JP2011161258A - 心肺蘇生中の胸部圧迫深度を測定する装置 - Google Patents
心肺蘇生中の胸部圧迫深度を測定する装置 Download PDFInfo
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Abstract
【解決手段】
本発明に係る装置は、胸部圧迫の加速度信号を生成する加速度計と、推定の実際加速度信号を加速度信号から生成するプロセッサと、推定の実際加速度信号を積分して、胸部圧迫の推定の実際深度に相当する推定の実際深度信号を生成する積分手段とを備える。このプロセッサは、加速度信号のノイズ成分に相当する推定ノイズ信号を生成し、かつ、測定された加速度と少なくとも1つのノイズ源のエラーノイズとを処理して推定ノイズ信号を生成するシステム識別部と、推定の実際加速度信号を生成するために加速度信号と推定ノイズ信号とを複合する信号複合手段とを有する。
【選択図】図1
Description
たとえば、フリーマン(Freeman)の米国特許出願公開第2001/0047140号(2001年11月29日)の「積分による蘇生法(Integrated Resuscitation)」によれば、
圧迫センサとして加速度計を用いた装置が開示され、加速度計を用いて胸部深度を測定することにいて記載されている。しかしながらフリーマンは、加速度計だけを用いた場合に本質的に生じる誤差を検出する方法を提供するものではない。すなわちフリーマンによる胸部圧迫深度の測定は正確ではない。
このようなドリフトの態様を正方向のドリフトと呼ぶ。一方、ドリフトにより圧迫モニタが実際の深度よりも徐々に浅くなる深度波形を検出する場合もある。言い換えれば、実際圧迫開始点は徐々に深くなるのに、圧迫モニタは開始点が初期の開始点とほとんど変わらないと検出することがある。このようなドリフトの態様を負方向ドリフトと呼ぶ。
・実際圧迫深度:任意の所定タイミングにおける実際の圧迫深度
・実際圧迫開始点:胸部圧迫が開始された実際の位置または点
・自動回帰移動平均:過去のデータサンプルを用いて現時点でのデータサンプルを修正する機能
・圧迫深度波形のベースライン部分:一連の実際圧迫開始点が最も頻繁に検出される圧迫深度の領域
・ベースラインリミッタ:圧迫深度波形のベースライン部分において作動するプロセッサまたは機能
・圧迫ピーク:圧迫深度が最大になる位置または点
・現時点での圧迫深度:任意の所定タイミングにおける圧迫深度
・現時点での開始点:現時点での圧迫の開始点
・圧迫深度:任意の所定タイミングで圧迫されたときの胸部深度で、リラックスした胸部位置から測定される深度
・実際圧迫開始点の推定値:胸部圧迫を開始した実際の位置または点の推定値
・初期圧迫開始点:一連の胸部圧迫を開始した位置または点
・圧迫開始点の測定値:胸部圧迫を開始した位置または点の測定値
・移動平均:過去のデータサンプルを用いて現時点でのデータサンプルの修正する機能
・過去の開始点:すでに計測された圧迫開始点
・圧迫深度波形のピーク位置:一連の実際のピーク位置が最も頻繁に検出される深度波形の位置
・圧迫開始点:胸部圧迫を開始した位置または点
[(0.5×100%)+(1.1×98.75%)+(0.9×96.25%)]÷3=0.853インチ
[(0.5×100%)+(1.1×98.75%)+(4.0×97.5%)+(0.9×96.25%)]÷4
=1.615インチ
すなわち、この値は実際の圧迫開始点の推定値である。
Dsは現時点での開始点の深度、nrはベースラインを超えた開始点すべてを削除した後に残っている開始点の数、iは開始点の数(または加算指数)、DBiはi番目の開始点の測定深度、ωは重み定数、そしてBはベースラインである。別の言い方をすれば、DBi×ωi−1をiが1からnrまで合計し、その加算値をnrで割る。DBiがBより大きい場合、そのDBiはゼロとする。
[(0.5×100%)+(1.082×98.75%)+(0.902×96.25%)]÷3=0.812インチ
換言すると、この値は実際の圧迫開始点の推定値である。
このとき、DSは現時点での開始点の深度、nrはベースラインを超えている開始点すべてを削除した後に残っている開始点の数、iは開始点数、DBiはi番目の開始点の測定深度、jはベースライン内にある最新の開始点の指数、DBi−jはベースライン内にある最新の開始点、PSは(DBi−DBi−j)の大きさのステップが生じる確率、ωは重み定数、そしてBはベースラインである。結果として得られたDsは、現時点での開始点の検出深度である。別の言い方をすれば、[(DBi−DBi−j)×PS×ωi−1)]をiが1からnまで加算し、その加算値をnrで割る。DBiがB(ベースライン)より大きい場合、そのDBiはゼロとする。
すなわち、同一の深度波形に対し、ベースラインリミッタ演算およびピークリミッタ演算を行う。その効果は、深度波形を構成する信号がまずベースラインリミッタ演算部に供給され、次にピークリミッタ演算部に供給されることである(信号は分割されない。)。
すなわち電流スパイクはシステムのノイズ要因と関連している。システム識別部は、この情報用いて、システムのモデル化を支援することができる。同様に、システム識別部は、電圧、シャフト位置変位、あるいは光学式エンコーダまたは回転式エンコーダを基準ノイズとして用いて、システムをモデル化しやすくすることができる(ここでも基準ノイズは有用ではあるが必須のものではない。)。
Claims (24)
- 胸部圧迫の深度を測定するための装置であって、
ノイズ成分と実際成分とを含む、胸部圧迫の加速度に相当する加速度信号を生成する加速度計と、
前記加速度計に動作可能に接続され、胸部圧迫の推定の実際加速度に相当する推定の実際加速度信号を前記加速度信号から生成するプロセッサとを備え、
前記プロセッサは、
・前記加速度計に接続され、前記加速度信号のノイズ成分に相当する推定ノイズ信号を生成し、かつ、測定された加速度と少なくとも1つのノイズ源のエラーノイズとを処理して推定ノイズ信号を生成するシステム識別部と、
・前記システム識別部および前記加速度計に動作可能に接続され、推定の実際加速度信号を生成するために前記加速度信号と前記推定ノイズ信号とを複合する信号複合手段とを有し、
前記胸部圧迫時の深度測定のための装置は、前記プロセッサに動作可能に接続され、推定の実際加速度信号を積分して、胸部圧迫の推定の実際深度に相当する推定の実際深度信号を生成する積分手段をさらに備えたことを特徴とする装置。 - 前記プロセッサに動作可能に接続されたディスプレイをさらに備え、
前記ディスプレイは推定の実際深度信号を表示することを特徴とする請求項1に記載の装置。 - 前記プロセッサに動作可能に接続されたユーザフィードバック手段をさらに備え、
前記ユーザフィードバック手段は、胸部圧迫が所定の設定値の範囲内にあるか否かを示してフィードバックすることを特徴とする請求項1に記載の装置。 - 前記プロセッサは胸部圧迫の速度を測定し、
前記ユーザフィードバック手段は胸部圧迫の速度を表示することを特徴とする請求項3に記載の装置。 - 前記プロセッサは胸部圧迫のデューティサイクルを測定し、
前記ユーザフィードバック手段は胸部圧迫のデューティサイクルを表示することを特徴とする請求項3に記載の装置。 - ・ノイズ成分および実際成分を含む患者の心電図信号を測定する手段と、
・前記心電図信号測定手段および前記プロセッサに動作可能に接続され、前記心電図信号のノイズ成分を推定する手段とをさらに備え、
前記プロセッサは、前記心電図信号のノイズ成分が所定の範囲内にあるとき、推定の実際深度信号を生成するようさらにプログラムされていることを特徴とする請求項1に記載の装置。 - 前記プロセッサに動作可能に接続されたディスプレイをさらに備え、
前記ディスプレイは推定の実際深度信号を表示することを特徴とする請求項6に記載の装置。 - 前記プロセッサに動作可能に接続されたユーザフィードバック手段をさらに備え、
前記ユーザフィードバック手段は、胸部圧迫が所定の設定値の範囲内にあるか否かを示してフィードバックすることを特徴とする請求項6に記載の装置。 - 前記プロセッサは胸部圧迫の速度を測定し、
前記ユーザフィードバック手段は胸部圧迫の速度を表示することを特徴とする請求項8に記載の装置。 - 前記プロセッサは胸部圧迫のデューティサイクルを測定し、
前記ユーザフィードバック手段は胸部圧迫のデューティサイクルを表示することを特徴とする請求項8に記載の装置。 - 心肺蘇生中に患者の換気を行う換気手段をさらに備えたことを特徴とする請求項1に記載の装置。
- 前記換気手段は電気的換気を行う手段を有することを特徴とする請求項11に記載の装置。
- 胸部圧迫を処置するための装置であって、
患者の胸部を圧迫する胸部圧迫手段と、
ノイズ成分と実際成分とを含む、胸部圧迫の加速度に相当する加速度信号を生成する加速度計と、
前記加速度計に動作可能に接続され、胸部圧迫の推定の実際加速度に相当する推定の実際加速度信号を前記加速度信号から生成するプロセッサとを備え、
前記プロセッサは、
・前記加速度計に接続され、前記加速度信号のノイズ成分に相当する推定ノイズ信号を生成し、かつ、測定された加速度と少なくとも1つのノイズ源のエラーノイズとを処理して推定ノイズ信号を生成するシステム識別部と、
・前記システム識別部および前記加速度計に動作可能に接続され、推定の実際加速度信号を生成するために前記加速度信号と前記推定ノイズ信号とを複合する信号複合手段とを有し、
前記胸部圧迫時の深度測定のための装置は、前記プロセッサに動作可能に接続され、推定の実際加速度信号を積分して、胸部圧迫の推定の実際深度に相当する推定の実際深度信号を生成する積分手段をさらに備え、
前記胸部圧迫手段は、前記推定の実際深度信号に基づいて胸部圧迫の深度を調整することを特徴とする装置。 - 前記プロセッサに動作可能に接続されたディスプレイをさらに備え、
前記ディスプレイは推定の実際深度信号を表示することを特徴とする請求項13に記載の装置。 - 前記プロセッサに動作可能に接続されたユーザフィードバック手段をさらに備え、
前記ユーザフィードバック手段は、胸部圧迫が所定の設定値の範囲内にあるか否かを示してフィードバックすることを特徴とする請求項13に記載の装置。 - 前記プロセッサは胸部圧迫の速度を測定し、
前記ユーザフィードバック手段は胸部圧迫の速度を表示することを特徴とする請求項15に記載の装置。 - 前記プロセッサは胸部圧迫のデューティサイクルを測定し、
前記ユーザフィードバック手段は胸部圧迫のデューティサイクルを表示することを特徴とする請求項15に記載の装置。 - ・ノイズ成分および実際成分を含む患者の心電図信号を測定する手段と、
・前記心電図信号測定手段および前記プロセッサに動作可能に接続され、前記心電図信号のノイズ成分を推定する手段とをさらに備え、
前記プロセッサは、前記心電図信号のノイズ成分が所定の範囲内にあるとき、推定の実際深度信号を生成するようさらにプログラムされていることを特徴とする請求項13に記載の装置。 - 前記プロセッサに動作可能に接続されたディスプレイをさらに備え、
前記ディスプレイは推定の実際深度信号を表示することを特徴とする請求項18に記載の装置。 - 前記プロセッサに動作可能に接続されたユーザフィードバック手段をさらに備え、
前記ユーザフィードバック手段は、胸部圧迫が所定の設定値の範囲内にあるか否かを示してフィードバックすることを特徴とする請求項18に記載の装置。 - 前記プロセッサは胸部圧迫の速度を測定し、
前記ユーザフィードバック手段は胸部圧迫の速度を表示することを特徴とする請求項20に記載の装置。 - 前記プロセッサは胸部圧迫のデューティサイクルを測定し、
前記ユーザフィードバック手段は胸部圧迫のデューティサイクルを表示することを特徴とする請求項20に記載の装置。 - 心肺蘇生中に患者の換気を行う換気手段をさらに備えたことを特徴とする請求項13に記載の装置。
- 前記換気手段は電気的換気を行う手段を有することを特徴とする請求項23に記載の装置。
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