JP5111488B2 - 換気制御装置 - Google Patents
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Description
Claims (22)
- 呼吸用気体の加圧流を発生する加圧流モジュールと、
前記加圧流モジュールに連結されかつ患者の気道に呼吸用気体流を伝達する患者回路と、
前記患者の呼吸パターンの特性を監視するセンサと、
前記センサに接続され、前記センサから受信した情報に基づいて前記患者の呼吸状態を判断し、かつ、前記患者の呼吸状態に基づいて、前記患者の治療をもたらす、制御装置と、を備え、
前記制御装置は更に、(i)上限閾値を超えている、監視された前記特性に応答して、前記呼吸状態が、高呼吸動作状態として判断されるよう、(ii)前記上限閾値と下限閾値との間である、監視された前記特性に応答して、前記呼吸状態が、正常の換気状態として判断されるよう、及び(iii)前記下限閾値を下回っている、監視された前記特性に応答して、前記呼吸状態が、低呼吸動作状態として判断されるよう、構成され、
前記患者の呼吸状態に基づいて、前記患者の治療をもたらすことは、前記高呼吸動作状態にある前記呼吸状態に応答して、吸気中の二酸化炭素割合を増加させること、及び、前記低呼吸動作状態である前記呼吸状態に応答して、自動制御換気を供すること、を含むように、前記制御装置は更に構成され、
所定の限界値を超えている、監視された前記特性の平均値の変化に応答して、前記上限閾値は減少し、
所定の回数を超えている、前記患者に供給された二酸化炭素で補助した呼吸の回数に応答して、前記上限閾値は増加し、かつ、
監視された前記特性に基づいて、前記下限閾値は変えられる、
患者の気道に呼吸用気体流を供給する装置。 - 前記制御装置は、前記呼吸状態が、前記低呼吸動作状態であるとき、自動制御換気の実施に加えて、吸気中の二酸化炭素割合を増加させるよう構成される、請求項1に記載の装置。
- 再呼吸を実現する、二酸化炭素の補充供給源を設ける、及び吐出された呼吸用気体を取り込む貯蔵部から二酸化炭素を供給する、の1つ又はそれ以上を実行することにより、前記制御装置は、吸気中の二酸化炭素割合を増加させるよう構成される、請求項1に記載の装置。
- 送風機及び弁の一方又は両方を前記加圧流モジュールに設けた請求項1に記載の装置。
- 上限閾値と下限閾値は、同一の単一値に相当して収束し得る、請求項1に記載の装置。
- 監視された前記特性は、前記患者のピーク流量又は前記患者の周期的換気量である請求項1に記載の装置。
- 前記制御装置は、呼気圧力に対してより高い比率の、吸気圧力を供給して、自動制御換気を実施する請求項1に記載の装置。
- 呼吸用気体流を発生する加圧流モジュールと、
前記加圧流モジュールに連結されかつ患者の気道に呼吸用気体流を搬送する搬送通路となる患者回路と、
前記患者の呼吸パターンの特性を監視するセンサと、
前記患者回路に接続される二酸化炭素補充装置と、
前記加圧流モジュールと前記二酸化炭素補充装置とに作動接続され、前記センサに接続され、前記患者の呼吸状態に基づいて前記患者の治療をもたらす、制御装置とを備え、
前記制御装置は更に、(i)上限閾値を超えている、監視された前記特性に応答して、前記呼吸状態が、高呼吸動作状態として判断されるよう、(ii)監視された前記特性が前記上限閾値と下限閾値との間にあるとき、前記呼吸状態が、正常の換気状態として判断されるよう、及び(iii)前記下限閾値を下回っている、監視された前記特性に応答して、前記呼吸状態が、低呼吸動作状態として判断されるよう、構成され、
前記患者の治療は、前記高呼吸動作状態である前記呼吸状態に応答して、前記患者による呼気に関して前記患者回路中の二酸化炭素量を増大させること、及び、前記低呼吸動作状態である前記呼吸状態に応答して、前記患者の気道に供給される呼気圧力に対する吸気圧力の比率を増大させるように、前記加圧流モジュールを制御すること、を含むよう、前記制御装置は更に構成され、
監視された前記特性の平均値の変化が所定の限界値を超えるとき、前記上限閾値が減少し、前記患者に供給された、二酸化炭素で補助した呼吸の回数が、所定の回数を超えるとき、前記上限閾値が減少し、前記下限閾値は、監視された前記特性に基づいて変えられる、ように前記制御装置は更に構成される、
患者の気道に呼吸用気体流を供給する装置。 - 送風機及び弁の一方又は両方を前記加圧流モジュールに設けた請求項8に記載の装置。
- 再呼吸のために、呼気中の二酸化炭素を前記患者に帰還させる弁;
前記患者回路に連絡される外部の二酸化炭素供給源;及び
呼気された呼吸用気体を捕捉する二酸化炭素貯蔵部;
の1つ以上を、前記二酸化炭素補充装置が含む、請求項8に記載の装置。 - 上限閾値と下限閾値は、同一の単一値に相当して収束し得る、請求項8に記載の装置。
- 監視された前記特性は、患者のピーク流量又は患者の周期的換気量である請求項8に記載の装置。
- 前記装置は、前記低呼吸動作状態である前記呼吸状態に応答して、呼気圧力に対して、より高い比率の吸気圧力を供する、請求項8に記載の装置。
- 患者回路を通じて呼吸用気体の供給源から患者の気道に運搬するための気体流を発生させる過程;
前記患者の呼吸パターンの特性を監視する過程;
一定時間の経過に亘って監視された前記特性の平均値に基づき、監視された前記特性の下限閾値を設定する過程;
監視された前記特性の初期値に基づいて、監視された前記特性の上限閾値を設定する過程;
所定の限界値を超えている、監視された前記特性の平均値の変化に応答して、前記上限閾値が減少するよう、かつ、所定の回数を超えている、前記患者に供給された二酸化炭素で補助した呼吸の回数に応答して、前記上限閾値が増加するよう、前記上限閾値を適合させる過程;
を含み、
呼吸状態は、前記上限閾値及び前記下限閾値の1つ以上に基づいており、
前記上限閾値を超えている監視された前記特性に応答して、前記呼吸状態は、高呼吸動作状態と判断され、
前記上限閾値と前記下限閾値との間である、監視された前記特性に応答して、前記呼吸状態は、正常の換気状態として判断され、
前記下限閾値を下回っている、監視された前記特性に応答して、前記呼吸状態は、低呼吸動作状態として判断される、
患者の気道に呼吸用気体流を運搬する装置を、前記装置の制御装置が制御する方法。 - 前記二酸化炭素で補助した呼吸は、二酸化炭素の再呼吸によって、前記患者に供給される、請求項14に記載の方法。
- 監視された前記特性の時間経過に伴う平均値を所定の係数だけ減少して、前記下限閾値を得る請求項14に記載の方法。
- 患者回路を通じて呼吸用気体の供給源から患者の気道に運搬するための気体流を発生させる過程;
前記患者の呼吸パターンの特性を監視する過程;
前記患者の呼吸状態を予測する過程であって、前記呼吸状態は、上限閾値を超えている、監視された前記特性に応答して、高呼吸動作状態として判断され、前記呼吸状態は、前記上限閾値と下限閾値との間である、監視された前記特性に応答して、正常の換気状態として判断され、前記呼吸状態は、前記下限閾値を下回っている、監視された前記特性に応答して、低呼吸動作状態として判断される、過程;
所定の限界値を超えている、監視された前記特性の平均値の変化に応答して、前記上限閾値が減少するよう、かつ、所定の回数を超えている、前記患者に供給された二酸化炭素で補助した呼吸の回数に応答して、前記上限閾値が増加するよう、前記上限閾値を適合させる過程;
前記下限閾値が、監視された前記特性に基づいて変えられるよう、前記下限閾値を適合させる過程;及び
予測された前記呼吸状態に基づいて、前記患者に適切な治療を適用する過程であって、前記適切な治療は、前記高呼吸動作状態にある前記呼吸状態に応答して、吸気中の二酸化炭素割合を増加させること、及び、前記低呼吸動作状態である前記呼吸状態に応答して、自動制御換気を供すること、を含む、過程;
を含む、患者の気道に呼吸用気体流を運搬する装置を、前記装置の制御装置が制御する方法。 - 監視された前記特性は、ピーク流量又は周期的換気量である請求項17に記載の方法。
- 監視された前記特性の前記平均値は、所定数の呼吸周期に亘って決定される、請求項17に記載の方法。
- 患者回路を通じて呼吸用気体の供給源から患者の気道に運搬するための気体流を発生させる過程;
前記患者の呼吸パターンの特性を監視する過程;
前記の呼吸状態を決定する過程であって、前記呼吸状態は、上限閾値を超えている、監視された前記特性に応答して、高呼吸動作状態として判断され、前記呼吸状態は、前記上限閾値と下限閾値との間である、監視された前記特性に応答して、正常の換気状態として判断され、前記呼吸状態は、前記下限閾値を下回っている、監視された前記特性に応答して、低呼吸動作状態として判断される、過程;
所定の限界値を超えている、監視された前記特性の平均値の変化に応答して、前記上限閾値を減少させる過程;
所定の回数を超えている、前記患者に供給された二酸化炭素で補助した呼吸の回数に応答して、前記上限閾値が増加させる過程;
監視された前記特性に基づいて、前記下限閾値を変える過程;
前記高呼吸動作状態にある前記呼吸状態に応答して、吸気中の二酸化炭素の割合を増加させる過程;及び
前記低呼吸動作状態にある前記呼吸状態に応答して、自動制御換気を供する過程;
を含む、患者の気道に呼吸用気体流を運搬する装置を、前記装置の制御装置が制御する方法。 - 呼吸の予測状態又は現行状態に基づき患者に適切な投与量の治療を施すように、装置を制御する過程;
施された投与量に応じて、前記患者の不安定性指数を測定する過程;
一連の投与量の各々に対する不安定性指数を示す一連の測定点を記録する過程;及び
施された投与量に対応する治療窓を、測定された不安定性指数が許容値を超える測定点を下回る不安定性指数に、かつ、測定された不安定性指数が許容値を下回る測定点を越える不安定性指数に、適合させる過程;
を含み、
前記不安定性指数は、最小の周期的換気量と最大の周期的換気量との割合、ピーク流量の移動窓平均又は中央に適合した線分の傾き、周期的換気量の移動窓平均又は中央に適合した線分の傾き、又は、前記患者の呼吸制御装置のループ利得の測定値又は予測値、を含む、
患者の治療窓を同定するための装置を、前記装置の制御装置が制御する方法。 - 呼吸の予測状態又は現行状態に基づき患者に適切な投与量の治療を施すように、装置を制御する過程;
施された投与量に応じて、前記患者の不安定性指数を測定する過程;
一連の投与量の各々に対する不安定性指数を示す一連の測定点を記録する過程;
施された投与量に対応する治療窓を、測定された不安定性指数が許容値を超える測定点を下回る不安定性指数に、かつ、測定された不安定性指数が許容値を下回る測定点を越える不安定性指数に、適合させる過程;及び
前記治療窓の範囲内で治療の次の投与量を与えるように前記装置を制御する過程;
を含み、
前記不安定性指数は、最小の周期的換気量と最大の周期的換気量との割合、ピーク流量の移動窓平均又は中央に適合した線分の傾き、周期的換気量の移動窓平均又は中央に適合した線分の傾き、又は、前記患者の呼吸制御装置のループ利得の測定値又は予測値、を含む、
患者の治療における理想的な治療窓を同定するための装置を、前記装置の制御装置が制御する方法。
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CN101448539B (zh) | 2012-12-12 |
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