JP2004222785A - Artificial respirator - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an artificial respirator allowing a person, who happens to be at the scene of an accident, to easily and precisely perform emergency cardiopulmonary resuscitation using a portable and lightweight artificial respirator and allowing a patient to smoothly withdraw from the respirator. <P>SOLUTION: This artificial respirator having an automatic inspiration mechanism is provided with a mechanism of setting a signal transmission period issuing repetition signals instructing heart compressing timings at fixed interval periods and signal stop periods of fixed interval periods, and a means of stopping the feed of inspiration air synchronously with the signal transmission periods. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a ventilator for emergency cardiopulmonary resuscitation used for a patient in a state of asphyxia.
[0002]
[Prior art]
In the event of syncope or asphyxia due to an accident, illness, disaster, etc., if breathing or heartbeat stops, the cardiopulmonary resuscitation needs to be performed as soon as possible because the mortality rate becomes extremely high after several minutes of cardiopulmonary arrest. . Conventionally, in such an emergency, the practitioner alternates between artificial respiration, in which air is directly blown into the patient's mouth by mouth, and heart massage, which intermittently presses the point of the chest with hands to encourage resuscitation of the heart. Emergency cardiopulmonary resuscitation methods performed at a prescribed rate have been performed. While this method does not require any instruments or equipment and has the great advantage of being able to be performed at any site, it has the disadvantage that the practitioner who happens to be is not necessarily proficient in emergency resuscitation. In addition, there is a risk that a layman may hesitate to perform the operation and inject valuable time if the practitioner directly blows air from his own mouth into the patient's mouth. There is also the possibility of contact or airborne infection if not done through a separator. Emergency cardiopulmonary resuscitation methods using equipment and devices can avoid such problems, and in recent years have progressed rapidly and high-performance ones have been installed in emergency vehicles and hospitals. In addition, although skilled practitioners are also provided, it is rare to be able to immediately connect to such equipment, and there is a serious drawback that a practitioner cannot immediately receive treatment at the accident site. Furthermore, such emergency resuscitation equipment and devices are generally large and heavy, and it is difficult to bring them to the site by human power.
In order to solve such difficulties, an emergency cardiopulmonary resuscitation method that can respond at the scene of an accident without using a large device or device has been proposed. For example, a portable ventilator has been proposed in which a practitioner can send air without bringing his / her own mouth into contact with a patient's mouth (Japanese Patent Application Laid-Open No. 2002-65555). This portable ventilator is lightweight and can discharge blood and vomit from the patient to the outside.However, even if forced insufflation is possible, exhaled carbon dioxide is insufficiently discharged and Artificial respiration and ventilation can not be performed at the correct cycle, and it is not possible to reliably cooperate with heart massage that promotes resuscitation of the heart. Therefore, there is a disadvantage that the spontaneous respiration promoting effect is weak.
Also, a software-driven ventilator has been proposed (Japanese Patent Laid-Open No. 2000-140113). This method is an improved software controller for a positive pressure ventilator, but does not involve the use of ventilator with heart massage. In addition, according to the heart massage method recommended by the American Heart Association (AHA) in recent years, both the compression speed of the heart and the number of consecutive times of the heart increase, and as a result, the resuscitation practitioner can perform compression treatment at fixed intervals for a long time. It is becoming increasingly difficult to do the work, and the need for accurate compression work has been pointed out.
Furthermore, a recording medium for an automatic respirator winning system using fuzzy logic control has been proposed (JP-A-11-206884). This method is performed by a physician while observing the patient's condition, and has a drawback that the patient cannot perform a training at home at a mode set by himself / herself.
Also, an automatic cardiopulmonary resuscitation device has been proposed in which a heart massage is performed by repeatedly applying an impact at an adjusted regular time interval and a respiratory gas is ventilated and supplied at the adjusted time and period (Japanese Patent Laid-Open No. 2000-2000). 84028). This automatic cardiopulmonary resuscitation device is installed in an ambulance or the like to allow the rescue worker to take appropriate measures promptly while monitoring the condition of the patient. Neither does it perform massage, nor does it provide a ventilator that can smoothly perform withdrawal training from the ventilator.
[Patent Document 1]
JP-A-2002-65555
[Patent Document 2]
JP-A-2000-140113
[Patent Document 3]
JP-A-11-206884
[Patent Document 4]
JP 2000-84028 A
[0003]
[Problems to be solved by the invention]
The present invention makes it possible for a person present at the accident site of a patient in a state of asphyxia to easily and accurately perform emergency cardiopulmonary resuscitation, and to quickly switch from manual cardiopulmonary resuscitation to an ambulance transport ventilator. It is an object of the present invention to provide a ventilator that can be achieved and that can smoothly perform withdrawal training from the ventilator.
[0004]
[Means for Solving the Problems]
The present inventors have conducted intensive studies on a means for adapting to the circumstances of an accident requiring emergency cardiopulmonary resuscitation, and as a result of performing a heart massage manually by a practitioner, according to the signal from the ventilator of the present invention. The inventor found that if inhaled and exhaled by a computer-controlled ventilator in conjunction with it, even an inexperienced person could immediately and accurately carry out emergency cardiopulmonary resuscitation and quickly transport it, and completed the present invention. .
That is, the present invention
(1) In a ventilator having an automatic inspiratory mechanism, a mechanism for setting a signal transmission period for issuing a repetitive signal indicating a cardiac compression timing at a constant interval and a signal pause period at a constant interval for a period following the signal transmission period; A ventilator having means for stopping supply of inhalation in synchronization with the signal transmission period,
(2) The mechanism for setting the signal transmission period and the signal pause period having a period of a constant interval following the signal transmission period sets the interval of the period of the repetitive signal to 0.4 to 2.5 seconds and sets the number of repetitions of the repetitive signal to The respirator according to claim 1, wherein the respirator is set to 3 to 30 times,
(3) The mechanism for setting the signal transmission period and the signal pause period having a period of a constant interval following the signal transmission period has variable means for changing the interval of the period of the repetitive signal and variable means for changing the number of repetitions of the repetitive signal. The respirator according to item 1 or 2, wherein
(4) The respirator according to any one of (1), (2) and (3), wherein the repetitive signal indicating the timing of cardiac compression is sound or light.
(5) A decorative signal capable of distinguishing 1 to 5 signals from the first signal or the last signal of the repetitive signal indicating the repetitive cardiac compression time or from each of the two signals. The respirator of paragraph 2, paragraph 3 or paragraph 4, and
(6) The artificial respiration according to any one of (1), (2), (3), (4) and (5), further comprising means capable of controlling the interval of the signal pause period to 5 to 40 seconds. vessel,
Is provided.
[0005]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, the present invention will be described in more detail with reference to the drawings. However, these drawings show one embodiment, and the present invention is not limited thereto.
The signal for instructing the cardiac compression timing of a fixed interval used in the present invention is a signal for instructing the timing of applying a compression stimulus for cardiac resuscitation at intervals of a fixed interval, and in the case of a cardiac massage by the use method. Indicates the time at which the practitioner applies the compression stimulus. When a heart massage machine is used, this signal can be transmitted to the heart massage machine to indicate the heart compression time.
Heart massage by a method that can be used with the ventilator of the present invention is a method of stimulating the chest of a patient with the hands of a practitioner without using an instrument. Normally, the practitioner faces the side of the patient's back on the back and places the palm of one hand on the center line of the sternum near the heart two fingers from the lower center of the sternum, and places the palm of the other hand on the palm and places both hands Can exert pressure on the heart by applying force to the palm. The predetermined number of times is repeated until the heart rate recovers in a predetermined cycle, and the pressing force is adjusted according to the physique (strength of the sternum) of the patient. As shown in FIG. 1 and FIG. 2, if the preparation is made with the start notice signal 4 for the start of the heart massage from the ventilator and the compression is performed according to the heart compression timing signal 5 issued each time, the compression can be performed accurately. Can be. By receiving the heart massage end signal 6 (final compression signal), the operation can be taken over to the automatic operation of the ventilator.
The signal transmission period for issuing the repetitive signal used in the present invention is a cardiac massage execution time M, which is from the first notice signal 4 to the first to last cardiac massage end signal 6 of the cardiac compression timing signal 5 after the start notice signal 4. This is the total signal period transmitted every time.
The interval of the cycle of the repetitive signal (compression time t for one cardiac massage) and the number of repetitions can be set or changed by the mode setting P1 of the operation panel P shown in FIG.
As shown in FIG. 1 and FIG. 2, after a signal transmission period for generating the repetitive signal is completed, the respiratory apparatus automatically operates and the inhalation I and the expiration E are used in the signal pause period of a fixed interval used in the present invention. Is a period during which the set ventilation period elapses by repeating the cycle from the start of inspiration 7, the end of inspiration 9 and the start of expiration 10 to the end of expiration 12 during the period of inspiration, and a signal during this period. Is not transmitted and can be a suspension period.
The interval of the signal pause period used in the present invention can be 5 to 40 seconds. The interval of this cycle is the sum of a series of periods of inspiration I and expiration E and a series of cardiac massage periods, and corresponds to the time from the start of inspiration 7 to the start of inspiration in the next cycle.
The setting mechanism used in the present invention fulfills a function of driving a device of a ventilator through an instruction manually given by a dial or the like or information transmission from a computer program. Instructions given manually by a dial or the like are provided by the number of ventilations P2, respiration time P3, tidal volume P4, trigger P5, inspired gas oxygen concentration, end-expiratory positive pressure breathing (PEEP) which are usually provided in a conventional ventilator. ), A cycle interval at the time of repetition, a number of repetitions at the time of repetition, and an interval of a cycle of a signal pause period, which are newly provided in the present invention, can be set. The massage end signal 6 can be transmitted by a sound signal or a light signal.
[0006]
The heart massage end signal 6 includes 1 to 5 signals including the final signal of the repetition signal indicating the repetitive cardiac compression time, the pitch, transmission length, tone, etc., and the color of light, transmission length, etc. Can be clearly distinguished from other cardiac compression timing signals 5 that continue, and the operator can be alerted. Similarly, the start notice signal 4 of the start of compression can be inserted as a single signal or a continuous signal as a decoration signal clearly distinguished from the cardiac compression timing signal 5. Reference numeral 4 in FIG. 1 is an example in which a sound of 0.1 second is continuously transmitted at intervals of 0.1 second. This allows a busy practitioner, such as an ambulance, to enter manual pressure without losing time. The setting and adjustment of such information can be performed by the mode setting P1 provided on the operation panel P, and can be incorporated in a computer program in the microcomputer CPU at the same time. Until the information once incorporated in the computer program is changed by the mode setting P1 provided on the operation panel P, the microcomputer operates without setting the operation panel P every time according to the designated program. Can be.
The compression cycle signal of the heart massage used in the ventilator of the present invention transmits once (at a pace of 60 to 150 times / minute) at intervals of 0.4 to 1.0 seconds, and continuously transmits the signal for 3 to 3 times. You can make 30 calls. It is possible to transmit 5 to 20 times continuously, preferably once (at a rate of 75 to 120 times / minute) at an interval of 0.5 to 0.8 seconds. At intervals of less than 0.4 seconds, the time per stroke is too short and the compression effect is insufficient. At intervals of more than 1.0 seconds, the interval is too long and the heartbeat recovery effect decreases. If the number of repetitions is less than three, there is no sustaining effect of the compression stimulus, and if it is more than 30, the time until inspiration becomes too long. Previously, the patient was instructed to perform five heart massages in this manner and then perform one air blow, but recently, he was instructed to perform 15 heart massages and then perform two air blows. ing. In the future, the number of heart massages and the number of air blows may be further increased. A predetermined cycle and a predetermined number of repetitions can be set by the mode check 2 and the mode setting 3 of the computer program control from the ventilator used in the present invention.
Also, when the patient tries to withdraw from the ventilator using the ventilator of the present invention, this compression cycle signal becomes an auxiliary rhythm for evoking spontaneous breathing, so it does not synchronize with the compression action. However, the interval is long. That is, it corresponds to a normal breathing rate of 12 times / minute (5 seconds / time), and if one beat is applied to inspiration and one beat is applied to expiration, the signal interval becomes 2.5 seconds / time. Therefore, the total of the periodic signals used in the present invention is 0.4 to 2.5 seconds.
[0007]
The sound signal used in the present invention may have a frequency of 3.0 to 4.0 kilohertz (kHz). Preferably, a frequency of 3.2 to 3.8 kHz can be used. When the frequency is lower than 3.0 kHz, the effect as a warning sound is insufficient, and when the frequency is higher than 4.0 kHz, it is difficult to hear.
The intensity of the sound signal used in the present invention may be 60 to 90 decibels (db). Preferably, those having 70 to 85 db can be used.
If it is less than 60 db, it is difficult to hear when the noise is severe, and the warning sound is specified to be 70 db or more. However, if it is larger than 90 db, discomfort is increased.
The optical signal used in the present invention can be used alone, but when shared with a sound signal, information can be more effectively transmitted to the practitioner. In addition, a practitioner with weak hearing can accurately grasp the timing of each cardiac massage and the timing of inhalation and expiration of the artificial respirator by the optical signal, and can start the next cycle of cardiac massage.
The optical signal used in the present invention can be used without any particular limitation on an optical signal used for a normal information transmission signal. Colored lights such as red, green, orange, and blue can be used.
[0008]
In the ventilator used in the present invention, setting and adjustment of information can be performed by a mode setting P1 provided on the operation panel P in FIG. Further, the information once incorporated in the computer program is activated according to the previously designated program by starting the microcomputer without setting the operation panel P every time until the information is changed by the mode setting P1 provided on the operation panel P. Can be operated.
As shown in FIG. 2, if the computer program control is started 1 and the signal from the ventilator of the present invention transmitted after the mode check 2 and the mode setting 3 is performed, the emergency cardiopulmonary resuscitation can be performed accurately even for an inexperienced person. Can be done.
As shown in FIG. 1, the artificial respiration performed using the artificial respirator of the present invention, as shown in FIG. The air or mixed gas amount can be supplied for a predetermined time (start of inspiration 7 and end of inspiration 9), and then gas can be discharged from the lungs (start of expiration 10 and end of expiration 12) for a predetermined time. Subsequently, the second inhalation I and the exhalation E can be performed as needed. If necessary, the third inhalation and exhalation can be performed after the second gas exhaustion is completed. After the end of predetermined inhalation and expiration, the heart massage by the above-mentioned method can be repeated again.
One cycle of inspiration and expiration of artificial respiration used in the present invention can be repeated 1 to 3 times continuously at 0.7 to 6.0 seconds (10 to 86 cycles / minute). It can be repeated 1-2 times, preferably at 1.0-4.0 seconds (15-60 cycles / minute). If the time is less than 0.7 seconds, the inhalation and expiration cannot be performed sufficiently, and if the time exceeds 6.0 seconds, the effect is too long to promote spontaneous respiration recovery. The start of inspiration 7, the timer of inspiration 8, the end of inspiration 9, the start of expiration 10, the start of expiration 10, the end of expiration 12, incorporated into the computer program control of the ventilator used in the present invention, The respiratory operation can be automatically and accurately performed. In addition, after spontaneous breathing is restored, a mode for automatically adjusting by detecting airway pressure can be incorporated.
The ventilation of the artificial respiration performed by using the present invention is formed by two distinct phases of inspiration and expiration. The pressure waveform of the inspiration and expiration of this ventilation is clearly different from the attenuation form of the discharge pressure as shown in the case of the cardiopulmonary resuscitation device discharged from the accumulated tank or the like. That is, ventilation can be achieved by an increase in the pressure waveform which does not oppose the compliance (elasticity, receptivity) of the patient's airway and lungs, instead of the discharge type having a high initial pressure as in a cardiopulmonary resuscitation device. Therefore, excellent ventilation efficiency can be exhibited when used in conjunction with the artificial respirator of the present invention and the compression heart massage technique. In addition, the ventilation can be performed accurately in synchronization with the rhythm of the compression heart massage.
[0009]
The ventilation of the artificial respiration used in the present invention can be automatically performed by a computer program control signal incorporated in advance. This will be described with reference to FIG.
At the time of the start of the inspiration 7, the microcomputer instructs the microcomputer CPU to open the inhalation solenoid valve C <b> 3 and simultaneously open the exhalation closing solenoid valve C <b> 5 to inflate the film (balloon) of the exhalation valve C <b> 8 and close the exhalation valve C <b> 8. it can. The inspired gas passing through the ventilation control needle valve C4 from the intake solenoid valve C3 can enter the airway and lungs of the patient A through the flexible tube C7 and the patient mask A1 while being delayed in time by the ventilation control needle valve C4. . During this time, the pressure in the airway gradually increases. The ventilation volume corresponding to the pressure in the airway set by the airway pressure sensor C6 is determined. The ventilation volume can be adjusted also by the opening time of the ventilation volume adjusting needle valve C4 or the intake solenoid valve C3. When the airway pressure sensor C6 senses that the internal pressure has reached a predetermined value, the intake solenoid valve C3 and the expiration closing solenoid valve C5 close on command, and the discharge valve of the exhalation valve C8 to the outside air can be opened. As a result, the exhalation of the patient can be naturally discharged to the outside air from the discharge valve of the exhalation valve C8 to the outside air. If the trigger P5 is set to a predetermined pressure (for example, -2 hPa), inspiration can be started when the suction force of the patient reaches the predetermined pressure (for example, -2 hPa). By adding these intermittent ventilation mechanisms to program control, the ventilator of the present invention can express its function finely during inspiration and expiration without fighting against lung compliance (elasticity, receptivity). Can be.
As shown in FIG. 2, after the end of expiration 12, the signal of the next operation is automatically transmitted through the process of the counter 13, the number check 14, and the number check selection 15 incorporated in the computer program control. it can.
As the ventilation gas for artificial respiration used in the present invention, oxygen, air, or a mixed gas thereof can be used. 100% by volume of oxygen, air alone, or a mixed gas of oxygen and air can be used. The choice can be made according to the patient's situation. A gas having 100% by volume of oxygen or a mixed gas with air containing 45% by volume of oxygen can be suitably used.
The amount of ventilation gas for artificial respiration used in the present invention is selected depending on the physique and age of the patient, but usually 10 mL or more per kg of the patient's body weight can be delivered per one inspiration and expiration cycle.
[0010]
The cardiac massage implementation time M used in the present invention can be implemented at least 1.0 times the continuous implementation time of inspiration I and expiration E of artificial respiration. For example, in a system in which compression of a heart massage is performed 15 times and then inspiration and expiration are repeated for 2 cycles (CPR 15: 2), the time required to perform compression of a heart massage 15 times is 2 cycles of inspiration and expiration. It is effective to carry out at least 1.0 times the total time. Preferably, the cardiac massage implementation time M can be implemented at a rate of 1.2 to 3.5 times the continuous implementation time of inspiration I and expiration E of artificial respiration. If it is less than 1.0 times, there is no heartbeat recovery effect, and if it exceeds 3.5 times, the spontaneous respiration recovery effect is reduced.
As the ventilator used in the present invention, a known ventilator can be used without particular limitation as long as the intermittent ventilation mechanism used in the present invention can be provided by program control. For example, as shown in FIG. 3, an oxygen gas cylinder B, a pressure reducing valve B1, a pressure gauge, an air intake switching valve, a mixed gas flow controller, an oxygen concentration meter in the mixed gas, an intake driving gas regulator C1, an intake driving gas pressure sensor C2, Intake solenoid valve C3, ventilation volume adjustment needle valve C4, exhalation obstruction solenoid valve C5, airway pressure sensor C6, flexible tube C7, exhalation valve C8, power supply unit U, microcomputer CPU with built-in computer program, mode setting P1, ventilation frequency It is possible to use a ventilator having an operation panel P capable of performing adjustment settings such as P2, inspiration time P3, tidal volume P4, and trigger P5, and a patient mask A1.
The ventilator of the present invention is an instrument that can transmit a sound massage or a light signal of a cardiac massage start notice signal 4, a cardiac compression timing signal 5, and a cardiac massage end signal 6 in addition to the above-described known devices. The function can be realized by providing an intermittent ventilation mechanism to the program control.
The ventilator of the present invention can also store or discharge inspired gas in a separate circuit while transmitting a repetitive signal by adding a solenoid valve or branching a circuit in addition to the above. Also, the supply to the patient can be cut off.
[0011]
The operation modes incorporated in the ventilator of the present invention include, for example, a volume cycling system that converts to expiration when a certain amount of inhalation is sent, a pressure cycling system that converts to expiration when a certain airway pressure is reached, and a certain method. For example, a time cycling method that switches to expiration after the inhalation time can be used. In addition, at the start of spontaneous breathing, a spontaneous breathing mode that detects airway pressure and changes oxygen concentration, an assisted breathing mode that starts positive pressure breathing by triggering (pulling) the patient's inspiratory effort, If not, a controlled breathing mode based on the set ventilation volume, the number of times, and the time ratio between inspiration and expiration, an intermittent mandatory ventilation mode used instead of the controlled breathing after the start of spontaneous breathing, and the like can be used.
It is desirable that the ventilator used in the present invention be lightweight and portable in order to be carried to the accident site, and that it can be easily operated even by a person who is not experienced in emergency cardiopulmonary resuscitation. As the respirator used in the present invention, a respirator obtained by incorporating a computer program used in the present invention into a light and small respirator can be preferably used. For example, a small portable respirator having a length of 250 mm, a width of 150 mm, a height of 80 mm and a weight of about 3 kg can be suitably used.
The sound signal or optical signal used in the present invention can be set by a known means, for example, a dial or mode setting P1 of the operation panel P. The practitioner can be notified of a heart massage start notice signal 4, a heart compression timing signal 5 for each heart massage, a heart massage end signal 6, and the like by a sound signal from a speaker or a light signal from a colored lamp. If the practitioner performs the compression stimulation of the heart massage in accordance with this signal, even an inexperienced person can perform it accurately and effectively. In addition, since the respirator automatically performs inhalation and expiration in accordance with the program control of the present invention, it is possible to rest the hand on the heart massage during this time. After receiving the cardiac compression start notice signal transmitted at the end of expiration, it is prepared and immediately following the cardiac compression shock compression of the next cycle can be performed in accordance with the cardiac compression instruction signal.
[0012]
As the computer program control used in the present invention, a method according to a known computer program creation method can be used without particular limitation. One embodiment of the computer program control of the present invention will be described with reference to FIG.
First, the computer program control of the ventilator used in the present invention is started 1. Next, a current mode check 2 is performed, a mode setting 3 to be performed this time is performed, and a standby can be performed. In actual use, starting from the start notice signal 4, a heart compression timing signal 5 for each compression time t of one cardiac massage can be transmitted to the practitioner. The heart massage execution time M ends with the heart massage end signal 6 at the end of the predetermined number of times, the process automatically shifts to the start of inspiration 7, and the inspiration I can be ended by the inhalation timer 8 and the end of inspiration 9. Then, the process proceeds to the start of exhalation 10, and the exhalation E can be ended by the expiration timer 11 and the end of exhalation 12. When proceeding to this stage, it is selected whether to proceed as it is at the branch point of the counter 13 and the number check 14 or to return to the number check selection 15. Whether to repeat the stroke or return to the heart massage stroke is selected.
In preparation for an emergency, the modes of the heart massage and the artificial respiration are set in advance as standard, and the treatment at the accident site can be performed immediately with this standard setting.
Further, the ventilator controlled by the computer program used in the present invention is capable of smoothly breathing spontaneously when a patient who regularly uses the ventilator comes off the ventilator due to recovery of spontaneous breathing power. It can be possible to return to life alone.
The computer-programmed breathing mode used in the present invention can use either an intermittent mandatory ventilation (IMV) or a synchronized intermittent mandatory ventilation (SIMV). Withdrawal can be achieved without doing so. In general, the IMV method may oppose (fight) the compliance (elasticity, receptivity) of the patient's airway and lungs due to the timing difference between the patient's spontaneous breathing and artificial respiration, and the patient tends to suffer. There is. Further, the SIMV system does not cause a defect (fighting) of the IMV system, but has too little effect of promoting the withdrawal from the respirator. With the use of the computer-programmed ventilator used in the present invention, the patient can be trained himself to gradually become a non-ventilated state (withdrawal from the ventilator) while repeating intermittent ventilation for a minute period in detail. .
Rhythmic transmission and planned ventilation, which are features of the present invention, stimulate the patient's willingness to recover, and can produce planned pause (ventilation) and planned increase in vital capacity (ventilation stop). is there.
The computer-programmed ventilator used in the present invention performs the emergency cardiopulmonary resuscitation from the state of cardiac arrest during transportation, and then returns to the original function of the transportation ventilator by operating one knob. Therefore, a smooth transition from the cardiopulmonary resuscitation to the respiratory tract can be achieved (in the past, it was not smooth because the machine was re-installed even between machines or from a hand).
[0013]
【Example】
Hereinafter, the present invention will be described in more detail with reference to examples, but the present invention is not limited to these examples.
Example 1
An emergency cardiopulmonary resuscitation experiment was performed. The artificial respirator used was a small portable artificial respirator (“Cruise-21” manufactured by Koken Medical Co., Ltd.) having a length of 250 mm, a width of 150 mm, a height of 80 mm and a weight of 3 kg. The respiratory mode used a continuous mandatory ventilation system (CMV). The interval between cardiac compressions was 0.6 seconds, one cycle of cardiac massage was repeated 15 times, and one cycle of inspiration and expiration was 2.5 seconds, and this was performed twice (CPR 15: 2). The frequency of the sound signal was 3.5 kHz and the intensity was 70 db. As the optical signal, a start notice signal 4 used a red light, a heart compression timing signal 5 used a yellow light, and a heart massage end signal 6 used a red light. At 0.6 seconds before the start of the first compression period of the heart massage, a short notice sound of two short 0.1 second sounds is made at intervals of 0.1 second, and every time from the first time to the 14th time The sound signal was set so that a short sound of 0.1 seconds was transmitted at the start time, and the heart massage end signal was sounded as a long sound of 0.6 seconds at the start time only at the 15th time. The red light flashed in synchronization with the sound signal. After the end of the heart massage end signal, the operation automatically shifted to the start of inspiration. As the ventilation gas, an air mixed gas containing 45% by volume of oxygen was used.
The practitioners randomly selected five of those who had no experience in emergency cardiopulmonary resuscitation. An emergency cardiopulmonary resuscitation test was performed using a model doll [Ambu Co., Ltd., "Ambman"] for training of a specialist in emergency cardiopulmonary resuscitation using the artificial respirator of the present invention. As a result of comparing the test results with the simulations of the actual examples, it was shown that all the practitioners could reach the state of heart recovery and spontaneous breathing start of the simulated patient (the training model doll) within 3 minutes after the operation.
[0014]
Example 2
A model experiment was performed assuming withdrawal from the ventilator. The test subjects were two small business workers who were both working and accounting, and both had normal spontaneous breathing. The spontaneous breathing volume was measured using an Analyzer RT-200 manufactured by Timer Instrument Corporation. The average spontaneous breathing was 230 mL / beat (5.1 mL / kg body weight) and 310 mL / beat (5.5 mL / kg body weight), respectively, and the spontaneous breathing was adjusted to 8 light deep breaths per minute. Was 540 mL / time on average and 630 mL / time on average. The rate of deep breathing (beats / minute) was in accordance with the signal instructions of the present invention.
The respirator used was the same as that in Example 1, and the following load was assumed for a withdrawal patient, and the respiratory disorder was reproduced. A porous filter paper is inserted into the outlet of the buffer expansion chamber of the needle valve shown in FIG. 6- (f) of JP-A-2000-84028 to form an intake air flow control valve, which is further branched and one of which is formed into a membrane (balloon). The other was connected to the atmosphere via a one-way valve and the other through the exhalation outlet of FIG. 3-C8 of the present invention. In this way, the inspired gas at the time of repetitive signal transmission (during spontaneous breathing) is inhaled through the needle filter obstacle (inspiratory control valve), and most of the exhaled air is discharged from the membrane one-way valve to the atmosphere. .
In the experiment, the experiment was started after adjusting the ventilation volume of both subjects with this intake control valve so that the spontaneous breathing when worn became 120 to 150 mL / time. Spontaneous breathing was measured at the time of 21 days after continuous training for 2 hours every day. In all cases, spontaneous breathing in a natural state averaged 305 mL / time and 430 mL / time, and Measurements of 8 deep breaths per minute improved to an average of 720 mL / beat and 840 mL / beat, respectively.
In this experiment, the ventilation was performed twice at continuous intervals of 12 times / minute (5 seconds / time) at an interval of 12 times / minute (600 seconds / time), and 600 mL of each was fed. Subsequently, the intake was stopped for 10 seconds. Thus, the ratio of the inhalation stop time to the ventilation time is 1: 1. Starting from this, the ratio of the intake stop time (repetitive signal transmission time) was gradually increased to 5: 1. Further, the signals repeatedly transmitted during the inhalation stop period were distributed one by one to each of the inspiratory effort and the expiration of spontaneous breathing, and the transmission interval was set to 24 beats / minute (2.5 seconds / time).
Usually, the patient cannot withstand long-term withdrawal training using SIMV (synchronous forced ventilation), and the patient himself tends to repeatedly put on and take off the mask. In this experiment, however, neither of these subjects observed this operation at all.
[0015]
【The invention's effect】
By using the portable lightweight ventilator of the present invention, a person present at the accident site can easily and accurately perform emergency cardiopulmonary resuscitation. In addition, if the ventilator of the present invention is always provided in a school or a gathering facility, it is possible to cope with an unexpected situation. Furthermore, the patient who has recovered from the use of the ventilator can be reasonably achieved.
[Brief description of the drawings]
FIG. 1 is a time series transition graph of heart massage and artificial respiration.
FIG. 2 is a program for repeatedly checking heart massage and artificial respiration.
FIG. 3 is a structural diagram of a ventilator.
[Explanation of symbols]
1 Start of computer program control
2 Mode check
3 Mode setting
4 Start notice signal
5 Heart compression timing signal
6 Heart massage end signal
7 Start of intake
8 Inspiration timer
9 End of inspiration
10 Start of exhalation
11 Expiration timer
12 End of exhalation
13 Counter
14 times check
15 Check selection
A Patient
A1 Patient mask
B oxygen cylinder
B1 Pressure reducing valve
C ventilator body
C1 Intake drive gas regulator
C2 Intake drive gas pressure sensor
C3 intake solenoid valve
C4 Ventilation volume adjustment needle valve
C5 Exhalation obstruction solenoid valve
C6 Airway pressure sensor
C7 Flexible tube
C8 exhalation valve
CPU microcomputer
P Operation panel
P1 mode setting
P2 ventilation frequency
P3 Inspiration time
P4 tidal volume
P5 trigger
U power supply
M heart massage implementation time
t Compression time for one heart massage
I intake
E exhalation

Claims (6)

In a ventilator having an automatic inspiration mechanism, a mechanism for setting a signal transmission period for issuing a repetitive signal indicating a cardiac compression timing at a constant interval and a signal pause period for a continuous constant interval at the same and the signal transmission A ventilator having means for stopping supply of inhalation in synchronization with a period. The mechanism for setting the signal transmission period and the signal pause period having a period of a fixed interval following the signal transmission period sets the interval of the period of the repetitive signal to 0.4 to 2.5 seconds and sets the number of repetitions of the repetitive signal to 3 to 30 seconds. The respirator according to claim 1, wherein the number of times is set to one. A mechanism for setting a signal transmission period and a signal pause period having a period of a constant interval following the signal transmission period includes variable means for changing the interval of the period of the repetitive signal and variable means for changing the number of repetitions of the repetitive signal. The respirator according to claim 1 or 2. 4. The respirator according to claim 1, wherein the repetitive signal indicating the timing of cardiac compression is sound or light. 3. A decoration signal which can be distinguished from 1 to 5 signals counted from the first signal or the last signal of the repetition signal indicating the repetition heart compression timing, or from each of the two signals. The respirator according to 3 or 4, wherein The respirator according to claim 1, 2, 3, 4, or 5, further comprising a unit capable of controlling a cycle of the signal suspension period to 5 to 40 seconds.

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