a ventilator, TV = (8 to 10ml/kg body weight G), tentatively taking TV =9ml/kg body weight G;
and (3) respiratory state prediction:
gas absorption powder:
predicting exhalation if K is less than K1 and TV1> N1 × TV;
predicting a second inspiration if K is greater than K2 and TV1< N1 × TV;
end-expiration:
predicting inspiration if K is greater than K3 and TV2> N2 TV1;
if K is less than K4 and TV2< N2 TV1, secondary exhalation is predicted.
Different pre-processing is provided for different predicted respiratory states:
the corresponding control process of the suction end is as follows:
prediction of exhalation: changing the normal respiration control coefficient a, recording the changed coefficient as a first respiration control coefficient A1, enabling A1 to take effect when the A1 exits from the holding phase and enters into the expiratory phase, and continuing for a period of time, when the expiratory tidal volume TV2 is greater than 50% and TV1 is changed, stopping the A1 effective time, and recovering the coefficient to be the original a;
the coefficient changing method comprises the following steps: a1= a (TV 1/(N1 TV)).
Predicting second inspiration: changing a normal respiration control coefficient a of the patient, recording the changed coefficient as a second respiration control coefficient A2, enabling the A2 to take effect when the patient exits from the holding phase and enters into the inspiration phase, and continuing for a period of time, wherein when the TV3 of the second inspiration is more than 50 percent (TV-TV 1), the A2 taking effect time is stopped, and the coefficient recovers the original a;
the coefficient changing method comprises the following steps: a2= a (N1 TV-TV 1)/(N1 TV);
TV3 is calculated in the same manner as TV1, TV3= (Fa-Fave) =2ms + (Fb-Fave) × 2ms +. + (Fx-Fave) × 2ms.
The corresponding control process of the end expiration:
prediction of inspiration:
changing its normal breathing control coefficient a, the changed coefficient being denoted as a third breathing control coefficient A3, and A3 being active upon exiting the hold phase, entering the inspiratory phase, and continuing for a period of time, when inspiratory TV1>50% TV, the A3 active time is stopped, the coefficient reverts to the original a;
the coefficient changing method comprises the following steps: a3= a (1 + (TV-TV 1)/TV).
Predicting secondary expiration: and changing the normal breathing control coefficient a, recording the changed coefficient as a fourth breathing control coefficient A4, enabling the A4 to take effect when the A4 exits from the holding phase and enters into the expiratory phase, and continuing for a period of time, wherein when the TV4 of the secondary expiration is more than 50 percent (TV 1-TV 2), the A4 effective time is stopped, and the coefficient recovers the original a.
The coefficient changing method comprises the following steps: a4= a (1 + (TV 2-TV 1)/TV 1);
TV4 is calculated in the same manner as TV2, TV4= (Fa-Fave) × 2ms + (Fb-Fave) × 2ms +. + (Fx-Fave) × 2ms.
In the above preferred embodiment, the control is performed by using the original coefficient a in the other cases not within the prediction result.
Example two
The second embodiment of the invention discloses a breathing machine, which is used for implementing the respiratory ventilation prediction preprocessing method in the first embodiment of the invention, and the breathing machine is provided with a gas circuit module, a detection module and a controller; wherein, the first and the second end of the pipe are connected with each other,
a gas circuit module configured to generate a flow of breathable gas for breathing, the flow of breathable gas employing breath phase control to adjust normal breathing control parameters;
a detection module configured at least for sampling traffic at a sampling frequency t;
a controller configured to use a normal breathing control parameter, a first breathing control parameter, a second breathing control parameter, a third breathing control parameter, or a fourth breathing control parameter for respiratory phase control to vary a flow of breathable gas in the gas circuit module.
In a second embodiment of the present invention, the controller is configured to perform the following method steps:
for different predicted respiratory states, the following preprocessing controls are performed:
pretreatment control of the gas absorption end:
if exhalation is predicted: adjusting the normal breathing control parameter of the gas circuit module to be a first breathing control parameter different from the normal breathing control parameter, wherein the first breathing control parameter takes effect when exiting from a holding phase and entering into an expiration phase, and the first breathing control parameter takes effect after a period of time, stops taking effect, and recovers to the original normal breathing control parameter;
if a second inspiration is predicted: adjusting the normal breathing control parameter of the gas circuit module to be a second breathing control parameter different from the normal breathing control parameter, wherein the second breathing control parameter takes effect when exiting from the holding phase and entering into the inspiration phase, and the second breathing control parameter takes effect after a period of time, stops taking effect, and recovers to the original normal breathing control parameter;
pretreatment control of the gas absorption powder:
if inhalation is predicted: adjusting the normal breathing control parameter of the gas circuit module to a third breathing control parameter different from the normal breathing control parameter, wherein the third breathing control parameter takes effect when the third breathing control parameter exits from a holding phase and enters an inspiration phase, and the taking-effect time of the third breathing control parameter stops after a period of time, and the third breathing control parameter is recovered to the original normal breathing control parameter;
predicting secondary expiration: and adjusting the normal breathing control parameter of the gas circuit module to a fourth breathing control parameter different from the normal breathing control parameter, wherein the fourth breathing control parameter takes effect when exiting the holding phase and entering the breathing phase, and the fourth breathing control parameter stops taking effect after a period of time, and the fourth breathing control parameter is recovered to the original normal breathing control parameter.
EXAMPLE III
The third embodiment of the invention discloses a controller, which comprises a storage medium, a processor and a control program which is stored on the storage medium and can run on the processor, wherein the processor executes the control program to realize the steps of the method of the first embodiment.
Example four
The fourth embodiment of the present invention further discloses a control storage medium, wherein a control program is stored on the control storage medium, and when the control program is executed by a processor, the processor is enabled to execute the steps of the method according to the first embodiment.
The breathing waveform diagrams before and after intervention in the technical scheme of the invention are obtained by performing simulation use in the same simulated lung by the prior art and the scheme of the invention and are respectively shown in the attached drawings 5 and 6, the scheme performs 'predicted expiration at the end of inspiration', predicted secondary inspiration 'at the end of expiration and predicted secondary expiration' at the end of expiration in a divided holding phase, and performs corresponding preprocessing, wherein A in the drawings 5 and 6 is expiration at the end of inspiration, B is inspiration at the end of expiration, C is inspiration at the end of expiration, D is expiration at the end of expiration, a curve with a solid line is a breathing waveform curve before intervention, a curve with a dotted line is a breathing waveform curve after intervention, and a curve with a dotted line is a breathing waveform curve after intervention, so that the method can obviously see from comparison of the curves in the drawings 5 and 6, after preprocessing intervention, different fine breathing pretreatments are performed according to different accurately predicted breathing states, the waveform has obvious changes, is closer to a human breathing rhythm under an ideal state, and more accurate and stable control can be more accurate and timely, and the breathing comfort can be accurately controlled to reduce the difficulty in controlling the late inspiration caused by switching, and the difficulty in controlling the delay of secondary inspiration caused by unstable expiration.
The above embodiments are merely illustrative of the technical ideas and features of the present invention, and the purpose thereof is to enable those skilled in the art to understand the contents of the present invention and implement the present invention, and not to limit the protection scope of the present invention. All equivalent changes and modifications made according to the spirit of the present invention should be covered within the protection scope of the present invention.
Claims (10)
1. A method of predictive preprocessing of respiratory ventilation, the method comprising:
in the breathing phase control of a breathing machine, setting an upper threshold value + e1 and a lower threshold value-e 1 aiming at the flow average value of the breathing machine; the breathing phase control comprises a normal breathing control parameter for breathing control;
dividing respiratory phases, wherein the respiratory phases are divided into inspiratory phases when the flow mean value is more than + e1, the respiratory phases are divided into expiratory phases when the flow mean value is less than-e 1, and the respiratory phases are divided into holding phases when the flow mean value is in an interval of [ -e1, + e1 ];
carrying out flow sampling at a sampling frequency t; calculating the flow slope of two adjacent flow sampling points;
calculating the flow in the inspiration period to obtain inspiration tidal volume; calculating the flow in the expiratory phase period to obtain the expiratory tidal volume;
after entering a holding phase, predicting the respiratory state according to the flow slope and tidal volume data in continuous sampling; the respiratory state prediction result comprises predicted expiration and predicted secondary inspiration of the end of inspiration, and predicted inspiration and predicted secondary expiration of the end of expiration;
for different predicted respiratory states, the following preprocessing is performed:
pretreatment of the gas absorption powder:
if exhalation is predicted: adjusting the normal breathing control parameter to a first breathing control parameter different from the normal breathing control parameter, wherein the first breathing control parameter takes effect when exiting the holding phase and entering the expiration phase, and the first breathing control parameter takes effect after a period of time, and the first breathing control parameter is stopped when taking effect, and the first breathing control parameter is recovered to the original normal breathing control parameter;
if a second inspiration is predicted: adjusting the normal breathing control parameter to a second breathing control parameter different from the normal breathing control parameter, wherein the second breathing control parameter takes effect when exiting the holding phase and entering the inspiration phase, and the second breathing control parameter takes effect after a period of time, and the second breathing control parameter stops taking effect, and the second breathing control parameter is recovered to the original normal breathing control parameter;
pretreatment of end-tidal gas:
if inhalation is predicted: adjusting the normal breathing control parameter to a third breathing control parameter different from the normal breathing control parameter, wherein the third breathing control parameter takes effect when exiting the holding phase and entering the inspiration phase, and the time for taking effect of the third breathing control parameter stops after a period of time, and the third breathing control parameter is recovered to the original normal breathing control parameter;
predicting secondary expiration: and adjusting the normal breathing control parameter to a fourth breathing control parameter different from the normal breathing control parameter, wherein the fourth breathing control parameter takes effect when the fourth breathing control parameter exits from the holding phase and enters into the breathing phase, and the effective time of the fourth breathing control parameter stops after a period of time, and the fourth breathing control parameter is restored to the original normal breathing control parameter.
2. The method of respiratory ventilation prediction preprocessing of claim 1, characterized by:
flow slope K = (current sampling point flow-previous sampling point flow)/sampling frequency;
a slope threshold K1 and a slope threshold K2 at the end of inspiration, a slope threshold K3 and a slope threshold K4 at the end of expiration and a predicted tidal volume TV are set in the respirator;
and (3) predicting and preprocessing the respiratory state according to the slope threshold K1 and the slope threshold K2 at the end of inspiration, the slope threshold K3 and the slope threshold K4 at the end of expiration, the flow slope K, the predicted tidal volume TV, the inspiration tidal volume TV1 and the expiration tidal volume TV2.
3. The method of predictive pre-processing of respiratory ventilation according to claim 2, wherein:
the step of predicting the respiratory state based on the flow slope and tidal volume data in the continuous sampling comprises the following steps of:
gas absorption powder:
predicting exhalation if K is less than K1 and TV1> N1 × TV;
predicting a second inspiration if K is greater than K2 and TV1< N1 × TV;
end-expiration:
predicting inspiration if K is greater than K3 and TV2> N2 TV1;
predicting secondary exhalation if K is less than K4 and TV2< N2 TV1;
wherein N1 is the percentage of the tidal volume of the user under normal breathing to the predicted tidal volume, and N2 is the percentage of the tidal volume of the user under normal breathing to the predicted tidal volume after error correction.
4. A method of predictive pre-processing of respiratory ventilation according to claim 3, wherein: the breathing phase control of the respirator adopts a form of PWM control, wherein PWM1= PWM2+ (F1-Fave) × a;
wherein PWM1 is a PWM value which is actually issued, PWM2 is a PWM value of output pressure under standard connection, F1 is a real-time flow value, fave is an average flow within a period of time T, and a normal breathing control parameter is a normal breathing control coefficient a.
5. The method of respiratory ventilation prediction preprocessing of claim 4, characterized by:
in the control process of the suction end:
adjusting the parameter of the predicted exhalation by adjusting the normal breathing control coefficient a to a first breathing control coefficient A1, wherein A1= a (TV 1/(N1 TV)); when the expiratory first breathing control coefficient A1 lasts for a period of time until the expiratory tidal volume TV2> 50%;
the parameter adjustment mode of the prediction second inspiration is to adjust the normal respiration control coefficient a to a second respiration control coefficient A2, wherein, A2= a (N1 TV-TV 1)/(N1 TV), when the second respiration control coefficient A2 of the second inspiration lasts for a period of time till the tidal volume TV3 of the second inspiration is more than 50% (TV-TV 1), the effective time of the second respiration control coefficient A2 stops, and the normal respiration control coefficient a is recovered; the tidal volume of second inspiration TV3 is equal to the tidal volume of inspiration TV1;
during end-tidal control:
adjusting the parameter of the predicted inspiration in a manner that adjusts the normal breathing control coefficient a to a third breathing control coefficient A3, wherein A3= a (1 + (TV-TV 1)/TV); when the inspiratory third respiratory control coefficient A3 continues for a period of time until the inspiratory tidal volume TV1> 50%;
the parameter adjustment mode of the secondary expiration prediction is to adjust the normal respiration control coefficient a to a fourth expiration control coefficient A4, wherein A4= a (1 + (TV 2-TV 1)/TV 1); when the fourth breath control coefficient A4 of the secondary expiration lasts for a period of time until the tidal volume TV4 of the secondary expiration is more than 50% (TV 1-TV 2), the effective time of the fourth breath control coefficient A4 stops, and the control coefficient a is restored to the normal breath control coefficient a; the tidal volume of secondary expiration TV4 is identical to tidal volume of expiratory expiration TV2.
6. The method of respiratory ventilation prediction preprocessing of claim 5, characterized by:
performing integral calculation on the flow of the inspiratory phase to obtain an inspiratory tidal volume TV1, TV1= (Fa-save) × t + (Fb-save) × t + - ((Fx-save) × t), wherein Fa-Fx in the formula refers to each flow sampling value in the period of the inspiratory phase; TV3= TV1;
performing integral calculation on the flow of the expiratory phase to obtain expiratory tidal volume TV2, wherein TV2= (Fa-Fave) × t + (Fb-Fave) × t + - + (Fx-Fave) × t, and Fa-Fx in the formula refer to each flow sampling value in the period of the expiratory phase; TV4= TV2.
7. A ventilator that uses the respiratory ventilation prediction preprocessing method of any one of claims 1 to 6, characterized by: the respirator is provided with a gas circuit module, a detection module and a controller; wherein the content of the first and second substances,
a gas circuit module configured to generate a flow of breathable gas for breathing, the flow of breathable gas employing breath phase control to adjust normal breathing control parameters;
a detection module configured at least for sampling traffic at a sampling frequency t;
a controller configured to use a normal breathing control parameter, a first breathing control parameter, a second breathing control parameter, a third breathing control parameter, or a fourth breathing control parameter for respiratory phase control to vary a flow of breathable gas in the airway module.
8. The ventilator of claim 7, wherein the controller is configured to perform the following method steps:
for different predicted respiratory states, the following preprocessing controls are performed:
pretreatment control of the gas absorption powder:
if exhalation is predicted: adjusting the normal breathing control parameter of the gas circuit module to be a first breathing control parameter different from the normal breathing control parameter, wherein the first breathing control parameter takes effect when exiting from a holding phase and entering into an expiration phase, and the first breathing control parameter takes effect after a period of time, stops taking effect, and recovers to the original normal breathing control parameter;
if a second inspiration is predicted: adjusting the normal breathing control parameter of the gas circuit module to be a second breathing control parameter different from the normal breathing control parameter, wherein the second breathing control parameter takes effect when exiting from the holding phase and entering into the inspiration phase, and the second breathing control parameter takes effect after a period of time, stops taking effect, and recovers to the original normal breathing control parameter;
pretreatment control of the gas absorption powder:
if inhalation is predicted: adjusting the normal respiration control parameter of the gas circuit module to a third respiration control parameter different from the normal respiration control parameter, wherein the third respiration control parameter takes effect when exiting from the holding phase and entering into the inspiration phase, and the time for taking the third respiration control parameter into effect stops after a period of time, and the third respiration control parameter is recovered to the original normal respiration control parameter;
predicting secondary expiration: and adjusting the normal breathing control parameter of the gas circuit module to a fourth breathing control parameter different from the normal breathing control parameter, wherein the fourth breathing control parameter takes effect when exiting the holding phase and entering the breathing phase, and the fourth breathing control parameter stops taking effect after a period of time, and the fourth breathing control parameter is recovered to the original normal breathing control parameter.
9. A controller, characterized by: the controller comprises a storage medium, a processor and a control program stored on the storage medium and executable on the processor, the processor implementing the steps of the method of any one of claims 1 to 6 when executing the control program.
10. A storage medium, characterized by: the storage medium has stored thereon a control 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 6.
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