JP2798259B2 - Ventilator - Google Patents

Description

The present invention relates to a ventilator.

(Prior Art) A ventilator generally gives a patient forced breathing at a low frequency, that is, almost the same number of times as a healthy person. More specifically, an intake passage connected to a supply source of intake gas and an intake passage connected to the intake passage are provided, and for example, an electromagnetic on-off valve provided in the intake passage is opened and closed at a predetermined cycle, The intermittent supply of the intake gas is performed, and the intermittent supply cycle of the intake gas is set to about 20 times per minute. Such a respiratory state will be referred to as a first respiratory state in the present application.

On the other hand, recently, an artificial respirator that breathes at a high frequency, for example, about 10 to 30 times per second while continuously supplying inspired gas, has been developed and has already been put to practical use by the present applicant. I have. The artificial respiration using such high-frequency vibration enables gas exchange between the inspired gas and the patient's lungs to be performed very efficiently and does not require the patient's lungs to be significantly expanded and contracted. As a lot of attention. In the present application, such a respiratory state is referred to as the second
Let's call it the breathing state.

(Problems to be Solved by the Invention) By the way, in the recent medical world, during the artificial respiration, the above-described artificial respiration in the first respiratory state and the artificial respiration in the second respiratory state are selected. What can be performed in a desired manner is desired.

However, the conventional ventilator is configured as a device that performs the above-mentioned first respiratory state artificial respiration and a device that performs the above-mentioned artificial respiration in the second respiratory state, as completely separate and independent devices. Therefore, in order to change the respiratory state, it is necessary not only to change the device of the ventilator itself, but also to change the circuit connection of the ventilator to the patient. This means that the artificial respiration must be interrupted for a very long time. In addition, providing the ventilator dedicated to each respiratory state independently of each other is disadvantageous in terms of cost, space, and the like.

Accordingly, an object of the present invention is to provide an artificial respirator that can selectively switch between artificial respiration in a first respiratory state and artificial respiration in a second respiratory state.

(Means and Actions for Solving the Problems) In order to achieve the above object, the present invention has the following configuration. That is, it is possible to selectively switch between a first breathing state in which inhalation gas is intermittently supplied to perform low-frequency breathing and a second breathing state in which inhalation gas is continuously supplied to perform high-frequency breathing. An inspiratory passage connected to a supply source of inspired gas, and a first expiratory passage for a first respiratory state and a second expiratory passage for a second respiratory state, each of which is connected to the inspiratory passage. Switching means connected to the intake passage for switching between a state in which the supply of intake gas is performed intermittently and a state in which the supply of intake gas is continuously performed; Flow control means for limiting a flow rate flowing through the intake passage to a small one when the air is continuously supplied, and a high-frequency high-frequency device connected to a breathing passage including the intake passage, the first breathing passage, and the second breathing passage. Give vibration Vibrating means for connecting to the intake passage at least on the supply source side with respect to the vibrating means, and being activated during the second respiratory state to transmit high-frequency vibrations to the supply source side. Filter means for preventing the pressure from flowing, first pressure adjusting means connected to the first expiratory passage and adjusting the discharge pressure of expiratory gas from the first expiratory passage in the first respiratory state, and the second First intercepting means for intercepting the discharge of exhaled gas from the first exhalation passage during a respiratory state, respectively connected to the second exhalation passage, and from the second exhalation passage during the second exhalation state Second pressure adjusting means for adjusting the discharge pressure; and
A second blocking means for blocking discharge of exhaled gas from the exhalation passage; and an artificial respirator characterized by comprising:

In the artificial respiration according to the present invention configured as described above, in order to set the first respiratory state, the switching means sets the state of intermittent supply of the inspired gas, and the flow rate adjusting means sets the state of the flow rate of the inspired gas large, The vibrating means may be stopped, the filter means may be deactivated, and the second blocking means may be in the blocked state.

Further, in order to set the second respiratory state, the switching means is set to continuously supply the inspired gas, the flow rate adjusting means is used to reduce the flow rate of the inspired gas, and the vibrating means and the filter means are operated. What is necessary is just to make a blocking means into a blocking state. By the operation of the filter means, the gas vibration by the vibration means is effectively performed without being greatly attenuated. That is, on the intake passage side,
In general, there are devices occupying a large volume, for example, a humidification table. Without a filter means, it is necessary to vibrate the intake gas in the large volume unnecessarily.

Incidentally, the average pressure during artificial respiration in the first respiratory state is adjusted by the first pressure adjusting means as before, and the average pressure during artificial respiration in the second respiratory state is adjusted by the second pressure adjusting means. You.

(Example) Hereinafter, an example of the present invention will be described with reference to the attached drawings.

In FIG. 1, reference numeral 1 denotes an adapter. The adapter 1 has a common connection port 1a connected to the patient's lung, and first to fourth four connection ports 1b connected to the common connection port 1a.
~ 1e. An intake passage 3 extending from a storage tank 2 serving as a supply source of intake gas is connected to the first connection port 1b. A first expiratory passage 4 for a first respiratory state is connected to the second connection port 1c, and a second exhalation passage 5 for a second respiratory state is connected to the third connection port 1d. The pressure sensor 7 is connected to the fourth connection port 1e via the pressure transmission passage 6. The tank 2 is provided with a pressure regulating valve (not shown) and the like so that intake gas at a predetermined pressure is supplied from the tank 2 to the intake passage 3. In addition, the second expiratory passage 5 has a smaller effective opening area than the other passages 3 and 4.

The intake passage 3 is provided with an electromagnetic on-off valve 11, a variable throttle 12, a check valve, and the like in order from the upstream side (tank 2 side) to the downstream side.
Box 13 with built-in 13a, humidifier 14, rotary valve 1
5 is connected.

The on-off valve 11 constitutes a switching means, and intermittently supplies and shuts off intake gas by being turned on and off in a predetermined cycle (low-frequency cycle). Further, the on-off valve 11 continuously flows the intake gas by being kept ON.

The variable throttle 12 constitutes a flow control valve, and changes the flow rate of the intake gas flowing through the intake passage 3 to a large or small value. Of course, in the first respiratory state, a relatively large amount of gas flows due to intermittent operation of inspiratory gas, and in the second respiratory state, a relatively small amount of gas flows due to continuous supply of inspiratory gas. Is done.

The box 13 always permits the flow of the intake gas to the humidifier 14 side. The box 13 has an airbag functioning as a kind of accumulator through a passage 16.
17 is connected. Then, the flow from the box 13 side to the airbag 17 side is blocked by the check valve 13a.

The humidifier 14 humidifies the intake gas as in the related art, and additionally heats the intake gas.

The rotary valve 15 constitutes a filter means. In the first breathing state, the valve body 15a is in the state shown in FIG. 2, and the intake gas passes through a large space 15b around the valve body 15a. In other words, the effective opening area of the intake passage 3 is made sufficiently large. In the second respiratory state,
When the valve body 15a is in the state shown in FIG. 1, the intake gas flows through a communication port (orifice) 15c having a small effective opening area formed in the valve body 15a. The state where the valve body 15a is in the state shown in FIG. 1 is when the rotary valve 15 as the filter means is operated. In this case, even though the gas on the adapter 1 side is vibrated at a high frequency, It is not transmitted to the upstream side of the rotary valve 15 (acts as a low-pass filter).

A vibration device as a vibration means is provided in the first expiration passage 4.
21 is connected. The vibrating device 21 has a piston mechanism
22 and a linear motor 23 as a driving means for reciprocatingly driving the piston mechanism 22.

The piston mechanism 21 has a cylinder 24 and a piston 25 slidably fitted therein.
A working chamber 26 is defined in the cylinder 24 by this. The working chamber 26 also constitutes a part of the first exhalation passage 4. That is, each of the cylinders 24 has a working chamber.
First and second two ports 27 and 28 opening to 26 are formed, and one port 27 is connected to the first exhalation passage 4, while the other port 28 is connected to the outlet of the first exhalation passage 4. Configure ports.

The outlet port 28 has a first pressure adjusting means and a first pressure adjusting means.
A control valve 29 is provided as shutoff means. The control valve 29 is of a diaphragm type and has a casing 30 and a diaphragm 32 defining a pressure chamber 31 in the casing. The diaphragm 32 faces the outlet port 28. A pilot passage 33 is connected to the pressure chamber 31, and a pressure regulating valve 34 is connected to the pilot passage 33. Thus, by adjusting the signal air pressure for the pressure chamber 31 with the pressure adjusting valve 34, the valve opening pressure of the outlet port 28 is adjusted. The valve opening pressure is set to a relatively small value in the first breathing state,
The discharge pressure from the exhalation passage 4 is adjusted (functions as first pressure adjusting means). Further, in the second breathing state, the valve opening pressure of the outlet port 27 is increased, and the pressure in the breathing passage is prevented from abnormally increasing (functioning as a first shut-off means).

The second exhalation passage 5 is connected to a control valve 41 as a second pressure adjusting means and a second shutoff means. The control valve 41 is of a spool type and includes a casing 42 and a spool 43 slidably fitted therein. The caging 42 has an inlet port 44 connected to the second exhalation passage 5 at one end in the stroke direction of the spool 43, and a port 45 opened at the other end in the stroke direction. The casing 42 has an outlet port 46 opened to the atmosphere and a port 47 opened in the radial direction of the spool 43. Meanwhile, spool 43
A valve portion 43a is formed at an end on the outlet port 44 side, and the valve portion 43a is detached and seated on a valve seat 42a formed on the inner peripheral edge of the outlet port 44 in accordance with sliding of the spool 43.
The spool 43 is urged by the return spring 48 in a direction in which the valve portion 43a is separated from the valve seat 42a. When the valve portion 43a is separated from the valve seat 42a, the inlet port 44 communicates with the outlet port 46, and conversely, the valve portion 43a
When seated on 2a, both ports 44 and 46 are shut off (function as second shut-off means-see FIG. 3). The sliding of the spool 43 (separation / seating of the valve portion 43a with respect to the valve seat 42a)
Switching is performed by supplying and shutting off a signal air pressure described later from the port 45.

The spool 43 is formed with a small-diameter nozzle portion 43b extending toward the inlet port 44, and the nozzle portion 43b
A communication passage 43c is formed to allow the communication with the port 47. Thereby, when air is supplied from the port 47 in the state of FIG. 1 in which the inlet port 44 communicates with the outlet port 46, the air is jetted from the nozzle portion 43b, and by adjusting the jetted air pressure, The discharge pressure from the second expiration passage 5 is adjusted (functions as a second pressure adjusting unit).

The control valve 41 is provided with a three-way switching valve 49. The three-way switching valve 49 is constantly supplied with air at a predetermined pressure from a passage 50, and according to the switching mode of the three-way switching valve 49, the air is supplied to the port 47 via the passage 51. (Second breathing state), said port via passage 52
The state is switched to a state (first respiratory state) supplied to 45. And the supply air pressure to the passage 51 or 52 is
It is adjusted by the electropneumatic converter 53.

A passage 52a is branched from the passage 52, and the branch passage 52a is connected to the passage 16 for the airbag 17. A variable throttle 54 is connected to the branch passage 52a. By adjusting the variable throttle 54, a predetermined amount of air is stored in the airbag 17 at least in the first breathing state.

In FIG. 1, U is a control unit configured using a microcomputer. The control unit U receives signals from the switches 61 to 64 in addition to the signal from the pressure sensor 7. In addition, the control unit U outputs the data to the devices 11, 12, 15, 23, 34, 49, 53, and 54. Among the switches 61 to 64, the switch 61 is for selecting between a first breathing state and a second breathing state. The switch 62 controls the vibration frequency (10 Hz) in the second breathing state.
(Stepless at ~ 30Hz). Switch 63
Is for instructing the reciprocating stroke amount of the linear motor 23. The switch 64 commands the average pressure in the adapter 1.

 Next, the operation of the above configuration will be described.

Second respiratory state At this time, the linear motor 23 is driven to apply high frequency vibration to the respiratory circuit. At this time, the number of reciprocating movements of the piston 25 determines the frequency of high frequency vibration (10 Hz to 30 Hz), and the amount of reciprocating stroke is the work amount of the vibration to be applied (set according to the capacity of the patient's lung). In the second breathing state, the operating states of the devices are as follows. First, the on-off valve 11 is kept in the open state. Variable aperture 12
Is set to a small opening to restrict the flow rate. The rotary valve 15 is set to the state shown in FIG. 1 in order to prevent high frequency vibration from being transmitted to the upstream side of the humidifier 14 or the like. Pressure regulating valve 34
Supplies a large air pressure to the pressure chamber 31 to make the control valve 29 function as a safety valve (relief valve). Three-way switching valve 49
Supplies air to the side of the passage 51 and opens the side of the passage 52 to the atmosphere. Thereby, as shown in FIG. 1, the control valve 41 injects air from the nozzle 43b with the inlet port 44 and the outlet port 46 in communication. The injection air pressure is adjusted by performing feedback control of the electropneumatic converter 53 so that the pressure read by the pressure sensor 7 becomes a specified pressure (average pressure).

First breathing state At this time, the linear motor 23 is stopped (the piston 25 stops at, for example, a position at the left stroke end in FIG. 1), and the operation of each device is performed as follows. First, the on-off valve 11 is operated in a cycle (1
Opening and closing are repeated about 20 times a minute). The opening of the variable throttle 12 is increased in order to increase the flow rate. The rotary valve 15 is configured as shown in FIG. The three-way switching valve 49 is switched to supply air to the passage 52 side. Thereby, the spool 43 becomes as shown in FIG.
The second exhalation passage 5 is closed, and no air is injected from the nozzle 43b. The pressure regulating valve 34 is feedback-controlled so that the pressure detected by the pressure sensor 7 becomes a specified pressure (average pressure).

When the patient himself / herself performs a breathing operation and the intake gas is insufficient, the check valve 13a is opened and the air in the airbag 17 is supplied to the adapter 1 side.

Although the embodiment has been described above, the present invention is not limited to this and includes, for example, the following case.

The second exhalation passage 5 may be configured to branch off from the first exhalation passage 4 without being provided in parallel with the first exhalation passage 4.

The vibration device 21 is not limited to the first exhalation passage 4 but may be connected to the second exhalation passage 5 or the intake passage 3. Of course, it is preferable that the vibration device 21 be connected as close as possible to the adapter 1 in order to effectively perform high-frequency vibration on the lungs of the patient.

The vibration device 21 is provided with an appropriate type, for example, a blower as a rotary blower and a rotary switching valve,
By using a switching valve, the breathing circuit can be excited by alternately connecting the suction port and the discharge port of the blower.

(Effects of the Invention) As is clear from the above description, the present invention can easily and quickly switch between the first breathing state and the second breathing state. In addition, since there are a number of devices that can be shared between the respirators for the first respiratory state and the second respiratory state, cost and space are higher than when these are separately installed separately. This is also advantageous from the viewpoint of.

[Brief description of the drawings]

FIG. 1 is an overall system diagram showing one embodiment of the present invention. FIG. 2 and FIG. 3 are views showing an operation mode of the main equipment which is different from the mode shown in FIG. 1: Adapter (for patient connection) 2: Tank (inspiratory gas supply source) 3: Inspiratory passage 4: First expiratory passage 5: Second expiratory passage 11: Opening / closing valve (switching means) 12: Adjustable throttle (flow rate adjusting means) 14: Humidifier 15: Rotary valve (filter means) 21: Vibration device 22: Piston mechanism 23: Linear motor 29: Control valve (first pressure adjusting means, first shutoff means) 41: Control valve (second pressure adjusting) Means, second blocking means)

Claims (5)

(57) [Claims] 1. A first breathing state in which inhalation gas is intermittently supplied to perform low-frequency breathing, and a second breathing state in which inhalation gas is continuously supplied to perform high-frequency breathing. A ventilator adapted to be switched between the first and second respiratory states, and an inspiratory passage connected to a supply source of inspired gas;
An exhalation passage and a second exhalation passage for a second respiratory state, connected to the inhalation passage, for switching between an intermittent supply of inspiratory gas and a state of continuous supply of inspiratory gas. Switching means connected to the intake passage, and a flow regulating means for restricting a flow rate flowing through the intake passage to a small amount when the intake gas is continuously supplied; A vibrating unit connected to a respiratory passage including a second respiratory passage, for applying high-frequency vibration; and a vibrating unit connected to the intake passage at least on the supply source side with respect to the vibrating unit, in a second respiratory state Filter means which is activated to prevent high frequency vibrations from being transmitted to the supply side; and exhalation gas from the first exhalation passage which is connected to the first exhalation passage during the first respiratory state, respectively. Spitting A first pressure adjusting unit that adjusts pressure, and a first shutoff unit that shuts off discharge of exhaled gas from the first exhalation passage during the second respiratory state. A second adjusting the discharge pressure from the second exhalation passage in the second exhalation state;
A ventilator comprising: a pressure adjusting unit; and a second blocking unit configured to block discharge of exhaled gas from the second exhalation passage during the first respiratory state. 2. The humidifier according to claim 1, wherein a humidifier is connected to the intake passage, and the filter is disposed downstream of the humidifier. 3. The apparatus according to claim 1, wherein said switching means is constituted by an on-off valve. 4. The apparatus according to claim 1, wherein said flow rate adjusting means is constituted by a variable throttle. 5. The effective opening of the intake passage in the first breathing state according to claim 1, wherein the filter means increases an effective opening area of the intake passage in the first breathing state. It is composed of a switching valve that reduces the area.