RU2336859C2 - Method for artificially pulmonary ventilation and device for its implementation - Google Patents

Method for artificially pulmonary ventilation and device for its implementation Download PDF

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Publication number
RU2336859C2
RU2336859C2 RU2006136947/14A RU2006136947A RU2336859C2 RU 2336859 C2 RU2336859 C2 RU 2336859C2 RU 2006136947/14 A RU2006136947/14 A RU 2006136947/14A RU 2006136947 A RU2006136947 A RU 2006136947A RU 2336859 C2 RU2336859 C2 RU 2336859C2
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Russia
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ventilation
beginning
respiratory
gas mixture
pause
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RU2006136947/14A
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Russian (ru)
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RU2006136947A (en
Inventor
Михаил Борисович Конторович (RU)
Михаил Борисович Конторович
Борис Давидович Зислин (RU)
Борис Давидович Зислин
ков Алексей Владимирович Чист (RU)
Алексей Владимирович Чистяков
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Общество с ограниченной ответственностью Фирма "Тритон-ЭлектроникС"
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Abstract

FIELD: medicine.
SUBSTANCE: invention relates to medicine and can be made used of in anesthesiology and critical care medicine, in particular for provision of biomechanics monitoring of breath and gas mixture composition in the process of jet pulmonary ventilation. Parameters of breath mechanism and the gas mixture composition are measured together with estimated result in accordance with physiologic norms. Respiratory support is also implemented, as well as a pause during 3-6 seconds, the beginning of which is chosen in arbitrary respiratory cycle simalteneousle with termination of the inhale phase and the beginning of the exhale phase 0.1-0.2 seconds prior the pause termination the measurement of alveolar pressure and carbonic acid and oxygen content are implemented. The ventilation is implemented with the frequency of 60-300 cycles a minute and turbulent current with the speed above 5 m/second.
EFFECT: provision of respiratory support parameters control registration.
5 dwg

Description

The invention relates to medicine and can find application in anesthesiology and intensive care, in particular when monitoring the biomechanics of respiration and the composition of the gas mixture during jet ventilation of the lungs.

There is a known method of artificial ventilation of the lungs, in which a device is connected to the patient’s highway, by which the parameters of respiratory mechanics of respiration and the composition of the gas mixture are measured, the results of measurements are evaluated in accordance with physiological norms, and respiratory support is performed according to the results of the assessment [1, 2].

A device for artificial ventilation of the lungs is also known, comprising a control unit, a jet artificial ventilation unit of the lungs, a patient line and a parameter display unit [3].

The method of artificial ventilation of the lungs described in [3] and the device for its implementation are characterized by limited functional capabilities due to the inability to monitor such important parameters of the respiratory function as the flow rate and gas volume during the respiratory cycle, as well as the concentration of oxygen and carbon dioxide in the alveolar gas. The well-known principles for recording these parameters are not applicable in conditions of jet ventilation with a frequency of 60-300 cycles per minute with a turbulent gas flow at a speed exceeding 5 m / s.

The invention solves the problem of creating a method of artificial ventilation of the lungs and a device for its implementation, characterized by wide functional capabilities due to the ability to monitor such important parameters of the respiratory function as the flow rate and gas volume during the respiratory cycle, as well as the concentration of oxygen and carbon dioxide in the respiratory gas mixture with at a frequency of 60-300 cycles per minute with a turbulent gas flow at a speed exceeding 5 m / s.

To solve the problem in the method of artificial ventilation of the lungs when measuring the parameters of respiratory mechanics of respiration and the composition of the gas mixture in the patient’s main, it is proposed according to the present invention to pause for 3-6 seconds, the beginning of which should be selected in an arbitrary respiratory cycle simultaneously with the moment of the end of the inspiration phase and the beginning of the phase expiration, during which to measure the alveolar pressure and alveolar content of carbon dioxide and oxygen, while the process is carried out at frequencies at 60-300 cycles per minute and turbulent flow with a speed of more than 5 m / s, then the measurement results are evaluated in accordance with physiological norms and respiratory support is carried out by the respirator unit according to the evaluation results.

To solve the problem, in a device for artificial ventilation of the lungs, comprising a control unit, an artificial lung ventilation unit, a respiratory mechanics unit, and a parameter display unit associated with a patient main, it is proposed according to the present invention to introduce a capnometry unit and a unit for measuring oxygen concentration in a gas mixture, connected to the control unit and the patient line, providing measurements of respiration mechanics and the composition of the gas mixture at frequencies of 60-300 cycles per minute turbulent flow and velocity of more than 5 m / s.

The inventive method of artificial ventilation and a device for its implementation are illustrated by the example of the drawings.

Figure 1 presents a block diagram of the inventive device; figure 2 - dependence of the operating mode of the device in time; figure 3 - dependence of airway pressure on time; figure 4 - dependence of the concentration of oxygen in the respiratory tract from time to time; figure 5 - dependence of the concentration of carbon dioxide in the respiratory tract from time to time.

The device for artificial ventilation of the lungs contains a control unit 1 electrically and pneumatically interconnected, an artificial lung ventilation unit 2, a patient manifold 3, a parameter display unit 4, a respiratory mechanics unit 5, a capnometry unit 6, and an oxygen measurement unit in the gas mixture 7.

The results of monitoring the flow rate, the volume of the gas mixture and the oxygen and carbon dioxide content in the alveolar gas, respectively, from the capnometry unit 6 and the unit for measuring oxygen in the gas mixture 7, measured at frequencies of 60-300 cycles per minute and turbulent flow velocity of more than 5 m / s, transmitted to the control unit 1 and displayed on the display unit 4, connected to the control unit 1.

The method of artificial lung ventilation is as follows. A device for jet mechanical ventilation of the lungs is connected to the patient. Using this device, artificial lung ventilation is carried out, during the implementation of which pressure in the airways is recorded and peak pressure (PIP), pressure at the end of exhalation of PEEP, are measured. At a given point in time, control unit 1 gives a command to pause 2 for blasting artificial ventilation of the lungs, at the end of which, at time T 1 , when the exhaled air reaches the alveolar concentration, the concentration of carbon dioxide and oxygen is measured, if necessary, the resuscitator can isolate the line the patient from the atmosphere and in this case, in addition to the peak pressure (PIP), the pressure at the end of the expiration of the PEEP, the alveolar pressure Pp1 (Auto PEEP) is measured (see FIG. 3).

The measurement results displayed on the display unit 4 are compared with the physiological norm values corresponding to them, and the patient's respiratory support parameters, in particular the minute volume of breathing and the flow rate of the respiratory mixture, are corrected according to the measurement results.

A temporary pause is performed for a duration of 3-6 seconds, during which, at time T 1 , the alveolar pressure and alveolar content of oxygen and carbon dioxide are measured, as shown in FIGS. 4 and 5, while the time measurement T 1 is selected as 0.1- 0.2 s to the end of the pause. The values of the measured parameters of oxygen and carbon dioxide at time T 1 correspond to the concentration of oxygen and carbon dioxide in the alveolar gas.

The moment of the beginning of the pause is selected in an arbitrary respiratory cycle at the end of inspiration. The value of the time interval between pauses can be set by the resuscitator at his discretion, from 30 s to 10 minutes.

Implementation of the proposed method of artificial lung ventilation and a device for its implementation will allow you to record the biomechanics of mechanical ventilation and gas exchange parameters at high respiration rates, 60-300 cycles per minute, and a turbulent flow, the speed of which exceeds 5 m / s.

The inventive method of artificial ventilation and a device for its implementation have been tested in the clinic of pulmonary surgery in Yekaterinburg. Its use made it possible to record more precise control of the parameters of respiratory support and earlier excommunication of the patient from the mechanical ventilation apparatus in comparison with the known similar methods and devices.

Literature

1. V.L. Kassil, M.A. Vyzhigina, G.S. Leskin. Artificial and assisted ventilation. M .: Medicine, 2004, p. 64.

2. B.D. Zislin, A.V. Chistyakov. Monitoring of respiration and hemodynamics in critical conditions. Yekaterinburg. Sokrat Publishing House, 2006, p.136.

3. Zislin B.D. High frequency ventilation. Yekaterinburg, Sokrat Publishing House, 2001, p.32.

Claims (1)

  1. A method of artificial ventilation of the lungs, including measuring the parameters of the mechanics of respiration and the composition of the gas mixture, evaluating the results of measurements in accordance with physiological norms and providing respiratory support, characterized in that they pause for 3-6 seconds, the beginning of which is chosen in an arbitrary respiratory cycle at the same time the end of the inhalation phase and the beginning of the exhalation phase, and 0.1-0.2 s before the end of the pause, the alveolar pressure and alveolar content of carbon dioxide and acid are measured kind, while ventilation is carried out at frequencies of 60-300 cycles per minute and a turbulent flow velocity of more than 5 m / s.
RU2006136947/14A 2006-10-18 2006-10-18 Method for artificially pulmonary ventilation and device for its implementation RU2336859C2 (en)

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RU2336859C2 true RU2336859C2 (en) 2008-10-27

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2597944C2 (en) * 2010-11-11 2016-09-20 Конинклейке Филипс Электроникс Н.В. Algorithm of chest movement repetition for automated cardiopulmonary resuscitation device
US9636058B2 (en) 2012-03-01 2017-05-02 Koninklijke Philips N.V. Sensor for determining concentration of gas
RU2665624C2 (en) * 2016-10-13 2018-09-03 Общество с ограниченной ответственностью Фирма "Тритон-ЭлектроникС" Method of implementation of artificial lung ventilation and apparatus for artificial lung ventilation in which this method is implemented
RU2695702C1 (en) * 2018-06-07 2019-07-25 Федеральное государственное бюджетное образовательное учреждение высшего образования "Алтайский государственный медицинский университет" Министерства здравоохранения Российской Федерации Method for determining driving pressure during artificial pulmonary ventilation

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
ЗИСЛИН Б.Д. Высокочастотная вентиляция легких. - Екатеринбург: СОКРАТ, 2001, с.32. *

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2597944C2 (en) * 2010-11-11 2016-09-20 Конинклейке Филипс Электроникс Н.В. Algorithm of chest movement repetition for automated cardiopulmonary resuscitation device
US9636058B2 (en) 2012-03-01 2017-05-02 Koninklijke Philips N.V. Sensor for determining concentration of gas
RU2665624C2 (en) * 2016-10-13 2018-09-03 Общество с ограниченной ответственностью Фирма "Тритон-ЭлектроникС" Method of implementation of artificial lung ventilation and apparatus for artificial lung ventilation in which this method is implemented
RU2695702C1 (en) * 2018-06-07 2019-07-25 Федеральное государственное бюджетное образовательное учреждение высшего образования "Алтайский государственный медицинский университет" Министерства здравоохранения Российской Федерации Method for determining driving pressure during artificial pulmonary ventilation

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