JP6112756B2 - Carbon monoxide dosing system - Google Patents

Description

  The present invention relates to a carbon monoxide administration system for administering carbon monoxide to a patient.

  Methods are known in which patients are treated with carbon monoxide that is toxic at high concentrations.

  When carbon monoxide is inhaled by a patient, it forms CO-Hb in the blood, preventing hemoglobin from transporting oxygen to the tissue. In addition, the produced CO-Hb impedes the dissociation of the remaining oxygen hemoglobin, further hindering the oxygen supply to the tissue. Furthermore, high concentration of carbon monoxide binds to myoglobin having a lower affinity than hemoglobin, suppresses myocardial function, lowers blood pressure and causes ischemia, and further deteriorates hypoxia.

  Therefore, when carbon monoxide is inhaled by the patient, it is necessary to pay sufficient attention to the predicted hypoxic state, that is, carbon monoxide poisoning.

  For example, in Patent Document 1, a gas preparation containing carbon monoxide is administered to a patient via a nasal cannula (hereinafter referred to as “cannula”) to treat a disease associated with pulmonary hypertension or respiratory distress.

  In this Patent Document 1, it is confirmed that carbon monoxide becomes an abnormal concentration by administering to a patient carbon monoxide set within an allowable concentration range and monitoring the patient's arterial blood or venous blood Hb-CO concentration. To prevent patient safety.

JP 2010-265205 A

  However, in the conventional method of administering carbon monoxide to a patient, the concentration of carbon monoxide in the blood of the patient to whom carbon monoxide is administered is monitored. For this reason, if an abnormal concentration is detected, carbon monoxide at that concentration has already been taken into the body, and adverse effects such as poisoning may occur in the patient.

  This invention is made | formed in view of this point, and it aims at providing the carbon monoxide administration system which can administer carbon monoxide to a patient more safely.

One aspect of the carbon monoxide administration system of the present invention is a carbon monoxide administration system for administering carbon monoxide to a patient when treating a patient's disease, the carbon monoxide supplying the carbon monoxide. A supply unit, a mixing unit that mixes oxygen supplied from an oxygen supply unit and the carbon monoxide supplied from the carbon monoxide supply unit, and outputs an air-fuel mixture to be administered to the patient; and the mixing unit and a flow rate adjustment and locking part for adjusting and blocking of the carbon monoxide flow rate of carbon monoxide supplied to the carbon monoxide concentration sensor for detecting the concentration of carbon monoxide in the gas mixture, the patient A biological information acquisition sensor for acquiring biological information, an adjustment region based on a set carbon monoxide concentration value, the carbon monoxide concentration detected by the carbon monoxide concentration sensor, and the living body by the biological information acquisition sensor Affection And controlling the flow rate adjustment / blocking unit to adjust or block the carbon monoxide concentration to be administered to the patient, and the adjustment region has the set monoxide concentration An upper adjustment region that is a region with a larger absolute value than a dead region that is a region near the carbon concentration value, and a lower adjustment region that is a region with a smaller absolute value, and the control unit is detected When the carbon monoxide concentration is larger than the upper limit of the upper adjustment region, the flow rate adjustment / blocking unit is controlled to block the carbon monoxide to be administered to the patient, and the predetermined adjustment condition is satisfied. In this case, the flow rate adjusting / blocking unit is controlled to adjust the carbon monoxide concentration to be administered to the patient by adjusting the flow rate of the carbon monoxide supplied to the mixing unit, and predetermined readjustment conditions If it falls under And it controls the parts, the readjustment of the concentration of carbon monoxide administered to the patient, carried out by readjustment of the flow rate of the carbon monoxide to be supplied to the mixing section, the adjustment condition, the detected one The readjustment condition includes a case where the detected carbon monoxide concentration is in the lower adjustment region, and a case where the detected carbon monoxide concentration is in the lower adjustment region. The carbon oxide concentration is below the lower limit value of the lower adjustment region or in the insensitive region, and the acquired biological information is more effective than the upper limit of the effective effect range in which carbon monoxide is effective during carbon monoxide administration. And a case where the detected carbon monoxide concentration is within a set region of the carbon monoxide concentration sensor indicating that no equipment failure has occurred.

  According to the present invention, carbon monoxide can be more safely administered to a patient.

The figure which shows the outline | summary of the carbon monoxide administration system which concerns on embodiment of this invention. The figure which shows the detection value with the carbon monoxide concentration sensor of the same carbon oxide administration system The figure which shows the detection value by the patient sensor of the same carbon oxide administration system The figure which shows the detection value with the environmental carbon monoxide concentration sensor of the same carbon oxide administration system Flowchart for explaining control of case 1 in the same carbon oxide administration system Diagram for explaining the determination of carbon monoxide concentration in the same carbon oxide administration system Flow chart for explaining control of case 3 in the same carbon oxide administration system

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

  First, the configuration of the carbon monoxide administration system according to the present embodiment will be described.

<Configuration of carbon monoxide administration system>
FIG. 1 is a diagram showing a configuration of a carbon monoxide administration system 10 according to an embodiment of the present invention.

  In the conventional gas inhalation therapy for treating a pulmonary hypertension emergency by inhaling a gas containing nitric oxide to a patient, a gas containing nitric oxide suspected of carcinogenicity was used. In the carbon monoxide administration system 10, a gas containing carbon monoxide capable of eliminating the possibility of carcinogenicity is used instead of nitric oxide.

  The carbon monoxide administration system 10 includes an oxygen supply unit 20 that outputs oxygen, a carbon monoxide supply unit 30 that outputs carbon monoxide, and a carbon monoxide concentration sensor 43, and carbon monoxide to be administered to a patient. A carbon monoxide administration unit (hereinafter referred to as “administration unit”) 40 that outputs the air-fuel mixture to be included to the patient, a patient connection unit 50, a control unit 60 that controls the operation of the administration unit 40, and a patient sensor (biological information) Acquisition sensor) 70 and an environmental carbon monoxide concentration sensor 80.

  The oxygen supply unit 20 supplies oxygen to the mixing unit 41, and here, an oxygen concentrator is used as an oxygen generation source. The oxygen supply unit 20 may use an oxygen cylinder or the like. The oxygen supply unit 20 includes an oxygen sensor 22 that detects an oxygen flow rate and an oxygen concentration, and information on oxygen supplied to the mixing unit 41, for example, oxygen flow rate and oxygen concentration parameters, is used as a controller 62 as an oxygen concentrator IF signal. Output to.

  The carbon monoxide supply unit 30 supplies carbon monoxide to the mixing unit 41. For example, carbon monoxide or a gas cylinder mixed with carbon monoxide may be applied to the carbon monoxide supply unit 30. The carbon monoxide supply unit 30 supplies a mixed gas mixed with carbon monoxide (referred to as “carbon monoxide gas” for convenience) to the mixing unit 41. The mixed gas containing carbon monoxide may be, for example, a gas mixed with oxygen, nitrogen, carbon dioxide, or the like. The concentration of carbon monoxide in the carbon monoxide gas output from the carbon monoxide supply unit 30 is, for example, 500 ppm.

  The administration unit 40 mixes the oxygen from the oxygen supply unit 20 and the carbon monoxide gas containing carbon monoxide from the carbon monoxide supply unit 30 to adjust the carbon monoxide concentration to the patient connection unit 50. Output as a mixture.

  The administration unit 40 includes a mixing unit 41 and a flow rate adjusting / blocking unit 42, and further includes a carbon monoxide concentration sensor 43, an oxygen concentration sensor 44, and a flow rate sensor 45.

  The mixing unit 41 mixes two gases and outputs them to the patient side. Here, the mixing unit 41 mixes oxygen from the oxygen supply unit 20 and carbon monoxide gas (mixed gas containing carbon monoxide) from the carbon monoxide supply unit 30.

  The flow rate adjusting / blocking unit 42 adjusts and blocks the flow rate of the carbon monoxide gas from the carbon monoxide supply unit 30 according to an instruction from the controller 62. For example, the flow rate adjusting / blocking unit 42 adjusts or blocks the flow rate so that the concentration of carbon monoxide to be administered to the patient can be adjusted within a range of 0 to 100 ppm. Or In addition, it is considered appropriate as a treatment that the carbon monoxide concentration in the air-fuel mixture administered to the patient is 50 to 100 ppm. For example, in Patent Document 1, the concentration of carbon monoxide to be administered to a patient can be adjusted in a range of 0 to 300 ppm, and the concentration of carbon monoxide to be administered to a patient is 40 to 100 ppm. The flow rate adjusting / blocking unit 42 blocks carbon monoxide after an administration time (for example, 12 hours) of carbon monoxide according to an instruction from the controller 62.

  The carbon monoxide concentration sensor 43 detects the carbon monoxide concentration in the air-fuel mixture to be administered to the patient, and outputs the detected data to the controller 62. The controller 62 compares the detection data from the carbon monoxide concentration sensor 43 with the set concentration and feeds it back to the flow rate adjustment / blocking unit 42 to adjust the carbon monoxide concentration.

  The carbon monoxide concentration sensor 43 detects the carbon monoxide concentration on the breathing side of the air-fuel mixture supplied to the patient, that is, the carbon monoxide concentration immediately before being administered to the patient.

  The oxygen concentration sensor 44 detects the oxygen concentration contained in the air-fuel mixture to be administered to the patient and outputs it to the controller 62. The oxygen concentration sensor 44 can be substituted by the oxygen sensor 22 of the oxygen supply unit 20. Here, the oxygen concentration sensor 44 is provided at a position immediately before being administered to the patient, whereby the oxygen concentration administered to the patient is measured more accurately to ensure the safety of the patient.

  The flow sensor 45 detects the flow rate of the air-fuel mixture to be administered to the patient and outputs it to the controller 62. From the values detected by the carbon monoxide concentration sensor 43, the oxygen concentration sensor 44, and the flow sensor 45, the doses of carbon monoxide and oxygen to the patient can be obtained. When the flow rate from the carbon monoxide supply unit 30 is sufficiently small, the oxygen sensor 22 of the oxygen supply unit 20 can be substituted for the flow rate sensor 45. This is because the flow rate from the carbon monoxide supply unit 30 is very small, so that the oxygen flow rate obtained from the oxygen sensor 22 can be regarded as substantially the same as the flow rate of the air-fuel mixture administered to the patient.

  The patient connection unit 50 is provided at the end of the inspiratory circuit that is output from the administration unit 40 to the patient, and includes a mask, a cannula, and the like. The inspiratory circuit is a path for carrying the air-fuel mixture from the oxygen supply unit 20 and the carbon monoxide supply unit 30 to the patient. This patient connection unit 50 is connected to the patient by the administration unit 40 via a mask, cannula or the like.

  The patient sensor 70 (biological information acquisition sensor) detects the patient's state (biological information) and outputs the detected data to the controller 62.

The patient sensor 70 is a sensor that acquires, for example, noninvasive arterial blood oxygen saturation (SPO ₂ ), carbon monoxide hemoglobin concentration (SPCO), and the like. Here are used the SPO ₂ sensor noninvasive to get SPO ₂ as a patient sensor 70, the patient sensors 70, the body of carbon monoxide using the difference from the acquired SPO ₂ and the initial measurement value of the SPO ₂ Concentration can be calculated.

  The environmental carbon monoxide concentration sensor 80 is a sensor that detects the concentration of carbon monoxide in air in a patient environment, for example, a room where a patient is present (for example, a hospital room, a treatment room, a bedroom, etc.). Are output to the controller 62. For example, the environmental carbon monoxide concentration sensor 80 is installed on the ceiling of a room where the patient is present, and is connected to the controller 62 by wire or wirelessly.

  The controller 62 controls each component of the carbon monoxide administration system 10.

  The controller 62 includes a CPU (Central Processing Unit) 621, a RAM (Random Access Memory) 622, a ROM (Read Only Memory) 623, a WORKRAM 624, and the like. The CPU 621 reads out a program corresponding to the processing content from the ROM 623, expands it in the RAM 622, cooperates with the expanded program, and controls the operation of each component (block) of the administration unit 40 using the data read from the WORKRAM 624. To do. The controller 62 has a timer function using a real time clock or the like.

  Specifically, the controller 62 includes detection from the oxygen sensor 22, the carbon monoxide concentration sensor 43, the oxygen concentration sensor 44, the flow sensor 45, the patient sensor 70, and the environmental carbon monoxide concentration sensor 80 of the oxygen supply unit 20. A signal is input. These detection signals are input to the controller 62 at a predetermined timing after the administration of carbon monoxide to the patient is started. In addition, the set carbon monoxide value is input to the controller 62 when, for example, the setting unit 66 having a setting panel or the like sets the carbon monoxide concentration value prescribed for the patient. By setting via the setting unit 66, the density can be set for the controller 62. In addition, when the administration schedule such as the administration time or non-administration time of carbon monoxide to the patient is input via the setting unit 66, the controller 62 stores the input schedule information in the WORKRAM 624 and stores it. The administration time and non-administration time of carbon monoxide are managed using the information.

  Based on these inputs, the controller 62 controls the flow rate adjusting / blocking unit 42 and the alarm 64.

  The controller 62 adjusts the flow rate of the carbon monoxide gas from the carbon monoxide supply unit 30 via the flow rate adjustment / blocking unit 42 so that the concentration of carbon monoxide in the air-fuel mixture becomes the concentration set by the controller 62. adjust.

  In addition, the controller 62 combines the detection data from the carbon monoxide concentration sensor 43 and the detection data from the patient sensor 70 singly and in combination, and is stored in the table of the WORKRAM 624 as a concentration of carbon monoxide that is set in advance. And the result is fed back to the flow rate adjusting / blocking unit 42 for control. By this feedback control, the controller 62 controls the flow rate of carbon monoxide so that oxygen monoxide is supplied to the patient at the set concentration. Further, depending on the comparison result, the controller 62 generates an alarm or cuts off the administration of carbon monoxide.

  Here, when carbon monoxide is administered to the patient by the controller 62, detection data detected by each sensor, which is a parameter for controlling the flow rate adjustment / blocking unit 42 and the alarm 64, will be described.

  FIG. 2 is a diagram illustrating values detected by the carbon monoxide concentration sensor 43 input to the controller 62. It should be noted that the carbon monoxide administered to the patient is controlled by the controller 62 so as not to be administered to the patient for a certain time t to 2t (for example, 12 hours) after being administered to the patient for a certain time t (for example, 12 hours). Is done. The administration time and non-administration time of these carbon monoxide are shown on the horizontal axis.

  As shown in FIG. 2, during the administration of carbon monoxide (during “carbon monoxide administration time”), the controller 62 adjusts the adjustment range based on the carbon monoxide concentration value (set value D) input by the setting unit 66. Within the (adjustment region), the concentration of carbon monoxide (indicated by the line L1) to be administered to the patient is adjusted via the flow rate adjusting / blocking unit 42. A value in the vicinity of the set value D is set as an insensitive area of the carbon monoxide concentration sensor 43, and an area having an absolute value larger than the insensitive area is set as an adjustment area of the carbon monoxide concentration sensor 43. For example, when the set value D is 50 ppm for the carbon monoxide concentration sensor 43, the controller 62 sets 50 ± 5 ppm as the insensitive region of the carbon monoxide concentration sensor 43, and 55-60 ppm, 40-45 ppm. Is set as the adjustment area.

  The area beyond this area is regarded as an alarm area requiring an alarm. In addition, after the administration time of carbon monoxide (time from t to 2t) is a non-administration time of carbon monoxide, and the detected carbon monoxide concentration value is 0.

  FIG. 3 is a diagram showing values (detected values), which are biological information detected by the patient sensor 70, as effective curves. The horizontal axis shows the administration time and non-administration time of carbon monoxide, as in FIG.

The effective curve L2 of FIG. 3 shows the change in the SPO ₂ value of the patient estimated by the controller 62 based on the initial measurement value (initial value) of the patient sensor 70, the administered carbon monoxide concentration, and the administration time of carbon monoxide. This is an estimated value. This estimate is the value that will be detected by the patient sensor 70 during the administration of carbon monoxide.

As shown in FIG. 3, the controller 62 sets a threshold value D2 for the value detected by the patient sensor (SPO ₂ sensor) 70 with the alarm area requiring an alarm being 90% or less, and the calculated effective curve ± 2% is set as a range in which carbon monoxide is effectively effective (effective range of carbon monoxide).

As shown in FIG. 3, when carbon monoxide is suitably administered to a patient (between carbon monoxide administration time 0 to t), the detected SPO ₂ decreases. In addition, when the administration of carbon monoxide is stopped (during the non-administration time t to 2t of carbon monoxide, for example, from 12 hours to 24 hours later), it rises. Although the alarm area that requires warning is 90% or less, the controller 62 may set the function to be a function related to the estimated value of the effective curve L2 from the estimated value of the effective curve L2 by the controller 62. good. At that time, the threshold D of the alarm region is set to be the bottom of the lower limit L22 of the effective range of carbon monoxide even when the effective curve L2 decreases and the effective range of carbon monoxide decreases accordingly. . For example, even if the detected SPO ₂ decreases to 95% in the initial stage of the initial administration of carbon monoxide and decreases to 94% and 93% according to the effective curve, 90% is used as the bottom limit line (absolute alarm value). , 90%, so that the threshold D2 of the alarm area is not lowered even when the effective curve drops further.

  FIG. 4 is a diagram showing the values detected by the environmental carbon monoxide concentration sensor 80 as an effective curve. The horizontal axis shows the administration time and non-administration time of carbon monoxide, as in FIG.

  In addition, an effective curve L3 shown in FIG. 4 is obtained by the controller 62 using the initial measurement value (initial value) F of the environmental carbon monoxide concentration sensor 80, the administered carbon monoxide concentration, the administration time of carbon monoxide, and the inspiratory circuit of the patient. It is an estimated value indicating a change in the concentration of carbon monoxide under the indoor environment, estimated based on the estimated amount of leakage.

  As shown in FIG. 4, the controller 62 sets a threshold value D3 for the environmental carbon monoxide concentration sensor 80, and warns the region over the threshold value D3 of the dangerous carbon monoxide concentration in the environment. Set as alarm area. When exceeding this region, the controller 62 controls the flow rate adjusting / blocking unit 42 and the alarm 64 to block the alarm and the administration of carbon monoxide.

  For example, the controller 62 performs alarming and carbon monoxide cutoff via the flow rate adjusting / blocking unit 42 and the alarm 64 when a predetermined concentration continues for a predetermined time as an alarm region.

  For example, the threshold value D3 is set to 70 ppm, and the alarm area is set to a concentration of 70 ppm (continuous for one hour) or more.

  The environmental carbon monoxide concentration increases due to, for example, leakage from the patient's exhalation circuit. Further, the alarm area may be set by the setting unit 66 from the controller 62 by using the predicted value of leakage as an associated function.

  The alarm 64 operates in response to an instruction from the controller 62 to notify a person such as a patient, a doctor, or a nurse who monitors the patient, or a person around the patient or a family member at home when the carbon monoxide concentration is abnormal. To do. As the alarm 64, for example, a speaker, a lamp such as an LED, or the like is used, and an abnormal carbon monoxide concentration or the like is alarmed by lighting or blinking of the speaker or the lamp. The alarm 64 includes a wired or wireless remote alarm.

  The setting unit 66 inputs the setting of the carbon monoxide concentration value administered to the patient and outputs it to the controller 62. The setting unit 66 includes, for example, a setting panel, sets the carbon monoxide concentration value via the setting panel, and outputs the set value to the controller 62. Further, the setting unit 66 can input a schedule such as the administration time and non-administration time of carbon monoxide to the patient. The schedule information, the concentration of carbon monoxide to be administered, and the alarm threshold can be set as a function. These settings are input to the controller 62.

  In addition, as a combination of each component in the carbon monoxide administration system 10, the administration unit 40 and the control unit 60 may be integrated and attached to the oxygen supply unit 20. In this case, the oxygen supply unit 20 is preferably an oxygen concentrator. In addition, the carbon monoxide supply unit 30 may be provided integrally with the administration unit 40 or the control unit 60. In addition, the alarm 64 and the like may be separately connected to the controller 62 by wireless or wired, so that an alarm may be issued at a place away from the patient.

  Control of the carbon monoxide administration system 10 configured as described above is controlled in the following three cases.

<Case 1>
In the control of the carbon monoxide administration system 10 in case 1, the controller 62 uses the carbon monoxide concentration sensor 43 disposed on the patient's inspiratory side during the administration of the carbon monoxide to the patient to actually Monitor the concentration of carbon monoxide administered. The control in this case 1 does not use the environmental carbon monoxide concentration sensor 80 in the carbon monoxide dosing system 10.

  The controller 62 uses at least the carbon monoxide concentration sensor 43 of the carbon monoxide concentration sensor 43 and the patient sensor 70 to control the flow rate adjustment / blocking unit 42, so that the carbon monoxide gas mixture to be administered to the patient The carbon monoxide concentration is monitored while adjusting the gas flow rate. Based on the carbon monoxide concentration to be monitored, the flow rate adjustment / blocking unit 42 is controlled to adjust the flow rate of carbon monoxide, thereby adjusting the concentration of carbon monoxide to be administered to the patient or administering to the patient. The carbon monoxide to be cut off is used, or the alarm 64 is used to notify the patient or medical staff of the alarm.

  The control in case 1 will be specifically described.

  FIG. 5 is a flowchart showing the operation of the carbon monoxide administration system 10 in Case 1.

  In step S <b> 10, when the administration carbon monoxide concentration setting value and the carbon monoxide administration schedule (administration time) are input to the setting unit 66, the controller 62 stores the setting information from the setting unit 66 in the table of the WORKRAM 624. And the process proceeds to step S11.

In step S11, the controller 62, via the patient sensor 70 initial measurement value of the biological information of the patient, where it measures the initial measurement value of the SPO ₂ are carbon monoxide administered to store the initial measurement value table WORKRAM624 generating an effective dose curve of SPO ₂ in the middle.

Effective dose curve of SPO ₂ are actually measured biological information (SPO _2), as compared with the initial measurement value of the initial measured value table, the effective dosage curve associated with the initial measurement value of the corresponding table It can be generated by reading. Further, the effective administration curve of SPO ₂ is obtained by using patient-specific information (gender, height and weight, etc.), predetermined calculation formulas and correction values, and initial measurement values of biological information measured by the patient sensor 70. Can be generated. The controller 62 monitors the value of SPO ₂ according to this effective administration curve, starts administration of carbon monoxide, and proceeds to step S12.

  In step S12, the controller 62 compares the value of the carbon monoxide concentration detected by the carbon monoxide concentration sensor 43 with the upper limit value of the adjustment region, and determines whether or not it is within an allowable range. Specifically, in step S12, the controller 62 determines that the value of the carbon monoxide concentration detected by the carbon monoxide concentration sensor 43 is the upper limit value of the adjustment region in the carbon monoxide concentration sensor 43 (for example, a set value of 50 ppm). It is determined whether or not the adjustment area is 50 + 10 ppm) or more.

  In step S12, if the detected carbon monoxide concentration value exceeds the upper limit value of the adjustment area shown in FIG. 2, the process proceeds to step S13. If the detected carbon monoxide concentration value is equal to or less than the upper limit of the dead area, the process proceeds to step S14. If it is within the region, that is, if it is less than the upper limit value of the adjustment region and larger than the adjustment region above the dead region, the process proceeds to step S15.

  In step S13, the controller 62 interrupts carbon monoxide administration via the flow rate adjustment / interruption unit 42, generates an alarm via the alarm 64 (warning), and notifies the people, patients, etc. around the patient. Then, the process proceeds to step S17. In step S17, the controller 62 administers only oxygen to the patient.

  In step S <b> 14, the controller 62 determines whether or not the carbon monoxide concentration value detected by the carbon monoxide concentration sensor 43 is within the allowable range by comparing with the lower limit value of the adjustment region. Specifically, in step S14, the controller 62 determines that the value of the carbon monoxide concentration detected by the carbon monoxide concentration sensor 43 is the adjustment region lower limit value (for example, the set value D = 50 ppm and the adjustment region 50-10 ppm). ) Determine whether or not.

  In step S14, if the detected carbon monoxide concentration value is within the adjustment region below the dead region shown in FIG. 2, the process proceeds to step S15, and if it is below the lower limit value of the adjustment region or within the dead region. The process proceeds to step S16. FIG. 6 shows the relationship between the processing of step S12 and step S14 and the detection value by the carbon monoxide concentration sensor 43. As shown in FIG. 6, the controller 62 monitors the value of the carbon monoxide concentration detected by the carbon monoxide concentration sensor 43 in the processing of step S12 and step S14. Then, whether this value is within the allowable range using the adjustment region and the insensitive region in the carbon monoxide concentration sensor 43, that is, whether it is an abnormal concentration value, readjustment of the initial setting flow rate adjustment, or initial setting flow rate It is determined whether to continue with adjustment.

  In step S15, the controller 62 controls the flow rate adjusting / blocking unit 42 based on the detection data of the carbon monoxide concentration sensor 43 so as to approach the set value (so that it falls within the dead region), and the flow rate of the carbon monoxide gas. To adjust the concentration of carbon monoxide in the air-fuel mixture administered to the patient.

In step S < _b > 16, the controller 62 determines whether the biological information (here, SPO ₂ ) acquired by the patient sensor 70 is equal to or greater than the upper limit value of the effective curve range (carbon monoxide effective effect range) of the patient sensor 70. In step S16, if the acquired biological information is less than the upper limit value of the effective curve range, the process proceeds to step S18, and if it is greater than or equal to the upper limit value of the effective curve range, the process proceeds to step S19. In the transition to step S19, the controller 62 determines that carbon monoxide is not contained in the patient's body.

In step S < _b > 18, the controller 62 determines whether the biological information (here, SPO ₂ ) acquired by the patient sensor 70 is equal to or less than the lower limit value of the effective curve range value of the patient sensor 70.

  If the biological information acquired in step S18 is larger than the lower limit value of the effective curve range value, the process proceeds to step S21, and if it is equal to or less than the effective curve range value, the process proceeds to step S22. In step S22, the controller 62 determines that carbon monoxide is excessively contained in the patient's body (the concentration of carbon monoxide being administered is an abnormal concentration).

In these step S16 and step S18, specifically controller 62, lowered the effective value of the SPO ₂ (maintain the value of the valid curve value range), and monitors so as not to exceed the alarm area.

  In step S19, the controller 62 determines whether or not the carbon monoxide concentration by the carbon monoxide concentration sensor 43 is within the setting region of the carbon monoxide concentration sensor 43. If within the setting region, the controller 62 proceeds to step S15. If it is out of the range (abnormal concentration), the process proceeds to step S20.

  In step S20, the controller 62 controls the flow rate adjusting / blocking unit 42 to block carbon monoxide and controls the alarm 64 to warn, and then proceeds to step S17. As an alarm in step S20, the device failure is notified.

  On the other hand, in step S21, the controller 62 determines whether or not the scheduled time and the set time t have elapsed. If the set time t has not elapsed, the controller 62 proceeds to step S23. .

  In step S22, the controller 62 controls the flow rate adjusting / blocking unit 42 to block carbon monoxide and also controls the alarm 64 to give a warning and proceeds to step S17 to administer only oxygen. As an alarm in step S22, a notification that the patient condition has deteriorated is given.

  In step S23, the controller 62 updates the table of time information set for the carbon monoxide concentration sensor 43 among the tables stored in the WORKRAM 624, and returns to step S12. In step S23, the controller 62 reads the measured values of the patient sensor 70 and the environmental carbon monoxide concentration sensor 80, the values in the initial measured value table, and the contents of the effective curves of the sensors 70 and 80 from the current administration time. Update.

  According to the control of case 1, the carbon monoxide concentration in the air-fuel mixture is measured using the carbon monoxide concentration sensor 43, and the flow rate adjusting / blocking unit 42 is controlled to adjust the flow rate of the carbon monoxide gas. Therefore, since the concentration of carbon monoxide in the air-fuel mixture to be administered to the patient is adjusted, carbon monoxide can be administered to the patient more safely and accurately.

  That is, since the carbon monoxide concentration sensor 43 detects the monoxide concentration at the time of inhalation of the patient, when the carbon monoxide concentration sensor 43 detects an abnormal concentration, the carbon monoxide concentration is blocked, so that the patient has an abnormal concentration. The influence of inhaling carbon monoxide gas can be minimized.

  Further, by using the detection value by the carbon monoxide concentration sensor 43 and the detection value by the patient sensor 70, leakage of carbon monoxide in the inhalation circuit to the patient can be detected.

That is, the carbon monoxide concentration sensor 43 despite the predetermined concentration of carbon monoxide value is detected, in case of detecting the patient not be observed change in the measurement data measured by the sensor 70 (SPO ₂ are In some cases, the SPO ₂ value does not decrease unlike the effective curve.

  In this case, assuming that there is a leak in the inspiratory circuit on the patient side of the carbon monoxide concentration sensor 43, the controller 62 warns via the alarm 64 and controls the flow rate adjustment / blocking unit 42 to control the mixing unit. The administration of carbon monoxide gas to 41 is cut off.

  Thus, carbon monoxide can be safely and suitably administered to the patient during the patient's breathing, and the treatment can be performed more safely by preventing leakage of carbon monoxide in the patient's surrounding environment.

<Case 2>
In addition to the components used in case 1, the control of the carbon monoxide administration system 10 (see FIG. 1) in case 2 uses an environmental carbon monoxide concentration sensor 80 disposed in the surrounding environment of the patient. Ensure patient safety as well as patient safety.

  That is, in the case 2, when the carbon monoxide is being administered to the patient, the controller 62 measures the carbon monoxide concentration around the patient by the environmental carbon monoxide concentration sensor 80 in addition to the function in the case 1. It has a function. Further, the controller 62 controls the flow rate adjusting / blocking unit 42 or the alarm 64 according to the measurement data of the carbon monoxide concentration detected by the environmental carbon monoxide concentration sensor 80.

  As shown in FIG. 4, the controller 62 sets a threshold value D <b> 3 indicating an alarm region (region requiring an alarm) for the environmental carbon monoxide concentration sensor 80. When the detected value by the environmental carbon monoxide concentration sensor 80 exceeds the threshold value D3, the controller 62 warns the detection of the abnormal concentration of carbon monoxide in the environment via the alarm 64, assuming that the value is in the alarm region. In addition, the flow rate adjusting / blocking unit 42 is controlled to block the administration of carbon monoxide to the patient. This minimizes the inhalation of abnormal concentrations of carbon monoxide gas by patients and people in the surrounding environment. In addition, treatment in an environment with a high carbon monoxide concentration can be prevented. Here, the controller 62 is set only as the threshold value D3 indicating the alarm region for the environmental carbon monoxide sensor 80. However, if a value that increases stepwise is set as the threshold value, the controller 62 increases the stepwise value according to the threshold value. An alarm can be performed.

  Thereby, even when carbon monoxide is leaking in the patient's inspiratory circuit, the environmental carbon monoxide concentration sensor 80 can reliably detect the carbon monoxide concentration in the patient environment (such as a room where the patient is present). .

  The operation of case 2 in such a carbon monoxide administration system 10 will be described with reference to a flowchart showing the operation of the carbon monoxide administration system 10 in case 1 of FIG.

  In Case 2, as in Case 1, first, the setting unit 66 sets the set value of the carbon monoxide concentration to be administered to the patient to the flow rate adjustment / blocking unit 42 (corresponding to step S10 in FIG. 5). .

  Next, in the initial state measurement process and administration start process (corresponding to step S11) of each sensor, the initial measurement value is read or measured by the patient sensor 70, and the initial measurement value of the environmental carbon monoxide concentration sensor 80 is read or measured. To start administration of carbon monoxide to the patient. Here, the controller 62 calculates an effective curve (see FIG. 3) using the initial measurement value by the patient sensor 70, and calculates an effective curve used by the environmental carbon monoxide concentration sensor 80. That is, the controller 62 changes the environmental carbon monoxide concentration according to the initial measurement value of the carbon monoxide concentration, the administration carbon monoxide concentration, the carbon monoxide administration time, and the estimated amount of leakage of carbon monoxide to be administered. The estimated effective curve is calculated (see FIG. 4). The controller 62 measures the environmental carbon monoxide concentration sensor 80.

  Then, the controller 62 in the control of case 2 starts administration of carbon monoxide to the patient (corresponding to step S11), and then any one of steps S12, S14, S16, S18, S21, and S23 in the process of case 1 The environmental carbon monoxide concentration monitored via the environmental carbon monoxide concentration sensor 80 is determined between two successive steps. In addition, since processes other than this process perform the same processes as in case 1 in order, a description thereof will be omitted.

  In this determination of the environmental carbon monoxide concentration, the controller 62 determines whether or not the environmental carbon monoxide concentration detected via the environmental carbon monoxide concentration sensor 80 is equal to or higher than a threshold D3 that defines the alarm region shown in FIG. Determine whether.

  In the determination of the environmental carbon monoxide concentration, if the detected environmental carbon monoxide concentration is smaller than D3, the controller 62 proceeds to the next step and sequentially performs the processing of the same steps as in case 1.

  On the other hand, in the determination of the environmental carbon monoxide concentration, if the environmental carbon monoxide concentration is equal to or greater than D3, the controller 62 determines that the environmental carbon monoxide concentration is an abnormal concentration through the alarm 64 and the flow rate adjustment / blocking unit 42. Alarming the patient's inhalation circuit and blocking the administration of carbon monoxide.

In this carbon monoxide administration system 10, it is considered that carbon monoxide leaks in the middle of the intake circuit in the following pattern.
1) The flow rate of carbon monoxide is adjusted by the flow rate adjustment / blocking unit 42 so as to obtain a set concentration, and information on the oxygen flow rate is output from the oxygen sensor 22, while the carbon monoxide concentration sensor 43 performs monoxide oxidation. Pattern in which carbon cannot be detected 2) Pattern in which the carbon monoxide concentration sensor 43 detects the concentration of carbon monoxide being administered to a patient, but the biological information acquired by the patient sensor 70 does not change

  As described above, the pattern in which carbon monoxide is discharged to the patient's surrounding environment is the leakage pattern in the intake circuit up to the carbon monoxide concentration sensor 43 and the inhalation on the patient side from the carbon monoxide concentration sensor 43. A leak pattern in which carbon monoxide is abnormally leaked from a circuit (mask, cannula, etc.) (more leaked than in normal use).

  In these patterns, if the controller 62 can measure the increase in the carbon monoxide concentration in the environment via the environmental carbon monoxide concentration sensor 80, it can be surely recognized that there is a leak of carbon monoxide. Further, the controller 62 is in a state where the detection values by the carbon monoxide concentration sensor 43 and the patient sensor 70 are within the adjustment range, and the flow rate of the carbon monoxide by the flow rate adjustment / blocking unit 42 is suitably adjusted. When the increase in the carbon monoxide concentration is detected by the environmental carbon monoxide concentration sensor 80, it can be assumed that carbon monoxide is leaked or generated due to other causes.

  Thus, the control of case 2 enables the carbon monoxide administration system 10 to measure the deterioration of the environment in the room where the patient is present, its signs, or the failure of the device, and provides an environment suitable for treatment, thereby providing carbon monoxide. Can be safely and suitably administered to a patient.

  The controller 62 can determine leakage of carbon monoxide around the patient's environment from the carbon monoxide concentration from the carbon monoxide concentration sensor 43 and the patient's biological information from the patient sensor 70. A more accurate patient environment can be measured using this determination and determination of the environmental carbon monoxide concentration.

<Case 3>
The control of the carbon monoxide administration system 10 in case 3 uses the same components as in case 2 (or case 1 may be used).

  The carbon monoxide administration system 10 in case 3 performs the process of carbon monoxide administration by each component used in case 2 based on the set schedule information.

  The schedule information is an administration schedule such as the administration time and non-administration time of carbon monoxide to a patient. This administration schedule is input to the controller 62 via the setting unit 66. The controller 62 can also be a function of schedule information, the concentration of carbon monoxide to be administered, and the alarm threshold.

  The controller 62 stores the inputted schedule information in the WORKRAM 624, and performs time management of carbon monoxide administration time and non-administration time based on this schedule information. That is, the controller 62 causes the flow rate adjusting / blocking unit 42 to block the carbon monoxide gas for a predetermined time after the carbon monoxide administration time (see “carbon monoxide non-administration time” from t to 2t in FIGS. 2 to 4). .

  As shown in FIG. 7, the controller 62 in case 3 first sets a dosing schedule including a carbon monoxide administration time and a non-dosing time via the setting unit 66 in step S31, and carbon monoxide at the time of administration. Set the density. Note that step S31 is a process similar to setting the non-administration time for a predetermined time after the carbon monoxide administration time in addition to the schedule set in the process of step S10 shown in FIG.

  In step S32, the initial state of each sensor is measured (measurement processing of the initial state of each sensor), and the process proceeds to step S33.

In step S32, the controller 62, via the patient sensor 70 initial measurement value of the biological information of the patient, where it measures the initial value of the SPO ₂ are carbon monoxide during administration by storing the initial measurement value table WORKRAM624 generating an effective dose curve of SPO ₂ in. In addition, the initial value of the environmental carbon monoxide concentration sensor 80 is measured, the initial measured value of the carbon monoxide concentration, the administered carbon monoxide concentration, the carbon monoxide administration time, and the estimated amount of leakage of the administered carbon monoxide. The effective curve which estimated the change of environmental carbon monoxide density | concentration is calculated by these (refer FIG. 4). The state of the surrounding carbon monoxide concentration where the patient is present can be measured by detecting the initial measurement value by the environmental carbon monoxide concentration sensor 80. If the concentration is abnormal, the controller 62 interrupts the alarm and carbon monoxide gas via the alarm 64 and the flow rate adjusting / blocking unit 42, and stops the carbon monoxide administration.

  In step S33, the controller 62 controls each component according to the same control as in the case 2 within the set carbon monoxide administration time (for example, 12 hours) based on the administration schedule, so Administer carbon oxide.

  In step S34, carbon monoxide is not administered after a predetermined time (for example, 12 hours) based on the administration schedule, and carbon monoxide non-administration time processing is performed.

  Specifically, in the carbon monoxide non-administration time process, the controller 62 controls the flow rate adjustment / blocking unit 42 to block the carbon monoxide gas, while the carbon monoxide concentration sensor 43, the patient sensor 70, and the environment An alarm is issued based on the value detected by the carbon oxide concentration sensor 80.

  During the carbon monoxide non-administration time, only oxygen in the oxygen supply unit 20 is supplied to the patient through the mixing unit 41, the carbon monoxide concentration sensor 43, the oxygen concentration sensor 44, and the flow rate sensor 45 via the patient connection unit 50. The

  During the carbon monoxide non-administration time, the controller 62 performs environmental carbon monoxide concentration measurement even after the carbon monoxide administration time has elapsed.

  In the environmental carbon monoxide concentration measurement, the controller 62 determines that the environmental carbon monoxide concentration is greater than or equal to the effective range value of the environmental carbon monoxide concentration sensor 80 (a value in the alarm region) via the environmental carbon monoxide concentration sensor 80. Determine if there is. When the environmental carbon monoxide concentration is equal to or greater than the effective range value, that is, when the environmental carbon monoxide concentration exceeds the alarm range, the controller 62 warns of deterioration of the indoor environment and equipment failure. Moreover, you may alarm the confirmation of the interruption | blocking state of carbon monoxide.

  If it is smaller than the effective range, the controller 62 determines whether the carbon monoxide concentration is 0 via the carbon monoxide concentration sensor 43. If the carbon monoxide concentration is not zero, the controller 62 alerts. In this case, even if the flow rate is cut off by the flow rate adjusting / cutting unit 42, if the carbon monoxide concentration sensor does not become zero, it can be diagnosed as a device failure.

  If the carbon monoxide concentration is 0, the controller 62 performs biological information measurement.

In the biological information measurement, the controller 62 determines whether the acquired biological information (here, SPO ₂ ) is equal to or less than the effective curve range value via the patient sensor 70. If it is less than or equal to the effective curve range value, the controller 62 warns because there may be a carbon monoxide concentration.

  In Case 3, the controller 62 performs environmental carbon monoxide concentration measurement, carbon monoxide concentration 0 determination, and biological information measurement until the administration schedule (here, non-administration time) set via the setting unit 66 elapses. Repeat in order.

  In other words, in case 3, the time during which carbon monoxide was administered to the patient in the control of cases 1 and 2 was defined as the administration time (carbon monoxide administration time), and a certain time after this administration time was assigned to the patient. The non-administration time (carbon monoxide non-administration time) when the administration of the carbon oxide concentration was stopped. In each case of the carbon monoxide administration time and the carbon monoxide non-administration time, in case 3, the patient condition is monitored, the patient environment is monitored, and the presence or absence of carbon monoxide contamination in the patient inhalation is monitored.

  This allows monitoring of the patient's condition, monitoring of the patient's environment, and monitoring of the presence of carbon monoxide in the patient's inspiration until it is fully recovered, even if it is time for the patient to recover after administering carbon monoxide. It can be carried out.

  The carbon monoxide administration system according to the present invention has an effect of allowing safer administration of carbon monoxide to a patient, and is useful as a method used for treatment of lung diseases and the like.

DESCRIPTION OF SYMBOLS 10 Carbon monoxide administration system 20 Oxygen supply part 22 Oxygen sensor 30 Carbon monoxide supply part 41 Mixing part 42 Flow control / blocking part 43 Carbon monoxide concentration sensor 44 Oxygen concentration sensor 45 Flow sensor 50 Patient connection part 62 Controller 64 Alarm ( Alarm part)
66 setting unit 70 patient sensor (biological information acquisition sensor)
80 Environmental carbon monoxide concentration sensor

Claims (5)

A carbon monoxide administration system for administering carbon monoxide to a patient in treating a patient's disease, comprising:
A carbon monoxide supply section for supplying the carbon monoxide;
A mixing unit that mixes oxygen supplied from an oxygen supply unit and the carbon monoxide supplied from the carbon monoxide supply unit, and outputs an air-fuel mixture to be administered to the patient;
A flow rate adjusting / blocking unit for adjusting the flow rate of carbon monoxide supplied to the mixing unit and blocking the carbon monoxide ;
A carbon monoxide concentration sensor for detecting the carbon monoxide concentration in the gas mixture;
A biological information acquisition sensor for acquiring the biological information of the patient;
The flow rate adjustment / blocking based on the adjustment region based on the set carbon monoxide concentration value, the carbon monoxide concentration detected by the carbon monoxide concentration sensor, and the biological information obtained by the biological information acquisition sensor A control unit that controls or regulates the carbon monoxide concentration to be administered to the patient;
Have
The adjustment region includes an upper adjustment region having a larger absolute value and a lower adjustment region having a smaller absolute value than a dead region that is a region in the vicinity of the set carbon monoxide concentration value. Including
Wherein the control unit, the carbon monoxide concentration detected is greater than the upper limit of the upper adjustment region, and controls the flow rate adjusting and locking part, it shuts off the carbon monoxide is administered to the patient When the predetermined adjustment condition is satisfied, the flow rate adjustment / blocking unit is controlled to adjust the carbon monoxide concentration to be administered to the patient, and to adjust the flow rate of the carbon monoxide supplied to the mixing unit. When the predetermined readjustment condition is satisfied, the flow rate adjustment / blocking unit is controlled to readjust the carbon monoxide concentration to be administered to the patient, and the carbon monoxide supplied to the mixing unit By re-adjusting the flow rate of
The adjustment condition is as follows:
Including the case where the detected carbon monoxide concentration is within the upper adjustment region;
The readjustment condition is:
The detected carbon monoxide concentration is within the lower adjustment region;
The detected carbon monoxide concentration is equal to or lower than the lower limit value of the lower adjustment region or in the insensitive region, and the acquired biological information is effective in that carbon monoxide is effectively effective during carbon monoxide administration. When the carbon monoxide concentration is larger than the upper limit of the effect range and the detected carbon monoxide concentration is within the set range of the carbon monoxide concentration sensor indicating that no device failure has occurred, and
including,
Carbon monoxide dosing system. The controller is configured such that the detected carbon monoxide concentration is equal to or lower than a lower limit value of the lower adjustment region or in the insensitive region, and the acquired biological information is greater than an upper limit of the effective effect range, and If the detected carbon monoxide concentration is outside the set region of the carbon monoxide concentration sensor, the flow rate adjusting / blocking unit is controlled to block the carbon monoxide to be administered to the patient. To
The carbon monoxide administration system according to claim 1. The control unit is a case where the detected carbon monoxide concentration is equal to or lower than a lower limit value of the lower adjustment region or in the insensitive region, and the acquired biological information is from a lower limit of the effective effect range If small, control the flow rate adjustment / blocking unit to block alarm and carbon monoxide administration to the patient,
The carbon monoxide administration system according to claim 1 or 2. The control unit controls the flow rate adjustment / blocking unit to block carbon monoxide to be administered to the patient and warns through an alarm unit.
The carbon monoxide administration system according to any one of claims 1 to 3. The oxygen supply unit is an oxygen concentrator;
The carbon monoxide administration system according to any one of claims 1 to 4.

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