CN117653845A - Auxiliary judging method, device, equipment and medium for relevance state of breathing machine - Google Patents
Auxiliary judging method, device, equipment and medium for relevance state of breathing machine Download PDFInfo
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- 230000029058 respiratory gaseous exchange Effects 0.000 title claims abstract description 57
- 238000000034 method Methods 0.000 title claims abstract description 52
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 claims abstract description 174
- 239000001301 oxygen Substances 0.000 claims abstract description 174
- 229910052760 oxygen Inorganic materials 0.000 claims abstract description 174
- 210000004369 blood Anatomy 0.000 claims abstract description 97
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- 230000036760 body temperature Effects 0.000 claims description 18
- 210000000265 leukocyte Anatomy 0.000 claims description 16
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- 238000004891 communication Methods 0.000 claims description 13
- 230000003434 inspiratory effect Effects 0.000 claims description 7
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- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 12
- 230000008569 process Effects 0.000 description 9
- 206010035664 Pneumonia Diseases 0.000 description 7
- 208000009470 Ventilator-Associated Pneumonia Diseases 0.000 description 6
- 238000005070 sampling Methods 0.000 description 5
- 230000005540 biological transmission Effects 0.000 description 4
- 238000012545 processing Methods 0.000 description 4
- 239000003242 anti bacterial agent Substances 0.000 description 3
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- 206010029803 Nosocomial infection Diseases 0.000 description 1
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- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
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Abstract
The invention discloses an auxiliary judging method, device, equipment and medium for the relevance state of a breathing machine, wherein the method comprises the following steps: continuously collecting a first blood oxygen saturation value and a first positive end expiratory pressure value of a monitored object, determining to exclude a ventilator correlation state caused by a specified ventilator when the first blood oxygen saturation value and the first positive end expiratory pressure value meet a first preset condition, continuously collecting an inhaled oxygen concentration value and a second positive end expiratory pressure value of the monitored object, determining a ventilator correlation state caused by the specified ventilator when the inhaled oxygen concentration value and the second positive end expiratory pressure value meet a second preset condition, and determining a ventilator correlation state related to infection caused by the specified ventilator when a first characteristic parameter, a second characteristic parameter and a second blood oxygen saturation value of the detected object meet a third preset condition. The method automatically realizes the real-time monitoring and judgment of the relevance state of the breathing machine and improves the detection efficiency.
Description
Technical Field
The present invention relates to the field of medical apparatuses, and in particular, to a method, an apparatus, a device, and a medium for auxiliary determination of a ventilator correlation state.
Background
Ventilator Associated Pneumonia (VAP) refers to pneumonia of tracheal intubation or tracheotomy patients after receiving mechanical ventilation for 48 hours, and is one of the most common hospital acquired infections of patients in severe medical disciplines, and the incidence and death rate of VAP reported at home and abroad are high. The VAP is monitored by monitoring Ventilator-associated event (VAC), which has good effect in terms of accuracy and objectivity of monitoring result, but the conventional monitoring method for monitoring VAP by VAC mainly relies on manually reading and recording patient sign data from monitoring equipment and evaluating physical state of patient to determine whether the patient has VAP, but the detection of the patient has vaP usually requires a longer monitoring period, and the physical state of patient is continuously changed with time, and the monitoring of the patient has vaP by manually performing the monitoring of the patient has high labor cost and may have missing abnormal state of patient. Therefore, how to automatically realize the real-time monitoring and judgment of the ventilator-related state related to infection caused by the ventilator, and to improve the detection efficiency are the problems to be solved.
Disclosure of Invention
Based on the above, an auxiliary judging method, device, equipment and medium for the relevance state of the breathing machine are provided, so that the problem that how to automatically realize the real-time monitoring and judging of the relevance state of the breathing machine related to infection caused by the breathing machine and improve the detection efficiency is to be solved is solved.
In a first aspect, an embodiment of the present invention provides a method for assisting in determining a ventilator correlation state, where the method for assisting in determining a ventilator correlation state includes the following steps:
continuously collecting a first blood oxygen saturation value and a first end-expiratory positive pressure value of a monitored object wearing a specified breathing machine, and determining to exclude a breathing machine correlation state caused by the specified breathing machine when the first blood oxygen saturation value and the first end-expiratory positive pressure value meet a first preset condition;
continuously collecting an inhalation oxygen concentration value and a second positive end expiratory pressure value of a monitored object wearing the specified ventilator after determining to exclude a ventilator correlation state caused by the specified ventilator, and determining the ventilator correlation state caused by the specified ventilator when the inhalation oxygen concentration value and the second positive end expiratory pressure value meet a second preset condition;
After the ventilator correlation state caused by the appointed ventilator is determined, acquiring a first sign parameter and a second sign parameter of the monitored object, continuously acquiring a second blood oxygen saturation value of the monitored object wearing the appointed ventilator, and determining the ventilator correlation state related to infection caused by the appointed ventilator when the first sign parameter, the second sign parameter and the second blood oxygen saturation value meet a third preset condition.
In a second aspect, an embodiment of the present invention provides an auxiliary determination device for a ventilator correlation state, where the auxiliary determination device for a ventilator correlation state includes:
the first determining module is used for continuously collecting a first blood oxygen saturation value and a first positive end expiratory pressure value of a monitored object wearing a specified breathing machine, and determining to exclude a breathing machine correlation state caused by the specified breathing machine when the first blood oxygen saturation value and the first positive end expiratory pressure value meet a first preset condition;
a second determining module, configured to continuously collect, after determining to exclude a ventilator-related state caused by the specified ventilator, an inhaled oxygen concentration value and a second expiratory positive end pressure value of a monitored subject wearing the specified ventilator, and determine the ventilator-related state caused by the specified ventilator when the inhaled oxygen concentration value and the second expiratory positive end pressure value satisfy a second preset condition;
And the third determining module is used for acquiring the first and second characteristic parameters of the monitored object after determining the breathing machine correlation state caused by the specified breathing machine, continuously acquiring a second blood oxygen saturation value of the monitored object wearing the specified breathing machine, and determining the breathing machine correlation state related to infection caused by the specified breathing machine when the first, second and second characteristic parameters meet a third preset condition.
In a third aspect, an embodiment of the present invention provides a ventilator, including a ventilator body, in which a processor is disposed, and the processor implements the step of the auxiliary determination method for the ventilator correlation state of the first aspect when executing a computer program;
the ventilator further comprises:
an oxygen concentration sensor connected with the processor and used for continuously collecting the inhaled oxygen concentration value of a monitored object wearing the specified breathing machine;
and the pressure sensor is connected with the processor and is used for continuously collecting the end expiratory positive pressure value of the monitored object wearing the specified breathing machine.
In a fourth aspect, an embodiment of the present invention provides a computer readable storage medium storing a computer program which, when executed by a processor, implements the steps of the method for assisting in determining a ventilator dependency status of the first aspect described above.
The invention is different from the technical effects obtained by the prior art scheme: according to the method, through continuously collecting a first blood oxygen saturation value and a first positive end-expiratory pressure value of a monitored object, when the first blood oxygen saturation value and the first positive end-expiratory pressure value meet a first preset condition, determining to exclude a ventilator correlation state caused by a specified ventilator, after determining to exclude the ventilator correlation state caused by the specified ventilator, continuously collecting an inhaled oxygen concentration value and a second positive end-expiratory pressure value of the monitored object, when the inhaled oxygen concentration value and the second positive end-expiratory pressure value meet a second preset condition, determining a ventilator correlation state caused by the specified ventilator, and after determining the ventilator correlation state caused by the specified ventilator, determining a ventilator correlation state related to infection caused by the specified ventilator when a first integral parameter, a second integral parameter and a second blood oxygen saturation value meet a third preset condition. The method comprises the steps of continuously collecting blood oxygen saturation values, end-expiratory positive pressure values and inhalation oxygen concentration values of a monitored object wearing a specified breathing machine, automatically collecting real-time data of the blood oxygen saturation values, the end-expiratory positive pressure values and the inhalation oxygen concentration values of the monitored object, judging the collected data values with preset conditions, automatically monitoring and judging the correlation state of the breathing machine in real time, reducing the risk of complications caused by the breathing machine, improving the objective accuracy of detection results and improving the detection efficiency.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings that are needed in the description of the embodiments of the present invention will be briefly described below, it being obvious that the drawings in the following description are only some embodiments of the present invention, and that other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
Fig. 1 is a flowchart of an auxiliary determination method for a ventilator correlation state according to an embodiment of the present invention;
fig. 2 is a flowchart of an auxiliary determination method for a ventilator correlation state according to a second embodiment of the present invention;
fig. 3 is a flowchart of an auxiliary determination method for a ventilator correlation state according to a third embodiment of the present invention;
fig. 4 is a flowchart of an auxiliary determination method for a ventilator correlation state according to a fourth embodiment of the present invention;
fig. 5 is a flowchart of an auxiliary determination method for a ventilator correlation state according to a fifth embodiment of the present invention;
FIG. 6 is a schematic view of a ventilator according to a sixth, seventh and eighth embodiment of the present invention;
fig. 7 is a schematic structural diagram of an auxiliary judging device for a ventilator correlation state according to a ninth embodiment of the present invention.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and fully with reference to the accompanying drawings, in which it is evident that the embodiments described are some, but not all embodiments of the invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
It should be understood that the sequence numbers of the steps in the following embodiments do not mean the order of execution, and the execution order of the processes should be determined by the functions and the internal logic, and should not be construed as limiting the implementation process of the embodiments of the present invention.
As shown in fig. 1, a flowchart of an auxiliary determination method for a ventilator dependency status according to an embodiment of the present invention is provided, and the embodiment is applicable to diagnosis and prevention of ventilator dependency status, and the method may be executed by a processor built in a ventilator, and the ventilator may be implemented in software and/or hardware, and includes the following steps:
step S101: continuously collecting a first blood oxygen saturation value and a first end-expiratory positive pressure value of a monitored object wearing a specified breathing machine, and determining to exclude a breathing machine correlation state caused by the specified breathing machine when the first blood oxygen saturation value and the first end-expiratory positive pressure value meet a first preset condition.
In this embodiment, the monitored subject may refer to a patient using mechanical ventilation, the patient is usually subjected to tracheal intubation or tracheotomy treatment, the ventilator may refer to a medical device capable of assisting or replacing a respiratory function of the monitored subject, the first blood oxygen saturation value may refer to a concentration value of blood oxygen in blood of the monitored subject continuously collected by the specified ventilator in a period from when ventilation of the monitored subject is started to when a ventilator-related state caused by the specified ventilator is determined to be excluded, the first end-expiratory positive pressure value may refer to an end-expiratory positive pressure value of the monitored subject continuously collected by the specified ventilator in a period from when ventilation of the monitored subject is started to when the ventilator-related state caused by the specified ventilator is determined to be excluded, the first preset condition may be that a continuous monitoring time in which the collected first blood oxygen saturation value and end-expiratory positive pressure are in a preset value range is greater than or equal to a preset time, or a continuous monitoring time in which the collected first blood oxygen saturation value and end-expiratory positive pressure value are less than or equal to a preset value is greater than or equal to a preset time, or equal to a preset value.
For example, in the process of determining to exclude the ventilator correlation state caused by the specified ventilator, the first blood oxygen saturation value and the first expiratory positive end pressure value of the monitored object may be continuously acquired according to a preset acquisition period in a periodic continuous sampling manner, or the first blood oxygen saturation value and the first expiratory positive end pressure value of the monitored object may be acquired in a random continuous sampling manner, and whether the first blood oxygen saturation value and the first expiratory positive end pressure value acquired each time meet a first preset condition may be monitored, and when the first blood oxygen saturation value and the first expiratory positive end pressure value meet the first preset condition, the ventilator correlation state caused by the specified ventilator may be determined to be excluded.
For example, the first blood oxygen saturation value and the first positive end expiratory pressure value of the monitored object are continuously collected in a periodic continuous sampling mode, the preset collection period is 2 hours, and the first preset condition is that the continuous monitoring time of the collected first blood oxygen saturation value being 95% -99% and the first positive end expiratory pressure value being 3-6 cm of water column is greater than or equal to 48 hours. And acquiring a first blood oxygen saturation value and a first positive end expiratory pressure value of the monitored object once every 2 hours sampling period, detecting whether the acquired first blood oxygen saturation value is 95% -99% and the first positive end expiratory pressure value is 3-6 cm of water column, and determining a ventilator correlation state caused by excluding a specified ventilator if the acquired first blood oxygen saturation value is 95% -99% each time and the continuous monitoring time of the acquired first positive end expiratory pressure value is 3-6 cm of water column is greater than or equal to 48 hours each time.
Step S102: after determining to exclude the ventilator-associated state caused by the specified ventilator, continuously collecting an inhaled oxygen concentration value and a second positive end-expiratory pressure value of a monitored subject wearing the specified ventilator, and determining the ventilator-associated state caused by the specified ventilator when the inhaled oxygen concentration value and the second positive end-expiratory pressure value meet a second preset condition.
In this embodiment, the inhalation oxygen concentration value may refer to an inhalation oxygen concentration of the monitoring object continuously collected by the specified ventilator in a period from determining the ventilator-related state caused by the specified ventilator to determining the ventilator-related state caused by the specified ventilator, the second expiratory positive end pressure value may refer to an expiratory positive end pressure value of the monitoring object continuously collected by the specified ventilator in a period from determining the ventilator-related state caused by the specified ventilator to determining the ventilator-related state caused by the specified ventilator, and the second preset condition may refer to a total variation of the inhalation oxygen concentration or a total variation of the second expiratory positive end pressure being greater than or equal to a preset limit value in a preset continuous monitoring time.
For example, in determining the ventilator-related state caused by the specified ventilator, the inhaled oxygen concentration value and the second expiratory positive pressure value of the monitored subject are collected by means of random continuous sampling, firstly, in a preset continuous monitoring time, the variation of the inhaled oxygen concentration value collected randomly each time compared with the inhaled oxygen concentration value collected randomly last time is recorded, and the variation of the second expiratory positive pressure value collected randomly each time compared with the second expiratory positive pressure value collected randomly last time is recorded, then, the total variation of the inhaled oxygen concentration value in a preset time period and the total variation of the second expiratory positive pressure value in the preset time period are calculated, and finally, when the total variation of the inhaled oxygen concentration value in the preset time period is larger than or equal to a preset limiting value, or when the total variation of the second expiratory positive pressure value in the preset time period is larger than or equal to a preset limiting value, the ventilator-related state caused by the specified ventilator is determined.
For example, if the preset time period is 12 hours, in the preset time period, the second positive expiratory pressure value of the monitored object is randomly and continuously collected for 5 times, the preset limit value is 3 cm of water column, and the change amount of the second positive expiratory pressure value randomly collected each time compared with the second positive expiratory pressure value collected last time is sequentially as follows: and adding 2 cm water column, adding 1 cm water column, reducing 2 cm water column, adding 1 cm water column and adding 2 cm water column, calculating to obtain the total change of the second positive end expiratory pressure value by adding 4 cm water column in a preset time period, and determining the ventilator correlation state caused by the specified ventilator if the total change of the second positive end expiratory pressure value is larger than a preset limit value in the preset time period.
Step S103: after the ventilator correlation state caused by the specified ventilator is determined, acquiring a first sign parameter and a second sign parameter of the monitored object, continuously acquiring a second blood oxygen saturation value of the monitored object wearing the specified ventilator, and determining the ventilator correlation state related to infection caused by the specified ventilator when the first sign parameter, the second sign parameter and the second blood oxygen saturation value meet a third preset condition.
In this embodiment, the first and second characteristic parameters may be body temperature parameters, leukocyte parameters, usage parameters of antibacterial drugs, and the like of the monitored subject, the second blood oxygen saturation value may refer to a value of blood oxygen in blood of the monitored subject continuously collected by the specified ventilator in a period from determination of a ventilator-related state caused by excluding the specified ventilator to determination of a ventilator-related state caused by the specified ventilator, the third preset condition may be that the first and second characteristic parameters are in a preset numerical range, and a continuous monitoring time when the collected second blood oxygen saturation value is less than or equal to a preset numerical value is greater than or equal to a preset time, and the like. Specific detection whether the second blood oxygen saturation value satisfies the third preset condition may refer to the specific content of step S101.
In this embodiment, by continuously collecting the first blood oxygen saturation value and the first positive end expiratory pressure value of the monitored subject, when the first blood oxygen saturation value and the first positive end expiratory pressure value satisfy a first preset condition, a ventilator correlation state caused by the specified ventilator is determined to be excluded, after the ventilator correlation state caused by the specified ventilator is determined to be excluded, an inhalation oxygen concentration value and a second positive end expiratory pressure value of the monitored subject are continuously collected, when the inhalation oxygen concentration value and the second positive end expiratory pressure value satisfy a second preset condition, a ventilator correlation state caused by the specified ventilator is determined, and after the ventilator correlation state caused by the specified ventilator is determined, when the first integral parameter, the second integral parameter, and the second blood oxygen saturation value satisfy a third preset condition, a ventilator correlation state related to infection caused by the specified ventilator is determined. The method comprises the steps of continuously collecting blood oxygen saturation values, end-expiratory positive pressure values and inhalation oxygen concentration values of a monitored object wearing a specified breathing machine, automatically collecting real-time data of the blood oxygen saturation values, the end-expiratory positive pressure values and the inhalation oxygen concentration values of the monitored object, judging the collected data values with preset conditions, automatically monitoring and judging the correlation state of the breathing machine in real time, reducing the risk of complications caused by the breathing machine, improving the objective accuracy of detection results and improving the detection efficiency.
As shown in fig. 2, in the second embodiment of the present invention, when the first blood oxygen saturation value and the first positive end expiratory pressure value meet the first preset condition in the first step S101, the method for determining to exclude the ventilator-related state caused by the specified ventilator may include the following steps:
step S201: a first initial value of oxygen saturation and a first initial value of positive end-expiratory pressure are acquired when a specified ventilator begins to ventilate.
In this embodiment, the first initial value of the oxygen saturation may refer to an oxygen saturation value of the subject collected when the specified ventilator starts ventilation, and the first initial value of the positive end-expiratory pressure may refer to an end-expiratory pressure value of the subject collected when the specified ventilator starts ventilation.
Step S202: and determining to exclude a ventilator-related state caused by the specified ventilator when the continuous monitoring time of the first blood oxygen saturation value being less than or equal to the first blood oxygen saturation initial value is greater than or equal to a first preset time and the continuous monitoring time of the first positive end-expiratory pressure value being less than or equal to the first positive end-expiratory pressure initial value is greater than or equal to the first preset time.
In this embodiment, the first preset time may refer to a preset time when the determination excludes the ventilator-related state caused by the specified ventilator.
For example, the initial value of the first blood oxygen saturation is 98%, the initial value of the first positive end expiratory pressure is 5 cm of water, the first preset time is 24 hours, and if the first blood oxygen saturation values continuously monitored within 48 hours are all less than or equal to 98%, and the first positive end expiratory pressure continuously monitored within 48 hours are all less than or equal to 5 cm of water, the ventilator-related state caused by the specified ventilator is determined to be excluded.
In this embodiment, by acquiring a first blood oxygen saturation initial value and a first expiratory positive end pressure initial value of a monitored object acquired when a specified ventilator starts ventilation, when a continuous monitoring time of the first blood oxygen saturation value being less than or equal to the first blood oxygen saturation initial value is greater than or equal to a first preset time, and a continuous monitoring time of the first expiratory positive end pressure value being less than or equal to the first expiratory positive end pressure initial value is greater than or equal to the first preset time, a ventilator correlation state caused by the specified ventilator is determined to be excluded. Through the steps, the real-time monitoring of the blood oxygen saturation value and the end-expiratory positive pressure value of the monitored object is automatically realized, the logic judgment is carried out according to the data obtained by monitoring, the judgment of the physical state of the monitored object is automatically realized, and the detection efficiency is improved.
As shown in fig. 3, a flowchart of an auxiliary determination method for ventilator dependency status provided in the third embodiment of the present invention, in the first embodiment, when the inhaled oxygen concentration value and the second positive end expiratory pressure value meet the second preset condition in step S102, the determining the ventilator dependency status caused by the specified ventilator may include the following steps:
step S301: a second initial value of positive end expiratory pressure and an initial value of inhaled oxygen concentration acquired after determining to exclude a ventilator-related state caused by a specified ventilator are acquired.
In this embodiment, the second initial value of the expiratory positive pressure may refer to the expiratory positive pressure value of the monitored subject collected for the first time after the determination of the ventilator-related state caused by the exclusion of the specified ventilator, and the initial value of the inspiratory oxygen concentration may refer to the inspiratory oxygen concentration value of the monitored subject collected for the first time after the determination of the ventilator-related state caused by the exclusion of the specified ventilator.
Step S302: calculating a first total increment of an inhaled oxygen concentration value and an inhaled oxygen concentration initial value in a preset continuous monitoring time, and calculating a second total increment of a second expiratory positive end pressure value and a second expiratory positive end pressure initial value in the continuous monitoring time.
Step S303: and determining a ventilator correlation state caused by the specified ventilator when the first total increment is greater than or equal to a first preset threshold value or the second total increment is greater than or equal to a second preset threshold value.
In this embodiment, the preset continuous monitoring time may refer to a monitoring time required for determining a ventilator correlation state caused by a specific ventilator, the first total increment may refer to a total increment limit value of the preset inhaled oxygen concentration obtained by adding the obtained total increment of the inhaled oxygen concentration value compared with the previous collected inhaled oxygen concentration value within the preset continuous monitoring time, the second total increment may refer to a total increment limit value of the preset second expiratory positive end pressure obtained by adding and processing the obtained total increment of the second expiratory positive end pressure value compared with the previous collected total increment of the second expiratory positive end pressure within the preset continuous monitoring time, and the first preset threshold value may be the preset total increment limit value of the inhaled oxygen concentration.
For example, if the initial value of the inhaled oxygen concentration is 40%, the preset continuous monitoring time is 48 hours, the first preset threshold value is 20%, after the initial value of the inhaled oxygen concentration is obtained, the continuously collected inhaled oxygen concentration values are sequentially 50%, 60%, 50%, 40%, 50% and 60%, and the first total increment of the inhaled oxygen concentration is calculated to be 20%, then the first total increment is equal to the first preset threshold value, and the ventilator correlation state caused by the specified ventilator can be determined.
In this embodiment, the ventilator-related state caused by the specified ventilator is determined by acquiring a second initial expiratory pressure value acquired after the ventilator-related state caused by the specified ventilator is excluded and an initial inspiratory oxygen concentration value of the monitored subject, calculating a first total increment of the initial inspiratory oxygen concentration value and the initial inspiratory oxygen concentration value within a preset continuous monitoring time, and calculating a second total increment of the initial second expiratory pressure value and the initial second expiratory pressure value within the preset continuous monitoring time, when the first total increment is greater than or equal to a first preset threshold value or the second total increment is greater than or equal to a second preset threshold value. Through the steps, the real-time monitoring of the inhalation oxygen concentration value and the end-expiratory positive pressure value of the monitored object is automatically realized, the logic judgment is carried out according to the data obtained by monitoring, the judgment of the relevance state of the breathing machine is automatically realized, and the detection efficiency is improved.
As shown in fig. 4, a flowchart of an assisted determination method for ventilator dependency status provided in the fourth embodiment of the present invention, in the first embodiment, when the first characteristic parameter, the second characteristic parameter and the second blood oxygen saturation value satisfy the third preset condition in step S103, the determining the ventilator dependency status related to the infection caused by the specified ventilator may include the following steps:
Step S401: a second initial value of blood oxygen saturation acquired after determining to exclude ventilator-related conditions caused by the specified ventilator is acquired.
Step S402: and when the continuous monitoring time of the second blood oxygen saturation value smaller than or equal to the second blood oxygen saturation initial value is larger than or equal to a second preset time, detecting whether the first and second sign parameters meet a third preset condition.
In this embodiment, the second blood oxygen saturation initial value may refer to a blood oxygen saturation value of the monitored subject acquired for the first time after determining that the ventilator-related state caused by the specified ventilator is excluded, and the second preset time may refer to a preset monitoring time for determining the blood oxygen saturation value after determining that the ventilator-related state caused by the specified ventilator is excluded. The first and second physical parameters may be body temperature parameters, leukocyte parameters, or parameters of use of an antibacterial agent, etc. The specific detection that the second blood oxygen saturation value is less than or equal to the second blood oxygen saturation initial value and the continuous monitoring time is greater than or equal to the second preset time can refer to the content in step S202 in the second embodiment, which is not described in detail herein.
Step S403: and if the first and second characteristic parameters meet a third preset condition, determining a ventilator correlation state related to infection caused by the specified ventilator.
In this embodiment, the third preset condition may refer to that the body temperature value of the monitored object is greater than or equal to the preset body temperature value, the number of white blood cells of the monitored object is in the preset white blood cell numerical value range, and the number of days of using the antibacterial agent is greater than or equal to the preset number of days, and if the body temperature value of the monitored object is greater than or equal to the preset body temperature value, the number of white blood cells of the monitored object is in the preset white blood cell numerical value range, and the number of days of using the antibacterial agent is greater than or equal to the preset number of days, the ventilator correlation state related to the infection caused by the specified ventilator is determined.
In this embodiment, by acquiring the second blood oxygen saturation initial value of the monitoring object acquired after determining that the ventilator-related state caused by the specified ventilator is excluded, when the continuous monitoring time of the second blood oxygen saturation value being less than or equal to the second blood oxygen saturation initial value is greater than or equal to the second preset time, it is detected whether the first and second characteristic parameters satisfy the third preset condition, and if the first and second characteristic parameters satisfy the third preset condition, the ventilator-related state caused by the specified ventilator is determined. Through the steps, the real-time monitoring of the blood oxygen saturation value, the first sign parameter and the second sign parameter of the monitored object is automatically realized, the logic judgment is carried out according to the monitored data, and the judgment of the ventilator correlation state related to infection is automatically realized.
As shown in fig. 5, a flowchart of an auxiliary determination method for ventilator relevance status provided in the fifth embodiment of the present invention is shown, and if the first and second characteristic parameters in step S403 in the fourth embodiment satisfy the third preset condition, the determining the ventilator relevance status related to infection caused by the specified ventilator may include the following steps:
step S501: detecting whether the first characteristic parameter is in a first preset range, and detecting whether the second characteristic parameter is in a second preset range, wherein the first characteristic parameter comprises a body temperature parameter, and the second characteristic parameter comprises a leukocyte parameter.
Step S502: if the first characteristic parameter is within a first preset range and the second characteristic parameter is within a second preset range, determining a ventilator-related state associated with the infection caused by the specified ventilator.
In this embodiment, the first preset range may refer to a preset range of body temperature values, and the second preset range may refer to a preset range of white blood cell numbers.
For example, the first preset range is a body temperature of greater than 38 ℃ or a body temperature of less than 36 ℃, and the second preset range is a leukocyte count of greater than or equal to 12000/mm 3 The value of the body temperature parameter is 39 ℃ and the white blood cell number is 12000/mm 3 If the body temperature value is within a first predetermined range and the white blood cell count is within a second predetermined range, a ventilator-associated state associated with the infection by the specified ventilator is determined.
In this embodiment, by detecting whether the first characteristic parameter is within a first preset range and detecting whether the second characteristic parameter is within a second preset range, the first characteristic parameter includes a body temperature parameter, the second characteristic parameter includes a leukocyte parameter, and if the first characteristic parameter is within the first preset range and the second characteristic parameter is within the second preset range, a ventilator correlation status related to infection caused by the specified ventilator is determined. Through the steps, the real-time monitoring of the first and second physical parameters is automatically realized, the logic judgment is carried out according to the monitored data, and the judgment of the infection-related ventilator correlation state caused by the specified ventilator is automatically realized.
Fig. 6 is a schematic structural diagram of a ventilator according to a sixth embodiment of the present invention. As shown in fig. 6, the ventilator 60 includes a ventilator body 61, an oxygen concentration sensor 62, and a pressure sensor 63. The detailed explanation of each structural module is as follows:
A ventilator body 61 having a processor incorporated therein, the processor executing a computer program to implement the steps of the auxiliary determination method for a ventilator correlation state described in any of the above embodiments;
the ventilator further includes:
an oxygen concentration sensor 62 connected to the processor for continuously collecting an inhaled oxygen concentration value of a monitored subject wearing the specified ventilator;
a pressure sensor 63 connected to the processor for continuously collecting the positive end expiratory pressure value of the monitored subject wearing the specified ventilator.
In this embodiment, the respiratory body may be an invasive respiratory body or a noninvasive respiratory body, the processor may refer to a functional unit that interprets and executes instructions, for example, the processor may be a micro-control unit (Microcontroller Unit, MCU), a microprocessor unit (Micro Processor Unit, MPU), or a digital signal processor (Digital Signal Processor, DSP), etc., the oxygen concentration sensor may be used to detect an inhaled oxygen concentration value of the monitored subject, for example, the oxygen concentration sensor may be an electrochemical oxygen sensor, a fluorescent oxygen sensor, an ultrasonic sensor, etc., and the pressure sensor may be used to detect an exhaled breath and a final positive pressure value of the monitored subject, for example, the pressure sensor may be a differential pressure gas pressure sensor, a normal pressure sensor, etc.
The working process of the breathing machine is as follows: the oxygen concentration sensor sends the acquired inhaled oxygen concentration signal of the monitored object and the expiratory positive end pressure signal of the monitored object acquired by the pressure sensor to a processor arranged in the breathing machine body, and the processor carries out logic judgment processing on the received inhaled oxygen concentration signal and the expiratory positive end pressure signal and carries out conversion and output of the processed auxiliary judgment result signal, wherein the logic judgment processing process can refer to the specific content of the auxiliary judgment method of the breathing machine correlation state in the previous embodiment.
In one embodiment, the ventilator further comprises a blood oxygen saturation acquisition module connected to the processor, and a crystal oscillator built in the ventilator body. The blood oxygen saturation acquisition module can be used for acquiring the blood oxygen saturation of a monitoring object, and the crystal oscillator can be used for counting the monitoring time. The blood oxygen saturation signal of the monitored object acquired by the blood oxygen saturation acquisition module is sent to a processor arranged in a breathing organism, the monitoring time signal counted by the crystal oscillator is sent to the processor, the processor carries out logic judgment on the received blood oxygen saturation signal and the monitoring time signal, and the processor converts and outputs the processed auxiliary judgment result.
In this embodiment, the ventilator is provided with a processor to logically determine the collected inhaled oxygen concentration and the expiratory positive end pressure, and is connected to an oxygen concentration sensor of the processor, to collect the inhaled oxygen concentration of the monitored object, and send the collected inhaled oxygen concentration to the processor, and is connected to a pressure sensor of the processor, to collect the expiratory positive end pressure of the monitored object, and send the collected expiratory positive end pressure to the processor. Through the equipment, the real-time monitoring and acquisition of the inhaled oxygen concentration and the expiratory positive terminal pressure of the monitored object and the automatic judgment of the infection-related breathing machine correlation state caused by the appointed breathing machine are automatically realized, so that the objective accuracy of the detection result is improved, and the detection efficiency is also improved.
In a seventh embodiment, a ventilator is provided, and in addition to the ventilator in the sixth embodiment, the ventilator of this embodiment further includes:
the human-computer interaction display is arranged on the breathing machine body, and the output end of the human-computer interaction display is connected with the input end of the processor and is used for sending the first and second physical parameters of the monitored object to the processor.
In this embodiment, the man-machine interaction display may be used for displaying physical parameters of a monitored object, such as an inhaled oxygen concentration value, a blood oxygen saturation value, and an expiratory positive end pressure value, and inputting body temperature parameters, leukocyte parameters, medication information, and the like of the monitored object, for example, the man-machine interaction display may be a liquid crystal display or a plasma display, and the like.
The working process of the man-machine interaction display comprises the following steps: the body temperature parameter signals, the leucocyte parameter signals, the medication information signals and the like of the monitored object acquired by the human-computer interaction display are sent to the processor, the processor carries out logic judgment on the received signals, and auxiliary judgment result signals are sent to the human-computer interaction display.
In one embodiment, if the auxiliary determination result of the processor is a ventilator correlation state related to infection, the processor sends a ventilator correlation state auxiliary determination result signal related to infection to the man-machine interaction display, and the man-machine interaction display outputs early warning information of the ventilator correlation state related to infection.
In this embodiment, the ventilator is provided with a man-machine interaction display, which is used to input the body temperature parameter, the leukocyte parameter, the medication information, etc. of the monitored object, and output the auxiliary determination result of the processor. Through the man-machine interaction display, interaction between related staff and the breathing machine is realized, so that the related staff can timely and clearly know real-time state information of a monitored object, and the detection efficiency is improved.
In an eighth embodiment, a ventilator is provided, and in addition to the ventilator in the sixth embodiment, the ventilator of this embodiment further includes:
the input end of the communication module is connected with the output end of the processor and is used for receiving the output parameters of the processor, the output parameters comprise auxiliary judging results of the relevance state of the breathing machine, and the output end of the communication module is connected with the input end of the processor and is used for sending the first and second sign parameters of the monitored object to the processor.
In this embodiment, the communication module may be used to implement data transmission and interaction between the inside and the outside of the ventilator, where the communication module may include a wired network transmission module or a wireless transmission module, for example, a bluetooth module, a ZigBee wireless communication module, a WiFi module, and the like, and the auxiliary determination result may be a determination of a ventilator correlation state caused by excluding the specified ventilator, a determination of a ventilator correlation state caused by the specified ventilator, and a determination of a ventilator correlation state caused by the specified ventilator and related to infection.
The working process of the communication module is as follows: the communication module receives the first and second sign parameter signals of the monitored object, sends the signals to the processor, receives the auxiliary judgment result signals sent by the processor, and converts the auxiliary judgment result signals to be transmitted in a wired or wireless mode.
In this embodiment, the ventilator is provided with a communication module, which is configured to send the first and second sign parameters of the monitored object to the processor, and receive the auxiliary determination result of the processor. Through the communication module, the physical sign parameters of the monitored object and the auxiliary judgment result are transmitted, and the data transmission efficiency is improved.
As shown in fig. 7, a device for assisting in determining a ventilator correlation state according to a ninth embodiment of the present invention is provided, where the device for assisting in determining a ventilator correlation state corresponds to the method for assisting in determining a ventilator correlation state in the above embodiment one by one. The auxiliary determination device of the ventilator dependency status comprises a first determination module 71, a second determination module 72 and a second determination module 73. The functional modules are described in detail as follows:
a first determining module 71, configured to continuously collect a first blood oxygen saturation value and a first positive end-expiratory pressure value of a monitored subject wearing a specified ventilator, and determine to exclude a ventilator-related state caused by the specified ventilator when the first blood oxygen saturation value and the first positive end-expiratory pressure value satisfy a first preset condition;
a second determining module 72, configured to continuously collect, after determining to exclude the ventilator-related state caused by the specified ventilator, an inhaled oxygen concentration value and a second positive end-expiratory pressure value of a monitored subject wearing the specified ventilator, and determine the ventilator-related state caused by the specified ventilator when the inhaled oxygen concentration value and the second positive end-expiratory pressure value satisfy a second preset condition;
A third determining module 73, configured to acquire a first feature parameter and a second feature parameter of the monitored object after determining the ventilator correlation status caused by the specified ventilator, continuously acquire a second blood oxygen saturation value of the monitored object wearing the specified ventilator, and determine the ventilator correlation status related to infection caused by the specified ventilator when the first feature parameter, the second feature parameter, and the second blood oxygen saturation value satisfy a third preset condition.
Optionally, the first determining module 71 includes:
the first acquisition unit is used for acquiring a first blood oxygen saturation initial value and a first expiratory positive end pressure initial value acquired when the specified breathing machine starts ventilation;
a fourth determining unit, configured to determine, when the continuous monitoring time of the first blood oxygen saturation value being less than or equal to the first blood oxygen saturation initial value is greater than or equal to a first preset time, and the continuous monitoring time of the first positive end expiratory pressure value being less than or equal to the first positive end expiratory pressure initial value is greater than or equal to the first preset time, to exclude a ventilator correlation state caused by the specified ventilator.
Optionally, the second determining module 72 includes:
a second acquisition unit configured to acquire a second initial expiratory positive pressure value and an initial inspiratory oxygen concentration value acquired after determining a ventilator-related state by excluding the specified ventilator;
the calculating unit is used for calculating a first total increment of the inhalation oxygen concentration value and the inhalation oxygen concentration initial value in a preset continuous monitoring time and a second total increment of the second positive end expiratory pressure value and the second positive end expiratory pressure initial value in the continuous monitoring time;
and a fifth determining unit, configured to determine a ventilator correlation state caused by the specified ventilator when the first total increment is greater than or equal to a first preset threshold value, or the second total increment is greater than or equal to a second preset threshold value.
Optionally, the third determining module 73 includes:
a third acquisition unit configured to acquire a second blood oxygen saturation initial value acquired after determining a ventilator correlation state caused by excluding the specified ventilator;
a first detection unit, configured to detect whether the first and second characteristic parameters meet the third preset condition when the continuous monitoring time of the second blood oxygen saturation value being less than or equal to the second blood oxygen saturation initial value is greater than or equal to a second preset time;
A sixth determining unit, configured to determine a ventilator correlation state related to infection caused by the specified ventilator if the first and second characteristic parameters meet the third preset condition.
Optionally, the sixth determining unit includes:
the second detection unit is used for detecting whether the first characteristic parameter is in a first preset range and detecting whether the second characteristic parameter is in a second preset range, wherein the first characteristic parameter comprises a body temperature parameter, and the second characteristic parameter comprises a leukocyte parameter;
a seventh determining unit, configured to determine a ventilator correlation state related to infection caused by the specified ventilator if the first characteristic parameter is in the first preset range and the second characteristic parameter is in the second preset range.
For specific limitations on the auxiliary determination means of the ventilator dependency status, reference may be made to the above limitation on the auxiliary determination method of the ventilator dependency status, and no further description is given here. The above-described modules in the auxiliary determination device of the ventilator dependency status may be implemented in whole or in part by software, hardware, or a combination thereof.
The memory includes a readable storage medium, an internal memory, etc., where the internal memory may be a memory of the terminal device, and the internal memory provides an environment for the operation of an operating system and computer readable instructions in the readable storage medium. The readable storage medium may be a hard disk of the terminal device, and in other embodiments may be an external storage device of the terminal device, for example, a plug-in hard disk, a Smart Media Card (SMC), a Secure Digital (SD) Card, a Flash Card (Flash Card), etc. that are provided on the terminal device. Further, the memory may also include both an internal storage unit of the terminal device and an external storage device. The memory is used to store an operating system, application programs, boot loader (BootLoader), data, and other programs such as program codes of computer programs, and the like. The memory may also be used to temporarily store data that has been output or is to be output.
It will be apparent to those skilled in the art that, for convenience and brevity of description, only the above-described division of the functional units and modules is illustrated, and in practical application, the above-described functional distribution may be performed by different functional units and modules according to needs, i.e. the internal structure of the apparatus is divided into different functional units or modules to perform all or part of the above-described functions. The functional units and modules in the embodiment may be integrated in one processing unit, or each unit may exist alone physically, or two or more units may be integrated in one unit, where the integrated units may be implemented in a form of hardware or a form of a software functional unit. In addition, the specific names of the functional units and modules are only for distinguishing from each other, and are not used for limiting the protection scope of the present invention. The specific working process of the units and modules in the above device may refer to the corresponding process in the foregoing method embodiment, which is not described herein again. The integrated units, if implemented in the form of software functional units and sold or used as stand-alone products, may be stored in a computer readable storage medium. Based on such understanding, the present invention may implement all or part of the flow of the method of the above-described embodiment, and may be implemented by a computer program to instruct related hardware, and the computer program may be stored in a computer readable storage medium, where the computer program, when executed by a processor, may implement the steps of the method embodiment described above. Wherein the computer program comprises computer program code, which may be in the form of source code, object code, executable files or in some intermediate form, etc. The computer readable medium may include at least: any entity or device capable of carrying computer program code, a recording medium, a computer Memory, a Read-Only Memory (ROM), a random access Memory (Random Access Memory, RAM), an electrical carrier signal, a telecommunications signal, and a software distribution medium. Such as a U-disk, removable hard disk, magnetic or optical disk, etc. In some jurisdictions, computer readable media may not be electrical carrier signals and telecommunications signals in accordance with legislation and patent practice.
The present invention may also be implemented by a computer program product for implementing all or part of the steps of the method embodiments described above, when the computer program product is run on a terminal device, causing the terminal device to execute the steps of the method embodiments described above.
In the foregoing embodiments, the descriptions of the embodiments are emphasized, and in part, not described or illustrated in any particular embodiment, reference is made to the related descriptions of other embodiments.
Those of ordinary skill in the art will appreciate that the various illustrative elements and algorithm steps described in connection with the embodiments disclosed herein may be implemented as electronic hardware, or combinations of computer software and electronic hardware. Whether such functionality is implemented as hardware or software depends upon the particular application and design constraints imposed on the solution. Skilled artisans may implement the described functionality in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the present invention.
In the embodiments provided in the present invention, it should be understood that the disclosed apparatus/terminal device and method may be implemented in other manners. For example, the apparatus/terminal device embodiments described above are merely illustrative, e.g., the division of modules or units is merely a logical function division, and there may be additional divisions when actually implemented, e.g., multiple units or components may be combined or integrated into another system, or some features may be omitted or not performed. Alternatively, the coupling or direct coupling or communication connection shown or discussed may be an indirect coupling or communication connection via interfaces, devices or units, which may be in electrical, mechanical or other forms.
The units described as separate units may or may not be physically separate, and units shown as units may or may not be physical units, may be located in one place, or may be distributed over a plurality of network units. Some or all of the units may be selected according to actual needs to achieve the purpose of the solution of this embodiment.
The above embodiments are only for illustrating the technical aspects of the present invention, not for limiting the same, and although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may be modified or some technical features may be replaced with other technical solutions, and these modifications or replacements do not make the essence of the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the embodiments of the present invention, and all the modifications or replacements are included in the protection scope of the present invention.
Claims (10)
1. The auxiliary judging method for the relevance state of the breathing machine is characterized by comprising the following steps of:
continuously collecting a first blood oxygen saturation value and a first end-expiratory positive pressure value of a monitored object wearing a specified breathing machine, and determining to exclude a breathing machine correlation state caused by the specified breathing machine when the first blood oxygen saturation value and the first end-expiratory positive pressure value meet a first preset condition;
Continuously collecting an inhalation oxygen concentration value and a second positive end expiratory pressure value of a monitored object wearing the specified ventilator after determining to exclude a ventilator correlation state caused by the specified ventilator, and determining the ventilator correlation state caused by the specified ventilator when the inhalation oxygen concentration value and the second positive end expiratory pressure value meet a second preset condition;
after the ventilator correlation state caused by the appointed ventilator is determined, acquiring a first sign parameter and a second sign parameter of the monitored object, continuously acquiring a second blood oxygen saturation value of the monitored object wearing the appointed ventilator, and determining the ventilator correlation state related to infection caused by the appointed ventilator when the first sign parameter, the second sign parameter and the second blood oxygen saturation value meet a third preset condition.
2. The assisted determination method of ventilator dependency status as claimed in claim 1, wherein the determining to exclude the ventilator dependency status caused by the specified ventilator when the first blood oxygen saturation value and the first positive end-expiratory pressure value meet a first preset condition comprises:
Acquiring a first blood oxygen saturation initial value and a first end expiratory positive pressure initial value acquired when the specified breathing machine starts ventilation;
and determining to exclude a ventilator correlation state caused by the specified ventilator when the continuous monitoring time of the first blood oxygen saturation value is less than or equal to the first blood oxygen saturation initial value is greater than or equal to a first preset time and the continuous monitoring time of the first positive end expiratory pressure value is less than or equal to the first positive end expiratory pressure initial value is greater than or equal to the first preset time.
3. The assisted determination method of a ventilator-associated state of claim 1, wherein the determining the ventilator-associated state by the given ventilator when the inhalation oxygen concentration value and the second positive end-expiratory pressure value meet a second preset condition comprises:
acquiring a second initial expiratory positive pressure value and an initial inspiratory oxygen concentration value acquired after determining and excluding a ventilator-related state caused by the specified ventilator;
calculating a first total increment of the inhaled oxygen concentration value and the inhaled oxygen concentration initial value in a preset continuous monitoring time, and calculating a second total increment of the second expiratory positive end pressure value and the second expiratory positive end pressure initial value in the continuous monitoring time;
And determining a ventilator correlation state caused by the specified ventilator when the first total increment is greater than or equal to a first preset threshold value or the second total increment is greater than or equal to a second preset threshold value.
4. The assisted determination method of ventilator dependency status as claimed in claim 1, wherein the determining the ventilator dependency status relating to infection by the specified ventilator when the first, second and second vital parameters and the second blood oxygen saturation value meet a third predetermined condition comprises:
acquiring a second blood oxygen saturation initial value acquired after determining to exclude a ventilator correlation state caused by the specified ventilator;
when the continuous monitoring time of the second blood oxygen saturation value being smaller than or equal to the second blood oxygen saturation initial value is larger than or equal to a second preset time, detecting whether the first and second characteristic parameters meet the third preset condition;
and if the first and second characteristic parameters meet the third preset condition, determining a ventilator correlation state related to infection caused by the specified ventilator.
5. The assisted determination method of ventilator associated state of claim 4, wherein determining the ventilator associated state associated with the infection by the given ventilator if the first and second characteristic parameters meet the third predetermined condition comprises:
detecting whether the first characteristic parameter is in a first preset range or not, and detecting whether the second characteristic parameter is in a second preset range or not, wherein the first characteristic parameter comprises a body temperature parameter and the second characteristic parameter comprises a leukocyte parameter;
and if the first characteristic parameter is in the first preset range and the second characteristic parameter is in the second preset range, determining a ventilator correlation state related to infection caused by the specified ventilator.
6. An auxiliary judging device for a ventilator correlation state, comprising:
the first determining module is used for continuously collecting a first blood oxygen saturation value and a first positive end expiratory pressure value of a monitored object wearing a specified breathing machine, and determining to exclude a breathing machine correlation state caused by the specified breathing machine when the first blood oxygen saturation value and the first positive end expiratory pressure value meet a first preset condition;
A second determining module, configured to continuously collect, after determining to exclude a ventilator-related state caused by the specified ventilator, an inhaled oxygen concentration value and a second expiratory positive end pressure value of a monitored subject wearing the specified ventilator, and determine the ventilator-related state caused by the specified ventilator when the inhaled oxygen concentration value and the second expiratory positive end pressure value satisfy a second preset condition;
and the third determining module is used for acquiring the first and second characteristic parameters of the monitored object after determining the breathing machine correlation state caused by the specified breathing machine, continuously acquiring a second blood oxygen saturation value of the monitored object wearing the specified breathing machine, and determining the breathing machine correlation state related to infection caused by the specified breathing machine when the first, second and second characteristic parameters meet a third preset condition.
7. A ventilator comprising a ventilator body, wherein the ventilator body has a processor built-in, the processor when executing a computer program performing the steps of the method for assisted determination of ventilator correlation status according to any one of claims 1 to 5;
The ventilator further comprises:
an oxygen concentration sensor connected with the processor and used for continuously collecting the inhaled oxygen concentration value of a monitored object wearing the specified breathing machine;
and the pressure sensor is connected with the processor and is used for continuously collecting the end expiratory positive pressure value of the monitored object wearing the specified breathing machine.
8. The ventilator of claim 7, wherein the ventilator further comprises:
the human-computer interaction display is arranged on the breathing machine body, and the output end of the human-computer interaction display is connected with the input end of the processor and is used for sending the first and second physical parameters of the monitored object to the processor.
9. The ventilator of claim 7, wherein the ventilator further comprises:
the input end of the communication module is connected with the output end of the processor and is used for receiving the output parameters of the processor, the output parameters comprise auxiliary judging results of the relevance state of the breathing machine, and the output end of the communication module is connected with the input end of the processor and is used for sending the first and second sign parameters of the monitored object to the processor.
10. A computer readable storage medium storing a computer program, wherein the computer program when executed by a processor implements the steps of the method for assisted determination of ventilator correlation status according to any one of claims 1 to 5.
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