RU2751651C1 - Hardware and software complex for physiotherapeutic training and prevention of respiratory diseases based on artificial lung ventilation apparatus - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: invention relates to medical equipment, namely to a hardware and software complex for physiotherapeutic training and prevention of respiratory diseases based on an artificial lung ventilation apparatus. The complex is comprised of an artificial lung ventilation apparatus with a control unit for adjusting pressure, oxygen content, frequency, and recurrence rate of respiratory gas supply. The complex includes a measuring unit including hardware for recording data on the current state of the subject, a programmable controller for collecting and processing the data on the current state of the subject received from the recording hardware, connected by the outputs thereof to the inputs of the control unit of the artificial lung ventilation apparatus, and a computer complex with software installed thereon. The measuring unit is equipped with an apparatus for recording the profile of volatile metabolites in the exhaled air, connected to the programmable controller. The computer complex is equipped with a program for processing the results of recording the profile of volatile metabolites in the exhaled air and a program for intelligent analysis of the data on the current state of the subject. Said computer complex is connected by direct and feedback connection to the programmable controller.

EFFECT: expanded operational capabilities of the complex based on an artificial lung ventilation apparatus.

3 cl, 1 dwg

Description

The invention relates to medicine, more specifically to the field of medical technology, and can be used in rehabilitation centers and clinics equipped with artificial lung ventilation devices (IVL), when training divers, climbers, in high-performance sports for the formation of correct breathing during physical exertion.

In various scientific publications, it is proposed to use the analysis of exhaled air, both for the diagnosis of diseases and for monitoring the physiological state of the human body. For this, directly exhaled air or its condensate is used. Known methods for detecting a number of diseases by the composition of exhaled air, for example, a method for the effective diagnosis of pneumonia in patients by measuring the maximum luminous flux intensity of the luminescence of exhaled air condensate [10], a method for diagnosing and monitoring chronic obstructive pulmonary disease [11]. The wide equipment of primary health care institutions with modern artificial lung ventilation (IVL) devices makes it possible to expand the arsenal of hardware for conducting treatment and prophylactic courses to improve breathing, increase lung volume, physiotherapy training and prevention of respiratory diseases in the mode of control of exhaled air with fixation of parameters and issuance of recommendations to the subject.

Known hardware and software complex (APC) for functional diagnostics of patients, containing a measuring unit and connected to an electronic signal processing unit. The electronic signal processing unit is made in the form of a personal computer equipped with a wireless interface of a personal computer, and the measuring unit is made in the form of a group of devices consisting of right and left spectrophotometric analyzers, right and left pulse oximeters, right and left skin temperature meters and a respiration rate meter, and also a data collection controller equipped with a wireless interface of a data collection controller, and the inputs-outputs of a group of devices are connected to the corresponding group of inputs-outputs of a data collection controller, which is connected to a wireless interface of a personal computer via the wireless interface of the data collection controller [12].

The technical solution under the patent RU 114409 has relatively narrow functionality. First of all, he does not use the analysis of the composition of organic metabolites of exhaled air, which prevents the solution of many problems of therapeutic and prophylactic courses to improve breathing, physiotherapy training and prevention of respiratory diseases, limiting himself to studying the microhemodynamics of the subject in motion.

The same disadvantages have APC for diagnosing the physiological state of the body, based on a biochemical study of the composition and properties of blood (Patent RU 2525432, 2014), and APC for automatic training of breathing muscles for patients receiving mechanical ventilation according to US patent 20130276787 A1, in which the analysis of exhaled air limited by pressure and volumetric content of oxygen and carbon dioxide [13].

The closest technical solution is a multifunctional artificially controlled or auxiliary ventilator (Patent RU 71250 U1). The multifunctional apparatus contains a blower and a rotonos mask for supplying breathing mixture, a master oscillator with a selectable frequency, master and receiving electrodes, and a synchronous detector. A microphone, a heart rate rheogram (HR) unit, a photocardiogram unit, a unit for synchronization and formation of a controlled shutter speed for the start of ventilation are introduced into it. The outputs of the generator are connected to the master electrodes, and the outputs of the receiving electrodes are connected to the signal inputs of the synchronous detector and to the inputs of the cardiac output rheogram unit, the outputs of the first and third receiving electrodes are connected to the inputs of the ECG unit, the microphone output is connected to the input of the photocardiogram unit, the output of which, as well as the outputs of the synchronous detector and the ECG unit are connected to the signal inputs of the synchronization unit and the formation of a controlled delay in the start of IVL, and the output of the unit for the formation of a controlled delay in the start of the ventilator through the blower and the oronas mask is the output of the IVL [14, selected as a prototype].

The device has the ability to control the delay in starting the blower and the delivery of the breathing mixture through the oronasal mask, depending on the physiological state of the subject (the beginning of inhalation and the beginning of cardiac output are measured). The common features of the claimed invention and the prototype are the presence of a ventilator, technical means for recording data on the current state of the subject, a synchronization system and a controlled delay in starting ventilator with a display.

The technical solution chosen for the prototype also has relatively narrow functionality. It is not suitable for physiotherapeutic training and prevention of respiratory diseases, since it does not allow changing the quantity and quality of the supplied respiratory mixture in accordance with the current physiological state of the subject and its dynamics.

The objective of the invention is to expand the functionality of the complex based on the ventilator by providing prompt changes in the parameters of the ventilator, taking into account the current state of the subject, for example, optimizing gas supply under conditions of increased physical exertion. The hardware-software complex based on the ventilator can be used as diagnostic, therapeutic or prophylactic physiotherapy equipment for primary care clinics, health, sports and training centers, and can be used in scientific research.

The required technical result is achieved by the fact that a device containing a ventilator (1) with a control unit (2), which provides regulation of pressure, oxygen content, frequency and frequency of delivery of the respiratory mixture, has a measuring unit and an electronic signal processing unit connected to it. Unlike the prototype, the measuring unit (7) is equipped, in addition to the known technical means for recording data on the current state of the subject (9-12), with a device for recording the profile of volatile metabolites (PLM) in the exhaled air (8). The signal processing unit is made in the form of a programmable controller (13), which provides the collection and processing of data from technical means of recording data on the current state of the subject and their transfer to a computer computer complex (14) with software installed on it, while commands from the processing unit can be received to the ventilator control unit and operate the various functions of this device. The instruments of the measuring unit (7) are connected to the programmable controller (13), the programmable controller is connected by direct and feedback to the computer computer complex (14), and the individual outputs of the programmable controller (13) are connected to the inputs of the control unit (2) of the ventilator.

As in the known analogs, the measuring unit may include a blood pressure meter (9), a blood oxygen saturation meter (10), means for registering an electrocardiogram (11), means for registering an electroencephalogram (12) and other meters, in accordance with the purposes of the required procedures.

The claimed APC for physiotherapeutic training and prevention of respiratory diseases differs from the known analogs using an artificial lung ventilation apparatus in that it is equipped with a device for registering the profile of volatile metabolites, and its computer complex (software part) is equipped with a program for processing the results of registering the profile of volatile metabolites in exhaled breath. air and the program of data mining about the current state of the subject. These signs are essential, ensuring the achievement of the claimed technical result and contributing to the solution of the task.

In a particular case, a laser optical-acoustic gas analyzer can be selected as a means of analyzing the exhaled air. These devices have an advantage over other known technical implementations of laser absorption gas analysis methods, in the case of dynamic observation of changes in the composition of exhaled air: the volume of the measuring optical-acoustic cell is 10-20 cm3, while the volume of the cells of absorption gas analyzers based on Bouguer's law at least a few liters. The volume of unforced expiration at rest is 300-900 ml. Accordingly, the optical-acoustic gas analyzer allows obtaining at least 15 readings during exhalation (at a constant radiation wavelength of the laser source). Absorption gas analyzers based on Bouguer's law only allow recording the parameters averaged over several exhalations.

The profile of volatile metabolites in exhaled air can be characterized indirectly by the shape of the absorption spectrum of exhaled air or directly using the program for processing and recording the results of spectral analysis of exhaled air. Thus, it is advisable to use the profile of volatile metabolites in exhaled air as a "state pattern".

In a specific implementation of the AIC, the computer computing complex can be equipped with a data store with replenished databases of text, graphic and sound tests, the results of their execution, the parameters of the ventilator and their dependence on the results of the data mining of the current state of the subject. This allows you to accumulate experience in the AIC, compare the results, collectively distinguish one state from another, implement machine learning algorithms and improve the efficiency of the device, even when working with one specific subject. A change in the physiological state of the subject causes a change in the group of pressure parameters, electrocardiogram and electroencephalogram [1, 2]. The relationship between the recorded parameters is not linear, and the assessment of the subject's state by a limited number of parameters is ineffective. Registration of the profile of organic volatile metabolites and the use of machine learning methods significantly expand the functionality of the APC based on the ventilator.

The essence of the claimed universal multifunctional hardware and software complex (APC) for physiotherapeutic training and prevention of respiratory diseases based on the ventilator is to establish a feedback between the parameters of the current state of the subject and the mode of operation of the ventilator. At the same time, the collection and transmission of data from technical means of recording data on the current state of the computer under test, classification of the current physiological state, access to replenished digital databases formed in the storage, regulation of the parameters of the ventilator in accordance with the tasks of training, prevention or rehabilitation of the system respiration taking into account the results of the classification of the current physiological state and its dynamics.

The technical solution is illustrated by a block diagram (Fig. 1), in which numbers indicate:

1 - ventilator;

2 - control unit;

3 - pressure regulator;

4 - oxygen content regulator;

5 - regulator of frequency and frequency of breathing mixture supply;

6 - subject;

7 - measuring unit containing technical means for recording data on the current state of the subject, including a device for recording the profile of volatile metabolites 8 (unit 7 may also include a blood pressure meter 9; a blood oxygen saturation meter 10; means for recording an electrocardiogram 11; means for registering an electroencephalogram 12 and other meters);

13 - programmable controller;

14 - computer computer complex with software.

Abbreviations used in the text of the description:

APK - hardware and software complex;

IVL - artificial ventilation of the lungs;

PLM - profile of volatile metabolites;

ECG - electrocardiogram;

EEG - electroencephalogram;

Software - software;

HR - heart rate;

IHT - Intensive Hypoxic Training.

The hardware and software complex (APC), like the known analogs, contains a ventilator (1), which has air channels for inhalation and exhalation and provides regulation of pressure, gas content and frequency of delivery of the respiratory mixture. The programmable controller (13) collects analog information from the technical means for recording data on the current state of the subject (block 7), translates them into digital form and transfers the data to a computer computer complex (14). The computing complex (14) is equipped with software installed on it, which allows, on the basis of the registered characteristics, to obtain information about the current state of the subject and to classify this state.

Currently, intensive scientific work is underway to study the gas composition of exhaled air and its comparison with the composition of the initial respiratory mixture, producing reliable data for the diagnosis of many respiratory diseases, recommendations are being developed for the prevention and rehabilitation of diseases of the respiratory system. On the other hand, it is known that the air that a person breathes, its pressure, gas composition, the content of ions, biologically active organic volatile substances is directly related to the physiological and psychological state of the body. The claimed invention helps to comprehensively solve both of these problems. A good result is provided by the supply of the analytical apparatus with the necessary reference material (updated databases), for example, based on machine learning by methods of pattern recognition.

The technical result of the invention is to expand the functional capabilities of the agro-industrial complex based on the ventilator, increase the arsenal of hardware for diagnostics, prevention and physiotherapy rehabilitation of respiratory diseases, training the respiratory system of athletes and professionals working in extreme conditions.

The work of the agro-industrial complex is carried out in the following order.

The ventilator 1 and the measuring unit 7, including the device for recording the profile of volatile metabolites in the exhaled air 8, are connected to the test subject. The medical specialist chooses the purpose of the procedure (training, prevention, treatment) and launches the appropriate program. The air channels of inhalation and exhalation are open, the subject breathes the air in the room. With the help of technical means for recording data on the current state of the subject, the physiological state of the subject is monitored. Then, the ventilator is turned on and the physical factors are applied that contribute to the training, prevention or rehabilitation of the respiratory system in accordance with the goals of the procedure. At the same time, the APC measuring unit contains a set of technical means for recording data on the current state of the subject corresponding to the task at hand (for example, a blood pressure meter, a blood oxygen saturation meter, a means for recording an electrocardiogram, a means for recording an electroencephalogram). Other devices used in analogs can also be connected.

Example 1. APK in training mode

In an illustrative example, the hardware and software complex is tuned, including the composition of the supplied breathing mixture, and, having set the appropriate programs, exercise, for example, the extensibility or elasticity of the respiratory muscles during prolonged breathing with rarefied air or oxygen-nitrogen mixture during diving. Analyzing the change in physiological parameters, the composition of the respiratory mixture that is optimal for the test subject is determined and a methodology for performing physical activity in extreme conditions is developed. For example, as a result of the action of a low oxygen content in the inhaled air, there is a significant (p <0.05) decrease in the amplitude of the alpha rhythm in most leads compared to the values in normoxia, in particular, in the occipital leads: the amplitude of the alpha rhythm decreases to 22, 03 ± 0.74 µV in the right occipital region and up to 24.20 ± 0.98 µV in the left occipital region [3]. With hypoxia, corresponding to an altitude of 5000 m above the sea surface, blood oxygen saturation drops to 85% or less, at an altitude of 6000 m - less than 70%, also on the ECG there is a deviation of the electrical axis of the heart to the left by 5-8 ° and flattening of the T wave in all leads, increased systolic blood pressure (SBP) and diastolic pressure [8], but significant differences between SBP before and after hypoxic training were revealed only at 12 minutes of short-term normobaric hypoxia. With short-term normobaric hypoxia, significant differences in heart rate were revealed before and after a course of intensive hypoxic training (IHT) at the 1st, 5th, 10th, 11th and 12th minutes of exposure. The maximum HR values during hypoxic exposure before the course of hypoxic training reached 96 ± 6 beats / min at the tenth minute, after - only 86 ± 5 beats / min [9, Fig. 2].

At the command of the operator, with the help of the SPO, control signals are sent to the ventilator control unit, a gas mixture with a component composition and physical parameters corresponding to the goals of the procedure enters the inspiratory channel. For example, during normobaric hypoxic training, the oxygen content in the inhaled mixture decreases to 15.4% -13.6% (corresponding to an altitude of 2500 to 3500 meters above sea level) [4]. To enhance the effect, the oxygen content can periodically (5-10 times) decrease to 9-10% (corresponds to an altitude of 5800 meters above sea level) [5].

Example 2. APK in prophylaxis mode

In an illustrative example, the APC may contain a touch screen display, through which a respiratory specialist, instructor or sports trainer can observe the operation of the ventilator, analyze physiological signals, and change the parameters of its operation. The user interface includes input devices (buttons, control knobs, switches, etc.), a keyboard, a mouse, a sound warning device, a light indicator, so that the user can manually perform a session of the developed respiratory disease prevention program. For example, with bioacoustic stimulation of the respiratory system, pressure modulation is created in the ventilation air duct of mechanical ventilation at individually selected frequencies in the range of 5 to 100 Hz [6, 7].

Example 3. APK in rehabilitation mode

The exhaled air is sampled through the exhalation air channel, and the profile of the volatile metabolites in the exhaled air is recorded by the device included in the APC. For example, when controlling oxidative stress (OS), OS markers are recorded, which include H2O2, lipid peroxidation products, NO, methylated alkanes, C4-C20 alkanes [1, 2]. Based on the obtained data on the state of the subject and the necessary reference data stored in the updated databases, and using machine learning methods implemented in the software, the current state of the subject is classified, a conclusion is made about the possibility of carrying out the procedure, and the optimal mode of its conduct is set.

The interest of doctors in the use of physiotherapy methods that help to reduce the drug load and prevent side effects of drugs in the treatment of therapeutic pathology is not weakening. One of these methods, based on the use of natural potassium salts, is salt therapy, which can be carried out using a ventilator. In recent years, the emergence of nosological forms in the form of irritative or allergic reactions of the respiratory tract has been observed. The positive therapeutic effect of the effects of natural potassium salts is provided due to immunomodulatory, hyposensitizing, mucolytic, draining and anti-inflammatory actions, which cause long-term sustained remissions, in particular in chronic bronchopulmonary and allergic diseases. The effectiveness of speleotherapy in the rehabilitation of, for example, allergies, with the correct selection of subjects, reached 93%. The procedure is completed when the planned results of the procedure are achieved, or according to other criteria, for example, if the subject's condition is out of the range of acceptable parameters.

Literature

1. Stephens J.W., Khanolkar M.R., Bain S.C. The biological relevance and measurement of plasma markers of oxidative stress in diabetes and cardiovascular disease // Atherosclerosis 202 (2009) 321-329.

2. Phillips M., Cataneo R. N., Cheema T., Greenberg J. Increased breath biomarkers of oxidative stress in diabetes mellitus // Clinica Chimica Acta 344 (2004) 189-194.

3. Borukaeva I.Kh., Abazova 3.X., Kumykov V.K. Influence of short-term hypoxia on the bioelectrical activity of the brain of children, adolescents and young men // Fundamental research. - 2014. - No. 4-3. - S. 466-471.

4. Ozolin E.S. The use of hyperbaric oxygenation and normobaric hypoxia in the preparation of athletes // Theory and practice of physical culture. - 2005. - No. 1. - S. 5-8.

5. Kolchinskaya A.Z., Tsyganova T.N. Ostapenko L.A. Normobaric interval hypoxic training in medicine and sports. M .: Medicine, 2003.408 p.

6. Naumenko Zh.K., Neklyudova G.V., Chikina S.Yu., Chernyak A.V. New functional research methods: pulse oscillometry and bronchophonography. Atmosphere. Pulmonology and Allergology. 2007; 2: 14-17.

7. Bogomolov A.V., Dragan S.P. Mathematical substantiation of the acoustic method for measuring the impedance of the respiratory tract. Reports of the Academy of Sciences. 2015; 464 (5): 623. DOI: 10.7868 / S0869565215290253.

8. Aghajanyan N.A. and other Military medical journal. 1959, no. 2.

9. Mateva E.V., Panteleeva N.I. The reaction of the human cardiovascular and respiratory systems to normobaric hypoxia before and after a course of interval hypoxic effects // Fundamental research. 2014. No. 6-7. S. 1406-1411.

10. Patent RU 2361513, IPC A61B 5/08, A61M 16/00, G01N 33/487, publ. 20.07.2009.

11. Bulanova A.A., Bukreeva E.B., Kistenev Yu.V. Modern problems of science and education. - 2014. - No. 4, URL: http://science-education.ru/ru/article/view?id=14408, access date: 16.07.2020.

12. Patent RU 114409, IPC A61B 5/00, publ. 03/27/2012.

13. Patent US 20130276787 Al, A61M 16/00 20060101, November 24, 2013.

14. Patent RU 71250, IPC A61M 21/00, publ. 10.03.2008.

Claims (3)

1. A hardware and software complex for physiotherapeutic training and prevention of respiratory diseases based on an artificial lung ventilation apparatus, containing a ventilator with a control unit that regulates pressure, oxygen content, frequency and frequency of delivery of the respiratory mixture, a measuring unit that includes technical means of data recording about the current state of the subject, a programmable controller that collects and processes data on the current state of the subject received from the technical means of recording, connected by its outputs to the inputs of the ventilator control unit, and a computer complex with software installed on it, characterized in that the measuring unit equipped with a device for recording the profile of volatile metabolites in the exhaled air, connected to a programmable controller, and the computer complex is equipped with a program for processing the results of registration of the profile cloudy metabolites in the exhaled air and a program for intelligent analysis of data on the current state of the subject, while the above-mentioned computer complex is connected by direct and feedback to a programmable controller. 2. Hardware and software complex for physiotherapeutic training and prevention of respiratory diseases according to claim 1, characterized in that said device for recording the profile of volatile metabolites in exhaled air is made on the basis of a frequency-tunable laser optical-acoustic gas analyzer. 3. Hardware and software complex for physiotherapeutic training and prevention of respiratory diseases according to claim 1, characterized in that the said computer complex contains a data store with replenished databases of text, graphic and sound tests, test results, parameters of the ventilator and their dependence on the results of data mining on the current state of the subject.

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