JP2020163032A - Determination device, control device, medical appliance, artificial respiration system, program, and recording medium - Google Patents

Abstract

To provide a determination device capable of inhibiting a trouble from being caused by esophageal intubation by quickly determining a state that tends to cause the esophageal intubation and to provide a control device, medical appliance, artificial respiration system, program, and recording medium in which the program is recorded, capable of inhibiting a trouble from being caused by esophageal intubation.SOLUTION: A determination device includes: a pressure sensor for detecting internal pressure of a cuff included by a tracheal tube; and a determination unit for determining that the tracheal tube is being inserted or has been inserted into an esophagus, on the basis of the internal pressure detected by the pressure sensor and a predetermined determination criterion. The determination criterion is calculated on the basis of a difference between internal pressure in the case that the tracheal tube is inserted into a trachea and internal pressure in the case that the tracheal tube is inserted into the esophagus.SELECTED DRAWING: Figure 4

Description

The present invention relates to determination devices, control devices, medical devices, artificial respiration systems, programs and recording media.

As an indispensable procedure performed daily in the medical field, a worker such as a doctor intubates a tracheal tube into the trachea of a patient to secure an airway, and can be mentioned as "tracheal intubation". In tracheal intubation, the operator usually uses a laryngoscope, a video laryngoscope, or the like to insert the tip of the tracheal tube into the trachea located behind the glottis while visually observing the patient's glottis. Oxygen is supplied to the patient's lungs through the airways secured by tracheal intubation.

The glottis, which is the target of the intubation position during tracheal intubation, is adjacent to the esophageal entrance (esophageal entrance). Therefore, during tracheal intubation, "esophageal intubation" may occur in which the tracheal tube is accidentally intubated into the esophagus. When esophageal intubation occurs, oxygen cannot be supplied to the patient's lungs, resulting in respiratory failure.

Usually, in order to detect esophageal intubation at an early stage, the following two operations are combined to determine whether or not the tracheal tube is correctly inserted into the trachea.

First, by monitoring the carbon dioxide concentration in the exhaled breath using a capnometer, it is determined whether or not the tracheal tube is correctly inserted into the trachea. When tracheal intubated, carbon dioxide is usually detected regularly in the exhaled breath and draws a distinctive waveform in the carbon dioxide detector, but when esophageal intubation is not detected, such a waveform is not detected.

In addition, a method of determining whether gas is supplied to the lungs or the stomach by auscultation of the chest and abdomen is also widely used. In the case of tracheal intubation, the lungs are supplied with gas so that breath sounds are heard in the chest, while air sounds are not heard in the upper abdomen. In the case of esophageal intubation, air sounds are auscultated in the upper abdomen because gas is supplied to the stomach, but breath sounds are not heard in the chest.

In addition, devices have been developed that can detect esophageal intubation. In Patent Document 1, whether the tracheal intubation or the esophageal intubation was performed by comparing the change in the amplitude of the signal (frequency) generated from the signal generator connected to the tracheal tube with the amplitude recorded in the memory. A tracheal intubation monitoring device that detects the above is described.

International Publication No. 1994/017731

However, the above method has the following problems.

First, when monitoring the carbon dioxide concentration in the exhaled breath using a capnometer, it is necessary to pressurize the oxygen bag connected to the tracheal tube as a procedure following the intubation operation. When the esophagus is intubated, this operation pushes gas into the stomach through the esophagus, increasing the internal pressure of the stomach and increasing the risk of vomiting and aspiration.

Also, if the patient is in cardiopulmonary arrest, the capnometer may not be able to detect the carbon dioxide concentration in the exhaled breath. Even when the patient's heart rate is reduced, it is difficult to detect the carbon dioxide concentration in the exhaled breath with a capnometer.

Furthermore, when auscultating the chest and abdomen, it is difficult to hear breath sounds and air sounds, especially in obese patients, and it is easy to make a judgment.

Further, in the case of the device of Patent Document 1, since the position of the tracheal tube is detected by using the signal (frequency) from the signal generator, there is a problem that the detection accuracy of esophageal intubation is not always sufficient.

In addition, the above-mentioned conventional confirmation method and monitoring device detect the state of esophageal intubation after placing a tracheal tube in the esophagus and pushing gas through the tube, thus suppressing the occurrence of esophageal intubation itself. Can't be done. In addition, conventional confirmation methods and monitoring devices cannot suppress problems that occur during esophageal intubation, such as aspiration and vomiting caused by pushing gas into the stomach.

For these reasons, situations that lead to esophageal intubation even in situations where esophageal intubation is likely to occur, such as when the operator performing the procedure is inexperienced or when it is necessary to urgently perform subsequent measures in the emergency lifesaving situation There was a need for a technology that could objectively judge.

The present invention has been made in view of such circumstances, and an object of the present invention is to provide a determination device capable of promptly determining a state in which esophageal intubation is likely to occur and suppressing the occurrence of defects due to esophageal intubation. To do. Another object of the present invention is to provide a control device, a medical device, an artificial respiration system, a program, and a recording medium on which the program is recorded, which can suppress the occurrence of a defect due to esophageal intubation.

In order to solve the above problems, the present invention includes the following aspects.

[1] The tracheal tube is being intubated into the esophagus based on a pressure sensor that detects the internal pressure of the cuff included in the tracheal tube, the internal pressure detected by the pressure sensor, and a predetermined criterion obtained in advance. Alternatively, it has a determination unit for determining that the tube has been intubated, and the determination criteria are the internal pressure when the tracheal tube is intubated into the esophagus and the internal pressure when the tracheal tube is intubated into the esophagus. Judgment device obtained based on the difference between.

[2] The determination device according to [1], which has an output unit that outputs a determination result by the determination unit.

[3] The determination unit determines whether the tracheal tube is being intubated or intubated in the esophagus or the trachea based on the internal pressure detected by the pressure sensor and the determination criterion. The determination device according to [1] or [2].

[4] A pump for adjusting the amount of gas inside the cuff provided in the tracheal tube, a pressure sensor for detecting the internal pressure of the cuff, and a gas amount inside the cuff based on the results detected by the pressure sensor. The control unit has a control unit for controlling, and the control unit determines whether the tracheal tube is in the esophagus or the trachea based on the internal pressure detected by the pressure sensor and a first determination criterion obtained in advance. It has a determination unit for determining whether it is being intubated or intubated, and an instruction unit for instructing the driving of the pump, and the first determination criterion is the case where the tracheal tube is intubated into the trachea. It is determined based on the difference between the internal pressure and the internal pressure when the tracheal tube is intubated into the esophagus, and the indicator determines that the tracheal tube has been intubated into the trachea by the determination unit. A control device that causes the pump to supply gas to the inside of the cuff based on the result, and brings the cuff into close contact with the inner wall of the trachea.

[5] The control unit determines in the first mode of determining whether the tracheal tube is intubated in the esophagus or the trachea, and in the first mode, determining that the tracheal tube has been intubated into the trachea. The control device according to [4], wherein the second mode for instructing the pump to supply the gas to the inside of the cuff is sequentially performed based on the determination result.

[6] The control device according to [5], which has an input unit for instructing switching between the first mode and the second mode.

[7] In the first mode, the control unit degass the inside of the cuff by the pump, and then the amount of the cuff is less than the amount that allows the cuff to adhere to the inner wall of the trachea inside the cuff. The control device according to [5] or [6], which supplies an amount of gas.

[8] The control device according to [5] or [6], wherein the control unit opens the inside of the cuff to the atmosphere after degassing the inside of the cuff by the pump in the first mode.

[9] In the second mode, the determination unit intubates the tracheal tube into either the esophagus or the trachea based on the internal pressure detected by the pressure sensor and the second determination criterion obtained in advance. The control device according to any one of [5] to [8], wherein the second determination criterion is determined based on the rate of change of the internal pressure with respect to the amount of gas inside the cuff.

[10] Based on the determination result that the determination unit determines that the tracheal tube has been intubated into the esophagus in the second mode, the indicator unit supplies the pump to the inside of the cuff with the gas. The control device according to [9], which stops the supply.

[11] A pump for adjusting the amount of gas inside the cuff provided in the tracheal tube, a pressure sensor for detecting the internal pressure of the cuff, an indicator for instructing the driving of the pump, and the internal pressure detected by the pressure sensor. And a determination unit for determining whether the tracheal tube was intubated in the esophagus or the tracheal tube based on a determination criterion obtained in advance, and the determination criterion is the amount of gas inside the cuff. A control device obtained based on the rate of change of the internal pressure with respect to the above.

[12] The indicating unit stops the supply of gas to the inside of the cuff to the pump based on the determination result that the determination unit determines that the tracheal tube has been intubated into the esophagus. [11] The control device described in.

[13] The control device according to any one of [4] to [12], which has an output unit that outputs a determination result by the determination unit.

[14] The tracheal tube is provided with the determination device according to any one of [1] to [3], wherein the tracheal tube is connected to the tracheal tube and controls the amount of gas inside the cuff. The internal pressure sensor having the tube main body, the cuff provided on the tip end side of the tube main body, and the inflation tube communicating with the internal space of the cuff, and the internal pressure sensor of the determination device is connected to the inflation tube. A medical device that detects the internal pressure of the cuff via the inflation tube.

[15] The medical device according to [14], wherein the tracheal tube has a pilot balloon communicating with the inflation tube in the path of the inflation tube, and further includes a regulator for regulating the expansion of the pilot balloon.

[16] The tracheal tube is connected to the tracheal tube and includes the control device according to any one of [4] to [13], which controls the amount of gas inside the cuff. The internal pressure sensor having the tube body, the cuff provided on the tip end side of the tube body, and the inflation tube communicating with the internal space of the cuff, and the internal pressure sensor of the control device is connected to the inflation tube. A medical device that detects the internal pressure of the cuff via the inflation tube.

[17] The medical device according to [16], wherein the tracheal tube has a pilot balloon communicating with the inflation tube in the path of the inflation tube, and further includes a regulator for regulating the expansion of the pilot balloon.

[18] An artificial respiration system comprising the medical device according to [16] or [17] and an artificial respirator to which the tracheal tube of the medical device is connected.

[19] A measuring unit for measuring the internal pressure of a computer provided with a determination device for determining esophageal intubation of the tracheal tube, and a measuring unit for measuring the internal pressure based on the detection result of the internal pressure sensor for detecting the internal pressure of the cuff included in the tracheal tube. A program that functions as a determination unit for determining whether or not the tracheal tube is being intubated into the esophagus based on the measured internal pressure and a determination criterion obtained in advance.

[20] A measuring unit for measuring the internal pressure of a computer provided in a control device for controlling the amount of gas inside the cuff, and a measuring unit for measuring the internal pressure based on the detection result of an internal pressure sensor for detecting the internal pressure of the cuff provided in the tracheal tube. Based on the measured internal pressure and the determination criteria obtained in advance, the determination unit for determining whether the tracheal tube is being intubated or intubated in the esophagus or the trachea, the determination unit is the trachea. When the placement of the tracheal tube in the trachea is continued based on the determination result that the tube is intubated into the trachea, the pump connected to the cuff and adjusts the amount of gas inside the cuff is connected to the cuff. A program that functions as an indicator that gives instructions to supply gas to the inside of the.

[21] A computer provided in a control device for controlling the amount of gas inside the cuff is attached to an indicator for instructing the amount of gas supplied to the inside of the cuff provided in the tracheal tube, and a detection result of an internal pressure sensor for detecting the internal pressure of the cuff. Based on the measuring unit that measures the internal pressure, the rate of change of the internal pressure measured by the measuring unit with respect to the amount of gas inside the cuff, and the determination criteria obtained in advance, the tracheal tube forms the esophagus and the trachea. A program that functions as a determination unit that determines which of the intubation was performed.

[22] A measuring unit for measuring the internal pressure, the internal pressure measured by the measuring unit, and a predetermined criterion obtained by using the computer based on the detection result of the internal pressure sensor for detecting the internal pressure of the cuff provided in the tracheal tube. A recording medium recording a program that functions as a determination unit for determining that the tracheal tube is being intubated or has been intubated based on the above.

[23] A measuring unit for measuring the internal pressure, the internal pressure measured by the measuring unit, and a predetermined criterion obtained in advance, based on the detection result of the internal pressure sensor for detecting the internal pressure of the cuff provided in the tracheal tube. Based on the above, a determination unit for determining whether the tracheal tube is being intubated or intubated in the esophagus or the trachea, and a determination result in which the determination unit determines that the tracheal tube has been intubated into the trachea. Based on this, when the placement of the tracheal tube in the trachea is continued, an instruction unit that instructs the pump connected to the cuff to adjust the amount of gas inside the cuff to supply gas to the inside of the cuff. A recording medium that records a program that functions as.

[24] An indicator that indicates the amount of gas to be supplied to the inside of the cuff provided in the tracheal tube, a measuring unit that measures the internal pressure based on the detection result of the internal pressure sensor that detects the internal pressure of the cuff, and the cuff. A determination unit that determines whether the endotracheal tube has been intubated into the esophagus or the tracheal tube based on the rate of change of the internal pressure measured by the measurement unit with respect to the amount of gas inside the tube and a determination criterion obtained in advance. A recording medium that records a program that functions as.

According to the present invention, it is possible to provide a determination device capable of promptly determining a state in which esophageal intubation is likely to occur and suppressing the occurrence of defects due to esophageal intubation. In addition, it is possible to provide a control device, a medical device, an artificial respiration system, a program, and a recording medium on which the program is recorded, which can suppress the occurrence of a defect due to esophageal intubation.

FIG. 1 is a schematic view showing the artificial respiration system 1000. FIG. 2 is a schematic view showing a state of tracheal intubation. FIG. 3 is a schematic view showing a state of esophageal intubation. FIG. 4 is a block diagram showing the control device 2. FIG. 5 is a flowchart showing a process performed by the control device 2. FIG. 6 is a diagram showing the results of measuring the internal pressure of the cuff at the time of intubation. FIG. 7 is a schematic view showing the state of the control device 2 when it is determined that the esophagus is intubated. FIG. 8 is a schematic view showing the state of the control device 2 when it is determined that the tracheal intubation is performed. FIG. 9 is a flowchart showing a process performed by the control device 2. FIG. 10 is a graph schematically showing the correspondence between the amount of gas inside the cuff 12 and the internal pressure of the cuff 12. FIG. 11 is an explanatory diagram illustrating the determination device 5. FIG. 12 is a flowchart showing a process performed by the determination device 5.

[First Embodiment]
Hereinafter, the control device, medical device, artificial respiration system, program, and recording medium according to the present embodiment will be described with reference to FIGS. 1 to 10. In all the drawings below, the dimensions and ratios of each component are appropriately different in order to make the drawings easier to see.

<Medical equipment, artificial respiration system>
FIG. 1 is a schematic view showing an artificial respiration system 1000 according to the present embodiment. As shown in FIG. 1, the artificial respiration system 1000 includes a tracheal tube 1, a control device 2, and a respirator 3. The tracheal tube 1 is connected to the control device 2 and the ventilator 3.

The ventilator 3 has a flex tube 39 that connects to the tracheal tube 1. As the respirator 3, a known respirator can be adopted.

<Endotracheal tube>
The tracheal tube 1 is used to intubate the patient's trachea and secure an airway. The tracheal tube 1 has a tube body 11, a cuff 12, an inflation tube 13, a pilot balloon 14, and an adapter 15.

The tube body 11 is connected to the flex tube 39 via an adapter 15 provided at one end. The tube body 11 is formed of a resin material and is freely bendable. The tube body 11 has an opening 11a at its tip. The tube body 11 may further have an opening called a Murphy hole on the side surface of the tube body 11.

The cuff 12 is a hollow (balloon-shaped) structure provided at the tip of the tube body 11. The cuff 12 is formed using a resin material and is deformable or expandable. The shape of the cuff 12 is not limited, and various commonly known shapes can be adopted.

The cuff 12 expands by putting gas (air) into the internal space, and deflate by removing the gas from the internal space. After intubating the tracheal tube 1 into the trachea, the cuff 12 is inflated so as to come into contact with the inner wall of the trachea, thereby suppressing gas leakage during artificial respiration and aspiration.

One end of the inflation tube 13 is connected to the cuff 12 via the inside of the tube body 11 and communicates with the internal space of the cuff 12. The inflation tube 13 is formed of a resin material and is freely bendable. The inflation tube 13 is used for supplying gas to the internal space of the cuff 12 and removing gas from the internal space of the cuff 12, and is used as an adjustment path for the amount of gas in the internal space of the cuff 12.

The pilot balloon 14 is a hollow (balloon-shaped) structure provided at the other end of the inflation tube 13. The pilot balloon 14 is formed using a resin material and is deformable or inflatable. The pilot balloon 14 is used to simply check the internal pressure of the cuff 12.

<Control device>
The control device 2 controls the amount of gas inside the cuff 12 included in the tracheal tube 1. The control device 2 has a connecting tube 29 that connects to the inflation tube 13 via the pilot balloon 14.
The control device 2 will be described in detail later.

<Medical equipment>
The configuration in which the tracheal tube 1 and the control device 2 are combined corresponds to the medical device 100 in the present invention. The medical device 100 further comprises a regulator 101 that regulates the expansion of the pilot balloon 14. In order to regulate the expansion of the pilot balloon 14, the regulator 101 may deform the pilot balloon 14 within a range that does not block the path from the cuff 12 to the control device 2.

Examples of such a regulator 101 include a clip that sandwiches the pilot balloon 14.

FIG. 2 is a schematic view showing a state of tracheal intubation, and FIG. 3 is a schematic view showing a state of esophageal intubation.

The trachea M1 is a tubular organ for taking in air. The trachea M1 is supported by cartilage and is always open.

The esophagus M2, on the other hand, is a tubular organ that is part of the digestive tract and through which food passes. Normally, the esophageal entrance M21 is closed. In addition, the entire esophagus M2 is flat.

The present invention utilizes the difference in structure between the trachea M1 and the esophagus M2 as described above to determine tracheal intubation and esophageal intubation.

As shown in FIG. 2, when the tracheal tube 1 is intubated into the trachea M1 of the patient M, the cuff 12 provided at the tip of the tracheal tube 1 comes into contact with the inner wall M11 of the trachea M1 to apply pressure F1 from the inner wall M11. receive.

On the other hand, as shown in FIG. 3, when the tracheal tube 1 is intubated into the esophagus M2 of the patient M, the cuff 12 provided at the tip of the tracheal tube 1 comes into contact with the esophageal entrance M21 and the inner wall M22 of the esophagus M2. Then, the pressure F2 is received from the esophageal entrance M21 and the inner wall M22.

At this time, the pressure F2 is larger than the pressure F1 received by the cuff 12 by intubating into the always open trachea M1 and the pressure F2 received by the cuff 12 by intubating into the normally closed esophagus M2. Is assumed.

The inventor uses the internal pressure value as a criterion based on the difference between the internal pressure of the cuff 12 when the tracheal tube 1 is intubated into the esophagus and the internal pressure of the cuff 12 when the tracheal tube 1 is intubated into the esophagus. We have come to the idea that it is possible to determine whether 1 is being intubated or the intubated location is the tracheal M1 or the esophagus M2.

Here, "intubating" in the present specification means that the tracheal tube 1 is in the process of being intubated into the trachea M1 or the esophagus M2, and specifically, the cuff 12 is the trachea M1 or It means when invading the inside from the entrance of the esophagus M2. As shown in FIGS. 2 and 3, when the tracheal tube 1 is being intubated into the esophagus M2, the pressure F2 is large and easy to detect.

Further, "intubated" means that the tracheal tube 1 has reached the inside of the trachea M1 or the esophagus M2, specifically, the position where the cuff 12 is in contact with the inner wall M11 of the trachea M1 or the inner wall M22 of the esophagus M2. Means that you have reached.

The inventor completed the present invention after diligent studies based on the above idea.

FIG. 4 is a block diagram showing the control device 2. As shown in FIG. 4, the control device 2 includes a pump 21, a pressure sensor 22, a storage unit 23, a control unit 24, an input unit 27, and an output unit 28.

When a worker such as a doctor intubates the tracheal tube 1, it is necessary to perform the following two types of operations. The control device 2 assists the operator in the following two types of operations.
(1) At the time of intubation operation of the tracheal tube 1, it is determined whether the tracheal tube 1 is being intubated or intubated in the esophagus or the trachea.
(2) After tracheal intubation, the cuff 12 is inflated and the tracheal tube 1 is placed in the trachea.

The control device 2 of the present embodiment can switch between two types of operations, a "first mode" that assists the operation of the above (1) and a "second mode" that assists the operation of the above (2). ing.

The pump 21 is connected to the cuff 12 via an inflation tube 13 and a connecting tube 29 (not shown). The pump 21 is used for adjusting the amount of gas inside the cuff 12 by performing intake and exhaust. The pump 21 may be one pump that performs intake and exhaust, or may be two pumps that perform intake and exhaust.

The pressure sensor 22 is connected to the cuff 12 via an inflation tube 13 and a connecting tube 29 (not shown). The pressure sensor 22 detects the internal pressure of the cuff 12.

The storage unit 23 stores the above-mentioned determination criteria. In FIG. 4, the storage unit 23 is described as one configuration of the control device 2, but the present invention is not limited to this. An external storage medium may be used as the storage unit 23.

The control unit 24 includes a measurement unit 241, a determination unit 242, a determination unit 243, and an instruction unit 244. The control unit 24 is a computer included in the control device 2.

The measuring unit 241 receives the detection result detected by the pressure sensor 22 as an electric signal, and calculates and obtains the internal pressure of the cuff 12 from the received electric signal. The measuring unit 241 sequentially receives the detection results continuously detected by the pressure sensor 22, and measures the internal pressure of the cuff 12.

The determination unit 242 indicates that the tracheal tube 1 is being intubated into either the esophagus or the trachea based on the internal pressure of the cuff 12 measured by the pressure sensor 22 and the determination criteria stored in the storage unit 23. Determine if intubated.

The determination unit 243 receives at least one of the determination result in the determination unit 242 and the instruction input from the input unit 27, and determines whether to drive the pump 21.

For example, when an instruction to select the first mode is input, in order to adjust the amount of gas inside the cuff 12 in preparation for tracheal intubation, an appropriate driving condition of the pump 21 is determined, and the instruction unit 244 is determined. Supply a signal.

When the determination unit 242 determines that the tracheal tube 1 is being intubated or the esophagus is intubated when an instruction to select the second mode is input, the determination unit 243 determines that the instruction unit 244 is intubating. Judge that no signal is supplied to.

When the determination unit 242 determines that the tracheal tube 1 has been intubated, the determination unit 243 waits for a second mode selection instruction input from the input unit 27. When the selection of the second mode is input, an appropriate driving condition of the pump 21 is determined, and a signal is supplied to the indicator unit 244.

The indicator unit 244 drives the pump 21 based on the signal received from the determination unit 243.

The input unit 27 may include an input button for inputting an instruction to the control device 2, a power switch of the control device 2, and the like. Examples of the instruction input by the input unit 27 include switching between the first mode and the second mode, setting the internal pressure of the cuff 12.

The output unit 28 outputs the determination result in the determination unit 242. The output unit 28 has a configuration that visually outputs, for example, a display unit that displays a determination result, a light emitting unit that lights up or blinks according to the determination result, and an auditory sound such as a beep sound depending on the determination result. Includes a configuration that produces various outputs.

The control device 2 shown in FIG. 1 has a display 281 and a lamp 282 as an output unit 28.

FIG. 5 is a flowchart showing a process performed by the control device 2. In the following description, the reference numerals shown in FIGS. 1 to 4 are used as appropriate.

First, the operator turns on the power of the control device 2 and selects the first mode as the operation mode (step S11).

The selection of the first mode may be performed by the operator via the input unit 27, and when the power switch (input unit 27) of the control device 2 is turned on, the first mode is set to be selected first. May be good.

The determination unit 243 determines that the instruction input from the input unit 27 is the first mode, and supplies the determination result to the instruction unit 244. The instruction unit 244 supplies a drive signal to the pump 21 based on the determination result received from the determination unit 243, and drives the pump 21 under the operating conditions preset for preparation for tracheal intubation.

Next, the pump 21 first decompresses the inside of the cuff 12 based on the drive signal received from the indicator 244, and discharges the gas inside the cuff 12 to the outside (step S12).

By this operation, the cuff 12 is deflated. The indicator 244 may operate the pump 21 for depressurizing the inside of the cuff 12 for a predetermined set time (for example, 5 to 10 seconds).

Next, the pump 21 supplies a small amount of gas to the inside of the cuff 12 based on the drive signal received from the indicator 244 (step S13).

The “small amount” is an amount smaller than the amount that allows the cuff 12 to adhere to the inner wall M11 of the trachea M1 by supplying the trachea tube 1 to the cuff 12 when the trachea tube 1 is placed inside the trachea M1.

At the time of tracheal intubation, the tracheal tube 1 passes through the glottis, but if the cuff 12 is inflated, the cuff 12 may come into contact with the vocal cords and damage the vocal cords. Therefore, normally, the tracheal intubation operation is performed in a state where the inside of the cuff 12 is degassed and the cuff 12 is crushed, that is, in a state after step S12.

On the other hand, in the present embodiment, a small amount of gas is supplied to the inside of the cuff 12 for detecting the internal pressure of the cuff 12, which will be described later.

According to the inventor's examination, it has been confirmed that even 1 mL of gas supplied to the cuff 12 functions sufficiently. Since it is considered that the amount of "small amount of gas" differs depending on the material of the cuff 12 and the size of the cuff 12 contained in the tracheal tube 1, it is advisable to carry out a preliminary experiment in advance and set an appropriate amount.

Further, instead of supplying a small amount of gas to the cuff 12 by the pump 21, the drive of the pump 21 may be stopped, the inside of the cuff 12 may be opened to the atmosphere, and a small amount of air may be introduced into the inside of the cuff 12. .. When the inside of the cuff 12 is opened to the atmosphere, the cuff 12 elastically recovers depending on the shape of the cuff 12 and the material for forming the cuff 12, and a small amount of gas can be introduced into the inside of the cuff 12.

Next, the tracheal tube 1 in which the cuff 12 is inflated with a small amount of gas is intubated into the patient M, and the internal pressure of the cuff 12 at the time of intubation is detected by the measuring unit 241 (step S14).

When the cuff 12 comes into contact with the trachea M1 or the esophagus M2 of the patient M during intubation of the tracheal tube 1, the internal pressure of the cuff 12 changes according to the pressure F1 or the pressure F2 applied to the cuff 12. The pressure sensor 22 detects the internal pressure of the cuff 12. The measuring unit 241 calculates and measures the internal pressure of the cuff 12 based on the detection result of the pressure sensor 22.

FIG. 6 is a diagram showing the results of measuring the internal pressure of the cuff at the time of intubation. The vertical axis represents the measured value of internal pressure (unit: mmHg).

The data shown in FIG. 6 is the result of tracheal intubation by a trainee for 100 adult male and female patients who explained the contents of this data acquisition in advance and obtained consent for the implementation.

A commercially available tracheal tube having an inner diameter of 7.5 mm was used for male patients and an inner diameter of 7.0 mm was used for female patients. The tracheal tubes used are of the same manufacturer and the same model number, and the shape and material conditions of the cuff 12 are the same.

In the measurement, after removing the air inside the cuff 12 with a syringe, a pressure transducer was connected to the inflation tube with 1 mL of air supplied into the cuff 12, and the internal pressure of the cuff was confirmed. Intubation was performed after general anesthesia of the patient in the usual manner.

As shown in FIG. 6, it was found that the internal pressure of the cuff during tracheal intubation is significantly lower than the internal pressure of the cuff during esophageal intubation, and it is possible to judge tracheal intubation and esophageal intubation from the internal pressure of the cuff. It was. In the results of FIG. 6, when 5 mmHg was used as the cutoff value, tracheal intubation and esophageal intubation could be determined with sensitivity of 90%, specificity of 99%, and overall accuracy of 98%.

Such a cutoff value is stored in the storage unit 23 in advance as a reference value (determination standard). The storage unit 23 may store a plurality of reference values in advance according to the type of tracheal tube 1 having a different shape and material of the cuff 12.

The determination unit 242 determines whether or not the internal pressure of the cuff 12 obtained by the measurement unit 241 exceeds the reference value stored in the storage unit 23, and if it exceeds the reference value, intubation of the esophagus and the reference value are exceeded. If not, it is determined to be tracheal intubation (step S15).

When the internal pressure of the cuff 12 exceeds the reference value and it is determined that the esophagus is intubated, the determination unit 242 instructs the output unit 28 to output an alarm (alert). The output unit 28 outputs an alarm based on the drive signal received from the determination unit 242 (step S16).

FIG. 7 is a schematic view showing the state of the control device 2 when it is determined that the esophagus is intubated. As shown in FIG. 7, it is conceivable that the control device 2 displays an error on the display 281 or blinks the lamp 282 in red, for example. In addition, a beep sound may be output from a speaker (not shown).

The operator can easily confirm the esophageal intubation by confirming the output of the output unit 28. Further, an increase in the internal pressure of the cuff 12 can be detected when the cuff 12 invades the entrance of the esophagus. Therefore, the operator can recognize at an early stage when the tracheal tube 1 is being intubated into the esophagus (when the tracheal tube 1 invades the esophagus M2) and can suppress the esophageal intubation.

The operator who confirms the error display and the beep sound extubates the tracheal tube 1 and re-intubates the trachea. As a result, esophageal intubation can be suppressed.

Further, after outputting the alarm, the control unit 24 repeats the measurement of the cuff internal pressure and the determination based on the internal pressure and the reference value (steps S14 to S16).

Due to the loop processing, when the operator tries to continue intubation of the tracheal tube 1 into the esophagus, the control device 2 repeats the above-mentioned error display and beep sound during the operation of the operator. Therefore, the worker is likely to notice the esophageal intubation. The control unit 24 may gradually increase the beep sound as the number of repetitions of steps S14 to S16 increases, that is, the duration of the esophageal intubation state is extended so that the operator can easily notice the esophageal intubation.

Further, when the internal pressure of the cuff 12 falls below the reference value and it is determined that the trachea is intubated, the determination unit 242 instructs the output unit 28 to output a pass. The output unit 28 outputs that the result is acceptable based on the drive signal received from the determination unit 242 (step S17).

FIG. 8 is a schematic view showing the state of the control device 2 when it is determined that the tracheal intubation is performed. As shown in FIG. 8, the control device 2 may, for example, display a pass on the display 281 or light the lamp 282 in green. In addition, a chime sound indicating pass may be output from a speaker (not shown).

After confirming that the trachea can be intubated, the operator intubates the tracheal tube 1 to a predetermined position. The control unit 24 repeats the measurement of the cuff internal pressure, the determination based on the internal pressure and the reference value, and the pass output based on the determination result until the mode switching described later (steps S14 to 18).

After intubating the tracheal tube 1 to a predetermined position, the operator determines to switch the operation of the control device 2 to the "second mode" that assists the operation of the above (2) (step S18), and makes an intratracheal operation. When the intubation of the tracheal tube 1 is continued, the input unit 27 gives an instruction to select the second mode (step S21).

The determination of switching from the first mode to the second mode may be made by the operator or the control unit 24.
When the operator makes a determination to switch from the first mode to the second mode, for example, the operator indwells the tracheal tube 1 based on the determination result that the tracheal tube 1 is intubated into the trachea by the determination unit 242. Intubate to the desired position and switch to the second mode.

When the control unit 24 determines the switching from the first mode to the second mode, for example, the determination unit 243 after a predetermined time elapses based on the determination result that the tracheal tube 1 is intubated into the trachea by the determination unit 242. Determines to switch from the first mode to the second mode.

The determination unit 243 determines that the instruction input from the input unit 27 is the second mode, and supplies the determination result to the instruction unit 244.

The instruction unit 244 supplies a drive signal to the pump 21 based on the determination result received from the determination unit 243, and drives the pump 21 under the operating conditions preset for the placement of the tracheal tube.

The pump 21 supplies gas to the inside of the cuff 12 based on the drive signal received from the indicator 244 (step S22).

The amount of gas supplied to the inside of the cuff 12 may be controlled based on the internal pressure of the cuff 12 by a known method.

Further, in the second mode, the additional determination may be performed as follows. FIG. 9 is a flowchart showing a process performed by the control device 2.

In the second mode, the internal pressure of the cuff 12 is continuously detected by the measuring unit 241 while supplying gas to the inside of the cuff 12 (step S23).

As mentioned above, the trachea is supported by cartilage and is always open. On the other hand, the entire esophagus is flat, and the esophageal entrance M21 is closed. Due to such a difference in structure, it is assumed that the cuff 12 that inflates in response to the supply of gas receives different pressures from the surroundings depending on whether the intubation position of the tracheal tube 1 is the trachea or the esophagus.

FIG. 10 is a graph schematically showing the correspondence between the amount of gas inside the cuff 12 and the internal pressure of the cuff 12. The horizontal axis shows the amount of gas supplied to the cuff 12, and the vertical axis shows the internal pressure of the cuff 12. When the supply rate of the gas supplied to the cuff 12 can be set, the horizontal axis can also be converted into the gas supply time.

In FIG. 10, reference numeral A indicates a pressure change when supplying gas to the cuff of tracheal tube 1 inserted into the trachea, and reference numeral B indicates a change in pressure when supplying gas to the cuff of tracheal tube 1 inserted into the esophagus. Shows the pressure change when Note that FIG. 10 is a schematic diagram, and the values on the vertical axis cannot be simply compared.

When the tracheal tube 1 is inserted into the trachea, it is assumed that the surface of the cuff 12 is only slightly in contact with the inner wall M11 (tracheal mucosa) of the trachea if it is only intubated. Therefore, when gas is supplied to the cuff 12, as shown by reference numeral A in FIG. 10, it is assumed that the internal pressure rises slowly at the stage when the gas is started to be supplied. Further, if the supply of gas to the cuff 12 progresses and the cuff 12 swells to the extent that the entire circumference of the surface of the cuff 12 touches the inner surface of the trachea, it is assumed that the internal pressure rises sharply thereafter.

On the other hand, when the tracheal tube 1 is inserted into the esophagus, it is assumed that the surface of the cuff 12 is in extensive contact with the inner wall M22 (esophageal mucosa) of the esophagus. When gas is supplied to the inside of the cuff 12 in such a state, it is considered that the cuff 12 expands while expanding the esophageal mucosa. Therefore, when gas is supplied to the cuff 12, it is assumed that the internal pressure tends to increase from the stage when the gas is started to be supplied, as shown by reference numeral B in FIG.

The inventor made a difference between the rate of change in the internal pressure of the cuff 12 when the tracheal tube 1 was intubated into the trachea and the rate of change in the internal pressure of the cuff 12 when the tracheal tube 1 was intubated into the esophagus. We came to the idea that it is possible to determine whether the location where the tube 1 was intubated is the trachea M1 or the esophagus M2. In this case, the rate of change of the internal pressure of the cuff 12 with respect to the amount of gas inside the cuff 12 at the time of tracheal intubation is used as a reference value (second determination standard).

The second determination criterion can be obtained, for example, as the rate of change of the internal pressure per unit time at the stage when the gas is started to be supplied, or the slope of the tangent line at the stage when the gas is started to be supplied in the graph shown in FIG. The second criterion is obtained in a preliminary experiment so that the esophageal intubation state and the tracheal intubation state can be determined.

The determination unit 242, for example, obtains the rate of change per unit time for the internal pressure of the cuff 12 obtained by the measurement unit 241 and determines whether or not the obtained rate of change exceeds the reference value stored in the storage unit 23. To do. If the rate of change per unit time exceeds the reference value, it is determined to be esophageal intubation, and if it does not exceed the reference value, it is determined to be tracheal intubation (step S24).

When the rate of change in the internal pressure of the cuff 12 exceeds the reference value and it is determined that the esophagus is intubated, the determination unit 242 instructs the output unit 28 to output an alarm (alert). The output unit 28 outputs an alarm based on the drive signal received from the determination unit 242 (step S25).

The determination unit 243 determines at least one of the determination result (determination result of determining that the tracheal tube 1 has been intubated into the esophagus) determined by the determination unit 242 to be intubated in the esophagus and the instruction input from the input unit 27. Is received and a decision is made to stop the pump 21. The determination unit 243 supplies the determination result to the instruction unit 244. The operator may input a stop instruction from the input unit 27 when he / she notices that the esophageal intubation state is no longer determined by the determination unit 242 while monitoring the change in the internal pressure.

Based on the determination result received from the determination unit 243, the instruction unit 244 supplies a stop signal to the pump 21 to stop the pump 21 and stop the supply of gas to the cuff 12 (step S26).

Next, the instruction unit 244 supplies a drive signal to the pump 21 based on the determination result received from the determination unit 243, and drives the pump 21 under the operating conditions preset for preparation for tracheal extubation.

Next, the pump 21 decompresses the inside of the cuff 12 based on the drive signal received from the indicator 244, and discharges the gas inside the cuff 12 to the outside (step S27).

After the gas inside the cuff 12 is discharged, the operator extubates the tracheal tube 1 and repeats the operation of tracheal intubation. As a result, esophageal intubation can be suppressed.

On the other hand, when the rate of change of the internal pressure of the cuff 12 is lower than the reference value and the determination unit 242 determines that the tracheal intubation state is present, the determination unit 242 instructs the output unit 28 to output a pass. The output unit 28 outputs that the result is acceptable based on the drive signal received from the determination unit 242 (step S28).

As a result, the cuff 12 adheres to the inner wall of the trachea M1, and the tracheal tube 1 is placed in the trachea M1.

After intubation, it is preferable to monitor the carbon dioxide concentration in the exhaled breath using a capnometer and auscultate the chest and abdomen to confirm tracheal intubation.

According to the control device having the above configuration, it is possible to suppress the occurrence of defects due to esophageal intubation.

Further, according to the medical device and the artificial respiration system having the above configuration, since the above-mentioned control device is provided, it is possible to suppress the occurrence of a defect due to esophageal intubation.

When the control device 2 is set to the first mode and the tracheal tube 1 is intubated, even if the pressure F1 or F2 is applied to the cuff 12, the pilot balloon 14 expands and deforms according to the change in the internal pressure of the cuff 12, resulting in the internal pressure. It is possible that the amount of change is difficult to detect. Therefore, when the tracheal tube 1 is intubated, the expansion of the pilot balloon 14 may be regulated by the regulator 101.

In the control device 2 as described above, the program installed in the computer used as the control unit 24 measures the internal pressure of the computer based on the detection result of the pressure sensor 22 that detects the internal pressure of the cuff 12 included in the tracheal tube 1. Based on the internal pressure measured by the measuring unit 241 and the measuring unit 241 and the judgment criteria obtained in advance, it is determined whether the tracheal tube 1 is being intubated or intubated in the esophagus or the trachea. When the determination unit 242 and the determination unit 242 continue to install the tracheal tube 1 in the trachea based on the determination result that the tracheal tube 1 has been intubated into the trachea, it is connected to the cuff 12 and inside the cuff 12. The pump 21 for adjusting the amount of gas is made to function as an instruction unit 244 for instructing the supply of gas to the inside of the cuff 12. The program also causes the computer to function as the determination unit 243 described above.

As the determination standard, a reference value obtained based on the difference between the internal pressure when the tracheal tube 1 is intubated into the trachea M1 and the internal pressure when the tracheal tube 1 is intubated into the esophagus M2 is adopted.

The information processing described in the above-mentioned program is read into a computer used as the control unit 24, so that the measurement unit 241 and the determination unit 242, which are specific means in which the software and the various hardware resources described above cooperate with each other, It functions as an instruction unit 244 and a determination unit 243. Then, by realizing the calculation or processing of the information according to the purpose of use of the control device 2 in the present embodiment by these specific means, the control device 2 according to the purpose of use is constructed.

[Second Embodiment]
The control device 2 in the first embodiment performs the second mode after the first mode, and can determine the esophageal intubation in the second mode, but it may be a control device that independently performs only the second mode. ..

The control device according to the second embodiment has the same configuration as the control device shown in FIG. 4 described above. The control device of the second embodiment is (2) inflating the cuff 12 after tracheal intubation, and when the tracheal tube 1 is placed in the trachea, whether the tracheal tube 1 is intubated in the esophagus or the trachea is determined. judge.

That is, in the control device of the second embodiment, the tracheal tube 1 is intubated into either the esophagus or the trachea in the determination unit 242 based on the internal pressure detected by the pressure sensor 22 and the determination criteria obtained in advance. Judge whether or not. As the determination criterion, the rate of change of the internal pressure with respect to the amount of gas inside the cuff 12 is used.

The specific operation of the control device of the second embodiment is the same as that of the second mode of the first embodiment.

Even with the control device having the above configuration, it is possible to suppress the occurrence of problems due to esophageal intubation.

In the determination device as described above, the program installed in the computer used as the control unit 24 is the instruction unit 244 and the cuff 12 for instructing the amount of gas to be supplied to the inside of the cuff 12 included in the tracheal tube 1. Based on the detection result of the pressure sensor 22 that detects the internal pressure, the measuring unit 241 that measures the internal pressure, the rate of change of the internal pressure measured by the measuring unit 241 with respect to the amount of gas inside the cuff 12, and the determination criteria obtained in advance are used. Based on this, the tracheal tube 1 functions as a determination unit 242 for determining whether the tracheal tube 1 has been intubated into the trachea M1 or the esophagus M2.

As the determination standard, the reference value of the rate of change of the internal pressure of the cuff 12 with respect to the amount of gas inside the cuff 12 at the time of tracheal intubation is adopted.

The information processing described in the above-mentioned program is read into a computer used as the control unit 24, so that the measurement unit 241 and the determination unit 242, which are specific means in which the software and the various hardware resources described above cooperate with each other, It functions as an indicator 244. Then, by realizing the calculation or processing of the information according to the purpose of use of the determination device in the present embodiment by these specific means, the determination device according to the purpose of use is constructed.

[Third Embodiment]
FIG. 11 is an explanatory diagram for explaining the determination device 5 according to the present embodiment, and is a block diagram corresponding to FIG. In this embodiment, the same components as those in the first embodiment are designated by the same reference numerals, and detailed description thereof will be omitted.

As shown in FIG. 11, the determination device 5 includes a pressure sensor 22, a storage unit 23, a control unit 25, and an output unit 28. The determination device 5 has a configuration in which the function is narrowed down to the determination of esophageal intubation from the control device 2 of the first embodiment described above.

The control unit 25 has a measurement unit 241 and a determination unit 242. The control unit 25 is a computer included in the determination device 5.

The pressure sensor 22, the storage unit 23, the output unit 28, the measurement unit 241 and the determination unit 242 in the control device 2 of the first embodiment correspond to the determination device in the present invention.

The configuration in which the tracheal tube 1 and the determination device 5 of the present embodiment are combined corresponds to the medical device in the present invention.

FIG. 12 is a flowchart showing a process performed by the determination device 5, and is a diagram corresponding to FIG.

First, the operator uses a syringe to remove gas from the cuff 12 of the tracheal tube 1 connected to the determination device 5, and then uses a syringe to put a small amount of gas, for example, about 1 mL, into the cuff 12 and intubate. Prepare.

Next, the tracheal tube 1 in which the cuff 12 is inflated with a small amount of gas is intubated into the patient M, and the internal pressure of the cuff 12 at the time of intubation is detected by using the pressure sensor 22 and the measuring unit 241 (step S14).

The determination unit 242 determines whether or not the internal pressure of the cuff 12 obtained by the measurement unit 241 exceeds the reference value stored in the storage unit 23, and if it exceeds the reference value, intubation of the esophagus and the reference value are exceeded. If not, it is determined to be tracheal intubation (step S15).

When the internal pressure of the cuff 12 exceeds the reference value and it is determined that the esophagus is intubated, the determination unit 242 instructs the output unit 28 to output an alarm (alert). The output unit 28 outputs an alarm based on the drive signal received from the determination unit 242 (step S16).

Further, when the internal pressure of the cuff 12 falls below the reference value and it is determined that the trachea is intubated, the determination unit 242 instructs the output unit 28 to output a pass. The output unit 28 outputs that the result is acceptable based on the drive signal received from the determination unit 242 (step S17).

After confirming that the trachea can be intubated, the operator intubates the tracheal tube 1 to a predetermined position. The control unit 25 repeats the measurement of the cuff internal pressure, the determination based on the internal pressure and the reference value, and the pass output based on the determination result until the mode is switched, which will be described later (steps S14 to S19).

The operator intubates the tracheal tube 1 to a predetermined position, and then ends the determination process of the determination device 5 (step S19).

Gas is supplied to the cuff 12 of the tracheal tube 1 intubated to a predetermined position by a known method. As a result, the tracheal tube 1 is placed in the trachea M1.

According to the determination device having the above configuration, it is possible to suppress the occurrence of defects due to esophageal intubation.

In the determination device 5 as described above, the program installed in the computer used as the control unit 25 uses the computer as an internal pressure based on the detection result of the pressure sensor 22 that detects the internal pressure of the cuff 12 included in the tracheal tube 1. Judgment unit 242 that determines that the tracheal tube 1 is being intubated or has been intubated into the esophagus M2 based on the internal pressure measured by the measuring unit 241 and the measuring unit 241 and the determination criteria obtained in advance. To function as.

As the determination standard, a reference value obtained based on the difference between the internal pressure when the tracheal tube 1 is intubated into the trachea M1 and the internal pressure when the tracheal tube 1 is intubated into the esophagus M2 is adopted.

The information processing described in the above-mentioned program is read into a computer used as the control unit 25, and as a measurement unit 241 and a determination unit 242, which are specific means in which the software and the various hardware resources described above cooperate with each other. Function. Then, by realizing the calculation or processing of the information according to the purpose of use of the determination device 5 in the present embodiment by these specific means, the determination device 5 according to the purpose of use is constructed.

The program installed in the computer used as the control unit 24 in the control device 2 of the first embodiment and the program installed in the computer used as the control unit 25 in the determination device 5 of the second embodiment are external to the external recording medium. It may be stored in a storage medium.

The storage medium includes a magnetic recording medium such as a flexible disk or a tape medium, an optical recording medium such as a CD-ROM or a DVD (Digital Virtual Disk), a magneto-optical recording medium such as an MO (Magnet-Optical disk), a USB memory, or an IC. A semiconductor memory such as a card can be used.

Further, a storage medium such as a hard disk or RAM provided in a dedicated communication network or a server system connected to the Internet may be used as a recording medium to provide a program to a computer via the network.

Although preferred embodiments of the present invention have been described above with reference to the accompanying drawings, it goes without saying that the present invention is not limited to such examples. The various shapes and combinations of the constituent members shown in the above-mentioned examples are examples, and can be variously changed based on design requirements and the like without departing from the gist of the present invention.

1 ... tracheal tube, 2 ... control device, 3 ... artificial respirator, 5 ... judgment device, 11 ... tube body, 12 ... cuff, 13 ... inflation tube, 14 ... pilot balloon, 21 ... pump, 22 ... pressure sensor, 24 , 25 ... Control unit, 27 ... Input unit, 28 ... Output unit, 100 ... Medical equipment, 101 ... Regulator, 241 ... Measurement unit, 242 ... Judgment unit, 243 ... Judgment unit, 244 ... Indicator unit, 282 ... Lamp, 1000 ... artificial respiration system, F1, F2 ... pressure, M1 ... trachea, M11 ... (trachea) inner wall, M2 ... esophagus, M21 ... esophageal entrance, M22 ... (esophagus) inner wall

Claims (24)

A pressure sensor that detects the internal pressure of the cuff of the tracheal tube,
It has a determination unit for determining that the tracheal tube is being intubated or has been intubated based on the internal pressure detected by the pressure sensor and a determination criterion obtained in advance.
The determination criterion is a determination device determined based on the difference between the internal pressure when the tracheal tube is intubated into the trachea and the internal pressure when the tracheal tube is intubated into the esophagus. The determination device according to claim 1, further comprising an output unit that outputs a determination result by the determination unit. The determination unit determines whether the tracheal tube is being intubated or intubated in the esophagus or the trachea based on the internal pressure detected by the pressure sensor and the determination criterion. Or the determination device according to 2. A pump that regulates the amount of gas inside the cuff of the tracheal tube,
A pressure sensor that detects the internal pressure of the cuff and
It has a control unit that controls the amount of gas inside the cuff based on the result detected by the pressure sensor.
The control unit determines whether the tracheal tube is being intubated or intubated in the esophagus or the trachea based on the internal pressure detected by the pressure sensor and the first determination criterion obtained in advance. Judgment unit and
It has an indicator unit that instructs the drive of the pump, and has
The first criterion is determined based on the difference between the internal pressure when the tracheal tube is intubated into the trachea and the internal pressure when the tracheal tube is intubated into the esophagus.
The indicating unit causes the pump to supply gas to the inside of the cuff based on the determination result of determining that the tracheal tube has been intubated into the trachea by the determination unit, and causes the cuff to adhere to the inner wall of the trachea. Control device to let. The control unit has a first mode for determining whether the tracheal tube is intubated in the esophagus or the trachea.
In the first mode, the second mode of instructing the pump to supply the gas to the inside of the cuff is performed in order based on the determination result of determining that the tracheal tube has been intubated into the trachea. The control device according to claim 4. The control device according to claim 5, further comprising an input unit for instructing switching between the first mode and the second mode. In the first mode, the control unit degass the inside of the cuff by the pump, and then the amount of gas inside the cuff is smaller than the amount that allows the cuff to adhere to the inner wall of the trachea. The control device according to claim 5 or 6. The control device according to claim 5 or 6, wherein the control unit opens the inside of the cuff to the atmosphere after degassing the inside of the cuff by the pump in the first mode. In the second mode, the determination unit determines whether the tracheal tube was intubated into the esophagus or the trachea based on the internal pressure detected by the pressure sensor and the second determination criterion obtained in advance. Judge,
The control device according to any one of claims 5 to 8, wherein the second determination criterion is obtained based on the rate of change of the internal pressure with respect to the amount of gas inside the cuff. The indicator stops the supply of the gas to the inside of the cuff to the pump based on the determination result that the determination unit determines that the tracheal tube has been intubated into the esophagus in the second mode. The control device according to claim 9. A pump that regulates the amount of gas inside the cuff of the tracheal tube,
A pressure sensor that detects the internal pressure of the cuff and
An indicator that instructs the drive of the pump and
It has a determination unit for determining whether the tracheal tube is intubated in the esophagus or the trachea based on the internal pressure detected by the pressure sensor and a determination criterion obtained in advance.
The determination standard is a control device obtained based on the rate of change of the internal pressure with respect to the amount of gas inside the cuff. The eleventh aspect of claim 11, wherein the indicating unit stops the supply of gas to the inside of the cuff by the pump based on the determination result of determining that the tracheal tube has been intubated into the esophagus by the determination unit. Control device. The control device according to any one of claims 4 to 12, further comprising an output unit that outputs a determination result by the determination unit. With the tracheal tube
The determination device according to any one of claims 1 to 3, wherein the tracheal tube is connected and the amount of gas inside the cuff is controlled.
The tracheal tube has a tube body, a cuff provided on the tip end side of the tube body, and an inflation tube communicating with the internal space of the cuff.
The internal pressure sensor included in the determination device is a medical device that is connected to the inflation tube and detects the internal pressure of the cuff via the inflation tube. The tracheal tube has a pilot balloon communicating with the inflation tube in the path of the inflation tube.
The medical device according to claim 14, further comprising a regulator that regulates the expansion of the pilot balloon. With the tracheal tube
The control device according to any one of claims 4 to 13, wherein the tracheal tube is connected and the amount of gas inside the cuff is controlled.
The tracheal tube has a tube body, a cuff provided on the tip end side of the tube body, and an inflation tube communicating with the internal space of the cuff.
An internal pressure sensor included in the control device is a medical device that is connected to the inflation tube and detects the internal pressure of the cuff via the inflation tube. The tracheal tube has a pilot balloon communicating with the inflation tube in the path of the inflation tube.
The medical device according to claim 16, further comprising a regulator that regulates the expansion of the pilot balloon. The medical device according to claim 16 or 17,
An artificial respiration system comprising an artificial respirator to which the tracheal tube of the medical device is connected. A computer equipped with a judgment device that determines esophageal intubation of the tracheal tube,
A measuring unit that measures the internal pressure based on the detection result of the internal pressure sensor that detects the internal pressure of the cuff provided in the tracheal tube.
A determination unit that determines that the tracheal tube is being intubated or has been intubated based on the internal pressure measured by the measurement unit and a determination criterion obtained in advance.
A program that functions as. A computer equipped with a control device that controls the amount of gas inside the cuff,
A measuring unit that measures the internal pressure based on the detection result of the internal pressure sensor that detects the internal pressure of the cuff provided in the tracheal tube.
A determination unit for determining whether the tracheal tube is being intubated or intubated in the esophagus or the trachea based on the internal pressure measured by the measurement unit and a determination criterion obtained in advance.
When the determination unit continues the placement of the tracheal tube in the trachea based on the determination result that the tracheal tube has been intubated into the trachea, it is connected to the cuff and the amount of gas inside the cuff is measured. An indicator that instructs the adjusting pump to supply gas to the inside of the cuff,
A program that functions as. A computer equipped with a control device that controls the amount of gas inside the cuff,
An indicator that indicates the amount of gas supplied to the inside of the cuff provided in the tracheal tube,
A measuring unit that measures the internal pressure based on the detection result of the internal pressure sensor that detects the internal pressure of the cuff.
Judgment as to whether the tracheal tube was intubated into the esophagus or the trachea based on the rate of change of the internal pressure measured by the measuring unit with respect to the amount of gas inside the cuff and a determination criterion obtained in advance. Department,
A program that functions as. Computer,
A measuring unit that measures the internal pressure based on the detection result of the internal pressure sensor that detects the internal pressure of the cuff provided in the tracheal tube.
A determination unit that determines that the tracheal tube is being intubated or has been intubated based on the internal pressure measured by the measurement unit and a determination criterion obtained in advance.
A recording medium that records a program that functions as. Computer,
A measuring unit that measures the internal pressure based on the detection result of the internal pressure sensor that detects the internal pressure of the cuff provided in the tracheal tube.
A determination unit for determining whether the tracheal tube is being intubated or intubated in the esophagus or the trachea based on the internal pressure measured by the measurement unit and a determination criterion obtained in advance.
When the determination unit continues the placement of the tracheal tube in the trachea based on the determination result that the tracheal tube has been intubated into the trachea, it is connected to the cuff and the amount of gas inside the cuff is measured. An indicator that instructs the adjusting pump to supply gas to the inside of the cuff,
A recording medium that records a program that functions as. Computer,
An indicator that indicates the amount of gas supplied to the inside of the cuff provided in the tracheal tube,
A measuring unit that measures the internal pressure based on the detection result of the internal pressure sensor that detects the internal pressure of the cuff.
It is determined whether the tracheal tube is intubated in the esophagus or the trachea based on the rate of change of the internal pressure measured by the measuring unit with respect to the amount of gas inside the cuff and a determination criterion obtained in advance. Judgment unit,
A recording medium that records a program that functions as.

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