JPH02209157A - Artificial respirator - Google Patents

Abstract

PURPOSE:To selectively switch and use artificial breathing by a first breathing state and artificial breathing by a second breathing state by providing a switching means to be connected to an air sucking route and to switch the breathing state to the state, in which the supply of sucking gas is intermittently executed, and to the state in which the supply is continuously executed. CONSTITUTION:An opening and closing valve 11 constitutes the switching means and the sucking gas is intermittently supplied and interrupted by ON and OFF in a prescribed cycle. A variable diaphragm 12 constitutes a flow adjusting valve and changes the flow of the sucking gas flowing in a sucking route 3 to be large and small. At the time of the first breathing state, the comparatively large quantity of the sucking gas flows by the intermittent operation and at the time of the second breathing state, the comparatively small quantity of the gas flows by the continuous supply of the sucking gas. Signals are inputted from switches 61-64 to a control unit U and the switch 61 selects either the first breathing state and second breathing state. Then, the switch 62 commands an oscillation frequency in the second breathing state and the switch 63 commands the reciprocative stroke quantity of a linear motor 23. Further, the switch 64 commands average pressure in an adapter 1.

Description

[Detailed description of the invention] (Industrial application field) The present invention relates to a ventilator.

(Prior Art) A ventilator generally provides forced breathing to a patient at a low frequency, that is, at approximately the same number of breaths as a healthy person. More specifically, an intake passage connected to an intake gas supply source and an intake passage connected to the intake passage are provided, and by opening and closing, for example, an electromagnetic on-off valve provided in the intake passage at a predetermined period, Intake gas is supplied intermittently, and the intermittent supply cycle of intake gas is set to around 20 times per minute. In this application, such a breathing state will be referred to as a first breathing state.

On the other hand, recently, a ventilator has been developed that continuously supplies inspiratory gas while breathing at a high frequency, for example, 10 to 30 times per second, and has already been put into practical use by the present inventor. ing.

Artificial respiration using such high-frequency vibrations can perform extremely efficient gas conversion between the inspiratory gas and the patient's lungs, and does not require the patient's lungs to inflate or deflate significantly. It is attracting a lot of attention as. In this application, such a breathing state will be referred to as a second breathing state.

(Problem to be solved by the invention) By the way, in the recent medical world, during artificial respiration, artificial respiration in the first respiration state described above,
What is desired is a device that can selectively perform artificial respiration in the second breathing state.

However, in conventional artificial respirators, the one that performs artificial respiration in the first respiration state and the one that performs artificial respiration in the second respiration state are configured as completely separate devices. Therefore, in order to change the respiratory status, not only the ventilator itself had to be changed, but also the circuit connection of the ventilator to the patient had to be changed. This results in artificial respiration having to be interrupted for a considerable period of time. Furthermore, providing separate and independent respirators for each respiratory condition is disadvantageous from the viewpoint of cost, space, and the like.

Therefore, an object of the present invention is to provide a ventilator that can selectively use artificial respiration in a first breathing state and artificial respiration in a second breathing state.

(Means and operations for solving the problems) In order to achieve the above-mentioned object, the present invention has the following configuration. That is, a first breathing state in which inspiratory gas is intermittently supplied to perform low-frequency breathing, and a second breathing state in which inspiratory gas is continuously supplied and high-frequency breathing is performed selectively. A respirator configured to switch between an inspiratory passageway connected to a source of inspiratory gas, a first exhalation passageway for a first breathing state, and a second exhalation passageway for a second breathing state, each of which is connected to the inspiratory passageway. a passage; a switching means connected to the intake passage for switching between a state in which intake gas is supplied intermittently and a state in which intake gas is continuously supplied; a flow rate adjusting means for limiting the flow rate through the intake passage to a small amount when intake gas is continuously supplied; connected to the breathing passage including the intake passage, a first breathing passage, and a second breathing passage; an excitation means for applying high-frequency vibrations; the excitation means is connected to the intake passage at least closer to the supply source than the excitation means, and is activated during the second breathing state to apply high-frequency vibrations to the supply source side; filter means for preventing the gas from being transmitted; and first pressure regulating means each connected to the first exhalation passage and adjusting the exhalation pressure of exhaled gas from the first exhalation passage when in the first breathing state. and a first blocking means for blocking exhalation of exhaled gas from the first exhalation passage when in the second breathing state; It is characterized by comprising: a second pressure regulating means for adjusting the exhalation pressure from the exhalation passage; and a second blocking means for blocking the exhalation of exhaled gas from the second exhalation passage when in the first breathing state. The configuration includes a respirator.

The artificial respiration according to the present invention configured as described above includes the first
In the breathing state, intake gas is intermittently supplied by the switching means, the flow rate of the intake gas is increased by the flow rate adjustment means, the excitation means is stopped, and the filter means is inactivated; The second blocking means may be placed in the blocking state.

In addition, in order to enter the second breathing state, the switching means is used to continuously supply intake gas, the flow rate adjustment means is used to reduce the flow rate of the intake gas, the vibration means and the filter means are activated, and the first What is necessary is just to put a cutoff means into a cutoff state. By operating the filter means, the gas vibrations caused by the vibration excitation means are effectively carried out without being significantly damped. In other words, there is generally equipment such as a humidifier that occupies a large volume on the intake passage side, and if there is no filter means, the intake gas in this large volume will have to be unnecessarily agitated. It will disappear! Note that the first pressure adjustment means adjusts the average pressure during artificial respiration in the first breathing state, as in the conventional case, and the second pressure adjustment means adjusts the average pressure during artificial respiration in the second breathing state. Ru.

(Example) Examples of the present invention will be described below based on the attached drawings.

In FIG. 1, l is an adapter. This adapter 1
has a common connection port la connected to the patient's lungs, and four connection ports tb to le, first to fourth, respectively, connected to the common connection port la. An intake passage 3 extending from a storage tank 2 serving as a supply source of intake gas is connected to the first connection port 1b. The second connection port 1b has the first exhalation passage 4 for the first [+7 inhalation state, and the third connection port 1d has the second
A second exhalation channel 5 for respiratory conditions is connected. A pressure sensor 7 is connected to the fourth connection port 1e via a pressure transmission passage 6. Note that the tank 2 is provided with a pressure regulating valve (not shown) and the like so that intake gas at a predetermined pressure is supplied from there to the intake passage 3. Also, the second
The exhalation passage 5 has a smaller effective opening area than the other passages 3.4.

In the intake passage 3, sequentially from the t-flow side (tank 2 side) to the downstream side, there are an electromagnetic on-off valve 11, a variable throttle 12), a box 13 containing a check valve 13a, a humidifier 14. A rotary valve 15 is connected.

The on-off valve 11 constitutes a switching means, and is turned on and off in a predetermined cycle (low frequency cycle) to intermittently supply and cut off intake gas. Further, the on-off valve 11 continues to flow the intake gas by continuing to be turned on.

The variable throttle 12 constitutes a flow rate regulating valve, and changes the flow rate of the intake gas flowing through the intake passage 3 to a large or small value. Of course, in the first breathing state, a relatively large amount of inspiratory gas flows due to the intermittent operation of the inspiratory gas, and in the second breathing state, a relatively small amount of inspiratory gas flows due to the continuous supply of inspiratory gas. be made into

The box 13 allows the intake gas to flow toward the humidifier 14 at all times. An airbag 17 functioning as a type of accumulator is connected to this box 13 via a passage 16. Then, the flow from the box 13 side to the airbag 17 side is blocked by the check valve 13a.

The humidifier 14 humidifies the intake gas as in the conventional case, and in addition to this, it also warms the intake gas.

The rotary valve 15 constitutes a filter means, and in the first breathing state, its valve body 15a is in the state shown in FIG. 2, and the intake gas passes through a large space 15b around the valve body 15a. In other words, the effective opening area of the intake passage 3 is made sufficiently large. Further, in the second breathing state, the valve body 15a is in the state shown in FIG. 1, and the intake gas flows through the communication port (orifice) 15c formed in the valve body 15a and having a small effective opening area. . When the valve body 15a is in the state shown in FIG. 1, the rotary valve 15 as a filter means is activated.At this time, although the gas on the adapter l side is subjected to high frequency vibration, this high frequency vibration is It will not be transmitted to the upstream side of the rotary valve 15 (acts as a low-pass filter).

The first exhalation passage 4 is provided with an excitation device 2 as an excitation means.
1 is connected. The vibration device 21 includes a piston mechanism 22 and a linear motor 23 as a driving means for reciprocating the piston mechanism 22.

The piston mechanism 21 includes a cylinder 24 and a piston 25 slidably inserted into the cylinder 24. The piston 25 defines an operating chamber 26 within the cylinder 24. The working chamber 26 also constitutes a part of the first exhalation passage 3. In other words, the cylinder 24 has two boats 27 and 28, each opening into the working chamber 26. is formed, and the first exhalation passage 4 is connected to one boat 27, while the other boat 28 constitutes an exit boat of the first exhalation passage 4.

The outlet boat 28 includes a first pressure regulating means and a first
A control valve 29 is provided as a shutoff means. This control valve 29 is of a diaphragm type, and the casing 30
and a diaphragm 32 defining a pressure chamber 31 within the casing, with the diaphragm 32 facing the outlet boat 28.

A pilot passage 33 is connected to the pressure chamber 31, and a pressure regulating valve 34 is connected to the pilot passage 33. As a result, by adjusting the signal air pressure to the pressure chamber 31 with the pressure regulating valve 34, the outlet boat 27
The valve opening pressure of is adjusted. This valve opening pressure is set to a relatively small value in the first breathing state, and the discharge pressure from the first exhalation passage 4 in the first breathing state is adjusted (functions as a first pressure regulating means). ). Furthermore, in the second breathing state, the valve opening pressure of the outlet boat 27 is increased to prevent the pressure within the breathing passage from increasing abnormally (functions as a first blocking means).

The second exhalation passage 5 includes a second pressure regulating means and a second exhalation passage 5.
A control valve 41 as a shutoff means is connected. This control valve 41 is of a spool type, and has a casing 42 and a spool 43 slidably inserted into the casing 42. The casing 42 has an artificial boat 4 connected to the second exhalation passage 5 at one end of the spool 43 in the stroke direction.
4 is opened, and the boat 4 is opened at the other end side in the stroke direction.
5 is open. Further, the casing 42 has an outlet boat 46 opened to the atmosphere and a photo 47 opened in the radial direction of the spool 43. - On the other hand, the spool 43 has a valve portion 43a formed at the end on the outlet boat 44 side, and this valve portion 43a is attached to a valve seat 42a formed on the inner peripheral edge of the outlet boat 44 according to the sliding movement of the spool 43. He was taken off and seated. And spool 4
3 is biased by a return spring 48 in a direction in which the valve portion 43a is separated from the valve seat 42a. When the valve part 43a is separated from the valve seat 42a, the inlet boat 44 is communicated with the outlet boat 46, and conversely, when the valve part 43a is seated on the valve seat 42a, both the boats 44 and 46 are communicated with each other.
(functions as a second blocking means - see Figure 3). Note that the sliding of the spool 43 (the valve seat 4 of the valve portion 43 a)
2a) is switched by supplying and cutting off signal air pressure, which will be described later, from the boat 45.

The spool 43 is formed with a small-diameter nozzle portion 43b that extends toward the inlet boat 44, and a communication path 43c that communicates the nozzle portion 43b with the boat 47. As a result, when air is supplied from the boat 47 in the state shown in FIG. 1 where the inlet boat 44 is in communication with the outlet boat 46, this air is injected from the nozzle portion 43b, and by adjusting the air pressure to be injected, The discharge pressure from the second exhalation passage 5 is adjusted (functions as a second pressure adjustment means).

A three-way switching valve 49 is attached to the control valve 41. This three-way switching valve 49 is always supplied with air at a predetermined pressure from one passage 50, and this air is supplied to the boat 4 through a passage 51 depending on the switching mode of the three-way switching valve 49.
7 (second breathing state) and a state in which the boat 45 is supplied via the passage 52 (first breathing state)
It can be switched to The air pressure supplied to the passage 51 or 52 is then adjusted by an electropneumatic converter 53.

A passage 52a branches off from the passage 52, and this branch passage 52a is connected to the passage 16 for the airbag 17. A variable throttle 54 is connected to this branch passage 52a.

By adjusting the variable throttle 54, a predetermined amount of air is stored in the airbag 17 at least in the first breathing state.

In FIG. 1, U is a control unit configured using a microcomputer. In addition to the signals from the pressure sensor 7, signals from the switches 61 to 64 are input to the control unit U. In addition, from the control unit U, each of the above-mentioned air intakes 11.12.15.23.34.49.53
．． 54. Among the switches 61 to 64,
The switch 61 is for selecting between the first breathing state and the second breathing state. The switch 62 is for commanding the excitation frequency (stepless from lOHz to 30F1Z) in the second breathing state. The switch 63 is the linear motor 2
This command commands the reciprocating stroke amount of 3. The switch 64 commands the average pressure within the adapter 1.

Next, the operation of the above configuration will be explained.

(2) Second breathing state At this time, the linear motor 23 is driven to apply high frequency vibration to the breathing circuit. The same number of reciprocations of the piston 25 at this time is the frequency of high-frequency vibration (IO) (z ~ 30
H7,) is determined, and the reciprocating stroke is the amount of vibration work to be applied (set according to the patient's lung pressure).
. In this second breathing state, the operating states of each device are as follows. First, the on-off valve 11 is kept open. The variable throttle 12 has a small opening degree to limit the flow rate. The rotary valve 15 is placed in the state shown in FIG. 1 in order to prevent high-frequency vibrations from being transmitted to the upstream side of the humidifier 14 and the like. The pressure regulating valve 34 controls the large air pressure into the pressure chamber 3.
1 and causes the control valve 29 to function as a safety valve (relief valve). The three-way switching valve 50 supplies air to the passage 51 side and opens the passage 52 side to the atmosphere. As a result, the control valve 41 controls the inlet boat 44 as shown in FIG.
The nozzle 43b is in communication with the outlet boat 46.
Air is injected from. This injection air pressure is determined by the pressure sensor 7
The electropneumatic converter 53 is adjusted by feedback control so that the pressure read out becomes the specified pressure (average pressure).

(1) First breathing state At this time, the linear motor 23 is stopped F (the piston 25 is stopped, for example, at the left stroke end in FIG. 1), and the various devices are operated as follows. First, the on-off valve 11 is repeatedly opened and closed in a cycle corresponding to the natural breathing frequency of a healthy person (approximately 20 times per minute).

The opening degree of the variable throttle 12 is increased in order to increase the flow rate.

The rotary valve 15 is constructed as shown in FIG. The three-way switching valve 50 is switched to supply air to the passage 52 side. As a result, the subur 43 becomes as shown in FIG. 3, the second exhalation passage 5 is closed, and the nozzle part 4
Air injection from 3b is also not performed. The pressure regulating valve 34 is feedback-controlled so that the pressure detected by the pressure sensor 7 becomes a designated pressure (average pressure).

Note that when the patient himself/herself performs a breathing motion and the intake gas becomes insufficient, the check valve 13a is opened and the airbag 17 is opened.
The air inside is supplied to the adapter 1 side.

Although the embodiments have been described above, the present invention is not limited thereto, and includes, for example, the following cases.

(2) The second exhalation passage 5 may be branched from the first exhalation passage 4 instead of being provided in parallel with the first exhalation passage 4.

(2) The vibration device 21 can be connected not only to the first exhalation passage 4 but also to the second exhalation passage 5 or the intake passage 3. Of course, it is preferable to connect the vibration bag @21 as close as possible to the adapter 1 in order to effectively apply high frequency vibration to the patient's lungs.

■The vibration device 21 is of an appropriate type, for example, a floor as a rotary blower and a rotary type switching valve are provided, and the switching valve alternately connects the breathing circuit to the suction port and the discharge port of the blower. Vibration can also be applied by

(Effects of the Invention) As is clear from the above description, the present invention can easily and quickly switch between the first breathing state and the second breathing state. In addition, since there are many devices that can be shared between each person's respiratory system for the first and second breathing conditions, it takes less cost and space compared to installing these separately. It is also advantageous from a superior standpoint.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an overall system diagram showing one embodiment of the present invention. FIGS. 2 and 3 are diagrams showing operating modes of main equipment that are different from those shown in FIG. 1. 1: Adapter (for patient connection) 2: Tank (inhalation gas supply source) 3: Intake passage 4: 1st expiration passage 5: 2nd exhalation passage 11: Opening/closing valve (switching means) 12: Restrictable restrictor (flow rate adjustment means) 14: Humidifier 15: Rotary valve (filter means) 21: Vibrator 22: Piston mechanism 23: Linear motor 29: Control valve (first pressure adjustment means, first cutoff means) 41: Control valve (second pressure adjustment means, second blocking means)

Claims (5)

[Claims] (1) Selectively switch between a first breathing state in which inspiratory gas is intermittently supplied to perform low-frequency breathing, and a second breathing state in which inspiratory gas is continuously supplied and high-frequency breathing is performed A ventilator configured to provide a ventilator, comprising: an intake passage connected to a supply source of intake gas; and a first intake passage for a first breathing state, each of which is connected to the intake passage.
an exhalation passage and a second exhalation passage for a second breathing state; and a second exhalation passage connected to the intake passage for switching between a state in which the supply of inspiratory gas is performed intermittently and a state in which the supply of inspiratory gas is continuously performed. a switching means connected to the intake passage, and a flow rate adjusting means for restricting the flow rate through the intake passage to a small value when intake gas is continuously supplied; an excitation means for applying high-frequency vibrations, the excitation means being connected to the inhalation passageway at least on the supply source side of the excitation means, and being connected to the inhalation passageway in the second respiration state; filter means which are actuated to prevent high frequency vibrations from being transmitted to the source side; and filter means, each connected to the first exhalation passage, to prevent exhaled gas from the first exhalation passage when in the first breathing condition. a first pressure regulating means for adjusting the exhalation pressure of the exhalation passage, and a first blocking means for interrupting exhalation of exhaled gas from the first exhalation passage when in the second breathing state, each connected to the second exhalation passage. ,
a second pressure regulating means for adjusting exhalation pressure from the second exhalation passage when in the second breathing state; and a second pressure regulating means for blocking exhalation gas from the second exhalation passage when in the first breathing state. 2. A respirator, characterized in that it is equipped with two shutoff means. (2) The device according to claim 1, wherein a humidifier is connected to the intake passage, and the filter means is arranged downstream of the humidifier. (3) In claim 1, the switching means is constituted by an on-off valve. (4) The device according to claim 1, wherein the flow rate adjusting means is constituted by a variable throttle. (5) In claim 1, the filter means increases the effective opening area of the intake passage in the first breathing state and increases the effective opening area of the intake passage in the second breathing state. It consists of a switching valve that reduces the size.