CN117531083A - Nitric oxide gas supply method and device - Google Patents
Nitric oxide gas supply method and device Download PDFInfo
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- CN117531083A CN117531083A CN202311833497.0A CN202311833497A CN117531083A CN 117531083 A CN117531083 A CN 117531083A CN 202311833497 A CN202311833497 A CN 202311833497A CN 117531083 A CN117531083 A CN 117531083A
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- MWUXSHHQAYIFBG-UHFFFAOYSA-N Nitric oxide Chemical compound O=[N] MWUXSHHQAYIFBG-UHFFFAOYSA-N 0.000 title claims abstract description 257
- 238000000034 method Methods 0.000 title claims abstract description 28
- 230000029058 respiratory gaseous exchange Effects 0.000 claims abstract description 125
- 230000000241 respiratory effect Effects 0.000 claims abstract description 47
- 238000001914 filtration Methods 0.000 claims description 19
- 238000004519 manufacturing process Methods 0.000 claims description 18
- 238000001514 detection method Methods 0.000 claims description 8
- 230000003434 inspiratory effect Effects 0.000 claims description 8
- 238000012935 Averaging Methods 0.000 claims description 3
- 230000006698 induction Effects 0.000 claims description 3
- 238000000746 purification Methods 0.000 claims 2
- 238000002716 delivery method Methods 0.000 claims 1
- 239000007789 gas Substances 0.000 abstract description 235
- MGWGWNFMUOTEHG-UHFFFAOYSA-N 4-(3,5-dimethylphenyl)-1,3-thiazol-2-amine Chemical compound CC1=CC(C)=CC(C=2N=C(N)SC=2)=C1 MGWGWNFMUOTEHG-UHFFFAOYSA-N 0.000 abstract description 13
- JCXJVPUVTGWSNB-UHFFFAOYSA-N nitrogen dioxide Inorganic materials O=[N]=O JCXJVPUVTGWSNB-UHFFFAOYSA-N 0.000 abstract description 13
- 230000033764 rhythmic process Effects 0.000 abstract description 10
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- 238000005399 mechanical ventilation Methods 0.000 abstract description 5
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- 239000012071 phase Substances 0.000 description 96
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- 239000001301 oxygen Substances 0.000 description 7
- 229910052760 oxygen Inorganic materials 0.000 description 7
- 230000001225 therapeutic effect Effects 0.000 description 5
- OKTJSMMVPCPJKN-UHFFFAOYSA-N Carbon Chemical compound [C] OKTJSMMVPCPJKN-UHFFFAOYSA-N 0.000 description 4
- 230000005540 biological transmission Effects 0.000 description 4
- 238000009423 ventilation Methods 0.000 description 4
- 238000010586 diagram Methods 0.000 description 3
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- 239000012535 impurity Substances 0.000 description 3
- 230000002685 pulmonary effect Effects 0.000 description 3
- 238000001179 sorption measurement Methods 0.000 description 3
- 210000003556 vascular endothelial cell Anatomy 0.000 description 3
- 238000010521 absorption reaction Methods 0.000 description 2
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- 239000000463 material Substances 0.000 description 2
- 230000007246 mechanism Effects 0.000 description 2
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- 206010001052 Acute respiratory distress syndrome Diseases 0.000 description 1
- 206010020772 Hypertension Diseases 0.000 description 1
- 206010021143 Hypoxia Diseases 0.000 description 1
- CBENFWSGALASAD-UHFFFAOYSA-N Ozone Chemical compound [O-][O+]=O CBENFWSGALASAD-UHFFFAOYSA-N 0.000 description 1
- 206010064911 Pulmonary arterial hypertension Diseases 0.000 description 1
- 208000013616 Respiratory Distress Syndrome Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 239000002250 absorbent Substances 0.000 description 1
- 230000002745 absorbent Effects 0.000 description 1
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- 150000004767 nitrides Chemical class 0.000 description 1
- 238000006213 oxygenation reaction Methods 0.000 description 1
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- HUAUNKAZQWMVFY-UHFFFAOYSA-M sodium;oxocalcium;hydroxide Chemical compound [OH-].[Na+].[Ca]=O HUAUNKAZQWMVFY-UHFFFAOYSA-M 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
- A61M16/022—Control means therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/105—Filters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/12—Preparation of respiratory gases or vapours by mixing different gases
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/20—Valves specially adapted to medical respiratory devices
- A61M16/201—Controlled valves
- A61M16/202—Controlled valves electrically actuated
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/1005—Preparation of respiratory gases or vapours with O2 features or with parameter measurement
- A61M2016/102—Measuring a parameter of the content of the delivered gas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2202/00—Special media to be introduced, removed or treated
- A61M2202/02—Gases
- A61M2202/0266—Nitrogen (N)
- A61M2202/0275—Nitric oxide [NO]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3331—Pressure; Flow
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- Health & Medical Sciences (AREA)
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- Pulmonology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
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- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
Abstract
The application provides a nitric oxide gas supply method and a nitric oxide gas supply device, wherein the gas supply method comprises the following specific steps: generating nitric oxide and acquiring data of the respiratory cycle of the patient; calculating a gas phase threshold for a respiratory cycle based on data for a plurality of patient respiratory cycles; comparing the current gas path flow value with a gas phase threshold value of the breathing cycle, and judging whether the breathing cycle enters a gas sucking phase or not; when the patient enters the inhaled gas phase, the patient is provided with a gas of nitric oxide mixed with air. The mixed gas of nitric oxide and air is delivered in the inspiration phase of the patient, so that the synchronization of the nitric oxide gas supply device and the gas supply rhythm of the invasive breathing machine is ensured, and the false triggering of mechanical ventilation of the invasive breathing machine is avoided. The gas mixed by nitric oxide and air is provided in the inspiration phase, so that nitric oxide and nitric oxide residues in the synchronous pipeline are avoided, the conversion of nitric oxide into nitrogen dioxide is prevented, and the safety of gas supply to patients is improved.
Description
Technical Field
The application relates to the technical field of medical equipment, in particular to a nitric oxide gas supply method and a nitric oxide gas supply device.
Background
Nitric oxide, also known as vascular endothelial cell dilating factor, can be produced by vascular endothelial cells and used as a signal molecule to regulate the activities of other cells and improve the functions of vascular endothelial cells. The nitric oxide with a certain concentration can be inhaled to selectively dilate pulmonary blood vessels, relax the smooth muscle of the trachea and bronchus, reduce the pulmonary artery pressure, improve the pulmonary flow ventilation ratio and oxygenation, has the advantages of quick curative effect, non-invasive injury, high selectivity and the like, is successfully applied to the treatment of continuous hypoxia and pulmonary arterial hypertension of newborns, and is also applied to the treatment of acute respiratory distress syndrome, hypertension and some pulmonary related diseases of adults.
When the nitric oxide gas supply system is clinically used and connected with the invasive ventilator at present, the nitric oxide gas supply system is directly connected to the gas supply system of the invasive ventilator by a common scheme, so that the expected tidal volume of the ventilator is greatly different from the actual tidal volume, the gas supply system of the nitric oxide can interfere with the gas supply rhythm of the invasive ventilator, and the rhythm feedback error of the invasive ventilator is caused. In addition, if nitric oxide gas is continuously supplied in the expiration phase, the concentration of nitric oxide in the ventilation pipeline is too high, the stay time process of nitric oxide is long, and as nitric oxide is unstable gas which is easily oxidized by oxygen, the probability of converting nitric oxide into nitrogen dioxide is increased, the actual concentration of the nitrogen dioxide inhaled by a patient is increased, the nitrogen dioxide is harmful to a human body, and excessive inhalation is unfavorable to the body of the patient.
Disclosure of Invention
The technical problem that this application will solve is that at current nitric oxide gas supply system direct with have the breathing machine of creating and be connected, leads to the gas supply system of nitric oxide can interfere the gas supply rhythm of having the breathing machine of creating, influences the rhythm feedback mistake of having the breathing machine of creating, in addition, exhale and continuously provide nitric oxide and lead to the concentration of nitric oxide to be too high in the ventilation line easily, increase the probability that nitric oxide converted into nitrogen dioxide.
To solve the above problems, or at least partially solve the above technical problems, the present application provides a method and apparatus for nitric oxide gas supply.
In a first aspect, the invention discloses a nitric oxide gas supply method, which comprises the following specific steps:
generating nitric oxide and acquiring data of the respiratory cycle of the patient;
calculating a gas phase threshold for a respiratory cycle based on data for a plurality of patient respiratory cycles;
comparing the current gas path flow value with a gas phase threshold value of the breathing cycle, and judging whether the breathing cycle enters a gas sucking phase or not;
when the patient enters the inhaled gas phase, the patient is provided with a gas of nitric oxide mixed with air.
Preferably, the method further comprises the following steps before generating nitric oxide:
judging whether the type of the breathing machine connected with the patient belongs to an invasive breathing machine, and executing the step of generating nitric oxide when the patient uses the invasive breathing machine.
Preferably, after determining whether the patient's respiratory cycle has entered the inspiratory phase, the method comprises the steps of:
when the patient enters the expiratory phase, nitric oxide is output to the atmosphere.
Preferably, the calculating the gas phase threshold of the breathing cycle based on the data of the breathing cycles of the plurality of patients specifically comprises the following steps:
determining the flow fluctuation amplitude of the air circuit according to the data of the breathing periods of a plurality of patients;
calculating the peak value of the flow fluctuation amplitude according to the flow fluctuation amplitude of the gas circuit to obtain the peak value of the flow amplitude;
and calculating an inspiratory phase threshold based on the peak-to-peak value of the flow amplitude to obtain a gas phase threshold of the respiratory cycle.
Preferably, the comparing the current air path flow value with the gas phase threshold of the breathing cycle, and judging whether the breathing cycle enters the inhaling phase, specifically includes the following steps:
making a difference value with a gas phase threshold value of a breathing cycle according to the current gas path flow value;
when the current gas path flow value is changed from a gas phase threshold value lower than the breathing cycle to a gas phase threshold value higher than the breathing cycle, judging that the breathing cycle of the patient is in a gas sucking phase;
and when the current gas path flow value is changed from a gas phase threshold value higher than the breathing cycle to a gas phase threshold value lower than the breathing cycle, or the gas path flow value is always lower than the gas phase threshold value of the breathing cycle, judging that the breathing cycle of the patient is in the breathing phase.
Preferably, the determining the flow fluctuation amplitude of the air path according to the data of a plurality of patient breathing cycles specifically includes the following steps:
and obtaining the flow fluctuation amplitude of the stable gas circuit by means of averaging and median or filtering for a plurality of stable respiratory cycles.
In a second aspect, the invention also discloses a nitric oxide gas supply device, which comprises a gas production unit, a switching unit, an induction unit and a control unit;
the gas production unit is connected with the switching unit, the sensing unit is connected with the gas outlet of the breathing machine of the patient, and the control unit is respectively connected with the gas production unit, the switching unit and the sensing unit.
Preferably, the medical treatment device comprises a filtering unit and a purifying unit, wherein one end of the filtering unit is connected with the switching unit, the other end of the filtering unit is connected with the patient, one end of the purifying unit is connected with the switching unit, and the other end of the purifying unit is communicated with the external environment.
Preferably, the switching unit comprises a three-way electromagnetic valve, and the three-way electromagnetic valve is respectively connected with the gas production unit, the filtering unit and the purifying unit.
Preferably, a gas concentration detection unit is included, connected to the control unit, which is mounted close to the patient.
Compared with the prior art, the technical scheme provided by the application has the following advantages:
the application provides a nitric oxide gas supply method and a device, in the gas supply method, the gas phase threshold value of the breathing cycle is calculated on the breathing cycle data of a patient, the comparison and judgment are carried out according to the gas phase threshold value of the breathing cycle and the current gas path flow value, whether the breathing cycle of the current patient enters the gas suction phase or not is judged, and when the gas suction phase is entered, the gas mixed with nitric oxide and air is provided for the patient so as to provide treatment for the patient. The mixed gas of nitric oxide and air is delivered in the inspiration phase of the patient, so that the synchronization of the nitric oxide gas supply device and the gas supply rhythm of the invasive breathing machine is ensured, and the false triggering of mechanical ventilation of the invasive breathing machine is avoided. The gas mixed by nitric oxide and air is provided in the inspiration phase, so that nitric oxide and nitric oxide residues in the synchronous pipeline are avoided, the conversion of nitric oxide into nitrogen dioxide is prevented, and the safety of gas supply to patients is improved.
In the gas supply device, the switching unit can switch the direction of nitric oxide gas output, the gas production unit provides nitric oxide gas, the sensing unit is used for sensing and recording the change of flow in the breathing machine, the control unit judges whether to inhale the gaseous phase and whether to output nitric oxide gas to the patient through the output end of the switching unit is controlled to the flow change information that the sensing unit feeds back, the control unit can also control the start-up and the closure of the gas production unit, nitric oxide gas that nitric oxide gas supply device produced only in patient's inhalation phase is carried in the gas transmission branch road of the invasive breathing machine, ensure that nitric oxide gas supply device keeps synchronous with the gas supply rhythm of the invasive breathing machine, avoid the false triggering mechanical ventilation of the invasive breathing machine, nitric oxide gas supply device only provides nitric oxide gas in patient's inhalation phase towards the invasive breathing machine gas transmission branch road, avoid providing nitric oxide in patient's exhalation phase and nitric oxide to remain in the air flue pipe, prevent nitric oxide from converting into nitrogen dioxide, in addition, gas supply device only provides nitric oxide gas in patient's inhalation gas circuit in opposite directions, expiration phase stops providing nitric oxide gas, guarantee that the tidal volume that the invasive breathing machine monitored is accurate.
Drawings
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments consistent with the invention and together with the description, serve to explain the principles of the invention.
In order to more clearly illustrate the embodiments of the invention or the technical solutions of the prior art, the drawings which are used in the description of the embodiments or the prior art will be briefly described, and it will be obvious to a person skilled in the art that other drawings can be obtained from these drawings without inventive effort.
Fig. 1 is a schematic flow chart of a nitric oxide gas supply method provided in the present application;
fig. 2 is a schematic flow chart of step S2 of a nitric oxide gas supply method provided in the present application;
fig. 3 is a schematic flow chart of step S3 of a nitric oxide gas supply method provided in the present application;
FIG. 4 is a waveform schematic diagram of the airway flow values of a ventilator;
FIG. 5 is a waveform schematic diagram of the pneumatic pressure values of a ventilator;
fig. 6 is a schematic structural diagram of a nitric oxide gas supply device provided in the present application.
Reference numerals illustrate:
1. a nitric oxide gas supply device;
11. a gas production unit; 12. a switching unit; 13. an induction unit; 14. a control unit; 15. a filtering unit; 16. a purifying unit; 17. a gas concentration detection unit; 18. a gas mixing unit;
2. a breathing machine.
Detailed Description
For the purposes of making the objects, technical solutions and advantages of the present application more apparent, the technical solutions in the present application will be clearly and completely described below with reference to the drawings in the present application, and it is apparent that the described embodiments are some, but not all, embodiments of the present application. All other embodiments, which can be made by one of ordinary skill in the art without undue burden from the present disclosure, are within the scope of the present application based on the embodiments herein.
In a first aspect, referring to fig. 1, the present invention provides a method for supplying nitric oxide, which specifically includes the steps of:
step S1: generating nitric oxide and acquiring data of the respiratory cycle of the patient;
step S2: calculating a gas phase threshold for a respiratory cycle based on data for a plurality of patient respiratory cycles;
step S3: comparing the current gas path flow value with a gas phase threshold value of the breathing cycle, and judging whether the breathing cycle enters a gas sucking phase or not;
step S4: when the patient enters the inhaled gas phase, the patient is provided with a gas of nitric oxide mixed with air.
Specifically, in step S1, the nitric oxide gas generating mechanism uses air under atmospheric pressure as a gas source, generates nitric oxide gas with a required concentration in a pulse discharge manner, and the breathing machine and the related mechanism record data of a breathing cycle of a patient, wherein the data of the breathing cycle of the patient can facilitate the subsequent judgment of whether the patient is in expiration or inspiration, so as to facilitate the input of nitric oxide gas.
Specifically, in step S2, unstable data exists in the respiratory cycle data of the patient, stable respiratory cycle data needs to be acquired, and a gas phase threshold of the respiratory cycle is calculated to perform subsequent comparison between the current gas path flow value and the gas phase threshold of the respiratory cycle, and stable respiratory cycle data is acquired, so that accuracy in judging the respiratory cycle can be improved.
Specifically, in step S3, whether the patient is in the respiratory phase or the inhalation phase is judged by the flow of the respiratory gas path of the current patient, and the nitric oxide gas supply and the breathing machine gas supply are synchronously implemented, so that the breathing machine realizes man-machine synchronization, and the breathing machine detects the tidal volume more accurately.
Specifically, in step S4, when the patient is judged to enter the inhalation phase, the nitric oxide gas is mixed with the air generated by the ventilator and is delivered to the patient for treatment.
Specifically, in the air supply method, the gas phase threshold value of the breathing cycle is calculated for the breathing cycle data of the patient, the comparison is carried out between the gas phase threshold value of the breathing cycle and the current gas path flow value, whether the breathing cycle of the current patient enters the gas suction phase is judged, and when the gas suction phase is entered, the gas mixed by nitric oxide and air is provided for the patient so as to provide treatment for the patient. The mixed gas of nitric oxide and air is delivered in the inspiration phase of the patient, so that the synchronization of the nitric oxide gas supply device and the gas supply rhythm of the invasive breathing machine is ensured, and the false triggering of mechanical ventilation of the invasive breathing machine is avoided. The gas mixed by nitric oxide and air is provided in the inspiration phase, so that nitric oxide and nitric oxide residues in the synchronous pipeline are avoided, the conversion of nitric oxide into nitrogen dioxide is prevented, and the safety of gas supply to patients is improved.
It will be appreciated that because of the long time inhalation of nitrogen dioxide, which is harmful to the human body, it is desirable to avoid that the patient inhales nitrogen dioxide when connecting the ventilator, which is generally easily generated in the ventilation duct when the patient exhales gas, resulting in inhalation of the patient in the inhalation phase, nitric oxide is not directly mixed with air to be delivered to the patient when the patient enters the exhalation phase until the patient enters the inhalation phase, nitric oxide gas is mixed into air to be delivered to the patient, whether the respiratory cycle is in the inhalation phase is determined by comparing the current gas circuit flow value with the gas phase threshold of the respiratory cycle, nitric oxide can be directly mixed into air to be delivered to the patient when in the inhalation phase,
the method can adaptively and synchronously supply nitric oxide according to the frequency of the air supply of the invasive ventilator, improves the accuracy of the man-machine synchronization of the invasive ventilator and the tidal volume detection of the ventilator, and can be suitable for various crowds and various invasive ventilators and improves the applicability of the method.
Referring to fig. 1, the following steps are further included before step S1:
step S0: judging whether the type of the breathing machine connected with the patient belongs to an invasive breathing machine, and executing the step of generating nitric oxide when the patient uses the invasive breathing machine.
Specifically, the breathing machine is divided into an invasive breathing machine, a non-invasive breathing machine, an oxygen generator, an oxygen inhaler and the like, the non-invasive breathing machine, the oxygen generator and the oxygen inhaler belong to open-type air-path equipment, the open-type air-path equipment does not have the problems of controlling breathing rhythm, overlarge air path pressure, nitric oxide accumulation variation and the like, and the air path of the invasive breathing machine belongs to non-open type air-path equipment, so that the flow or pressure change in the air path is monitored better. When the patient adopts the breathing machine, the invasive breathing machine is adopted to generate nitric oxide gas, the nitric oxide gas is input into the invasive breathing machine, and when the patient is connected with the non-invasive breathing machine, the nitric oxide gas is not input into the breathing machine.
As an embodiment, by arranging a flow sensor or a pressure sensor in the air path, the change of the flow or the pressure in the air path is sensed, when the fluctuation of the flow or the pressure in the air path is in a breathing cycle rule and the amplitude exceeds a certain threshold (namely, the peak value of the pressure or the flow exceeds a certain specific value), the breathing machine is an invasive breathing machine, otherwise, the breathing machine is a noninvasive breathing machine or other open equipment, and the threshold is input in advance by an operator.
Referring to fig. 1, after step S3, the method includes the following steps:
step S5: when the patient enters the expiratory phase, nitric oxide is output to the atmosphere.
Specifically, the patient enters the expiratory phase and is in the expiratory phase, and in order to avoid the residual conversion of nitric oxide into nitrogen dioxide in the gas circuit, the continuous input of nitric oxide needs to be avoided in the phase, and nitric oxide needs to be output to the atmospheric environment due to the continuous generation.
Referring to fig. 2, step S2 specifically includes the following steps:
step S21: determining the flow fluctuation amplitude of the air circuit according to the data of the breathing periods of a plurality of patients;
step S22: calculating the peak value of the flow fluctuation amplitude according to the flow fluctuation amplitude of the gas circuit to obtain the peak value of the flow amplitude;
step S23: and calculating an inspiratory phase threshold based on the peak-to-peak value of the flow amplitude to obtain a gas phase threshold of the respiratory cycle.
Specifically, a stable gas circuit flow fluctuation amplitude is obtained from a plurality of patient respiratory cycle data, a maximum value and a minimum value of the gas circuit flow fluctuation amplitude are collected, a peak-to-peak value of the flow amplitude is obtained, and calculation is performed through a gas phase inhalation threshold calculation formula to obtain a gas phase threshold of the respiratory cycle, namely, b=k×a, wherein B is the gas phase threshold of the respiratory cycle, K is a coefficient, a is the peak-to-peak value of the flow amplitude, and it is understood that the gas phase threshold is equal to the peak-to-peak value of the flow amplitude multiplied by the coefficient, wherein the coefficient is 0.1-0.4, the flow amplitude needs to be determined in a plurality of stable cycles, so that accurate and correct judgment of the data is ensured, and the patient enters the gas phase is performed.
The step S21 specifically includes the following steps:
and obtaining the flow fluctuation amplitude of the stable gas circuit by means of averaging and median or filtering for a plurality of stable respiratory cycles.
Specifically, in order to more accurately acquire that the respiratory cycle of the patient enters the respiratory phase or the respiratory phase, the respiratory cycle needs to be stabilized, the accurate respiratory phase of the patient is determined, nitric oxide is conveniently conveyed in the respiratory phase of the patient, the flow fluctuation amplitude of the stabilized gas circuit is acquired in a mean value, median value or filtering mode, the respiratory cycle is closer to the actual respiratory cycle of the patient, and the acquired data is more accurate.
Referring to fig. 3-4, step S3 specifically includes the following steps:
step S31: making a difference value with a gas phase threshold value of a breathing cycle according to the current gas path flow value;
step S32: when the current gas path flow value is changed from a gas phase threshold value lower than the breathing cycle to a gas phase threshold value higher than the breathing cycle, judging that the breathing cycle of the patient is in a gas sucking phase;
step S33: and when the current gas path flow value is changed from a gas phase threshold value higher than the breathing cycle to a gas phase threshold value lower than the breathing cycle, or the gas path flow value is always lower than the gas phase threshold value of the breathing cycle, judging that the breathing cycle of the patient is in the breathing phase.
Specifically, the gas circuit flow value can be through placing flow sensor at the air feed end of breathing machine, acquires the gaseous phase threshold value of stable breathing cycle, because the air feed end of breathing machine is the same with patient's breathing environment, and the data of acquisition is more accurate. The method comprises the steps that through comparing a gas phase threshold value of a breathing cycle with a current gas path flow value, when the current gas path flow value is changed from a gas phase threshold value lower than the breathing cycle to a gas phase threshold value higher than the breathing cycle, at the moment, the fluctuation amplitude of the gas path flow is in a rapid rising and higher value, the flow in the gas path is rapidly transmitted to a patient, the flow value is increased from a low value to a high value, namely, the patient continuously acquires gas from a breathing machine, the gas path flow value is gradually increased, when the current gas path flow value is changed from the gas phase threshold value higher than the breathing cycle to the gas phase threshold value lower than the breathing cycle, or the gas path flow value is always lower than the gas phase threshold value of the breathing cycle, namely, the patient continuously exhales, the gas is not acquired from the breathing machine, the gas flow value of the patient cannot be increased, the flow value in the gas path can be gradually decreased, the difference point is used for distinguishing the inspiration phase and the breathing phase of the breathing cycle of the patient, and nitric oxide is supplied to the patient in the inspiration phase.
As an example, as shown in fig. 5, the change value of the pressure in the ventilator and the air path may be used to determine whether the patient enters the inspiratory phase, the pressure sensor may be used to collect the current pressure value, the pressure value may be determined to be in the inspiratory phase when the pressure value changes from a low pressure value to a high pressure value, and the pressure value may be determined to be in the expiratory phase when the pressure value changes from the high pressure value to the pressure value.
In a second aspect, referring to fig. 6, the present invention provides a nitric oxide gas supply device 1, which is connected to a ventilator 2 to supply nitric oxide gas to the ventilator 2, wherein the device comprises a gas production unit 11, a switching unit 12, a sensing unit 13, a control unit 14, a filtering unit 15, a purifying unit 16, and a gas concentration detecting unit 17; the gas production unit 11 with the switching unit 12 is connected, and sensing unit 13 connects the gas outlet of patient's breathing machine 2, the control unit 14 is connected gas production unit 11, switching unit 12, sensing unit 13 respectively, filtering unit 15 one end is connected switching unit 12, the other end is connected the patient, purifying unit 16 one end is connected switching unit 12, the other end and external environment intercommunication, gas concentration detection unit 17 with control unit 14 is connected, gas concentration detection unit 17 installs near the patient.
Specifically, in the air supply device, each unit is connected through a pipeline, the air production unit 11 provides nitric oxide air, the sensing unit 13 is used for sensing and recording the flow change in the breathing machine 2, the control unit 14 controls the output end of the switching unit 12 through the flow change information fed back by the sensing unit 13 to judge whether the air is in the gas suction phase or not and whether nitric oxide air is output to a patient, the control unit 14 can also control the starting and closing of the air production unit 11, the switching unit 12 can switch the output direction of nitric oxide air from the purifying unit 16 to the atmosphere or the output direction of nitric oxide air to the patient through the filtering unit 15, the air concentration detecting unit 17 is used for detecting the ratio of various gases in mixed air which is transmitted to the patient, and when harmful gases are detected, the harmful gases are transmitted to the control unit 14 through an electric signal to stop air supply.
It can be understood that the sensing unit 13 senses the change of the flow value in the air path and feeds back the change of the flow value to the control unit 14 through an electric signal, the control unit 14 judges whether the flow belongs to the air suction phase by acquiring the electric signal change of the sensing unit 13, and if the flow belongs to the air suction phase, the switching unit 12 is controlled to flow the therapeutic gas generated by the gas generating module to the filtering unit 15 and then to be delivered to the patient. Otherwise, the switching unit 12 is controlled to flow the therapeutic gas to the purifying unit 16 and then to the atmosphere, so as to realize automatic air supply and synchronous air supply with the breathing machine 2. The nitric oxide gas generated by the nitric oxide gas supply device 1 is only transmitted to the gas transmission branch of the invasive ventilator 2 in the inhalation phase of the patient, so that the nitric oxide gas supply device 1 and the gas supply rhythm of the invasive ventilator 2 are kept synchronous, the false triggering of mechanical ventilation of the invasive ventilator 2 is avoided, the nitric oxide gas supply device 1 only provides nitric oxide gas in the inhalation phase of the patient to the gas transmission branch of the invasive ventilator 2, the nitric oxide is prevented from being provided in the airway tube in the exhalation phase of the patient, the nitric oxide is prevented from being converted into nitrogen dioxide, in addition, the gas supply device only provides nitric oxide gas in the inhalation phase of the patient to the gas path, the nitric oxide gas is stopped being provided in the exhalation phase, and the accurate expiratory tidal volume monitored by the invasive ventilator 2 is ensured.
Before the gas supply device supplies nitric oxide gas to the ventilator 2 used by the patient, the sensing unit 13 first determines the type of the current ventilator 2 according to the variation range and frequency of the flow value, when the fluctuation of the respiratory flow exceeds a certain threshold, the control unit 14 determines that the invasive ventilator 2 is currently used, then the subsequent gas supply is performed, when the respiratory flow is too small, the control unit 14 considers that the respiratory flow is an oxygen inhaler or a noninvasive ventilator 2 or other gas supply equipment, and stops the gas supply of the gas generating unit and the switching unit 12 switches to gas supply to the purifying unit 16.
The sensing unit 13 adopts any one of a flow sensor and a pressure sensor, when the flow sensor or the pressure sensor is adopted, the sensing unit can monitor the flow value of the air path of the air supply end of the breathing machine 2 or the pressure value of the air in the air path in real time through being connected to the air supply end of the breathing machine 2, and send a flow signal or a pressure signal to the control unit 14, and the control unit 14 analyzes and judges whether the current respiratory cycle of the patient is in the respiratory phase or the inhalation phase according to the corresponding signal, so that the corresponding control switching unit 12 performs switching of the output end to output the air.
As an embodiment, the sensing unit 13 may be installed at any position of the air path, and the air path in the pipeline is in the same state, but in this embodiment, the sensing unit 13 is disposed on the air supply end of the ventilator 2 to obtain the best effect, but the location of the sensing unit 13 is not limited to the location in this embodiment.
The switching unit 12 comprises three-way electromagnetic valves, the three-way electromagnetic valves are respectively connected with the gas production unit 11, the filtering unit 15 and the purifying unit 16, one end of each three-way electromagnetic valve receives the gas of the gas production unit 11, the other two ends of each three-way electromagnetic valve output to the filtering unit 15 and the purifying unit 16, the three-way electromagnetic valves are matched with equipment such as a motor, and the like, the time of outputting nitric oxide gas can be controlled by controlling the opening and closing of the output ports of the three-way electromagnetic valves, and when a patient is inhaling, the three-way electromagnetic valves are connected with one end of the filtering unit 15 to output the gas, so that the nitric oxide gas is synchronous with the gas supply of the respirator 2; in addition, the three-way electromagnetic valve is arranged in the switching unit 12, and the opening and closing of the valve can be controlled through an electric signal, so that manual operation is reduced, the equipment is simpler, the automation degree of the device is improved, meanwhile, the reaction speed of the equipment is improved, and nitric oxide output when a patient exhales gas is avoided.
Wherein the gas generating unit takes the nitric oxide gas from the clean air by ionization or other modes, and the gas generating unit continuously works to continuously output the nitric oxide gas to the switching unit 12.
The device comprises a gas mixing unit 18, wherein the gas mixing unit 18 is arranged at a pipeline connection port of a patient and the breathing machine 2 or is worn on a respirator on the patient, and the gas mixing unit 18 is used for fully mixing generated therapeutic gas with mixed gas of oxygen and air supplied by the breathing machine 2 so as to facilitate the absorption of the patient; in addition, the gas mixing unit 18 and the gas concentration detecting unit 17 are arranged on the respiratory tract of the patient, so that the gas concentration detecting unit 17 can obtain the concentration of the therapeutic gas more accurately.
In particular, the purifying unit 16 is filled with an absorbent of nitride, including substances with strong adsorption capacity such as soda lime, activated carbon or charcoal, so as to realize maximum catalysis and absorption of harmful gases discharged to the atmosphere, and ensure that the gases discharged to the atmosphere reach the standard of safe discharge.
In particular, the filtering unit 15 performs gas impurity removal by any one of an adsorption method, a compression adsorption method, and a membrane separation method, and performs filtering impurity removal treatment such as nitrogen dioxide, ozone, residual water vapor, and the like on impurities in the nitric oxide gas generated in the gas generating unit, thereby delivering safe and pure therapeutic gas to the patient.
In the foregoing embodiments, the descriptions of the embodiments are focused on, and for those portions of one embodiment that are not described in detail, reference may be made to the related descriptions of other embodiments.
In the description of the present invention, it should be understood that the terms "center", "longitudinal", "lateral", "length", "width", "thickness", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", "clockwise", "counterclockwise", etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings are merely for convenience in describing the present invention and simplifying the description, and do not indicate or imply that the devices or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present invention.
Furthermore, the terms "first," "second," and the like, are used for descriptive purposes only and are not to be construed as indicating or implying a relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defining "a first" or "a second" may explicitly or implicitly include one or more such feature. In the description of the present invention, the meaning of "a plurality" is two or more, unless explicitly defined otherwise.
In the present invention, unless explicitly specified and limited otherwise, the terms "mounted," "connected," "secured," and the like are to be construed broadly, and may be attached, detached, or integrated, for example; can be mechanically or electrically connected; can be directly connected or indirectly connected through an intermediate medium, and can be communicated with the inside of two elements or the interaction relationship of the two elements. The specific meaning of the above terms in the present invention can be understood by those of ordinary skill in the art according to the specific circumstances.
In the present invention, unless expressly stated or limited otherwise, a first feature "above" or "below" a second feature may include both the first and second features being in direct contact, as well as the first and second features not being in direct contact but being in contact with each other through additional features therebetween. Moreover, a first feature being "above," "over" and "on" a second feature includes the first feature being directly above and obliquely above the second feature, or simply indicating that the first feature is higher in level than the second feature. The first feature being "under", "below" and "beneath" the second feature includes the first feature being directly under and obliquely below the second feature, or simply means that the first feature is less level than the second feature.
In the description of the present specification, a description referring to terms "one embodiment," "some embodiments," "examples," "specific examples," or "some examples," etc., means that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the present invention. In this specification, schematic representations of the above terms should not be understood as necessarily being directed to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, one skilled in the art can combine and combine the different embodiments or examples described in this specification.
It will be apparent to those skilled in the art that various modifications and variations can be made to the present invention without departing from the spirit or scope of the invention. Thus, it is intended that the present invention also include such modifications and alterations insofar as they come within the scope of the appended claims or the equivalents thereof.
While the invention has been described with reference to certain preferred embodiments, it will be understood by those skilled in the art that various changes and substitutions of equivalents may be made and equivalents will be apparent to those skilled in the art without departing from the scope of the invention. Therefore, the protection scope of the invention is subject to the protection scope of the claims.
Claims (10)
1. The nitric oxide gas supply method is characterized by comprising the following specific steps of:
generating nitric oxide and acquiring data of the respiratory cycle of the patient;
calculating a gas phase threshold for a respiratory cycle based on data for a plurality of patient respiratory cycles;
comparing the current gas path flow value with a gas phase threshold value of the breathing cycle, and judging whether the breathing cycle enters a gas sucking phase or not;
when the patient enters the inhaled gas phase, the patient is provided with a gas of nitric oxide mixed with air.
2. The nitric oxide gas supply method according to claim 1, wherein said generating nitric oxide is preceded by the further step of:
judging whether the type of the breathing machine connected with the patient belongs to an invasive breathing machine, and executing the step of generating nitric oxide when the patient uses the invasive breathing machine.
3. The method of nitric oxide delivery according to claim 1, wherein said determining whether the patient's respiratory cycle has entered the inspiratory phase comprises the steps of:
when the patient enters the expiratory phase, nitric oxide is output to the atmosphere.
4. The method of nitric oxide delivery according to claim 1, wherein said calculating a gas phase threshold of a breathing cycle based on data of a plurality of patient breathing cycles, in particular comprises the steps of:
determining the flow fluctuation amplitude of the air circuit according to the data of the breathing periods of a plurality of patients;
calculating the peak value of the flow fluctuation amplitude according to the flow fluctuation amplitude of the gas circuit to obtain the peak value of the flow amplitude;
and calculating an inspiratory phase threshold based on the peak-to-peak value of the flow amplitude to obtain a gas phase threshold of the respiratory cycle.
5. The nitric oxide delivery method according to claim 1, wherein comparing the current flow value of the gas circuit with a gas phase threshold of the breathing cycle, and determining whether the breathing cycle enters the inspiratory phase, comprises the steps of:
making a difference value with a gas phase threshold value of a breathing cycle according to the current gas path flow value;
when the current gas path flow value is changed from a gas phase threshold value lower than the breathing cycle to a gas phase threshold value higher than the breathing cycle, judging that the breathing cycle of the patient is in a gas sucking phase;
and when the current gas path flow value is changed from a gas phase threshold value higher than the breathing cycle to a gas phase threshold value lower than the breathing cycle, or the gas path flow value is always lower than the gas phase threshold value of the breathing cycle, judging that the breathing cycle of the patient is in the breathing phase.
6. The method for nitric oxide delivery according to claim 4, wherein said determining the flow fluctuation amplitude of the gas circuit based on the data of the plurality of patient respiratory cycles comprises the steps of:
and obtaining the flow fluctuation amplitude of the stable gas circuit by means of averaging and median or filtering for a plurality of stable respiratory cycles.
7. The nitric oxide gas supply device is characterized by comprising a gas production unit, a switching unit, an induction unit and a control unit;
the gas production unit is connected with the switching unit, the sensing unit is connected with the gas outlet of the breathing machine of the patient, and the control unit is respectively connected with the gas production unit, the switching unit and the sensing unit.
8. The nitric oxide gas supply device according to claim 7, comprising a filter unit, a purification unit, wherein one end of the filter unit is connected with the switching unit, the other end is connected with the patient, one end of the purification unit is connected with the switching unit, and the other end is communicated with the external environment.
9. The nitric oxide gas supply device according to claim 8, wherein the switching unit comprises a three-way solenoid valve, which is connected to the gas production unit, the filtering unit, and the purifying unit, respectively.
10. The nitric oxide gas supply device according to claim 7, comprising a gas concentration detection unit, said gas concentration detection unit being connected to said control unit, said gas concentration detection unit being mounted close to the patient.
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