CN116370769B - Ventilation device, method and storage medium - Google Patents
Ventilation device, method and storage medium Download PDFInfo
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Classifications
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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
- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
- A61M16/022—Control means therefor
- A61M16/024—Control means therefor including calculation means, e.g. using a processor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
Abstract
A ventilation apparatus, comprising: the gas source interface is used for connecting a gas source for providing gas; a breathing circuit for communicating with the air source interface and the patient's respiratory system to input air provided by the air source to the patient and to exhaust air exhaled by the patient; the ventilation detection sensor is used for detecting ventilation parameters in the breathing pipeline and obtaining ventilation signals; the processor is used for: acquiring a respiratory signal used for representing the respiration of a patient, and setting an inspiration trigger window of the respiratory signal; acquiring the position relation of the breathing signal between the current and the inspiration trigger window, and adjusting the intensity of the breathing signal based on the position relation; whether the adjusted respiratory signal meets a trigger threshold is determined for controlling inhalation triggering of the ventilator. Because the intensity of the breathing signal is adjusted based on the inspiration triggering window, the breathing signal is ensured to be accurately triggered. The application also provides a ventilation method and a storage medium.
Description
Technical Field
The application relates to the technical field of ventilation apparatuses, in particular to ventilation equipment, a ventilation method and a storage medium.
Background
Human breath refers to periodic inhalation and exhalation of gases, specifically oxygen absorption and carbon dioxide removal, to effect gas exchange. When some patients cannot breathe spontaneously, mechanical ventilation is used to help the patients to breathe, for example, for patients with respiratory failure, breathing support is usually provided to the patients by external devices such as a ventilator.
The ventilation device generally comprises a breathing machine, an anesthesia machine and the like, and when the ventilation device mechanically ventilates a patient, the ventilation device needs to perform breathing identification on the patient in real time so as to trigger a corresponding ventilation mode, thereby achieving the purpose of man-machine synchronization. Currently, ventilators such as ventilators can identify the breathing state of a patient based on signals such as airway pressure, patient flow rate, and diaphragm electricity. For example, the airway pressure drops when the patient inhales, and if the airway pressure drops to a threshold, a self-main inhalation is identified, requiring triggering of the ventilator to enter an inhalation ventilation mode. However, the above breath recognition method is prone to the problem of inaccurate breath recognition, even erroneous recognition, so that a new technical solution is still required.
Disclosure of Invention
The application mainly solves the technical problem of inaccurate breath identification.
According to a first aspect, there is provided in one embodiment a ventilation device comprising:
the gas source interface is used for connecting a gas source for providing gas;
a breathing circuit for communicating with the source port and the patient's respiratory system to input gases provided by the source to the patient and to exhaust gases exhaled by the patient;
a ventilation detection sensor for detecting a ventilation parameter in the respiratory line and obtaining a ventilation signal;
a processor for:
acquiring a respiratory signal used for representing the respiration of a patient, and setting an inspiration trigger window of the respiratory signal;
acquiring the position relation between the current respiratory signal and the inhalation trigger window, and adjusting the intensity of the respiratory signal based on the position relation;
and judging whether the adjusted respiratory signal meets a trigger threshold or not, so as to control inhalation triggering of the ventilation equipment.
In some embodiments, the adjusting the intensity of the respiratory signal based on the positional relationship includes:
when the respiration signal is currently in the inspiration trigger window, the intensity of the respiration signal is enhanced.
In some embodiments, the ventilation apparatus further comprises:
judging whether the respiratory signal meets a preset condition or not;
and if the preset condition is not met, executing the enhancement of the current strength of the respiratory signal.
In some embodiments, the adjusting the intensity of the respiratory signal based on the positional relationship further includes:
when the respiratory signal is not in the inhalation triggering window at present, acquiring the type of the respiratory signal corresponding to the respiratory action at present, wherein the type of the respiratory action comprises inhalation and exhalation;
and adjusting the current intensity of the respiratory signal according to the type of the respiratory action.
In some embodiments, the adjusting the intensity of the current respiratory signal according to the type of the respiratory action includes:
when the type of the breathing action belongs to inspiration, weakening the intensity of the current breathing signal;
when the type of respiratory action belongs to expiration, the intensity of the current respiratory signal is not adjusted.
In some embodiments, the respiration signal is used to characterize a physiological parameter of the patient that is related to respiration;
alternatively, the respiratory signal is the ventilation signal.
In some embodiments, when the respiratory signal is used to characterize a physiological parameter of the patient that is related to respiration, the respiratory signal is a respiratory muscle pressure signal.
In some embodiments, the setting the inhalation trigger window of the respiratory signal comprises:
a respiratory cycle of a patient is acquired, the respiratory cycle including an inspiratory phase and an expiratory phase, the inspiratory trigger window being disposed in at least a portion of each of the inspiratory phases.
In some embodiments, the acquiring the respiratory cycle of the patient comprises:
acquiring the position of each breathing characteristic related to breathing action in the ventilation signal, and acquiring the time difference between the positions of any two adjacent same breathing characteristics;
the breathing cycle is derived from each of the time differences.
In some embodiments, the acquiring the location of each respiratory feature in the ventilation signal that is related to respiratory effort comprises:
dividing the acquired ventilation signal into a plurality of segments in sequence on a time axis;
acquiring characteristics of each segment in a frequency domain, and determining each target segment with the breathing characteristics according to the characteristics of each segment in the frequency domain;
determining the position of each of the respiratory features based on the position of each of the target segments on the ventilation signal.
In some embodiments, the determining each target segment having the respiratory feature based on the features of each segment in the frequency domain comprises:
for any one of the plurality of segments, obtaining the amplitude thereof in the frequency domain;
and if the amplitude of any one of the fragments is changed by more than a preset amplitude compared with the amplitude of the previous fragment, determining the fragment as the target fragment.
In some embodiments, adjacent ones of the segments have an overlap region on the time axis.
In some embodiments, said deriving said breathing cycle from each of said time differences comprises:
if the fluctuation between the time differences meets the preset fluctuation, calculating the respiratory cycle from the time differences.
According to a second aspect, there is provided in one embodiment a method of ventilation comprising:
acquiring a respiratory signal used for representing the respiration of a patient, and setting an inspiration trigger window of the respiratory signal;
acquiring the position relation between the current respiratory signal and the inhalation trigger window, and adjusting the intensity of the respiratory signal based on the position relation;
and judging whether the adjusted respiratory signal meets a trigger threshold or not, so as to control related actions of the ventilation equipment.
In some embodiments, the adjusting the intensity of the respiratory signal based on the positional relationship includes:
when the respiration signal is currently in the inspiration trigger window, the intensity of the respiration signal is enhanced.
In some embodiments, the adjusting the intensity of the respiratory signal based on the positional relationship further includes:
when the respiratory signal is not in the inhalation triggering window at present, acquiring the type of the respiratory signal corresponding to the respiratory action at present, wherein the type of the respiratory action comprises inhalation and exhalation;
and adjusting the current intensity of the respiratory signal according to the type of the respiratory action.
In some embodiments, the adjusting the intensity of the current respiratory signal according to the respiratory action includes:
when the type of the breathing action belongs to inspiration, weakening the intensity of the current breathing signal;
when the type of respiratory action belongs to expiration, the intensity of the current respiratory signal is not adjusted.
According to a third aspect, an embodiment provides a computer readable storage medium having stored thereon a program executable by a processor to implement the method of the second aspect.
According to the ventilation equipment of the embodiment, the inspiration trigger window is set after the breathing signal is acquired, and then the intensity of the breathing signal is adjusted according to the position relation between the current breathing signal and the inspiration trigger window.
Drawings
FIG. 1 is a schematic diagram of the structure of a ventilation device of an embodiment;
FIG. 2 is a schematic view of the structure of a ventilation device according to another embodiment;
FIG. 3 is a waveform diagram of a pressure signal according to one embodiment;
FIG. 4 is a schematic diagram of segment selection of a pressure signal according to an embodiment;
FIG. 5 is a schematic diagram showing segment selection of a pressure signal according to another embodiment;
FIG. 6 is a graph of the spectrum of the segment of FIG. 4;
FIG. 7 is a graph of the spectrum of the segment of FIG. 5;
FIG. 8 is a schematic diagram of segment selection of a pressure signal according to one embodiment;
FIG. 9 is a schematic diagram of segment selection of a pressure signal according to another embodiment;
FIG. 10 is a graph of the spectrum of the segment of FIG. 8;
FIG. 11 is a graph of the spectrum of the segment of FIG. 9;
FIG. 12 is a schematic diagram of a respiratory signal setup inhalation trigger window of an embodiment;
FIG. 13 is a flow chart of a ventilation method according to an embodiment.
Detailed Description
The application will be described in further detail below with reference to the drawings by means of specific embodiments. Wherein like elements in different embodiments are numbered alike in association. In the following embodiments, numerous specific details are set forth in order to provide a better understanding of the present application. However, one skilled in the art will readily recognize that some of the features may be omitted, or replaced by other elements, materials, or methods in different situations. In some instances, related operations of the present application have not been shown or described in the specification in order to avoid obscuring the core portions of the present application, and may be unnecessary to persons skilled in the art from a detailed description of the related operations, which may be presented in the description and general knowledge of one skilled in the art.
Furthermore, the described features, operations, or characteristics of the description may be combined in any suitable manner in various embodiments. Also, various steps or acts in the method descriptions may be interchanged or modified in a manner apparent to those of ordinary skill in the art. Thus, the various orders in the description and drawings are for clarity of description of only certain embodiments, and are not meant to be required orders unless otherwise indicated.
The numbering of the components itself, e.g. "first", "second", etc., is used herein merely to distinguish between the described objects and does not have any sequential or technical meaning. The term "coupled" as used herein includes both direct and indirect coupling (coupling), unless otherwise indicated.
In the current breath recognition method, after a trigger threshold is set, whether a breath signal meets the trigger threshold is judged according to the trigger threshold, if yes, the inhalation trigger is performed, otherwise, the inhalation trigger is not performed. Because it is simply determined whether the respiration signal satisfies the trigger threshold, and the setting of the trigger threshold is usually unchanged, when the respiration signal is strong, there is a possibility that the respiration signal satisfies the trigger threshold multiple times, and false triggering is generated. When the respiratory signal is weak, the respiratory signal is easy to not meet the triggering threshold value, and the problem of no triggering is generated.
In some embodiments of the present application, after the respiratory signal is acquired, an inspiration trigger window is set, and then the intensity of the respiratory signal is adjusted according to the current position relationship between the respiratory signal and the inspiration trigger window, and after the intensity of the respiratory signal is adjusted based on the inspiration trigger window, the respiratory signal can also normally meet a trigger threshold when being stronger or weaker, and multiple inspiration triggers are avoided, so that the respiratory signal can be ensured to be accurately triggered.
In some embodiments, a ventilation apparatus is provided for respiratory assistance to a user after respiratory identification of the patient, thereby providing respiratory support to the patient. Referring to fig. 1, the ventilation apparatus includes an air source interface 10, a breathing circuit 20, a ventilation control unit 30, a ventilation detection sensor 40, and a processor 50, each of which is described in detail below.
In some embodiments, the ventilator may be a ventilator, which is an artificial mechanical ventilator for assisting or controlling spontaneous respiratory motion of a patient to achieve the function of gas exchange in the lungs, and to reduce the consumption of the human body, so as to facilitate recovery of respiratory function. The ventilation device is described below with respect to an example of a ventilator.
The gas source interface 10 is adapted to be connected to a gas source for providing a gas, typically oxygen, air or the like. In some embodiments, the air source may adopt a compressed air bottle or a central air supply source, and the air source interface 10 is used for supplying air to the breathing machine, and the air supply types include oxygen, air and the like, and the air source interface 10 may comprise conventional components such as a pressure gauge, a pressure regulator, a flowmeter, a pressure reducing valve, an air-oxygen ratio regulating and protecting device and the like, which are respectively used for controlling the flow of various gases (such as oxygen and air).
The breathing circuit 20 is used to selectively communicate the air supply interface 10 with the patient's respiratory system. In some embodiments respiratory circuit 20 includes an exhalation branch 21 and an inhalation branch 22, with exhalation branch 21 connected between a respiratory interface 23 and an exhaust port 24 for directing the exhaled gases from the patient to exhaust port 24. The exhaust port 24 may be open to the environment or may be in a dedicated gas recovery device. An inhalation branch 22 is connected between the breathing interface 23 and the source interface 10 for providing oxygen or air to the patient, for example, gas fed from the source interface 10 enters the inhalation branch 22 and then through the breathing interface 23 into the lungs of the patient. The breathing interface 23 is used to connect the patient to the breathing circuit 20, and in addition to the gases delivered by the inspiratory limb 22, gases exhaled by the patient may be directed through the expiratory limb 21 to the exhaust port 24. In some embodiments, the respiratory interface 23 may be a nasal cannula or a mask for wearing over the mouth and nose.
The ventilation control unit 30 is connected to the air supply interface 10, the breathing circuit 20 for controlling the delivery of air supplied by an external air supply to the patient via the breathing circuit 20. In some embodiments ventilation control unit 30 may include an exhalation controller 31 and an inhalation controller 32, with exhalation controller 31 being disposed on exhalation limb 21 for switching exhalation limb 21 on or off, or controlling the flow rate or pressure of the patient's exhaled gas, in accordance with control instructions. In particular implementations, the exhalation controller 31 may include one or more of an exhalation valve, a one-way valve, a flow controller, a PEEP valve, etc. that enable flow or pressure control. An inhalation controller 32 is provided on the inhalation limb 22 for switching on the inhalation limb 22 or switching off the inhalation limb 22, or controlling the flow rate or pressure of the output gas, in accordance with a control instruction. In particular implementations, the inspiration controller 32 may include one or more of an exhalation valve, a one-way valve, or a flow controller, among other devices capable of effecting flow or pressure control.
The ventilation detection sensor 40 is used to detect a ventilation parameter in the breathing circuit 20 and to obtain a ventilation signal. In some embodiments, the ventilation parameters include pressure parameters, flow parameters, etc., and the ventilation detection sensor 40 includes a flow sensor for detecting flow parameters in the breathing circuit 20 and obtaining flow signals, and a pressure sensor for detecting pressure parameters in the breathing circuit 20 and obtaining pressure signals, which may be analog signals or digital signals.
The processor 50 is at least for controlling the ventilation control unit 30 to control the delivery of gas provided by an external gas source to the patient via the breathing circuit 20. For example, the processor is configured to obtain a respiration signal indicative of respiration of the patient, e.g. the respiration signal is a flow signal or a pressure signal in the ventilation signal, or the respiration signal is a physiological parameter indicative of respiration of the patient, e.g. the respiration signal may be a respiratory muscle pressure signal (Pmus signal). When the patient's respiratory signal meets the trigger threshold for inhalation, the processor then assists the patient in inhalation by controlling the ventilation control unit 30 to control the inhalation triggering of the ventilation.
The above is some description of the ventilation apparatus, and the ventilation method of the ventilation apparatus is specifically described below.
The processor acquires a respiration signal that characterizes the patient's respiration, which is used to trigger the ventilation device to assist the patient in performing an inspiratory effort. When the respiratory signal is a flow signal or a pressure signal, it may be obtained by directly detecting the ventilation parameter in the respiratory line 20 by the ventilation detection sensor 40. When the respiratory signal is a respiratory muscle pressure signal, the respiratory signal may be obtained by pressure detection of an esophageal tube, or may be obtained by calculation based on a flow signal and a pressure signal. For example, the respiratory muscle pressure signal may be determined by the following equation:
Py(t)=RrsV 1 (t)+(1/Crs)V 2 (t)+Pmus(t)+P0；
where Pmus (t) represents the strength of the respiratory muscle pressure signal and Py (t) is the pressure measured at the respiratory line 20, for example at the junction between the expiratory limb 21 and the inspiratory limb 22. V (V) 1 (t) is the air flow into and out of the respiratory system of the patient, for example measuring the flow at the junction between the expiratory limb 21 and the inspiratory limb 22. V (V) 2 (t) is the headroom volume delivered to the patient by the ventilator (by the flow signal V 1 (t) time integration). P0 is a constant term used to characterize the end-expiratory pressure. Rrs represents the resistance of the respiratory system, crs represents the compliance of the respiratory system, and Rrs and Crs can be estimated by applying a flow interrupter technique (also called end-inspiration pause, EIP).
The processor sets an inspiration trigger window for the respiration signal, acquires the position relation between the respiration signal and the inspiration trigger window, and adjusts the strength of the respiration signal based on the position relation. The setting of the inhalation trigger window will be specifically described below.
The inhalation trigger window is used to indicate that the patient will perform an inhalation during the window period, so that when the inhalation trigger window is set, a partial signal related to inhalation in the respiratory signal can be determined first, and then the inhalation trigger window is set based on the partial signal, for example, the inhalation trigger window is set on a part or an entirety of the partial signal. In some embodiments, the processor may also obtain a respiratory cycle of the patient first, where the respiratory cycle includes an inhalation phase and an exhalation phase, i.e., each respiratory cycle is performed by the patient for one inhalation and for one exhalation for the exhalation phase, and the inhalation trigger window is set based on at least a portion of the inhalation phase of each respiratory cycle. For example, the duration of the inspiration trigger window is set to be half of the inspiration phase, and the starting position of the inspiration trigger window can be set at different positions in the inspiration phase according to practical situations, for example, the starting position of the inspiration trigger window is set at the starting position of the inspiration phase, and the first half of the inspiration phase is the inspiration trigger window. For example, the duration of the inspiration trigger window is set to be the same as the inspiration, and the whole inspiration phase is the inspiration trigger window. In this embodiment, since the respiratory signal is in the respiratory cycle, the inhalation trigger window is set in the respiratory cycle as the inhalation trigger window of the respiratory signal.
In some embodiments, the patient's breathing cycle may be obtained in advance or may be obtained by detecting the patient's breathing, and the breathing cycle obtained by detecting the breathing will be described in detail below.
The processor first performs preprocessing operations, such as analog-to-digital conversion and filtering, on the ventilation signals, such as the flow signal and the pressure signal, obtained by the ventilation detection sensor 40, and then samples the preprocessed ventilation signals, for example, the sampling frequency is 50Hz, that is, 50 sample points are acquired per second. In the sampling process, the sampled signal is segmented on a time axis according to a certain time length, for example, each time 25 sample points are sampled to form a segment, namely, the time length of each segment is 0.5s. At the same time, there is an overlap region between adjacent segments, for example, the data repetition rate between adjacent segments is 50%. In this embodiment, after the ventilation signal is segmented, the ventilation signal can reflect that the respiratory feature related to respiration is distributed in each segment, for example, the respiratory feature related to inspiration or expiration is distributed in each segment, and after the adjacent segments have overlapping areas, the respiratory feature can be prevented from being segmented by the adjacent segments, so that the discontinuity of the respiratory feature in each segment is avoided. Thus, a suitable overlap region may allow a more complete presence of the respiratory feature in a segment, so that the segment may well represent the respiratory feature. It will be appreciated that the larger the overlap region, the higher the probability that the breathing characteristic will be more complete in a segment, but the more computing resources it requires, and conversely the lower the probability, the less computing resources it requires, so the size of the overlap region can be set as desired.
The processor then extracts features in the individual segments to determine a target segment having respiratory features. In some embodiments, frequency domain analysis may be performed on each segment, that is, the signal corresponding to each segment is transformed from the time domain to the frequency domain, for example, FFT processing is performed on each segment to obtain a corresponding spectrogram. The amplitude in the spectrogram is the characteristic of each segment in the frequency domain, when the amplitude of the spectrogram corresponding to any one segment is suddenly changed compared with the amplitude of the spectrogram corresponding to the previous segment, the any one segment can be determined to be a target segment with breathing characteristic at the moment, for example, when the change of the amplitude in the spectrogram exceeds the preset amplitude, the mutation is judged. In this embodiment, since there is a significant period of change in the ventilation signal during the inspiration and expiration actions and there is a gradual period of change in the ventilation signal during the alternation of the inspiration and expiration actions during one respiratory cycle, it can be determined that there is an inspiration or expiration action at this time when there is a significant change in the amplitude in the spectrogram. In this embodiment, when the amplitude of the spectrogram corresponding to any one segment is greater than the amplitude of the spectrogram corresponding to the previous segment and the change is greater than the preset amplitude, the any one segment is considered as the target segment, and the respiratory feature of the target segment can be considered as being related to inhalation.
After each target segment having a respiratory feature is determined, the location of each respiratory feature needs to be determined based on the location of each target segment on the ventilation signal. In some embodiments, since information in the time domain is not represented in the spectrogram, it is also desirable to determine specific locations of respiratory features in the target segment after the target segment is determined. In this embodiment, any position in the target segment may be used as the position of the respiratory feature, for example, the starting position may be used as the position of the respiratory feature, and at this time, after determining the position of the target segment on the ventilation signal, the position of the respiratory feature may be determined. In this embodiment, each segment may be numbered, so that the position of the segment on the ventilation signal may be determined according to the number, and each segment has a plurality of sample points, so that the position of the sample point may be used as the position of the respiratory feature, or the position of the segment on the ventilation signal may be reversely deduced according to the position of the sample point. For example, a total of 1000 sample points are sampled for the ventilation signal, wherein each segment comprises 25 sample points, e.g. when the sample points comprised by the target segment are 100-124 th sample points, any of the 100-124 th sample points may be taken as the location of the respiratory feature, e.g. the 100 th sample point as the location of the respiratory feature.
The processor obtains the time difference between the positions of any two adjacent identical breathing characteristics, and obtains the breathing cycle according to each time difference. In this embodiment, multiple respiratory features may be acquired through the ventilation signal, or only one respiratory feature may be acquired, for example, only respiratory features related to inspiration, and then a time difference between two adjacent respiratory features may be acquired according to the positions of the two adjacent respiratory features, where the time difference may be used to represent a respiratory cycle. For example, when a sample point is used as the position of the respiratory feature, the time difference between any two sample points can be obtained according to the sampling frequency. When a plurality of time differences are obtained according to the positions of a plurality of respiratory features, whether the fluctuation among the time differences meets the preset fluctuation or not is also needed to be judged, for example, whether the variance of each time difference meets the requirement or not is judged, for example, the newly acquired target segment is compared with the target segment acquired before, and whether the target segments are matched or not is judged. If the fluctuation between the time differences satisfies the preset fluctuation, it is indicated that the patient has a relatively stable respiratory rate at this time, and then a respiratory cycle may be calculated from the time differences, for example, an average value of the time differences may be used as the respiratory cycle, or one of the time differences may be selected as the respiratory cycle.
When the respiratory cycle of the patient is acquired and the inspiration trigger window is set, respiratory signals of the patient are acquired in real time, and whether the respiratory signals meet preset conditions or not is judged when the current respiratory signals are in the inspiration trigger window, for example, whether triggering thresholds are met or not is judged. If the triggering threshold is not met, the intensity of the current respiratory signal is enhanced, whether the triggering threshold is met or not is judged, and the ventilation equipment is controlled to perform inhalation triggering when the triggering threshold is met, so that the patient is assisted in inhaling. In this embodiment, when the current respiratory signal reaches the inspiration trigger window, if the respiratory signal does not meet the trigger threshold, the intensity of the respiratory signal may be multiplied by a coefficient with a fixed weight greater than 1 to strengthen the respiratory signal. In some embodiments, if the current respiratory signal is not within the inspiration trigger window, the type of respiratory signal at the current corresponding respiratory effort is determined, including inspiration and expiration, e.g., by a flow signal or a pressure signal, to determine whether the patient is inhaling or breathing at the time. When the type of respiratory effort is inspiration, the current respiratory signal intensity is then attenuated, e.g., the respiratory signal intensity may be multiplied by a coefficient with a fixed weight less than 1 to attenuate it. When the type of respiratory action is exhalation, then no adjustment is made to the intensity of the current respiratory signal. In this embodiment, when the current respiratory signal does not reach the inspiration trigger window and the patient is in the inspiration process, weakening the intensity of the respiratory signal can effectively reduce the dual triggering problem in the inspiration process, thereby improving the accuracy of breath identification.
In some embodiments, since the current respiration signal needs to be adjusted in intensity according to the positional relationship with the inspiration trigger window, the adjusted respiration signal may be expressed as follows:
P_ratio(t) = P(t)*Twin(t)；
where P (t) represents the intensity of the respiratory signal at time t, twin (t) represents the value of the weighting coefficient at time t, and p_ratio (t) represents the intensity of the adjusted respiratory signal at time t. Therefore, when the current respiratory signal reaches the inspiration trigger window and the respiratory signal does not meet the trigger threshold, the value of Tain (t) is larger than 1, when the current respiratory signal is not in the inspiration trigger window, if the type of the respiratory action is inspiration, the value of Tain (t) is smaller than 1, and if the type of the respiratory action is expiration, the value of Tain (t) is equal to 1.
From the above, by identifying the breathing characteristics in the ventilation signal, the breathing cycle of the patient can be identified and the inspiratory trigger window of the matching patient can be set according to the breathing cycle. And the intensity of the current respiratory signal can be adaptively adjusted based on the inhalation trigger window, so that the intensity of the respiratory signal and the inhalation trigger window are subjected to data fusion, and the adjusted respiratory signal is obtained and used for judging whether the trigger threshold is met or not. Thus, an accurate inhalation trigger signal can be obtained when the respiratory signal is stronger or weaker, for example, accurate response to the inhalation trigger of a patient with weak or long and slow inhalation capability is realized. Meanwhile, due to the existence of the inspiration triggering window, false triggering in the inspiration process can be effectively reduced, and accuracy and safety of inspiration triggering are improved to the greatest extent.
The calculation of the time difference between the positions of two adjacent identical respiratory features is illustrated below.
In this embodiment, the respiratory cycle is obtained by the pressure signal, it is understood that the respiratory cycle may be obtained by the flow signal, or the respiratory cycle may be obtained by the pressure signal in combination with the flow signal.
Wherein fig. 3 is a preprocessed pressure signal, i.e. a pressure waveform, with a corresponding sampling frequency f of 50Hz. The acquired signals are divided into a plurality of equal-length segments according to time, each segment has a duration of about 0.5s, the data repetition rate of an overlapping area between the segments is 50% (about 0.25 s), two segments selected by the pressure signals are shown in fig. 4 and 5, broken lines of the two segments are shown in the figures, and solid lines of the two segments are shown by the pressure signals. The frequency domain conversion is performed on the two selected fragments, and the corresponding spectrograms are respectively shown in fig. 6 and fig. 7. As can be seen from the spectrogram, the amplitude corresponding to fig. 7 is significantly changed compared with the amplitude corresponding to fig. 6, but the time-domain pressure signal corresponding to fig. 6 is gentle, and the time-domain pressure signal corresponding to fig. 7 is abrupt, so that the respiratory feature corresponding to inspiration can be determined and included in fig. 5 as a target segment. The position of the breathing characteristic is then determined to be (65, 5) based on the position of the target segment in fig. 5, i.e. corresponding to sample point 65, with a pressure amplitude of 5. Similarly, fig. 8 and 9 are two other segments of the pressure signal selected, and the corresponding spectrograms are fig. 10 and 11, respectively, where the segment corresponding to fig. 9 may be determined to be the target segment, and the position of the respiratory feature may be determined to be (273,5). The corresponding time difference = (273-65) ×1/50=4.16 can thus be calculated from the two respiration characteristics. Referring to fig. 12, after the breath cycle is acquired from each time difference, the setting of the inspiration trigger window may be performed on the breath signal.
Referring to fig. 13, in some embodiments, a ventilation method is provided, which may be used with the ventilation device described above to control the inhalation triggering of the ventilation device, and the ventilation method may include the steps of:
step 100: a respiratory signal is acquired that characterizes the respiration of the patient and an inhalation trigger window of the respiratory signal is set.
Step 200: and acquiring the position relation between the current respiratory signal and the inhalation trigger window, and adjusting the intensity of the respiratory signal based on the position relation.
Step 300: and judging whether the adjusted respiratory signal meets a trigger threshold or not, so as to control related actions of the ventilation equipment.
In some embodiments, the adjusting the intensity of the respiratory signal based on the positional relationship includes: when the respiration signal is currently in the inspiration trigger window, the intensity of the respiration signal is enhanced.
In some embodiments, the ventilation method further comprises: judging whether the respiratory signal meets a preset condition or not; and if the preset condition is not met, executing the enhancement of the current strength of the respiratory signal.
In some embodiments, the adjusting the intensity of the respiratory signal based on the positional relationship further includes: when the respiratory signal is not in the inhalation triggering window at present, acquiring the type of the respiratory signal corresponding to the respiratory action at present, wherein the type of the respiratory action comprises inhalation and exhalation; and adjusting the current intensity of the respiratory signal according to the type of the respiratory action.
In some embodiments, the adjusting the intensity of the current respiratory signal according to the type of the respiratory action includes: when the type of the breathing action belongs to inspiration, weakening the intensity of the current breathing signal; when the type of respiratory action belongs to expiration, the intensity of the current respiratory signal is not adjusted.
In some embodiments, the respiration signal is used to characterize a physiological parameter of the patient that is related to respiration; alternatively, the respiratory signal is the ventilation signal. In some embodiments, when the respiratory signal is used to characterize a physiological parameter of the patient that is related to respiration, the respiratory signal is a respiratory muscle pressure signal.
In some embodiments, the setting the inhalation trigger window of the respiratory signal comprises: a respiratory cycle of a patient is acquired, the respiratory cycle including an inspiratory phase and an expiratory phase, the inspiratory trigger window being disposed in at least a portion of each of the inspiratory phases.
In some embodiments, the acquiring the respiratory cycle of the patient comprises: acquiring the position of each breathing characteristic related to breathing action in the ventilation signal, and acquiring the time difference between the positions of any two adjacent same breathing characteristics; the breathing cycle is derived from each of the time differences.
In some embodiments, the acquiring the location of each respiratory feature in the ventilation signal that is related to respiratory effort comprises: dividing the acquired ventilation signal into a plurality of segments in sequence on a time axis; acquiring characteristics of each segment in a frequency domain, and determining each target segment with the breathing characteristics according to the characteristics of each segment in the frequency domain; determining the position of each of the respiratory features based on the position of each of the target segments on the ventilation signal.
In some embodiments, the determining each target segment having the respiratory feature based on the features of each segment in the frequency domain comprises: for any one of the plurality of segments, obtaining the amplitude thereof in the frequency domain; and if the amplitude of any one of the fragments is changed by more than a preset amplitude compared with the amplitude of the previous fragment, determining the fragment as the target fragment.
In some embodiments, adjacent ones of the segments have an overlap region on the time axis.
In some embodiments, said deriving said breathing cycle from each of said time differences comprises: if the fluctuation between the time differences meets the preset fluctuation, calculating the respiratory cycle from the time differences.
Some embodiments provide a computer readable storage medium having a program stored thereon, the program being executable by a processor to implement the ventilation method described above.
Those skilled in the art will appreciate that all or part of the functions of the various methods in the above embodiments may be implemented by hardware, or may be implemented by a computer program. When all or part of the functions in the above embodiments are implemented by means of a computer program, the program may be stored in a computer readable storage medium, and the storage medium may include: read-only memory, random access memory, magnetic disk, optical disk, hard disk, etc., and the program is executed by a computer to realize the above-mentioned functions. For example, the program is stored in the memory of the device, and when the program in the memory is executed by the processor, all or part of the functions described above can be realized. In addition, when all or part of the functions in the above embodiments are implemented by means of a computer program, the program may be stored in a storage medium such as a server, another computer, a magnetic disk, an optical disk, a flash disk, or a removable hard disk, and the program in the above embodiments may be implemented by downloading or copying the program into a memory of a local device or updating a version of a system of the local device, and when the program in the memory is executed by a processor.
The foregoing description of the application has been presented for purposes of illustration and description, and is not intended to be limiting. Several simple deductions, modifications or substitutions may also be made by a person skilled in the art to which the application pertains, based on the idea of the application.
Claims (11)
1. A ventilation apparatus, comprising:
the gas source interface is used for connecting a gas source for providing gas;
a breathing circuit for communicating with the source port and the patient's respiratory system to input gases provided by the source to the patient and to exhaust gases exhaled by the patient;
a ventilation detection sensor for detecting a ventilation parameter in the respiratory line and obtaining a ventilation signal;
a processor for:
acquiring a respiratory signal used for representing the respiration of a patient, and setting an inspiration trigger window of the respiratory signal;
acquiring the position relation between the current respiratory signal and the inspiration trigger window, and adjusting the intensity of the respiratory signal based on the position relation, wherein when the respiratory signal is currently positioned in the inspiration trigger window, the intensity of the current respiratory signal is enhanced; when the respiratory signal is not in the inhalation triggering window at present, acquiring the type of the respiratory signal corresponding to the respiratory action at present, wherein the type of the respiratory action comprises inhalation and exhalation; adjusting the current intensity of the respiratory signal according to the type of the respiratory action: when the type of the breathing action belongs to inspiration, weakening the intensity of the current breathing signal; when the type of the breathing action belongs to expiration, not adjusting the current intensity of the breathing signal;
and judging whether the adjusted respiratory signal meets a trigger threshold or not, so as to control inhalation triggering of the ventilation equipment.
2. The ventilation apparatus of claim 1, further comprising:
judging whether the respiratory signal meets a preset condition or not;
and if the preset condition is not met, executing the enhancement of the current strength of the respiratory signal.
3. The ventilation device of any one of claims 1-2, wherein the respiratory signal is used to characterize a physiological parameter of the patient related to respiration;
alternatively, the respiratory signal is the ventilation signal.
4. A ventilation device as claimed in claim 3, wherein the respiratory signal is a respiratory muscle pressure signal when the respiratory signal is used to characterize a physiological parameter of the patient associated with respiration.
5. The ventilation apparatus of any one of claims 1-2, wherein the setting of the inhalation trigger window of the respiratory signal comprises:
a respiratory cycle of a patient is acquired, the respiratory cycle including an inspiratory phase and an expiratory phase, the inspiratory trigger window being disposed in at least a portion of each of the inspiratory phases.
6. The ventilation apparatus of claim 5, wherein the acquiring the respiratory cycle of the patient comprises:
acquiring the position of each breathing characteristic related to breathing action in the ventilation signal, and acquiring the time difference between the positions of any two adjacent same breathing characteristics;
the breathing cycle is derived from each of the time differences.
7. The ventilation apparatus of claim 6, wherein the obtaining the location of each respiratory feature in the ventilation signal that is related to respiratory activity comprises:
dividing the acquired ventilation signal into a plurality of segments in sequence on a time axis;
acquiring characteristics of each segment in a frequency domain, and determining each target segment with the breathing characteristics according to the characteristics of each segment in the frequency domain;
determining the position of each of the respiratory features based on the position of each of the target segments on the ventilation signal.
8. The ventilation apparatus of claim 7, wherein the determining of each target segment having the respiratory characteristic based on the characteristics of each segment in the frequency domain comprises:
for any one of the plurality of segments, obtaining the amplitude thereof in the frequency domain;
and if the amplitude of any one of the fragments is changed by more than a preset amplitude compared with the amplitude of the previous fragment, determining the fragment as the target fragment.
9. The ventilation apparatus of claim 7, wherein adjacent ones of the segments have an overlap region on a time axis.
10. The ventilation apparatus of claim 6, wherein said deriving said breathing cycle from each of said time differences comprises:
if the fluctuation between the time differences meets the preset fluctuation, calculating the respiratory cycle from the time differences.
11. A computer-readable storage medium, wherein the medium has stored thereon a program executable by a processor to perform a method of:
acquiring a respiratory signal used for representing the respiration of a patient, and setting an inspiration trigger window of the respiratory signal;
acquiring the position relation between the current respiratory signal and the inspiration trigger window, and adjusting the intensity of the respiratory signal based on the position relation, wherein when the respiratory signal is currently positioned in the inspiration trigger window, the intensity of the current respiratory signal is enhanced; when the respiratory signal is not in the inhalation triggering window at present, acquiring the type of the respiratory signal corresponding to the respiratory action at present, wherein the type of the respiratory action comprises inhalation and exhalation; adjusting the current intensity of the respiratory signal according to the type of the respiratory action: when the type of the breathing action belongs to inspiration, weakening the intensity of the current breathing signal; when the type of the breathing action belongs to expiration, not adjusting the current intensity of the breathing signal;
and judging whether the adjusted respiratory signal meets a trigger threshold or not, so as to control related actions of the ventilation equipment.
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN101310784A (en) * | 2007-12-28 | 2008-11-26 | 北京谊安医疗系统股份有限公司 | High response air controlled trigger mechanism |
| CN105664313A (en) * | 2014-11-21 | 2016-06-15 | 中国医学科学院北京协和医院 | Respirator and ventilation control device and method thereof |
| CN112999479A (en) * | 2019-12-20 | 2021-06-22 | 广州和普乐健康科技有限公司 | Breathing machine inspiration triggering method and application |
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| CN112449607B (en) * | 2018-08-21 | 2023-05-05 | 深圳迈瑞生物医疗电子股份有限公司 | Ventilation trigger detection method, device, ventilation equipment and storage medium |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101310784A (en) * | 2007-12-28 | 2008-11-26 | 北京谊安医疗系统股份有限公司 | High response air controlled trigger mechanism |
| CN105664313A (en) * | 2014-11-21 | 2016-06-15 | 中国医学科学院北京协和医院 | Respirator and ventilation control device and method thereof |
| CN112999479A (en) * | 2019-12-20 | 2021-06-22 | 广州和普乐健康科技有限公司 | Breathing machine inspiration triggering method and application |
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