CN116236652A - Spontaneous breathing trigger judging method and system in noninvasive ventilation mode of neonate - Google Patents
Spontaneous breathing trigger judging method and system in noninvasive ventilation mode of neonate Download PDFInfo
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- CN116236652A CN116236652A CN202211728142.0A CN202211728142A CN116236652A CN 116236652 A CN116236652 A CN 116236652A CN 202211728142 A CN202211728142 A CN 202211728142A CN 116236652 A CN116236652 A CN 116236652A
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- 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
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- 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
- A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A90/00—Technologies having an indirect contribution to adaptation to climate change
- Y02A90/10—Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation
Abstract
The invention provides a spontaneous breathing trigger judging method and a spontaneous breathing trigger judging system under a non-invasive ventilation mode of a neonate, wherein the method comprises the following steps: 1) Obtaining the expiratory pressure data Lastp of the detected person at the time t0 t0 The method comprises the steps of carrying out a first treatment on the surface of the 2) The airway pressure value monitored by the pressure sensor is processed by low-pass filtering to obtain low-pass data FilterData t0 The method comprises the steps of carrying out a first treatment on the surface of the 3) Obtaining an expiration pressure data predicted value plaftp at the time t1 according to the two data t1 The method comprises the steps of carrying out a first treatment on the surface of the 4) Repeating the steps 1) to 3) until N expiration pressure data and expiration pressure data predicted values are obtained, and turning to the step 5); 5) Drawing an actual expiratory pressure line Pn according to expiratory pressure data; 6) Drawing an expiration pressure reference line P according to the expiration pressure data predicted value; 7) And judging that the difference value between the expiration pressure datum line and the actual expiration pressure line is larger than a preset trigger value, and judging that the detected person triggers spontaneous breathing.
Description
Technical Field
The invention belongs to the technical field of respirators, and particularly relates to a spontaneous breathing trigger judging method and system in a noninvasive ventilation mode of a neonate.
Background
Spontaneous respiration refers to respiration under normal conditions of an individual, namely respiration under the condition that no auxiliary equipment or external pressure is applied, belongs to basic physiological behaviors of a human body, mainly comprises the steps of automatically exhaling waste gas in the body and inhaling external oxygen through elastic contraction of the lung, and achieves the purpose of absorbing and exhausting carbon dioxide like oxygen.
The breathing machine is a device which can replace, control or change normal physiological breathing of people, increase the ventilation quantity of lungs, improve the respiratory function, lighten the consumption of breathing work and save the reserve capacity of the heart. There are several ventilation modes of the breathing machine, and PEEP (Positive End Expiratory Pressure ) is one of them, and it is to maintain a certain pressure in the end expiratory airway on the premise of intermittent positive pressure ventilation, and plays an important role in treating respiratory distress syndrome, non-cardiac pulmonary edema and pulmonary hemorrhage.
In a breathing machine, judging whether a patient triggers spontaneous breathing is a very important function, and when the breathing machine judges that the patient triggers spontaneous breathing, the breathing machine can mechanically ventilate the patient once, so that man-machine synchronization can be well achieved, and the patient can be better treated.
At present, a more-used spontaneous breathing triggering method generally uses a set expiratory pressure value as a reference, and judges whether to trigger spontaneous breathing according to a set triggering level or a pressure triggering condition and comparison with the reference, wherein the specific flow is as follows:
1) Taking the expiratory pressure value as a reference value;
2) Airway pressure values monitored by the pressure sensor during exhalation;
3) Judging whether the difference value between the read pressure value and the reference value meets the pressure triggering level or the pressure triggering condition within a certain time;
4) If the condition is satisfied, a mechanical ventilation is performed.
According to the judging method, the expiratory pressure is used as a reference, the expiratory pressure is required to be too high during spontaneous breathing of a patient, the patient cannot ensure that the same expiratory pressure is generated during each spontaneous breathing, and therefore the problem that spontaneous breathing is not triggered or is triggered by mistake is caused, and the phenomenon of man-machine asynchronism is generated.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provides a spontaneous breathing trigger judging method and system in a non-invasive ventilation mode of a neonate.
In order to achieve the above object, the present invention provides a method for determining spontaneous breathing trigger in a non-invasive ventilation mode of a neonate, the method comprising:
step 1) obtaining the expiratory pressure data Lastp of the detected person at the time t0 t0 ；
Step 2) obtaining low-pass data FilterData through low-pass filtering on the airway pressure value monitored by the pressure sensor t0 ；
Step 3) obtaining the expiration pressure data predicted value PLaspp at the time t1 according to the two data t1 ；
Step 4), repeating the steps 1) to 3) until N expiration pressure data and expiration pressure data predicted values are obtained, and turning to the step 5);
step 5) drawing an actual expiratory pressure line Pn according to expiratory pressure data;
step 6), drawing an expiration pressure datum line P according to the expiration pressure data predicted value;
and 7) judging that the difference value between the expiration pressure datum line and the actual expiration pressure line is larger than a preset trigger value, and judging that the detected person triggers spontaneous breathing.
As an improvement of the above method, the step 3) includes:
obtaining an expiration pressure data predicted value PLaspp at the time t1 according to the following formula t1 ：
PLastp t1 ＝0.98×Lastp t0 +0.02×FilterData t0 。
As an improvement of the above method, the preset trigger value in step 7) is 0.2×trigger level.
As an improvement of the above method, the triggering level includes 1-10 levels adjustable, and the smaller the triggering level, the higher the sensitivity.
In another aspect, the present invention provides a spontaneous breathing trigger determination system in a non-invasive ventilation mode of a neonate, the system comprising:
the expiration pressure data acquisition module is used for acquiring the detected person at the time t0Is set by the exhalation pressure data Lastp of (a) t0 ；
The low-pass processing module is used for obtaining low-pass data FilterData through low-pass filtering processing on the airway pressure value monitored by the pressure sensor t0 ；
An expiration pressure data predicted value obtaining module for obtaining an expiration pressure data predicted value PLastp at time t1 according to the two data t1 ；
The pressure line drawing module is used for repeating the processing of the three modules until N expiration pressure data and expiration pressure data predicted values are obtained; drawing an actual expiratory pressure line Pn according to expiratory pressure data; drawing an expiration pressure reference line P according to the expiration pressure data predicted value; and
and the trigger judging module is used for judging that the difference value between the expiration pressure datum line and the actual expiration pressure line is larger than a preset trigger value, and judging that the detected person triggers spontaneous breathing.
As an improvement of the above system, the processing procedure of the expiration pressure data prediction value obtaining module includes:
obtaining an expiration pressure data predicted value PLaspp at the time t1 according to the following formula t1 ：
PLastp t1 ＝0.98×Lastp t0 +0.02×FilterData t0 。
As an improvement of the above system, the trigger judgment module presets a trigger value of 0.2×trigger level.
As an improvement of the above system, the triggering level includes 1-10 levels adjustable, and the smaller the triggering level, the higher the sensitivity.
Compared with the prior art, the invention has the advantages that:
the method of the invention judges the specific trend in the expiration stage, so that the spontaneous breathing of the patient is accurately judged, and the false triggering or non-triggering phenomenon can be effectively prevented.
Drawings
FIG. 1 is a flow chart of a spontaneous breathing trigger determination method in a neonatal noninvasive ventilation mode of the present invention;
fig. 2 is a schematic representation of an actual expiratory pressure line and expiratory pressure baseline drawn by the method of the present invention.
Detailed Description
The invention improves the spontaneous breathing triggering of the non-invasive nasal synchronous intermittent positive pressure ventilation mode of the neonate, uses the expiratory pressure of each breathing period as a reference, uses the inspiratory effort during spontaneous breathing as a trend, and compares the inspiratory effort with the expiratory pressure, so that the pressure triggering condition can be well compared, and the problem of false triggering or non-triggering is prevented.
The technical scheme of the invention is described in detail below with reference to the accompanying drawings and examples.
Example 1
As shown in fig. 1, embodiment 1 of the present invention proposes a method for determining spontaneous breathing trigger in a non-invasive ventilation mode of a neonate, the method comprising:
step 1) obtaining the expiratory pressure data Lastp of the detected person at the time t0 t0 ；
Step 2) obtaining low-pass data FilterData through low-pass filtering on the airway pressure value monitored by the pressure sensor t0 ；
Step 3) obtaining the expiration pressure data predicted value PLaspp at the time t1 according to the two data t1 ；
Step 4), repeating the steps 1) to 3) until N expiration pressure data and expiration pressure data predicted values are obtained, and turning to the step 5);
step 5) drawing an actual expiratory pressure line Pn according to expiratory pressure data;
step 6), drawing an expiration pressure datum line P according to the expiration pressure data predicted value;
and 7) judging that the difference value between the expiration pressure datum line and the actual expiration pressure line is larger than a preset trigger value, and judging that the detected person triggers spontaneous breathing.
The specific analysis is as follows:
in the expiration stage, the method obtains an expiration pressure data predicted value PLastp at the time t1 according to the following formula by low-pass filtering t1 ：
PLastp t1 ＝0.98×Lastp t0 +0.02×FilterData t0
Find the baseline P of the expiratory pressure and make the baseline and the current playing pressure value Pn different, as shown in fig. 2. When the difference is greater than the trigger level multiplied by 0.2cmH 2 O-time (P-Pn)>Trigger level 0.2), indicating that the patient has triggered spontaneous breathing, the trigger level 1-10 is adjustable, the smaller the value the more sensitive the trigger, illustrating: when the trigger level is 1, the trigger parameter is 0.2cmH 2 O, when the trigger level is 2, the trigger parameter is 0.4cmH 2 O, and so on, the maximum trigger parameter is 2cmH 2 O。
The neonatal ventilator was adjusted to snipv (transnasal intermittent positive airway pressure) mode and the parameters were set as follows: IPAP (inspiratory pressure) =20cmH 2 O, ti (inspiration time) =1s, f (respiratory rate) =17 bpm, EPAP (expiration pressure) =5 cmH 2 O、FIO 2 (oxygen concentration) =40%, trigger level is set, simulated lung is pulled to Trigger spontaneous breathing, and whether the neonatal ventilator triggers spontaneous breathing is observed.
Example 2
Embodiment 2 of the present invention proposes a spontaneous breathing trigger judging system in a non-invasive ventilation mode of a neonate, implemented based on the method of embodiment 1, the system comprising:
an expiratory pressure data acquisition module for acquiring expiratory pressure data Lastp of the detected person at time t0 t0 ；
The low-pass processing module is used for obtaining low-pass data FilterData through low-pass filtering processing on the airway pressure value monitored by the pressure sensor t0 ；
An expiration pressure data predicted value obtaining module for obtaining an expiration pressure data predicted value PLastp at time t1 according to the two data t1 ；
The pressure line drawing module is used for repeating the processing of the three modules until N expiration pressure data and expiration pressure data predicted values are obtained; drawing an actual expiratory pressure line Pn according to expiratory pressure data; drawing an expiration pressure reference line P according to the expiration pressure data predicted value;
and the trigger judging module is used for judging that the difference value between the expiration pressure datum line and the actual expiration pressure line is larger than a preset trigger value, and judging that the detected person triggers spontaneous breathing.
Verification analysis:
the following table is a list of trigger conditions for different trigger levels using the present method and prior art.
| Trigger level | Whether or not the method triggers | Whether or not the existing method triggers |
| 1 | Triggering | Occurrence of false triggering |
| 2 | Triggering | Occurrence of false triggering |
| 5 | Triggering | Triggering |
| 10 | Triggering | Triggering |
As can be seen from the table, the prior art may have false triggers at a trigger level of 1, 2. Further, the method has the advantages of accurate judgment, capability of effectively preventing false triggering or non-triggering, and high sensitivity.
Finally, it should be noted that the above embodiments are only for illustrating the technical solution of the present invention and are not limiting. Although the present invention has been described in detail with reference to the embodiments, it should be understood by those skilled in the art that modifications and equivalents may be made thereto without departing from the spirit and scope of the present invention, which is intended to be covered by the appended claims.
Claims (8)
1. A method of spontaneous breathing trigger determination in a neonatal noninvasive ventilation mode, the method comprising:
step 1) obtaining the expiratory pressure data Lastp of the detected person at the time t0 t0 ；
Step 2) obtaining low-pass data FilterData through low-pass filtering on the airway pressure value monitored by the pressure sensor t0 ；
Step 3) obtaining the expiration pressure data predicted value PLaspp at the time t1 according to the two data t1 ；
Step 4), repeating the steps 1) to 3) until N expiration pressure data and expiration pressure data predicted values are obtained, and turning to the step 5);
step 5) drawing an actual expiratory pressure line Pn according to expiratory pressure data;
step 6), drawing an expiration pressure datum line P according to the expiration pressure data predicted value;
and 7) judging that the difference value between the expiration pressure datum line and the actual expiration pressure line is larger than a preset trigger value, and judging that the detected person triggers spontaneous breathing.
2. The method for determining spontaneous breathing trigger in the non-invasive ventilation mode of neonates according to claim 1, wherein the step 3) includes:
obtaining an expiration pressure data predicted value PLaspp at the time t1 according to the following formula t1 ：
PLastp t1 ＝0.98×Lastp t0 +0.02×FilterData t0 。
3. The method according to claim 1, wherein the trigger value preset in step 7) is 0.2 x trigger level.
4. A method of determining spontaneous breathing triggers in a non-invasive ventilation mode of a neonate according to claim 3, wherein the trigger level comprises 1-10 levels which are adjustable, the smaller the trigger level, the higher the sensitivity.
5. A spontaneous breathing trigger determination system in a neonatal noninvasive ventilation mode, the system comprising:
an expiratory pressure data acquisition module for acquiring expiratory pressure data Lastp of the detected person at time t0 t0 ；
The low-pass processing module is used for obtaining low-pass data FilterData through low-pass filtering processing on the airway pressure value monitored by the pressure sensor t0 ；
An expiration pressure data predicted value obtaining module for obtaining an expiration pressure data predicted value PLastp at time t1 according to the two data t1 ；
The pressure line drawing module is used for repeating the processing of the three modules until N expiration pressure data and expiration pressure data predicted values are obtained; drawing an actual expiratory pressure line Pn according to expiratory pressure data; drawing an expiration pressure reference line P according to the expiration pressure data predicted value; and
and the trigger judging module is used for judging that the difference value between the expiration pressure datum line and the actual expiration pressure line is larger than a preset trigger value, and judging that the detected person triggers spontaneous breathing.
6. The spontaneous breathing trigger determination system in a non-invasive ventilation mode of a neonate according to claim 5, wherein the processing of the expiratory pressure data predictor obtaining module comprises:
obtaining an expiration pressure data predicted value PLaspp at the time t1 according to the following formula t1 ：
PLastp t1 ＝0.98×Lastp t0 +0.02×FilterData t0 。
7. The spontaneous breathing trigger determination system in a non-invasive ventilation mode of claim 5, wherein the trigger determination module presets a trigger value of 0.2 x trigger level.
8. The spontaneous breathing trigger determination system in a non-invasive ventilation mode of a neonate of claim 7, wherein the trigger level comprises a level 1-10 adjustable, the smaller the trigger level, the higher the sensitivity.
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| CN202211728142.0A CN116236652A (en) | 2022-12-29 | 2022-12-29 | Spontaneous breathing trigger judging method and system in noninvasive ventilation mode of neonate |
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| CN202211728142.0A CN116236652A (en) | 2022-12-29 | 2022-12-29 | Spontaneous breathing trigger judging method and system in noninvasive ventilation mode of neonate |
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| CN116236652A true CN116236652A (en) | 2023-06-09 |
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