SU1143425A1 - Apparatus for auxiliary blood circulation - Google Patents

Abstract

1. AUXILIARY CIRCULATION MACHINE containing serially connected cardiac synchronizer, control unit with drive and working unit and blood pressure meter, characterized in that, in order to increase the accuracy of cardiac synchronization in the process of assisted blood circulation by automatically controlling the length of time delays in triggering the working unit according to performance criteria auxiliary blood circulation, a time delay correction block is inserted in it, containing a follower o United systole duration determinant, average systolic and dystolic pressure determinant, auxiliary crown sampling efficiency criterion, analog-to-digital converter, time delay increment sign determinant and control signal driver that is connected to the cardiosynchronizer input, the output of which is connected to the input of the cardiac synchronizer duration of systole and to the second. the input of an analog-digital converter, the third input of which is connected to the second output of the determinant of mean systolic and diastolic pressures, the second input of which is connected to a blood pressure monitor.

Description

Ji

2. An apparatus according to claim 1, characterized in that the systole duration determiner comprises a serially connected reference generator, a first decimal counter, a memory register, a match element and a trigger, the second input of which is connected to the first input of the second decimal counter, the second input of which connected to the reference frequency generator, the second input of the first forest counter, the second input of the memory register and the second output of the cardiac synchronizer, and the output of the ten counter is connected to the second input of the coincidence element.

The invention relates to medical technology, in particular to heart-lung machines. A device is known that contains a display, two optical sensors, two photocells, two optical fibers, a control circuit, an actuator, and a working organ. The duration of the phases of the working body is set as light marks on the display. The control triggering signals are taken directly from the display screen by optical sensors moving parallel to the scan on the display and connected to the photocells by means of fiber LEDs. Photocells control time delays. During work, a visual comparison of the ECG and blood pressure curves takes place before and after turning on the auxiliary blood circulation apparatus ij. A disadvantage of this device is the manual adjustment of the cardio synchronization mode to achieve a therapeutic effect. The closest technical solution to the invention is an auxiliary device; —this blood circulation containing a cardiac synchronizer, a drive with a control unit made in the form of a linear motor, a control unit, a mechanopneumatic converter, two electromagnetic valves and a phasing unit, and a working member H. A disadvantage of the known apparatus is the need to manually control the duration of the cardiosynchronized time delays of the actuator operation in order to achieve the required efficiency of the auxiliary blood circulation, determined visually by the software; curve of blood pressure on the osciloscope. This reduces the accuracy of the cardiac synchronization and affects the therapeutic effect. The purpose of the invention is to improve the accuracy of cardiac synchronization in the process of auxiliary circulation by automatically controlling the duration of time delays in working the working organ according to the criteria of secondary circulation efficiency. The goal is achieved by having an auxiliary blood circulation apparatus containing a series-connected cardiac synchronizer, a control unit with a drive and working organ and blood pressure monitor; time delay correction unit introduced; consistently connected systole duration determinant, average systolic and diastolic pressure determinant, auxiliary blood circulation efficiency criterion, analog-digital converter, time delay increment sign determinant, and control signal generator connected to the edge synchronizer input, the output of which is connected to the systole determinant input and to the second input of the analog-digital converter, the third input of which is connected to the second at the output determinator average systolic and diastolic pressures, a second input coupled to a blood pressure meter. In addition, the systole duration determiner contains a serially connected reference frequency generator, a first decimal counter, a memory register, a coincidence element, and a trigger whose second input is connected to the hepBbiM input of the second decimal counter, the second input of which is connected to the reference frequency generator, the second input of the first the second counter of the memory register and the second output of the cardiosynchronizer, and the output of the second decimal counter is connected to the second input of the coincidence element, the change in time delays actuation working body leads to variations in the values of performance criteria auxiliary blood-handling, the sign-tim prirap which automatically due to the presence of feedback through the patient vypo n a further step the stepped measuring time delays. In this case, the process of secondary blood circulation is optimized by increasing the accuracy of cardiosynchronization. Fig. 1 shows a block diagram of an auxiliary blood apparatus; figure 2 - structural diagram of the duration of systole; FIG. 3 is a structural diagram of the determinant of mean systolic and diastolic pressures, the determinant of the efficiency criteria of the auxiliary blood circulation, the determinant of the sign of the increments of time delays; Fig. 4 shows a logic circuit defining the direction of the next step of the driver for controlling signals; Fig. 5 is a table defining the operation of the logic circuit. The auxiliary blood circulation apparatus contains a series-connected cardiac synchronizer 1 (Fig. 1), a control unit 2 with a drive, a working member 3, a blood pressure meter 4 and a time delays correction unit 5, made in the form of successively connected determinants of the system duration 6, the determinant 7 of the average systolic and diastolic pressures, determinant 8 of the efficiency criterion of the auxiliary blood circulation, the second input of which is under the keys to the gauge 4, analog-digital converter 9, op edelitel plate 10 increments the time delays and shaper 11 to Tsikh control signals coupled to the input cardiosynchronizer 1 which through- embedded therein Wuxi divisor electrocardiosignals (not shown) is connected to the patient. The determinant b of the length of the systo. PY contains a reference frequency generator 12, the first 13 and second 14 counters, memory register 15, match element 16 and trigger 17. The decimal counter 13 contains an input frequency divider by three (not shown) and determines the time systole, and counter 14 - time of the entire cardiocycle. Register 15 stores the previous cycle information received from counter 13. Counter inputs of counters 13 and 14 are connected to generator output 12, BTO {% i. Inputs (reset) are connected to cardiac synchronizer output 1. Counter 13 output is associated with matching element 16 via a register 15, the second input of which is connected to the output of the cardiac synchronizer 1, the output of the counter 14 is connected to the second input of the coincidence element 16 connected to the trigger 17, the second input of which is also connected to. the output of the cardiosynchronizer 1. The distributor 7 of average systolic and diastolic pressures contains two analog switches 18 (Fig. 3) and two integrators 19 connected by inputs to the keys 18, and outputs to the input of the determinant 8 of the efficiency criterion and to the input of the analog-digital converter 9. The integrators 19 average the values of systolic and diastolic pressures over ten cardiac cycles. The analog inputs of the analog switches 18 are connected to the output of the blood pressure monitor 4, and the control inputs to the trigger 17 (FIG. 2) of the systole duration determiner 6, and one of the keys is simultaneously open depending on the position of the trigger 17. The determinant 8 (FIG. 3) The criteria for the efficiency of auxiliary blood circulation are made in the form of a pulse multiplier - a divider on analog switches controlled by a pulse width and amplitude pulse modulators. Qualifier 8 continuously calculates the ratio of the mean systolic to the mediastolic pressure. Analog-to-digital converter 9, once every ten cycles, converts the average values of systolic and diastolic pressures and their ratio into digital form and transmits them to the appropriate channels of the 10th sign of the increment of time delays. The determinant 10 of the time delay increment symbol contains in each of the three channels a binary-decimal counter 20, memory register 21 and logic circuits 22 MORE-LESS, and output logic logic 23, which determines the direction of the next step of the control signal generator 11 (figure 4 and 5). The outputs of the -20 counters are connected to the logic circuit 22 MORE-LESS directly and through the memory registers 21. Memory register 21 stores information in a binary-decimal code about a parameter for the previous 10 cycles, logic circuit 22 MORE THAN performs a random comparison of two binary-decimal numbers of blocks 20 and 21, outputting at output O or depending on the sign differences. The driver 11 (Fig. 1) of the control signals is made in the form of two reversible (forward and reverse) shift registers (not shown), the inputs of which are connected to the outputs of the determinant 10 of the time delay increment sign, and

the outputs of the registers are connected via keys (not shown) to the calibrated resistances in the cardiosynchronizer 1, which determine the delays in the operation of the actuator 3.

Apparate works as follows.

The patient is connected via ECG electrodes (not shown) to the cardiac synchronizer 1. A blood pressure meter 4 and the operating element 3 are also connected to the patient.

The cardiosynchronizer 1 extracts from the patient's ECG R-teeth formed in frequency, duration and amplitude, and generates filling and emptying pulses of the actuator 3, which are fed to the control unit 2 with the drive. The pulse phase and duration depend on the duration of the response time delays, set in the initial state manually, and provide an increase in the patient's blood pressure in the diastole and a decrease in pressure in the systole, thereby relieving the heart and increasing the coronary blood flow.

During the first 10 cycles, the device operates at the time delays of the operation of the working body, set manually.

From the moment the device is turned on, the generator 12 generates every 2 ms pulses arriving at the decade counters 13 and 14. From the cardiac synchronizer 1, the sync pulse coinciding in phase with the QRS ECG complex enters the determinant (the systole duration of the time delay correction unit 5 to the inputs of counters 13 and 14, memory register 15 and trigger 17, transfer of information about the duration of systole from counter 13 to memory register 15, resetting the counters 13 and 14 and register 15, switching the trigger 17 to the initial state. The initial state of the trigger 17 corresponds The discovery of one of the analog keys 18 of the determinant 7 is accomplished by ensuring that the systolic pressure integrator 19 is connected to the blood pressure monitor 4.

At the match element 16, a continuous comparison of information from the register 15 and the current information from the counter 14 occurs.

At the moment of coincidence, the trigger 17 is switched by opening the second analog switch 18 and closing the first one. The second integrator of 19 dastolic pressure begins to work. When the analog switch 18 is opened, the integrator 19 receives a signal from the blood pressure monitor 4, and the signal is integrated during the systole or diastole, respectively, and the result is memorized during the opposite phase.

The determinant 8 of the secondary blood circulation efficiency criterion divides the median systolic per cycle pressure by the mediastolic per cycle, the values of which are taken from the outputs of the integrators 19.

Parameters from the outputs of the integrator 19 and determinant 8 every 10 cardiocycles are entered into

5, the binary-decimal code of the analog-to-digital converter 9 to the determinant 10 of the time delay increment symbol, and the transfer of information from the binary-decimal counter 20 to the memory register 21, and the counter 20 being reset by entering the new analogue information. .

The information obtained by binary decimal counters 20 is compared one by one with previous information stored in memory registers 21 (after the first 10 cycles with zero information), on logic circuits 22 MORE THAN, which change the output signal at the positive difference of the numbers received in the counters 20 and the numbers stored in the registers 21 of the memory.

5 The signals from the outputs of the circuits 22 MORE are fed to the logic circuit 23, which acts directly on the forward and reverse inputs of the shift registers of the driver 11, thereby ensuring the next step of changing the delay and switching on the corresponding-calibrated resistance setting the delays in the cardiac synchronizer 1.

c In this case, each of the delays will receive a positive or negative increment, based on the conditions given in Table 5, where plus corresponds to a positive difference of numbers, PE) The counters 20 and stored in memory registers 21 (change sign at the output of circuit 22 ), and minus - the negative difference of numbers (preservation of the signal at the output of the circuit 22).

5 Thus, the cardio-synchronization accuracy is improved, since the duration of the time delays of the actuator response is automatically controlled according to the criteria of the process efficiency by means of a stepwise search for the optimal mode of operation of the auxiliary blood circulation apparatus. Process optimization ensures maximum

5 unloading of the left ventricle of the heart,

improves hemodynamics, increasing medium-f non-arterial pressure;

The enclosed technical solution allows automatic adjustment of OGL 1

13

to improve the mode of operation of the device, which increases the accuracy of cardio synchronization by 10–15%, and, consequently, increases the therapeutic effect.

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FIG. 2

Sync pulse

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Claims (2)

1. AUXILIARY BLOOD CIRCULATION APPARATUS, containing a serially connected cardiosynchronizer, a control unit with a drive and a working body and a blood pressure meter, characterized in that, in order to improve the accuracy of cardiosynchronization delays of the working body according to the criteria for the effectiveness of auxiliary blood circulation, a correction block for temporary circulation is introduced into it delays, containing sequentially connected determinant of systole duration, determinant of mean systolic and diastolic pressure, determinant of the auxiliary blood circulation efficiency criterion, analog-to-digital converter, sign of time delay increment sign and control signal generator connected to the input of the cardiosynchronizer, the output of which is connected to the input of the systole duration determiner * and to the second, input of the analog-to-digital converter, third input which is connected to the second output of the determinant of the average systolic and diastolic 4* Fo f sl Figure 1 2. The apparatus according to claim 1, characterized in that the systole duration determiner comprises a reference frequency generator, a first decimal counter, a memory register, a coincidence element and a trigger, the second input of which is connected to the first input of the second decimal counter, the second input of which is connected to the reference frequency generator, the second input of the first decimal counter, the second input of the memory register and the second output of the cardiosynchronizer, and the output of the decimal counter is connected to the second input of the match element.