JP6859330B2 - 漏れが存在する患者回路のコンプライアンスを推定する方法及びシステム - Google Patents
漏れが存在する患者回路のコンプライアンスを推定する方法及びシステム Download PDFInfo
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
- A61M16/022—Control means therefor
- A61M16/024—Control means therefor including calculation means, e.g. using a processor
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
- A61M16/022—Control means therefor
- A61M16/024—Control means therefor including calculation means, e.g. using a processor
- A61M16/026—Control means therefor including calculation means, e.g. using a processor specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
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- A—HUMAN NECESSITIES
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
- A61M16/0875—Connecting tubes
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0057—Pumps therefor
- A61M16/0066—Blowers or centrifugal pumps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/06—Respiratory or anaesthetic masks
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
- A61M16/0883—Circuit type
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/20—Valves specially adapted to medical respiratory devices
- A61M16/201—Controlled valves
- A61M16/202—Controlled valves electrically actuated
- A61M16/203—Proportional
- A61M16/205—Proportional used for exhalation control
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
- A61M2016/0042—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the expiratory circuit
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61M2205/00—General characteristics of the apparatus
- A61M2205/15—Detection of leaks
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3331—Pressure; Flow
- A61M2205/3344—Measuring or controlling pressure at the body treatment site
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61M2205/00—General characteristics of the apparatus
- A61M2205/70—General characteristics of the apparatus with testing or calibration facilities
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- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Heart & Thoracic Surgery (AREA)
- Emergency Medicine (AREA)
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- Medical Informatics (AREA)
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- Epidemiology (AREA)
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- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
Description
Pp=(Qv−Ql)/sCT (式1)
Pp=K2Ql 2+K1Ql (式2)
Pp=K2(Qv−sCTPP)2+K1(Qv−sCTPP) (式3)
Pp=K2Qv 2−K2CT2(sPP)Qv+K2CT 2(sPP)2+K1Qv−K1CT(sPP) (式4)
z(s)=θTφ(s) (式6)
ここで、zは、以下のように評価された、フィルタリングされた近位圧力の読み値の1×Nベクトルである。
θ=zφT(φφT)−1 (式10)
Κ2=θ1、Κ1=θ4、CT=θ2/θ1 (式11)
又は
PpDOT(m)=(Pprox(m)−Pprox(m−1))/ΔT (式16)
Pprox(0)=Pprox(1)
φ1(m)=FLP(Qb 2(m)) (式17)
φ2(m)=−2・FLP(PpDOT(m)・Qb(m)) (式18)
φ3(m)=FLP(PpDOT 2(m)) (式19)
φ4(m)=FLP(Qb(m)) (式20)
φ5(m)=−FLP(PpDOT(m)) (式21)
z(m)=FLP(PpDOT(m)) (式22)
ここで、FLP( )は、以下の低域通過フィルタによって定義される。ここで、y(m)=FLP(x(m))とすると、
θ=zφT(φφT)−1 (式24)
一実施形態によれば、これは、ステップ1及び2が7000個のサンプルに対して完了した後に実行される単一ステップのベクトル−行列計算である。積φφTは、5×5の行列であるため、その逆行列は比較的単純である。
Κ2=θ1 (式25)
Κ1=θ4 (式26)
CT=θ2/θ1 (式27)
K2min<K2<K2max (式28)
K1min<K1<K1max (式29)
CTmin<CT<CTmax (式30)
ここで、K2min=30cmH2O/(l/sec)2; K2max=130cmH2O/(l/sec)2; K1min=0cmH2O/(l/sec)2; K1max=10cmH2O/(l/sec)2; CTmin=0.5ml/cmH2O; CTmax=4.0ml/cmH2Oである。
Qb_traj(m)=QNIV_circ_cal(m) (式35)
θ(m)=θ(m−1)+K(m)[z(m)−θT(m−1)φ(m)] (式44)
Claims (9)
- 非侵襲的な人工呼吸システムの接続回路のコンプライアンスを決定する方法であって、当該方法は、
非侵襲的な人工呼吸システムを提供するステップであって、前記人工呼吸システムは、流量又は圧力コントローラを含み、低周波カットオフフィルタ、高周波カットオフフィルタ、低域通過フィルタをさらに含む、提供するステップと、
前記流量又は圧力コントローラのためのテスト信号を生成するステップであって、前記テスト信号は、ホワイトノイズを前記低周波カットオフフィルタ、高周波カットオフフィルタ、低域通過フィルタの順にフィルタリングした信号を含む、生成するステップと、
該生成されたテスト信号を用いて前記流量又は圧力コントローラを所定期間に亘って励起させるステップと、
前記圧力又は流量コントローラの励起中に、前記非侵襲的な人工呼吸システムのガス圧力及び流量の少なくとも一方の測定値を取得するステップと、
該取得した測定値の圧力のベクトルを決定するステップと、
該決定された圧力のベクトルを使用して、前記接続回路のコンプライアンスを示すための圧力フローモデルのパラメータを決定するステップと、を含む、
方法。 - 前記測定値は、近位圧力、又はブロワの流量である、請求項1に記載の方法。
- 前記所定期間の第1のサブセット中に取得した1つ又は複数の測定値を平均するステップと、
平均値を解析して、前記取得するステップ中に、前記非侵襲的な人工呼吸システムの患者ポートが遮断されていたかどうか、及び/又は漏れが不十分であったかどうかを判定するステップと、
前記患者ポートが遮断されていた場合及び/又は前記漏れが十分であった場合にのみ、前記取得した測定値のベクトルを決定するステップに進むステップと、をさらに含む、
請求項1に記載の方法。 - 前記生成されたテスト信号は、バイアスによってオフセットされる、請求項1に記載の方法。
- 前記ベクトルは、ムーア−ペンローズ(Moore-Penrose)擬似逆行列法を使用して決定される、請求項1に記載の方法。
- 前記決定された物理的パラメータの推定値を所定の許容範囲と比較するステップをさらに含む、請求項1に記載の方法。
- 前記決定された物理的パラメータの推定値は、該決定された物理的パラメータの推定値が所定の許容範囲内にある場合にのみ、前記非侵襲的な人工呼吸システムによって利用される、請求項6に記載の方法。
- 非侵襲的な人工呼吸システムであって、当該システムは、
低周波カットオフフィルタ、高周波カットオフフィルタ、低域通過フィルタと、
ホワイトノイズを該低周波カットオフフィルタ、高周波カットオフフィルタ、低域通過フィルタの順にフィルタリングしてテスト信号を生成し、該生成されたテスト信号を用いて前記非侵襲的な人工呼吸システムの流れ供給源を所定期間に亘って励起し、当該システムのガス圧力及び流量の少なくとも一方の測定値を取得し、該取得した測定値の圧力のベクトルを決定し、該決定された圧力のベクトルを使用して、当該システムの接続回路のコンプライアンスを示すための圧力フローモデルのパラメータを決定するように構成されるコントローラを有する、
非侵襲的な人工呼吸システム。 - 前記測定値は、近位圧力である、請求項8に記載の非侵襲的な人工呼吸システム。
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US201562233483P | 2015-09-28 | 2015-09-28 | |
US62/233,483 | 2015-09-28 | ||
PCT/EP2016/072794 WO2017055195A1 (en) | 2015-09-28 | 2016-09-26 | Methods and systems to estimate compliance of a patient circuit in the presence of leak |
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JP2018528023A JP2018528023A (ja) | 2018-09-27 |
JP6859330B2 true JP6859330B2 (ja) | 2021-04-14 |
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US (1) | US11027082B2 (ja) |
EP (1) | EP3355977B1 (ja) |
JP (1) | JP6859330B2 (ja) |
CN (1) | CN108136146B (ja) |
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USD989291S1 (en) * | 2020-12-31 | 2023-06-13 | Corvent Medical, Inc. | Ventilator tubing assembly |
CN113877031A (zh) * | 2021-09-30 | 2022-01-04 | 深圳市科曼医疗设备有限公司 | 呼吸机泄漏流速计算方法、装置、计算机设备及存储介质 |
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WO2016209129A1 (en) * | 2015-06-25 | 2016-12-29 | Maquet Critical Care Ab | Oxygen boost during mechanical ventilation of a patient |
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