SU1303165A1 - Auxiliary blood circulation apparatus - Google Patents

Description

The invention relates to a medical technique, mainly to aparates of a potent blood circulation for counterpulsation with an intra-aortic balloon pump.

The purpose of the invention is to increase the durability of a flexible cylinder by reducing the load on the cylinder in a closed state. FIG. 1 shows the block diagram of the proposed circulatory system; in fig. 2 - low pressure regulator; in fig. 3 is a block diagram of a control unit.

The auxiliary blood circulation apparatus contains a compressor 1, a vacuum receiver 2, a high pressure receiver 3, a catheter 4, a flexible cylinder 5, a distributor 6, a control unit 7, an operating pressure receiver 8, an operating pressure regulator 9, a source 10 of compressed gas, single-membrane element 11 equipped with a nozzle 12 of a deaf chamber 13, a flow chamber 14 and a membrane 15, electropneumatic valve 16, vacuum regulator 17, electropneumatic dampers 18 and 19, adjustable pneumatic resistance 20, vacuum detector 21, device 22 for resetting excess gas with Stem 23 with pneumatic signaling. the outputs 24-27 and the electrical outputs 28 and 29, the distributor 30, the pulse former 31, the flow sensor 32, the low pressure regulator 33, the low pressure receiver 34.

The pulse shaper 31 comprises a power amplifier -35, a trigger 36, a flow meter 37, a threshold element 38, a differentiator 39, and an inverter 40.

The low pressure regulator 33 has an electrical inlet 41, pneumatic inlets 42-44, outlet 45 and includes a housing 46, membrane blocks 47 and 48, flow chambers 49 and 50, a blind chamber 51, nozzles 52 and 53, a pressure setting device 54, electropneumatic pan 55.

Control unit 7 contains biopotential amplifier 56, synchronizer pulse generator 57, cardiac cycle duration meter 58, beginning and end of the injection phase of a flexible cylinder 5, disjunctor 61, O-flip-flop 62, power amplifier 63, signaling unit 64 with a lamp Kami 65 and 66, the trigger 67 lock, switch 68 modes with poles 69-72, having three positions 73-75.

The pulse shaper 31 forms the pulses of the beginning of the phase to inflate the cylinder 5.

Cylinder 5, receivers 2, 3, 8 and 34, as well as compressor 1, form the apparatus’s pneumatic system.

Using the regulators 9, 17 and 33 of the working pressure, vacuum and low pressure, respectively, the pressure in the cylinder 5 is set at the end of the blow up phase, the speed of collapse of the cylinder 5 is necessary (ideally, the speed of fall of the cylinder

five

o

0 5

d 5

55

5 must be equal to the rate of systolic ejection of blood from the left ventricle of the heart) and the pressure in cylinder 5 in a closed state. The pressure in the cylinder 5 in the inflated (limiting) state is equal to the pressure at the outlet of the regulator 9 and is determined from the expression

PP9 (1-1.05) Pd. “Ahs,

where Pfg is the pressure at the outlet of the regulator 9 | Lax.- maximum diastolic pressure in the aorta during counterpulsation.

The pressure in the cylinder 5 in the closed state is equal to the pressure at the inlet 42 of the regulator 33 and is determined from the expression

/ rzz z., lux. (60-80 mm Hg. Art.),

where .3 is the pressure at the inlet 42 of the regulator 33;

with. Nax.- maximum systolic pressure in the aorta during counterpulsation.

The pulse former 31 generates a rectangular electrical pulse, the duration of which is determined from the following expression:

FZ 1 with cl

where Lf3 is the pulse duration of the imager 31;

tc is the duration of systole; ten is the fall of the cylinder 5 to the closed state,

in this case: 4L GD6 / s - the duration of the closed state of the cylinder 5.

The conductivity of pneumatic resistance 20 is selected on the basis of ensuring the flow of gas through it, exceeding the leakage of gas from the pneumatic system during counterpulsation, for example, due to the gas permeability of the material of the cylinder 5.

The circulatory system operates as follows.

Before starting the auxiliary circulation, air is removed from the pneumatic system. The poles 69-72 of the mode switch 68 are set to position 73. In this position, the electro-pneumatic valves 16, 18 and 55 and the S-input of the trigger of block 67 are connected to the voltage source, and the indicator 21 is connected to the light bulb 66 of the block 64. In this case the trigger 67 is set to "1, and flip-flop 62 to" O, and the switchgear 6 is de-energized. The electropneumatic valve 16 switches to the position corresponding to the disconnection of the nozzle 12 and the deaf chamber 13 of the element 11 from the receiver 8, the electric pneumatic valve 18 switches to the position corresponding to the connection of the compressor 1 to the atmosphere (the receiver 3 is disconnected from the compressor 1) and the electric pneumatic valve 55 switches to the position corresponding to the connection of the input 42 and the output 45 of the controller 33. The switchgear 6 at this time is in the position shown in FIG. 1. Air from cylinder 5, receivers 3, 8, and 34 is pumped out by compressor 1 to receiver 2 and via electric pneumatic valve 18 to the atmosphere (through switchgear 6 and regulator 33). Air removal from the pneumatic system is carried out to a residual pressure of 0.05-0.1 kgf / cm in it, the value of which is measured by a vacuum alarm device 21. With a residual pressure in the pneumatic system equal to 0.05-0.1 kgf / cm the contacts of the vacuum detector 21 are closed and on the alarm unit 64 a light bulb 66 lights up, which indicates the end of the air removal from the pneumatic system.

To fill the pneumatic system with gas, poles 69-72 switch to position 74. In this position of the poles, electropneumatic valve 19 and / -input of trigger 67 are connected to a voltage source, and outlet 28 and C-inlet of trigger 67 are connected to the first input of block 64, where a corresponding signal is present, for example, the light bulb 66 lights up. In this case, the trigger 67 is set to " O, and while the output of the trigger of the block 67 is "

As a result, the electropneumatic valves 16, 18 and 55 are switched to the positions shown in FIG. 1, and the control unit 6 receives the control clock pulses: the switch unit 6 in the systole connects the cylinder 5 to the receiver 2, the receiver 8 is connected to the receiver 3, and in diastole the cylinder 5 is connected to the receiver 8, the receivers 2 and 3 are disconnected respectively from cylinder 5 and receiver 8.

At the same time, the control unit 7 generates a signal for switching the electropneumatic valve 19 to the position corresponding to connecting the output of the regulator 9 to the flow chamber 14 of the element 11. The apparatus’s pneumatic system begins to be filled with gas, which is carried out by the regulator 9.

At the initial moment of filling, the pressure in the flow chamber 14 of the element 1 1 in systole and diastole is higher than the pressure in its blind chamber 13 (the pressure in the receivers 3 and 8 is less than the adjustment pressure of the regulator 9 and is equal to the residual pressure in the pneumatic system). The membrane 15 of the element 11 is moved towards a lower pressure, and its nozzle 12 is opened. In the systole, the switchgear 6 is in the position shown in the drawing, and the output of the regulator 9 is connected through this electropneumatic valve 19, the flow chamber 14 and the nozzle 12 of the element 11 and the electropneumatic valve 16 to the receiver 8 and through the switchgear 6 to the receiver 3. The receivers 3 and 8 and the deaf chamber 13 are filled with gas up to a pressure not exceeding the setting pressure of the regulator 9 (the capacity of the nozzle 12 of the element 11 does not ensure the filling of the total capacity of the receivers 3 and 8 and deaf chamber 13 until the pressure of the regulator 9 is set during the system). Cylinder 5 is at this time connected via switchgear 6 to receiver 2.

In diastole, the switchgear 6 switches and disconnects the cylinder 5

0 from receiver 2, and receiver 3 from receiver 8, connect the latter to cylinder 5, and gas from receiver 8 flows into cylinder 5. Pressure in cylinder 5 rises, and in receiver 8 and deaf chamber 13 decreases and at the end of the balloon filling transient five

5, the gas pressure in them is equalized, the balloon 5 is inflated if the pressure in it is higher than the aortic one (the duration of the filling transient process is less than the duration of the diastole). Regulator output 9 into this

Q time is connected through an electropneumatic valve 19, a flow chamber 14, a nozzle 12 and an electropneumatic valve 16 to the receiver 8 and a deaf chamber 13 and through the distributor 6 to the cylinder 5 and they are filled to a pressure not exceeding 5 the adjustment pressure of the regulator 9 ( the capacity of the nozzle 12 does not ensure the filling of the total capacity of the receiver 8, the deaf chamber 13 and the cylinder 5 up to the adjustment pressure of the regulator 9 during the diastole time).

0 At the same time, compressor 1 pumps gas from receiver 2 to receiver 3, the pressure level is higher in the latter. At the same time, at the beginning of the diastole, the start of the injection start shaper 59 outputs to the S input of the trigger 36 a signal phased at the front

the front of the pulse phase of the cylinder 5, and at the output of the shaper 31, a control pulse is formed, setting the distributor 30 to the position shown in FIG. one.

In the next systole, the switchgear 6 switches and the cylinder 5 is connected to the receiver 2. And the receiver 3 is connected to the receiver 8, the cylinder 5 is emptied and the receiver 8 is filled (the pressure in the receivers 3 and 8 is equal at the end of the filling transition). Gas from tank 5 flows to receiver 2. Pressure in tank 5 decreases and at the end of the transition process of emptying tank 5, pressure in tank 5 and receiver 2 is equalized. Cylinder 5 is folded. At the same time, a control impulse is formed at the exit of the former 31, switching the distributor 30, and the cylinder 5 is connected to the receiver 34. The gas from the receiver 3 through the nozzle 53 and the flow-through chambers 50 of the regulator 33, the receiver 34, the distributor 30

5 and the switchgear 6 flows into the cylinder 5. Its pressure rises to the setting pressure of the setting device 54. When

by accidentally increasing the pressure at that time in the cylinder 5, the nozzle 53 closes and the nozzle 52 opens. The excess gas from the cylinder 5 is discharged through the nozzle 52 to the receiver 2 to the setpoint adjustment pressure 54. At the same time, the compressor 1 pumps the gas from the receiver 2 to the receiver 3, increasing the pressure in the latter.

In diastole, the dispenser 6 and the dispenser 30 are switched, and the filling cycle is repeated.

In the process of filling, pressure in receiver 3 rises from cycle to cycle, and pressure in receiver 8 and deaf chamber 13 pulsates between pressures in receiver 3 and in systole and settings of regulator 9 in diastole. In this case, the pressure in the balloon 5 pulses between the pressures in receivers 2 and 34 in the systole (the balloon 5 folds and is in the closed position) and the adjustment pressure of the regulator 9 (the balloon 5 is inflated if it is above the aortic pressure). With pressure in the receivers 3 and 8 and a deaf chamber 13 in the systo; 1e (the distributor 6 is in the position shown in Fig. 1) greater than the setting pressure of the regulator 9, the membrane 15 blocks the nozzle 12 of the mono-membrane element 11 by disconnecting the regulator 9 from the receiver 8. The filling of the pneumatic system with gas at this point in time is stopped. However, the pressure in receivers 3 and 8 in the systole continues to grow, as gas from cylinder 5 at this moment of time passes through switchgear b to receiver 2, and compressor 1 pumps gas from receiver 2 to receiver 3. In diastole switchboard 6 switches and reports receiver 8 with balloon 5.

The pressure in the cylinder 5 rises, and in the receiver 8 and the deaf chamber 13 it decreases and at the end of the transition process of filling the cylinder 5 with gas, the pressure in them is equalized. The pressure in the flow chamber 14 at this time interval is greater than the pressure in the deaf chamber 13. The membrane 15 is stirred and opens the nozzle 12, together with the regulator 9 with the receiver 8 and the balloon 5; the receiver 8, the deaf chamber 13 and the balloon 5 are filled to a pressure not exceeding the adjustment pressure of the regulator 9 (the balloon 5 is inflated if its pressure is higher than the aortic pressure). At the same time, compressor 1 pumps gas from receiver 2 to receiver 3, increasing the pressure level in the latter over the previous one.

In systole, the switchgear 6 is switched and the filling cycle is repeated.

In the process of filling, the minimum pressure value in the receiver 8 (the pressure in it at the end of the transition process of filling the cylinder 5), the deaf chamber 13 and the cylinder 5 in diastole increases from the cycle

the cycle and tends to the pressure settings of the regulator 9, and the pressure in the receiver 3 increases to a maximum value greater than the pressure settings of the regulator 9. At the minimum pressure in the receiver 8, equal to the response pressure of the alarm system 23, the output 28 an alarm unit 64, a light 66 is turned on, indicating the end of the initial phase of filling the pneumatic system with gas. At the same time, the control unit 7 issues a command for switching the electropneumatic valve 19 to the position shown in FIG. 1. The final phase of filling the pneumatic system with gas is carried out through pneumatic resistance 20.

5 In diastole, the receiver 8 is connected to the cylinder 5. The gas from the receiver 8 flows into the cylinder 5. The pressure in the cylinder 5 rises, and the pressure in the receiver 8 decreases and at the end of the filling transient of ball Q of the pressure 5 they equalize (the duration of the filling transition is less the duration of diastole). The output of the regulator 9 at this time is connected through pneumatic resistance 20, flow chamber 14, nozzle 12 and electropneumatic valve 16

5 to the receiver 8, the deaf chamber 13 and the cylinder 5 — they are filled with gas to the pressure not exceeding:; its pressure is adjusted by the regulator 9, and the filling rate is proportional to the conductivity of the pneumatic conductivity 20 (balloon 5 is inflated). At the same time, at the beginning of the diastole, the shaper 59 of the control unit 7 outputs to the S input of the trigger 36 a signal phased at the leading edge of the pulse of the filling phase of the cylinder 5, and at the output of the shaper 31 a control pulse is formed, setting the distributor 30 to the position shown in FIG. 1. In systole, the receiver 3 is connected to the receiver 8 and the deaf chamber 13, and the cylinder 5 is connected to the receiver 2 — the receiver 8 and the blank chamber 13 are filled to the pressure in the receiver 3, and the cylinder 5 is emptied into the receiver 2 to pressure in the receiver 2. At the end of the transition process of emptying the cylinder 5, a control pulse is formed at the outlet of the former 31, a switching valve 30, and the cylinder 5 is connected to the receiver 34 - the pressure in them is equalized. At the same time, the pressure in the blind chamber 13 rises and the membrane 15 closes the nozzle 12, disconnecting the regulator 9 from the receiver 8. In diastole, the receiver 8 switches to the cylinder 5 and the cycle of the final filling phase repeats.

When the receiver 8, the deaf chamber 13 and the balloon 5 in the diastole are filled through the pneumatic resistance 20 to the adjustment pressure of the regulator 9, the apparatus’s pneumatic system is no longer filled with gas (the nozzle 12 at the end of the diastole is open, but there is no gas flow through the regulator 9 and pneumo5

7

resistance 20, since there is no pressure difference between them and the receiver 8). Thus, the regulator 9 is connected at the end of the transition process of filling the cylinder 5 in the diastole to the receiver 8 and through the distribution device 6 connected to the cylinder 5, and disconnected in the systole. With a slight decrease in the minimum value of pressure in the receiver 8 at the end of the transition process of filling the balloon 5 in diastole (the pressure in the receiver 3 is less than necessary), for example, due to the gas permeability of the chamber material of the balloon 5, catheter 4, a pressure differential appears between the regulator 9 , the receiver 8 and the balloon 5. Through the pneumatic resistance 20 and the open nozzle 12, the required gas flow and pressure in the receiver 8 and the balloon 5 increase to the adjustment pressure of the regulator 9.

The pressure in the receiver 3 at this time is equal to the value determined by the expression

p (Vp8 + Voi + Vss) -Par9- Kui -Jaog34

 up. i 77

Vp8

where Papft, Rarz, and Pup, 34 are respectively the absolute values of the pressure settings of the regulator 9 and in the receivers 3 and 34;

Vp8, Upl and Vss - respectively, the volumes of the receiver 8, the pneumatic line between the distributor 6 and the cylinder 5

and with an appropriate choice of the volume of the receiver 8 may be several times greater than the pressure settings of the regulator 9.

Thus, the initial phase of filling the cylinder 5 with gas in diastole occurs at high pressure in the receiver 8, and at the end of the transition process} 1 filling the pressure in the cylinder 5 and receiver 8 is equalized to the adjustment pressure of the regulator 9.

Cylinder 5 is rapidly inflated, and its time to inflate is much less than diastole. In the systole, the balloon 5 is first connected to the receiver 2, and at the end of the transition process is emptied to the receiver 34, which ensures the rapid folding of the balloon 5 and its operation within the limits of elastic deformations.

In the process of counterpulsation, the minimum value of pressure in the receiver 8 at the end of the transition process of filling the balloon 5 in diastole may exceed the pressure by 8

the settings of the regulator 9, for example, due to the additional leakage of air from the atmosphere. When the minimum pressure value in the receiver 8 rises to the actuation pressure of the alarm system 23, output 29 energizes the power supply and the light 65 lights up, which indicates an excess of gas in the pneumatic system. At the same time, the device 22 is triggered, and the excess gas is discharged into the atmosphere.

As a result, the light goes out 65.

During counterpulsation, the minimum value of pressure in the receiver 8 and the cylinder 5 at the end of the transition process in diastole can dramatically decrease, for example, due to the leakage of the base 5. The leakage of gas through the wall of the cylinder 5 into the blood will increase and can no longer be compensated gas flow through pneumatic resistance 20.

When the minimum pressure value in the receiver 8 drops to the actuation pressure of the alarm system 23, the power supply voltage comes from output 28 and the power supply voltage 66 comes on, indicating an emergency leak of gas from the pneumatic system

the switchgear 6 is locked in the position corresponding to the bottoming of the cylinder 5 to the receiver 2, and after the cylinder 5 is empty, the latter is connected to the receiver 34 (at the output of the shaper 31, the control pulse 30 switches the corresponding position to the appropriate position). If necessary, the pressure at the end of the transition process of filling the balloon 5 in diastole can be changed during counterpulsation. To reduce the pressure in the cylinder 5, it is sufficient to decrease the pressure of the adjustment of the regulator 9 to a value exceeding the opening pressure of the alarm system 23. To increase the pressure; 1 tank in cylinder 5, switch 68 is set to position 74. As a result, blocking block 67 is turned off and electropneumatic valve 19 is switched to the position corresponding to the connection of regulator 9 to flow chamber 14 of element 11. Adjustment pressure of regulator 9 must be increased to values exceeding the trigger pressure of the alarm system 23. At the same time, at the output 28 of the last and at the signaling block 64, a signal appears corresponding to the filling of the pneumatic system with gas. The process of filling the pneumatic system to the new pressure setting value of the regulator 9 is similar to the initial and final phases of filling the pneumatic system of the apparatus with gas.

figg

Compiled by N. Andrienko

Editor T. ParfenovaTechred I. VeresKorrektor M. Samborska

Order 1239/6 Circulation 596 Subscription

VNIIPI USSR State Committee on Inventions and Discoveries

1 13035, Moscow, Zh-35, Rauikka Embankment, 4/5 Production and printing company, Uzhgorod, ul. Project, 4

Claims (1)

AUXILIARY BLOOD CIRCULATION DEVICE for ed. St. No. 1032613, characterized in that, in order to increase the durability of the flexible cylinder by reducing the load on the cylinder in the closed state, it is additionally equipped with a distributor, a flow sensor, a pulse shaper, a low pressure receiver and a low pressure regulator, in the pneumatic line between the switchgear and the vacuum receiver a distributor and a flow sensor are connected in series, the second output of the distributor through the low pressure receiver is connected to the first input of the low pressure regulator the second and third inputs of the low pressure regulator are connected respectively to a source of compressed gas and to a high pressure receiver, the output of the low pressure regulator is connected to a vacuum receiver, the output of the flow sensor is electrically connected to the first input of the pulse shaper, the output of which is connected to the distributor, the second input of the shaper pulses are connected to the control unit, and the low pressure regulator is electrically connected to the control unit. 1303 165 A 2