JP3775118B2 - High frequency ventilator - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a ventilator, and more particularly to a ventilator suitable for high-frequency ventilation.
[0002]
[Prior art]
A high-frequency ventilator is an inspiratory system containing high-concentration oxygen that flows through a fluid circuit system that branches from an oxygen supply source to a patient and an exhaust port via a branch point (normal flow rate of 10 to 30 [l / min], This refers to a ventilator that supplies oxygen into the patient's lungs by energizing oscillating air pressure at a high frequency (1 [Hz] or higher) for a maximum of 60 [l / min]).
[0003]
The oxygen supply principle of a high-frequency ventilator will be explained. Due to the pressure amplitude of inspiration, small volume ventilation (convective gas exchange) for inspiration containing carbon dioxide in the patient's lungs (hereinafter referred to as exhalation) ) Occurs and exhalation is led out of the lungs to the outside of the lungs (patient's mouth) by the effect of the diffusion movement by the vibration of the inspiration. The subsequent inspiration performs the above-described ventilation and also has an action of sending the exhaled air derived from the lungs to the exhaust port side. This makes it possible to always maintain a constant oxygen concentration in the patient's lungs.
[0004]
A conventional example will be described with reference to FIG. This conventional example shows a high-frequency vibration ventilation (HFO) ventilator 200 that performs oxygen inhalation and exhalation to a patient X. FIG. 9 shows the overall structure of the ventilator 200.
[0005]
The ventilator 200 includes an inhalation introduction unit 262 that supplies inspiration (a mixture of air and oxygen), a blower 252 that simultaneously generates both positive pressure Ap and negative pressure An, and a positive pressure generated by the blower 252. A rotary valve mechanism 254 that alternately selects Ap or negative pressure An and converts it to a predetermined oscillating air pressure Apn, and is actuated by the oscillating air pressure Apn from the rotary valve mechanism 254 to act on the patient X from the inhalation inlet 262 And a diaphragm mechanism 256 for energizing the oscillating air pressure to the supplied intake air.
[0006]
The intake air introduction unit 262 described above includes an intake unit 263 that sucks and mixes outside air and oxygen prepared in advance, and a humidifier 264 that humidifies air sent from the intake unit 263. The intake unit 263 is provided with adjustment means (not shown) for adjusting the flow rate of intake air.
[0007]
On the other hand, the rotary valve mechanism 254 can adjust the rotation cycle of the valve, and alternately selects the positive pressure Ap and the negative pressure An according to the adjusted cycle, and outputs a predetermined vibration air pressure Apn.
[0008]
The diaphragm mechanism 256 is located downstream of the rotary valve mechanism 254, and the vibration of the diaphragm film 257 is urged by the vibration air pressure Apn. The diaphragm membrane 257 faces the passage region of the intake air supplied from the intake air introduction portion 262, and applies the oscillating air pressure Apn to the intake air that passes therethrough.
Further, a three-way branch pipe 270 is disposed on the downstream side of the inspiratory flow direction, and the advancing direction of the inhalation is branched into the patient side and the exhaust side. A patient pipe 271 for sending inhalation to the patient's lungs is connected to the patient side port of the three-way branch pipe 270, and an exhaust pipe 272 is connected to the exhaust side port. A flow rate adjustment valve 273 is provided at the end portion of the exhaust pipe 272, and excess intake and exhalation are exhausted from the flow rate adjustment valve 273.
[0009]
The opening degree of the flow rate adjustment valve 273 can be adjusted by an external operation, and the pressure inside the ventilator 200 is adjusted by the supply flow rate of the intake air and the valve opening degree.
[0010]
Further, reference numerals 281 to 285 in the figure are pressure sensors for detecting the pressure in the pipes of each part.
[0011]
Reference numeral 274 in the figure is a bacteria filter that filters out bacteria contained in exhaled breath. Each part of the high frequency ventilator 200 exposed to direct exhalation requires careful sterilization after use. Since the structure of the flow control valve 273 is complicated, the sterilization work after use becomes very complicated when exposed to direct exhalation. Therefore, as a countermeasure for solving this problem, the bacteria filter 274 is provided in front of the flow rate control valve 273.
[0012]
Since the flow rate control valve is not directly exposed to exhalation by the installation of the bacterial filter 274, it is possible to avoid a complicated sterilization operation and a decrease in the operation capacity of the flow rate control valve due to saliva, moisture, etc. contained in exhalation.
[0013]
In the above-described conventional example, an inspiratory unit 263 generates an inhaled air with a high oxygen concentration by an operator (for example, a doctor) who operates the ventilator 200, and the inhaled air is delivered at a desired set flow rate (10 to a maximum of 60 [l / min]). Supplied downstream. At this time, the flow rate adjustment valve 273 adjusts the valve opening. The average pressure on the patient's lung is 5-15 cmH ₂ 0] is appropriate, and the exhaust flow rate can be adjusted by the open area of the rubber valve member of the flow rate adjusting valve 272, and at the same time, the pressure inside the ventilator 200 can be controlled.
[0014]
The flowing inspiration is ventilated in the lungs of the patient via the patient pipe 271 by energizing the high-frequency oscillating air pressure Apn and sends out exhaled air to the exhaust pipe 272 side. Such exhaled air and inhaled air are exhausted into the atmosphere through the bacteria filter 274 and the flow rate control valve 273.
[0015]
[Problems to be solved by the invention]
By the way, in the above-described high-frequency ventilator 200, the exhaled breath drawn out by vibration to the mouth must always be pushed away to the exhaust port side by the subsequent inspiration so that the patient does not inhale again by breathing. Further, if the supply flow rate of inhalation is increased, an effect is produced in which exhaled air generated from the patient's lungs is efficiently delivered. Therefore, when the concentration of carbon dioxide in the patient's lungs is higher than usual or when it is desired to keep the oxygen concentration high, measures are taken to increase the supply flow rate of inspiration (maximum 40-60 [l / min]).
[0016]
However, since the high-frequency ventilator 200 is a solid structure and the pipe diameter and pipe length of each part are constant, the total air resistance of the ventilator 200 is as long as the flow control valve 273 has a constant opening. It is constant. The viscosity coefficient of intake air is determined by the mixing ratio of air and high concentration oxygen. The pipe length from the pressure sensors 281 to 284 of the high-frequency ventilator 200 is l [m], the pipe diameter is d [m], the viscosity coefficient of intake is μ, and the supply flow rate of intake is Q [m. ^Three / s] and the average flow velocity of the intake air is U [m / s], the pressure drop ΔP between the pressure sensors 281 to 284 is expressed by the following equation (1) according to Hagen-Poiseuille's law.
[0017]
ΔP = Q · 128 μl / πd ⁴ = U · 32μl / d ² ... (1)
[0018]
Therefore, when the supply amount of inspiration increases, the supply pressure of inspiration to the patient increases in proportion thereto. In this case, even if the flow rate adjusting valve 273 is fully opened, the limit is limited, and thus the pressure rise is unavoidable.
[0019]
More specifically, when the inspiratory air supply is performed with the flow rate set to 30 [l / min] or more for the above-described high-frequency ventilator 200 with the bacterial filter 274 removed, the flow rate is adjusted. Even when the valve 273 is set to the maximum opening, the internal average pressure is 13 [cmH]. ₂ O] Could not be reduced below. In the state where the bacteria filter 274 is equipped, 2 to 3 [cmH ₂ O] pressure rises and 15 [cmH] ₂ O] Could not be reduced below.
[0020]
Therefore, the conventional high-frequency ventilator 200 cannot maintain the supply pressure suitable for oxygen inhalation when the inhalation supply amount is increased, and the carbon dioxide concentration in the lung increases substantially due to the change in the patient's condition. There is a disadvantage that it is difficult to increase the intake air supply amount due to the necessity of treatment.
[0021]
Furthermore, if a bacterial filter is provided in the patient circuit system, the flow resistance increases accordingly, and the tendency to increase the pressure in the exhalation circuit becomes more prominent. There was a disadvantage that it was more difficult to increase the ventilation efficiency inside.
[0022]
OBJECT OF THE INVENTION
An object of the present invention is to provide a high-frequency respirator that improves the disadvantages of the conventional example and can freely adjust the ventilation efficiency in the lung.
[0023]
[Means for Solving the Problems]
According to the first aspect of the present invention, a high-frequency vibration ventilation method is employed in which inhalation including oxygen supplied to a patient is energized with an oscillating air pressure having a period higher than the patient's respiratory cycle to perform oxygen inhalation and exhalation. Exhaust route that discharges exhaled air from the patient to the atmosphere in a high-frequency ventilator Provided with a flow rate adjustment valve for freely adjusting the flow rate of the exhalation in the first discharge pipe whose discharge end is open to the atmosphere, and in the middle of the first discharge pipe, On the upstream side of the exhalation direction of the flow control valve The exhaust gas urging means for actively flowing the exhaled air in the direction in which the exhaled air is discharged into the atmosphere is employed.
[0024]
In the above-described configuration, the oscillating air pressure having a high frequency is applied when inhalation is supplied to the patient. Such oscillating air pressure is set to a cycle that is independent of and higher than the patient's spontaneous breathing cycle. When the highly oscillating inspiration is positive pressure (phase of pressure higher than atmospheric pressure), inhalation enters the patient's lungs, and when negative pressure (phase of pressure lower than atmospheric pressure) is from the patient's lungs It works to breathe out the exhaled breath containing carbon dioxide. By repeating such a positive pressure and a negative pressure in a short cycle, the patient's lungs are ventilated, and the lungs can be maintained at a constant oxygen concentration.
[0025]
When the above ventilation operation is performed, The exhaled air exhausted from the patient is exhausted into the atmosphere at a constant flow rate through a flow control valve. At this time, the exhaust flow rate may be adjusted by using the exhaust urging means together. Further, the exhaust urging means may be operated when the intake air supply amount is set high and exhaust is insufficient even when the flow control valve is at the maximum opening. .
The exhaust urging means causes the exhaled air exhaled from the patient to flow toward the atmosphere (outside the high-frequency ventilator) through the exhaust path. The operation of the exhaust urging means may be performed only when the supply flow rate of the intake air exceeds a certain amount. The active flow energization of exhaled air by the exhaust energizing means suppresses an increase in the internal pressure and the supply pressure to the patient due to the inherent flow loss of the high-frequency ventilator.
[0028]
Claim 2 In the described invention, Claim 1 In addition to the configuration of the described invention, the exhaust urging means includes a branch pipe that is upstream of the flow regulating valve in the exhalation discharge direction and branches from the middle of the first exhaust pipe, and one end thereof is opened to the atmosphere. It has a second discharge pipe in which an air flow is formed toward the open side and a blowing means for forming the air flow, and the second discharge pipe has a partially set inner diameter in the middle thereof. The downstream end portion of the branch pipe is joined to the throttle portion of the second discharge pipe.
[0029]
In such a configuration, in addition to the same operation as described above, when the air blowing means of the exhaust urging means is activated, exhaled air enters the branch pipe from the first exhaust pipe. As described above, the branch pipe has a structure in which the air flow is formed in the second discharge pipe and is joined at the position of the throttle portion, so that the exhalation is branched due to the pressure drop of the throttle portion caused by the venturi effect. Through the first discharge pipe to the second discharge pipe and discharged into the atmosphere.
[0030]
Claim 3 In the described invention, in addition to each of the above-described configurations, a configuration is adopted in which a branch portion from the first discharge pipe to the branch pipe communicates through innumerable small holes. In such a configuration, operations similar to those described above are performed, and the flow of exhaled air from the first discharge pipe to the branch pipe is performed through the small holes.
[0031]
Claim 4 In the described invention, Claim 1, 2 or 3 A pressure sensor that detects the pressure of inspiration or expiration, and an operation control unit that freely controls output adjustment by the exhaust urging means, and the operation control unit includes the pressure sensor. The first output adjustment function for driving the exhaust urging means with the output corresponding to the detected pressure is adopted.
[0032]
In such a configuration, operations similar to those described above are performed, and when the intake air starts to flow, the pressure is detected by the pressure sensor. In the operation control unit, the output of the exhaust urging means according to the detected pressure is stored. With reference to this, the exhaust urging means is driven with the output according to the detected pressure, and the expiratory active means is activated at a predetermined flow rate. Exhaust is performed.
[0033]
Claim 5 In the described invention, Claim 1, 2 or 3 A first pressure sensor for detecting an inspiratory pressure before supply to a patient, a second pressure sensor for detecting a pressure of exhaled air discharged from the patient, and an exhaust energization. And a second output adjustment function for driving the exhaust urging means with an output corresponding to the difference between the detected pressures of the pressure sensors. The structure is adopted.
[0034]
In the above configuration, the same operation as in each of the above configurations is performed, and the gas flow rate between the sensors can be obtained from the output pressure difference between the two pressure sensors. In the operation control unit, an output for setting the exhaust urging means to the target flow rate is stored. With reference to this, the exhaust urging means is driven with an output corresponding to the flow rate, and active exhaust of exhaled air at a predetermined flow rate. Is done.
[0035]
The present invention intends to achieve the above-described object by the above-described configurations.
[0036]
DETAILED DESCRIPTION OF THE INVENTION
An embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a high-frequency vibration ventilation method in which an inspiratory gas containing oxygen supplied to a patient X is energized with an oscillating air pressure having a period higher than that of the patient X to perform oxygen inhalation and exhalation. 2 is a block diagram showing a configuration of a ventilator 12. FIG.
[0037]
The high-frequency ventilator 12 includes an inhalation introduction unit 62 as an oxygen supply source, a blower 52 (air pressure generation source) that simultaneously generates air pressures of both positive pressure Ap and negative pressure An, and positive air generated by the blower 52. The rotary valve mechanism 54 (oscillating air pressure generating mechanism) that alternately selects the pressure Ap or the negative pressure An and converts it into a predetermined oscillating air pressure Apn, and is actuated by the oscillating air pressure Apn from the rotary valve mechanism 54 to operate the intake air. A diaphragm mechanism 56 that biases oscillating air pressure to oxygen supplied to the patient X from the introduction unit 62 (strictly, oxygen mixed with air) and an operation control unit 40 that controls the operation of each unit are provided.
[0038]
The intake air introduction unit 62 includes a blender 621 that sucks and mixes outside air and oxygen prepared in advance, and a humidifier 622 that humidifies air sent from the blender 621. The blender 621 is provided with a plurality of output valves (not shown) that allow intake air to flow to the humidifier 622 side. The various output valves have different flow rates, and intake air at a predetermined flow rate is supplied by selecting an output valve with an arbitrary flow rate. Each output valve is provided with an actuator that switches between opening and closing by an operation signal from the operation control unit 40.
[0039]
The humidifier 622 is connected to an intake pipe 623 that supplies the inhaled air Ai passed through the humidifier 622 to the patient X. The intake pipe 623 communicates with the pressurized chamber 563 of the diaphragm mechanism 56 in the middle thereof, and is connected to a three-way branch pipe 170 described later at the end thereof.
[0040]
The blower 52 takes in air into the inside and generates positive pressure and negative pressure simultaneously by sending out the air. The air intake port is connected to a negative pressure port 542 of a rotary valve mechanism 54 described later, and the air delivery port is connected to a positive pressure port 541.
[0041]
The rotary valve mechanism 54 includes a positive pressure port 541 to which a positive pressure is input from the blower 52, a negative pressure port 542 to which a negative pressure is urged from the blower 52, an output port 543 that outputs vibration air pressure, and its rotation. Thus, the output port 543 is composed of a rotary valve 544 that alternately connects the positive pressure port 541 and the negative pressure port 542, and a drive unit 545 that rotates the rotary valve 544. The drive unit 545 includes an electric motor and a speed reducer (not shown), and rotates the rotary valve 544 at, for example, 900 [rpm]. Each time the rotary valve 544 rotates, only the port 541 and the port 543 are communicated once, and then only the port 542 and the port 543 are communicated once. Thereby, the oscillating air pressure Apn having a frequency of 15 [Hz] is urged to the supplied intake air. An oscillating air pressure tube 546 that transmits the oscillating air pressure Apn to the diaphragm mechanism 56 is connected to the port 543.
[0042]
The diaphragm mechanism 56 includes a pressurizing chamber 562 and a pressurized chamber 563, and a diaphragm 561 formed of a stretchable film member that partitions the pressurized chamber 562 and the pressurized chamber 563. . The pressurizing chamber 562 is connected to the oscillating pneumatic tube 546. The pressurizing chamber 562 is connected to the output port 543 of the rotary valve 54, and the pressurized chamber 563 is connected to the intake pipe 623. With this structure, the oscillating air pressure formed by the rotary valve 54 is urged by the intake air flowing through the intake pipe 623 via the diaphragm 561.
[0043]
Further, the high-frequency ventilator 12 includes a three-way branch pipe 170 on the downstream side of the intake pipe 623, and the three-way branch pipe 170 further branches the downstream side into the patient X side and the discharge path side. The exhaust path of the high-frequency ventilator 12 includes a bacteria filter 70 that filters out bacteria contained in the exhalation and an exhaust energization that actively flows the exhalation in the direction in which the exhalation is discharged into the atmosphere. Means 80 are provided.
[0044]
The above-described three-way branch pipe 170 includes three pipe lines, a patient-side pipe line 171, an oxygen supply source-side pipe line 172, and an exhalation-exhaust side pipe line 173, and all of these pipes are merged inside. . The oxygen supply source side pipe line 172 is connected to the inspiratory pipe 623, and the patient side pipe line 171 is connected to the terminal inspiratory pipe 605 reaching the patient X.
[0045]
Further, the exhalation discharge side pipe line 173 is connected to one end of the first discharge pipe 604, and a flow rate adjusting valve 607 is connected to the other end of the first discharge pipe 604. The first exhaust pipe 604 and the flow control valve 607 serve as a passage for inhalation (exhalation) containing carbon dioxide emitted from the lungs of the patient X, and constitute an exhaust path through which exhalation is discharged into the atmosphere. .
[0046]
FIG. 2 is an enlarged view showing a part of the periphery of the discharge path. As shown in this figure, the flow rate adjusting valve 607 includes a housing 607a, an exhaust port 607b, a flow control valve (control silicon sheet) 607c, and a reciprocating movement that moves the transfer valve 607c back and forth along a certain direction. And a solenoid 607d as an urging mechanism.
[0047]
The first discharge pipe 604 is divided into an upstream portion 604a and a downstream portion 604b with the bacterial filter 70 in between, and the end portion of the downstream portion 604b is inserted into the housing 607a of the flow control valve 607. The moving valve 607c is mounted on the housing 607a in the vicinity of the front face in the exhaust direction at the end of the downstream portion 604b of the first discharge pipe 604. A solenoid 607d supported by the casing 607a is disposed behind the moving valve 607c, and the moving valve 607c is brought into contact with and separated from the end of the downstream portion of the first discharge pipe 604. The solenoid 607d can freely set the distance from the moving valve 607c to the end of the first discharge pipe 604 by the control signal of the operation control unit 40. Therefore, the moving valve 607c can be separated most from the state where the end of the first discharge pipe 604 is completely blocked within the range allowed by the solenoid 607d, and the exhalation passage flow rate is adjusted according to the separation distance. It is possible.
[0048]
The bacteria filter 70 is provided in the middle of the first discharge pipe 604, and more precisely, is mounted at the end of the upstream portion 604a of the first discharge pipe 604. The bacterial filter 70 mainly includes a filter unit 71 that filters out bacteria and a plastic container 72 that houses the filter unit 71. The exhaled air flowing from the upstream portion 604a of the first exhaust pipe 604 is first sent to the filter unit 71, and the exhaled air that has passed through the filter unit 71 passes from the inside of the container 72 to the downstream part 604b of the first exhaust tube 604. Will flow into. When passing through the filter unit 71, bacteria in the exhaled breath are collected by filtration.
[0049]
This bacterial filter 70 is disposable, and used ones are exhausted. Therefore, the upstream end portion of the container 72 is detachable by the pushing operation or the pulling operation of the end portion of the upstream portion 604a of the first discharge pipe 604. Further, the downstream end portion of the container 72 is connected to the upstream end portion of the downstream portion 604 b of the first discharge pipe 604 through the silicon rubber joint 73. Also in the silicon rubber joint 73, the downstream portion 604b of the first discharge pipe 604 is detachable by a pushing operation or a pulling operation.
[0050]
The exhaust urging means 80 is provided in the middle of the first discharge pipe 604 and downstream of the bacterial filter 70. The exhaust urging means 80 includes a branch pipe 81 which is upstream of the flow rate adjusting valve 607 in the exhalation direction and branches from the middle of the first exhaust pipe 604, and one end thereof opened to the atmosphere and opened to the inside. A second discharge pipe 82 in which an air flow toward the end is formed, and an air blowing means 83 that forms the air flow are provided.
[0051]
Innumerable small holes 811 penetrating through the pipe wall are formed at the branch point of the first discharge pipe 604 to the branch pipe 81 side. A tubular container 812 is mounted so as to surround the portion of the first discharge pipe 604 where the small hole 811 is formed from the outside. A seal structure is provided between the tubular container 812 and the outer wall surface of the first discharge pipe 604, and all the exhaled air flowing out of the first discharge pipe 604 through each small hole 811 is formed in this tubular shape. The structure reaches the inside of the container 812 and is not directly released into the atmosphere.
[0052]
One end of the branch pipe 81 communicates with the tubular container 812. Therefore, the exhaled air flowing out from each small hole 811 of the first discharge pipe 604 passes through the tubular container 812 and flows into the branch pipe 81. The other end of the branch pipe 81 is connected to the middle part of the second discharge pipe 82.
[0053]
As described above, the second discharge pipe 82 includes the air blowing means 83 at one end thereof, and can form an air flow in the direction from the one end to the other end. Further, a throttle part 821 having a gradually decreasing pipe diameter is provided in the middle part of the second discharge pipe 82, and the air flow velocity is accelerated from the throttle part 821.
[0054]
The other end of the branch pipe 81 is communicated with the second discharge pipe 82 at a position immediately downstream of the throttle portion 821. The branch pipe 81 and the second discharge pipe 82 are so-called ejectors. A structure is formed. Accordingly, the branch pipe 81 has a venturi effect with respect to the second discharge pipe 82. That is, in the inside of the second discharge pipe 82, the portion immediately downstream of the throttle portion 821 has a negative pressure (atmospheric pressure lower than atmospheric pressure).
[0055]
On the other hand, the end portion of the first discharge pipe 604 does not fall below the atmospheric pressure even when the flow rate adjustment valve 607 is in the maximum opening. Therefore, in a state where an air flow is formed inside the second discharge pipe 82, the exhaled air flowing from the upstream side of the first discharge pipe 604 is sucked out from each small hole 811, and the tubular container It flows into the 2nd discharge pipe 82 via 812 and the branch piping 81, and will be discharged | emitted in air | atmosphere with an air flow.
[0056]
By the way, the blowing means 83 provided at one end of the second discharge pipe 82 includes a blower 831 that takes in the atmosphere and sends it out into the second discharge pipe 82, and a flow rate variable valve 832 that adjusts the flow rate of the sent out air. It consists of and. The flow rate of the flow rate variable valve 832 is set by an operation signal received from the operation control unit 4. Specifically, as the flow variable valve 832, a combination of an electropneumatic proportional valve or a needle type flow control valve and a stepping motor that adjusts the opening degree thereof is suitable.
[0057]
Further, as shown in FIG. 1, pressure sensors 91 to 95 for detecting the pressure at the passage location are equipped in each part of the path through which inspiration or expiration passes. The first pressure sensor 91 is provided between the blender 621 and the humidifier 622 of the intake air introduction unit 62, and the second pressure sensor 92 is provided between the bacteria filter 70 and the exhaust urging means 80, The pressure sensor 93 is provided in the patient-side pipe line 171 of the three-way branch pipe 170, and the fourth pressure sensor 94 is located downstream of the diaphragm mechanism 56 in the intake pipe 623 and upstream of the three-way branch pipe 170. The fifth pressure sensor 95 is provided between the three-way branch pipe 170 and the bacterial filter 70. Detection signals from these sensors 91 to 95 are output to the operation control unit 40.
[0058]
Next, the operation control unit 40 will be described with reference to FIGS. 1 and 2. The operation control unit 40 is composed of a calculation device including a CPU, a ROM, and an A / D converter, and a program for executing operation control of the high-frequency ventilator 12 described later is input.
[0059]
The operation control unit 40 is provided with an input unit 401 for receiving an operation input by an operator and a display unit 402 including a display for displaying an operation state of the ventilator 12.
[0060]
The input unit 401 inputs on / off of the main switch and selection of the supply flow rate of intake air. That is, the operation control unit 40 has a driver (not shown) of an actuator for each output valve of the blender 621. When the selection of the supply flow rate of intake air is input, the operation control unit 40 corresponds to the flow rate selected via the driver. Open only the valves to be closed and keep the other valves closed.
[0061]
In addition, setting input of first and second specified values α and β, which will be described later, is performed from the input unit 401. Furthermore, the high-frequency ventilator 12 can perform two types of normal ventilations that supply inspiration in accordance with the spontaneous breathing cycle of the patient X without energizing the oscillating air pressure ( Whether to perform high-frequency ventilation or one of two types of normal ventilation can be selected from the input unit 401.
[0062]
Further, the operation control unit 40 includes a driver for the solenoid 607d of the flow rate adjustment valve 607, and operates the solenoid 607d via the driver to move the moving valve 607c by a predetermined distance. Further, the operation control unit 40 displays the detected pressure corresponding to the output signals of the pressure sensors 91 to 95 on the display unit 402.
[0063]
Further, the operation control unit 40 has a first predetermined value α (for example, 10 [cmH], in which the pressure detected by the third pressure sensor 93 is preset. ₂ O]) is provided with a pressure maintaining function 41 for adjusting the valve opening degree of the flow rate adjusting valve 607.
[0064]
That is, the operation control unit 40 A / D converts the detection signal of the third pressure sensor 93 and averages a plurality of detection pressures obtained at a sampling interval finer than the vibration air pressure Apn. If the pressure value exceeds the first specified value α, the actuator 607d is driven to control the movement valve 607c gradually away from the end of the first discharge pipe 604. Further, when the detected pressure value is lower than the first specified value α, operation control is performed to gradually bring the moving valve 607c closer to the end of the first discharge pipe 604. As a result, the pressure of inspiration or expiration at the position where the third pressure sensor 93 is disposed is maintained at the first specified value α.
[0065]
Further, the operation control unit 40 sets the second specified value β (β> α, for example, 15 [cmH], in which the average value of the pressure detected by the third pressure sensor 93 is set in advance. ₂ O]) When the above is reached, the exhaust switching function 42 is provided to start driving the blower 831 of the exhaust urging means 80 and drive the solenoid 607d of the flow rate adjusting valve 607 to close the flow rate adjusting valve 607.
[0066]
That is, when the set flow rate of the intake air is high, the detected pressure is maintained at the first specified value α even when the flow rate adjustment valve 607 is at the maximum opening (the movement valve 607c is farthest from the first discharge pipe 604). In this case, the detected pressure rises to the second specified value β. Then, when the second specified value β is exceeded, the blower 831 that has been stopped until then is driven, and exhalation is positively passed from the first discharge pipe 604 via the branch pipe 81 to the second discharge pipe. 82, and is discharged into the atmosphere from the end of the second discharge pipe 82. At the same time, the actuator 607d of the flow rate adjusting valve 607 is driven to move until the moving valve 607c closes the first discharge pipe 604.
[0067]
The operation control unit 40 further includes a first output adjustment function 43 that drives the exhaust urging means 80 with an output corresponding to the pressure detected by the third pressure sensor 93.
[0068]
That is, the operation control unit 40 includes a driver (not shown) of the flow rate variable valve 83 of the exhaust urging means 80, and the pressure value detected by the third pressure sensor 93 exceeds the first specified value (same as described above). In this case, operation control is performed to gradually open the opening of the variable flow rate valve 83. Further, when the detected pressure value is lower than the first specified value, operation control for gradually decreasing the opening degree of the flow rate variable valve 83 is performed. As a result, the pressure of inspiration or expiration at the position where the third pressure sensor 93 is disposed is maintained at the first specified value.
[0069]
The operation of the high-frequency ventilator 12 having the above configuration will be described with reference to FIGS. FIG. 3 is a flowchart showing the operation of the high-frequency ventilator 12 including the operation of the operator.
[0070]
First, the main switch is turned on by the input unit 401, and the high frequency ventilation mode is selected (step S1). Then, when the intake air flow rate and the first and second specified values are set, the supply of the intake air is started at the flow rate set from the intake air introduction unit 62, and at the same time, the blower 52 and the rotary valve mechanism 54 start operating. The oscillating air pressure Apn is urged against the intake air. Then, high-frequency artificial respiration is performed on the patient X, and exhaled air generated from the patient X is sent to the first exhaust pipe 604 via the terminal inspiratory pipe 605. At this time, the exhaust urging means 80 has not been operated yet, and exhaled air is exhausted into the atmosphere from both the end of the first exhaust pipe 604 and the end of the second exhaust pipe 82 (step S2).
[0071]
Detection signals are output to the operation control unit 40 from the pressure sensors 91 to 95 installed in each part of the inhalation and expiration passage routes, and the operation control unit 40 calculates a detection pressure based on the detection signals. And output to the display unit 402. Further, it is determined whether the detected pressure p based on the third pressure sensor 93 is the first specified value α (step S3).
[0072]
If the detected pressure p is α, it is continuously monitored whether α is maintained until the main switch is turned off (step S4).
[0073]
When the detected pressure p deviates from the first specified value α, the operation control unit 40 adjusts the opening degree of the flow rate adjusting valve 607 by the pressure maintaining function 41. That is, if p> α, the opening degree of the flow rate adjustment valve 607 is increased, and if p <α, the opening degree of the flow rate adjustment valve 607 is reduced (step S5).
[0074]
When the opening degree of the flow control valve 607 is adjusted, the pressure determination is performed again. That is, it is determined whether or not the detected pressure p of the third pressure sensor 93 exceeds the second specified value β. This is because when the inspiratory flow rate is set high in advance or when the inspiratory flow rate is changed to high during use, even if the opening degree of the flow rate adjusting valve 607 is maximized, a sufficient expiratory flow rate cannot be secured and the detected pressure p is sufficiently May not be lowered. In such a case, the detected pressure p exceeds the first specified value α and further exceeds the second specified value β. Therefore, the pressure determination is performed again after adjusting the opening degree of the flow rate adjustment valve 607, and it is determined whether the pressure adjustment is covered only by adjusting the opening degree of the flow rate adjustment valve 607 (step S6).
[0075]
Accordingly, when it is determined that the detected pressure p has not increased, the process returns to step S3, and it is continuously monitored whether the detected pressure p is maintained at α.
[0076]
On the other hand, when the detected pressure p exceeds the second specified value β, the exhaust gas switching function 42 determines that the pressure adjustment of the flow rate adjusting valve 607 cannot be completed, and the exhaust urging means 80 actively Exhalation starts. That is, the drive of the blower 831 of the exhaust urging means 80 is started, and an air flow is formed in the second exhaust pipe 82, so that the exhaled air in the first exhaust pipe 604 passes through the branch pipe 81. It is led to the second discharge pipe 82 side and actively discharged into the atmosphere. At this time, the flow rate adjusting valve 607 moves the moving valve 607c to block the end of the first discharge pipe 604 (step S7).
[0077]
When the driving of the exhaust urging means 80 is started, the pressure determination is performed again. It is determined whether the detected pressure p of the third pressure sensor 93 maintains the first specified value α (step S8).
[0078]
If the detected pressure p is α, it is continuously monitored whether α is maintained until the main switch is turned off (step S9).
[0079]
When the detected pressure p deviates from the first specified value α, the operation control unit 40 adjusts the opening degree of the flow rate variable valve 832 by the first output adjustment function 43. That is, if p> α, the opening degree of the flow rate variable valve 832 is increased, and if p <α, the opening degree of the flow rate variable valve 832 is reduced (step S10).
[0080]
Thereafter, when the detected pressure p detected by the third pressure sensor 93 has settled to the first specified value α, such a pressure state is watched until the main switch is turned off (steps S8 and S9).
[0081]
FIG. 4 is a diagram showing changes in inspiratory and expiratory pressure due to the operation of the exhaust urging means 80. FIG. 4A shows the pressure change detected by the fourth pressure sensor 94 from the intake air immediately after the oscillating air pressure Apn is energized, derived from the intake air introduction portion 62, and FIG. FIG. 4C shows the pressure change before the operation of the exhaust urging means 80 detected by the third pressure sensor 93 with respect to the inhalation and exhalation in the patient side conduit 171, and FIG. The pressure change after the operation of the exhaust urging means 80 detected by the third pressure sensor 93 with respect to inspiration and expiration is shown.
[0082]
Since FIG. 4A is near the intake air introduction portion 62, it is difficult to be affected by the exhaust urging means 80, and only the state before the operation of the exhaust urging means 80 is shown. In addition, the straight line by the dotted line shown to each FIG. 4 (A)-(C) shows the average pressure of the detected pressure of FIG. 4 (A).
[0083]
It is desirable that the oscillating air pressure Apn immediately downstream of the diaphragm mechanism 56 as shown in FIG. 4A is also observed at the location where the third pressure sensor 93 that is the mouth of the patient X is provided. However, when the exhaust urging means 80 is not in operation, the atmosphere enters from the flow rate adjustment valve 607 at the negative pressure of the oscillating air pressure Apn, and the minimum pressure rises uniformly as shown in FIG. To do. On the other hand, in FIG. 4C, the flow rate adjustment valve 607 is closed and the exhaust urging means 80 operates, so that exhaled air is actively discharged into the atmosphere via the exhaust urging means 80. Since the intrusion of the atmosphere is rejected, the pressure amplitude similar to the state immediately after the vibration air pressure Apn is urged by the diaphragm mechanism 56 is observed at the mouth of the patient X.
[0084]
Therefore, it can be seen that the high-frequency ventilator 12 maintains high ventilation efficiency in the lungs of the patient X.
[0085]
In addition, the high-frequency ventilator 12 having the above-described configuration can perform two types of normal artificial respiration that are not high-frequency. On the other hand, the normal ventilation is a method in which the high-frequency ventilator 12 actively performs inspiration supply and exhalation discharge with respect to the patient X at a predetermined cycle. The other normal ventilation is a system in which the high-frequency ventilator 12 actively supplies only inspiration according to the patient's X breathing intention.
[0086]
FIG. 5 is a flowchart showing the operation of the high-frequency ventilator 12 including the operation of the operator when performing artificial respiration according to the normal ventilation mode A. The operation will be described with reference to FIG.
[0087]
First, the normal ventilation mode A is selected by the input unit 401 (step S21). Further, the input unit 401 sets a ventilation cycle, an intake supply flow rate per cycle, and a supply time (step S22).
[0088]
When the above input is made, the flow rate adjustment valve 607 is closed (step S23). Then, the intake air is supplied for a predetermined time set by the set intake air supply flow rate (step S24). Subsequently, the exhaust urging means 80 is operated for a time obtained by subtracting the set inspiratory supply time from the set cycle, and exhalation is discharged (step S25).
[0089]
The above-described inhalation supply and exhalation discharge are repeated until the main switch OFF is input from the input unit 401 (step S26).
[0090]
FIG. 6 is a flowchart showing the operation of the high-frequency ventilator 12 including the operation of the operator when performing artificial respiration according to the normal ventilation mode B. The operation will be described with reference to FIG.
[0091]
First, the normal ventilation mode B is selected by the input unit 401 (step S31). Further, the intake air supply flow rate, the intake start pressure γ, and the intake end pressure δ (δ> γ) are set by the input unit 401 (step S32).
[0092]
When the input is made, the flow rate adjustment valve 607 is closed (step S33). When the detected pressure p at the mouth (pressure detected by the third pressure sensor 93) falls below the set intake start pressure γ by the patient X's spontaneous suction operation (step S34), the set supply flow rate is set. Intake is supplied (step S35).
[0093]
When the spontaneous suction operation of the patient X approaches the end, the pressure at the mouth rises due to the supplied inspiration (step S36). When the detected pressure p at the mouth exceeds the set intake end pressure δ, the supply flow rate of the intake air decreases, and the supply is stopped after a predetermined time has elapsed (step S37).
[0094]
The above-described intake air supply is repeated until the main switch OFF is input from the input unit 401 (step S38).
[0095]
As described above, the high-frequency ventilator 12 can also perform normal artificial respiration that is not high-frequency. In the normal ventilation mode A, inhalation supply and exhalation discharge are performed in a preset cycle, but these may be performed using a change in the detected pressure at the mouth as a trigger.
[0096]
As described above, in the high-frequency ventilator 12, since the exhaust urging means 80 is provided in the discharge path, the expiratory discharge is actively performed as compared with the case where the end of the discharge path is simply opened to the atmosphere. It is possible to avoid an increase in in-pipe pressure for inspiration or expiration. That is, conventionally, when the supply flow rate of inhalation is increased due to the flow resistance of each pipe of the ventilator, the supply pressure to the patient X tends to increase. However, the high frequency ventilator 12 has a flow resistance. However, since exhalation is actively performed, an increase in the supply pressure of inspiration is avoided, and it is possible to perform artificial respiration with an appropriate supply pressure. In particular, when a bacterial filter is installed in the discharge path, the flow resistance increases, and the above-described pressure increase tends to occur. However, even in such a case, the exhaust urging means 80 positively expiratory air. Since it drains, it became possible to perform artificial respiration with an appropriate supply pressure.
[0097]
In addition to this effect, it is possible to avoid an increase in the pressure inside the ventilator, so the restrictions on the design of dimensions and shape of each part such as piping that will be the passage path of inspiration or expiration are relaxed, and the degree of freedom in design is expanded. It was done.
[0098]
In addition, in order to increase the ventilation efficiency in the lung according to the change in the condition of patient X and the need for treatment, it is possible to easily increase the supply flow rate of inspiration, and respond to various aspects of artificial ventilation Therefore, it is possible to provide a high-frequency ventilator 12 capable of
[0099]
Further, since the exhaust urging means 80 urges the flow in the direction in which exhaled air is discharged, the intrusion of air from the discharge end is suppressed when the oscillating air pressure Apn is negative pressure, and the patient X enters the lungs of the patient X. It became possible to promote the exhalation of air and improve the ventilation efficiency in artificial respiration.
[0100]
The exhaust urging means 80 also makes it possible to realize a negative pressure state throughout the ventilator tube, which is impossible with a conventional ventilator with an open exhaust path. It became possible to respond.
[0101]
Further, in the high-frequency ventilator 12, since the exhaust gas switching function 42 performs control to close the flow rate adjustment valve 607 simultaneously with the operation of the exhaust gas urging means 80, the intrusion of the atmosphere is more effectively prevented, and further It is possible to improve the ventilation efficiency.
[0102]
Furthermore, in the high frequency ventilator 12, since the exhaust urging means 80 is disposed on the upstream side of the flow control valve 607, it is not affected by the flow resistance of the flow control valve 607 at the time of exhalation. Therefore, it is possible to secure a wide range in which the flow response is high and the pressure can be adjusted.
[0103]
Further, since the high-frequency ventilator 12 includes the first exhaust pipe 604 and the second exhaust pipe 82 that exhaust exhaled air, these can be used selectively or in combination. It is possible to adjust the discharge flow rate over a wide range. In addition, since there are two discharge pipes, even if a failure occurs on one side, it can be dealt with on the other side, and the reliability of the apparatus can be improved.
[0104]
The second discharge pipe 82 is connected to the first discharge pipe 604 via the branch pipe 81, and the end of the branch pipe 81 is connected to the throttle portion 821 of the second discharge pipe 82. By forming an air flow in the exhaust pipe 82, the exhaled air in the first exhaust pipe 604 can be guided to the second exhaust pipe 82 side. With such a structure, the air blowing means 83 is not directly exposed to the exhaled breath, so even if the bacteria filter 70 is not provided, it is not necessary to disinfect and clean the air blowing means 80 every time when the use is completed. Complexity has been eliminated, and it has become possible to improve the workability of the apparatus.
[0105]
Furthermore, in the high-frequency ventilator 12, a branch portion from the first discharge pipe 604 to the branch pipe 81 is connected through an infinite number of small holes 811. Such a small hole has a large air resistance against a gas with a high flow velocity, and therefore air vibrations with a high degree of turbulence are difficult to escape. Therefore, the vibration state of the inspiration supplied to the lungs of the patient X is preserved. It is possible to effectively transmit high-frequency vibrations. Therefore, it is possible to maintain high ventilation efficiency. In addition, since the actual opening area can be ensured by increasing the number of small holes 811, it is possible to secure a sufficient flow rate of exhaled air per time. Furthermore, since the exhaled air that has passed through the small hole 811 flows as a laminar flow, it is effective in reducing air noise.
[0106]
Furthermore, in the high-frequency ventilator 12, the first output adjustment function 43 drives the exhaust urging means 80 with an output corresponding to the inspiratory pressure supplied to the patient, so that the inspiratory pressure can be freely set to a predetermined value. It is adjusted, it becomes possible to perform artificial respiration while maintaining an appropriate inspiratory pressure, and the reliability of the ventilator is improved. Further, the pressure maintaining function 41 has the same effect.
[0107]
Here, in the operation control unit 40 of the high frequency ventilator 12, the pressure maintenance function 41, the exhaust gas switching function 42, and the first output adjustment function 43 are all based on the detected pressure of the third pressure sensor 93. The operation control of each part was performed, and these similar controls were performed based on the difference in detected pressure between the first pressure sensor 91 and the second pressure sensor 92 that detects the pressure of exhaled air discharged from the patient. You may go. That is, when the detected pressure difference between the first pressure sensor 91 and the second pressure sensor 92 is large, the detected pressure of the third pressure sensor is also increased. When the detected pressure difference with the second pressure sensor 92 is small, the detected pressure of the third pressure sensor 93 is also decreased. Therefore, the same effect can be obtained by performing the same operation control as that of the functions 41, 42, 43 based on the difference between the detected pressures of the two pressure sensors 91, 92.
[0108]
Further, a continuous pressure gradient is obtained from the two detected pressures according to the fluid continuity law, and it is possible to appropriately control inhalation supply and exhalation discharge based on this.
[0109]
In the exhaust urging means 80 described above, the flow rate of the air flow formed in the second discharge pipe 82 is changed by adjusting the opening of the flow rate variable valve 832 to increase or decrease the exhalation discharge amount. However, the flow rate variable valve 832 may be removed from the configuration of the exhaust urging means 80 and the expiratory discharge amount may be increased / decreased by rotational speed control via an inverter that controls the rotational speed of the blower 831.
[0110]
Moreover, it is good also as a structure equipped with the blower which generate | occur | produces a negative pressure in the edge part on the opposite side of the 2nd discharge pipe 82 instead of the blower 831 of the exhaustion urging means 80.
[0111]
Next, another high frequency ventilator 12A will be described with reference to FIG. This high-frequency ventilator 12A is different from the high-frequency ventilator 12 described above mainly in the installation location of the exhaust urging means 80A, and the other configurations are substantially the same. Therefore, about the same structure as the high frequency ventilator 12 mentioned above about this high frequency ventilator 12A, the same code | symbol is attached | subjected and the overlapping description shall be abbreviate | omitted.
[0112]
The exhaust urging means 80A is provided further downstream of the flow rate adjustment valve 607 provided at the end of the first discharge pipe 604A. Here, the first discharge pipe 604A is substantially the same as the first discharge pipe 604 described above, but is not provided with a small hole 811 for branching.
[0113]
The exhaust urging means 80A has a second exhaust pipe 82A having one end communicating with the exhalation discharge port of the flow rate adjusting valve 607 and the other end opened to the atmosphere, and an inside of the second exhaust pipe 82A. And air blowing means 83 for forming an air flow to the open end.
[0114]
The second discharge pipe 82A is a pipe communicating from one end to the other end, and the blower 831 of the air blowing means 83 is equipped at the other end. The blower 831 has a negative pressure generating side port connected to the second discharge pipe 82A. For this reason, an air flow is formed in the second discharge pipe 82A from one end to the other end.
[0115]
The flow rate adjustment valve 832 is disposed on the upstream side of the blower 831, but may be disposed on the downstream side.
[0116]
Next, the operation control unit 40A will be described. The operation control unit 40A has substantially the same function as the operation control unit 40 described above, but is slightly different. That is, the operation control unit 40A has a first predetermined value α (for example, 10 [cmH ₂ O]) is adjusted so that the valve opening degree of the flow rate adjusting valve 607 is adjusted, and the pressure maintaining function 41A for maintaining the valve opening degree of the flow rate variable valve 832 at the maximum opening degree is provided.
[0117]
In addition, the operation control unit 40A sets the second specified value β (β> α, for example, 15 [cmH], in which the average value of the pressure detected by the third pressure sensor 93 is set in advance. ₂ O]) When the above is reached, an exhaust gas switching function 42A that starts driving the blower 831 of the exhaust urging means 80A and drives the solenoid 607d of the flow rate adjustment valve 607 to bring the flow rate adjustment valve 607 to the maximum opening degree is provided. Yes.
[0118]
Still further, the operation control unit 40A is configured such that the detected pressure of the third pressure sensor 93 is set to a first predetermined value α (for example, 10 [cmH ₂ O]) is provided with a first output adjustment function 43A for adjusting the valve opening of the variable flow rate valve 832.
[0119]
With the above configuration, the high-frequency ventilator 12A can perform substantially the same operation as the high-frequency ventilator 12, and can obtain the same effects.
[0120]
【Example】
An embodiment of the present invention will be described with reference to FIGS. In this embodiment, the high-frequency ventilator 12 shown in FIG. 1 is connected to the test lung T for testing instead of being attached to the patient end of the end inspiratory tube 605 by the patient X. This shows a comparative test in which the ventilation state is observed when the exhaust urging means 80 is not used and when it is used. FIG. 8 is a diagram showing the results of the comparative test.
[0121]
The test lung T is a plastic tank having a volume of 20 [l]. With the test lung T connected to the high frequency ventilator 12, carbon dioxide gas is constantly injected into the test lung T at 200 [ml / min]. In this state, the mouth pressure (detected pressure of the third pressure sensor 93) p is set to 15 [cmH ₂ High-frequency artificial respiration is performed in the state in which the exhaust urging means 80 is operated and the state in which the exhaust urging means 80 is not operated, while maintaining O].
[0122]
When the inspiratory flow rate is set to 20 [l / min] without operating the exhaust urging means 80, the carbon dioxide gas that is constantly infused and the carbon dioxide gas discharged from the test lung T by high-frequency artificial respiration are balanced. The carbon dioxide concentration inside the test lung T was 15 [mmHg] (partial pressure notation) as shown at the left end of the diagram of FIG.
[0123]
Further, from the above equilibrium state, it took about 240 [s] until the carbon dioxide injection was stopped and all the carbon dioxide was discharged from the test lung as shown in FIG. Moreover, the discharge rate when the concentration is shifted from 10.5 [mmHg] to 6.0 [mmHg] is about 0.1 [mmHg / sec].
[0124]
To further increase the ventilation efficiency, if the intake flow rate is 30 [l / min], the mouth pressure p is 15 [cmH]. ₂ O] was exceeded, and high-frequency ventilation was not possible with mouth pressure over.
[0125]
On the other hand, when the exhaust urging means 80 is operated, the mouth pressure p is 15 [cmH] even if the intake air supply flow rate is 30 [l / min]. ₂ O]. When high-frequency artificial respiration is performed at such a set flow rate, the concentration of carbon dioxide in the test lung T becomes 10.5 [mmHg], which is about 30% of the intake supply flow rate of 20 [l / min] described above. Could also be reduced. This suggests that when artificial respiration is performed with the high-frequency ventilator 12, carbon dioxide gas hardly accumulates in the lungs of the patient.
[0126]
Further, as shown in FIG. 8, when carbon dioxide injection is stopped from the parallel state, all carbon dioxide is discharged in 150 [s]. In addition, the discharge rate when the concentration is shifted from 10.5 [mmHg] to 6.0 [mmHg] is as high as about 0.15 [mmHg / sec]. Carbon dioxide discharge speed is also increased by nearly 50%, and the ventilation efficiency of carbon dioxide is good. In other words, the following effective points were confirmed.
(1) If the exhaust urging means is used, the intake air supply flow rate can be set high.
According to (2) and (1), the carbon dioxide concentration in the lung can be reduced.
According to (3) and (1), the discharge rate of carbon dioxide in the lung can be accelerated.
[0127]
【The invention's effect】
In the present invention according to claim 1, since the exhaust urging means is provided in the exhaust path, the expiratory exhaust is actively performed as compared with the case where the end of the exhaust path is open to the atmosphere, It is possible to avoid an increase in the exhalation pipe pressure. That is, conventionally, when the supply flow rate of inhalation is increased due to the flow resistance of each pipe of the ventilator, the supply pressure to the patient tends to increase. Since the discharge is performed, an increase in the supply pressure of the intake air is avoided, and it is possible to perform artificial respiration with an appropriate supply pressure. In particular, when a bacterial filter is installed in the exhaust path, the flow resistance increases, and the above-mentioned pressure increase tends to occur. Even in such a case, the exhaust urging means actively exhausts exhaled air. Therefore, artificial respiration can be performed with an appropriate supply pressure.
[0128]
In addition to this effect, it is possible to avoid an increase in the pressure inside the ventilator, so the restrictions on the design of dimensions and shape of each part such as piping that will be the passage path of inspiration or expiration are relaxed, and the degree of freedom in design is expanded. It was done.
[0129]
In addition, in order to increase the ventilation efficiency in the lung according to the patient's condition change and the need for treatment, it is possible to easily increase the supply flow rate of inspiration, and it can cope with various aspects of artificial respiration A possible high frequency ventilator can be provided.
[0130]
Further, since the flow is urged in the direction of exhalation by the exhaust urging means, the intrusion of air from the discharge end is suppressed when the oscillating air pressure is negative pressure, and exhalation from the patient's lungs is suppressed. It became possible to improve ventilation efficiency in artificial respiration.
[0131]
In addition, the exhaust urging means makes it possible to realize a negative pressure state throughout the ventilator tube, which was impossible with a conventional ventilator with an open exhaust path. It became possible to do.
[0132]
More Since the exhaust biasing means is arranged upstream of the flow control valve, it is not affected by the flow resistance of the flow control valve when exhaling, so the flow response is high and the pressure can be adjusted. It is possible to ensure a wide range.
[0133]
Claim 2 In the described invention, Claim 1 Since the first exhaust pipe and the second exhaust pipe for discharging exhalation are provided while having the same effects as the invention described, these can be used selectively or in combination, and the exhaust flow rate Can be adjusted over a wide range. In addition, since there are two discharge pipes, even if a failure occurs on one side, it can be dealt with on the other side, and the reliability of the apparatus can be improved.
[0134]
In addition, the second discharge pipe is connected to the first discharge pipe via the branch pipe, and the end of the branch pipe is connected to the throttle portion of the second discharge pipe. By forming the above, exhaled air in the first exhaust pipe can be led out to the second exhaust pipe side. With this structure, since the blowing means is not directly exposed to the exhaled breath, the necessity of disinfecting and cleaning the blowing means at the end of use is alleviated even if a bacterial filter is not provided. It became possible to improve the workability of the device by eliminating the property.
[0135]
Claim 3 In the described invention, Claim 2 While having the same effect as that of the described invention, the branch portion from the first discharge pipe to the branch pipe is connected through countless small holes. Such a small hole has a large air resistance to a gas with a high flow velocity, so it is difficult to escape air vibration etc. with a large degree of turbulence, so preserve the vibration state of the inspiration supplied to the patient's lungs, It is possible to transmit high frequency vibrations effectively. Therefore, it is possible to maintain high ventilation efficiency. Further, since the actual opening area can be secured large by increasing the number of small holes, it is possible to secure a sufficient amount of exhaled air flow per hour. Furthermore, since the exhaled air that has passed through the small holes flows as a laminar flow, it is effective in reducing air noise.
[0136]
Claim 4 In the described invention, Claim 1, 2 or 3 Since the exhaust urging means is driven by the output according to the intake pressure supplied to the patient by the first output adjustment function, the intake pressure can be freely adjusted to a predetermined value. Therefore, it becomes possible to perform artificial respiration while maintaining an appropriate inspiratory pressure, and the reliability of the ventilator is improved.
[0137]
Claim 5 In the described invention, Claim 1, 2 or 3 Since the exhaust urging means is driven with an output corresponding to the pressure gradient between the inspiratory side pressure and the expiratory side pressure by the second output adjustment function, the inspiratory pressure has a predetermined value. Therefore, it is possible to perform artificial respiration while maintaining an appropriate inspiratory pressure, thereby improving the reliability of the ventilator. Further, a continuous pressure gradient is obtained from the two detected pressures according to the fluid continuity law, and appropriate exhalation control can be performed based on the pressure gradient.
[0138]
Since this invention is comprised and functions as mentioned above, according to this, the outstanding high frequency ventilator which is not in the past can be provided.
[Brief description of the drawings]
FIG. 1 is a schematic configuration diagram showing an embodiment of the present invention.
FIG. 2 is an explanatory view in which a main part of the embodiment of FIG. 1 is enlarged and a part thereof is cut away;
FIG. 3 is a flowchart showing the operation of the embodiment of the present invention.
FIG. 4 is a diagram showing changes in pressure of inspiration and expiration due to the operation of the exhaust urging means, and FIG. 4 (A) is an inspiration immediately after being derived from the inhalation introduction portion and oscillating air pressure is urged; 4B shows the pressure change detected by the fourth pressure sensor, and FIG. 4B shows the operation of the exhaust urging means detected by the third pressure sensor for inhalation and expiration in the patient side line of the three-way branch pipe FIG. 4C shows the pressure change after the operation of the exhaust urging means detected by the third pressure sensor with respect to inhalation and exhalation in the patient side conduit.
FIG. 5 is a flowchart showing an operation in a normal ventilation mode A.
6 is a flowchart showing an operation in a normal ventilation mode B. FIG.
FIG. 7 is a schematic configuration diagram showing another embodiment of the present invention.
FIG. 8 is a diagram showing the results of a comparative test depending on whether or not an exhaust urging means is used.
FIG. 9 is a schematic configuration diagram showing a conventional example.
[Explanation of symbols]
12,12A high frequency ventilator
40, 40A operation control unit
43,43A First output adjustment function
80,80A Exhaust energizing means
81 Branch piping
811 Small hole
82,82A Second discharge pipe
821 Aperture
83 Blower means
604, 604A first discharge pipe
607 Flow control valve
X patient

Claims (5)

In a high-frequency ventilator that adopts a high-frequency vibration ventilation method that inhales oxygen and supplies exhaled air by energizing an oscillating air pressure that is higher than the patient's respiratory cycle into inspiratory oxygen that is supplied to the patient.
A flow rate adjusting valve for freely adjusting the flow rate of the exhaled air is provided in a first exhaust pipe provided in an exhaust path for discharging exhaled air from the patient into the atmosphere and having a discharge end opened to the atmosphere. While providing
Exhaust urging means that actively flows the exhaled air in the middle of the first exhaust pipe and upstream of the flow regulating valve in the exhaled gas exhaust direction in the direction in which the exhaled air is discharged into the atmosphere. A high frequency ventilator characterized by being equipped. The exhaust urging means includes a branch pipe that is upstream of the flow control valve in the exhalation discharge direction and branches from the middle of the first exhaust pipe, and one end of the branch pipe that is open to the atmosphere, and the open end inside the branch pipe. A second exhaust pipe in which an air flow is formed, and a blowing means for forming the air flow,
The second discharge pipe has a throttle portion in which a part of the inner diameter is set to be small,
The high-frequency respirator according to claim 1 , wherein the downstream end portion of the branch pipe is joined to the throttle portion of the second exhaust pipe. The high-frequency respirator according to claim 2, wherein a branch portion from the first discharge pipe to the branch pipe communicates through an infinite number of small holes. A pressure sensor that detects the pressure of the inhalation or expiration, and an operation control unit that freely controls output adjustment by the exhaust urging means,
4. The high-frequency artificial device according to claim 1 , wherein the operation control unit includes a first output adjustment function that drives the exhaust urging means with an output corresponding to a detected pressure of the pressure sensor. Respiratory organ. A first pressure sensor for detecting an inspiratory pressure before supply to the patient, a second pressure sensor for detecting a pressure of exhaled air exhausted from the patient, and output adjustment by the exhaust urging means are freely controlled. An operation control unit to
The operation control unit, of claim 1, 2 or 3, wherein further comprising a second output adjustment function for driving the exhaust biasing means output corresponding to the difference between the detected pressure of the pressure sensor High frequency ventilator.

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