CN116672598A

CN116672598A - Pump control method and device

Info

Publication number: CN116672598A
Application number: CN202310967538.9A
Authority: CN
Inventors: 杨羽卓; 余顺周
Original assignee: Shenzhen Core Medical Technology Co Ltd
Current assignee: Shenzhen Core Medical Technology Co Ltd
Priority date: 2023-08-03
Filing date: 2023-08-03
Publication date: 2023-09-01
Anticipated expiration: 2043-08-03
Also published as: CN116672598B

Abstract

The embodiment of the application discloses a pump control method and a device, wherein the method comprises the following steps: obtaining a first left rotating speed and a first right rotating speed, wherein the first left rotating speed is the current rotating speed of the first ventricular assist device, the first right rotating speed is the current rotating speed of the second ventricular assist device, a first left differential pressure is estimated according to the first left rotating speed, and a first right differential pressure is estimated according to the first right rotating speed, and further the first left rotating speed and/or the first right rotating speed are controlled according to the first left differential pressure and the first right differential pressure, so that the first left differential pressure is in a first preset differential pressure range, and the first right differential pressure is in a second preset differential pressure range. The application ensures that the first left pressure difference and the first right pressure difference are in the pressure difference range of healthy people by respectively adjusting the rotating speeds of the first ventricular assist device and the second ventricular assist device, thereby ensuring the safety of the user and ensuring the balance of the systemic circulation and the pulmonary circulation of the user.

Description

Pump control method and device

Technical Field

The application relates to the technical field of medical equipment, in particular to a pump control method and device.

Background

Mechanical circulatory support devices, such as ventricular assist devices (Ventricular Assist Devices, VAD), may be used to provide long-term mechanical support or assistance to heart failure patients or patients suffering from other heart related diseases that assist the heart in pumping blood from the heart to other parts of the body.

The mechanical circulatory support device comprises two independent ventricular assist devices, one ventricular assist device being disposable in the left ventricle for pumping blood from the left ventricle to the aorta to assist in supporting the user's systemic circulation; another ventricular assist device may be disposed in the right ventricle for pumping blood from the right ventricle to the pulmonary artery to assist in supporting the user's pulmonary circulation. However, the symptoms of each patient are different, and the degree to which the left and right ventricles of the patient need to assist may also be different, so how to control the rotational speeds of the two ventricular assist devices to ensure the blood balance of the patient's systemic and pulmonary circulation is a major issue.

Disclosure of Invention

The embodiment of the application provides a pump control method and a pump control device, which can respectively control the rotating speeds of a first ventricular assist device and a second ventricular assist device so as to keep balance between systemic circulation and pulmonary circulation and ensure the safety of users.

In a first aspect, an embodiment of the present application provides a pump control method, including:

acquiring a first left rotating speed and a first right rotating speed, wherein the first left rotating speed is the current rotating speed of a first ventricular assist device, the first right rotating speed is the current rotating speed of a second ventricular assist device, the first ventricular assist device is arranged in a left ventricle of a target user and used for pumping fluid from the left ventricle to an aorta, and the second ventricular assist device is arranged in a right ventricle of the target user and used for pumping the fluid from the right ventricle to a pulmonary artery;

Estimating a first left pressure difference from the first left rotational speed, which is a difference between the pressure of the aorta and the pressure of the left ventricle at the first left rotational speed, and estimating a first right pressure difference from the first right rotational speed, which is a difference between the pressure of the pulmonary artery and the pressure of the right ventricle at the first right rotational speed;

and controlling the first left rotating speed and/or the first right rotating speed according to the first left differential pressure and the first right differential pressure so that the first left differential pressure is in a first preset differential pressure range, and the first right differential pressure is in a second preset differential pressure range.

In a second aspect, an embodiment of the present application provides a pump control apparatus, including:

the device comprises an acquisition unit, a first control unit and a second control unit, wherein the acquisition unit is used for acquiring a first left rotating speed and a first right rotating speed, the first left rotating speed is the current rotating speed of a first ventricular assist device, the first right rotating speed is the current rotating speed of a second ventricular assist device, the first ventricular assist device is arranged in a left ventricle of a target user and used for pumping fluid from the left ventricle to an aorta, and the second ventricular assist device is arranged in a right ventricle of the target user and used for pumping the fluid from the right ventricle to a pulmonary artery;

An estimation unit configured to estimate a first left pressure difference, which is a difference between the pressure of the aorta and the pressure of the left ventricle at the first left rotational speed, from the first left rotational speed, and to estimate a first right pressure difference, which is a difference between the pressure of the pulmonary artery and the pressure of the right ventricle at the first right rotational speed, from the first right rotational speed;

the control unit is used for controlling the first left rotating speed and/or the first right rotating speed according to the first left pressure difference and the first right pressure difference so that the first left pressure difference is in a first preset pressure difference range, and the first right pressure difference is in a second preset pressure difference range.

In a third aspect, embodiments of the present application provide a medical device comprising a processor, a memory, a communication interface, and one or more programs stored in the memory and configured to be executed by the processor, the programs comprising instructions for performing part or all of the steps described in the method of the first aspect above.

In a fourth aspect, embodiments of the present application provide a computer-readable storage medium storing a computer program for electronic data exchange, wherein the computer program causes a computer to perform some or all of the steps described in the method of the first aspect.

In a fifth aspect, embodiments of the present application provide a computer program product, wherein the computer program product comprises a non-transitory computer readable storage medium storing a computer program, the computer program being operable to cause a computer to perform some or all of the steps described in the method according to the first aspect of the embodiments of the present application. The computer program product may be a software installation package.

According to the technical scheme provided by the application, a first left rotating speed and a first right rotating speed are obtained, wherein the first left rotating speed is the current rotating speed of a first ventricular assist device, the first right rotating speed is the current rotating speed of a second ventricular assist device, the first ventricular assist device is arranged in a left ventricle of a target user and used for pumping fluid from the left ventricle to an aorta, and the second ventricular assist device is arranged in a right ventricle of the target user and used for pumping fluid from the right ventricle to a pulmonary artery; estimating a first left differential pressure according to the first left rotational speed, and estimating a first right differential pressure according to the first right rotational speed, the first left differential pressure being a difference between the pressure of the aorta and the pressure of the left ventricle at the first left rotational speed, the first right differential pressure being a difference between the pressure of the pulmonary artery and the pressure of the right ventricle at the first right rotational speed; and further controlling the first left rotating speed and/or the first right rotating speed according to the first left differential pressure and the first right differential pressure so that the first left differential pressure is in a first preset differential pressure range and the first right differential pressure is in a second preset differential pressure range. The application ensures that the first left pressure difference and the first right pressure difference are in the pressure difference range of healthy people by respectively adjusting the rotating speeds of the first ventricular assist device and the second ventricular assist device, thereby ensuring the safety of the user and ensuring the balance of the systemic circulation and the pulmonary circulation of the user.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings that are needed in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present application, and other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.

FIG. 1 is a schematic diagram of a blood flow direction according to an embodiment of the present application;

FIG. 2 is a flow chart of a pump control method according to an embodiment of the present application;

FIG. 3 is a schematic flow chart of controlling the rotation speed according to an embodiment of the present application;

FIG. 4 is a block diagram showing the functional units of a pump control apparatus according to an embodiment of the present application;

fig. 5 is a schematic structural diagram of another medical device according to an embodiment of the present application.

Detailed Description

For better understanding of the technical solutions of the present application by those skilled in the art, the technical solutions of the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present application, and it is apparent that the described embodiments are only some embodiments of the present application, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the description of the embodiments of the application without making any inventive effort, are intended to fall within the scope of the application.

The terms first, second and the like in the description and in the claims and in the above-described figures are used for distinguishing between different objects and not necessarily for describing a sequential or chronological order. Furthermore, the terms "comprise" and "have," as well as any variations thereof, are intended to cover a non-exclusive inclusion. For example, a process, method, software, article, or apparatus that comprises a list of steps or elements is not limited to only those listed steps or elements but may include other steps or elements not listed or inherent to such process, method, article, or apparatus.

Reference herein to "an embodiment" means that a particular feature, structure, or characteristic described in connection with the embodiment may be included in at least one embodiment of the application. The appearances of such phrases in various places in the specification are not necessarily all referring to the same embodiment, nor are separate or alternative embodiments mutually exclusive of other embodiments. Those of skill in the art will explicitly and implicitly appreciate that the embodiments described herein may be combined with other embodiments.

The medical apparatus and pump to which the present application relates may be a ventricular assist device (Ventricular Assist Devices, VAD), such as an implantable ventricular assist device, an interventional ventricular assist device, or the like; the ventricular assist device may include at least one blood pump, wherein the blood pump may be a centrifugal pump, an axial flow pump, a magnetic suspension pump, or the like.

The term "current" in the present application refers to the current driving the motor or the electric machine, which is associated with the power of the motor or the electric machine, with the supply voltage unchanged. "rotational speed" refers to the rotational speed of a motor or electric machine, which is related to the rotational speed of the rotor or impeller of the ventricular assist device, and may be defined as a rotational speed per minute. "flow," "fluid flow," "pumping flow" refers to the volume of fluid delivered by a ventricular assist device per unit of time, which can be estimated and measured in liters per minute.

Wherein, as shown in fig. 1, from the flow direction of the blood of the user, the fluid systems are arranged in series with each other, the blood flows first through the pulmonary artery to the lung, the pulmonary system is in direct fluid communication with the left ventricle, and after oxygenation of the blood in the lung, the blood returns to the left ventricle. Blood is pumped from the left ventricle into the main artery, where it flows through the user's vascular system to the right ventricle. Thus, blood in turn forms a fluid circulation in the pulmonary artery, right ventricle, left ventricle and aorta. The flow direction in which blood flows from the right ventricle to the pulmonary artery is called pulmonary circulation, and the flow direction in which blood flows from the left ventricle to the aorta is called systemic circulation.

When the heart of the user fails and the blood pumping requirement cannot be met, a first ventricular assist device can be arranged in the left ventricle and a second ventricular assist device can be arranged in the right ventricle. As shown in fig. 1, the first ventricular assist device acts on the left heart, which may be disposed on the apex of the left ventricle with its inflow of fluid within the left ventricle of the user and with its fluid outlet connected to the aorta of the user; the first ventricular assist device may also span the aortic valve of the user with its proximal end positioned in the aorta of the user and its distal end positioned in the left ventricle of the user, thereby pumping blood in the left ventricle of the user into the aorta. The second ventricular assist device acts on the right heart, it can be disposed on the apex of the right ventricle, its fluid inlet is located in the right ventricle of the user, and its fluid outlet is connected to the pulmonary artery of the user; or the second ventricular assist device can span the pulmonary valve of the user so that the proximal end thereof is positioned in the pulmonary artery of the user and the distal end thereof is positioned in the right ventricle of the user, and the user pumps blood in the right ventricle into the pulmonary artery, thereby realizing blood circulation.

Wherein the first ventricular assist device and the second ventricular assist device are independently drivable by a common control device, but have a modulation of each other, a predetermined correlation of blood flow, and the flow of fluid pumped by the ventricular assist devices is correlated to the volume of blood and pressure within the chambers, such that a change in the flow of fluid from one ventricular assist device causes a corresponding change in the flow of fluid from the other ventricular assist device. For example, an increase in the rotational speed of the first ventricular assist device, a decrease in the volume of blood in the left ventricle causes a decrease in pressure in the left ventricle, which decreases in pressure in the left ventricle facilitating blood flow in the lungs to the left ventricle, thereby causing a decrease in pulmonary artery pressure. The reduction in pulmonary artery pressure reduces the differential pressure between the pulmonary artery pressure and the right ventricular pressure, allowing better pumping of blood in the right ventricle into the pulmonary artery.

The degree of heart failure of the left ventricle and the right ventricle of the current user is different, the degree of support assistance of the ventricular assist device is also different, and the ventricular assist devices can mutually influence, so that ensuring the blood balance of the body circulation and the pulmonary circulation of the patient according to the real-time condition of each patient is a problem to be solved urgently.

Based on the above, the application provides a pump control method, which estimates the ventricular pressure difference to adjust the rotation speeds of the first ventricular assist device and the second ventricular assist device, so that the pressure differences of the first ventricular assist device and the second ventricular assist device are in the pressure difference range of healthy people, thereby ensuring that the ventricular pumping function of a patient user is the same as that of the normal people and meeting the user requirements.

In connection with the above description, the present application is described below from the viewpoint of a method example.

Referring to fig. 2, fig. 2 is a schematic flow chart of a pump control method according to an embodiment of the application, and as shown in fig. 2, the method includes the following steps.

S210, acquiring a first left rotating speed and a first right rotating speed, wherein the first left rotating speed is the current rotating speed of a first ventricular assist device, the first right rotating speed is the current rotating speed of a second ventricular assist device, the first ventricular assist device is arranged in a left ventricle of a target user and used for pumping fluid from the left ventricle to an aorta, and the second ventricular assist device is arranged in a right ventricle of the target user and used for pumping the fluid from the right ventricle to a pulmonary artery.

The first left rotating speed can be the rotating speed set by the first ventricular assist device currently set by the user or the rotating speed of the current first ventricular assist device obtained through measurement and estimation; the first right rotational speed may be a rotational speed set by the second ventricular assist device currently set by the user or a rotational speed of the current second ventricular assist device estimated by measurement.

Further, the first left rotational speed and the first right rotational speed may be rotational speeds set by a user according to a pumping flow required by a target user or a pressure difference required.

S220, estimating a first left pressure difference according to the first left rotating speed and a first right pressure difference according to the first right rotating speed, wherein the first left pressure difference is a difference value between the pressure of the aorta and the pressure of the left ventricle at the first left rotating speed, and the first right pressure difference is a difference value between the pressure of the pulmonary artery and the pressure of the right ventricle at the first right rotating speed.

The ventricular assist device delivers blood to a desired location by rotation of an impeller, which is driven by rotation of a motor. At a given impeller speed or motor speed, the flow of fluid through the ventricular assist device is dependent on the pressure differential that the ventricular assist device is required to overcome. The relationship between the pumped flow of fluid and the current of the motor of the ventricular assist device is monotonic for the range of currents over which the ventricular assist device can operate, so the relationship between current-flow at a preset rotational speed can be used to determine a flow estimate for the ventricular assist device, and the relationship between flow-pressure difference at the preset rotational speed can be used to determine a pressure difference estimate for the ventricular assist device.

Optionally, the estimating the first left differential pressure according to the first left rotation speed and the estimating the first right differential pressure according to the first right rotation speed includes:

acquiring a first current and a second current, wherein the first current is a current flowing through the first ventricular assist device at the first left rotating speed, and the second current is a current flowing through the second ventricular assist device at the first right rotating speed; estimating a first left flow rate corresponding to the first current according to a first fluid characteristic curve, and estimating a first right flow rate corresponding to the second current according to a second fluid characteristic curve, wherein the first fluid characteristic curve is a relation curve between a current of the first ventricular assist device running at the first left rotating speed and a pumped fluid flow rate, and the second fluid characteristic curve is a relation curve between a current of the second ventricular assist device running at the first right rotating speed and the pumped fluid flow rate; and determining a first left differential pressure corresponding to the first left flow and a first right differential pressure corresponding to the first right flow according to the mapping relation between the fluid flow and the differential pressure.

In the present application, before the first and second auxiliary devices are shipped, the first and second auxiliary devices may be placed in a test environment to measure the mapping relationship between fluid flow and differential pressure, and the current-to-fluid flow fluid characteristic curves at different rotational speeds. And then storing the mapping relation between the fluid characteristic curve and the fluid flow rate at each rotating speed and the pressure difference into a control device for controlling the operation of the first and second auxiliary devices, and when the first and second auxiliary devices operate, obtaining the current rotating speeds of the first and second auxiliary devices so as to obtain the mapping relation between the fluid characteristic curve and the fluid flow rate at the current rotating speeds and the pressure difference, and estimating the fluid flow rates and the pressure differences of the current first and second auxiliary devices according to the mapping relation between the fluid characteristic curve and the fluid flow rates and the pressure differences.

The first current and the second current may be obtained by measurement, such as a phase current detection circuit, and after detecting and obtaining the first current flowing through the first ventricular assist device and the second current flowing through the second ventricular assist device, the first left fluid flow corresponding to the first current at the first left rotational speed is determined according to the stored fluid characteristic curve of the first ventricular assist device, and the first right fluid flow corresponding to the second current at the first right rotational speed is determined according to the stored fluid characteristic curve of the second ventricular assist device. And then determining a first left differential pressure corresponding to the first left flow at a first left rotating speed according to the stored mapping relation between the first ventricular assist device fluid flow and the differential pressure, and determining a first right differential pressure corresponding to the first right flow at a lower first right rotating speed according to the stored mapping relation between the second ventricular assist device fluid flow and the differential pressure.

S230, controlling the first left rotating speed and/or the first right rotating speed according to the first left differential pressure and the first right differential pressure so that the first left differential pressure is in a first preset differential pressure range, and the first right differential pressure is in a second preset differential pressure range.

According to the application, the hemodynamic state is judged through the differential pressure of the first ventricular assist device and the second ventricular assist device at the current rotating speed, so that the rotating speed of the first ventricular assist device and/or the rotating speed of the second ventricular assist device are controlled and adjusted, the differential pressure of the left ventricle and the differential pressure of the right ventricle of the user are in the differential pressure range of healthy people, and the balance of the target user body circulation and the pulmonary circulation is ensured.

Wherein the first preset differential pressure range is the differential pressure between the aortic pressure and the left ventricular pressure of a normal person or a healthy person; the second preset differential pressure range is the differential pressure of the pulmonary artery pressure and the right ventricle pressure of a normal person or a healthy person. For example, the first preset pressure difference may be 60mmHg to 80 mmHg, and the second preset pressure difference may be 20mmHg to 30 mmHg.

Optionally, as shown in fig. 3, the controlling the first left rotational speed and/or the first right rotational speed according to the first left differential pressure and the first right differential pressure includes the following steps.

S310, judging the target state of the target user according to the first left pressure difference.

Wherein the target state of the target user is indicative of a pressure state within the left ventricle or aorta of the target user. When the pressure difference of the left ventricle of the target user is higher than a first preset pressure difference value, the current left ventricle pressure of the target user is too low or the aortic pressure is too high; when the pressure difference of the left ventricle of the target user is lower than the first preset pressure difference, the current target user is indicated to have too high left ventricular pressure or too low aortic pressure.

Optionally, the determining the target state of the target user according to the first left pressure difference includes: if the first left pressure difference is larger than a first preset pressure difference, judging that the target user is in a first state or a second state, wherein the first preset pressure difference range comprises the first preset pressure difference; and if the first left pressure difference is smaller than the first preset pressure difference, judging that the target user is in a third state.

The first state is used for indicating that the aortic pressure of the target user is too high, the second state is used for indicating that the left ventricular pressure of the target user is too low, and the third state is used for indicating that the left ventricular pressure of the target user is too high or the aortic pressure of the target user is too low. When the first left pressure difference of the target user is larger than the pressure difference of a normal person, judging that the aortic pressure of the current target user is too high or the left ventricular pressure is too low; when the first left pressure difference of the target user is smaller than the pressure difference of a normal person, judging that the aortic pressure of the current target user is too low or the left ventricular pressure is too high. Further, when the first left differential pressure of the target user is equal to the first preset differential pressure, the heart of the current target user is in a normal state, and the current rotating speed can be directly kept.

Further, the first preset pressure difference is a maximum value, a minimum value, an average value or an arbitrary value within a first preset pressure difference range, and the second preset pressure difference is a maximum value, a minimum value, an average value or an arbitrary value within a second preset pressure difference range.

For example, the target user may be in the first state (i.e., too high aortic pressure) because of the high blood pressure due to the excessive vascular resistance, and the blood (in which case the left ventricular volume is normal) is pooled in the left ventricle and cannot be pumped into the aorta. The target user may be placed in the second state (left ventricular pressure is too low) because the first ventricular assist device is rotating too high to cause too little blood volume in the left ventricle, or left ventricular blood volume is too little due to systemic hypovolemia or right heart failure. And the target user may be in a third state (too low aortic pressure or too high left ventricular pressure) because the rotational speed of the first ventricular assist device is too low to allow excessive volume in the left ventricle.

Optionally, the method further comprises: if the difference between the third left flow rate and the second left flow rate is greater than the preset difference, determining that the target user is in the first state, wherein the second left flow rate is the fluid flow rate pumped by the first ventricular assist device at a second left rotation speed, the third left flow rate is the fluid flow rate pumped by the first ventricular assist device at a third left rotation speed, and the difference between the second left rotation speed and the first left rotation speed is equal to the difference between the third left rotation speed and the second left rotation speed; otherwise, determining that the target user is in the second state.

To further determine whether the target user is currently in the first state or the second state, a determination may be made by increasing the rotational speed of the first ventricular assist device. For example, the first left rotational speed is increased to a second left rotational speed, a second left flow corresponding to the second left rotational speed is determined according to the fluid characteristic curve, then the second left rotational speed is increased to a third left rotational speed, and a third left flow corresponding to the third left rotational speed is determined according to the fluid characteristic curve. Then comparing the values of the first left flow, the second left flow and the third left flow, if the difference between the third left flow and the second left flow is larger than the preset difference, namely the third left flow is larger than the second left flow, and the second left flow is larger than the first left flow, the target user is in a first state, and when the aortic pressure is high so that the rotating speed of the first ventricular assist device is continuously increased, blood in the left ventricle is rapidly pumped into the aorta, so that the pumping flow of the first ventricular assist device is obviously increased; otherwise, the target user is considered to be in the second state, and the pumping flow rate of the first ventricular assist device is not increased significantly by continuing to increase the rotational speed of the first ventricular assist device due to the low blood volume in the left ventricle.

Illustratively, the method further comprises: if the difference between the second incremental left differential pressure and the first incremental left differential pressure is larger than a preset difference, determining that the target user is in the second state, wherein the first incremental left differential pressure is the differential pressure between the aortic pressure and the left ventricular pressure at a first incremental left rotating speed, the second incremental left differential pressure is the differential pressure between the aortic pressure and the left ventricular pressure at a second incremental left rotating speed, and the difference between the second incremental left rotating speed and the first incremental left rotating speed is equal to the difference between the first incremental left rotating speed and the first left rotating speed; otherwise, determining that the target user is in the first state.

The first increasing left rotating speed is the rotating speed after the rotating speed is increased based on the first left rotating speed, and the second increasing left rotating speed is the rotating speed after the rotating speed is increased based on the first increasing left rotating speed. The application judges whether the current target user is in the first state or the second state by judging the change of the pumping flow or the pressure difference after the rotating speed of the first ventricular assist device is increased.

Specifically, the first left rotating speed is increased to the first increasing left rotating speed, the first increasing left pressure corresponding to the first increasing left rotating speed is determined according to the mapping relation between the fluid characteristic curve and the fluid flow and the pressure difference, then the first increasing left rotating speed is increased to the second increasing left rotating speed, and the second increasing left pressure difference corresponding to the second increasing left rotating speed is determined according to the mapping relation between the fluid characteristic curve and the fluid flow and the pressure difference. Then comparing the values of the first incremental left pressure difference, the second incremental left pressure difference and the first left pressure difference, if the difference between the second incremental left pressure difference and the first incremental left pressure difference is larger than a preset difference, namely the second incremental left pressure difference is larger than the first incremental left pressure difference, and the first incremental left pressure difference is larger than the first left pressure difference, the target user is in a second state at the moment, the blood volume in the left ventricle is small, and the continuous increase of the rotating speed of the first ventricular assist device can lead to continuous increase of the pressure in the left ventricle; otherwise, the target user is considered to be in the second state, and the aortic pressure is high, so that when the rotating speed of the first ventricular assist device is continuously increased, blood in the left ventricle is rapidly pumped into the aorta, and the pressure in the aorta is obviously increased.

By way of example, the present application may further increase the second incremental left rotational speed to a third incremental left rotational speed, increase the third incremental left rotational speed to a fourth incremental left rotational speed, and so forth. And judging whether the target user is in the first state or the second state by comparing the values of the fourth increment left flow corresponding to the fourth increment left rotating speed, the third increment left flow corresponding to the third increment left rotating speed, the second increment left flow, the first increment left flow and the first left flow or comparing the values of the fourth increment left pressure difference corresponding to the fourth increment left rotating speed, the third increment left pressure difference corresponding to the third increment left rotating speed, the second increment left pressure difference, the first increment left pressure difference and the first left pressure difference according to the method.

By way of example, the present application may also determine whether the target user is in the first state or the second state according to a change in the pumping flow rate of the first ventricular assist device or a change in the differential pressure between the aortic pressure and the left ventricular pressure when the rotational speed of the first ventricular assist device is continuously increased for a preset period of time according to the above-described method.

S320, controlling the first left rotating speed and/or the first right rotating speed according to the target state and the first right pressure difference.

After determining the current target state of the target user, the rotation speed of the first ventricular assist device and/or the second ventricular assist device can be adjusted to enable the pressure difference between the aortic pressure and the left ventricular pressure and the pressure difference between the pulmonary artery pressure and the right ventricular pressure of the target user to be in the pressure difference range of normal people, so that the systemic circulation and the pulmonary circulation are kept balanced, and the safety of the user is ensured.

Optionally, the controlling the first left rotational speed and/or the first right rotational speed according to the target state and the first right differential pressure includes: if the first right differential pressure is greater than a second preset differential pressure, and the target state is in the first state or the third state, increasing the first left rotating speed and decreasing the first right rotating speed, wherein the second preset differential pressure range comprises the second preset differential pressure; if the first right differential pressure is smaller than the second preset differential pressure and the target state is in the first state, increasing the first right rotating speed; if the first right differential pressure is larger than the second preset differential pressure and the target state is in the second state, the first right rotating speed is reduced; if the first right differential pressure is smaller than the second preset differential pressure and the target state is in the second state, reducing the first left rotating speed and increasing the first right rotating speed; and if the first right differential pressure is smaller than the second preset differential pressure and the target state is in the third state, increasing the first left rotating speed and the first right rotating speed.

In the present application, when the aortic pressure is too high, the aortic pressure is allowed to be reduced by increasing the rotational speed of the first ventricular assist device; allowing the left ventricular pressure to be increased by decreasing the rotational speed of the first ventricular assist device when the left ventricular pressure is too low; in case of too low aortic pressure or too high left ventricular pressure, it is allowed to simultaneously decrease the left ventricular pressure and increase the aortic pressure by increasing the rotational speed of the first ventricular assist device.

Further, when the first right differential pressure is larger than the second preset differential pressure, the pulmonary artery pressure of the current target user is too high or the right ventricular pressure is too low; and when the first right pressure difference is smaller than the second preset pressure difference, indicating that the pulmonary artery pressure of the current target user is too low or the right ventricle pressure is too high.

Wherein the left ventricular unloading may be increased by increasing the rotational speed of the first ventricular assist device when the pulmonary artery pressure is too high or the right ventricular pressure is too low, thereby facilitating a reduction in the pulmonary artery pressure, and/or reducing the pulmonary artery pressure by reducing the rotational speed of the second ventricular assist device. In case of too high pulmonary artery pressure or too high right ventricular pressure, the right ventricular unloading can be increased by increasing the rotational speed of the second ventricular assist device, thereby facilitating the reduction of the right ventricular pressure.

Thus, when the first right differential pressure is greater than the second preset differential pressure and the target state is in the first state or the third state, i.e., when the aortic pressure is too high and the pulmonary artery pressure is too high or the right ventricular pressure is too low, the aortic pressure and the pulmonary artery pressure can be reduced by increasing the first left rotational speed and decreasing the first right rotational speed. When the first right differential pressure is smaller than the second preset differential pressure and the target state is in the first state, i.e. when the aortic pressure is too high and the pulmonary artery pressure is too low or the right ventricular pressure is too high, the right ventricular pressure can be reduced by increasing the first right rotational speed. When the first right pressure difference is larger than the second preset pressure difference and the target state is in the second state, namely when the left ventricular pressure is too low and the pulmonary artery pressure is too high or the right ventricular pressure is too low, the pulmonary artery pressure can be reduced by reducing the first right rotating speed so as to avoid lung injury caused by continuous rising of the pulmonary artery pressure. When the first right differential pressure is less than the second preset differential pressure and the target state is in the second state, i.e. when the left ventricular pressure is too low and the pulmonary artery pressure is too low or the right ventricular pressure is too high, the left ventricular pressure can be increased by reducing the first left rotational speed to avoid the right ventricular overcharge, and simultaneously the first right rotational speed is increased to increase the right ventricular unloading to reduce the right ventricular pressure.

Optionally, the method further comprises: obtaining a target flow step; determining the first rotational speed step according to the target flow step and the first preset pressure difference; and determining the second rotating speed step according to the target flow step and the second preset pressure difference.

In the present application, in order to secure the safety of the target user, it may be required that the progressive flow rates of the first ventricular assist device and the second ventricular assist device are uniform every time the rotation speed is increased or decreased when the first left rotation speed and the first right rotation speed are increased or decreased. The first rotating speed step is a progressive value of the first left rotating speed of the first ventricular assist device which is increased or decreased each time, and the second rotating speed step is a progressive value of the first right rotating speed of the second ventricular assist device which is increased or decreased each time. According to the application, the target flow step can be determined according to the health condition of a target user, and further, according to the mapping relation between the flow and the differential pressure under different rotating speeds, the first rotating speed step which is required to be increased or decreased when the target flow step is increased or decreased when the differential pressure is first preset and the second rotating speed step which is required to be increased or decreased when the target flow step is increased or decreased when the differential pressure is second preset are determined.

The difference between the second left rotating speed and the first left rotating speed is the first rotating speed step.

When the target user is in the first state or the second state, the first left rotating speed can be sequentially increased according to the first rotating speed step, and then the pressure difference between the aortic pressure and the left ventricular pressure or the pumping flow of the first ventricular assist device after the first left rotating speed is increased is analyzed to judge, so that the state of the target user can be accurately determined.

Based on this, there are five control modes according to different states of the target user and the values of the first left pressure difference and the first right pressure difference.

The present application increases or decreases the rotational speed of the first ventricular assist device (the first left rotational speed) in steps of the first rotational speed step and decreases or increases the rotational speed of the second ventricular assist device (the first right rotational speed) in steps of the second rotational speed step.

Mode one: the first left pressure difference is larger than a first preset pressure difference, the first right pressure difference is larger than a second preset pressure difference, and the target user is in a first state; or the first left pressure difference is smaller than the first preset pressure difference, the first right pressure difference is larger than the second preset pressure difference, and the target user is in a third state.

Allowing the first left rotational speed to be increased when the aortic pressure is too high; when the pulmonary artery pressure is too high or the right ventricular pressure is too low, the first left rotational speed is allowed to increase and the first right rotational speed is allowed to decrease. Therefore, in the case of the first mode, the aortic pressure and the pulmonary artery pressure can be reduced by increasing the first left rotation speed, and then the pulmonary artery pressure can also be reduced by reducing the first right rotation speed.

Wherein said increasing said first left rotational speed and decreasing said first right rotational speed comprises: if the i-th left pressure difference is larger than the first preset pressure difference, increasing the i-th left rotating speed by a first rotating speed step, wherein i is a positive integer; if the i right differential pressure is larger than the second preset differential pressure, reducing the i right rotating speed by a second rotating speed step; let i=i+1 until the i-th left differential pressure is in the first preset differential pressure range and the i-th right differential pressure is in the second preset differential pressure range; when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

In the embodiment of the application, the first left rotating speed is increased first; if the pressure difference between the pulmonary artery pressure and the right ventricular pressure is still larger than the second preset pressure difference, the first right rotating speed is reduced, and then the pressure difference between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is increased and the pressure difference between the aortic pressure and the left ventricular pressure are judged.

If the pressure difference between the aortic pressure and the left ventricular pressure is still larger than the first preset pressure difference and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is still larger than the second preset pressure difference, the first left rotating speed is increased again, and the steps are repeated; if the pressure difference between the aortic pressure and the left ventricular pressure is still greater than the first preset pressure difference, and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is in the second preset pressure difference range, the first left rotating speed is increased again, namely the ith left rotating speed is increased by the first rotating speed step. If the pressure difference between the aortic pressure and the left ventricular pressure is in the first preset pressure difference range, and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is still larger than the second preset pressure difference, the first right rotating speed is reduced again, namely the ith right rotating speed is reduced by the second rotating speed step. Repeating the steps until the differential pressure of the aortic pressure and the left ventricular pressure is in a first preset differential pressure range, and the differential pressure of the pulmonary artery pressure and the right ventricular pressure is in a second preset differential pressure range.

For example, the control manner of increasing the first left rotational speed and the first right rotational speed is as follows:

step one: the first left rotational speed is increased by a first rotational speed step to decrease the aortic pressure.

Step two: if the pressure difference between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is increased is still larger than the second preset pressure difference, the first right rotating speed is reduced by the second rotating speed step to reduce the pulmonary artery pressure.

Step three: if the differential pressure between the pulmonary artery pressure and the right ventricle pressure after the first left rotating speed is increased and the first right rotating speed is reduced is still larger than the second preset differential pressure, and the differential pressure between the aortic pressure and the left ventricle pressure is still larger than the first preset differential pressure, repeating the step one and the step two; if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is increased and the first right rotating speed is reduced is in a second preset differential pressure range, and the differential pressure between the aortic pressure and the left ventricular pressure is still larger than the first preset differential pressure, repeating the step one; if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is increased and the first right rotating speed is reduced is still larger than the second preset differential pressure, and the differential pressure between the aortic pressure and the left ventricular pressure is in the first preset differential pressure range, repeating the step two.

Step four: repeating the third step until the differential pressure of the pulmonary artery pressure and the right ventricle pressure is in a second preset differential pressure range, and the differential pressure of the aortic pressure and the left ventricle pressure is also in a first preset differential pressure range.

Mode two: the first left pressure difference is larger than a first preset pressure difference, the first right pressure difference is smaller than a second preset pressure difference, and the target user is in a first state.

Allowing the first left rotational speed to be increased when the aortic pressure is too high; the first right rotational speed is allowed to increase when the pulmonary artery pressure is too low or the right ventricular pressure is too high. Thus, in the second mode, the right ventricular pressure is reduced or the pulmonary artery pressure is increased by increasing the first right rotational speed, and the pressure and the blood volume of the right ventricle are reduced so as to accelerate the blood in the aorta to flow into the right ventricle through the vascular system, thereby reducing the aortic pressure.

Wherein said increasing said first right rotational speed comprises: if the i left differential pressure is larger than the first preset differential pressure, increasing the i left rotating speed by a first rotating speed step; if the i right differential pressure is larger than the second preset differential pressure, increasing the i right rotating speed by a second rotating speed step; let i=i+1 until the i-th left differential pressure is equal to the first preset differential pressure and the i-th right differential pressure is equal to the second preset differential pressure; when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

In the embodiment of the application, the first right rotation speed can be increased first, and then the differential pressure between the pulmonary artery pressure and the right ventricular pressure and the differential pressure between the aortic pressure and the left ventricular pressure after the first left rotation speed is increased are judged. If the pressure difference between the pulmonary artery pressure and the right ventricular pressure is still larger than the second preset pressure difference, and the pressure difference between the aortic pressure and the left ventricular pressure is still larger than the first preset pressure difference, the first right rotating speed is increased again; if the pressure difference between the aortic pressure and the left ventricular pressure is still greater than the first preset pressure difference, and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is in the second preset pressure difference range, the first left rotating speed is increased. If the pressure difference between the aortic pressure and the left ventricular pressure is in the first preset pressure difference range and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is smaller than the second preset pressure difference, the first right rotating speed is increased again.

For example, the control manner of increasing the first right rotational speed is as follows:

step one: the first right rotational speed is increased by a second rotational speed step to decrease the right ventricular pressure.

Step two: if the pressure difference between the pulmonary artery pressure and the right ventricular pressure after the first right rotating speed is increased is still larger than the second preset pressure difference, and the pressure difference between the aortic pressure and the left ventricular pressure is still larger than the first preset pressure difference, repeating the step one; if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first right rotation speed is increased is in a second preset differential pressure range, and the differential pressure between the aortic pressure and the left ventricular pressure is still larger than the first preset differential pressure, increasing the first left rotation speed by a first rotation speed step to reduce the aortic pressure; and if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first right rotating speed is increased is still smaller than the second preset differential pressure, and the differential pressure between the aortic pressure and the left ventricular pressure is in the first preset differential pressure range, repeating the step one.

Step three: repeating the second step until the differential pressure between the pulmonary artery pressure and the right ventricle pressure is in a second preset differential pressure range, and the differential pressure between the aortic pressure and the left ventricle pressure is also in a first preset differential pressure range.

Mode three: the first left pressure difference is greater than a first preset pressure difference, the first right pressure difference is greater than a second preset pressure difference, and the target user is in a second state.

When left ventricular pressure is too low, the first left rotational speed is not allowed to be reduced to avoid causing left ventricular aspiration and/or collapse; while too high a pulmonary artery pressure or too low a right ventricular pressure allows the first right rotational speed to be reduced to reduce the lung injury caused by a sustained increase in pulmonary artery pressure.

Wherein said decreasing said first right rotational speed comprises: if the i left differential pressure is larger than the first preset differential pressure, reducing the i left rotating speed by a first rotating speed step; if the i right differential pressure is larger than the second preset differential pressure, reducing the i right rotating speed by a second rotating speed step; let i=i+1 until the i-th left differential pressure is equal to the first preset differential pressure and the i-th right differential pressure is equal to the second preset differential pressure; when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

In the embodiment of the application, when the left ventricular pressure is too low and the pulmonary artery pressure is too high or the right ventricular pressure is too low, the first right rotating speed can be reduced first, and then the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is increased and the differential pressure between the aortic pressure and the left ventricular pressure are judged. If the pressure difference between the pulmonary artery pressure and the right ventricular pressure is still larger than the second preset pressure difference, and the pressure difference between the aortic pressure and the left ventricular pressure is still larger than the first preset pressure difference, the first right rotating speed is reduced again; if the pressure difference between the pulmonary artery pressure and the right ventricle pressure is in a second preset pressure difference range, and the pressure difference between the aortic pressure and the left ventricle pressure is still larger than the first preset pressure difference, reducing the first left rotating speed so as to avoid adverse phenomena such as suction and/or collapse of the left ventricle; if the pressure difference between the pulmonary artery pressure and the right ventricular pressure is still larger than the second preset pressure difference, and the pressure difference between the aortic pressure and the left ventricular pressure is in the first preset pressure difference range, reducing the first right rotating speed again; repeating the steps until the differential pressure of the pulmonary artery pressure and the right ventricle pressure is in a second preset differential pressure range, and the differential pressure of the aortic pressure and the left ventricle pressure is also in a first preset differential pressure range.

For example, the control manner of decreasing the first right rotational speed is as follows:

step one: the first right rotational speed is reduced by a second rotational speed step to reduce pulmonary artery pressure.

Step two: if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first right rotating speed is reduced is still larger than the second preset differential pressure, and the differential pressure between the aortic pressure and the left ventricular pressure is still larger than the first preset differential pressure, repeating the step one; if the differential pressure between the aortic pressure and the left ventricular pressure after the first right rotational speed is reduced is still larger than the first preset differential pressure, and the differential pressure between the pulmonary artery pressure and the right ventricular pressure is in the second preset differential pressure range, reducing the first left rotational speed by a first rotational speed step; if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first right rotation speed is reduced is still larger than the second preset differential pressure, and the differential pressure between the aortic pressure and the left ventricular pressure is in the first preset differential pressure range, repeating the step one.

Mode four: the first left pressure difference is larger than a first preset pressure difference, the first right pressure difference is smaller than a second preset pressure difference, and the target user is in a second state.

Too low left ventricular pressure does not allow the first left rotational speed to be reduced; while a pulmonary arterial pressure that is too low or a right ventricular pressure that is too high allows for a decrease in right ventricular pressure by decreasing the first left rotational speed to avoid the left ventricular pressure continuing to be too low causing right ventricular overcharge and increasing the first right rotational speed to increase right ventricular unloading. Therefore, when the left ventricular pressure is too low and the pulmonary artery pressure is too low or the right ventricular pressure is too high, the first left rotating speed can be reduced firstly to avoid continuous reduction of the left ventricular pressure, so as to avoid suction and/or collapse of the left ventricle and right ventricular overcharging; the right ventricular pressure is then reduced by increasing the first right rotational speed.

Wherein said decreasing said first left rotational speed and increasing said first right rotational speed comprises: if the i left differential pressure is larger than the first preset differential pressure, reducing the i left rotating speed by a first rotating speed step; if the i right differential pressure is larger than the second preset differential pressure, increasing the i right rotating speed by a second rotating speed step; let i=i+1 until the i-th left differential pressure is equal to the first preset differential pressure and the i-th right differential pressure is equal to the second preset differential pressure; when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

In the embodiment of the application, when the left ventricular pressure is too low and the pulmonary artery pressure is too low or the right ventricular pressure is too high, the first left rotating speed can be reduced first to avoid continuous reduction of the left ventricular pressure; and judging the pressure difference between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is reduced, if the pressure difference is still smaller than the second preset pressure difference, then increasing the first right rotating speed to reduce the right ventricular pressure, and then judging the pressure difference between the pulmonary artery pressure and the right ventricular pressure and the pressure difference between the aortic pressure and the left ventricular pressure after the first right rotating speed is increased.

If the pressure difference between the aortic pressure and the left ventricular pressure is still larger than the first preset pressure difference and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is still larger than the second preset pressure difference, the first left rotating speed is reduced again, and the steps are repeated; if the pressure difference between the aortic pressure and the left ventricular pressure is still greater than the first preset pressure difference, and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is in the second preset pressure difference range, the first left rotating speed is reduced again, namely the ith left rotating speed is reduced by the first rotating speed step. If the pressure difference between the aortic pressure and the left ventricular pressure is in the first preset pressure difference range, and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is still larger than the second preset pressure difference, the first right rotating speed is increased again, namely the ith right rotating speed is reduced by the second rotating speed step. Repeating the steps until the differential pressure of the aortic pressure and the left ventricular pressure is in a first preset differential pressure range, and the differential pressure of the pulmonary artery pressure and the right ventricular pressure is in a second preset differential pressure range.

For example, the control manner of decreasing the first rotation speed and increasing the first right pressure difference is as follows.

Step one: the first left rotating speed is made to perform first rotating speed stepping so as to avoid the phenomena of suction and the like of the left ventricle while avoiding the overcharge of the right ventricle.

Step two: if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first left rotation speed is reduced is still smaller than the second preset differential pressure, the first right rotation speed is reduced by the second rotation speed step to reduce the right ventricular pressure.

Step three: if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is reduced and the first right rotating speed is increased is still smaller than the second preset differential pressure, and the differential pressure between the aortic pressure and the left ventricular pressure is still larger than the first preset differential pressure, repeating the step one and the step two; if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is reduced and the first right rotating speed is increased is in a second preset differential pressure range, and the differential pressure between the aortic pressure and the left ventricular pressure is still larger than the first preset differential pressure, repeating the step one; if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is reduced and the first right rotating speed is increased is still smaller than the second preset differential pressure, and the differential pressure between the aortic pressure and the left ventricular pressure is in the first preset differential pressure range, repeating the step two.

Step four: and repeating the third step until the differential pressure of the pulmonary artery pressure and the right ventricle pressure is in a second preset differential pressure range, and the differential pressure of the aortic pressure and the left ventricle pressure is also in a first preset differential pressure range.

Mode five: the first left pressure difference is smaller than a first preset pressure difference, the first right pressure difference is smaller than a second preset pressure difference, and the target user is in a third state.

Too high left ventricular pressure or too low aortic pressure allows for increasing the first left rotational speed; while a too low pulmonary artery pressure or too high right ventricular pressure allows the right ventricular pressure to be reduced by increasing the first right rotational speed to increase the right ventricular unloading. Thus, when left ventricular pressure is too high or the aortic pressure is too low, and pulmonary arterial pressure is too low or right ventricular pressure is too high, the first left rotational speed may be increased simultaneously with the first right rotational speed to simultaneously reduce left ventricular pressure and reduce right ventricular pressure.

Wherein said increasing the first left rotational speed and increasing the first right rotational speed comprises: if the i left differential pressure is larger than the first preset differential pressure, increasing the i left rotating speed by a first rotating speed step; if the i right differential pressure is larger than the second preset differential pressure, increasing the i right rotating speed by a second rotating speed step; let i=i+1 until the i-th left differential pressure is equal to the first preset differential pressure and the i-th right differential pressure is equal to the second preset differential pressure; when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

In the embodiment of the application, the first right rotating speed and the first left rotating speed can be increased first, and then the pressure difference between the pulmonary artery pressure and the right ventricular pressure and the pressure difference between the aortic pressure and the left ventricular pressure after the first right rotating speed and the first left rotating speed are increased are judged. If the pressure difference between the aortic pressure and the left ventricular pressure is still greater than the first preset pressure difference and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is still greater than the second preset pressure difference, repeating the steps to increase the first left rotating speed and the first right rotating speed; if the pressure difference between the aortic pressure and the left ventricular pressure is still smaller than the first preset pressure difference, and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is in the second preset pressure difference range, the first left rotating speed is increased again, namely the ith left rotating speed is increased by a first rotating speed step; if the pressure difference between the aortic pressure and the left ventricular pressure is in the first preset pressure difference range and the pressure difference between the pulmonary artery pressure and the right ventricular pressure is still smaller than the second preset pressure difference, the first right rotating speed is increased again, namely the ith right rotating speed is increased by the second rotating speed step. Repeating the steps until the differential pressure of the aortic pressure and the left ventricular pressure is in a first preset differential pressure range, and the differential pressure of the pulmonary artery pressure and the right ventricular pressure is in a second preset differential pressure range.

step one: the first left rotational speed is increased by a first rotational speed step and the first right rotational speed is increased by a second rotational speed step to simultaneously reduce left ventricular pressure and right ventricular pressure.

Step two: if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is increased and the first right rotating speed is increased is still smaller than the second preset differential pressure, and the differential pressure between the aortic pressure and the left ventricular pressure is still smaller than the first preset differential pressure, repeating the step one; if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is increased and the first right rotating speed is in a second preset differential pressure range, and the differential pressure between the aortic pressure and the left ventricular pressure is still smaller than the first preset differential pressure, then the first left rotating speed is increased by a first rotating speed step; if the differential pressure between the pulmonary artery pressure and the right ventricular pressure after the first left rotating speed is increased and the first right rotating speed is increased is still smaller than the second preset differential pressure, and the differential pressure between the aortic pressure and the left ventricular pressure is in the first preset differential pressure range, the first right rotating speed is increased by the second rotating speed step.

According to the application, the first left rotating speed and/or the first right rotating speed are/is controlled to be reduced or increased according to the state of the target user and the first left pressure difference and the first right pressure difference, so that the balance between the body circulation and the lung circulation of the target user is realized under different conditions, meanwhile, the times of blind rotation speed adjustment of the first ventricular assist device and/or the second ventricular assist device can be reduced through specific analysis control under specific conditions, the more serious hemodynamic unstable influence on the target user in the rotation speed adjustment process is avoided, and the acute lung injury is avoided.

It can be seen that the present application provides a pump control method, in which a first left rotational speed and a first right rotational speed are obtained, the first left rotational speed is a current rotational speed of a first ventricular assist device, the first right rotational speed is a current rotational speed of a second ventricular assist device, the first ventricular assist device is disposed in a left ventricle of a target user for pumping fluid from the left ventricle to an aorta, and the second ventricular assist device is disposed in a right ventricle of the target user for pumping fluid from the right ventricle to a pulmonary artery; estimating a first left differential pressure according to the first left rotational speed, and estimating a first right differential pressure according to the first right rotational speed, the first left differential pressure being a difference between the pressure of the aorta and the pressure of the left ventricle at the first left rotational speed, the first right differential pressure being a difference between the pressure of the pulmonary artery and the pressure of the right ventricle at the first right rotational speed; and further controlling the first left rotating speed and/or the first right rotating speed according to the first left differential pressure and the first right differential pressure so that the first left differential pressure is in a first preset differential pressure range and the first right differential pressure is in a second preset differential pressure range. The application ensures that the first left pressure difference and the first right pressure difference are in the pressure difference range of healthy people by respectively adjusting the rotating speeds of the first ventricular assist device and the second ventricular assist device, thereby ensuring the safety of the user and ensuring the balance of the systemic circulation and the pulmonary circulation of the user.

The foregoing description of the embodiments of the present application has been presented primarily in terms of a method-side implementation. It will be appreciated that the network device, in order to implement the above-described functions, includes corresponding hardware structures and/or software modules that perform the respective functions. Those of skill in the art will readily appreciate that the various illustrative elements and algorithm steps described in connection with the embodiments disclosed herein may be implemented as hardware or combinations of hardware and computer software. Whether a function is implemented as hardware or computer software driven hardware depends upon the particular application and design constraints imposed on the solution. Skilled artisans may implement the described functionality in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the present application.

Referring to fig. 4, fig. 4 is a block diagram illustrating functional units of a pump control apparatus 400 according to an embodiment of the present application, where the apparatus 400 is applied to a medical device, and the apparatus 400 includes: an acquisition unit 410, an estimation unit 420 and a control unit 430, wherein,

the acquiring unit 410 is configured to acquire a first left rotational speed and a first right rotational speed, where the first left rotational speed is a current rotational speed of a first ventricular assist device, the first right rotational speed is a current rotational speed of a second ventricular assist device, the first ventricular assist device is disposed in a left ventricle of a target user and is configured to pump fluid from the left ventricle to an aorta, and the second ventricular assist device is disposed in a right ventricle of the target user and is configured to pump the fluid from the right ventricle to a pulmonary artery;

The estimating unit 420 is configured to estimate a first left pressure difference according to the first left rotational speed, and estimate a first right pressure difference according to the first right rotational speed, where the first left pressure difference is a difference between the pressure of the aorta and the pressure of the left ventricle at the first left rotational speed, and the first right pressure difference is a difference between the pressure of the pulmonary artery and the pressure of the right ventricle at the first right rotational speed;

the control unit 430 is configured to control the first left rotational speed and/or the first right rotational speed according to the first left differential pressure and the first right differential pressure, so that the first left differential pressure is in a first preset differential pressure range, and the first right differential pressure is in a second preset differential pressure range.

Optionally, in the estimating the first left differential pressure according to the first left rotational speed and the estimating the first right differential pressure according to the first right rotational speed, the estimating unit 420 is specifically configured to: acquiring a first current and a second current, wherein the first current is a current flowing through the first ventricular assist device at the first left rotating speed, and the second current is a current flowing through the second ventricular assist device at the first right rotating speed; estimating a first left flow rate corresponding to the first current according to a first fluid characteristic curve, and estimating a first right flow rate corresponding to the second current according to a second fluid characteristic curve, wherein the first fluid characteristic curve is a relation curve between a current of the first ventricular assist device running at the first left rotating speed and a pumped fluid flow rate, and the second fluid characteristic curve is a relation curve between a current of the second ventricular assist device running at the first right rotating speed and the pumped fluid flow rate; and determining a first left differential pressure corresponding to the first left flow and a first right differential pressure corresponding to the first right flow according to the mapping relation between the fluid flow and the differential pressure.

Optionally, in controlling the first left rotational speed and/or the first right rotational speed according to the first left differential pressure and the first right differential pressure, the control unit 430 is specifically configured to: judging the target state of the target user according to the first left pressure difference; and controlling the first left rotating speed and/or the first right rotating speed according to the target state and the first right pressure difference.

Optionally, in judging the target state of the target user according to the first left pressure difference, the control unit 430 is specifically configured to: if the first left pressure difference is larger than a first preset pressure difference, judging that the target user is in a first state or a second state, wherein the first preset pressure difference range comprises the first preset pressure difference; and if the first left pressure difference is smaller than the first preset pressure difference, judging that the target user is in a third state.

Optionally, in controlling the first left rotational speed and/or the first right rotational speed according to the target state and the first right differential pressure, the control unit 430 is specifically configured to: if the first right differential pressure is greater than a second preset differential pressure, and the target state is in the first state or the third state, increasing the first left rotating speed and decreasing the first right rotating speed, wherein the second preset differential pressure range comprises the second preset differential pressure; if the first right differential pressure is smaller than the second preset differential pressure and the target state is in the first state, increasing the first right rotating speed; if the first right differential pressure is larger than the second preset differential pressure and the target state is in the second state, the first right rotating speed is reduced; if the first right differential pressure is smaller than the second preset differential pressure and the target state is in the second state, reducing the first left rotating speed and increasing the first right rotating speed; and if the first right differential pressure is smaller than the second preset differential pressure and the target state is in the third state, increasing the first left rotating speed and the first right rotating speed.

Alternatively, in terms of increasing the first left rotational speed and decreasing the first right rotational speed, the control unit 430 is specifically configured to: if the i-th left pressure difference is larger than the first preset pressure difference, increasing the i-th left rotating speed by a first rotating speed step, wherein i is a positive integer; if the i right differential pressure is larger than the second preset differential pressure, reducing the i right rotating speed by a second rotating speed step; let i=i+1 until the i-th left differential pressure is in the first preset differential pressure range and the i-th right differential pressure is in the second preset differential pressure range; when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

Optionally, in increasing the first right rotational speed, the control unit 430 is specifically configured to: if the i left differential pressure is larger than the first preset differential pressure, increasing the i left rotating speed by a first rotating speed step; if the i right differential pressure is larger than the second preset differential pressure, increasing the i right rotating speed by a second rotating speed step; let i=i+1 until the i-th left differential pressure is equal to the first preset differential pressure and the i-th right differential pressure is equal to the second preset differential pressure; when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

Optionally, in reducing the first right rotational speed, the control unit 430 is specifically configured to: if the i left differential pressure is larger than the first preset differential pressure, reducing the i left rotating speed by a first rotating speed step; if the i right differential pressure is larger than the second preset differential pressure, reducing the i right rotating speed by a second rotating speed step; let i=i+1 until the i-th left differential pressure is equal to the first preset differential pressure and the i-th right differential pressure is equal to the second preset differential pressure; when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

Alternatively, in terms of decreasing the first left rotational speed and increasing the first right rotational speed, the control unit 430 is specifically configured to: if the i left differential pressure is larger than the first preset differential pressure, reducing the i left rotating speed by a first rotating speed step; if the i right differential pressure is larger than the second preset differential pressure, increasing the i right rotating speed by a second rotating speed step; let i=i+1 until the i-th left differential pressure is equal to the first preset differential pressure and the i-th right differential pressure is equal to the second preset differential pressure; when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

Alternatively, in terms of increasing the first left rotational speed and increasing the first right rotational speed, the control unit 430 specifically functions to: if the i left differential pressure is larger than the first preset differential pressure, increasing the i left rotating speed by a first rotating speed step; if the i right differential pressure is larger than the second preset differential pressure, increasing the i right rotating speed by a second rotating speed step; let i=i+1 until the i-th left differential pressure is equal to the first preset differential pressure and the i-th right differential pressure is equal to the second preset differential pressure; when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

Optionally, the obtaining unit 410 is further configured to: obtaining a target flow step; determining the first rotational speed step according to the target flow step and the first preset pressure difference; and determining the second rotating speed step according to the target flow step and the second preset pressure difference.

Optionally, the control unit 430 is further configured to: if the difference between the second incremental left differential pressure and the first incremental left differential pressure is larger than a preset difference, determining that the target user is in the second state, wherein the first incremental left differential pressure is the differential pressure between the aortic pressure and the left ventricular pressure at a first incremental left rotating speed, the second incremental left differential pressure is the differential pressure between the aortic pressure and the left ventricular pressure at a second incremental left rotating speed, and the difference between the second incremental left rotating speed and the first incremental left rotating speed is equal to the difference between the first incremental left rotating speed and the first left rotating speed; otherwise, determining that the target user is in the first state.

It should be appreciated that the apparatus 400 herein is embodied in the form of functional units. The term "unit" herein may refer to an application specific integrated circuit (application specific integrated circuit, ASIC), an electronic circuit, a processor (e.g., a shared, dedicated, or group processor, etc.) and memory that execute one or more software or firmware programs, a combinational logic circuit, and/or other suitable components that support the described functionality. In an alternative example, it will be understood by those skilled in the art that the apparatus 400 may be specifically configured as the medical device in the foregoing embodiment, and the apparatus 400 may be configured to perform each flow and/or step corresponding to the medical device in the foregoing method embodiment, which is not described herein for the sake of avoiding repetition.

The apparatus 400 of each of the above aspects has a function of implementing the corresponding steps performed by the medical device in the above method; the functions may be implemented by hardware, or may be implemented by hardware executing corresponding software. The hardware or software comprises one or more modules corresponding to the functions; for example, the acquisition unit 410 may be replaced by a transceiver, the estimation unit 420 and the control unit 430 may be replaced by a processor, performing the transceiving operations and the associated processing operations in the respective method embodiments, respectively.

In an embodiment of the present application, the apparatus 400 may also be a chip or a chip system, for example: system on chip (SoC). Correspondingly, the transceiver unit may be a transceiver circuit of the chip, which is not limited herein.

Referring to fig. 5, fig. 5 is a schematic structural diagram of a medical device according to an embodiment of the present application, where the medical device includes: one or more processors, one or more memories, one or more communication interfaces, and one or more programs; the one or more programs are stored in the memory and configured to be executed by the one or more processors.

The program includes instructions for performing the steps of: acquiring a first left rotating speed and a first right rotating speed, wherein the first left rotating speed is the current rotating speed of a first ventricular assist device, the first right rotating speed is the current rotating speed of a second ventricular assist device, the first ventricular assist device is arranged in a left ventricle of a target user and used for pumping fluid from the left ventricle to an aorta, and the second ventricular assist device is arranged in a right ventricle of the target user and used for pumping the fluid from the right ventricle to a pulmonary artery; estimating a first left pressure difference from the first left rotational speed, which is a difference between the pressure of the aorta and the pressure of the left ventricle at the first left rotational speed, and estimating a first right pressure difference from the first right rotational speed, which is a difference between the pressure of the pulmonary artery and the pressure of the right ventricle at the first right rotational speed; and controlling the first left rotating speed and/or the first right rotating speed according to the first left differential pressure and the first right differential pressure so that the first left differential pressure is in a first preset differential pressure range, and the first right differential pressure is in a second preset differential pressure range.

All relevant contents of each scenario related to the above method embodiment may be cited to the functional description of the corresponding functional module, which is not described herein.

It should be appreciated that the memory described above may include read only memory and random access memory and provide instructions and data to the processor. A portion of the memory may also include non-volatile random access memory. For example, the memory may also store information of the device type.

In an embodiment of the present application, the processor of the above apparatus may be a central processing unit (Central Processing Unit, CPU), which may also be other general purpose processors, digital Signal Processors (DSPs), application Specific Integrated Circuits (ASICs), field Programmable Gate Arrays (FPGAs) or other programmable logic devices, discrete gate or transistor logic devices, discrete hardware components, etc. A general purpose processor may be a microprocessor or the processor may be any conventional processor or the like.

It should be understood that references to "at least one" in embodiments of the present application mean one or more, and "a plurality" means two or more. "and/or", describes an association relationship of an association object, and indicates that there may be three relationships, for example, a and/or B, and may indicate: a alone, a and B together, and B alone, wherein a, B may be singular or plural. The character "/" generally indicates that the context-dependent object is an "or" relationship. "at least one of" or the like means any combination of these items, including any combination of single item(s) or plural items(s). For example, at least one (one) of a, b, or c may represent: a, b, c, a-b, a-c, b-c, or a-b-c, wherein a, b, c may be single or plural.

And, unless specified to the contrary, references to "first," "second," etc. ordinal words of embodiments of the present application are used for distinguishing between multiple objects and are not used for limiting the order, timing, priority, or importance of the multiple objects. For example, the first information and the second information are only for distinguishing different information, and are not indicative of the difference in content, priority, transmission order, importance, or the like of the two information.

In implementation, the steps of the above method may be performed by integrated logic circuits of hardware in a processor or by instructions in the form of software. The steps of the method disclosed in connection with the embodiments of the present application may be embodied directly in a hardware processor for execution, or in a combination of hardware and software elements in the processor for execution. The software elements may be located in a random access memory, flash memory, read-only memory, programmable read-only memory or electrically erasable programmable memory, registers, etc. as well known in the art. The storage medium is located in a memory, and the processor executes instructions in the memory to perform the steps of the method described above in conjunction with its hardware. To avoid repetition, a detailed description is not provided herein.

The embodiment of the present application also provides a computer storage medium storing a computer program for electronic data exchange, where the computer program causes a computer to execute some or all of the steps of any one of the methods described in the above method embodiments.

Embodiments of the present application also provide a computer program product comprising a non-transitory computer-readable storage medium storing a computer program operable to cause a computer to perform part or all of the steps of any one of the methods described in the method embodiments above. The computer program product may be a software installation package.

It should be noted that, for simplicity of description, the foregoing method embodiments are all described as a series of acts, but it should be understood by those skilled in the art that the present application is not limited by the order of acts described, as some steps may be performed in other orders or concurrently in accordance with the present application. Further, those skilled in the art will also appreciate that the embodiments described in the specification are all preferred embodiments, and that the acts and modules referred to are not necessarily required for the present application.

In the foregoing embodiments, the descriptions of the embodiments are emphasized, and for parts of one embodiment that are not described in detail, reference may be made to related descriptions of other embodiments.

In the several embodiments provided by the present application, it should be understood that the disclosed apparatus may be implemented in other manners. For example, the above-described apparatus embodiments are merely illustrative, and the division of elements, such as those described above, is merely a logical function division, and may be implemented in other manners, such as multiple elements or components may be combined or integrated into another system, or some features may be omitted, or not performed. Alternatively, the coupling or direct coupling or communication connection shown or discussed with each other may be an indirect coupling or communication connection via some interfaces, devices or units, or may be in electrical or other forms.

The units described above as separate components may or may not be physically separate, and components shown as units may or may not be physical units, may be located in one place, or may be distributed over a plurality of network units. Some or all of the units may be selected according to actual needs to achieve the purpose of the embodiment of the present application.

In addition, each functional unit in the embodiments of the present application may be integrated in one processing unit, or each unit may exist alone physically, or two or more units may be integrated in one unit. The integrated units may be implemented in hardware or in software functional units.

The integrated units described above, if implemented in the form of software functional units and sold or used as stand-alone products, may be stored in a computer readable memory. Based on such understanding, the technical solution of the present application may be embodied essentially or partly in the form of a software product or all or part of the technical solution, which is stored in a memory, and includes several instructions for causing a computer device (which may be a personal computer, a server, or TRP, etc.) to perform all or part of the steps of the method of the embodiments of the present application. And the aforementioned memory includes: a U-disk, a Read-Only Memory (ROM), a random access Memory (RAM, random Access Memory), a removable hard disk, a magnetic disk, or an optical disk, or other various media capable of storing program codes.

Those of ordinary skill in the art will appreciate that all or a portion of the steps in the various methods of the above embodiments may be implemented by a program that instructs associated hardware, and the program may be stored in a computer readable memory, which may include: flash disk, ROM, RAM, magnetic or optical disk, etc.

The foregoing has outlined rather broadly the more detailed description of embodiments of the application, wherein the principles and embodiments of the application are explained in detail using specific examples, the above examples being provided solely to facilitate the understanding of the method and core concepts of the application; meanwhile, as those skilled in the art will have variations in the specific embodiments and application scope in accordance with the ideas of the present application, the present description should not be construed as limiting the present application in view of the above.

Claims

1. A method of controlling a pump, the method comprising:

2. The method of claim 1, wherein the estimating a first left differential pressure from the first left rotational speed and estimating a first right differential pressure from the first right rotational speed comprises:

acquiring a first current and a second current, wherein the first current is a current flowing through the first ventricular assist device at the first left rotating speed, and the second current is a current flowing through the second ventricular assist device at the first right rotating speed;

estimating a first left flow rate corresponding to the first current according to a first fluid characteristic curve, and estimating a first right flow rate corresponding to the second current according to a second fluid characteristic curve, wherein the first fluid characteristic curve is a relation curve between a current of the first ventricular assist device running at the first left rotating speed and a pumped fluid flow rate, and the second fluid characteristic curve is a relation curve between a current of the second ventricular assist device running at the first right rotating speed and the pumped fluid flow rate;

And determining a first left differential pressure corresponding to the first left flow and a first right differential pressure corresponding to the first right flow according to the mapping relation between the fluid flow and the differential pressure.

3. The method according to claim 1, wherein said controlling said first left rotational speed and/or said first right rotational speed in accordance with said first left differential pressure and said first right differential pressure comprises:

judging the target state of the target user according to the first left pressure difference;

and controlling the first left rotating speed and/or the first right rotating speed according to the target state and the first right pressure difference.

4. The method of claim 3, wherein said determining the target state of the target user based on the first left differential pressure comprises:

if the first left pressure difference is larger than a first preset pressure difference, judging that the target user is in a first state or a second state, wherein the first preset pressure difference range comprises the first preset pressure difference;

and if the first left pressure difference is smaller than the first preset pressure difference, judging that the target user is in a third state.

5. The method according to claim 4, wherein said controlling the first left rotational speed and/or the first right rotational speed according to the target state and the first right differential pressure comprises:

If the first right differential pressure is greater than a second preset differential pressure, and the target state is in the first state or the third state, increasing the first left rotating speed and decreasing the first right rotating speed, wherein the second preset differential pressure range comprises the second preset differential pressure;

if the first right differential pressure is smaller than the second preset differential pressure and the target state is in the first state, increasing the first right rotating speed;

if the first right differential pressure is larger than the second preset differential pressure and the target state is in the second state, the first right rotating speed is reduced;

if the first right differential pressure is smaller than the second preset differential pressure and the target state is in the second state, reducing the first left rotating speed and increasing the first right rotating speed;

and if the first right differential pressure is smaller than the second preset differential pressure and the target state is in the third state, increasing the first left rotating speed and the first right rotating speed.

6. The method of claim 5, wherein the increasing the first left rotational speed and decreasing the first right rotational speed comprises:

if the i-th left pressure difference is larger than the first preset pressure difference, increasing the i-th left rotating speed by a first rotating speed step, wherein i is a positive integer;

If the i right differential pressure is larger than the second preset differential pressure, reducing the i right rotating speed by a second rotating speed step;

let i=i+1 until the i-th left differential pressure is in the first preset differential pressure range and the i-th right differential pressure is in the second preset differential pressure range;

when i=1, the i-th left differential pressure is the first left differential pressure, the i-th left rotating speed is the first left rotating speed, the i-th right differential pressure is the first right differential pressure, and the i-th right rotating speed is the first right rotating speed.

7. The method of claim 5, wherein said increasing said first right rotational speed comprises:

if the i left differential pressure is larger than the first preset differential pressure, increasing the i left rotating speed by a first rotating speed step;

if the i right differential pressure is larger than the second preset differential pressure, increasing the i right rotating speed by a second rotating speed step;

let i=i+1 until the i-th left differential pressure is equal to the first preset differential pressure and the i-th right differential pressure is equal to the second preset differential pressure;

8. The method of claim 5, wherein said reducing said first right rotational speed comprises:

if the i left differential pressure is larger than the first preset differential pressure, reducing the i left rotating speed by a first rotating speed step;

9. The method of claim 5, wherein the decreasing the first left rotational speed and increasing the first right rotational speed comprises:

10. The method of claim 5, wherein the increasing the first left rotational speed and the increasing the first right rotational speed comprises:

11. The method according to any one of claims 6-10, further comprising:

obtaining a target flow step;

determining the first rotational speed step according to the target flow step and the first preset pressure difference;

And determining the second rotating speed step according to the target flow step and the second preset pressure difference.

12. The method according to any one of claims 4-10, further comprising:

if the difference between the second incremental left differential pressure and the first incremental left differential pressure is larger than a preset difference, determining that the target user is in the second state, wherein the first incremental left differential pressure is the differential pressure between the aortic pressure and the left ventricular pressure at a first incremental left rotating speed, the second incremental left differential pressure is the differential pressure between the aortic pressure and the left ventricular pressure at a second incremental left rotating speed, and the difference between the second incremental left rotating speed and the first incremental left rotating speed is equal to the difference between the first incremental left rotating speed and the first left rotating speed;

otherwise, determining that the target user is in the first state.

13. A pump control device, the device comprising:

14. A medical device comprising a processor, a memory and a communication interface, the memory storing one or more programs, and the one or more programs being executed by the processor, the one or more programs comprising instructions for performing the steps in the method of any of claims 1-12.

15. A computer readable storage medium storing a computer program for electronic data exchange, wherein the computer program causes a computer to perform the steps of the method according to any one of claims 1-12.