JP6828649B2 - IABP drive - Google Patents

Description

The present invention relates to an IABP drive device used to drive a balloon of a balloon catheter in the IABP (Intra-Aortic Balloon Pumping) method.

In the IABP method, in order to obtain a sufficient assisting (reducing the burden on the heart) effect, it is necessary to expand and contract the balloon placed in the aorta at an appropriate timing for the patient's pulsation. Therefore, in the driving device used for driving the balloon of the balloon catheter in the IABP method, there is a driving device that displays the internal pressure waveform of the balloon together with the blood pressure waveform and the electrocardiogram waveform of the patient. The operator of such an IABP drive can compare the displayed waveforms to see if the balloon is expanding and contracting at the right time for the patient's heartbeat ( See Patent Document 1).

Further, the IABP drive device has been proposed to include an adjusting mechanism for adjusting the internal pressure of the balloon. The internal pressure adjustment mechanism of the balloon applies the internal pressure of the balloon when a procedure called volume weaning, which intentionally weakens the auxiliary function to the heart, is performed, or when the internal pressure of the balloon becomes higher than expected unintentionally. It can be used when lowering to an appropriate range. For example, even if the same amount of shuttle gas is applied to a balloon of the same volume, the internal pressure of the balloon becomes too high due to the difference in the thickness and shape of the aorta in which the balloon is placed depending on the patient. In such a case, the internal pressure of the balloon can be adjusted to an appropriate range by the adjusting mechanism.

By the way, in the IABP drive device, when the measured value of the balloon internal pressure (plateau pressure) exceeds a predetermined upper limit value (threshold value), there is a high possibility that some abnormality has occurred. In order to notify, an alarm operation is performed by an alarm lamp or an alarm sound. When an alarm operation is performed, the operator, etc. identifies the cause, takes appropriate measures if there is a problem, and if there is no problem, performs an operation for canceling the alarm operation. Do and continue driving. As the threshold value for performing this alarm operation, a value (for example, 200 mmHg (gauge pressure)) set appropriately in advance is used.

However, since the balloon internal pressure needs to be adjusted according to its back pressure, that is, the patient's blood pressure, it is necessary to drive the balloon in the region where the balloon internal pressure is high when applied to a patient with high blood pressure in the first place. , Even if the alarm is not originally needed, the alarm may occur. Since the generation of the alarm interferes with the continuous driving of the IABP drive device, the generation of an alarm that is not originally necessary should be suppressed.

Japanese Unexamined Patent Publication No. 6-315528

The present invention is made in view of such an actual situation, and is to provide an IABP driving device capable of suppressing the occurrence of an alarm that is originally unnecessary and is generated due to a high blood pressure of a patient.

In order to achieve the above object, the IABP drive device according to the present invention
An IABP drive that attaches a balloon catheter to which a balloon is connected and expands and contracts the balloon.
The alarm section that generates an alarm and
A measuring unit that measures the internal pressure of the balloon, which is the internal pressure of the balloon,
A reference threshold storage unit that stores a predetermined reference threshold value for generating an alarm regarding an increase in plateau pressure in the measured value of the balloon internal pressure measured by the measurement unit, and a reference threshold value storage unit.
A correction value calculation unit that calculates a correction value related to the reference threshold value according to the patient's blood pressure,
A determination unit for determining whether or not the plateau pressure exceeds the correction threshold value corrected by the correction value, and
It has an alarm indicator unit that instructs the alarm unit to generate an alarm when the determination unit determines that the plateau pressure exceeds the correction threshold value.

In the IABP drive device according to the present invention, an alarm is used by using a threshold value (correction threshold value) obtained by correcting a threshold value (reference threshold value) for generating an alarm regarding an increase in plateau pressure according to a patient's blood pressure (for example, average blood pressure). Since the occurrence of the blood pressure is determined, if the patient's blood pressure is high, the threshold value can be corrected accordingly. Therefore, it is possible to reduce the occurrence of unnecessary alarms that are caused by the high blood pressure of the patient.

In the IABP drive device according to the present invention
It further has an exclusion pressure detection unit that detects an exclusion pressure that is an increase in the patient's blood pressure caused by the expansion of the balloon.
Even if the determination unit determines that the plateau pressure exceeds the correction threshold value, the alarm indicating unit may contact the alarm unit when the exclusion pressure is detected by the exclusion pressure detection unit. On the other hand, it is possible not to instruct the occurrence of an alarm.

If the plateau pressure exceeds the correction threshold, the balloon may not be driven normally due to the occurrence of some abnormality, and the blood pressure assisting effect by the IABP method may not be obtained. Therefore, in principle. Should generate an alarm to notify the operator and the like. However, even when the plateau pressure exceeds the correction threshold, it is not necessary to generate an alarm if it is highly probable that the blood pressure assisting effect is obtained, and the alarm is generated instead of IABP. It may interfere with the continuous drive of the drive. Therefore, such a problem can be solved by detecting the exclusion pressure, which is an increase in the blood pressure of the patient caused by the expansion of the balloon, and not generating an alarm when the exclusion pressure is detected.

FIG. 1 is an overall external view of an IABP drive device according to an embodiment of the present invention. FIG. 2 is a block diagram showing a schematic structure of the IABP drive device shown in FIG. FIG. 3 is an external view of the monitor unit included in the IABP drive device of FIG. 1 as viewed from the front. FIG. 4 is a block diagram showing a functional configuration related to a process for generating an alarm when the measured value of the balloon internal pressure in the control unit of the IABP drive device shown in FIG. 2 is high. FIG. 5 is a flowchart showing a process for generating an alarm when the measured value of the balloon internal pressure in the control unit of the IABP drive device shown in FIG. 2 is high.

Hereinafter, the IABP drive device according to the present invention will be described in detail based on the embodiments shown in the drawings.

FIG. 1 is an overall external view of the IABP drive device 10 according to an embodiment of the present invention, and FIG. 2 is a block diagram showing a schematic structure of the IABP drive device 10. As shown in FIG. 2, the IABP drive device 10 is a drive device used for attaching a balloon catheter 80 for the IABP method to which the balloon 82 is connected and expanding and contracting the balloon 82. The balloon catheter 80 is used by being attached to the device body 20 of the IABP drive device 10 shown in FIG. The balloon 82 connected to the tip of the balloon catheter 80 is placed and used in the descending aorta. The IABP drive device 10 can assist the blood circulation function of the heart by expanding and contracting the balloon 82 in accordance with the beating of the heart.

As shown in FIG. 1, the IABP drive device 10 has a device main body 20 and a monitor unit 50. Inside the device main body 20, a pressure generating means for expanding and contracting the balloon 82, a power supply means for supplying electric power to the expanding and contracting means, and the like are housed. A caster 32 is attached to the lower part of the device main body 20, and the IABP drive device 10 can be easily moved in a hospital or the like.

The monitor unit 50 is attached to the device main body 20 via a monitor installation unit 30 provided on the upper surface of the device main body 20. The monitor unit 50 is removable from the device main body 20. The monitor unit 50 is connected to the device main body 20 via a cable or the like (not shown), receives power from the device main body 20, transfers data to and from the device main body 20, and inputs / outputs signals. Can be done.

As shown in FIG. 2, a pressure generating means for expanding / contracting the balloon 82 is housed inside the apparatus main body 20. The pressure generating means includes a gas tank (not shown) for storing shuttle gas for expanding the balloon 82, a pressure chamber (not shown) for maintaining a predetermined pressure, a pressure transmission partition wall device 25 (isolator) for transmitting pressure, and the like. It has a secondary pipe 21a for connecting the pressure transmission partition wall device 25 and the balloon catheter 80, a primary pipe 21b for connecting the pressure transmission partition wall device 25 with the electromagnetic valve 28 and the pressure chamber, and the like.

The pressure transmission partition wall device 25 transmits the pressure change of the primary pipe 21b to the secondary pipe 21a while separating the secondary pipe 21a connected to the balloon catheter 80 and the primary pipe 21b connected to the solenoid valve 28. It has a diaphragm 26. The primary pipe 21b is connected to two pressure chambers having different pressures via a solenoid valve 28. The pressure generating means controls the connection of the solenoid valve 28, moves the diaphragm 26 by switching and connecting the two pressure chambers to the primary pipe 21b, and transmits the pressure to the secondary pipe 21a and the balloon 82. To do. The fluid filled in the primary pipe 21b is not particularly limited, but for example, air or the like is used.

On the other hand, the secondary pipe 21a connected to the balloon catheter 80 is filled with shuttle gas that circulates in the balloon catheter 80 and expands / contracts the balloon 82. As the shuttle gas filled in the balloon catheter 80 and the secondary pipe 21a, it is preferable to use helium gas having a small mass in order to enhance the responsiveness of the balloon 82, but the shuttle gas is not particularly limited.

The secondary pipe 21a is provided with a measuring unit 22 for measuring the internal pressure of the balloon, which is the internal pressure of the balloon 82, and an adjusting unit 24 for adjusting the internal pressure of the balloon. The measuring unit 22 is composed of a pressure sensor or the like, and measures the pressure inside the balloon catheter 80 filled with shuttle gas. The internal pressure signal, which is a signal related to the balloon internal pressure measured by the measuring unit 22, is output to the control unit 52 of the monitor unit 50.

The adjusting unit 24 adjusts the amount of shuttle gas circulating in the secondary pipe 21a and the balloon catheter 80 in order to expand the balloon 82, and adjusts the internal pressure of the balloon. For example, the adjusting unit 24 supplies the shuttle gas to the secondary pipe 21a or discharges the shuttle gas from the secondary pipe 21a, so that the reference pressure 76b, which is the internal pressure of the balloon when the balloon 82 contracts (FIG. 3). (See) is adjusted by increasing or decreasing the internal pressure of the balloon.

As shown in FIG. 2, the monitor unit 50 includes a screen display unit 54, a second display unit 56, an operation signal input unit 58, an alarm unit 60, an external signal input unit 60c, and a reference threshold storage unit 62. Have. As shown in FIG. 3, the screen display unit 54 is arranged in an area of about the upper half of the front surface of the monitor unit 50, and is composed of a display such as a liquid crystal display or an organic EL display.

As shown in FIG. 2, the screen display unit 54 includes a first display unit 54a, a waveform display unit 54b, and a blood pressure / heart rate display unit 54c. As shown in FIG. 3, the first display unit 54a is arranged at the upper center of the screen display unit 54, and the plateau pressure at the measured value of the balloon internal pressure measured by the measurement unit 22 is applied while the balloon 82 is being driven. Numerical values can be displayed at all times. The plateau pressure is the internal pressure of the balloon when the balloon 82 is expanded. The plateau pressure is the pressure of the plateau 76a seen in the internal pressure waveform 76, and is calculated by the control unit 52 based on the internal pressure signal output from the measuring unit 22.

As shown in FIG. 3, in addition to the plateau pressure, the first display unit 54a includes information on waveforms and peaks for detecting the timing of expansion and contraction of the balloon 82, information on drive time, assist ratio, and the like. Can be displayed. However, the display items of the first display unit 54a may be changed according to the driving conditions and the like, and for example, the operator may be able to select the display items to be displayed on the first display unit 54a.

As shown in FIG. 3, the waveform display unit 54b is arranged in the center of the screen display unit 54, and the waveform display unit 54b has an electrocardiogram waveform 72, a blood pressure waveform 74, and an internal pressure waveform 76 in this order from the top. Two waveforms are displayed side by side. The electrocardiogram waveform 72 is a waveform display of changes over time in an electrocardiogram signal representing the electrical activity of the patient's heart. The electrocardiogram signal is acquired by the electrocardiograph via an electrode pad attached to the patient, and is input to the monitor unit 50 via the external signal input unit 60c shown in FIG. The control unit 52 of the monitor unit 50 displays the electrocardiogram signal input via the external signal input unit 60c on the waveform display unit 54b as an electrocardiogram waveform 72. The electrocardiogram signal may be acquired directly by the IABP drive device 10 itself by incorporating an electrocardiograph in the IABP drive device 10, or via an electrocardiograph (polygraph, bedside monitor, etc.) outside the IABP drive device 10. May be obtained indirectly.

The blood pressure waveform 74 is a waveform display of changes over time in a blood pressure signal representing a patient's blood pressure. The blood pressure signal is measured using a blood pressure measuring device such as a balloon catheter 80 or a pressure transducer attached to another catheter connected to an artery, and is measured by a monitoring unit 50 via an external signal input unit 60c shown in FIG. Is entered in. The control unit 52 of the monitor unit 50 displays the blood pressure signal input via the external signal input unit 60c on the waveform display unit 54b as the blood pressure waveform 74. Further, the blood pressure signal may be indirectly acquired by the IABP drive device 10 acquiring the output signal from the polygraph after the output signal of the blood pressure measuring instrument is input to the polygraph.

The internal pressure waveform 76 is a waveform display of the change over time of the internal pressure signal representing the measured value of the balloon internal pressure, which is the internal pressure of the balloon 82. As shown in FIG. 2, the internal pressure signal is output by the measuring unit 22 provided in the secondary pipe 21a of the apparatus main body 20 and input to the monitor unit 50.

As shown in FIG. 3, a blood pressure / heart rate display unit 54c that numerically displays blood pressure and heart rate is arranged on the right side of the screen display unit 54. In the example shown in FIG. 3, the heart rate, systolic pressure, diastolic pressure, average pressure, and augmentation pressure are displayed in this order from above the blood pressure / heart rate display unit 54c. The heart rate is calculated by the control unit 52 based on the electrocardiogram signal, and the systolic pressure, the diastolic pressure, the average pressure, and the augmentation pressure are calculated based on the blood pressure signal.

As shown in FIG. 3, the operation signal input unit 58 is arranged below the front surface of the monitor unit 50. The operator of the IABP drive device 10 can input various signals related to the drive of the IABP drive device 10, such as the drive conditions of the balloon 82 and the display conditions of the monitor unit 50, via the operation signal input unit 58.

As shown in FIG. 2, the operation signal input unit 58 has an alarm release unit 58b for inputting a release signal for canceling the alarm operation by the alarm unit 60, which will be described later. As shown in FIG. 3, the alarm release unit 58b has a push button arranged at the lower right of the front surface of the monitor unit 50, and when the operator presses the push button of the alarm release unit 58b, the alarm operation is released. A release signal for this is input to the monitor unit 50. When a release signal for canceling the alarm operation is input to the monitor unit 50, the control unit 52 controls the alarm unit 60 to stop or interrupt the alarm operation by the pilot lamp 60a and the alarm sound generating unit 60b.

As shown in FIG. 2, the operation signal input unit 58 has an adjustment input unit 58a for inputting an operation signal for adjusting the balloon internal pressure. As shown in FIG. 3, the adjustment input unit 58a has two push buttons arranged at the lower right of the front surface of the monitor unit 50 and to the left of the alarm release unit 58b, and has two push buttons. The upper button is a push button for increasing the internal pressure of the balloon, and the lower button is a push button for decreasing the internal pressure of the balloon.

When the operator presses the push button of the adjustment input unit 58a, an operation signal for adjusting the balloon internal pressure is input to the monitor unit 50. When an operation signal for increasing the balloon internal pressure is input, the control unit 52 of the monitor unit 50 controls the adjustment unit 24 of the device main body 20, and the amount of shuttle gas circulating in the secondary pipe 21a and the balloon catheter 80. By increasing, the reference pressure 76b of the balloon internal pressure is increased. However, if the adjustment degree described later is already the upper limit value, the adjustment for increasing the balloon internal pressure is not executed.

On the other hand, when an operation signal for lowering the internal pressure of the balloon is input, the control unit 52 of the monitor unit 50 controls the adjustment unit 24 of the device main body 20, and the shuttle that circulates in the secondary pipe 21a and the balloon catheter 80. By reducing the amount of gas, the reference pressure 76b of the balloon internal pressure is lowered. However, if the degree of adjustment described later is already the lower limit, the adjustment for lowering the internal pressure of the balloon is not executed.

The second display unit 56 displays the degree of adjustment in which the adjustment unit 24 in the device main body 20 adjusts the balloon internal pressure according to the amount of shuttle gas. As shown in FIG. 3, the second display unit 56 is arranged at the lower part of the front surface of the monitor unit 50 like the operation signal input unit 58, and in particular, is arranged directly above the adjustment input unit 58a. The second display unit 56 includes a first light emitting unit 56a, a second light emitting unit 56b, and third to tenth light emitting units. The first to tenth light emitting units 56a and 56b have rod-shaped light emitting portions extending in the horizontal direction, and are vertically arranged in the order of the first light emitting unit 56a, the second light emitting unit 56b, and the third light emitting unit. It is arranged. The first light emitting unit 56a can switch on, blinking, and extinguishing, and the second to tenth light emitting units 56b can switch on and off.

The light emitting states of the first to tenth light emitting units 56a and 56b of the second display unit 56 change according to the degree of adjustment of the balloon internal pressure. In the monitor unit 50 shown in FIG. 3, the degree of adjustment of the balloon internal pressure is in the first to tenth stages, and for example, the first degree of adjustment of the balloon internal pressure is the upper limit value (the reference pressure of the balloon 82 is the maximum value). In the state (10th stage), the 2nd to 10th light emitting units 56b are lit, and the 1st light emitting unit 56a is lit or blinking. Further, when the degree of adjustment of the balloon internal pressure is in the second state (9th stage), which is one step lower than the first state, the second to tenth light emitting units 56b are turned on and the first light emitting unit 56a is turned off. Furthermore, when the adjustment degree of the balloon internal pressure decreases in the 8th and 7th stages, the light is turned off from the top in the order of the 3rd light emitting part and the 4th light emitting part, and conversely, when the adjustment degree of the balloon internal pressure increases, the light emitting part goes up. Lights up.

As described above, the degree of adjustment of the balloon internal pressure is changed by the operator inputting an operation signal via the adjustment input unit 58a. Therefore, when the operation signal for adjusting the balloon internal pressure is input, the control unit 52 of the monitor unit 50 drives the adjusting unit 24 to adjust the shuttle gas amount, thereby adjusting the balloon internal pressure at the same time. , The display state of the second display unit 56 is changed.

The alarm unit 60 shown in FIG. 2 causes an operator or the like to recognize an abnormality detected by the IABP drive device 10 by performing an alarm operation. Under the control of the control unit 52, the alarm unit 60 performs a visual and auditory alarm operation, for example, when the plateau pressure rises. The alarm operation when the plateau pressure rises will be described in detail later. The reason why the measured value of the balloon internal pressure (plateau pressure) rises is that when the secondary pipe 21a between the measuring unit 22 and the balloon 82 or the tube of the balloon catheter 80 is blocked by a kink or the like, the patient If the blood pressure is high, the expansion timing is too early and the balloon is driven under systolic pressure, the balloon diameter is larger than the aortic diameter, the shuttle gas amount exceeds the specified amount, the balloon catheter 80 and The drive tube (a part of the secondary pipe 21a) connecting to the IABP drive device 10 may be shorter than the specified one. Among these, when the secondary pipe 21a between the measuring unit 22 and the balloon 82 or the tube of the balloon catheter 80 is blocked by a kink or the like, the pressure around the measuring unit 22 becomes high, so that the balloon Although the measured value of the internal pressure becomes high, the balloon 82 is not driven normally, which is a particular problem.

The alarm unit 60 has a pilot lamp 60a arranged at the upper center of the monitor unit 50 and an alarm sound generating unit 60b. When an abnormality occurs, such as when the plateau pressure rises, the alarm unit 60 blinks the pilot lamp 60a in red and generates a high intermittent sound from the alarm sound generation unit 60b, so that the abnormality can be resolved even after the alarm operation. If the release signal for canceling the alarm operation is not input, the operation of the balloon 82 by the pressure generating means is stopped.

The control unit 52 shown in FIG. 2 is composed of a microprocessor or the like, and by performing various arithmetic processes, control processing of the pressure generating means, the screen display unit 54, and other configurations included in the IABP drive device 10 will be described later. Perform various processes, including a process for generating an alarm regarding an increase in the measured value of the balloon internal pressure. Further, the external signal input unit 60c shown in FIG. 2 receives signals from devices other than the IABP drive device 10, such as an electrocardiograph, a blood pressure measuring device, a polygraph, and a bedside monitor. The signal input to the external signal input unit 60c may be a digital signal that can be processed by the control unit 52, or may be an analog signal that has not been A / D converted. When the signal is an analog signal, the signal input unit 51 converts each signal into a digital signal that can be processed by the control unit 52, and then transmits each signal to the control unit 52.

In the reference threshold value storage unit 62 shown in FIG. 2, a predetermined reference threshold value for generating an alarm regarding an increase in the plateau pressure (alarm with a high balloon internal pressure) in the measured value of the balloon internal pressure measured by the measurement unit 22 is stored in advance. ing. In the present embodiment, it is assumed that 200 mmHg (gauge pressure) is stored as this reference threshold value.

FIG. 4 is a block diagram showing a functional configuration related to processing for generating an alarm when the measured value of the balloon internal pressure in the control unit 52 is high, and FIG. 5 is a block diagram showing an alarm when the measured value of the balloon internal pressure is also high. It is a flowchart which shows the process to occur. The control unit 52 has an average blood pressure calculation unit 52a, a correction value calculation unit 52b, a determination unit 52c, a plateau pressure detection unit 52d, an alarm indication unit 52e, and an exclusion pressure detection unit 52f as functional configurations related to the alarm processing. There is.

When the process is started, a blood pressure signal is input to the average blood pressure calculation unit 52a via the external signal input unit 60c, and the average blood pressure calculation unit 52a calculates the average blood pressure according to the following arithmetic formula (step S001).
Mean blood pressure = (systolic blood pressure-diastolic blood pressure) / 3 + diastolic blood pressure

The average blood pressure calculated by the average blood pressure calculation unit 52a is sent to the correction value calculation unit 52b. Here, in order to calculate the average blood pressure of the patient, it is described that the blood pressure signal from the external device input via the external signal input unit 60c is used, but the balloon catheter 80 is used. The patient's blood pressure may be measured. That is, if the balloon 82 is brought into the semi-expanded state before the normal drive (pumping drive) or by interrupting the normal drive, the internal pressure of the balloon becomes equal to the external pressure (back pressure). (For example, see Japanese Patent Application Laid-Open No. 2011-500204), the blood pressure of the patient may be measured.

The correction value calculation unit 52b calculates the correction value according to the following arithmetic expression (step S002).
Correction value = average blood pressure-70 mmHg

The correction value calculated by the correction value calculation unit 52b is sent to the determination unit 52c. Further, the measured value of the balloon internal pressure measured by the measuring unit 22 is input to the plateau pressure detecting unit 52d. The plateau pressure detection unit 52d calculates the plateau pressure, which is the pressure of the plateau 76a (see FIG. 3) in the balloon internal pressure. The plateau pressure calculated by the plateau pressure calculation unit 52d is sent to the determination unit 52c.

The determination unit 52c reads the reference threshold value stored in the reference threshold value storage unit 62, corrects (adds) the reference threshold value with the correction value sent from the correction value calculation unit 52b, and calculates the correction threshold value. Next, the determination unit 52c compares the plateau pressure sent from the plateau pressure detection unit 52d with the correction threshold value, and determines whether or not the plateau pressure exceeds the correction threshold value (step S003). The determination result by the determination unit 52c is sent to the alarm indicator unit 52e.

Further, the blood pressure signal measured by the external signal input unit 60c or the like is also input to the exclusion pressure detection unit 52f. The exclusion pressure detection unit 52f determines the presence or absence of exclusion pressure, which is an increase in the patient's blood pressure caused by the expansion of the balloon 82, based on the blood pressure signal (step S004). The exclusion pressure can be detected as the difference between the blood pressure of the patient when the balloon 82 is not expanded and the blood pressure (augmentation pressure) of the patient when the balloon 82 is expanded. When the exclusion pressure is detected, it can be said that the expansion of the balloon 82 has a blood pressure assisting effect, and when the exclusion pressure is not detected, it can be determined that the blood pressure assisting effect of the balloon 82 has not occurred. .. Then, the determination result (presence / absence of exclusion pressure) by the exclusion pressure detection unit 52f is sent to the alarm indicator unit 52e.

The alarm indicator 52e determines that the plateau pressure exceeds the correction threshold (Yes in step S003) based on the determination result by the determination unit 52c, and the determination result by the exclusion pressure detection unit 52f is no exclusion pressure (step). If No) in S004, the alarm unit 60 is instructed to generate an alarm (step S005). In other cases, the alarm indicating unit 52e indicates that the determination result by the determination unit 52c is equal to or less than the correction threshold value (No in step S003), or the determination result by the exclusion pressure detection unit 52f. When there is an exclusion pressure (Yes in step S004), the alarm generation unit 60 is not instructed to generate an alarm.

It is preferable to provide the exclusion pressure detection unit 52f, but it may be omitted. If omitted, the alarm indicating unit 52e gives an instruction to the alarm unit 60 based only on the determination result by the determination unit 52c. Do. That is, when the alarm indicating unit 52e determines that the plateau pressure exceeds the correction threshold value (yes in step S003), the alarm indicating unit 52e generates an alarm for the alarm unit 60. If it is determined that the plateau pressure does not exceed the correction threshold value (or less) (No in step S003), the alarm generation unit 60 is not instructed to generate an alarm.

Upon receiving the alarm generation instruction from the alarm indicating unit 52e, the alarm unit 60 executes a predetermined alarm operation. The alarm operation of the alarm unit 60 is visual and auditory, such as blinking the pilot lamp 60a in red (see FIG. 3) or generating an intermittent alarm sound in the alarm sound generating unit 60b (see FIG. 2). It is done by various methods. An operator or the like who has noticed the alarm operation can cancel the alarm operation by the alarm unit 60 by inputting a release signal from the alarm release unit 58b in the operation signal input unit 58.

In the above-described embodiment, the occurrence of the alarm is determined by using the threshold value (correction threshold value) obtained by correcting the threshold value (reference threshold value) for generating the alarm regarding the increase in plateau pressure according to the average blood pressure of the patient. Therefore, when the average blood pressure of the patient is high (in the present embodiment, it exceeds 70 mmHg), the correction threshold value is corrected so as to be higher than the reference threshold value (200 mmHg in the present embodiment). It becomes. Therefore, it is possible to reduce the occurrence of unnecessary alarms that are caused by the high blood pressure of the patient.

In the above-described embodiment, when the average blood pressure of the patient is low (less than 70 mmHg in the present embodiment), the correction threshold value is corrected in the lower direction, but in the lower direction. If it is not necessary to correct the above, the reference threshold value may be used without the correction.

Further, in the above-described embodiment, not only the plateau pressure exceeds the correction threshold value, but also the alarm is generated only when the exclusion pressure is not detected, so that the plateau pressure is increased. Even if the correction threshold is exceeded, the alarm is generated only when there is no blood pressure assisting effect. Therefore, it is possible to more effectively suppress the generation of an originally unnecessary alarm that may hinder the continuous driving of the IABP driving device 10.

The embodiments described above are described for facilitating the understanding of the present invention, and are not described for limiting the present invention. Therefore, each element disclosed in the above-described embodiment is intended to include all design changes and equivalents belonging to the technical scope of the present invention.

10 ... IABP drive device 20 ... Device body 21b ... Primary piping 21a ... Secondary piping 22 ... Measuring unit 24 ... Adjusting unit 26 ... Diaphragm 28 ... Electromagnetic valve 30 ... Monitor installation unit 32 ... Caster 50 ... Monitor unit 52 ... Control unit 52a ... Average blood pressure calculation unit 52b ... Correction value calculation unit 52c ... Judgment unit 52d ... Plateau pressure detection unit 52e ... Alarm indication unit 52f ... Exclusion pressure detection unit 54 ... Screen display unit 54a ... First display unit 54b ... Waveform display unit 54c ... Blood pressure / heart rate display 56 ... 2nd display 56a ... 1st light emitting unit 56b ... 2nd light emitting unit 58 ... Operation signal input unit 58a ... Adjustment input unit 58b ... Alarm release unit 60 ... Alarm unit 60a ... Pilot lamp 60b ... Sound generation unit 60c ... External signal input unit 62 ... Reference threshold storage unit 72 ... Electrocardiogram waveform 74 ... Blood pressure waveform 76 ... Internal pressure waveform 76a ... Plateau 76b ... Reference pressure 80 ... Balloon catheter 82 ... Balloon

Claims (2)

An IABP drive that attaches a balloon catheter to which a balloon is connected and expands and contracts the balloon.
The alarm section that generates an alarm and
A measuring unit that measures the internal pressure of the balloon, which is the internal pressure of the balloon,
A reference threshold storage unit that stores a predetermined reference threshold value for generating an alarm regarding an increase in plateau pressure in the measured value of the balloon internal pressure measured by the measurement unit, and a reference threshold value storage unit.
A correction value calculation unit that calculates a correction value related to the reference threshold value according to the patient's blood pressure,
A determination unit for determining whether or not the plateau pressure exceeds the correction threshold value corrected by the correction value, and
An IABP drive device including an alarm indicator unit that instructs the alarm unit to generate an alarm when the determination unit determines that the plateau pressure exceeds the correction threshold value. It further has an exclusion pressure detection unit that detects an exclusion pressure that is an increase in the patient's blood pressure caused by the expansion of the balloon.
Even if the determination unit determines that the plateau pressure exceeds the correction threshold value, the alarm indicator unit may contact the alarm unit when the exclusion pressure is detected by the exclusion pressure detection unit. The IABP drive device according to claim 1, which does not instruct the generation of an alarm.

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