JP2019000657A - 一酸化窒素の送達による治療の最中に酸素化を監視する装置および方法 - Google Patents
一酸化窒素の送達による治療の最中に酸素化を監視する装置および方法 Download PDFInfo
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Abstract
Description
を使用して計算される。
Qtherapeutic=[γset/(γtherapeutic−γset)]*Qbreathing
(式中、Qbreathingは、呼吸ガスの流量であり、γsetは、所望の一酸化窒素濃度であり、γtherapeuticは、治療用ガス供給における一酸化窒素の濃度であり、およびQtherapeuticは、気体混合物に一酸化窒素の所望の濃度をもたらすために必要な治療用ガスの流量である)
を使用して実行できる。ここで、必要なQtherapeuticは、制御システムと通信する1つ以上の制御弁によってもたらされ得る。
酸素化指数は、患者がいかに良くO2を取り込むかの測定値であり、かつ治療に関する患者の病状の進行を評価するために使用され得る。酸素化指数(OI)は、吸入酸素濃度(FiO2)およびその体内での使用を測定するために集中治療医学において使用される計算である。ヒトの酸素化が改善すると、より低いFiO2および/または平均気道圧(MP AW)において、動脈血(PaO2)中のより高い酸素分圧を実現することができる。結果として得られるOIは低くなる。OIは、以下の通り計算される。
Claims (17)
- 一酸化窒素の送達による治療の最中に酸素化指数を計算および監視する装置であって:
一酸化窒素または一酸化窒素放出剤を含む治療用ガス供給部と流体連通して配置される第1の入口;
呼吸ガスの流れと流体連通して配置される第2の入口;
前記第1の入口、前記第2の入口、および患者と流体連通して配置される出口;
平均気道圧を決定するための近位圧力トランスデューサ;
吸入酸素濃度(FiO2)を測定するためのFiO2測定手段;
動脈血酸素飽和度(SaO2)、末梢血中酸素飽和度(SpO2)および動脈血酸素分圧(PaO2)からなる群から選択される1つ以上の酸素測定値を測定するための酸素測定手段;
前記近位圧力トランスデューサから取得した平均気道圧測定値、前記酸素測定手段から取得した酸素測定値、および前記FiO2測定手段から取得したFiO2測定値に基づいて酸素化指数を計算できる信号プロセッサー;および
ディスプレイ
を含む装置。 - 前記信号プロセッサーが中央処理装置である、請求項1に記載の装置。
- 前記FiO2測定手段が人工呼吸器を含む、請求項1または2に記載の装置。
- 前記FiO2測定手段がFiO2センサーを含む、請求項1〜3のいずれか一項に記載の装置。
- 前記酸素測定手段がパルスオキシメータを含み、および前記酸素測定値がSpO2を含む、請求項1〜4のいずれか一項に記載の装置。
- さらに、SpO2を測定するための血液ガスモニターを含む、請求項1〜5のいずれか一項に記載の装置。
- さらに、酸素化指数、SpO2、SaO2、メトヘモグロビン、または気道圧の予め決められた値を示す前記信号プロセッサーからの信号によって動作可能なアラームシステムを含む、請求項1〜6のいずれか一項に記載の装置。
- さらに、前記呼吸ガスの流量を測定する流量トランスデューサ、および前記流量トランスデューサと通信する制御システムを含む、請求項1〜7のいずれか一項に記載の装置。
- さらに、患者に、予め決められた濃度の一酸化窒素をもたらす量で、一酸化窒素または一酸化窒素放出剤を含む前記治療用ガスの流れを送達する、1つ以上の制御弁を含む、請求項1〜8のいずれか一項に記載の装置。
- 前記流量トランスデューサが、前記呼吸ガスの流れと、一酸化窒素または一酸化窒素放出剤を含む前記治療用ガスの流れとを組み合わせる注入モジュールに一体化されている、請求項1〜9のいずれか一項に記載の装置。
- 前記信号プロセッサーが、吸入酸素濃度(FiO2)を測定する前記FiO2測定手段、ならびに動脈血酸素飽和度(SaO2)、末梢血中酸素飽和度(SpO2)および動脈血酸素分圧(PaO2)からなる群から選択される1つ以上の酸素測定値を測定する酸素測定手段と通信するように構成されている、請求項1〜10のいずれか一項に記載の装置。
- 前記ディスプレイが、メトヘモグロビン、酸素化指数、SpO2、SaO2、および気道圧の計算値を示す、請求項1〜11のいずれか一項に記載の装置。
- さらに、メトヘモグロビン、酸素化指数、SpO2、SaO2、および気道圧の計算値をリモート情報管理システムに伝送する送信機を含む、請求項1〜12のいずれか一項に記載の装置。
- さらにパージ弁を含む、請求項1〜13のいずれか一項に記載の装置。
- 酸素化指数を監視する方法であって:
(a)近位圧力トランスデューサから平均気道圧(MAP)測定値を取得するステップ;
(b)動脈血酸素飽和度(SaO2)、末梢血中酸素飽和度(SpO2)および動脈血酸素分圧(PaO2)からなる群から選択される1つ以上の酸素測定値を酸素測定手段から取得するステップ;
(c)FiO2測定手段から吸入酸素濃度(FiO2)測定値を取得するステップ;
(d)前記MAP測定値、前記酸素測定値および前記FiO2測定値を信号プロセッサーに伝送するステップ;
(e)以下の式
を使用して、前記信号プロセッサーによって酸素化指数(OI)の値を計算するステップ、
(f)前記酸素化指数をディスプレイによってエンドユーザーに伝達するステップ
を含む方法。 - さらに、一酸化窒素を含む治療用ガスを患者に投与するステップを含む、請求項15に記載の方法。
- さらに、前記酸素化指数の値を、予め決められた上限値と比較し、前記酸素化指数が前記上限値を超える場合、アラームを発するステップを含む、請求項15または16に記載の方法。
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JP2020102066A JP6906661B2 (ja) | 2013-03-13 | 2020-06-12 | 一酸化窒素の送達による治療の最中に酸素化を監視する装置および方法 |
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US201361779301P | 2013-03-13 | 2013-03-13 | |
US61/779,301 | 2013-03-13 | ||
US14/209,096 | 2014-03-13 | ||
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JP2021168924A (ja) | 2021-10-28 |
EP2967434A1 (en) | 2016-01-20 |
JP7195380B2 (ja) | 2022-12-23 |
JP6654558B2 (ja) | 2020-02-26 |
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