JP5022057B2 - 心蘇生術における胸部圧迫および換気の同期 - Google Patents
心蘇生術における胸部圧迫および換気の同期 Download PDFInfo
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- JP5022057B2 JP5022057B2 JP2007034847A JP2007034847A JP5022057B2 JP 5022057 B2 JP5022057 B2 JP 5022057B2 JP 2007034847 A JP2007034847 A JP 2007034847A JP 2007034847 A JP2007034847 A JP 2007034847A JP 5022057 B2 JP5022057 B2 JP 5022057B2
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Description
肺胞PCO2との間の平衡に到達するまで、CO2は混合静脈血から肺胞へ拡散する。被験者が息を吐くとき、吐かれる最初のガスはガス交換の不可能な気管および気管支からのものであるため、ガス組成は吸い込まれたガスと同様である。この呼気の終わりのガスは肺胞からのものと考えられ、毛細管と肺胞との間の平衡CO2濃度を反映している。このガスのPCO2を呼吸終期PCO2(PEtCO2)と呼ぶ。
。また、特許文献11では、ほぼ6番目の圧迫/非圧迫のサイクル毎に、圧迫が発生していないときに、従来の換気サイクルを導入することが推奨されている。圧迫期と同期されている陽圧の換気圧力サイクルのあいだ空気のフローはほとんど発生しないので、このことは充分な肺胞ガス交換に有益であると述べられている。特許文献11では、その発明を用いて圧力およびフローにおける著しい改良が観察されたと報告されているが、典型的な患者の生理学的状態は、それらの実験において用いられている動物モデルとは相当に異なる。
びプロセッサと、制御回路およびプロセッサは胸部圧迫器に、心収縮期の非圧迫期および心収縮期の圧迫期を各々含む、複数の心収縮期フローサイクルを含むセット、ならびに、心拡張期の非圧迫期および心拡張期の圧迫期を各々含み、かつ、心収縮期フローサイクルのセットの間に散在する1つ以上の心拡張期フローサイクル、を反復的に与えさせるように構成されていることと、心拡張期の非圧迫期は心収縮期の非圧迫期より長いことと、からなる。
、またはほぼ0の圧力を気道へ与えるように構成されている人工呼吸器と、人工呼吸器によって与えられるガスを冷却するための冷却器と、冷却器は肺、心臓および肺血流を冷却するように構成されていることと、からなる。
フローサイクル、52…心拡張期フローサイクル、54,58…圧迫期、56,60,62,66…非圧迫期。
Claims (21)
- 胸部圧迫および換気を患者へ自動的に与えるための装置であって、
胸部を圧迫するために圧力の加えられる圧迫期および胸部に加えられる圧力がほぼ0の非圧迫期を与えるように構成されている胸部圧迫器と、
陽圧、陰圧、またはほぼ0の圧力を気道へ与えるように構成されている人工呼吸器と、
制御回路およびプロセッサと、を備え、
制御回路およびプロセッサは胸部圧迫器に、複数の第1の種類のフローサイクルからなるフローサイクルのセットと、1つ以上の第2の種類のフローサイクルとを反復的に与えさせるように構成されており、
第1の種類のフローサイクルは、胸部に圧力が加えられない第1の種類の非圧迫期と胸部に圧力の加えられる第1の種類の圧迫期とを各々含み、
第2の種類のフローサイクルは、第1の種類のフローサイクルのセット同士の間において、胸部に圧力が加えられない第2の種類の非圧迫期と胸部に圧力の加えられる第2の種類の圧迫期とを各々含み、
第2の種類の非圧迫期は第1の種類の非圧迫期より長く、
制御回路およびプロセッサは、第2の種類の非圧迫期のあいだ、人工呼吸器に陰圧の換気圧力を与えさせるように構成されている、装置。 - 心収縮期の圧迫期および心収縮期の非圧迫期の持続時間はほぼ同じである請求項1に記載の装置。
- 心拡張期の非圧迫期の持続時間は心拡張期の圧迫期の持続時間の2倍より長い請求項2に記載の装置。
- 心拡張期の非圧迫期の持続時間は心拡張期の圧迫期の持続時間のほぼ4倍である請求項3に記載の装置。
- 心拡張期フローサイクルは第2の圧迫期および第2の非圧迫期を含むことと、第1の非圧迫期および第2の非圧迫期のうちの一方のあいだには陰圧の換気圧力が与えられ、かつ、第1の非圧迫期および第2の非圧迫期のうちの他方のあいだには陽圧の換気圧力が与え
られることと、を含む請求項1に記載の装置。 - 人工呼吸器は心収縮期フローサイクルのあいだ陽圧の換気圧力および陰圧の換気圧力を与える請求項1に記載の装置。
- 心収縮期フローサイクルの非圧迫期のうちの大部分のあいだ陰圧の換気圧力が与えられる請求項6に記載の装置。
- 心収縮期フローサイクルの圧迫期のうちの大部分のあいだ陽圧の換気圧力が与えられる請求項7に記載の装置。
- 換気圧力は陰圧から陽圧へと反復的にランプ状に変化し、圧迫期の開始時の換気圧力はほぼ0である、を含む請求項8に記載の装置。
- 非圧迫期の開始時または開始直前に換気圧力は陽圧から陰圧へ急速に変化する請求項9に記載の装置。
- 換気圧力の波形は非圧迫期の開始時にピークまたはピーク近くである請求項6に記載の装置。
- 患者の基礎的な心収縮期および心拡張期の活動を強めるために、圧迫および換気は患者のECGと同期される請求項1に記載の装置。
- 血管を通じて物質を供給可能な液体注入装置を含む請求項1に記載の装置。
- 液体注入装置によって注入された液体は再潅流中に代謝物質を供給するように構成されている請求項13に記載の装置。
- 代謝物質はアミノ酸である請求項14に記載の装置。
- アミノ酸はアスパラギン酸塩またはグルタミン酸塩である請求項15に記載の装置。
- 除細動器および血管を通じて物質を供給可能な液体注入装置を含むことと、
除細動器、圧迫器、人工呼吸器および液体注入装置は別個の機器であり、通信リンクによって接続されていることと、を含む請求項1に記載の装置。 - 除細動器、圧迫器、人工呼吸器および液体注入装置を同期させるための追加の機器を含む請求項17に記載の装置。
- 人工呼吸器による陰圧の圧力および陽圧の圧力が利用可能である請求項1に記載の装置。
- 酸素レベルは40%より高く上昇される請求項1に記載の装置。
- 全身性虚血が存在し、かつ、蘇生中の再酸素化によって犠牲者が再潅流障害を起こす可能性がある、心停止および外傷性心停止の両方の犠牲者において用いられるように構成されている請求項1に記載の装置。
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2006
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2007
- 2007-02-14 EP EP10075406A patent/EP2308447A3/en not_active Withdrawn
- 2007-02-14 EP EP07250605.8A patent/EP1820484B1/en active Active
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- 2007-02-15 CN CN201110264200.4A patent/CN102415938B/zh not_active Expired - Fee Related
- 2007-02-15 JP JP2007034847A patent/JP5022057B2/ja not_active Expired - Fee Related
- 2007-02-15 CN CN2007100051696A patent/CN101023902B/zh not_active Expired - Fee Related
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2011
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2012
- 2012-03-06 JP JP2012049660A patent/JP5531042B2/ja active Active
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2015
- 2015-11-02 US US14/930,589 patent/US10251811B2/en active Active
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2019
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EP2305203A2 (en) | 2011-04-06 |
US20110224587A1 (en) | 2011-09-15 |
US10251811B2 (en) | 2019-04-09 |
EP2308447A3 (en) | 2012-05-02 |
EP1820484B1 (en) | 2016-09-21 |
CN101023902A (zh) | 2007-08-29 |
US20190262226A1 (en) | 2019-08-29 |
US11839586B2 (en) | 2023-12-12 |
EP2305203A3 (en) | 2012-05-09 |
JP2007216027A (ja) | 2007-08-30 |
CN102415938A (zh) | 2012-04-18 |
US9174064B2 (en) | 2015-11-03 |
JP5531042B2 (ja) | 2014-06-25 |
US20160193110A1 (en) | 2016-07-07 |
EP2308447A2 (en) | 2011-04-13 |
US20120059292A1 (en) | 2012-03-08 |
US20070225623A1 (en) | 2007-09-27 |
CN101023902B (zh) | 2011-11-09 |
JP2012106090A (ja) | 2012-06-07 |
EP1820484A3 (en) | 2007-09-19 |
CN102415938B (zh) | 2015-05-20 |
US8105249B2 (en) | 2012-01-31 |
EP1820484A2 (en) | 2007-08-22 |
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