RU2788809C1 - Device and method for measuring inspiratory rate in patients with broncho-obstructive diseases - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: inventions group relates to medical equipment, namely to a device for measuring inhalation volume in patients with broncho-obstructive diseases and a method for measuring inhalation volume in patients with broncho-obstructive diseases. The device contains a plastic case consisting of a chamber and a cap, a cover for resistance regulation. The cap and cover for resistance regulation contain marks, a mouthpiece, a scale for measuring the volume of the inhaled air flow, a resistance regulation scale, a metal rod located inside the body, on which a slider and a weight for reset are mounted, and a slider is also movably mounted. The cap and cover for resistance adjustment contain three calibration holes arranged symmetrically with respect to each other. The plastic case of the device is made of a transparent material with sufficient transparency for visual inspection. The device includes a button for turning on the device and resetting the readings, with a reciprocating mechanism configured to abut against the cap, which is adjacent to the rod due to the cap for adjusting the resistance. The button for turning on the device and resetting the readings is made with the possibility of moving the slider to the initial position, and is also made with the possibility of turning the device on and off. A one-way valve is installed in the lid to control the resistance, designed to prevent exhalation into the device. The slider and weight for dumping are made magnetic. The drop load is configured to return the slider to its original position. The method includes measuring the inspiratory volume of patients with broncho-obstructive diseases using the device. The method includes measuring an inspiratory flow value achieved by the patient during inhalation based on a minimum inspiratory airflow pressure. The method determines the readiness of the device for measuring inhalation volume for operation and the correct connection of the mouthpiece, regulates the resistance of the inhaled air flow by changing the area of the gap between the holes of the cap and the cover to control the resistance. In the method, the patient is prevented from exhaling into the device by means of a one-way valve installed in the cover to regulate the resistance. Also in the method, before starting measurements, the readings are reset using the button for turning on the device and resetting the readings.

EFFECT: accurate measurement by the doctor of the inspiratory rate with the necessary pre-set resistance, which allows assessing the ability to perform the inspiratory maneuver necessary for the use of the drug with one or another type of delivery method (type of inhaler).

7 cl, 3 dwg

Description

The invention relates to medicine, in particular to pulmonology and internal medicine, and can be used to treat patients with broncho-obstructive diseases, in particular, to assess the ability of patients to inhale a certain force in order to select an inhaler with the drug delivery system that suits the patient, as well as for teaching patients the correct technique of inhalation, taking into account the strength and speed of the flow of inhaled air.

Experimental data indicate that 88% of patients with asthma and chronic obstructive pulmonary disease (COPD) who used inhalers showed at least one error in the use of drugs with an inhalation route of administration. Two weeks after the briefing, patients again had problems with the use, so training and monitoring should be repeated periodically. Patients unable to manage one type of inhaler, when transferred to another type, showed more successful treatment outcomes. Therefore, the choice of treatment must take into account various factors, such as age, the ability to learn the correct use of drugs with inhalation route of administration and individual preferences of patients.

Errors in the technique of inhalation reduce the effectiveness of therapy, therefore, for the success of treatment, it is very important that the patient understands the essence of the therapy being taken, knows how to use the inhaler correctly and follows the doctor's prescription.

The inspiratory effort required to use inhalation devices effectively depends on the maximum inspiratory flow achieved by patients. Effective use of inhalation devices requires a minimum flow rate, and this flow rate may vary depending on the type of device in a given medicinal product.

The maximum flow rate achievable by the patient depends on the airflow resistance associated with the inspiratory rate device. Patients may not have enough inspiratory force to achieve flow rates above a certain minimum if the resistance of the inspiratory rate device is too high. Therefore, in order to select the appropriate drug for inhalation administration, it is important to choose an inhaler in which the required inhalation resistance matches the patient's capabilities.

The closest analogue of the proposed invention are the device and method for measuring the inspiratory force of the patient described in the patent for the invention US 6450969 B1 (CL. A61 B 5.08, 17.09.2002). The known device contains a plastic case, consisting of a chamber and a cap, a valve for regulating resistance, a mouthpiece, a scale for measuring the airflow rate during inhalation, a calibration scale, a metal rod located inside the case, on which a slider and a weight for reset are mounted. A known method for measuring the inspiratory force of patients with broncho-obstructive diseases includes adjusting the resistance, measuring the value of the inspiratory flow achieved by the patient during inhalation, based on the minimum airflow pressure generated by inhalation.

The disadvantages of the known analogue are the lack of disinfectants in the known device, which can lead to a deterioration in the patient's health. Due to the insufficient size of the grooves in the valve to regulate the resistance and in the cap (small capacity), high breathing resistance is created, which requires the creation of a significant inspiratory pressure drop, which is difficult to develop in patients with broncho-obstructive diseases.

The technical objective of the invention is to improve the accuracy of the doctor's assessment of the patient's ability to inhale a certain force and speed in order to select an inhaler with the drug delivery system that suits the patient, as well as to educate patients in the correct inhalation technique, taking into account the strength and speed of the inhaled air flow. The patient needs to learn how to inhale correctly when using an inhaled drug with one or another drug delivery system.

The technical result of the proposed invention consists in the doctor accurately measuring the inspiratory rate with the necessary pre-set resistance, which makes it possible to assess the ability to perform the inspiratory maneuver necessary to use the drug with one or another type of delivery method (type of inhaler).

The inhalation rate device is designed to assess the condition of patients with broncho-obstructive diseases, as well as to simulate the resistance of inhalation devices, which allows doctors to teach patients the correct inhalation technique when using an inhaler, taking into account the force and flow rate to achieve the most effective delivery of the inhaled drug to the lungs.

Inhalers for the treatment of broncho-obstructive diseases are classified by resistance.

The technical result is achieved by the fact that the device for measuring the inspiratory rate in patients with broncho-obstructive diseases, containing a plastic housing, consisting of a chamber and a cap, a cover for regulating resistance, while the cap and cover for regulating resistance contain marks, a mouthpiece, a scale for measuring the volume of inhaled air flow, a resistance adjustment scale, a metal rod located inside the body, on which a slider and a weight for resetting are installed, and a slider is movably mounted, a cap and a cover for resistance adjustment contain at least three calibration holes located symmetrically relative to each other, at the same time, the plastic case of the device is made of a transparent material with a transparency sufficient for visual control according to the invention , contains a button for turning on the device and resetting the readings, with a reciprocating mechanism configured to abut against the cap, which is adjacent to the rod due to the cover for resistance control, while the button for turning on the device and resetting the readings is made with the possibility of moving the slider to the initial position, and is also made with the possibility of turning the device on and off, a one-way valve is installed in the cover for resistance control, configured to obstructing exhalation into the device, while the slider and the weight for resetting are made magnetic, in addition, the weight for resetting is made with the possibility of returning the slider to its original position.

In addition, it contains an adapter for changing mouthpieces, the mouthpiece contains a double-sided mesh filter, made with the possibility of unhindered inhalation, the inner surface of the mouthpiece is coated with antiseptic impregnation, and the inner surface of the mouthpiece is coated with antiseptic impregnation.

The technical result is achieved by the fact that a method for measuring the inhalation volume of patients with broncho-obstructive diseases using a device, including measuring the value of the inspiratory flow achieved by the patient during inhalation, obtained on the basis of the minimum air flow pressure generated by inhalation, in addition, determine the readiness of the device for measuring inhalation volume to work and the correct connection of the mouthpiece, regulate the resistance of the flow of inhaled air by changing the area of the gap between the holes of the cap and the cover to regulate the resistance, prevent the patient from exhaling into the device through a one-way valve installed in the cover to regulate the resistance, while before starting measurements, reset the readings using buttons for turning on the device and resetting the readings.

In addition, the mouthpiece and mouthpiece are stored in a sealed package before use.

The invention is illustrated by drawings.

Figure 1 shows the appearance of the device for measuring the inspiratory rate in patients with broncho-obstructive diseases; figure 2 is a sectional view of a device for measuring inspiratory velocity in patients with broncho-obstructive diseases (assembly for adult patients); figure 3 is a separate view of the cap and cover for adjusting the resistance.

The device for measuring inspiratory force in patients with broncho-obstructive diseases contains a cylindrical plastic body 1, a chamber 2 with holes, a cap 3, a mouthpiece 4 and a cover 5 for resistance regulation. The cap 3 and the cap 5 for adjusting the resistance are connected by means of a threaded connection. A metal rod 6 is installed inside the chamber 2, on which a slider 7, a magnetic slider 8, and a magnetic drop weight 9 are movably mounted. The metal rod 6 is made of a ferromagnetic metal, in particular iron or nickel.

Inside cover 5 there is a check valve made of rubber and consisting of two parts - a rubber washer and a polymer bed.

Different levels of resistance are achieved by matching the holes 10 in the cap 5 with the holes 11 in the cap 3. The different resistance values are displayed on the resistance adjustment scale 12 when one of the marks 13 on the variable resistance adjustment cap 5 matches the mark 14 on the cap 3. Holes 10 in the cap 5 and the holes 11 in the cap 3 are symmetrical and are the same in one device. Moreover, depending on the required resistance, they can be of different shapes, in particular, round or oval.

The conducted tests have shown that for persons who have a high probability of respiratory failure and the volume-velocity parameters of inhalation may decrease, the most optimal is the number of holes from 3 to 8 in the cap 3 and lid 5, as well as their implementation with an area of 2.5 mm ² , 3 .25 mm ² 5.0 mm ² .

The size of the cross section between the cap 3 and the control cap 5 varies depending on the required housing pressure.

As a working range of inspiratory volume for this group of patients, 50-70 L/min should be considered.

On the outer part of the chamber 2 there is a scale 15 for measuring the rate of inhaled air flow (l / min), and in the lower part there is a button 16 for turning on the device and resetting the readings for measuring the volume of inhalation, through which the slider 8 is moved to the initial position

To be able to turn on the button 16, the reciprocating mechanism must rest firmly against the cap 3, which fits snugly against the rod due to the cover 5. Without a snug fit, the button 16 will not be pressed.

The execution of the rod 6 and the slider 8 of magnetic materials is due to the minimization of the friction force when moving the slider 7 along the rod 6 and obtaining more accurate initial values on the scale 15.

The mouthpiece 4 can be disposable and made of cardboard in the form of a cylinder, and can also be made of plastic, in particular silicone, fluoroplastic or ABS plastic, and be made in the form of a cylinder or a truncated cone.

In the proposed device for measuring inspiratory volume, mouthpieces of 4 different diameters can be used - for adults and for children. Children's mouthpieces are attached using an adapter 17.

Mouthpieces 4 for adults are attached directly to the cap 5. Disposable mouthpieces 4 are of a smaller diameter than the inner diameter of the cap 5 in order to fit snugly against the inner surface of the cap 5 when they are inserted. When using plastic mouthpieces 4, they are attached to the cap 5 by means of a threaded connection.

If it is necessary to use pediatric (children's) mouthpieces 4, an adapter 17 is fixed with a thread between the cover 5 and the mouthpiece 4.

Disinfection and prevention of viruses and bacteria from entering the patient's body is a fundamental task in the development and use of the device for measuring inspiratory volume. Therefore, in the proposed invention, there are several options for using agents that prevent infection of patients.

The mouthpiece 4 may include an adapter 17 in the form of a mesh filter, made with the possibility of unhindered inhalation. Also, the inner surface of the mouthpiece 4 can be coated with antiseptic impregnation.

In order to reduce the risk of cross-contamination to the lowest possible level, the mouthpiece 4 can be provided with a one-way valve preventing exhalation into the device or with a two-way filter.

Also, for the purpose of disinfection, the inner surface of the mouthpiece 4 can be coated with antiseptic impregnation.

Mouthpieces 4 and adapters 17, made of plastic, are subject to any type of disinfection permitted for items that come into contact with the human mucosa.

Before use, it is optimal to pack and store the mouthpiece 4 (disposable and reusable) in a sealed package, which allows you to comply with sanitary and epidemiological requirements, as well as prevent evaporation of the antiseptic impregnation in case of its use.

Each inspiratory volume device is individually calibrated to ensure a high degree of accuracy. Inspiratory flows range from 15 L/min to 120 L/min.

The plastic housing 1 is formed by a chamber 2 and a cap 3 made of a transparent material with sufficient transparency for visual inspection, in particular PC polycarbonate, ABS plastic, etc.

Assembly of the inventive inhaler is carried out in the following sequence. A cap 3 is attached to the chamber 2 using a threaded connection. To the cap 3, in turn, a cover 5 is attached using a threaded connection to control the resistance with a check valve. After that, the mouthpiece 4 is attached. In the case of measuring the volume of a child's inhalation and the need to use a child's mouthpiece 4 (with a smaller diameter), an adapter 17 is placed between the cover 5 and the mouthpiece 4.

The device for measuring inspiratory volume works as follows.

Before measuring the patient's inspiratory volume, the disposable mouthpiece 4 is inserted into the cover 5, after which the button 16 is turned on. The patient holds the mouthpiece 4 vertically upward so that the rounded end of the device can be strongly tapped on the other hand or a horizontal surface such as a table. This will displace the magnetic reset weight 9 which will return the magnetic slider 8 to its original position. In accordance with the recommendations of the attending physician, on the device for measuring inhalation volume, the necessary values of resistance to the flow of inhaled air (resistance adjustment scale 12) are set by changing the area of the clearance between the holes of the cap 3 and cover 5.

The cap 5 is scrolled relative to the cap 3 and the required resistance is set by aligning its mark 13 with the mark 14 on the cap 3. For the convenience of the user, a distinct click should be heard when setting the required resistance.

The patient makes a full exhalation, after which he closes his lips around the mouthpiece 4. After that, the doctor asks the patient to inhale. Scale 15 shows the volume of air that the patient can inhale. Slider 8 will stop at the value corresponding to the patient's inspiratory volume. The volume of the patient's inhalation is fixed, after which the reset button 16 is pressed. For reliable results, this procedure must be repeated at least two more times, each time following the correct technique of inhalation and exhalation.

When inhaling, the rubber washer of the non-return valve deforms under pressure, opening the passage of the cover 5. When exhaling, the rubber washer rests against the bed, thereby preventing air from entering.

According to the results of the obtained measurements, a drug is selected for the patient with the delivery system that is most suitable for the patient. To operate the inhaler correctly, the patient must be able to achieve airflow rates within the clinically effective range.

If, after retraining, the patient cannot achieve these values, then the clinician may evaluate the patient's ability to use the drug with a different delivery system.

Example 1

In patient F, (54 years old, diagnosis BA) the inspiratory volume was measured.

The inspiratory volume was 30 l/min. It turned out that the ongoing treatment was ineffective due to the fact that the patient could not achieve the required inspiratory volume when using the drug (pulmicort with a turbuhaler substance delivery system). The drug was changed to Symbicort with a turbuhaler delivery system, because the patient's inspiratory volume when testing this inhaler was 60 l / min, which is quite enough for the use of this drug.

Claims (7)

1. A device for measuring the volume of inhalation in patients with broncho-obstructive diseases, containing a plastic case consisting of a chamber and a cap, a lid for adjusting resistance, while the cap and lid for adjusting resistance contain marks, a mouthpiece, a scale for measuring the volume of inhaled air flow, a scale resistance control, a metal rod located inside the body, on which a slider and a weight for resetting are installed, as well as a slider is movably installed, a cap and a cover for resistance control contain at least three calibration holes located symmetrically relative to each other, while the plastic case device is made of a transparent material with transparency sufficient for visual control, characterized in that it contains a button to turn on the device and reset the readings, with a reciprocating mechanism made with the ability to abut against the cap, which is adjacent to the rod due to the cover and to regulate the resistance, while the button to turn on the device and reset the readings is made with the ability to move the slider to the initial position, and is also made with the ability to turn the device on and off, a one-way valve is installed in the cover for regulating the resistance, designed to prevent exhalation into the device, when In this case, the slider and the drop weight are made magnetic, in addition, the drop weight is made with the possibility of returning the slider to its original position. 2. A device for measuring inspiratory volume in patients with broncho-obstructive diseases according to claim 1, characterized in that it contains an adapter for changing mouthpieces. 3. A device for measuring inspiratory volume in patients with broncho-obstructive diseases according to claim 1, characterized in that the mouthpiece contains a double-sided mesh filter, made with the possibility of unobstructed inspiration. 4. A device for measuring inspiratory volume in patients with broncho-obstructive diseases according to claim 1, characterized in that the inner surface of the mouthpiece is covered with antiseptic impregnation. 5. A device for measuring inspiratory volume in patients with broncho-obstructive diseases according to claim 1, characterized in that the button for turning on the device and resetting the readings is mechanical. 6. A method for measuring the inspiratory volume of patients with broncho-obstructive diseases using the device according to claim 1, including measuring the value of the inspiratory flow achieved by the patient during inhalation, obtained on the basis of the minimum pressure of the air flow generated by inhalation, in addition, determining the readiness of the device for measuring volume inhalation to work and the correct connection of the mouthpiece, regulate the resistance of the flow of inhaled air by changing the area of the gap between the holes of the cap and cover to regulate resistance, prevent the patient from exhaling into the device through a one-way valve installed in the cover to regulate resistance, while before starting measurements, reset the readings from using the power button of the device and reset the readings. 7. A method for measuring the volume of inhalation in patients with broncho-obstructive diseases according to claim 6, characterized in that the mouthpiece and mouthpiece are stored in a sealed package before use.

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