CN117042825A - Respiratory therapy apparatus and method - Google Patents

Respiratory therapy apparatus and method Download PDF

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Publication number
CN117042825A
CN117042825A CN202380010072.1A CN202380010072A CN117042825A CN 117042825 A CN117042825 A CN 117042825A CN 202380010072 A CN202380010072 A CN 202380010072A CN 117042825 A CN117042825 A CN 117042825A
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Prior art keywords
rox
index
operation mode
mode
preset value
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李勃
刘勇
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Chongqing Yongrenxin Medical Equipment Co ltd
Taili'er Co ltd
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Chongqing Yongrenxin Medical Equipment Co ltd
Taili'er Co ltd
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Priority claimed from PCT/US2023/061818 external-priority patent/WO2024144891A1/en
Publication of CN117042825A publication Critical patent/CN117042825A/en
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Abstract

A respiratory therapy apparatus and method. The device is configured with at least two modes of operation, including a first mode of operation that provides HFNC support for the patient and a second mode of operation that provides NIV support or INV support for the patient; the device includes a processor and a memory storing instructions configured to invoke and execute the instructions stored in the memory to: acquiring a ROX index based on the first parameter; and triggering the mode switching of the equipment according to the ROX index and a preset triggering strategy for switching the operation mode of the equipment.

Description

Respiratory therapy apparatus and method
Cross Reference to Related Applications
The present disclosure claims priority from U.S. patent application Ser. No. 18/147,215 entitled "respiratory therapy apparatus and method," filed on month 28 of 2022, the entire contents of which are incorporated herein by reference.
Technical Field
The present disclosure relates to the field of medical devices for respiratory therapy, and in particular to an integrated respiratory therapy device and respiratory therapy method based on respiratory rate-oxygenation (ROX) index.
Background
Transnasal high-flow nasal cannula (HFNC) oxygen therapy is a non-invasive and better-compliance treatment for patients suffering from respiratory diseases caused by the covd-19 virus. However, when there is insufficient HFNC respiratory support for the patient, an upgrade to non-invasive ventilation (noninvasive ventilation, NIV for short) or invasive ventilation (invasive ventilation, INV) may be required.
This background information is provided to reveal information believed by the applicant to be of possible relevance to the present disclosure. It is not intended to be admitted or construed that any of the preceding information constitutes prior art against the present disclosure.
Disclosure of Invention
The present disclosure provides a respiratory therapy apparatus and method. According to the device and method, three different ventilation modes are enabled on a single integrated device, including HFNC, NIV and INV, and time to replace the ventilator is saved as compared to the prior art, thereby providing timely treatment to the patient.
In a first aspect, embodiments of the present disclosure provide a respiratory therapy device, wherein the device is configured with at least two modes of operation, and the at least two modes of operation include a first mode of operation that provides HFNC support for a patient and a second mode of operation that provides NIV support or INV support for the patient;
the device includes a processor and a memory storing instructions, the processor configured to call and execute the instructions stored in the memory to:
acquiring a ROX index based on the first parameter; and
and triggering the mode switching of the equipment according to the ROX index and a preset trigger strategy for switching the operation mode of the equipment.
In a possible embodiment, the device is provided with a humidification assembly configured to humidify the airflow delivered to the patient.
In a possible embodiment, the humidifying assembly comprises a temperature sensor and a heating element connected to the temperature sensor, the temperature sensor being configured to measure the temperature of the heating element when the device is operated in the first or second mode of operation.
In a possible embodiment, the device is provided with a flow sensor configured to measure the flow rate of the gas flow.
In a possible embodiment, the humidity of the gas stream is adjustable by the humidification assembly based on the flow rate.
In a possible embodiment, the temperature of the heating element is adjustable based on the flow rate.
In a possible implementation manner, the preset trigger policy is any one of the following: based on a manual trigger strategy, a semi-automatic trigger strategy or a fully automatic trigger strategy.
In one possible embodiment, when the preset trigger policy is the manual-based trigger policy,
The processor is further configured to invoke and execute the instructions stored in the memory to:
determining whether the ROX index is less than a preset value;
when the ROX index is determined to be smaller than the preset value, a first notification is sent to a user terminal, wherein the first notification indicates that the ROX index is smaller than the preset value;
when the ROX index is not smaller than the preset value, sending a second notification to the user terminal, wherein the second notification indicates that the ROX index is not smaller than the preset value;
the mode switching of the device is triggered based on a switching instruction from the user.
In a possible implementation, the switching instruction instructs to switch from the first operation mode to the second operation mode when the device is in the first operation mode; the switch instruction directs switching from the second mode of operation to the first mode of operation when the device is in the second mode of operation.
In a possible implementation, when the preset trigger policy is the semiautomatic trigger policy, the processor is further configured to invoke and execute the instructions stored in the memory to perform the following operations:
Determining whether the ROX index is less than a preset value;
determining an operating mode of the device;
when it is determined that the ROX index is less than the preset value and the device is in a first operation mode, sending a third notification to a user terminal, wherein the third notification indicates a switch from the first operation mode to the second operation mode;
when it is determined that the ROX index is not less than the preset value and the device is in the second operation mode, sending a fourth notification to the user terminal, wherein the fourth notification indicates that the second operation mode is switched to the first operation mode; and
when a switching confirmation instruction is received from the user terminal, the device is switched from the current operation mode to a different operation mode.
In one possible implementation, when the preset trigger policy is the fully automatic trigger policy,
the processor is further configured to invoke and execute the instructions stored in the memory to:
determining whether the ROX index is less than a preset value;
determining an operating mode of the device;
triggering the device to switch from the first operation mode to the second operation mode when the ROX index is determined to be less than the preset value and the device is in the first operation mode; and
Triggering the device to switch from the second operation mode to the first operation mode when the ROX index is determined to be not less than the preset value and the device is in the second operation mode.
In a possible embodiment, the first parameter is measured by a different sensor; the sensor includes a first sensor configured to measure blood oxygen saturation, a second sensor configured to measure an inspired oxygen fraction, and a third sensor configured to measure respiration rate;
the processor is further configured to invoke and execute the instructions stored in the memory to:
the ROX index is calculated from the blood oxygen saturation measured by the first sensor, the inhaled oxygen fraction measured by the second sensor, and the respiratory rate measured by the third sensor.
In one possible embodiment, the first sensor is a pulse oximeter, the second sensor is an oxygen concentration sensor, and the third sensor is a flow sensor or a pressure sensor.
In a possible embodiment, the sensor is integrated into the device.
In a possible embodiment, the sensor is communicatively connected to the device.
In a possible implementation, the processor is further configured to call and execute the instructions stored in the memory to:
collecting a plurality of groups of first parameters measured in a preset time interval;
calculating a temporary ROX index based on the plurality of sets of first parameters, respectively;
and averaging the temporary ROX index to obtain the ROX index.
In a second aspect, embodiments of the present disclosure provide a respiratory therapy method applied to a device configured with at least two modes of operation, including a first mode of operation providing HFNC support for a patient and a second mode of operation providing NIV support or INV support for the patient; wherein the method comprises:
acquiring a ROX index based on the first parameter; and
and triggering the mode switching of the equipment according to the ROX index and a preset trigger strategy for switching the operation mode of the equipment.
In a possible embodiment, the first parameter is measured by a different sensor; the sensor includes a first sensor configured to measure blood oxygen saturation, a second sensor configured to measure an inspired oxygen fraction, and a third sensor configured to measure respiration rate; wherein said obtaining a ROX index based on said first parameter comprises:
The ROX index is calculated from the blood oxygen saturation measured by the first sensor, the inhaled oxygen fraction measured by the second sensor, and the respiratory rate measured by the third sensor.
In one possible embodiment, the first sensor is a pulse oximeter, the second sensor is an oxygen concentration sensor, and the third sensor is a flow sensor or a pressure sensor.
In a possible embodiment, the sensor is integrated into the device.
In a possible embodiment, the sensor is communicatively connected to the device.
In a possible implementation manner, the acquiring the ROX index based on the first parameter includes:
collecting a plurality of groups of first parameters measured in a preset time interval;
calculating a temporary ROX index based on the plurality of sets of first parameters, respectively;
and averaging the temporary ROX index to obtain the ROX index.
In a possible implementation manner, the preset trigger policy is any one of the following: based on a manual trigger strategy, a semi-automatic trigger strategy or a fully automatic trigger strategy.
In a possible implementation manner, the preset trigger strategy is a trigger strategy based on manual operation;
Wherein said triggering a mode switch of said device according to said ROX index and said preset trigger policy for switching an operation mode of said device comprises:
determining whether the ROX index is less than a preset value;
when the ROX index is determined to be smaller than the preset value, a first notification is sent to a user terminal, wherein the first notification indicates that the ROX index is smaller than the preset value;
when the ROX index is not smaller than the preset value, sending a second notification to the user terminal, wherein the second notification indicates that the ROX index is not smaller than the preset value;
the mode switching of the device is triggered based on a switching instruction from the user.
In a possible implementation, the switching instruction instructs to switch from the first operation mode to the second operation mode when the device is in the first operation mode; the switch instruction directs switching from the second mode of operation to the first mode of operation when the device is in the second mode of operation.
In a possible implementation manner, the preset trigger policy is a semiautomatic trigger policy;
wherein said triggering a mode switch of said device according to said ROX index and said preset trigger policy for switching an operation mode of said device comprises:
Determining whether the ROX index is less than a preset value;
determining an operating mode of the device;
when it is determined that the ROX index is less than the preset value and the device is in a first operation mode, sending a third notification to a user terminal, wherein the third notification indicates a switch from the first operation mode to the second operation mode;
when it is determined that the ROX index is not less than the preset value and the device is in the second operation mode, sending a fourth notification to the user terminal, wherein the fourth notification indicates that the second operation mode is switched to the first operation mode; and
when a switching confirmation instruction is received from the user terminal, the device is switched from the current operation mode to a different operation mode.
In a possible implementation manner, the preset trigger policy is a fully automatic trigger policy;
wherein said triggering a mode switch of said device according to said ROX index and said preset trigger policy for switching an operation mode of said device comprises:
determining whether the ROX index is less than a preset value;
determining an operating mode of the device;
triggering the device to switch from the first operation mode to the second operation mode when the ROX index is determined to be less than the preset value and the device is in the first operation mode; and
Triggering the device to switch from the second operation mode to the first operation mode when the ROX index is determined to be not less than the preset value and the device is in the second operation mode.
In a possible embodiment, the device is provided with a humidification assembly configured to humidify the airflow delivered to the patient.
In a possible embodiment, the humidifying assembly comprises a temperature sensor and a heating element connected to the temperature sensor, the temperature sensor being configured to measure the temperature of the heating element when the device is operated in the first or second mode of operation.
In a possible embodiment, the device is provided with a flow sensor configured to measure the flow rate of the gas flow.
In a possible embodiment, the humidity of the gas stream is adjustable by the humidification assembly based on the flow rate.
In a possible embodiment, the temperature of the heating element is adjustable based on the flow rate.
In a third aspect, embodiments of the present disclosure provide a non-transitory computer-readable storage medium having stored therein computer-executable instructions that, when executed by a processor, implement a respiratory therapy method according to the first aspect or any possible implementation of the first aspect.
In a fourth aspect, embodiments of the present disclosure provide a computer program product comprising computer-executable instructions which, when executed by a processor, implement a method according to the first aspect or any possible implementation of the first aspect.
In a fifth aspect, embodiments of the present disclosure provide a computer program, wherein the method according to the first aspect or any possible implementation of the first aspect is implemented when the program is executed by a processor.
The present disclosure provides a respiratory therapy apparatus configured with at least two modes of operation including a first mode of operation providing HFNC support for a patient and a second mode of operation providing NIV support or INV support for the patient; the device includes a processor and a memory storing instructions, the processor configured to call and execute the instructions stored in the memory to: acquiring a ROX index based on the first parameter; and triggering the mode switching of the equipment according to the ROX index and a preset trigger strategy for switching the operation mode of the equipment. With the respiratory therapy apparatus, three different ventilation modes, including HFNC, NIV and INV, are enabled on a single integrated device, saving time to replace the ventilator as compared to the prior art, thereby providing timely treatment to the patient.
It should be understood that the description herein is not intended to identify key or critical features of the embodiments of the disclosure, nor is it intended to limit the scope of the disclosure. Other features of the present disclosure will be readily appreciated from the following description.
Drawings
The drawings are included to provide a better understanding of the present disclosure and are not to be construed as limiting the present disclosure in any way.
Fig. 1 is a schematic block diagram one of a respiratory therapy apparatus provided in accordance with an embodiment of the present disclosure.
Fig. 2 is a schematic block diagram two of another respiratory therapy apparatus provided in accordance with an embodiment of the present disclosure.
Fig. 3 is a schematic block diagram three of yet another respiratory therapy apparatus provided in accordance with an embodiment of the present disclosure.
Fig. 4 is a schematic block diagram four of yet another respiratory therapy apparatus provided in accordance with an embodiment of the present disclosure.
Fig. 5 is a schematic block diagram five of yet another respiratory therapy apparatus provided in accordance with an embodiment of the present disclosure.
Fig. 6 is a schematic flow chart of a respiratory therapy method provided in accordance with an embodiment of the present disclosure.
Fig. 7 is a schematic flow chart of a method of obtaining a ROX index based on a first parameter.
Fig. 8 is a schematic flow chart of a manual-based triggering strategy for triggering mode switching of a respiratory therapy device.
Fig. 9A is a schematic flow chart of a semi-automatic trigger strategy for triggering a mode switch of a respiratory therapy apparatus.
Fig. 9B is a schematic flow chart of another half of an automatic triggering strategy for triggering a mode switch of a respiratory therapy device.
Fig. 10A is a schematic flow chart of a fully automatic trigger strategy for triggering a mode switch of a respiratory therapy apparatus.
Fig. 10B is a schematic flow chart of another fully automatic triggering strategy for triggering a mode switch of a respiratory therapy apparatus.
Detailed Description
In the following description, reference is made to the accompanying drawings, which form a part hereof and show by way of illustration specific aspects of embodiments of the disclosure or in which the disclosure may be used. It is to be understood that embodiments of the present disclosure may be used in other respects and including structural or logical changes not depicted in the drawings. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope of the present disclosure is defined by the appended claims.
The term "comprising" and variants thereof as used herein are open ended terms including, i.e., "including, but not limited to. The term "based on" means "based at least in part on. The term "one embodiment" means "at least one embodiment"; the term "another embodiment" means "at least one other embodiment"; the term "some embodiments" means "at least some embodiments. Related definitions of other terms will be given below.
It should be noted that concepts such as "first," "second," etc. in this disclosure are merely used to distinguish between different devices, modules or units and are not intended to limit the order or relativity of the functions performed by such devices, modules or units.
It should be noted that reference to singular or plural modifications in this disclosure are exemplary and not limiting, and those of skill in the art will understand that they are to be interpreted as "one or more" unless the context clearly indicates otherwise.
In recent years, HFNC has been widely used to provide respiratory support for patients suffering from respiratory diseases caused by the COVID-19 virus and who have difficulty ensuring adequate ventilation through self-respiratory efforts. HFNC may deliver a continuous high flow of heated and humidified gas to a patient through a tube placed in the nostril. HFNC is easier to use, has better patient compliance than NIV and INV, and is a good alternative treatment for hypoxic acute respiratory failure (acute respiratory failure, abbreviated ARF).
However, when there is insufficient respiratory support for the patient's HFNC, it may be necessary to upgrade the treatment to NIV or INV. For example, when the patient's condition deteriorates, the HFNC may not be suitable and may need to be replaced with NIV or INV. Clinical studies indicate that the ROX index is a good predictor of HFNC failure in ARF patients. When the ROX index is below a certain value (e.g., 4.88), the patient may be at high risk of HFNC failure. Thus, the ROX index may be used as a reference for switching ventilation modes. However, in the prior art HFNC, NIV, INV is provided in a separate ventilator, which results in difficulties in switching between the three ventilation modes, thereby delaying the treatment of the patient.
In addition, conventional NIV or INV ventilators can be used with external humidifiers, which typically have only a heating function, and no airflow rate detection function. External humidifiers typically have several heating ranges, which a user can switch according to his own judgment. Such inaccurate adjustment may cause problems, for example, if the heating temperature is too high, the moisture evaporates too much, which may cause condensed water to form on the patient's trachea after the patient inhales the heated and humidified gas, thereby causing infection of the patient.
In view of the foregoing, the present disclosure provides an integrated respiratory therapy apparatus and respiratory therapy method based on a ROX index. According to the device, three modes, i.e., HFNC, NIV and INV, are integrated into one device, and switching of these modes can be done automatically by the device or with the help of a user (i.e., doctor). In addition, to address the humidification problem described above, the apparatus may also be provided with a humidification assembly that may be common to the three modes.
The technical scheme of the present disclosure is described in detail below with reference to the accompanying drawings.
Fig. 1 is a schematic block diagram one of a respiratory therapy apparatus provided in accordance with an embodiment of the present disclosure.
As shown in fig. 1, respiratory therapy apparatus 100 includes a processor 102 and a memory 101 storing instructions.
In one possible implementation, the memory may exchange data via a bus 103 that connects the memory to the processor. The device 100 is configured with at least two modes of operation, including a first mode of operation that provides HFNC support for the patient and a second mode of operation that provides NIV support or INV support for the patient.
The processor is configured to call and execute instructions stored in the memory to:
acquiring a ROX index based on the first parameter; and
and triggering the mode switching of the equipment according to the ROX index and a preset triggering strategy for switching the operation mode of the equipment.
Specifically, the ROX index is defined as the ratio of pulse oximetry/fraction of inhaled oxygen to respiration rate, i.e., spO2/FiO2/RR (where "/" indicates divisor), where SpO2 is the blood oxygen saturation level, fiO2 is the fraction of inhaled oxygen, and RR is the respiration rate. Thus, the first parameters for obtaining the ROX index include SpO2, fiO2, and RR. In one possible implementation, the device 100 may obtain the first parameter from different sensors.
After obtaining the ROX index based on the first parameter, the device 100 may trigger a mode switch according to the ROX index and a preset trigger policy for switching the operation mode of the device. In a possible implementation manner, the preset trigger policy may be any one of the following: based on a manual trigger strategy, a semi-automatic trigger strategy or a fully automatic trigger strategy. The manually-based triggering policy may be a policy in which a user decides whether to make a mode switch, and a basis (e.g., a comparison result between a ROX value and a threshold value) for making this decision is calculated by the device. The semi-automatic trigger policy may be a policy that determines by the device whether to make a mode switch, but may be confirmed by the user. The fully automatic trigger policy may be a policy that determines by the device whether to make a mode switch without user confirmation.
With the respiratory therapy apparatus, three different ventilation modes, including HFNC, NIV and INV, are enabled on a single integrated device, saving time to replace the ventilator as compared to the prior art, thereby providing timely treatment to the patient.
Fig. 2 is a schematic block diagram two of another respiratory therapy apparatus provided in accordance with an embodiment of the present disclosure.
In this embodiment, in addition to having a memory 201 and a processor 202 with the same functions as the memory 101 and the processor 102 described above, the respiratory therapy device 200 may be provided with a humidification assembly 204 configured to humidify the airflow delivered to the patient. Referring to fig. 2, a humidifying component 204 may exchange data with a memory 201 and a processor 202 via a bus 203. Data from humidification assembly 204 may be stored in memory 201 and processor 202 may read the data from memory 201 and control humidification assembly 204 to adjust parameters related to the humidification function (e.g., the humidity level of the humidified gas).
Humidification of the airflow delivered to the patient may reduce the irritation of the nasal cavity by the airflow, and therefore most ventilators are used with humidifiers. As described above, conventional NIV or INV ventilators must be used with external humidifiers, which can lead to a number of problems. According to the respiratory therapy apparatus provided by the present embodiment, NIV and INV are integrated into a single apparatus, and thus share the same humidification component of the single apparatus and can be uniformly controlled by a processor, so that high-precision humidification control can be achieved.
Fig. 3 is a schematic block diagram three of yet another respiratory therapy apparatus provided in accordance with an embodiment of the present disclosure. The respiratory therapy apparatus 200 'includes a memory 201', a processor 202', and a bus 203', which function and connection are the same as the memory 201, processor 202, and bus 203 shown in fig. 2.
In this embodiment, the humidifying assembly 204' may further include a temperature sensor 205 and a heating element 206 coupled to the temperature sensor 205, as compared to the humidifying assembly 204 shown in FIG. 2. The temperature sensor 205 and the heating element 206 are communicatively coupled to the processor 202', and the temperature sensor 205 is communicatively coupled to the memory 201'. In one possible embodiment, the temperature sensor 205 is configured to measure the temperature of the heating element 206 when the respiratory therapy apparatus is operated in the first or second modes of operation described above.
The temperature sensor 205 is configured to report the temperature of the heating element 206 to the processor 202', and the processor 202' may then adjust the temperature of the heating element 206. In one possible embodiment, the temperature of the heating element 206 may have a preset value, which may be pre-stored in the memory 201'. When the temperature of the heating element 206 reaches the preset value, the heated air flow may reach the desired temperature. If the temperature of the heating element 206 measured by the temperature sensor 205 is above or below the preset value, the processor 202' may adjust the temperature of the heating element 206 until the temperature of the heating element 206 measured by the temperature sensor 205 reaches the preset value, thereby enabling automatic control of the temperature of the airflow delivered to the patient.
In one possible embodiment, the number of temperature sensors 205 may be more than one, one for measuring the temperature of the heating element 206 and the other for measuring the temperature of the heated and humidified gas. In one possible embodiment, a temperature sensor 205 for measuring the temperature of the heated and humidified gas may be provided in the respiratory path for directing the heated and humidified gas to the patient. The temperature sensor 205 may send temperature data of the heated and humidified gas to the processor 202'. The processor 202' described above may be configured to adjust the temperature of the heating element 206 based on the measured temperature of the heating element 206 and the temperature of the heated and humidified gas. Similarly, the temperature of the heated and humidified gas may also have a preset value stored in the memory 201', and the processor 202' may read the preset value of the temperature of the heated and humidified gas from the memory 201' to adjust the temperature of the heating element 206 according to the preset value of the temperature of the heated and humidified gas.
Fig. 4 is a schematic block diagram four of yet another respiratory therapy apparatus provided in accordance with an embodiment of the present disclosure, wherein the memory 301, the processor 302, and the humidification assembly 304 have the same functions as the memory 201, the processor 202, and the humidification assembly 204, respectively, described above. In addition, the humidifying assembly 304 may have the same components and functions as the humidifying assembly 204'.
In this embodiment, respiratory therapy apparatus 300 is provided with a flow sensor 305 configured to measure a flow rate of an airflow delivered to the patient, wherein flow sensor 305 is communicatively coupled to memory 301 and processor 302 via bus 303 to enable data exchange with memory 301 and processor 302.
In one possible embodiment, the humidity of the gas stream is adjustable by the humidification assembly 304 based on the flow rate. In one possible embodiment, the temperature of the heating element is adjustable based on the flow rate.
For example, to achieve a desired humidification output in a heated and humidified gas stream delivered to a patient, depending on the application of HFNC, NIV or INV, >12 or 33 mg/l (i.e. more than 12 or 33 mg of water vapor per liter of gas), the temperature of the heating element for heating the fluid stored in the chamber needs to be controlled in a certain reference range. The processor 302 may first coarse tune the temperature of the heating element to an approximation by:
T heating etement (t)a n ·Q(t) n +a n-1 ·Q(t) n-1 +a n-2 Q(t) n-2 +…+a 1 Q(t)+a 0
wherein T is heating element (t) is the temperature of the heating element at time t; q (t) is the flow rate of the gas through the chamber at time t, where the flow rate herein refers to the flow rate of the gas before heating and humidification; a, a n ,a n-1 ,a n-2 ,…,a 1 ,a 0 Is a coefficient of a polynomial equation, where n is a positive integer.
In one possible embodiment, the coefficients of the polynomial equation may be obtained by fitting experimental data of a series of experiments and may be pre-stored in memory. For example, the temperature of the heating element when the heated and humidified gas reaches a desired temperature (e.g., 37 degrees celsius) at different gas flow rates may be tested, the value of the gas flow rate and the temperature value of the heating element corresponding to the value of the gas flow rate are recorded, and the relationship between the gas flow rate and the temperature of the heating element is obtained by fitting the recorded value of the gas flow rate and the temperature value of the heating element corresponding to the value of the gas flow rate, thereby obtaining the coefficients of the polynomial equation.
In one possible embodiment, in the above experiments, the flow rate of the gas through the chamber may be controlled from a minimum flow rate to a maximum flow rate in increments, wherein the gas flow rate may range between 2LPM (liters per minute) and 80LPM, and the increments may be 2LPM. For example, when the airflow rate measured by the flow sensor 305 reaches 2LPM, the airflow rate is recorded as 2LPM and the temperature of the heating element is maintained at 37 degrees celsius while the temperature of the airflow delivered to the patient; when the gas flow rate measured by the flow sensor 305 reaches 4LPM (gas flow rate increased by 2 LPM), the gas flow rate is recorded as 4LPM and the temperature of the heating element is maintained at 37 degrees celsius while the temperature of the gas delivered to the patient is maintained; the foregoing steps are repeated until the air flow rate measured by the flow sensor 305 reaches 80LPM. Through such experiments, the temperature of the heating element at which the heated and humidified gas reaches a desired temperature (e.g., 37 degrees celsius body temperature) at different gas flow rates can be obtained, thereby obtaining coefficients of the polynomial equation.
In one possible embodiment, when heating and humidification of the gas delivered to the patient is desired, the processor 302 may read the coefficients stored in the memory 301 and calculate the approximate temperature of the heating element in combination with the gas flow rate according to the above equation. In one possible embodiment, the temperature of the heating element may be in the range of 50 degrees celsius to 90 degrees celsius.
In one possible implementation, the humidifying component 304 may include circuitry that may be connected to the humidifying component and may be configured to communicate with the processor 302 and control the operation of the humidifying component.
After the above-described rough adjustment, the temperature of the heating element may be finely adjusted based on the temperature of the heated and humidified gas. For example, after coarse tuning, if the temperature of the heated and humidified gas has not reached the desired temperature, the processor may further adjust the temperature of the heating element until the measured temperature of the heated and humidified gas reaches the desired temperature. By combining coarse and fine tuning of the heating element, the temperature of the heated and humidified gas stream exiting the chamber accurately reaches the desired temperature.
With the respiratory therapy apparatus described above, mode switching between HFNC and NIV/INV may be achieved according to the ROX index and a preset trigger strategy for switching the operation mode of the apparatus.
As described above, the preset trigger policy is any one of the following: based on a manual trigger strategy, a semi-automatic trigger strategy or a fully automatic trigger strategy. The three strategies differ in that the degree of intervention by the user (i.e. the physician) in the mode switching between the first and second modes of operation is different, i.e. the present disclosure can adjust the degree of control of the device over the mode switching as desired.
In an embodiment of the present disclosure, when the preset trigger policy is based on a manual trigger policy, the processor is further configured to invoke and execute instructions stored in the memory to:
determining whether the ROX index is smaller than a preset value;
when the ROX index is determined to be smaller than the preset value, a first notification is sent to the user terminal, wherein the first notification indicates that the ROX index is smaller than the preset value;
when the ROX index is not smaller than the preset value, sending a second notification to the user terminal, wherein the second notification indicates that the ROX index is not smaller than the preset value;
the mode switching of the device is triggered based on a switching instruction from the user.
In one possible embodiment, the preset value of the ROX index may be 4.88. The threshold may be used to identify patients who may be at high risk of HFNC failure. If the preset value of the ROX index is less than the threshold value, the HFNC mode (i.e., the first operation mode) may need to be switched to the NIV mode or the INV mode (i.e., the second operation mode); if the preset value of the ROX index is equal to or greater than the threshold, the NIV or INV mode may need to be switched to the HFNC mode.
In this embodiment, when it is determined that the ROX index is less than the preset value, the processor may send a first notification to the user terminal, where the first notification indicates that the ROX index is less than the preset value; when it is determined that the ROX index is not less than the preset value, the processor may send a second notification to the user terminal, wherein the second notification indicates that the ROX index is not less than the preset value. Upon receiving the first notification, the user terminal may alert the user (e.g., doctor) that the ROX index is below or not below a preset value, so that the user may be alerted that the patient may or may not be at high risk of HFNC failure, so that the user may determine whether a mode switch is needed based on the first notification or the second notification.
For example, after the user is reminded by the user terminal that the ROX index is less than or not less than a preset value, the user may trigger a switching instruction through the user terminal to switch the operation mode of the device. In this example, the user already knows the current operating mode of the device. The user terminal may also acquire the operation mode of the device based on communication with the device, e.g. by means of a request and a response, if the user is unaware of the current operation mode of the device, and the user then knows the current operation mode of the device from his user terminal.
For another example, after the user is alerted by the user terminal that the ROX index is less than or not less than a preset value, the user may visit the patient to learn the actual physical condition of the patient and the operating mode of the device, and further determine whether a mode switch is required based on the operating mode of the device and the actual physical condition of the patient. If the user determines to switch the operating mode of the device, the user may trigger a switch instruction through an input means on the device, for example, the user may trigger a switch instruction by touching a button on the device to generate a switch instruction, and the device may then switch modes based on the generated switch instruction. Alternatively, the user may trigger a switching instruction via the user terminal, e.g. the user may trigger a switching instruction by touching a control on the screen of the terminal device or a button on the terminal device, and the terminal device may then generate and send the switching instruction to the device, which may switch its operation mode once the respiratory therapy device receives the switching instruction from the user.
In a possible embodiment, the switching instruction instructs to switch from the first operation mode to the second operation mode when the device is in the first operation mode; the switch instruction instructs switching from the second operation mode to the first operation mode when the device is in the second operation mode.
With the respiratory therapy apparatus in this embodiment, the ROX index that can reflect the physical condition of the patient can be automatically monitored and timely notified to the user for providing the user with a basis for determining whether to perform mode switching, so that the user can understand the change of the ROX index without frequent visit to the patient, and the user can further timely respond appropriately, so that the patient can be timely treated.
In an embodiment of the present disclosure, when the preset trigger policy is a semi-automatic trigger policy, the processor is further configured to invoke and execute instructions stored in the memory to:
determining whether the ROX index is smaller than a preset value;
determining an operating mode of the device;
when the ROX index is determined to be smaller than the preset value and the equipment is in the first operation mode, sending a third notification to the user terminal, wherein the third notification indicates that the equipment is switched from the first operation mode to the second operation mode;
when the ROX index is not smaller than the preset value and the equipment is in the second operation mode, a fourth notification is sent to the user terminal, wherein the fourth notification indicates that the equipment is switched from the second operation mode to the first operation mode; and
When a switch confirmation instruction from the user terminal is received, the device is switched from the current operation mode to a different operation mode.
In this embodiment, the device may determine an operation mode of the device and determine how to switch the operation mode of the device based on the ROX index and the operation mode of the device to send a third notification or a fourth notification to the user terminal, so that a user (e.g., a doctor) of the user terminal may be alerted that a switch from the first operation mode to the second operation mode may be required, or from the second operation mode to the first operation mode. The user can determine whether to switch modes according to the third notification or the fourth notification, and if the user determines that the current operation mode needs to be switched according to the third notification or the fourth notification, a switching confirmation instruction is sent to the device through the user terminal. Upon receiving a switch confirmation instruction from the user terminal, the processor of the device may control the device to switch from the current operation mode to another operation mode.
By using the respiratory therapy device in this embodiment, the device determines whether to switch the operation mode, and the user only needs to confirm whether to switch the mode, so that the patient can be treated in time, and the burden of the doctor can be reduced.
In an embodiment, when the preset trigger policy is a fully automatic trigger policy, the processor is further configured to invoke and execute instructions stored in the memory to:
determining whether the ROX index is smaller than a preset value;
determining an operating mode of the device;
triggering the device to switch from a first operation mode to a second operation mode when the ROX index is determined to be smaller than a preset value and the device is in the first operation mode; and
triggering the device to switch from the second operation mode to the first operation mode when the ROX index is determined to be not less than the preset value and the device is in the second operation mode.
In this embodiment, the device may determine its operation mode and determine how to switch the operation mode of the device based on the ROX index and the operation mode of the device, and then the device may automatically switch from the first operation mode to the second operation mode when it is determined that the ROX index is less than a preset value and the device is in the first operation mode, or automatically switch from the second operation mode to the first operation mode when it is determined that the ROX index is not less than the preset value and the device is in the second operation mode.
After triggering the mode switch of the device according to any of the above-mentioned preset trigger policies, the user (i.e., doctor) may need to perform a subsequent operation. For example, after switching the device from HFNC mode to NIV mode, the user may need to help the patient wear the ventilation mask; after switching the device from HFNC mode to INV mode, the user may need to insert an endotracheal tube into the patient; after switching the device from INV/NIV mode to HFNC mode, the user may need to assist the patient in donning the nasal oxygen cannula.
As described above, the ROX index is an important indication to determine whether to switch the operation mode of the device, and is obtained based on the first parameter. In the present disclosure, the devices mentioned in the above embodiments may acquire the first parameters including SpO2, fiO2 and RR through different sensors.
In one possible embodiment, the first parameter is measured by a different sensor; the sensors include a first sensor configured to measure blood oxygen saturation (i.e., pulse blood oxygen saturation), a second sensor configured to measure an inspired oxygen fraction, and a third sensor configured to measure respiration rate; the processor is further configured to invoke and execute instructions stored in the memory to:
the ROX index is calculated from the blood oxygen saturation measured by the first sensor, the inhaled oxygen fraction measured by the second sensor, and the respiratory rate measured by the third sensor.
In one possible embodiment, the first sensor is a pulse oximeter, the second sensor is an oxygen concentration sensor, and the third sensor is a flow sensor or a pressure sensor. Blood oxygen saturation is the blood oxygen saturation of the gas delivered to the patient. It should be appreciated that the gas is comprised of oxygen and compressed air and is delivered to the patient to provide respiratory support. Other sensors may also be used to measure the first parameter described above, which is not limited by the present disclosure.
In a possible embodiment, the sensor for acquiring the first parameter is integrated into the device and is in communication with the device, as shown in fig. 5. Fig. 5 is a schematic block diagram five of yet another respiratory therapy apparatus provided in accordance with an embodiment of the present disclosure. Respiratory therapy apparatus 400 includes memory 401, processor 402, bus 403, first sensor 405, second sensor 406, and third sensor 407. In one possible embodiment, respiratory therapy apparatus 400 may include humidification assembly 404 having the same functions as humidification assemblies 204, 204', or 304 shown in fig. 2, 3, and 4, respectively. Similarly, the memory 401, the processor 402, and the bus 403 have the same functions as those of the memory, the processor, and the bus shown in fig. 2, 3, and 4, respectively. The sensors 405 to 407 may be communicatively connected with the processor 402 and the memory 401 via the bus 403 to enable exchange of data with the processor 402 and the memory 401.
In one possible implementation, one or more of the sensors may be an external sensor communicatively coupled to the device.
To obtain the ROX index, in one possible implementation, the processor is further configured to invoke and execute instructions stored in the memory to:
Collecting a plurality of groups of first parameters measured in a preset time interval;
calculating temporary ROX indexes based on the plurality of groups of first parameters respectively;
the temporary ROX index is averaged to obtain the ROX index.
In a possible embodiment, the time interval may be preset by the user via an input means on the device or via the user terminal. For example, input devices include a keyboard and a pointing device (e.g., a mouse or a trackball). For another example, the user may input a preset time interval on the user terminal, and the user terminal may send a message carrying the preset time interval to the device. As described above, by calculating the temporary ROX index based on the sets of first parameters acquired in the preset time interval, respectively, the ROX index can be obtained by averaging the temporary ROX indexes. In this way, the preset time interval can be flexibly set by the user according to the needs and the conditions of different patients, so that the mode switching is more reasonable.
In a possible embodiment, the device may be configured with an emergency mechanism for a method of obtaining a ROX index by averaging temporary ROX indexes. In particular, when the temporary ROX index is too low, the device may trigger the emergency mechanism. In one possible embodiment, the contingency mechanism is triggered when the temporary ROX index is below a second threshold. In one possible implementation, the emergency mechanism is: when the temporary ROX index is lower than the second threshold, the device triggers the mode switching not according to the ROX index obtained by averaging the temporary ROX index and the preset trigger policy, but according to the temporary ROX index and the preset trigger policy. In a possible embodiment, the second threshold may be preset by the user. In a possible embodiment, the contingency mechanism may be cancelled when the ROX index is equal to or greater than the second threshold, i.e. the device may trigger a mode switch according to the ROX index obtained by averaging the temporary ROX index and the trigger policy.
Fig. 6 is a schematic flow chart of a respiratory therapy method provided according to an embodiment of the present disclosure, which may be applied to a respiratory therapy apparatus provided according to an embodiment of the present disclosure. As mentioned above, the respiratory therapy apparatus is configured with at least two modes of operation, including a first mode of operation that provides HFNC support for the patient and a second mode of operation that provides NIV support or INV support for the patient. The method comprises the following steps:
step S601, the device acquires a ROX index based on the first parameter; and
step S602, the device triggers mode switching of the device according to the ROX index and a preset trigger policy for switching the operation mode of the device.
As in the previous examples, the ROX index is the ratio of pulse oximetry/fraction of inhaled oxygen to respiration rate (i.e., spO2/FiO2/RR, where "/" represents divisor), and the first parameters used to obtain the ROX index include SpO2, fiO2 and RR.
In one possible embodiment, the first parameter may be obtained from a different sensor. In one possible embodiment, the different sensors include a first sensor configured to measure blood oxygen saturation, a second sensor configured to measure an inspired oxygen fraction, and a third sensor configured to measure respiration rate.
In a possible implementation manner, the step S601 of obtaining, by the device, a ROX index based on the first parameter may include:
the apparatus calculates a ROX index based on the blood oxygen saturation measured by the first sensor, the fraction of inhaled oxygen measured by the second sensor, and the respiratory rate measured by the third sensor.
In this embodiment, the apparatus may calculate the ROX index from the blood oxygen saturation measured by the first sensor, the inhaled oxygen fraction measured by the second sensor, and the respiratory rate measured by the third sensor, thereby obtaining the ROX index.
In one possible embodiment, the first sensor is a pulse oximeter, the second sensor is an oxygen concentration sensor, and the third sensor is a flow sensor or a pressure sensor. It should be understood that other sensors may be employed to measure the first parameter, as this disclosure is not limited in this regard. In a possible embodiment, the sensor for acquiring the first parameter is integrated into the device and is in communication with the device. In one possible implementation, one or more of the sensors may be an external sensor communicatively coupled to the device.
In a possible embodiment, the step S601 of the device obtaining the ROX index based on the first parameter may include the following steps (as shown in fig. 7):
Step S701, the equipment collects a plurality of groups of first parameters measured in a preset time interval;
step S702, the apparatus calculates temporary ROX indexes based on the plurality of sets of first parameters, respectively;
in step S703, the apparatus averages the temporary ROX index to obtain the ROX index.
In this embodiment, the apparatus may collect a plurality of sets of first parameters measured during a preset time interval before calculating the ROX index based on the first parameters. In a possible embodiment, the time interval may be preset by the user via an input means on the device or via the user terminal. For example, input devices include a keyboard and a pointing device (e.g., a mouse or a trackball). For another example, the user may enter a preset time interval on the user terminal, which may then be sent to the device with the preset time interval carried in a message.
After acquiring the plurality of sets of first parameters, the apparatus may calculate the temporary ROX index based on the plurality of sets of first parameters, respectively, i.e., calculate the temporary ROX index for each of the plurality of sets of first parameters, so as to acquire the temporary ROX index corresponding to the plurality of sets of first parameters. The ROX index is obtained by averaging the temporary ROX index. The ROX index obtained by averaging the temporary ROX index is the ROX index according to which the device triggers the mode switching of the device.
In a possible embodiment, the time interval may be preset by the user via an input means on the device or via the user terminal. For example, input devices include a keyboard and a pointing device (e.g., a mouse or a trackball). For another example, the user may enter a preset time interval on the user terminal, which may then be sent to the device with the preset time interval carried in a message. As described above, by calculating the temporary ROX index based on the sets of first parameters acquired in the preset time interval, respectively, the ROX index can be obtained by averaging the temporary ROX indexes. In this way, the preset time interval can be flexibly set by the user according to the needs and the conditions of different patients, so that the time for switching the modes is more reasonable.
In one possible embodiment, the respiratory therapy method may include an emergency mechanism for a method of obtaining a ROX index by averaging temporary ROX indices. In particular, when the temporary ROX index is too low, the device may trigger the emergency mechanism. In one possible embodiment, the contingency mechanism is triggered when the temporary ROX index is below a second threshold. In one possible implementation, the emergency mechanism is: when the temporary ROX index is lower than the second threshold, the device triggers the mode switching not according to the ROX index obtained by averaging the temporary ROX index and the preset trigger policy, but according to the temporary ROX index and the preset trigger policy. In a possible embodiment, the second threshold may be preset by the user. In a possible embodiment, the contingency mechanism may be cancelled when the ROX index is equal to or greater than the second threshold, i.e. the device may trigger a mode switch according to the ROX index obtained by averaging the temporary ROX index and the trigger policy.
In a possible embodiment, after acquiring the ROX index based on the first parameter according to the above method, the mode switching of the device between the first operation mode and the second operation mode may be triggered by the device according to the ROX index and a preset trigger policy for switching the operation mode of the device. In a possible implementation manner, the preset trigger policy may be any one of the following: based on a manual trigger strategy, a semi-automatic trigger strategy or a fully automatic trigger strategy.
In a possible embodiment, when the preset trigger policy is based on a manual trigger policy, the step S602 of triggering the mode switching of the device according to the ROX index and the preset trigger policy for switching the operation mode of the device may include the steps of (as shown in fig. 8):
step S801, the apparatus determines whether the ROX index is smaller than a preset value;
step S802, when the ROX index is smaller than a preset value, the device sends a first notification to the user terminal, wherein the first notification indicates that the ROX index is smaller than the preset value;
step S803, when the ROX index is not smaller than the preset value, the device sends a second notification to the user terminal, wherein the second notification indicates that the ROX index is not smaller than the preset value;
In step S804, the device triggers a mode switch of the device based on a switch instruction from the user.
As described above, the preset value of the ROX index may be 4.88. The threshold may be used to identify patients who may be at high risk of HFNC failure. In one possible implementation, the threshold may be preset by the user.
In this embodiment, a determination is made as to whether or not the ROX index is less than a preset value. When the device determines that the ROX index is less than the preset value, a first notification is sent to the user terminal to alert the user via the user terminal that the ROX index is less than the preset value (i.e., the patient may be at a high risk of HFNC failure), and the user may then determine whether a mode switch is required based on the first notification. When the device determines that the ROX index is not less than the preset value, a second notification is sent to the user terminal to alert the user via the user terminal that the ROX index is not less than the preset value (i.e., the patient may not be at high risk of HFNC failure), and the user may then determine whether a mode switch is required based on the second notification.
For example, after the user is reminded by the user terminal that the ROX index is less than or not less than a preset value, the user may trigger a switching instruction through the user terminal to switch the operation mode of the device. In this example, the user already knows the current operating mode of the device. The user terminal may also acquire the operation mode of the device based on communication with the device, e.g. in a request and response, if the user is unaware of the current operation mode of the device, and the user then knows the current operation mode of the device from his user terminal.
For another example, after the user is alerted by the user terminal that the ROX index is less than or not less than a preset value, the user may visit the patient to learn the actual physical condition of the patient and the operating mode of the device, and further determine whether a mode switch is required based on the operating mode of the device and the actual physical condition of the patient. If the user determines to switch the operating mode of the device, the user may trigger a switch instruction through an input means on the device, for example, the user may trigger a switch instruction by touching a button on the device to generate a switch instruction, and the device may then switch modes based on the generated switch instruction. Alternatively, the user may trigger a switching instruction via the user terminal, e.g. the user may trigger a switching instruction by touching a control on the screen of the terminal device or a button on the terminal device, and the terminal device may then generate and send the switching instruction to the device, which may switch its operation mode once the respiratory therapy device receives the switching instruction from the user.
In a possible embodiment, the switching instruction instructs to switch from the first operation mode to the second operation mode when the device is in the first operation mode; the switch instruction instructs switching from the second operation mode to the first operation mode when the device is in the second operation mode.
According to the respiratory therapy method, by acquiring the ROX index based on the first parameter and triggering the mode switching of the device according to the ROX index and the preset trigger strategy for switching the operation mode of the device, the ROX index capable of reflecting the physical condition of the patient can be automatically monitored and timely notified to the user for providing the basis for determining whether to perform the mode switching for the user, so that the user can know the change of the ROX index without frequently checking the device, and can further timely respond appropriately, so that the patient can obtain timely therapy.
In a possible embodiment, when the preset trigger policy is a semiautomatic trigger policy, the step S602 of triggering the mode switching of the device according to the ROX index and the preset trigger policy for switching the operation mode of the device may include the steps of:
s901 the apparatus determines whether the ROX index is less than a preset value;
s902, the device determines an operation mode of the device;
s903, when the ROX index is smaller than a preset value and the equipment is in a first operation mode, sending a third notification to the user terminal, wherein the third notification indicates that the equipment is switched from the first operation mode to a second operation mode;
S904, when the ROX index is not smaller than a preset value and the equipment is in a second operation mode, a fourth notification is sent to the user terminal, wherein the fourth notification indicates that the equipment is switched from the second operation mode to the first operation mode; and
s905, when the apparatus receives a switching confirmation instruction from the user terminal, the apparatus switches from the current operation mode to a different operation mode.
In one possible embodiment, as shown in fig. 9A, fig. 9A is a schematic flow chart of a semi-automatic triggering strategy for triggering a mode switch of a respiratory therapy device. In step S901, a determination is made as to whether or not the ROX index is smaller than a preset value (e.g., 4.88). In step S902, the device may determine the operation mode in which it is currently located. It should be noted that, step S902 may be performed before step S901 is performed, may be performed after step S901 is performed, or may be performed during step S901 is performed, which is not limited by the embodiment of the present disclosure. Based on the determination results of steps S901 and S902, the apparatus may send a third notification or a fourth notification to the user terminal to alert the user via the user terminal that a mode switch between the first operation mode and the second operation mode may need to be performed.
Specifically, in step S903, when it is determined that the ROX index is less than the preset value (i.e., the patient may be at a high risk of HFNC failure) and the device is currently in the first operation mode (i.e., HFNC mode), the device may send a third notification to the user terminal to alert the user via the user terminal that a switch from the first operation mode (HFNC mode) to the second operation mode (NIV mode or INV mode) may be required, and then the user may confirm whether or not to make the switch from the first operation mode to the second operation mode through the user terminal. In one possible scenario, where the ROX index is less than the preset value but the device is not in the first mode of operation, i.e. the patient may be at high risk of HFNC failure but the device is in NIV/INV mode (i.e. the second mode of operation), it may be necessary to switch modes of operation. For example, when the ROX index is less than a preset value and the device is in NIV mode, but the patient's physical condition may deteriorate, INV support is required; for another example, when the ROX index is less than the preset value and the device is in INV mode, but the patient's physical condition may improve, NIV support is required. In view of these circumstances, in one possible implementation, the device may send a notification only if the ROX index is less than a preset value, where the notification indicates that the ROX index is less than the preset value. Accordingly, the step S602 of triggering the mode switching of the device according to the ROX index and the preset trigger strategy for switching the operation mode of the device may further comprise a step S906 as shown in fig. 9B, fig. 9B being a schematic flow chart of the other half of the automatic trigger strategy for triggering the mode switching of the respiratory therapy device. When the device determines in step S901 that the ROX index is less than the preset value and in S902 that it is in the second operation mode, the device sends a fifth notification to the user terminal in step S906 to alert the user that the ROX index is less than the preset value so that the user can be alerted to visit the patient to know the physical condition of the patient and the user can decide to upgrade the treatment from NIV mode to INV mode or to degrade the treatment from INV mode to NIV mode.
Specifically, in step 904, when it is determined that the ROX index is not less than the preset value and the device is in the second operation mode, the device may send a fourth notification to the user terminal to alert the user via the user terminal that a mode switch from the second operation mode to the first operation mode may be required, and then the user may confirm whether or not to make a mode switch from the second operation mode to the first operation mode through the user terminal. In one possible scenario, the ROX index is not less than the preset value and the device is not in the second mode of operation, i.e. HFNC mode is required and the device is currently in HFNC mode. In this case, the device need not send a notification to the patient. Accordingly, step S602 of triggering the mode switching of the device according to the ROX index and the preset trigger policy for switching the operation mode of the device may further include step S907 as shown in fig. 8B. When the device determines that the ROX index is not less than the preset value in step S901 and the device determines that it is in the first operation mode in step S902, the device stays in its current operation mode, i.e., the device stays in the first operation mode in step S907.
According to the third notification or the fourth notification, the user may confirm whether to trigger a mode switch between the first operation mode and the second operation mode by sending a switch confirmation instruction to the device via the user terminal, or directly via an input means or a button on the device, whereby the device switches from the current operation mode to a different operation mode upon receiving the switch confirmation instruction from the user terminal.
In a possible embodiment, the step of determining the operation mode of the device may be performed after the step of determining whether the ROX index is smaller than a preset value. In this case, a determination is made as to whether or not the ROX index is smaller than a preset value, and then the current operation mode of the apparatus is determined based on the determination result as to whether or not the ROX index is smaller than the preset value.
In this embodiment, when the ROX index is less than the preset value, the device continues to determine whether the current operation mode is the first operation mode, and in a scenario where the ROX index is less than the preset value, when the current operation mode of the device is in the first operation mode, i.e., provided that the device determines that the ROX index is less than the preset value (i.e., the patient may be at a high risk of HFNC failure) and the device is currently in the first operation mode (i.e., HFNC mode), the device may send a third notification to the user terminal to alert the user via the user terminal that a user may need to switch from the first operation mode (HFNC mode) to the second operation mode (NIV mode or INV mode), and then the user may confirm whether a mode switch from the first operation mode to the second operation mode is made by the user terminal.
When the ROX index is not less than a preset value (i.e., the ROX index is equal to or greater than the preset value), the device continues to determine whether the current operation mode is in the second operation mode, and in a scenario in which the ROX index is not less than the preset value, when the current operation mode of the device is in the second operation mode, i.e., provided that the device determines that the ROX index is not less than the preset value (i.e., the patient may not be at a high risk of HFNC failure) and the device is currently in the second operation mode (NIV mode or INV mode), the device may send a fourth notification to the user terminal to alert the user via the user terminal that a mode switch from the second operation mode to the first operation mode may be required, and then the user may confirm whether a mode switch from the second operation mode to the first operation mode may be made through the user terminal.
According to the third notification or the fourth notification, the user may confirm whether to trigger a mode switch between the first operation mode and the second operation mode by sending a switch confirmation instruction to the device through the user terminal, so that the device switches from the current operation mode to a different operation mode when receiving the switch confirmation instruction from the user terminal.
In one possible implementation, the user terminal, upon receiving the notification (third notification or fourth notification), displays the operation mode to be switched to, and displays the "confirm" and "cancel" buttons. The user of the user terminal may press a "confirm" button to cause the user terminal to send a "confirm" instruction (i.e., a handover confirm instruction) to the device; alternatively, the user may select a "cancel" button, causing the user terminal to send a "cancel" instruction to the device (i.e., a switch cancel instruction indicating that the mode switch of the device is canceled). In one possible implementation, the device maintains the current mode of operation when the device receives a handover cancel instruction from the user terminal.
In this embodiment, the device determines whether to switch the operation mode, and the user only needs to confirm whether to perform mode switching, so that not only can the patient be treated in time, but also the burden of the doctor can be reduced.
In a possible embodiment, when the preset trigger policy is a fully automatic trigger policy, the step S602 of triggering the mode switching of the device according to the ROX index and the preset trigger policy for switching the operation mode of the device may include the steps of:
s1001, the apparatus determines whether the ROX index is less than a preset value;
s1002, the device determines an operation mode of the device;
s1003, when it is determined that the ROX index is less than the preset value and the device is in the first operation mode, switching the device from the first operation mode to the second operation mode; and
s1004, when it is determined that the ROX index is not less than the preset value and the apparatus is in the second operation mode, the apparatus switches from the second operation mode to the first operation mode.
In one possible embodiment, as shown in fig. 10A, it is a schematic flow chart of a fully automatic triggering strategy for triggering a mode switch of a respiratory therapy device. Similar to the semiautomatic trigger strategy, in the fully automatic trigger strategy, in step S1001, a determination is made as to whether the ROX index is smaller than a preset value (e.g., 4.88). In step S1002, the device may determine the operation mode in which it is currently located. It should be noted that, step S1002 may be performed before step S1001 is performed, may be performed after step S1001 is performed, or may be performed during step S1001 is performed, which is not limited in the embodiments of the present disclosure.
The difference between the semiautomatic trigger strategy and the full-automatic trigger strategy is that in the full-automatic trigger strategy, the device automatically triggers the mode switching according to the requirement, and user confirmation is not needed. Based on the determination results of steps S1001 and S1002, the apparatus may trigger a mode switch between the first operation mode and the second operation mode. Specifically, when it is determined that the ROX index is less than the preset value and the apparatus is in the first operation mode, the apparatus switches from the first operation mode to the second operation mode (step S1003); and when it is determined that the ROX index is not less than the preset value and the apparatus is in the second operation mode, the apparatus switches from the second operation mode to the first operation mode (step S1004).
In contrast, in the case where the ROX index is less than the preset value but the device is not in the first operation mode, or in the case where the ROX index is not less than the preset value but the device is not in the second operation mode, the device remains in the current operation mode and does not perform mode switching. Accordingly, the step S602 of triggering the mode switching of the device according to the ROX index and the preset trigger strategy for switching the operation mode of the device may comprise a step S1005 as shown in fig. 10B, fig. 10B being a schematic flow chart of another fully automatic trigger strategy for triggering the mode switching of the respiratory therapy device. When the device determines that the ROX index is less than the preset value in step S1001 but the device is in the second operation mode in step S1002, or when the device determines that the ROX index is not less than the preset value in step S1001 and the device is in the first operation mode in step S1002, the device remains in the current operation mode in step S1005 without mode switching.
In this embodiment, the mode of operation of the device and how to switch the mode of operation of the device may be determined directly and automatically by the device itself, the mode switching may be triggered automatically, so that the user does not need to determine or confirm whether to switch the mode of operation and so that the patient may obtain timely treatment.
The device can switch modes between HFNC mode and NIV/INV mode by any of the three preset strategies.
In one possible embodiment, as described with respect to fig. 2, the apparatus is provided with a humidification assembly configured to humidify the airflow delivered to the patient.
In one possible embodiment, as described with respect to fig. 3, the humidifying assembly includes a temperature sensor configured to measure the temperature of the heating element when the device is operating in the first or second mode of operation, and a heating element connected to the temperature sensor.
In a possible embodiment, as described with respect to fig. 4, the device is provided with a flow sensor configured to measure the flow rate of the gas flow.
In one possible embodiment, the humidity of the gas stream may be adjusted by the humidification assembly based on the flow rate, and more particularly, the humidity of the gas stream may be adjusted by the humidification assembly based on the flow rate by a combination of coarse and fine adjustments as described above.
In this embodiment, the ROX index, the switching of modes of operation using the ROX index, and the three different ventilation modes, including HFNC, NIV, and INV, may all be implemented in a single integrated device to provide timely, appropriate treatment to the patient. In addition, in the embodiment, the three ventilation modes can share the same humidification and heating components and are uniformly controlled by the processor, so that high-precision humidification and temperature control can be realized, and a better clinical effect is obtained.
Further, the present disclosure also provides a non-transitory computer-readable storage medium having stored therein computer-executable instructions that, when executed by a processor, implement a respiratory therapy method according to embodiments of the present disclosure.
It should be understood that the processor in embodiments of the present disclosure may be an integrated circuit chip having signal processing capabilities. The processor may be a general purpose processor, a digital signal processor (Digital Signal Processor, DSP), an application specific integrated circuit (Application Specific Integrated Circuit, ASIC), a field programmable gate array (Field Programmable Gate Array, FPGA) or other programmed logic device, discrete gate or transistor logic device, discrete hardware components. A general purpose processor may be a microprocessor, or the processor may be any conventional processor or the like.
It will be appreciated that the memory in the embodiments of the disclosure may be volatile memory, may be non-volatile memory, and may include both volatile and non-volatile memory. The nonvolatile Memory may be Read-Only Memory (ROM), programmable ROM (PROM), erasable PROM (EPROM), electrically EPROM (EEPROM), or flash Memory. The volatile memory may be random access memory (Random Access Memory, RAM) which acts as an external cache. By way of example and not limitation, many forms of RAM are available, such as Static RAM (SRAM), dynamic RAM (DRAM), synchronous DRAM (SDRAM), double Data Rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), synchronous Link DRAM (SLDRAM), and Direct bus RAM (DR RAM). It should be noted that the memory in the apparatus and methods described herein is intended to comprise, without being limited to, these and any other suitable types of memory.
It should be understood that the above memory is an exemplary, but non-limiting, description. For example, the memory in embodiments of the present disclosure may also be Static RAM (SRAM), dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), synchronous Link DRAM (SLDRAM), direct bus RAM (DR RAM), and the like. That is, the memory in the embodiments of the present disclosure is intended to comprise, without being limited to, these and any other suitable types of memory.

Claims (20)

1. A respiratory therapy apparatus, wherein the apparatus is configured with at least two modes of operation, and the at least two modes of operation include a first mode of operation that provides nasal high flow oxygen therapy (HFNC) support to a patient and a second mode of operation that provides non-invasive ventilation (NIV) support or invasive ventilation (INV) support to a patient;
the device includes a processor and a memory storing instructions, the processor configured to call and execute the instructions stored in the memory to:
acquiring a respiration Rate Oxygenation (ROX) index based on the first parameter; and
and triggering the mode switching of the equipment according to the ROX index and a preset trigger strategy for switching the operation mode of the equipment.
2. The device of claim 1, wherein the device is provided with a humidification assembly configured to humidify an air stream delivered to the patient.
3. The apparatus of claim 2, wherein the humidification assembly includes a temperature sensor and a heating element connected to the temperature sensor, the temperature sensor configured to measure a temperature of the heating element when the apparatus is operating in the first or second modes of operation.
4. A device according to claim 3, wherein the device is provided with a flow sensor configured to measure the flow rate of the airflow.
5. The apparatus of claim 4, wherein the humidity of the gas stream is adjustable by the humidification assembly based on the flow rate.
6. The apparatus of claim 4, wherein a temperature of the heating element is adjustable based on the flow rate.
7. The apparatus of claim 1, wherein the preset trigger policy is one of: based on a manual trigger strategy, a semi-automatic trigger strategy or a fully automatic trigger strategy.
8. The apparatus of claim 7, wherein, when the preset trigger policy is the manual-based trigger policy,
the processor is further configured to invoke and execute the instructions stored in the memory to:
determining whether the ROX index is less than a preset value;
when the ROX index is determined to be smaller than the preset value, a first notification is sent to a user terminal, wherein the first notification indicates that the ROX index is smaller than the preset value;
when the ROX index is not smaller than the preset value, sending a second notification to the user terminal, wherein the second notification indicates that the ROX index is not smaller than the preset value; and
The mode switching of the device is triggered based on a switching instruction from the user.
9. The apparatus of claim 8, wherein,
the switch instruction instructs switching from the first operation mode to the second operation mode when the device is in the first operation mode; and
the switch instruction directs switching from the second mode of operation to the first mode of operation when the device is in the second mode of operation.
10. The device of claim 7, wherein when the preset trigger policy is the semi-automatic trigger policy, the processor is further configured to invoke and execute the instructions stored in the memory to:
determining whether the ROX index is less than a preset value;
determining an operating mode of the device;
when it is determined that the ROX index is less than the preset value and the device is in a first operation mode, sending a third notification to a user terminal, wherein the third notification indicates a switch from the first operation mode to the second operation mode;
when it is determined that the ROX index is not less than the preset value and the device is in the second operation mode, sending a fourth notification to the user terminal, wherein the fourth notification indicates that the second operation mode is switched to the first operation mode; and
When a switching confirmation instruction is received from the user terminal, the device is switched from the current operation mode to a different operation mode.
11. The apparatus of claim 7, wherein, when the preset trigger policy is the fully automatic trigger policy,
the processor is further configured to invoke and execute the instructions stored in the memory to:
determining whether the ROX index is less than a preset value;
determining an operating mode of the device;
triggering the device to switch from the first operation mode to the second operation mode when the ROX index is determined to be less than the preset value and the device is in the first operation mode; and
triggering the device to switch from the second operation mode to the first operation mode when the ROX index is determined to be not less than the preset value and the device is in the second operation mode.
12. The apparatus of claim 1, wherein the first parameter is measured by a different sensor; the sensor includes a first sensor configured to measure blood oxygen saturation, a second sensor configured to measure an inspired oxygen fraction, and a third sensor configured to measure respiration rate; and
The processor is further configured to invoke and execute the instructions stored in the memory to:
the ROX index is calculated from the blood oxygen saturation measured by the first sensor, the inhaled oxygen fraction measured by the second sensor, and the respiratory rate measured by the third sensor.
13. The apparatus of claim 12, wherein the first sensor is a pulse oximeter, the second sensor is an oxygen concentration sensor, and the third sensor is a flow sensor or a pressure sensor.
14. The device of claim 12, wherein the sensor is integrated into the device.
15. The device of claim 12, wherein the sensor is communicatively coupled to the device.
16. The device of claim 1, wherein the processor is further configured to invoke and execute the instructions stored in the memory to:
collecting a plurality of groups of first parameters measured in a preset time interval; and
calculating a temporary ROX index based on the plurality of sets of first parameters, respectively;
and averaging the temporary ROX index to obtain the ROX index.
17. A respiratory therapy method, wherein the method is applied to a device configured with at least two modes of operation, including a first mode of operation providing nasal high flow oxygen therapy (HFNC) support to a patient and a second mode of operation providing non-invasive ventilation (NIV) support or invasive ventilation (INV) support to the patient; wherein the method comprises:
acquiring a respiration Rate Oxygenation (ROX) index based on the first parameter; and
and triggering the mode switching of the equipment according to the ROX index and a preset trigger strategy for switching the operation mode of the equipment.
18. The method of claim 17, wherein the preset trigger strategy is a manually-based trigger strategy;
wherein triggering the mode switching of the device according to the ROX index and the preset trigger policy for switching the operation mode of the device includes:
determining whether the ROX index is less than a preset value;
when the ROX index is determined to be smaller than the preset value, a first notification is sent to a user terminal, wherein the first notification indicates that the ROX index is smaller than the preset value;
when the ROX index is not smaller than the preset value, sending a second notification to the user terminal, wherein the second notification indicates that the ROX index is not smaller than the preset value; and
The mode switching of the device is triggered based on a switching instruction from the user.
19. The method of claim 17, wherein the preset trigger policy is a semi-automatic trigger policy;
wherein triggering the mode switching of the device according to the ROX index and the preset trigger policy for switching the operation mode of the device includes:
determining whether the ROX index is less than a preset value;
determining an operating mode of the device;
when it is determined that the ROX index is less than the preset value and the device is in a first operation mode, sending a third notification to a user terminal, wherein the third notification indicates a switch from the first operation mode to the second operation mode;
when it is determined that the ROX index is not less than the preset value and the device is in the second operation mode, sending a fourth notification to the user terminal, wherein the fourth notification indicates that the second operation mode is switched to the first operation mode; and
when a switching confirmation instruction is received from the user terminal, the device is switched from the current operation mode to a different operation mode.
20. The method of claim 17, wherein the preset trigger policy is a fully automatic trigger policy;
Wherein triggering the mode switching of the device according to the ROX index and the preset trigger policy for switching the operation mode of the device includes:
determining whether the ROX index is less than a preset value;
determining an operating mode of the device;
triggering the device to switch from the first operation mode to the second operation mode when the ROX index is determined to be less than the preset value and the device is in the first operation mode; and
triggering the device to switch from the second operation mode to the first operation mode when the ROX index is determined to be not less than the preset value and the device is in the second operation mode.
CN202380010072.1A 2023-02-02 2023-02-02 Respiratory therapy apparatus and method Pending CN117042825A (en)

Applications Claiming Priority (1)

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PCT/US2023/061818 WO2024144891A1 (en) 2022-12-28 2023-02-02 Device and method for respiratory therapy

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