RU2016140202A - Method for implementing artificial lung ventilation and the lung artificial ventilation device in which this method is implemented - Google Patents

Method for implementing artificial lung ventilation and the lung artificial ventilation device in which this method is implemented Download PDF

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Publication number
RU2016140202A
RU2016140202A RU2016140202A RU2016140202A RU2016140202A RU 2016140202 A RU2016140202 A RU 2016140202A RU 2016140202 A RU2016140202 A RU 2016140202A RU 2016140202 A RU2016140202 A RU 2016140202A RU 2016140202 A RU2016140202 A RU 2016140202A
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Russia
Prior art keywords
ventilation
volume
flow
lungs
minute
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RU2016140202A
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Russian (ru)
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RU2665624C2 (en
Inventor
Юрий Владимирович Кофман
Анатолий Викторович Сергиенко
Алексей Владимирович Чистяков
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Общество с ограниченной ответственностью Фирма "Тритон-ЭлектроникС"
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Priority to RU2016140202A priority Critical patent/RU2665624C2/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00Artificial respiration or heart stimulation
    • A61H31/02"Iron-lungs", i.e. involving chest expansion by applying underpressure thereon, whether or not combined with gas breathing means

Claims (48)

1. A method of performing artificial ventilation of the lungs, including determining the target minute breathing volume based on the ideal body weight and specific coefficient of the minute breathing volume, calculating the ratio of the respiratory rate and tidal volume corresponding to the minimum respiratory work, calculating the safe boundaries of the respiratory rate, tidal volume, inspiratory time and expiratory time, and the retention of the target minute volume of respiration when changing the respiration rate in the calculated safe limits, characterized in that the minutes the volume of respiration is automatically adjusted within a predetermined range when the spontaneous respiration rate goes beyond the limits of the calculated dynamic range.
2. The method of implementing artificial ventilation of the lungs according to claim 1, characterized in that the minute volume of respiration is automatically adjusted in the range,%: from the specific coefficient of the minute volume affixed by the doctor to 220.
3. The method of implementing artificial ventilation of the lungs according to claim 1, characterized in that the automatic adjustment of the minute volume of breathing is carried out depending on the frequency of spontaneous breathing.
4. The method of implementing artificial lung ventilation according to claim 2, characterized in that the upper limit of the adjustment of the minute volume of breathing is limited by the absolute value,%: 220.
5. A method of performing artificial ventilation of the lungs according to claim 2, characterized in that the lower limit of the minute volume of breathing is established on the basis of calculating the ideal body weight and selecting a specific coefficient for the minute volume of breathing.
6. The method of implementing artificial lung ventilation according to claim 1, characterized in that the upper limit of the tidal volume is determined by the formula:
Figure 00000001
where V Tmax is the upper limit of the tidal volume;
P max - the upper limit of the safe pressure set by the operator;
PEEP - positive pressure at the end of exhalation;
C st - static compliance;
K v - maximum volume ratio (default - 22)
IBW - ideal body weight;
V Tmin is the lower boundary of the tidal volume.
7. A method of implementing artificial lung ventilation according to claim 1, characterized in that the lower boundary of the tidal volume is determined by the formula:
Figure 00000002
where V Tmin is the lower boundary of the tidal volume;
V d is the estimated volume of dead space;
IBW - ideal body weight.
8. The method of implementing artificial ventilation of the lungs according to claim 1, characterized in that the upper limit of the safety of respiratory rate is determined by the formula:
Figure 00000003
where RB max is the upper limit of the safe respiratory rate;
RC exp - expiratory constant;
RB min is the lower limit of the safe respiratory rate.
9. The method of implementing artificial lung ventilation according to claim 1, characterized in that the lower limit of the safe respiratory rate is determined by the relationship:
Figure 00000004
where RB min is the lower limit of the safe respiratory rate;
IBW - ideal body weight.
10. The method of implementing artificial ventilation of the lungs according to claim 1, characterized in that the minimum expiration time is determined by full expiration (flow from the patient’s lungs is zero) or stabilization of flow, but not more than Te max ,
where Te max = 11 s.
11. The method of implementing mechanical ventilation according to claim 1, characterized in that the minimum inspiratory time is determined by the formula:
Figure 00000005
where Ti min is the minimum inspiration time;
Ti P is the pressure build -up time;
Ti f - time to reduce the flow to a level determined by the program (usually zero - for a full breath)
Ti max = 3 ... 5 s depending on the expiratory constant.
12. The method of implementing artificial lung ventilation according to claim 1, characterized in that the minute volume of respiration is automatically adjusted depending on the content of CO 2 in the output stream.
13. The method of implementing artificial ventilation of the lungs according to claim 12, characterized in that the adjustment of the minute volume of breathing is additionally carried out in accordance with the following algorithm: setting the upper and lower values of the range of CO 2 content in the output stream, measuring the actual CO 2 content in the output stream, comparing the actual content of CO 2 in the output stream to an upper value range a predetermined CO 2 content, comparing the actual content of CO 2 in the effluent to a lower value of the predetermined content range About 2, the adjustment of the respiratory minute volume at an output real-CO 2 content beyond a certain range of CO 2, the repetition cycle before entering the actual content in the exhaled CO 2 stream specified range of values of CO 2 in the exhaled flow.
14. The method of implementing artificial lung ventilation according to claim 12, characterized in that the CO 2 content in the expiratory fraction is determined by means of a capnograph.
15. The method of implementing artificial lung ventilation according to claim 12, characterized in that the rate of adjustment of the minute volume of respiration is 2% for each breath.
16. The method of implementation of artificial ventilation according to paragraphs. 1 and 12, characterized in that they use automatic adjustment of the minute volume of respiration according to one of the parameters: according to the frequency of spontaneous respiration or according to the content of CO 2 in the exhaled stream (according to the maximum adjustment).
17. An artificial lung ventilation apparatus comprising a gas mixer, a flow sensor, a flow generator, inhalation and exhalation lines, pressure sensors located in the inhalation and exhalation lines, an exhalation valve and a flow sensor located at the outlet of the exhalation valve, a ventilation controller electrically connected to a gas mixer, flow sensors, a flow generator, an exhalation valve and pressure sensors and an information input and output device connected to a ventilation controller, characterized in that the ventilation controller receives yes from flow and pressure sensors, calculates the parameters of inspiratory volume, suppleness and aerodynamic resistance, calculates the ratio of the respiratory rate and tidal volume corresponding to the minimum respiratory work, calculates the safe boundaries of the respiratory rate, tidal volume, inspiratory time and expiratory time, holds the target minute respiratory volume when changing the respiratory rate within the calculated safe limits, adjusting the minute volume of breathing within a predetermined range at the exit of sp ntannoy respiratory rate beyond the dynamic range calculated by the control action on the flow generator and an exhalation valve.
18. The artificial lung ventilation apparatus according to claim 17, characterized in that the ventilation controller receives data from flow sensors and according to the formula:
F lungs = F inspiratory -F exhalation ;
where F lungs is the flow of gas entering the patient's lungs;
F inspiration - gas flow at the inlet (on the tee, taking into account the contour);
F exhalation is the gas flow at the outlet (on the tee, taking into account the circuit),
moreover, the ventilation controller uses the F light value to calculate the control action on the flow control devices and valves.
RU2016140202A 2016-10-13 2016-10-13 Method of implementation of artificial lung ventilation and apparatus for artificial lung ventilation in which this method is implemented RU2665624C2 (en)

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RU2016140202A RU2665624C2 (en) 2016-10-13 2016-10-13 Method of implementation of artificial lung ventilation and apparatus for artificial lung ventilation in which this method is implemented

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Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2624744B1 (en) * 1987-12-18 1993-09-17 Inst Nat Sante Rech Med Method for regulating an artificial ventilation device and such a device
US6071237A (en) * 1999-02-19 2000-06-06 Institute Of Critical Care Medicine Device and method for assessing perfusion failure in a patient during endotracheal intubation
RU2255723C2 (en) * 2003-07-14 2005-07-10 Новокузнецкий государственный институт усовершенствования врачей Method for carrying out prolonged artificial pulmonary ventilation
DE602007009800D1 (en) * 2006-01-30 2010-11-25 Hamilton Medical Ag Device for regulating mechanical ventilation
RU2336859C2 (en) * 2006-10-18 2008-10-27 Общество с ограниченной ответственностью Фирма "Тритон-ЭлектроникС" Method for artificially pulmonary ventilation and device for its implementation
US8701665B2 (en) * 2009-07-25 2014-04-22 Fleur T Tehrani Automatic control system for mechanical ventilation for active or passive subjects

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Effective date: 20180425