JP6912388B2 - 逐次パラメータ推定を介する患者呼吸状態をモニタリングする非侵襲的方法 - Google Patents
逐次パラメータ推定を介する患者呼吸状態をモニタリングする非侵襲的方法 Download PDFInfo
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Description
表1−各Pmus(t)モデルのためのRrs推定器の式
Claims (15)
- 人工呼吸器が付けられた患者に換気をデリバリするベンチレータと、
前記人工呼吸器が付けられた患者の気道内圧Py(t)を測定する圧力センサと、
前記人工呼吸器が付けられた患者に入る及び前記人工呼吸器が付けられた患者から出る空気流量
前記測定された気道内圧Py(t)及び空気流量
前記MWLS推定の移動時間ウィンドウは、その継続時間をLとすると、時間tにおいて間隔[t−L+1,t]に及ぶものであり、
前記MWLS推定は、各移動時間ウィンドウについて、時間tにおける前記移動時間ウィンドウ内の前記圧力センサ及び前記空気流量センサの測定値を使用して最小二乗最小化方法により推定を行うものであり、前記移動時間ウィンドウが前進するにつれて連続的に行われ、
前記移動時間ウィンドウの継続時間は、呼吸器系エラスタンスErs及び呼吸器系抵抗Rrsが各移動時間ウィンドウ内で一定であるとみなされるように、呼吸サイクル継続時間の一部であり、各移動時間ウィンドウ内の呼吸筋圧Pmus(t)は、低次多項式関数を用いることにより近似される、医用ベンチレータデバイス。 - 前記MWLS推定は、前記MWLS推定の各移動時間ウィンドウについて、以下の演算:
(i)エラスタンス又はコンプライアンス、及び、(ii)抵抗のうちの一方を推定する演算(1)と、
前記演算(1)からの推定された値を使用して、(i)エラスタンス又はコンプライアンス、及び、(ii)抵抗のうちの他方を推定する演算(2)と、
前記演算(1)及び(2)において推定された値を使用して、呼吸筋圧を推定する演算(3)と
を順に行うことを含む、請求項1に記載の医用ベンチレータデバイス。 - 前記演算(1)は、エラスタンス又はコンプライアンスを推定し、前記演算(2)は、前記演算(1)からのエラスタンス又はコンプライアンスの推定された値を使用して、抵抗を推定する、請求項2に記載の医用ベンチレータデバイス。
- Pmus(t)は、時間の多項式関数によってモデル化される、請求項5に記載の医用ベンチレータデバイス。
- 前記演算(2)は、時間のゼロ次多項式関数、一次多項式関数及び二次多項式関数によってモデル化されたPmus(t)で繰り返され、これら3つの繰り返しの最適化されたエラスタンスErs又は抵抗Rrsが組み合わされる、請求項6に記載の医用ベンチレータデバイス。
- 前記演算(1)及び前記演算(2)の片方及び両方は、推定された値にカルマンフィルタを適用することを含む、請求項2乃至8の何れか一項に記載の医用ベンチレータデバイス。
- 前記演算(1)及び前記演算(2)の片方及び両方は更に、前記カルマンフィルタの雑音分散に基づいて、推定された値の不確実性のメトリックを生成することを含む、請求項9に記載の医用ベンチレータデバイス。
- 前記呼吸器系アナライザによって推定される前記人工呼吸器が付けられた患者の前記呼吸パラメータのうちの1つ以上を表示するディスプレイを更に含む、請求項1乃至10の何れか一項に記載の医用ベンチレータデバイス。
- 前記ベンチレータは、患者−ベンチレータ同期不全を低減するために、前記ベンチレータによって出力される空気陽圧を、前記呼吸筋圧Pmus(t)の増加する大きさ又は減少する大きさに同期して調整するようにプログラミングされている、請求項1乃至11の何れか一項に記載の医用ベンチレータデバイス。
- 前記呼吸器系アナライザは、呼吸仕事量WoBを、WoB=∫Pmus(t)dV(t)として推定し、式中、Pmus(t)は、前記MWLS推定を使用して推定される時間の関数としての呼吸筋圧であり、
前記ベンチレータは、推定された前記WoBを設定点WoB値に維持するように、前記ベンチレータによって提供される機械的人工換気を制御するようにプログラミングされている、請求項1乃至12の何れか一項に記載の医用ベンチレータデバイス。 - ベンチレータの患者の気道内圧Py(t)及び空気流量
(i)呼吸器系エラスタンスErs、(ii)呼吸器系抵抗Rrs、及び、(iii)呼吸筋圧Pmus(t)を推定するために、測定された気道内圧Py(t)及び空気流量
前記MWLS推定の移動時間ウィンドウは、その継続時間をLとすると、時間tにおいて間隔[t−L+1,t]に及ぶものであり、
前記MWLS推定は、各移動時間ウィンドウについて、時間tにおける前記移動時間ウィンドウ内の前記測定値を使用して最小二乗最小化方法により推定を行うものであり、前記移動時間ウィンドウが前進するにつれて連続的に行われ、
前記移動時間ウィンドウの継続時間は、呼吸器系エラスタンスErs及び呼吸器系抵抗Rrsが各移動時間ウィンドウ内で一定であるとみなされるように、呼吸サイクル継続時間の一部であり、各移動時間ウィンドウ内の呼吸筋圧Pmus(t)は、低次多項式関数を用いることにより近似され、
MWLS推定(i)は、
MWLS推定(ii)は、
MWLS推定(iii)は、
- 呼吸器系エラスタンスErsは、前記MWLS推定演算において、呼吸器系コンプライアンスCrs=1/Ersとして表される、請求項14に記載の非一時的記憶媒体。
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PCT/IB2016/053206 WO2016193915A1 (en) | 2015-06-02 | 2016-06-01 | Non-invasive method for monitoring patient respiratory status via successive parameter estimation |
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DE102020133460A1 (de) * | 2020-01-07 | 2021-07-08 | Drägerwerk AG & Co. KGaA | Verfahren und Signalverarbeitungseinheit zur Ermittlung eines pneumatischen Maßes unter Verwendung eines lungenmechanischen Modells und eines Verlaufsmodells |
CN113082412B (zh) * | 2021-03-30 | 2023-11-17 | 湖南万脉医疗科技有限公司 | 呼吸机的吸入气氧浓度分数控制系统 |
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EP3302664A1 (en) | 2018-04-11 |
JP2018516675A (ja) | 2018-06-28 |
CN107690310B (zh) | 2021-06-15 |
EP3302664B1 (en) | 2020-08-05 |
CN107690310A (zh) | 2018-02-13 |
US20180177963A1 (en) | 2018-06-28 |
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