EP2435117A1 - Appareil de respiration et procédé de réglage associé - Google Patents

Appareil de respiration et procédé de réglage associé

Info

Publication number
EP2435117A1
EP2435117A1 EP10722414A EP10722414A EP2435117A1 EP 2435117 A1 EP2435117 A1 EP 2435117A1 EP 10722414 A EP10722414 A EP 10722414A EP 10722414 A EP10722414 A EP 10722414A EP 2435117 A1 EP2435117 A1 EP 2435117A1
Authority
EP
European Patent Office
Prior art keywords
ventilation
curve
actual
parameters
breathing
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP10722414A
Other languages
German (de)
English (en)
Inventor
Jakob Daescher
Harri Friberg
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
IMT Information- Management- Technology AG
Original Assignee
IMT Information- Management- Technology AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by IMT Information- Management- Technology AG filed Critical IMT Information- Management- Technology AG
Publication of EP2435117A1 publication Critical patent/EP2435117A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • 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
    • A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
    • A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
    • A61M2016/0021—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with a proportional output signal, e.g. from a thermistor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0036—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the breathing tube and used in both inspiratory and expiratory phase
    • 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
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502—User interfaces, e.g. screens or keyboards
    • A61M2205/505—Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches

Definitions

  • the invention relates to a ventilator for the ventilation of a patient, comprising an interface for reading at least one relevant for the ventilation
  • Ventilation parameters a computing unit for calculating a breathing curve from the at least one ventilation parameter and a display unit for displaying the calculated breathing curve.
  • the invention relates to a method for setting a ventilator for the ventilation of a patient, wherein at least one relevant for the ventilation ventilation parameters is read.
  • the invention also relates to a computer program product.
  • a ventilator or respirator is an electrically or pneumatically driven machine for ventilating persons with inadequate or suspended self-breathing.
  • a criterion for the classification of the ventilators is the type of application. In invasive ventilation, the patient is either intubated or tracheotomized. In noninvasive ventilation, the patient is ventilated via a tight-fitting mask.
  • a further classification of respirators can be made according to their field of application in emergency respirators, intensive care and home respirators.
  • volume control for example, is ventilated or inspired until a defined inspiratory volume is reached. Accordingly, the pressure-controlled respirators inspired until a preset airway pressure is reached.
  • Timed ventilators ventilate for a predetermined period of time. To control the respirators, for example, a maximum pressure or a maximum volume will be given, when it reaches a switch to the exhalation or expiration occurs.
  • a ventilator which can calculate a ventilation curve from certain input parameters and display it on a display unit.
  • this ventilator also requires a relatively large amount of expertise, or the risk of incorrect entries by stressed operating personnel is considerable.
  • the object of the invention is therefore an improved ventilator or an improved
  • a ventilator with the features of patent claim 1, namely by a ventilator of one or more of the group: desired respiratory parameters, actual respiratory parameters or reference respiratory parameters and respiratory curve one or more of the group: target breathing curve, actual breathing curve or reference breathing curve are provided.
  • the object of the invention is achieved by a method according to the patent claim 11, namely a method of the type mentioned, in which a respiratory curve calculated from the at least one ventilation parameter and the calculated respiratory curve is displayed on a display unit.
  • the object of the invention is also achieved by a computer program product according to claim 22, namely by a computer program product with a computer program stored thereon, which can be loaded into the one memory of a ventilator and executes the method according to the invention when the computer program is executed in the ventilator.
  • nominal respiration parameters and a desired respiratory curve represent a desired ventilation characteristic set on the device, actual ventilation parameters and an actual respiratory curve which is actually determined on the patient
  • the respiratory parameters are, for example, the inhalation pressure, the exhalation pressure, the
  • the ventilator not only reproduces information inputted by the operator, albeit graphically, but can also display a detected target respiration characteristic and a detected actual respiration characteristic and a stored or determined reference respiration characteristic. The latter, in particular, is a valuable aid for less-trained, unsafe or stressed operating personnel.
  • the computing unit in the respirator can be embodied in software and / or hardware. It is particularly advantageous if a program stored in a memory, which among other things depicts the method according to the invention, of a processor is executed. In this way, the algorithm can be easily adapted to different circumstances.
  • the interface for reading in the at least one ventilation parameter is provided by evaluating a drag-and-drop operation performed by an operator on the displayed breathing curve. This allows a particularly intuitive setting of a breathing curve, which can still be performed safely by an operator of the ventilator even under high stress.
  • a breathing curve in a range is selected and then changed by pulling in the desired manner. It is particularly advantageous if a touch screen is used, since the curve can then be easily changed with your finger.
  • target ventilation parameters, target respiratory curve, reference respiration parameters or reference respiratory curve are determined from at least one patient parameter characterizing the patient.
  • reference ventilation parameters and a reference breathing curve represent optimal ventilation behavior on a standard patient. This optimal ventilation characteristic will of course vary from patient to patient and will depend on certain patient parameters. For example, age, weight, gender, general fitness status and the clinical picture can have an influence on the said, optimal Have ventilation behavior.
  • optimal reference respiration parameters or an optimal reference respiratory curve can now be determined from at least one patient parameter and offered to the operator of the ventilator as an aid.
  • desired ventilation parameters or a desired breathing curve can be determined from the at least one patient parameter, so that the adjustment work is reduced to a minimum.
  • a key can also be provided with which the reference ventilation parameters are assigned to the desired ventilation parameters or the reference breathing curve to the desired breathing curve.
  • the ventilator comprises means for measuring the actual respiration curve and / or the actual respiration parameters at an outlet of a breathing tube. In this way, the real respiratory characteristics of patients can be determined, on the basis of which further treatment measures can be derived.
  • the ventilator comprises means for measuring the actual ventilation curve / an actual ventilation parameter and for determining an actual ventilation parameter / the actual ventilation curve from the determined actual ventilation curve / from the determined actual ventilation parameter.
  • Variant are determined from a measured actual respiratory curve (i.e., the pressure or volume over time) actual ventilation parameters.
  • the inhalation pressure can be determined very easily by forming the maximum value. But also the opposite way is possible.
  • an actual breathing curve can be calculated from measured actual ventilation parameters.
  • the inhalation pressure, the exhalation pressure, the inhalation time and the exhalation time measured.
  • the same algorithm can be used for this, which is also used for the calculation of the desired respiratory curve or the reference respiratory curve.
  • the reading of the actual ventilation parameters takes place via a measuring apparatus, whereas the reading of the desired ventilation parameters takes place, for example, via a keyboard of the ventilator.
  • the reference ventilation parameters can be read in via a table stored in the ventilator or in a remote database.
  • the display unit is prepared for displaying at least one ventilation parameter on the display unit. This is another support for the ventilator operator, who also has one
  • Training effect has.
  • these ventilation parameters are also memorized by the operator - even unconsciously - so that the operation of the ventilator can always be faster and safer over time.
  • several ventilation parameters can be compared with each other. For example, the actual inspiratory pressure may be displayed next to the desired inspiratory pressure, so that deviations between the two values are immediately visible.
  • the ventilator comprises means for outputting a warning if the difference and / or the ratio between two different ventilation parameters exceeds a presettable value.
  • a presettable value it is automatically monitored whether the deviation between the actual inhalation pressure addressed above, for example, and the set inspiratory pressure exceeds a predefinable threshold value. If this is true, then an optical and / or audible warning to alert the operator to this circumstance.
  • the threshold value can be entered by the operator himself or specified by the factory.
  • the ventilator comprises means for determining the area between two different breathing curves during an observation period and for issuing a warning if the area exceeds a predetermined value. This is another possibility for checking whether the ventilation is carried out in the desired manner or else whether the entered desired values are plausible with regard to existing reference values. Not only individual ventilation parameters, such as the exhalation pressure, are monitored, but the course of the respiratory curve.
  • observation period is longer than the duration of a breath. Both for the monitoring of a respiration parameter and for the monitoring of a respiratory curve, it is advantageous to use an observation period which is longer than the duration of a breath. In this way, individual disturbances of the ventilation process, e.g. Coughing of the patient, or even single measurement errors are better suppressed.
  • the observation period can be determined based on a time indication or else on the basis of a number of breaths (for example 2.7 breaths).
  • the ventilator comprises a memory for permanently storing a set of ventilation parameters and / or a ventilation curve.
  • ventilation parameters remain, for example after switching off the ventilator and can be called so comfortably, eg when the same patient in the context of a respiratory therapy with intermittent pauses recurrent ventilation must be called again.
  • FIG. 1 shows a schematically illustrated control panel of an exemplary ventilator
  • FIG. 2 shows an arrangement in which, instead of the respiratory curve of FIG. 1, two breathing curves are shown;
  • Fig. 4 as a breathing curve using a drag-and-drop operation can be changed.
  • control panel 1 shows a schematically illustrated control panel 1 of an exemplary ventilator, comprising a display unit 2, and a plurality of control buttons 3.
  • a breathing curve 4 is shown on the display unit 2.
  • a region 5 is shown on the display unit 2 in which ventilation parameters are displayed.
  • the ventilator operator inputs desired ventilation parameters via the ventilator control buttons 3.
  • the control buttons are fixed in this example the parameters: inhalation pressure PINSP,
  • Exhalation pressure PEEP the slope of the pressure during inhalation RAM, the ratio between inhalation time and exhalation time I / E as well as respiratory rate RAT assigned.
  • FIG. 1 also shows the significance of the inspiration pressure PINSP, the exhalation pressure PEEP, the slope of the pressure during inhalation RAM, the inhalation time Ti NS p and the exhalation time T EXP (Hint: this information is not necessarily also given on a) Display unit 2 shown and serve here mainly for a better understanding of the invention).
  • the ratio between inhalation time Ti NS p and exhalation time T EXP now corresponds to I / E, the sum of the two times 1 / respiratory rate RAT.
  • the method according to the invention now calculates a desired respiratory curve 4 for the parameters entered and displays them on the display unit 2. This is a tremendous help to the operator as the impact of a particular input becomes immediately apparent.
  • the parameters themselves are also displayed in a region 5.
  • the operator can memorize such common parameter sets more easily and adjust the ventilator correspondingly faster the next time.
  • Fig. 2 shows an arrangement which is very similar to the arrangement of Fig. 1. Instead of the breathing curve 4, however, two breathing curves 4a and 4b are shown here.
  • the respiratory curve 4a represents a reference respiratory curve
  • the respiratory curve 4b a desired respiratory curve.
  • the ventilator operator inputs patient parameters characterizing the patient. These may be, for example, weight, age, sex, severity of the disease, etc.
  • the ventilator now calculates a reference respiratory curve 4a from the patient parameters and displays these on the display unit 2.
  • the operator enters desired respiration parameters for the patient.
  • the ventilator calculates a desired ventilation curve 4b from it and also displays these on the display unit 2. The operator thus not only sees the effects of the various desired ventilation parameters on the basis of the desired breathing curve 4b but also a deviation from the reference breathing curve 4a.
  • Ventilation parameters are assigned to the desired ventilation parameters or the reference respiratory curve of the target breathing curve automatically, so that the adjustment work is facilitated. This step can also be done automatically after entering the patient parameters.
  • the respiratory curve 4a represents an actual respiratory curve
  • the respiratory curve 4b again a desired respiratory curve.
  • the operator of the ventilator can check to what extent the actual respiration curve 4a measured on the patient corresponds to the set desired respiratory curve 4b and If necessary, that is, in case of a strong deviation, initiate corresponding countermeasures.
  • the breathing curve 4a represents an actual breathing curve
  • the breathing curve 4b now represents a reference breathing curve.
  • the ventilator's operator can check to what extent the actual breathing curve 4a measured on the patient corresponds to a reference breathing curve 4b, which is calculated on the basis of at least one patient parameter characterizing the patient. In this way, the operator can thus determine to what extent the actual breathing curve 4a deviates from the "standard".
  • the actual respiratory curve was always measured, that is to say a pressure course was measured over a period of time.
  • a variant is also conceivable in which merely certain actual ventilation parameters are read in, ie measured, and from this an actual breathing curve is calculated.
  • the inhalation pressure PINSP ie the maximum pressure during the breathing process
  • the exhalation pressure PEEP ie the minimum pressure during the breathing process
  • the inhalation time time between pressure rise and pressure drop
  • the exhalation time time between pressure drop and pressure rise
  • actual ventilation parameters can also be determined from the actual breathing curve.
  • the inspiratory pressure PINSP can be determined by evaluating the actual breathing curve (ie determining its maximum value).
  • different ventilation parameters can be contrasted with one another in the area 5 of the display unit 2.
  • the reference ventilation parameters can be compared with the desired ventilation parameters (Example 1), the actual ventilation parameters can be compared with the desired ventilation parameters (Example 2) or the actual ventilation parameters can be compared with the reference ventilation parameters (Example 3).
  • a corresponding table is advantageously displayed in the upper right corner of the display unit (note: in area 5, however, no concrete values are shown in this example).
  • a desired respiratory curve, a reference respiratory curve and an actual respiratory curve or desired respiration parameters, reference respiration parameters and actual respiration parameters can also be displayed simultaneously.
  • a warning can be output if the difference or the ratio between two different ventilation parameters exceeds a predefinable value.
  • a deviation of the actual inhalation pressure from the desired inspiratory pressure or also a deviation of the setpoint inspiratory pressure may occur.
  • Respiratory rate from the reference rate of respiration detected and brought to the attention of the operator of the ventilator.
  • an optical display will be sufficient (it is assumed that the operator has directed his gaze towards the display unit 2 during the setting of the ventilator) should a deviation of an actual ventilation parameter from preference is given to a desired or reference ventilation parameter of an (additional) audible warning.
  • the area between two different breath curves during an observation period can be used to issue a warning.
  • the area between the actual respiratory curve and the desired respiratory curve or between the desired respiratory curve and the reference respiratory curve can be determined and a warning output if the difference exceeds a certain level (see the hatched area in FIG. 3).
  • observation period which is longer than the duration of a breath.
  • the observation period can be determined on the basis of a time specification or else on the basis of a number of breaths (eg 2.7 breaths).
  • ventilation parameters and / or respiratory curves and / or patient parameters can also be stored permanently. These then remain, for example, even after the ventilator has been switched off and can thus be called up again conveniently, eg when the same patient has to be ventilated recurrently with intervening pauses.
  • the ventilation parameters can be set via buttons 3, knobs, controls and the like arranged on the device.
  • these input elements are arranged on a touch screen.
  • so-called “soft keys” can be realized, that is to say setting elements which can change the function assigned to them, for example the same buttons can be provided for the input of ventilation parameters or patient parameters depending on the set function.
  • the ventilation curve can be changed directly, that is to say without changing a specific ventilation parameter.
  • a breathing curve or a region thereof is selected via the touchscreen and changed by pulling.
  • Figure 4 shows exemplary points on a breathing curve 4, where it can be "touched” and pulled with the finger.
  • the arrows symbolize in which direction pulling is possible, or causes a change in the breathing curve 4.
  • the values of the associated ventilation parameters can be ongoing adapted to the new breathing curve 4 and displayed.
  • the application of the drag-and-drop method is not tied to the use of a touch screen, but can also be done in conjunction with other input devices, such as in conjunction with buttons, levers or a computer mouse.
  • the arrangement of the areas where the breathing curve 4 can be touched, to see only by way of example.
  • regions away from the respiratory curve 4 may also be provided, for example at the lower or upper edge of the screen.
  • buttons are shown in FIG. 4, with the aid of which the value of a previously selected ventilation parameter can be changed (in the case of the keys 3 from FIGS. 1 to 3, the value can be, for example, by pressure in the right / upper area of the key 3 increased, lowered by pressure in the left / lower area of button 3).
  • the invention relates not only to pressure-controlled ventilators but also to volume-controlled or time-controlled, although not explicitly shown in the figures.
  • One skilled in the art will readily apply the teachings disclosed herein to the noted fields can, in particular by using other ventilation parameters, such as the inspiratory volume.

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  • Health & Medical Sciences (AREA)
  • Emergency Medicine (AREA)
  • 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)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

L'invention concerne un appareil de respiration pour la respiration d'un patient, comportant une interface (3) pour la lecture d'au moins un paramètre de respiration important pour la respiration (PINSP, PEEP, RAM, I/E, RAT, TiNSp, TEXP, TAZ). Selon l'invention, l'appareil de respiration comprend une unité de calcul pour calculer une courbe de respiration (4, 4a, 4b) à partir du ou des paramètres de respiration (PINSP, PEEP, RAM, I/E, RAT, TiNSP, TEXP, TAZ) et une unité d'affichage (2) pour l'affichage de la courbe de respiration (4, 4a, 4b) calculée. L'invention concerne également un procédé destiné à faire fonctionner l'appareil de respiration selon l'invention.
EP10722414A 2009-05-28 2010-05-10 Appareil de respiration et procédé de réglage associé Withdrawn EP2435117A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH00817/09A CH701124B1 (de) 2009-05-28 2009-05-28 Beatmungsgerät und Einstellverfahren hierfür.
PCT/IB2010/052043 WO2010136923A1 (fr) 2009-05-28 2010-05-10 Appareil de respiration et procédé de réglage associé

Publications (1)

Publication Number Publication Date
EP2435117A1 true EP2435117A1 (fr) 2012-04-04

Family

ID=41009877

Family Applications (1)

Application Number Title Priority Date Filing Date
EP10722414A Withdrawn EP2435117A1 (fr) 2009-05-28 2010-05-10 Appareil de respiration et procédé de réglage associé

Country Status (6)

Country Link
US (1) US20120055479A1 (fr)
EP (1) EP2435117A1 (fr)
JP (1) JP5592483B2 (fr)
CN (1) CN102448529A (fr)
CH (1) CH701124B1 (fr)
WO (1) WO2010136923A1 (fr)

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CH701124A1 (de) 2010-11-30
WO2010136923A1 (fr) 2010-12-02
JP2012527937A (ja) 2012-11-12
CN102448529A (zh) 2012-05-09
CH701124B1 (de) 2019-09-13
US20120055479A1 (en) 2012-03-08
JP5592483B2 (ja) 2014-09-17

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