EP4004937A1 - Dispositif de respiration de soutien d'un être vivant et programme informatique - Google Patents

Dispositif de respiration de soutien d'un être vivant et programme informatique

Info

Publication number
EP4004937A1
EP4004937A1 EP20745173.3A EP20745173A EP4004937A1 EP 4004937 A1 EP4004937 A1 EP 4004937A1 EP 20745173 A EP20745173 A EP 20745173A EP 4004937 A1 EP4004937 A1 EP 4004937A1
Authority
EP
European Patent Office
Prior art keywords
breathing
air flow
control unit
air pressure
curves
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.)
Pending
Application number
EP20745173.3A
Other languages
German (de)
English (en)
Inventor
Stephan RÜLLER
Susanne Greve
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.)
Forschungszentrum Borstel Leibniz Lungenzentrum FZB
Original Assignee
Forschungszentrum Borstel Leibniz Lungenzentrum FZB
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 Forschungszentrum Borstel Leibniz Lungenzentrum FZB filed Critical Forschungszentrum Borstel Leibniz Lungenzentrum FZB
Publication of EP4004937A1 publication Critical patent/EP4004937A1/fr
Pending legal-status Critical Current

Links

Classifications

    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/40—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A61M16/024—Control means therefor including calculation means, e.g. using a processor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
    • A61B5/082—Evaluation by breath analysis, e.g. determination of the chemical composition of exhaled breath
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • 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
    • 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
    • A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
    • 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
    • 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
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/40—Respiratory characteristics

Definitions

  • the invention relates to a device for assistive ventilation of a living being sens.
  • the invention also relates to a computer program with program code means.
  • the invention relates to the field of assistive ventilation for patients with breathing problems.
  • Supportive ventilation refers to the ventilation of living beings that make breathing movements independently during ventilation.
  • this includes so-called assisted and partially controlled ventilation, in which a breathing effort on the part of the living being is recognized by the device and, depending on the natural breathing of the living being, an inhalation (“inspiration”) or an exhalation (“expiration”) of the living being a negative or positive pressure induced by the device relative to the currently existing pressure is promoted in the respiratory tract of the living being.
  • An inspiration is a breathing phase with a predominantly inward flow of air into the living being
  • an expiration is a breathing phase with a predominantly outward flow of air out of the living being.
  • controlled ventilation is known in medicine, which must be distinguished from supportive ventilation insofar as controlled ventilated patients do not carry out independent breathing movements or ventilation is forced on the patient, who has to adapt to it with his independent breathing efforts.
  • breathing frequencies and thus inspiration and expiration phases are specified by the device, while with assisted ventilation they are automatically adapted by the device to the independently performed breathing of the living being.
  • Partially controlled ventilation is based on assisted ventilation, but there is a minimum breathing frequency ("safety frequency" or "Ba- ckup frequency ”) specified by the device.
  • Examples of devices for assistive ventilation are BiPAP-S, Bilevel-S or PSV devices in the case of assisted ventilation, PCV or BiPAP-T devices in the case of controlled ventilation, and BiPAP-ST or aPCV devices in the case of partially controlled ventilation.
  • COPD patients especially those with hypercapnic respiratory insufficiency
  • these patients structural changes in the lungs have occurred due to various diseases, which necessitate increased work of the respiratory muscles in order to guarantee adequate gas exchange.
  • the respiratory muscles become increasingly exhausted, as a result There may be sensations of shortness of breath when breathing even with very little exertion.
  • the respiratory muscles and the respiratory drive especially at night during sleep, are no longer able to adequately compensate for the structural changes in the lungs due to increased breathing depth and increased breathing frequency, and ventilatory insufficiency occurs.
  • EP 2542286 A2 discloses a ventilation device with a controllable air delivery unit or a valve control unit with a pressure regulating valve, the ventilation device having an air mass meter, a pressure sensor and a programmable control unit.
  • the ventilation device having an air mass meter, a pressure sensor and a programmable control unit.
  • an early reduced pressure curve in the inhalation phase and a dynamically controlled counter pressure in an exhalation phase of the living being are provided when controlling the air delivery unit or the valve control unit.
  • WO 2006/079152 A1 discloses a method and a system for detecting inefficient breathing movements of a ventilated living being. For this purpose, an expiratory airflow of the living being is monitored for disturbances.
  • the device is used for the supportive ventilation of a living being, for example a human.
  • the supportive ventilation can be necessary, for example, due to a respiratory or lung disease of the living being, which is why the living being is also referred to as a patient in this application.
  • a controllable air delivery unit for example a ventilator, a pump, a controllable turbine or an air compression device, eg. B. has a reciprocating compressor.
  • the air delivery unit can also have a pressure control valve or a Ventilan arrangement.
  • a valve control device can also be provided instead of the air delivery unit.
  • the valve control device can be switched between a conventional ventilator and the living being to be ventilated.
  • the air delivery unit can for example optionally, in particular automatically, generate a continuously adjustable negative or positive pressure, for example by adapting the direction and speed of rotation of a fan. In this way, the living being can be provided with the breathing support that is currently required.
  • IPAP Inspirational Positive Airway Pressure, ventilation pressure during inspiration
  • EPAP Expiratory Positive Airway Pressure, ventilation pressure during expiration
  • the IPAP and EPAP are usually determined by a therapist and set on the device.
  • the ventilation frequency the IPAP time (time for which the inspiratory pressure is set in the inhalation phase)
  • the ratio of the times of IPAP / EPAP and a sensitivity for the inspiration and expiration triggers explained below.
  • Ventilation is usually considered efficient if a sufficient tidal volume and / or a sufficient minute ventilation is achieved. The sufficient level is determined, among other things, based on experience, the underlying ventilation indication, the disease and blood gas analyzes.
  • the switchover of the device from an EPAP to an IPAP marks the end of an expiratory mode and the start of an inspiratory mode, which continues until the device switches from the IPAP to an EPAP.
  • Switching the device from an IPAP to an EPAP marks the end of an inspiratory mode and the beginning of an expiratory mode, which continues until the device switches from the EPAP to an IPAP.
  • the device has a sensor arrangement with a pressure sensor and an air flow sensor.
  • the pressure sensor can, for example, be a differential pressure sensor
  • the air flow sensor is, for example, a pneumotachograph. Both sensors can be provided in a common housing or spatially separated from one another.
  • the sensors are arranged, for example, in or on a breathing mask or in or on a connecting hose between the ventilator and the breathing mask or in a valve control device of the device.
  • the words “a” are not to be understood as a number, but as an indefinite article with the literal meaning of “at least one”.
  • several pressure or air flow sensors can be provided.
  • the pressure sensor and the air flow sensor are set up for the chronologically successive acquisition of respiratory air pressure values and respiratory air flow values of the living being, so that the sensors are suitable for continuous measurement of the values mentioned.
  • the recorded respiratory air pressure values and respiratory air flow values are, for example, continuously or quasi-continuously transmitted to a programmable control unit of the device and evaluated by this.
  • the programmable control unit has a suitable arithmetic unit and any necessary computing unit Storage means and / or suitable software in order, for example, to evaluate several respiratory air pressure values and / or respiratory air flow values in succession in each case or in relation to one another. Due to the chronologically successive breath air pressure values and breath air flow values, these are also referred to in the registration documents as breath air pressure curves and breath air flow curves in order to distinguish them from the evaluation of individual, time-independent absolute values, for example in the context of exclusive threshold value monitoring.
  • Breathing air pressure curves and breathing air flow curves can, for example, be graphically displayed in practice as function curves or curve segments for illustration purposes and thus depict a relative or absolute time curve of pressure or air flow values.
  • the absolute breath air pressure values and breath air flow values can be considered at different points in time as well as relative changes over time of the respective values.
  • a coherent evaluation of the respiratory air pressure curves and respiratory air flow curves in relation to one another can also be provided.
  • the programmable control unit is set up to recognize frustrating respiratory movements of the living being associated with ventilation on the basis of characteristic features of the respiratory air pressure curves and / or the respiratory air flow curves.
  • a frustrating breathing movement under ventilation is understood to mean a breathing effort of the living being which does not lead to the aspirated or emitted air volume aspired to with the breathing effort, for example not sufficiently recognized as a breathing effort by a device for supporting ventilation and thus not to a switchover of the device leads from an inspiratory mode to an expiratory mode or vice versa.
  • Such frustrating breathing movements can be uncomfortable for the patient and lead to what feels like shortness of breath or shallow breathing.
  • a frustrating breathing movement can also be ineffective, especially during sleep, and only lead to increased work of breathing, which counteracts the actual goal of ventilation, since ventilation, for example, has the purpose of minimizing the patient's work of breathing.
  • Frustrating breathing movements can occur during an inspiration phase and / or an expiration phase of the being or occur at a point in time at which there is an outward or inward airflow or at which the pressure applied by the device is at an IPAP level or an EPAP level det.
  • Obstructive sleep-related respiratory regulation disorders can also lead to frustrating breathing movements, but do not arise primarily during ventilation and must therefore be fundamentally differentiated.
  • the programmable control unit analyzes the respiratory air pressure and / or respiratory air flow curves formed from the respiratory air pressure values and breath air flow values recorded in succession in time. It was recognized that frustrating breathing movements can already be identified on the basis of characteristic features in the course of the recorded sensor values. Accordingly, the frustrating breathing movement is recognized in the present case, in particular, exclusively on the basis of the breathing air pressure curves and / or the breathing air flow curves, so that one or two sensors, which are usually already used for other measurement purposes in such devices, can detect the presence of a frustrating breathing movement can be closed.
  • the device according to the invention has a simple structure and a simple mode of operation.
  • the features characteristic of frustrating breathing movements can be maxima, minima, turning points, saddle points, amplitudes, integrals and / or derivatives in predefined times and / or time segments of the breathing air pressure curves and / or the breathing air flow curves.
  • Individual local or regional features can be viewed individually or referred to as characteristic in connection with other features. For example, in an expiration phase of a breathing air pressure profile, a local minimum with a local maximum following within a given period of time can be used as characteristic features of a frustrated breathing movement.
  • a respiratory air flow profile for example, two respiratory air flow increases following one another within a predetermined time span in an expiratory phase can be used as characteristic features of a frustrating respiratory movement.
  • Oscillations occurring in the breathing air flow and / or breathing air pressure curves in predefined time periods can also be used as characteristic features of one or more consecutive frustrating breathing movements. These are examples that are not to be regarded as an exhaustive list of characteristic features, especially since the precise detection and analysis of frustrated breathing movements based on the respiratory air flow and air pressure curves are highly complex, depending on the patient's breathing and ventilation status can.
  • the characteristic features are characteristic deviations from predetermined reference breathing air pressure curves and / or reference breathing air flow curves.
  • the programmable control unit compares the breathing air pressure curves and / or breathing air flow curves recorded with the sensor arrangement with reference curves; for example, these are computationally or graphically superimposed, as well as the shape, intensity and characteristics of any differences between the recorded curves and the reference curves determined. For example, deviations of the currently recorded breathing air pressure curves and / or breathing air flow curves from the reference curves at certain times, in particular during the expiratory phase, can be used as characteristic deviations.
  • the reference breathing air pressure curves and / or reference breathing air flow curves can be specified, for example, as reference curves stored in advance and stored in the programmable control unit. It is also possible for the device to “learn” such reference breath air pressure profiles and / or reference breath air flow profiles on the basis of previous evaluations and even store them in the programmable control unit in order to identify individual
  • Such a learning process can, for example, be initiated and carried out under medical supervision in order to monitor an at least approximately ideal regular ventilation process and not make it more difficult to detect them when the curves are later compared with reference curves by frustrating breathing movements that already occur.
  • the programmable control unit has a memory unit for storing predetermined reference breath air pressure profiles and / or reference breath air flow profiles and / or reference features for characteristic features of frustrating breathing movements in order to carry out the internal evaluation of the deviations and / or features Facilitate comparison.
  • the memory unit has various disease-specific reference breathing air pressure profiles and / or reference Breathing air flow curves and / or various disease-specific reference features for characteristic features of frustrated breathing movements.
  • the reference breathing air pressure curves and / or reference breathing air flow curves and / or the reference features can, for example, be stored in tabular form in a memory unit of the programmable control unit so that the control unit can select or limit the affected features or curves in columns or rows can make.
  • the device has a setting option for selecting the specific disease or the expression of a specific disease by a person, for example a therapist or patient.
  • the setting option can be, for example, a user interface or a data interface for storage media.
  • the programmable control unit is set up for automatic detection of the disease present, for example on the basis of characteristics of the respiratory air pressure curves and / or the respiratory air flow curves that are characteristic for the respective illness.
  • the programmable control unit is set up to detect frustrating breathing movements of the living being based on an occurring phase divergence between the real ventilation phase of the living being and a ventilation phase carried out by the device.
  • the device automatically or independently recognizes that a switchover of the device from an expiratory mode to an inspiratory mode or vice versa has taken place incorrectly, for example too early or too late or not at all.
  • the aforementioned characteristic features of the breathing air pressure curves and / or the breathing air flow curves can be used, for example, by identifying characteristic deviations from predetermined reference breathing air pressure curves and / or reference breathing air flow curves by the programmable control unit.
  • the programmable control unit can also determine the extent of the phase divergence that occurs, for example determine a time offset between expected characteristic features and actually determined characteristic features. It can thus be determined the extent to which an inspiration mode or expiration mode of the device lags behind or runs ahead of the real inspiration or expiration of the living being or is completely dissociated from it.
  • the programmable control unit is set up to differentiate between a frustrated breathing movement that occurs as a result of an intrinsic PEEP of the living being and a frustrated breathing movement that occurs as a result of a trigger insufficiency that will be explained below on the basis of characteristic features of the breathing air pressure profiles and / or the breathing air flow profiles. In this way, two essential, frequently occurring causes of frustrating breathing movements can be recognized and distinguished by the device.
  • the abbreviation PEEP stands for the technical term "Positive End-Expiratory Pressure" and thus for the pressure existing in the living being's airways at the end of the exhalation phase.
  • this residual pressure in the respiratory organs can increase at the end of the exhalation phase and is then called intrinsic PEEP or auto PEEP designated.
  • the intrinsic PEEP can be very heterogeneous locoregionally in the lungs of the living being.
  • incomplete exhalation can also occur if the patient inhales but exhalation has not yet ended.
  • an increasing intrinsic PEEP leads to an increase in the breathing load and forms a threshold for the patient that must be overcome with each inspiration in addition to a load that is positively correlated with the breathing depth.
  • the increasing intrinsic PEEP leads to an increasing and also heterogeneously developed overinflation in the lungs of the living being, since the residual pressure can no longer sufficiently escape into the environment.
  • intrinsic PEEP is not only uncomfortable for the patient, it is also dangerous. There may be sensations of shortness of breath, but also negative effects on the cardiovascular situation. Pendulum air can also arise during ventilation. Ventilation can also become ineffective which leads to additional stress on the lung structure.
  • an intrinsic PEEP should therefore be avoided or at least reduced as much as possible during supportive ventilation of a living being. It should be noted here that the intrinsic PEEP can change continuously, for example, depending on the disease, infection situation, mucus build-up, breathing rate or the psychological patient situation.
  • Intrinsic PEEP under supportive ventilation can lead to frustrated breathing movements in the patient, in which the residual pressure in the airways can change due to inefficient breathing efforts.
  • This frustrating breathing movement can be read from the characteristics characteristic of the intrinsic PEEP in the breathing air pressure curves and / or the breathing air flow curves, so that the intrinsic PEEP as a trigger of a frustrating breathing movement can be differentiated from other causes.
  • the device used for this purpose does not recognize an incipient inhalation or exhalation process of the living being, or at an incorrect point in time, due to the trigger.
  • an inspiration and / or expiration trigger is usually used in such devices, which recognizes the change in the breathing direction of the living being based on a measured pressure or air flow change at the end of an inspiration or expiration phase and initiates the corresponding inspiration or expiration mode of the device. in order to generate, for example, a counter pressure that supports the patient's expiration or a pressure different from the pressure present during inspiration.
  • trigger insufficiency An incorrect detection of the real ventilation phase of the living being by the device due to too high or too low a trigger sensitivity is referred to as trigger insufficiency.
  • trigger insufficiency can occur as insufficiency of the inspiration trigger and / or as insufficiency of the expiration trigger.
  • a setting that is too sensitive can, for example, be due to a slight pressure fluctuation contrary to the The patient's intention to initiate the inspiratory mode prematurely, whereas an overly insensitive setting leads to an expiratory mode that is too late or even skipped.
  • the trigger sensitivity is influenced, for example, by leaks in the device or the living being, for example through mouth or mask leaks or a technical leak in the device. In particular, this can lead to leakage-related trigger insufficiency of the inspiration trigger. If such a leak is present, the device automatically generates a higher counterpressure in order to compensate for the leak, so that an inspiration trigger of the device does not identify a negative pressure possibly induced by the patient at the beginning of inspiration.
  • a frustrating respiratory movement caused by trigger insufficiency can be read off from the characteristic features in the respiratory air pressure curves and / or the respiratory air flow curves, whereby parameter-related and leakage-related trigger insufficiency as a trigger of a frustrating respiratory movement can be differentiated from other causes (e.g. intrinsic PEEP) can be delimited.
  • the device can also be set up to determine a leakage-related trigger insufficiency with the aid of measurable leakage values of the device and, for example, to compare the measured leakage values with leakage values from previous breathing cycles.
  • the programmable control unit On the basis of the respectively different characteristic features of a frustrated breathing movement occurring due to an intrinsic PEEP or a trigger insufficiency, the programmable control unit is thus able to identify the respective cause of the frustrating breathing movement.
  • Trigger insufficiency but also intrinsic PEEP, can lead to a phase divergence of the real ventilation phase of the living being and the ventilation phase carried out by the device.
  • the phase divergence can be recognized by the device, for example, using characteristic features in the respiratory air pressure curves and / or the respiratory air flow curves.
  • the programmable control unit is used to distinguish between a frustrated breathing movement occurring as a result of a leakage-related trigger insufficiency and a frustrating breathing movement occurring as a result of a parameter-related trigger insufficiency on the basis of characteristic features Features of the breathing air pressure curves and / or the breathing air flow are set up.
  • the control unit is suitable for further recognition and differentiation of two possible triggers for a trigger insufficiency that occurs.
  • a leakage-related trigger insufficiency arises, for example, due to the mask leakage described above or technical leakage of the device.
  • the leakage values of the device are determined, for example, as a function of the therapy pressure and on the basis of empirical values or measurements, and are incorporated into the control calculations as a correction value.
  • inaccuracies can arise, for example due to the assumptions made and averaged values, which can have an indirect effect on the sensitivity of the inspiration and expiration triggers.
  • Such a leakage-related trigger insufficiency can be identified using characteristic features of the respiratory air pressure curves and / or the respiratory air flow curves, for example within an expiratory phase using an increase in the respiratory air flow pronounced as a bulge during the increase in the respiratory air flow curve and a bulge that occurs essentially at the same time Breathing air pressure increase.
  • a parameter-related trigger insufficiency arises due to an imprecise pre-setting of the trigger parameters of the programmable control unit, so that the inspiration and / or expiration trigger is set too sensitive or too insensitive. This is a trigger insufficiency that is directly influenced by specific device settings.
  • a parameter-related trigger insufficiency can be recognized on the basis of characteristic features of the respiratory air pressure curves and / or the respiratory air flow curves, for example within an expiratory phase based on an increase in the air flow that is pronounced as a bulge during the increase in the air flow and changes in the air pressure occurring during this increase in the air flow in the form of a tip having breathing air pressure reduction and a subsequent breathing air pressure increase in the form of a tip in the breathing air pressure curve during the increase in the breathing air flow.
  • a leakage-related trigger insufficiency and a parameter-related trigger insufficiency can be distinguished by the programmable control unit this can be set up to initiate appropriate countermeasures. For example, when a leakage-related trigger insufficiency is identified, the programmable control unit can adapt the above-described correction values to take account of leakage values in a suitable manner or also regulate them dynamically until no leakage-related trigger insufficiency can be recognized any more on the basis of characteristic features in the respiratory air flow and / or respiratory air pressure courses .
  • the programmable control unit can independently adapt the preset parameter sets to the inspiration and / or expiration trigger in a suitable manner, request a user to change the parameter sets or also perform dynamic control of the parameters until there is no more parameter-related trigger insufficiency can be recognized on the basis of characteristic features in the breathing air flow curves and / or breathing air pressure curves.
  • the programmable control unit is set up to detect a frustrated breathing movement on the basis of the point in time, the time span and / or the shape of a breathing air pressure and / or breathing air flow increase or reduction in the breathing air pressure curves and / or breathing air flow curves.
  • a point in time when the breathing air pressure and / or breathing air flow is increased or reduced in an expiratory phase, in the first or second half of the expiratory phase or during the transition from an inspiratory phase to an expiratory phase can be used as a characteristic feature of a frustrating breathing movement.
  • characteristics characteristic of frustrating breathing movements occur increasingly in expiratory sections of the respiratory air pressure curves and / or the respiratory air flow curves.
  • a duration of the breathing air pressure and / or breathing air flow increase or reduction which can typically be 0.1 to 1.0 seconds, can be used as a characteristic feature of a frustrating breathing movement.
  • the breathing air pressure and / or breathing air flow increase or reduction can be designed, for example, as a bulge or point.
  • a curvature represents an arcuate increase or decrease; in the case of a tip, the increase or decrease has a kink, in particular a kink with an acute angle between the curve rising before the maximum and after the maximum.
  • a breathing air pressure and / or breathing air flow increase or reduction occurs in the middle of the expiratory phase detected by the device for 0.2 to 0.7 seconds, the existence of a frustrating breathing movement can be concluded the.
  • the maxima, minima, turning points, saddle points, amplitudes, integrals and / or derivatives in predefined times and / or time segments of the respiratory air pressure curves and / or the respiratory air flow curves can be used to identify and differentiate the aforementioned curves.
  • the device is in particular for differentiating a frustrated breathing movement occurring as a result of an intrinsic PEEP of the living being and a frustrating breathing movement occurring as a result of trigger insufficiency on the basis of the time, the time span and / or the form of an increase or reduction in breathing air pressure and / or breathing air flow the breathing air pressure curves and / or breathing air flow curves set up.
  • This differentiation is based on the knowledge that the characteristic features of frustrated breathing movements as a result of intrinsic PEEP or trigger insufficiency differ from one another, particularly with regard to the times, periods of time and / or the forms of air pressure and air flow increases or decreases.
  • the programmable control unit is set up to recognize a frustrating breathing movement on the basis of characteristic features of the respiratory air flow curves and related characteristic features of the respiratory air pressure curves. This improves the detection accuracy. For example, the control unit first determines an increase in the breathing air flow in the breathing air flow and then checks whether there is a breathing air pressure increase in the breathing air pressure in a predetermined period of time before, after or at the same time as the breathing air flow increase. In addition to the point in time, the time spans and forms of breathing air pressure and breathing air flow increases can also be related to one another. The detection can thus take place in the sense of a multi-factor dependency on the basis of characteristic features of the breathing air flow curves and the breathing air pressure curves in combination.
  • the programmable control unit is set up in particular to distinguish between a frustrated breathing movement that occurs as a result of an intrinsic PEEP of the living being and a frustrated breathing movement that occurs as a result of trigger insufficiency on the basis of characteristic features of the respiratory air flow and related characteristic features of the respiratory air pressure curves.
  • the control unit first detects an increase in the breathing air flow present as a bulge in the breathing air flow and then checks whether there is an increase in breathing air pressure in the form of a bulge at essentially the same time and for essentially the same period of time. If this is the case, the control unit detects a frustrated breathing movement as a result of a leakage-related trigger insufficiency.
  • the simultaneously occurring increases in the respiratory air flow and respiratory air pressure curves can have essentially the same shape, for example the same gradients at the same points in time or an essentially identical integral over the time of the respective increase.
  • control unit can also initially determine an increase in breathing air flow in the breathing air flow and then check whether there is an increase in breathing air pressure formed as a peak in a predetermined period of time, for example before the end of the time or during a second half of the time of the increase in breathing air flow present. If this is the case, the control unit detects a frustrated breathing movement due to an intrinsic PEEP.
  • the tip in the breathing air pressure curve can be made smaller in comparison to the curvature in the breathing air flow curve, for example have a smaller integral over the time of the increase.
  • the programmable control unit is set up to identify the characteristic features and to evaluate them as a function of one another in order to recognize a frustrating breathing movement and to differentiate between intrinsic PEEP and trigger insufficiency with regard to its cause.
  • the programmable control unit is also set up to carry out oscillometric airway resistance measurements.
  • oscillometric airway resistance measurements can facilitate the detection of an intrinsic PEEP of the living being, so that a better distinction is made possible between a frustrated breathing movement occurring as a result of an intrinsic PEEP of the living being and a frustrating breathing movement occurring as a result of trigger insufficiency.
  • the oscillometric airway resistance measurement can be implemented without additional device components by activating the air delivery unit accordingly.
  • oscillometric airway resistance measurements which are known for example in the form of so-called pulse oscillometry (IOS) or forced oscillation technology (FOT)
  • IOS pulse oscillometry
  • FOT forced oscillation technology
  • the flow resistance and thus airway resistance can be determined on the basis of the ratio of the pressure difference to the respiratory flow measured here.
  • An intrinsic PEEP of the living being can be inferred indirectly or directly from the airway resistance. Thus, the detection and differentiation accuracy of the device for frustrating breathing movements due to intrinsic PEEP or trigger insufficiency is increased.
  • the programmable control unit is set up to determine the frequency and / or intensity of the intrinsic PEEP or the trigger insufficiency as a result of which the frustrating breathing movement occurs.
  • the time expansion, the amplitude, the slope, the integral and the number of respiratory air pressure and / or respiratory air flow increases or reductions are determined and evaluated, for example compared with reference or threshold values.
  • the analysis can in particular also take place over several breathing cycles in order, for example, to differentiate recurring symptoms from irregularities that occur once or to observe an increase or decrease in symptoms.
  • the programmable control unit is set up to output, for example, an optical, acoustic and / or haptic alarm signal when a predetermined threshold value for the frequency and / or intensity of the intrinsic PEEP or trigger insufficiency is exceeded, for example in order to achieve a health-critical To indicate the condition and to enable the living being or other people present to initiate an appropriate response such as an emergency call.
  • the programmable control unit is set up to automatically vary control parameters of the air delivery unit when a frustrating breathing movement is detected.
  • the device itself can initiate suitable countermeasures to reduce or avoid further frustrating breathing movements.
  • the programmable control unit is set up to continuously regulate automatic variation of control parameters of the air delivery unit to reduce and / or eliminate the characteristics of the breathing air pressure curves and / or the breathing air flow curves characteristic of the frustrating breathing movement.
  • the device itself iteratively approaches the most favorable air flow parameters for the patient by continuously changing the control parameters in the sense of a control loop. For example, in one or consecutive expiratory phases, the dynamic counter air pressure generated by the air conveying unit is increased or decreased incrementally or intermittently for a period of time that is shorter than an expiratory phase, until the programmable control system based on characteristic features the breathing air pressure curves and / or the breathing air flow curves the occurrence of a frustrating breathing movement is recognized.
  • the induced air pressure is then reduced again. Completely reduced or increased or the intermittent increase in air pressure started later and checked whether further frustrating breathing movements occur.
  • This process can be repeated at any frequency in order to determine suitable control parameters at any point in time, which reduce or avoid the occurrence of frustrating breathing movements.
  • a doctor or therapist to only set a value range for the IPAP and EPAP and, if necessary, a backup frequency for breathing on the device and the IPAP and / or the currently most favorable IPAP and / or EPAP value and other parameters are determined and set by the device itself on the basis of the respiratory air flow and the respiratory air pressure curves.
  • a backup frequency can be a minimum breathing frequency that ensures a sufficient number of breaths by the living being.
  • a continuous, regulating automatic variation of the control parameters which aims to eliminate frustrating breathing movements as a regulation goal, in particular due to intrinsic PEEP or trigger insufficiency, is based on a fundamentally different approach than is usual in current ventilation concepts.
  • Current guidelines on non-invasive ventilation are primarily based on pC02 values as a control criterion, with high pressure amplitudes in particular intended to promote the patient's C02 exchange.
  • the pressure values, in particular the I-PAP should only be regulated in such a way that no more frustrating breathing movements occur, since such regulated support ventilation increases the wellbeing of the living being and the harmful effects of excessively high pressure the lungs are avoided.
  • the programmable control unit can be set up to automatically vary the control parameters of the air delivery unit to reduce the characteristics of the breathing air pressure curves and / or the breathing air flow curves that are characteristic of the frustrated breathing movement according to a predetermined intrinsic minimum PEEP.
  • a certain permissible intrinsic basic or minimum PEEP minimum PEEP
  • pCO2 value which during the automatic variation of control parameters tern of the air delivery unit for reducing the characteristics of the breathing air pressure curves and / or breathing air flow curves characteristic of the frustrating breathing movement is not fallen below.
  • the programmable control unit can be set up to determine a given intrinsic minimum PEEP based on pCO2 measurements.
  • pC02 denotes the carbon dioxide partial pressure, which reflects the amount of carbon dioxide dissolved in the blood of the living being.
  • the control unit can, for example, use measured pC02 values or pC02 value ranges and information or calculation instructions stored in the control unit to determine an intrinsic minimum PEEP and automatically vary control parameters in such a way that the intrinsic minimum PEEP is not fallen below. To check this condition and to regulate, the control unit can be set up to use the measured pCO2 values and / or the characteristics of the respiratory air pressure curves and / or the respiratory air flow curves that are characteristic of the frustrating breathing movement.
  • the control unit can be set up for continuous pCO2 measurement.
  • the device can have at least one pCO2 sensor for determining, in particular for the continuous or continuous determination of pCO2 values of the living being.
  • the pC02 sensor can be set up for transcutaneous or end-ti
  • the control parameter can for example also be an inspiration trigger or an expiration trigger for changing the device from an inspiration to an expiration mode or vice versa.
  • the programmable controller can automatically increase or reduce the sensitivity of the inspiration trigger or expiration trigger. For example, the sensitivity of the inspiration trigger or expiration trigger is increased or reduced until the programmable control unit no longer detects frustrating breathing movements as a result of trigger insufficiency.
  • the change in sensitivity of the inspiration or expiration trigger can also take place in response to a frustrating breathing movement as a result of intrinsic PEEP.
  • the ratio of the current to maximum respiratory flow used as a switchover criterion. If intrinsic PEEP occurs, the ratio can be increased so that an inspiration is switched to expiration more quickly. This reduces the intrinsic PEEP. The ratio can then be reset to the original value or reduced until characteristic features for an intrinsic PEEP are recognizable again.
  • the control parameter can also be a breathing air pressure and / or breathing air flow course, predetermined by the programmable control unit, of the air conveyed by the air conveying unit.
  • the air flow provided by the air delivery unit can be reduced or increased in order to support the living being's breathing efforts in a suitable manner.
  • the controller can also set different, respectively suitable increases or decreases in breathing air pressure and / or breathing air flow per unit of time or different minimum and maximum values of breathing air pressure and breathing air flow.
  • the control parameter can also be an air pressure and / or air flow profile of the air conveyed by the air conveying unit, which is predetermined by the programmable control unit.
  • the air flow provided by the air delivery unit can be reduced or increased in order to support the living being's breathing efforts in a suitable manner. It is also possible for the control to set different, respectively suitable increases or decreases in air pressure and / or air flow per unit of time or different minimum and maximum values of air pressure and air flow.
  • control parameters can also include, for example, an inspiration time or expiration time specified by the programmable controller, in particular a respective minimum or maximum inspiration time or expiration time, an IPAP value, an EPAP value, a pressure rise time (time in which the IPAP after triggering the Inspiration is reached) and a pressure drop time (time in which the EPAP is reached after the expiration is triggered).
  • the control parameters mentioned are particularly suitable for reducing or avoiding a frustrating breathing movement that occurs as a result of an intrinsic PEEP.
  • Indirect parameters such as a given tidal volume, that can be influenced by the parameters described above can be included as control or regulation variables.
  • the programmable control unit can, upon detection of a frustrating breathing movement occurring as a result of an intrinsic PEEP of the living being, to automatically reduce the backup frequency and / or the IPAP value and / or the maximum inspiration time and / or to automatically increase the expiratory trigger sensitivity be set up.
  • the programmable control unit can be set up to automatically increase the backup frequency and / or the IPAP value and / or the maximum inspiration time and / or to automatically reduce the expiratory trigger sensitivity after eliminating a frustrating breathing movement that occurs as a result of an intrinsic PEEP of the living being his.
  • the programmable control unit to automatically increase the backup frequency and / or the IPAP value and / or the maximum inspiration time and / or to automatically reduce the expiration trigger sensitivity up to a recognition of an intrinsic PEEP of the living being kicking frustrating breathing movement is established.
  • the control unit automatically sets an always optimal operating point of the device with a high level of user comfort.
  • a breathing air pressure and / or breathing air flow course predetermined by the programmable control unit is particularly relevant for ventilation devices with a deflation function.
  • An air pressure and / or air flow profile predetermined by the programmable control unit is particularly relevant for ventilation devices with a deflation function.
  • Such ventilation devices generate a counterpressure when the patient exhales. Due to the provided breathing resistance, the air pressure or breathing air pressure in the airways of the living being is increased in a termitting manner and a collapse of the airways is prevented.
  • the expiratory phase of the living being can be supported by regulating the air pressure or breathing air pressure in the respiratory organ in accordance with the breathing air flow or exhalation parameters derived therefrom in the exhalation phase such that the breathing air flow flowing out of the living being reaches a predetermined level . It is therefore not, as with known ventilators, a predetermined pressure is set, but the air pressure or breathing air pressure is regulated dynamically in accordance with the breathing air flow of the exhalation, so that a specific exhalation air flow can be ensured as a result.
  • the air pressure or breathing air pressure can be increased or reduced as required, whereby by regulating the air pressure or breathing air pressure according to the breathing air flow, a corresponding minimum pressure in the respiratory organs can be maintained dynamically as a changing counter pressure, so that the small ones Airways and their branches to the alveoli are kept open. It will thus create a certain dynamic resistance during exhalation, which is surprisingly perceived by patients as pleasant and supportive. The result is an improved exhalation and an avoidance of the unwanted overinflation of the lungs.
  • a relatively short pressure pulse when exhaling helps to open the airways.
  • the counterpressure is in particular an application of air pressure by the device that rises at least in sections during the expiratory phase and then falls again and is directed against the respiratory flow of the animal.
  • the resistance generated by the device with the inflation function can, however, also lead to the above-mentioned intrinsic PEEP if air cannot sufficiently escape from the respiratory tract and the lungs of the living being due to the counter pressure of the ventilator. It is therefore particularly important for ventilation devices with an integrated inflation function to identify the occurrence of frustrated breathing movements and, as a reaction, for example to vary the set back pressure parameters such as back pressure waiting time or back pressure amplitude or, for example, to activate or deactivate dynamic back pressure control.
  • a control parameter is a counterpressure and / or counterpressure curve predetermined by the programmable control unit and / or a counterpressure amplitude and / or counterpressure waiting time predetermined by the programmable control unit during the expiratory phase.
  • the counterpressure waiting time is a delay in the buildup of counterpressure after the change from an inspiration phase to an expiration phase; it is, for example, between 0 and 0.8 seconds after the start of expiration.
  • the counter-pressure amplitude and / or the counter- Pressure waiting time during the expiratory phase can be set as a function of one another and / or as a function of an IPAP value or IPAP value range and / or a differential pressure from IPAP to EPAP.
  • the back pressure waiting time can be longer, the higher the IPAP value or the higher the permissible IPAP value range selected.
  • the back pressure amplitude i.e. the maximum back pressure value, can be varied depending on the existing breathing air pressure and the back pressure waiting time.
  • the back pressure amplitude can be greater the higher the IPAP value or the higher the permissible IPAP value range selected.
  • the correlations between back pressure waiting time, back pressure amplitude and IPAP value can in particular be stored in the programmable control unit.
  • the programmable control unit can be set up to automatically determine and set an optimal counterpressure waiting time and an optimal counterpressure amplitude on the basis of an IPAP value set by external input.
  • the control unit preferably selects a longer counterpressure time and a higher counterpressure amplitude, the higher the entered or regulated IPAP value.
  • the counterpressure curve over time can also be varied so that, for example, a maximum counterpressure is reached or left sooner or later. Usually, a higher back pressure leads to a longer expiration time. However, too high a counterpressure can make expiration more difficult, so that the counterpressure parameters are advantageously regulated as a function of the occurrence of frustrated breathing movements.
  • intrinsic PEEP and trigger insufficiency can occur at the same time and influence or reinforce one another.
  • the sensitivity of the inspiration trigger to increased intrinsic PEEP can be too weak, since the residual pressure in the airways covers a negative pressure built up by the living being for inspiration.
  • pronounced breathing movements, leakages and / or a simultaneous intrinsic PEEP can overlap and make it difficult to recognize frustrating breathing movements based on characteristic features in the breathing air flow and breathing air pressure curves.
  • it can be effective in such a case to initiate several countermeasures in combination as a precaution, for example lowering the IPAP, shortening the counterpressure waiting time and reducing the counterpressure. Through this leakages and intrinsic PEEP are reduced at the same time.
  • the above-described implementation of oscillometric airway resistance measurements can be advantageous in distinguishing between intrinsic PEEP and trigger insufficiency.
  • the programmable control unit can furthermore be set up to recognize inspiratory inhibitions of the living being on the basis of characteristic features of the respiratory air pressure curves and / or the respiratory air flow curves.
  • characteristic features of the respiratory air pressure curves and / or the respiratory air flow curves Compared to a frustrating breathing movement, there is no phase divergence in the case of inhibition of inspiration, but rather a reduced or even interrupted breathing air flow of the living being during inhalation.
  • Inhibition of inspiration can occur reflexively, for example through a sensitive protective reflex such as the Hering-Breuer reflex.
  • Characteristic features of such an inspiratory inhibition can be expressed in recorded respiratory air pressure curves and / or respiratory air flow curves, for example as respiratory air flow curves which drop steeply in the early inspiration phase while the IPAP level remains unchanged.
  • the programmable control unit can be set up to automatically vary control parameters of the air delivery unit and, for example, adjust predetermined breathing air pressure and / or breathing air flow profiles of the air delivered by the air delivery unit, in particular also a pressure rise time, in a suitable manner until the characteristic features of the inhibition of inspiration no longer occur.
  • the IPAP can also be reduced.
  • the device can also output an optical, acoustic and / or haptic warning signal to indicate the inhibition of inspiration.
  • the characteristic features of the respiratory air pressure curves and / or the respiratory air flow curves can also be viewed as characteristic patterns, especially if they are viewed or evaluated in connection with one another, since they can repeatedly occur in the same or similar manifestations in frustrating breathing movements.
  • the programmable control unit has a pattern recognition unit for recognizing characteristic features of the breathing air pressure curves and / or the breathing air pressure current curves on.
  • the programmable control unit can be equipped with a corresponding pattern recognition and / or classification software that can carry out computational pattern recognition and classification processes by means of main component analyzes, discriminant analyzes or support vector machines.
  • the use of artificial neural networks is also advantageous.
  • the invention also comprises a method for assisting ventilation of a living being with a ventilator, whereby by means of a pressure sensor and an air flow sensor of the ventilator, respiratory air pressure values and respiratory air flow values of the living being that follow one another in time are recorded and with a programmable control unit of the ventilator from the breathing air pressure values and breathing air flow values formed breathing air pressure curves and breathing air flow curves are evaluated and with the help of characteristic features of the breathing air pressure curves and / or the breathing air flow curves frustrating breathing movements of the living being recognized.
  • the advantages explained above can also be realized in this way.
  • the ventilator can be designed as a device of the type explained above.
  • the characteristic features can be maxima, minima, turning points, saddle points, amplitudes, integrals and / or derivatives in predefined time points and / or time segments of the respiratory air pressure curves and / or the respiratory air flow curves.
  • the characteristic features can also be characteristic deviations from predetermined reference breath air pressure profiles and / or reference breath air flow profiles.
  • the method can include storing predetermined reference breath air pressure profiles and / or reference breath air flow profiles and / or reference features for characteristic features of frustrating breathing movements in a memory unit of the programmable control unit.
  • predetermined reference breath air pressure profiles and / or reference breath air flow profiles and / or reference features for characteristic features of frustrating breathing movements in a memory unit of the programmable control unit.
  • it is possible to store various disease-specific reference breath air pressure profiles and / or reference breath air flow profiles and / or different disease-specific reference Features for characteristic features of frustrating breathing movements can be provided in the storage unit.
  • the method can include a detection of frustrated breathing movements of the living being based on a phase divergence that occurs between the real ventilation phase of the living being and a ventilation phase carried out by the ventilator.
  • the method can contain a distinction between a frustrated breathing movement occurring as a result of an intrinsic PEEP of the living being and a frustrating breathing movement occurring as a result of triggersufficiency on the basis of characteristic features of the respiratory air pressure curves and / or the respiratory air flow curves.
  • the method can differentiate between a frustrated breathing movement occurring as a result of a leakage-related trigger insufficiency and a frustrating breathing movement occurring as a result of a parameter-related trigger insufficiency on the basis of characteristic features of the respiratory air pressure curves and / or the respiratory air flow curves.
  • the method can identify a frustrated breathing movement based on the point in time, the time span and / or the form of an increase or reduction in breathing air pressure and / or breathing air flow in the breathing air pressure curves and / or breathing air flow curves and in particular to differentiate between an intrinsic PEEP of the living being and a frustrating breathing movement occurring as a result of a trigger insufficiency based on the point in time, the time span and / or the form of an increase or reduction in breathing air pressure and / or air flow in the breathing air pressure profiles and / or breathing air flow profiles.
  • the method can recognize a frustrated breathing movement and in particular to differentiate a frustrating breathing movement occurring as a result of an intrinsic PEEP of the living being and a frustrating breathing movement occurring as a result of trigger insufficiency on the basis of characteristic features of Breathing air flow curves and related characteristic features of the breathing air pressure curves contain.
  • the method may further include performing oscillometric airway resistance measurements.
  • the method can include a determination of the frequency and / or intensity of the intrinsic PEEP or the trigger insufficiency.
  • an output of an in particular acoustic, optical and / or haptic alarm signal can be provided when a predetermined threshold value for the frequency and / or intensity of the intrinsic PEEP or the trigger insufficiency is exceeded.
  • the method can include an automatic variation of control parameters of the air delivery unit when a frustrating breathing movement is detected.
  • a continuous regulating automatic variation of control parameters of the air delivery unit can be provided to reduce and / or eliminate the characteristics of the breathing air pressure curves and / or the breathing air flow curves characteristic of the frustrating breathing movement.
  • the method can contain an automatic variation of control parameters of the air delivery unit in order to reduce the characteristics of the breathing air pressure curves and / or the breathing air flow curves that are characteristic of the frustrating breathing movement according to a predetermined intrinsic minimum PEEP.
  • a predetermined intrinsic minimum PEEP can be determined on the basis of pCO2 measurements.
  • a suitable control parameter is, for example, an inspiration trigger or expiration trigger for changing the device from an inspiration to an expiration mode or vice versa.
  • Another suitable control parameter is, for example, a breathing air pressure and / or breathing air flow course of the air conveyed by the air conveying unit, which is predetermined by the programmable control unit.
  • Another suitable control parameter is, for example, an air pressure and / or air flow, predetermined by the programmable control unit, of the air conveyed by the air conveying unit.
  • the control parameter can also be a counterpressure and / or counterpressure curve prescribed by the programmable control unit and / or a counterpressure amplitude and / or counterpressure waiting time prescribed by the programmable control unit during the expiration phase.
  • the counterpressure amplitude and / or the counterpressure waiting time during the expiratory phase can be set as a function of one another and / or as a function of an IPAP value or IPAP value range and / or as a function of a differential pressure from IPAP to EPAP.
  • the method can include an automatic reduction of the IPAP value and / or the maximum inspiration time and / or an automatic increase in the expiratory trigger sensitivity upon detection of a frustrating breathing movement occurring as a result of an intrinsic PEEP of the living being.
  • the method can contain an automatic increase in the IPAP value and / or the maximum inspiration time and / or an automatic reduction in the expiratory trigger sensitivity after eliminating a frustrating breathing movement that occurs as a result of an intrinsic PEEP of the living being.
  • the method can include a recognition of inspiratory inhibitions of the living being based on characteristic features of the respiratory air pressure curves and / or the respiratory air flow curves.
  • the method can contain a pattern recognition for recognizing characteristic features of the breathing air pressure curves and / or the breathing air flow curves.
  • the object of the invention is also achieved by a computer program with program code means, set up to carry out a method for supporting ventilation of a living being with a ventilator, when the computer program is executed on a computing unit of the ventilator, using a pressure sensor and an air flow sensor Respiratory air pressure values and air flow values of the living being that follow each other over time are recorded and the respiratory air pressure and air flow curves formed from the breathing air pressure values and air flow values are evaluated using characteristic features of the breathing air pressure curves and / or the Breath airflow gradients frustrating respiratory movements of the living being recognized and in particular differentiated with regard to their cause, for example as a result of an intrinsic PEEP of the living being or as a result of trigger insufficiency.
  • the advantages explained above can also be realized in this way.
  • FIG. 1 shows a device for assisting ventilation of a living being
  • FIG. 2 shows a normal breathing air pressure and breathing air flow course
  • FIGS. 6-8 respiratory air pressure curves over time during a breathing cycle with activated inflation function of the device; and FIG. 9 shows a real recorded breathing air pressure curve and
  • FIG. 1 shows a device 1 for assisting ventilation of a living being 3.
  • the device 1 has a hose 8 and a breathing mask 2 or another suitable interface for connecting the device 1 to the living being 3.
  • the breathing mask 2 is for this purpose on the mouth, for example and / or nose or can be connected to deeper airways of the living being 3.
  • the breathing mask 2 has an outlet 4 which is open to the atmosphere and which is connected to the hose 8 via a throttle point 5. In this way, a defined leakage can be provided in the breathing mask 2.
  • the device 1 has a controllable air delivery unit 6 with a fan for generating the overpressure required for the supportive ventilation in the respiratory organs of the living being 3. Via the air delivery unit 6, for example, air is sucked in from an air inlet 7 connected to the atmosphere and compressed accordingly via the Hose 8 to the breathing mask 2 and thus to the living being 3.
  • the device 1 has a sensor arrangement with a pressure sensor 9 and an air flow sensor 11, which are set up for the temporally successive detection of respiratory air pressure values and respiratory air flow values of the living being 3.
  • the air delivery unit 6 can have an integrated pneumotachographic measuring arrangement for measuring pressure and / or volume flow.
  • the pressure sensor 9, the air flow sensor 11 and the air delivery unit 6 are connected to a programmable control unit 10 via electrical lines.
  • the programmable control unit 10 evaluates the respiratory air pressure curves and respiratory air flow curves formed from the respiratory air pressure values and respiratory air flow values recorded by the pressure sensor 9 and the air flow sensor 11.
  • the programmable control unit 10 is set up to recognize frustrating respiratory movements of the living being 3 on the basis of characteristic features of the respiratory air pressure curves and / or the respiratory air flow curves.
  • the programmable control unit is also set up to determine the cause (s) of the frustrating breathing movements and, if necessary, to take countermeasures to reduce or avoid the frustrating breathing movements.
  • it can optionally have a suitable memory unit, suitable software, transmission means and / or a pattern recognition unit (in each case not shown in more detail).
  • FIG. 2 shows, in a highly schematic manner, a normal breathing air pressure and breathing air flow course, as it can ideally be measured in a healthy living being under ventilation.
  • the upper diagram shows a breathing air pressure curve as a function of pressure p over time t.
  • the middle diagram shows a breathing air flow curve as a function of the volume flow v over time t.
  • the lower diagram shows the time sequence of ventilation modes of the device 1, here an inspiration mode INSP and an expiration mode EXSP during a breathing cycle as a result of an automatic detection of the ventilation phase Ti, TE of the living being 3 by the device 1. All that is shown is a complete breathing cycle with an inspiration phase Ti and an expiration phase TE, which can be viewed as representative of previous and subsequent breathing cycles.
  • the breathing cycle begins at time to and ends at time t2.
  • the change from an inspiration phase Ti to an expiration phase TE takes place after approximately half of the breathing cycle at time ti.
  • the time ti can, however, also be significantly closer to to, so that the ratio of Ti to TE can also assume values of 1: 2 to 1: 4 or can be even smaller. In individual cases, time ti can also be closer to t2.
  • Figure 2 it can be seen that the breathing air pressure in the inspiration phase Ti is initially steadily increased to the IPAP value pi, then assumes an approximately constant pressure level at the level of the IPAP value pi over a certain period of time and still in the inspiration phase Ti steadily decreases.
  • the breathing air flow initially increases steadily in the inspiration phase Ti and, after reaching a local maximum, continues to decrease in the inspiration phase Ti.
  • the breathing air flow changes to a value range below the initial level of the inspiring air flow, which illustrates the change in the direction of the breathing flow of the living being.
  • an inspiration trigger of the device 1 detects the end of an expiration TE and / or the beginning of an inspiration Ti of the living being 3, idealized here at time to, and causes the programmable control unit 10 to switch on an inspiration mode INSP of the control unit 10.
  • the inspiration mode INSP can For example, the air delivery unit 6 generate an overpressure supporting the inspiration of the living being 3 with a given pressure profile.
  • an expiration trigger of the device 1 recognizes the end of an inspiration Ti and / or the beginning of an expiration TE of the living being 3, idealized here at time ti, and causes the programmable control unit 10 to switch on an expiration mode EXSP of the control unit 10 EXSP, for example, the air delivery unit 6 can generate an overpressure supporting the expiration of the living being 3 with a predetermined pressure profile.
  • the control unit 10 ends the expiratory mode EXSP, for example on the basis of a signal from the inspiration trigger.
  • the idealized representation of the switching times of the two modes does not take into account any technical delay times such as electronic switching times.
  • the beginning or the end of the inspiration mode INSP or expiration mode EXSP are not rigidly specified by the control unit 10, but are dynamically adapted to the ventilation phases Ti, TE of the living being 3 by recognizing a corresponding breathing effort of the living being 3.
  • FIGS. 3 to 5 show breathing air pressure curves and breathing air flow curves, each with a breathing cycle consisting of the modes INSP and EXSP with a frustrating breathing movement and a subsequent breathing cycle without frustrating breathing movement for comparison.
  • the curves shown here have different characteristic features or feature combinations Mi to M4 for frustrated breathing movements of the living being 3. It should be pointed out that the characteristic features or feature combinations Mi to M4 shown here are, on the one hand, highly schematic in order to increase understanding and, on the other hand, they only represent examples of features that have already been identified as characteristic in tests.
  • the first breathing cycle which has a frustrating breathing movement, begins at time to and ends at time t2.
  • the change from an inspiration phase Ti to an expiration phase TE of the living being 3 takes place at time ti.
  • a characteristic feature Mi, M2, M3, M4 occurs in the breathing air pressure curve and / or the breathing air flow curve.
  • the second breathing cycle which has no frustrating breathing movement, begins at time t2 and ends at time t6.
  • the change from an inspiration phase Ti to an expiration phase TE of the living being 3 takes place at time t5.
  • FIG. 3 it can be seen that within the expiratory phase TE during the increase in the respiratory air flow curve between times t3 and t4, an increase in respiratory air flow which is pronounced as a bulge occurs as a characteristic feature Mi.
  • an increase in breathing air pressure pronounced as a bulge can be seen as a further characteristic feature M2 essentially at the same time as the characteristic feature Mi.
  • the features Mi and M2 can already be considered characteristic features of a frustrating breathing movement represent. However, they can also form a common characteristic of a frustrated breathing movement and be evaluated in relation to one another or in relation to one another. For example, it can be specified in the programmable control unit 10 that in the sense of a two-factor dependency, the existence of a frustrating breathing movement is only concluded when the characteristic features Mi and M2 occur together.
  • the characteristic features Mi and M2 are not only characteristic of a frustrated breathing movement in general, but in particular for a frustrating breathing movement as a result of trigger insufficiency. If the programmable control unit 10 detects an increase in breathing air flow present as a bulge in the breathing air flow as well as an essentially simultaneous increase in breathing air pressure in the form of a bulge, which preferably also have essentially the same or similar slopes and / or integrals, the control unit 10 closes the presence of a frustrating breathing movement due to trigger insufficiency.
  • the characteristic features Mi and M2 are not only characteristic of trigger insufficiency, but in particular of leakage-related trigger insufficiency.
  • the trigger insufficiency shown is thus caused by leaks or insufficient correction values determined by the programmable control unit 10 to take account of leakage values such as mask leaks or technical leaks and can be reduced or avoided independently by the programmable control unit 10 by taking appropriate countermeasures.
  • FIG. 4 it can be seen that within the expiratory phase TE of the breathing air flow curve, during the increase in the breathing air flow between times t3 and t4, an increase in breathing air flow which is pronounced as a bulge occurs as a characteristic feature Mi.
  • a characteristic feature Mi In the respiratory air pressure profile, an increase in respiratory air pressure that is pronounced as a peak can be seen as a further characteristic feature M3 between times t3 and t4 near t4.
  • the features Mi and M3 can each represent characteristic features of a frustrated breathing movement. However, they can also have a common characteristic a frustrating breathing movement and are evaluated coherently or in relation to one another. For example, it can be established in the programmable control unit 10 that in the sense of a two-factor dependency, the existence of a frustrating breathing movement is only concluded when the characteristic features Mi and M3 occur together.
  • the characteristic features Mi and M3 are not only characteristic of a frustrated breathing movement in general, but in particular for a frustrating breathing movement as a result of an intrinsic PEEP of the living being 3. If the programmable control unit 10 detects an increase in breathing air flow present as a bulge in the breathing air flow as well as a breathing air pressure increase that occurs simultaneously or during a second half of the time of the breathing air flow increase and is designed as a peak, the breathing air pressure increase preferably being a smaller integral over the time of the increase than the breathing Heilstromerhö hung, the control unit 10 concludes on the presence of a frustrating breathing movement as a result of an intrinsic PEEP.
  • FIG. 5 it can be seen that within the expiratory phase TE of the breathing air flow curve, during the increase in the breathing air flow between times t3 and t4, an increase in breathing air flow which is pronounced as a bulge occurs as a characteristic feature Mi.
  • a peak reduction in respiratory air pressure can be seen in the first half of the period between times t3 and t4, and a peak increase in respiratory air pressure as a common characteristic feature M4 in the second half of the period between times t3 and t4.
  • the features Mi and M4 can each represent characteristic features of a frustrated breathing movement. However, they can also form a common characteristic feature of a frustrated breathing movement and be evaluated in relation to one another or in relation to one another.
  • the characteristic features Mi and M4 are characteristic not only of a frustrating breathing movement in general, but in particular of a frustrating breathing movement as a result of trigger insufficiency.
  • the programmable control unit 10 detects an increase in the breathing air flow present as a bulge in the breathing air flow as well as a peak reduction in breathing air pressure during the first half of the period between times t3 and t4 and in the second half of the period between times t3 and t4 an increase in breathing air pressure pronounced as a peak, the breathing air pressure increases preferably each having a smaller integral over the time of the increase than the breathing air flow increase, the control unit 10 concludes that a frustrating breathing movement is present due to trigger insufficiency.
  • the characteristic features Mi and M4 are characteristic not only of trigger insufficiency, but in particular of parameter-related trigger insufficiency.
  • the trigger insufficiency shown is caused by the programmable control unit 10 predetermined parameter values for sensitivity settings of the inspiration and / or expiration trigger and can be reduced or avoided by appropriate countermeasures independently by the control unit 10 or by external correction inputs.
  • respiratory air pressure curves over time during a breathing cycle with activated inflation function of the device 1 are shown by way of example.
  • the device 1 in the expiratory phase TE of the breathing cycle, the device 1 generates a counter-pressure which provides the living being 3 with breathing resistance and thereby enables a more comfortable exhalation and prevents collapse of the respiratory tract.
  • the breathing cycle begins at time to with an increase in the breathing air pressure to the IPAP value pi. Inspiration ends at time ti and expiration begins, which ends at time t2. Between times ti and t2, that is to say during expiration, the device 1 generates a counterpressure.
  • the back pressure is controlled in particular dynamically from a back pressure start time tGA to a back pressure end time tGE.
  • a maximum counter pressure, the counter pressure amplitude PG, is reached between the times tGA and tGE.
  • this counter pressure is already generated with the start of expiration at time ti, that is to say without a counterpressure waiting time after time ti.
  • FIGS. 7 and 8 there is a delayed initiation of the counterpressure generation, so that there is a time difference between the point in time ti and the point in time tGA. This time difference is referred to as the back pressure waiting time TGW.
  • the counterpressure waiting time TGW is set longer than in FIG. 7.
  • the fleas of the IPAP values pi and the counterpressure amplitudes PG in FIGS. 6 to 8 are selected to be different.
  • the back pressure parameters of the back pressure generated by the device 1 are thus variably adjustable, specified by the programmable control unit 10 and / or dynamically adaptable to the breathing air flow of the living being 3.
  • the counterpressure parameters include, in particular, the counterpressure waiting time TGW, the counterpressure amplitude PG and the counterpressure rise and counterpressure decrease times.
  • the counterpressure waiting time TGW is the time span between the point in time of the change from an inspiration phase to an expiration phase and the start of the counterpressure build-up generated by the device 1.
  • the counterpressure amplitude PG describes the maximum pressure value of the counterpressure above the pressure value that prevails at the point in time ti + TGW at which no counterpressure is yet generated by the device 1.
  • the back pressure amplitude PG is preferably selected as a function of the back pressure waiting time TGW. Furthermore, the backpressure waiting time TGW is preferably selected as a function of the level of the I-PAP value pi.
  • the counterpressure curve over time can vary in order to meet the individual needs of the living being 3 for breathing resistance. For example, the counterpressure curve in FIG. 8 has a less steep counterpressure drop time compared to the counterpressure curve in FIG. 6 or 7.
  • the back pressure parameters are preferably automatically regulated by the programmable control unit 10 in such a way that the occurrence of frustrated breathing movements is avoided or at least reduced by the control unit 10 varying the back pressure parameters in a suitable manner when frustrated breathing movements are recognized on the basis of characteristic features.
  • FIG. 9 shows a respiratory air pressure curve and a respiratory air flow curve with recognizable frustrated breathing movements that are actually recorded on the basis of measured values of a living being 3.
  • the upper diagram shows the breathing air pressure curve and the lower diagram shows the breathing air flow curve.
  • the beginning and end of the respiratory air flow increase in a breathing cycle are indicated by arrows A and B.
  • increases in breathing air pressure that are pronounced as peaks can repeatedly be recognized, the peaks of the breathing air pressure increases being clearly smaller than the increases in breathing air flow that are pronounced as bulges.
  • the respiratory air pressure increases occur temporally at the end of the respiratory air flow increases present as bulges, as can be seen for the breathing cycle selected as an example by the arrow C, which characterizes the occurrence of the respiratory air pressure increase.

Abstract

L'invention concerne un dispositif (1) de respiration de soutien d'un être vivant (3), ledit dispositif comprenant un agencement de capteurs, une unité de commande programmable (10) et une unité de transport d'air (6), cette dernière pouvant être commandée par l'unité de commande (10). L'agencement de capteurs comprend un capteur de pression (9) et un capteur d'écoulement d'air (11), qui sont conçus pour la détection temporellement successive de valeurs de pression respiratoire et de valeurs d'écoulement d'air respiratoire de l'être vivant (3). L'unité de commande programmable (10) est conçue pour évaluer les profils de pression d'air respiratoire et les profils d'écoulement d'air respiratoire formés à partir des valeurs de pression respiratoire temporellement successives et des valeurs d'écoulement d'air respiratoire détectées par l'agencement de capteurs dans le but de fournir une respiration pour l'être vivant (3), qui est en particulier confortable et individuellement adaptée aux besoins actuels de l'être vivant (3). Selon l'invention, l'unité de commande programmable (10) est conçue pour détecter des mouvements respiratoires infructueux de l'être vivant (3) et leur cause sur la base d'éléments caractéristiques des profils de pression respiratoire et/ou des profils d'écoulement d'air respiratoire. L'invention concerne en outre un programme informatique comprenant un moyen de code de programme, conçu pour mettre en œuvre un procédé de respiration de soutien d'un être vivant (3) au moyen d'un dispositif respiratoire (1) lorsque le programme informatique est exécuté sur une unité informatique du dispositif respiratoire (1).
EP20745173.3A 2019-07-26 2020-07-22 Dispositif de respiration de soutien d'un être vivant et programme informatique Pending EP4004937A1 (fr)

Applications Claiming Priority (2)

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DE102019120307.4A DE102019120307A1 (de) 2019-07-26 2019-07-26 Vorrichtung zur unterstützenden Beatmung eines Lebewesens und Computerprogramm
PCT/EP2020/070687 WO2021018691A1 (fr) 2019-07-26 2020-07-22 Dispositif de respiration de soutien d'un être vivant et programme informatique

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EP (1) EP4004937A1 (fr)
CN (1) CN114144218A (fr)
AU (1) AU2020321288B2 (fr)
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WO (1) WO2021018691A1 (fr)

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CN112401867A (zh) * 2019-08-21 2021-02-26 西门子(深圳)磁共振有限公司 确定呼吸阶段的方法及装置、磁共振成像方法及系统
CN114917438A (zh) * 2022-05-17 2022-08-19 山东大学 一种基于流速控制的呼吸机工作方法及呼吸机

Family Cites Families (18)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SE9801427D0 (sv) * 1998-04-23 1998-04-23 Siemens Elema Ab Förfarande för bestämning av minst en parameter samt en andningsapparat
CN101043913B (zh) * 2004-10-20 2012-02-08 雷斯梅德有限公司 用于检测无效吸气努力并改进患者-呼吸机相互作用的方法和装置
DE102005031808B4 (de) * 2005-04-22 2018-08-16 Löwenstein Medical Technology S.A. Vorrichtung zur Drucksteuerung bei Beatmungsgeräten
DE202005017045U1 (de) * 2005-07-21 2006-07-20 Weinmann Geräte für Medizin GmbH & Co. KG Vorrichtung zur Zufuhr eines Atemgases
WO2007131314A1 (fr) * 2006-05-12 2007-11-22 Yrt Limited Procédé et dispositif pour générer un signal reflétant les efforts respiratoires de patients sous assistance respiratoire
DE112007002265T5 (de) * 2006-09-29 2009-10-08 Draeger Medical Systems, Inc., Andover System zum Verarbeiten, Herleiten und Anzeigen von Beziehungen zwischen medizinischen Patientenparametern
DE102010010248A1 (de) * 2010-03-03 2011-09-08 Forschungszentrum Borstel Leibniz-Zentrum Für Medizin Und Biowissenschaften Beatmungsverfahren und Beatmungsgerät
US8607791B2 (en) * 2010-06-30 2013-12-17 Covidien Lp Ventilator-initiated prompt regarding auto-PEEP detection during pressure ventilation
EP2686050B1 (fr) * 2011-03-18 2018-04-25 Maquet Critical Care AB Appareil respiratoire et procédé d'aide à la ventilation
DE102012024672A1 (de) * 2012-12-18 2014-06-18 Dräger Medical GmbH Beatmungsgerät und Verfahren zum Betrieb eines Beatmungsgerätes
US20140261409A1 (en) * 2013-03-13 2014-09-18 Covidien Lp Systems and methods for ventilation with unreliable exhalation flow and/or exhalation pressure
US20150090258A1 (en) * 2013-10-01 2015-04-02 Covidien Lp Ventilator-initiated prompt or setting regarding detection of asynchrony during ventilation
WO2017068464A1 (fr) * 2015-10-19 2017-04-27 Koninklijke Philips N.V. Dispositif de détection d'anomalie et procédé pour l'estimation de paramètres de mécanique respiratoire
EP3405245A4 (fr) * 2016-01-18 2019-09-11 Fisher&Paykel Healthcare Limited Humidification de gaz respiratoires
CN109069030B (zh) * 2016-02-18 2021-10-19 皇家飞利浦有限公司 经由使用中心静脉压测压法增强呼吸参数估计和异步检测算法
EP3338843A1 (fr) * 2016-12-23 2018-06-27 Löwenstein Medical Technology S.A. Dispositif respiratoire à spécification d'un profil de pression individuel du patient
US10874811B2 (en) * 2017-11-09 2020-12-29 Autonomous Healthcare, Inc. Clinical decision support system for patient-ventilator asynchrony detection and management
DE102018004341A1 (de) * 2018-05-31 2019-12-05 Drägerwerk AG & Co. KGaA Beatmungsgerät und Verfahren zum Betrieb eines Beatmungsgeräts

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WO2021018691A1 (fr) 2021-02-04
AU2020321288A1 (en) 2022-03-03
DE102019120307A1 (de) 2021-01-28
CN114144218A (zh) 2022-03-04
AU2020321288B2 (en) 2023-06-15
US20220305227A1 (en) 2022-09-29

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