TW201713373A - Expectoration system - Google Patents

Abstract

An expectoration system comprises an expectoration line comprising a throttling device and a balloon valve; an expectoration apparatus, comprising a main line assembly, an air pump assembly and a control system, the main line assembly comprises a fan and a shutter valve; the air pump assembly comprises a first air pump and a second air pump; the control system comprises a first sensor for measuring air pressure of the throttling device and a microcomputer control unit; the microcomputer control unit judges a patient being in an exhaling or inhaling stage through an air pressure difference detected by the first sensor, during expectoration, the first air pump supplies air to the balloon valve to disconnect a respirator air circuit, the fan and shutter valve are started to control the second air pump to supply air to the throttling device, and a respirator never stops running in the expectoration sage. The expectoration system is friendly to normal running of the respirator.

Description

Cough system

The present invention relates to a medical care device, and in particular to a cough system.

The ventilator is an essential life support device for respiratory failure due to various causes, including respiratory distress syndrome (ARDS), severe acute pulmonary edema and asthma, respiratory insufficiency, and major surgery. For patients who have been in the ventilator, timely and effective removal of sputum is very important. If sputum is not discharged in the respiratory tract, concentrated sputum and sputum tend to accumulate and block the bronchial lumen, which seriously affects the patient's ventilatory function and aggravates breathing. Failure, and even cause secondary atelectasis. Sputum is also a breeding ground for bacterial growth. Bacteria infect respiratory organs and make patients susceptible to ventilator-associated pneumonia (VAP). However, due to the loss of cough function, severe lung function decline, and respiratory muscle weakness, patients with mechanical ventilation often cannot sputum and discharge significantly. In addition, mechanical ventilation patients are mostly in consciousness disorder, systemic failure, cough and expectoration. Reduced function, the original respiratory diseases and respiratory failure worse; tracheal intubation and tracheotomy to destroy the natural barrier of the throat, weaken the cleansing effect of airway cilia, and weaken the reflex mechanism of cough and cough. Therefore, for mechanically ventilated patients, continuous and effective sputum removal is the key to prevent airway obstruction and maintain mechanical ventilation.

The conventional suction method is suction tube suction, which uses a small catheter to pass through the tracheal intubation or tracheotomy tube, insert the patient's airway, and draw the sputum out of the patient through continuous negative pressure suction in the small catheter. . When the catheter is close to the secretions, the secretions are aspirated. However, the disadvantages of this method of suction are also obvious. First, it is an invasive suction. Because of the insertion and movement of the catheter, it is easy to cause damage to the airway and even the airway scar increases the secretion of airway secretion. . At the same time, aggravating hypoxemia, can not immediately remove sputum, increasing the risk of infection and bleeding. It is a very painful experience for most patients.

Another method of airway secretion clearance in mechanically ventilated patients is to use a common coughing machine, such as the Philips coughassist, which, when coughing, first, the patient's lungs inhale air close to the maximum tidal volume, then quickly and suddenly At the highest rate, the air inhaled into the lungs is exhaled from the patient's lungs at a very high rate. The airflow will carry the secretions up and flow out from the patient's airway at a very high flow rate, thereby achieving the purpose of clearing the patient's secretions. . It clears the secretions in essence as an analogous way of coughing, which can be connected to the patient's airway through a tracheal intubation, tracheal incision or mask. This coughing method should be much better than the aforementioned suction tube suction. First, it is a non-invasive suction. Secondly, the coughing machine produces a high-speed airflow that flows throughout the diameter and length of the patient's airway, thus acting to remove secretions from the entire airway. The suction tube suction is only a low-speed airflow generated inside the small catheter. Secondly, due to the size of the suction tube, the suction tube can only approach the larger air passage, and for those smaller and more advanced branch air passages, Then there is nothing to do. There is also the branch shape of the patient's left and right bronchus, which determines that the suction tube can only be inserted into the right airway when inserted into the patient's bronchial suction. The airway on the left side cannot be sucked. At the time of sucking, most of the patient's respiratory tract does not come into contact with the suction tube and the suction airflow, and only a little sputum can be removed near the suction tube. The coughing machine coughs and the secretions are removed by the airflow in the patient's airway.

However, cough machines also have disadvantages. For example, when coughing a mechanically ventilated patient, it is necessary to cut off the ventilation line of the ventilator and the patient, and connect the coughing machine to the patient to perform a coughing operation. However, for mechanically ventilated patients who are on a ventilator, especially for critically ill patients, frequent disconnection of the ventilator from the ventilator of the patient may result in worsening of the condition. The coughing machine uses a periodic loop to stop the patient's inhalation phase, which can cause problems because the volume loop or flow loop mode is safer and more effective for ventilated patients. In addition, the coughing machine does not have a positive end expiratory pressure (PEEP) function, and its pressure in the airway at the end of the cough can only be approximately equal to atmospheric pressure. Positive end expiratory pressure plays an important role in the treatment of respiratory distress syndrome (ARDS), non-cardiogenic pulmonary edema, pulmonary hemorrhage, and can promote sputum clearance. The coughing machine is not suitable for patients with the above symptoms. In addition, the coughing machine does not have an alarm system equipped with life support equipment, and the safety of use cannot be guaranteed.

Conventional coughing machines, whether inhaling or coughing, use the same line. The coughing airflow contains the patient's secretions, which may contain large amounts of bacteria that are exposed to the trachea. Repeated contact with the patient's inspiratory flow, which brings the risk of secondary infection to the patient.

In addition, the coughing machine uses the same fan for inhalation and coughing. When inhaling and coughing, the face of the fan may contain bacterial airflow and sputum. If different patients use the same cough machine, the potential is reduced. The life of the fan increases the risk of cross-contamination between different patients.

Patent WO2007054829 proposes a coughing machine that works in conjunction with a ventilator to assist the patient in breathing, coughing, and removing airway secretions from the patient. It differs from the Philips coughassist in that the source of positive pressure ventilation for the patient no longer uses a coughing machine. The internal fan is a ventilator that mechanically ventilates the patient. The patient's breathing and coughing use different pipelines. The breathing circuit and the coughing tube are respectively provided with on-off valves. When the ventilator is normally ventilated to the patient, the on-off valve provided on the breathing circuit is opened, and the cough is opened. The on/off valve on the 痰 line is closed. When the patient inhales and is about to enter the exhalation state, the valve on the coughing tube opens and the coughing machine begins to cough. After the cough is over, the valve on the cough line is closed, the valve on the breathing line is opened, and the patient enters the inspiratory state and loops accordingly.

Compared with Philips' coughassist coughing machine, it is not necessary to remove the connecting line between the patient and the ventilator when performing suction. Therefore, the patient does not interrupt the ventilator treatment, especially for patients who need to be treated with PEEP. The interruption is even more unfavorable, and PEEP is more conducive to coughing. At the same time, because the Philips cough machine needs to remove the ventilator to cough, it can only cough at a certain stage, and the sputum can not be removed immediately. The patent WO2007054829 has a problem of coughing and disassembling the ventilator, so that it can cough at any time and immediately. The patient uses different pipelines for inhalation and coughing, which reduces the risk of secondary infection of the patient. The patient's positive pressure ventilation and negative pressure cough are respectively used in the ventilator and the negative pressure fan inside the coughing machine to avoid the patient. Cross-infection improves the life of the fan.

However, the invention of WO2007054829 still has many problems in implementation, such as excessive noise, poor heat dissipation, affecting the work and even alarm of the ventilator during coughing, hidden dangers of the safety of the system, poor adaptability to the clinic, etc., the present invention The problem of the invention of WO2007054829 is effectively solved, which is the engineering implementation of the block diagram of the invention, and further refines, enriches and perfects the WO2007054829 patent.

In view of the problems of the prior art described above, the present invention provides a cough system comprising: a coughing machine and a coughing circuit.

The coughing tube includes a throttling device and a balloon valve, wherein the balloon valve is a two-way valve, one of which is a ventilator, connected to the ventilator by a throttling device, and the other is divided into two, one for The coughing machine is connected to the coughing machine, the other is the patient, and the patient is connected; the coughing machine includes the main road component, the air pump component and the control system, and the main road component includes a fan that generates a negative pressure and is opened when coughing. a shutter valve; the air pump component includes a first air pump that supplies air to the balloon valve and a second air pump that supplies air to the throttle device; and a control system for controlling the main flow path component and the air pump component, the control system including a throttle device for measuring a first sensor and a microcomputer control unit at the air pressure; wherein the microcomputer control unit determines that the patient is in a breathing phase or an inhalation phase by the air pressure difference detected by the first sensor, and shifts to the exhalation phase when the patient is in the inhalation phase When the microcomputer control unit controls the first air pump to supply air to the balloon of the balloon valve to disconnect the ventilator to the patient's fistula, the control system opens the fan and the shutter valve to assist the patient to cough, and at the same time, A second control unit controls the air pump to the gas expansion device, during sputum, the ventilator does not stop working.

The cough sucking provided by the invention can work fully automatically, and it is not necessary to stop the ventilator when used together with the ventilator, and does not affect the normal operation of the ventilator.

Embodiments of the invention are described below with reference to the drawings, in which like parts are designated by the same reference numerals.

Figure 1 illustrates in more detail the gas path principle of the fully automatic cough system of the present invention. The automatic cough system consists of two parts: a coughing machine 1 and a coughing line 20. The coughing line 20 is a disposable item, for example, can be made of medical plastic.

The main function of the coughing machine 1 is to provide negative pressure for generating high-speed airflow, and to monitor the pressure, flow, tidal volume, time and other data of the whole system, and analyze, judge and calculate according to the monitoring results, thereby implementing the system. Effective control, as well as triggering and stopping coughing.

The core components of the coughing tube 20 are the throttling device 21 and the balloon valve 19, and the coughing line 20 forms a gas path connection between the patient, the ventilator and the coughing machine 1, providing an interface for various pressure and flow sensing. The device performs data acquisition and, at the same time, under the control of the coughing machine 1, completes the airway switching between the ventilator-patient and the coughing machine-patient.

Specifically, the throttling device 21 of the coughing line 20 has an interface A and an interface B thereon. The interface A is connected to the second air pump 3 of the air pump element 2 (described in detail below) in the coughing machine 1, and the second air pump 3 can supply the air to the interface A. The interface B is connected to the third air pump 5 of the air pump element 2 in the coughing machine 1, and the third air pump 5 can supply air to the interface A. Further, the interfaces A and B are respectively connected to the two input ports of the differential pressure sensor 12 (first sensor) in the coughing machine 1, and constitute a substantially differential pressure flowmeter. Optionally, the interface A is connected to the pressure sensor 12, and the interface B is connected to the pressure sensor 11 (second sensor), and the pressure of the two ports is detected by the two sensors respectively, thereby feeling the pressure The detector 12 and the pressure sensor 11 constitute a substantially differential pressure flow meter.

The balloon valve 19 is a two-way valve including a ventilator that is connected to the ventilator, and the other end is divided into two, one is a coughing machine that connects the coughing machine, and the other is a patient who is connected to the patient. The passage of the ventilator and the patient's ankle is normally open for the ventilator to deliver air to the patient, but the balloon can be closed by the balloon valve 19. The closing is achieved by providing a balloon inside the balloon valve 19, which increases in volume when the balloon is inflated, clogging the valve port, thereby shutting off the ventilator-patient airway. The passage of the coughing device and the patient's ankle is always open, but since the shutter valve 17 is normally closed, it does not affect the supply of air to the patient by the ventilator, and the shutter valve 17 is only opened when the coughing machine is working, and When the coughing machine is in operation, the ventilator-patient airway is closed by inflating the balloon inside the balloon valve 19 so as not to affect the operation of the coughing machine. When the cough is finished, the shutter valve 17 is closed, the balloon inside the balloon valve 19 is deflated, the volume of the balloon is reduced, and a large gap is generated between the valve port and the balloon, and the airflow can pass to realize the connection of the airway. The function. Further, the balloon valve 19 is supplied by the first air pump 6 of the air pump unit 2 in the coughing machine 1, and the air supply of the first air pump 6 is controlled by the electromagnetic valve 4 in the air path unit 2 (described in detail below).

Preferably, when the balloon valve 19 is deflated, the gas in the balloon valve 19 is not discharged into the atmosphere, but in the main breathing circuit, the purpose of which is: if the space inside the balloon valve 19 is directly connected to the atmosphere, Due to the spontaneous breathing of some patients, it may cause a negative pressure environment in the main breathing circuit. Under the action of the negative pressure difference between the atmospheric pressure and the main breathing circuit, the soft and thin balloon valve 19 may be cut off. The road narrows the breathing tube, thereby jeopardizing the patient's life (see Figure 2). At the same time, after each cough, the gas released from the balloon valve 19 can also be used to detect the pressure of the patient (C in Figure 1). The measuring and controlling pipeline of the pressure sensor 9 (third sensor) performs purging to prevent water droplets or sputum in the measuring and controlling pipeline of the sensor, which affects the operation of the sensor.

The coughing machine 1 is described in detail below. The coughing machine 1 is composed of five components, including: a gas pump element 2, a pneumatic path element 22, a main line element 15, a control system 8, and a noise reduction and noise reduction system 18.

The gas pump element 2 comprises three micro air pumps: a first air pump 6, a second air pump 3 and a third air pump 5. The first air pump 6 supplies air to the balloon of the balloon valve 19. The second air pump 3 supplies air to the interface A of the expansion device 21, and the third air pump 5 supplies air to the interface B of the expansion device 21. The second air pump 3 and the third air pump 5 have two functions. The first function is to prevent the ventilator from alerting when the coughing machine is working normally. When the cough begins, because the ventilator's airway is cut off, no gas exhaled by the patient enters the ventilator's exhalation circuit. The breathing opportunity mistakenly believes that the patient is suffocated, the trachea is disengaged, or other abnormal conditions occur, and an alarm is issued. The second air pump 3 and the third air pump 5 at this time provide a flow of sufficient flow to enter the ventilator expiratory circuit passage through the throttling device 21 to avoid ventilator alarms. In addition to avoiding ventilator alarms. In addition, in actual use, in order to ensure that the air or oxygen inhaled by the patient is wet, it is necessary to connect the humidifying bottle in series in the pipeline. Therefore, a large amount of liquid water is condensed at any time in the breathing pipeline, and the gas exhaled by the patient also contains moisture. Moreover, during the process of sucking the patient, the sucked sputum may also adhere or adhere to the pipeline. This complicated pipeline environment is very unfavorable for various sensors to accurately detect signals, especially liquid water or sputum. The liquid accumulates in the extremely thin piping used for measurement and control. Therefore, the second function of the second air pump 3 and the third air pump 5 is to periodically purge the pipeline between the pressure sensor 11, the differential pressure sensor 12, and the throttle device 21 to prevent liquid water or Sputum affects sensor operation. Wherein, the power component that generates the purge airflow is not limited to the air pump or the micro air compressor, and the fan or the high pressure storage tank for storing the gas may be used, and the above power components or energy storage components are used alone, in multiple or in combination, or collected by the fan. The gas is blown back to the expiratory circuit of the ventilator instead of the purging, etc. In the present embodiment, two high-pressure second air pumps 3 and 5 are used in parallel to supply air to meet the demand of transient large flow. Alternatively, the air supply to the interface A and the interface B of the throttling device 21 may be simultaneously performed by an air pump.

The function of the pneumatic circuit assembly 22 is to complete the pneumatic communication and control connection of the coughing machine 1 with the coughing circuit 20, the core component of which is the solenoid valve 4. The solenoid valve is preferably a two-position three-way, but is not limited to a two-position three-way, such as a two-position two-way, four-way, five-way, three-position solenoid valve, and the like. The solenoid valve 4 controls the first air pump 6, which functions to supply and exhaust the balloon valve 19 under the control of the two-position three-way solenoid valve 4. The gas path component 22 may also include another two-position three-way solenoid valve 7, which belongs to the backup solenoid valve and functions as a double safety protection, that is, when the two-position three-way solenoid valve 4 fails, the inside of the balloon valve 19 When the gas cannot be discharged, the ventilator line cannot be connected, and the patient cannot be mechanically ventilated, the two-position three-way solenoid valve 7 will be electrically opened to discharge the gas in the balloon valve 19.

The main line assembly 15 includes a shutter valve 17, a mass flow meter 14, a pressure sensor 13 (fifth sensor), and a blower 16. Preferably, since the negative pressure fan 16 generates high decibel rotation noise and eddy current noise when the exhaust gas is operated, the main line element 15 further includes an muffling noise reduction system 18 for effectively reducing the influence of noise on the environment. Fan 16 is used to generate the negative pressure required for coughing. The pressure sensor 13 immediately detects the pressure of the blower 16 and transmits it to the control system 8. The fan 16 can be, for example, a centrifugal or axial fan, but is not limited to a fan, and includes all power components that can generate a negative pressure, such as a vacuum pump, a vacuum generator, and the like. The mass flow meter 14 detects the suction flow at the time of coughing and provides it to the control system 8 to close the shutter valve 17 to close the cough circuit when the suction flow is detected to be close to zero or as needed by the control system 8. The mass flow meter 14 may also be any other type of mass flow meter such as a differential pressure type, a thermal type, a turbine type, an ultrasonic wave, or the like, and is preferably a differential pressure type mass flow meter or a thermal mass flow meter. The shutter valve 17 is normally closed and is only opened by the control system 8 when the coughing machine is in operation. At the same time, it has the function of quick opening and closing and realizing airflow disturbance, which can enhance the cough effect.

The control system 8 is composed of a microcomputer control unit, a human machine interface (a parameter for setting a fully automatic cough system), various pressure or differential pressure sensors. The control system 8 collects various parameters collected by the sensor and performs control to output other components (such as the shutter valve 17, the solenoid valve 4) and human-machine interaction.

The control system 8 includes a pressure sensor 11 and a pressure sensor 12, and the pressure sensors 11 and 12 immediately monitor the pressure and pressure difference on both sides of the throttle device 21, that is, the pressure sensor 11 detects the interface of the throttle device 21. At the pressure at A, the pressure sensor 12 detects the pressure at the interface B of the throttling device 21 and transmits the data to the microcomputer control unit. As previously mentioned, it is also possible to detect the pressure at interface A and interface B, respectively, using only one differential pressure sensor 12. The pressure sensors 11, 12 monitor the pressure of the throttling device 21 in order to determine whether the patient is in the inspiratory phase or the expiratory phase, and prepare the data for whether or not to open the coughing device.

Preferably, the control system 8 preferably further comprises a pressure sensor 9 which immediately detects the pressure at the patient's sac (at C in Figure 1) of the balloon valve 19 and transmits the data to the microcomputer control unit .

In fact, the pressure sensor 9 and the pressure sensor 11 detect the pressure on both sides of the balloon valve 19, and for the pressure difference on both sides, in the normal breathing phase, if the pressure values on both sides of the balloon valve 19 are greater than one The threshold (for example, 5 cm water column) is alarmed by the microcomputer control unit. The purpose of this is: if the solenoid valve 4 fails, the balloon valve 19 fails to open, and the double protection solenoid valve 7 does not deflate the balloon valve. When the ventilator line is blocked and the patient is not supplied with gas, the control system 8 alarms to inform the staff that the system can be inspected immediately, thereby giving the patient a third protection.

Preferably, the control system 8 preferably further comprises a pressure sensor 10 (fourth sensor) for detecting the pressure sensor 10 at the outlet of the first air pump 6. The pressure sensor 10 may be disposed between the first air pump 6 and the solenoid valve 4, or between the solenoid valve 4 and the balloon valve 19. In order to prevent the outlet pressure of the first air pump 6 from being too high, the clogging may cause the motor to burn or blow the balloon of the balloon valve 19. The first solution is to add a gas storage tank, which has a small hole and can be slowly placed. Gas, so as to avoid excessive pressure at the outlet of the pump. More preferably, a pressure sensor 10 (second pressure sensor) is added at the outlet of the first air pump 6, and the rotation speed of the first air pump 6 is automatically adjusted by the PWM method according to the outlet pressure of the first air pump 6 (ie, When the outlet pressure of the air pump is low, the speed of the air pump is increased, and when the outlet pressure is high, the rotation speed of the pump is stopped or stopped), so that the output port of the first air pump 6 maintains a constant pressure to ensure the safety of the air pump. At the same time, the volume of the device is reduced, the energy consumption is reduced, and the reliability of the system is increased.

FIG. 3 shows a connection diagram of an example of the air passage member 22. The pneumatic circuit assembly 22 includes 10 joints: a first joint 207, a second joint 206, a third joint 204, a fourth joint 203, a fifth joint 258, a sixth joint 205, and a connection to the sexual coughing line 20. The four joints are a seventh joint 226, an eighth joint 228, a ninth joint 229, and a tenth joint 230.

Specifically, the first joint 207 is connected to the second air pump 3 at one end and the seventh joint 226 at one end, and is connected to the A port of the throttling device 21 in the coughing line 20, and the compressed air output by the second air pump 3 passes. The first joint 207 and the seventh joint 226 are outputted to the A port of the throttle device 21, and the second air pump 3 is blown to the A port. The second joint 206 is connected to an input port of the differential pressure sensor 12, and the pressure data acquisition of the point A on the throttling device 21 by the differential pressure sensor 12 is realized by the path. The third joint 204 is in communication with the other input port of the differential pressure sensor 12 (or is in communication with the pressure sensor 11), and the third joint 204 is connected to the B port of the throttle device 21 through the ninth joint 229, through which the third joint 204 is connected. The pressure difference sensor 12 is used to acquire the pressure data of the B port on the throttling device 21. Similarly, the fourth joint 203 is in communication with the third air pump 5, and is further connected to the B port of the throttle device 21 in the coughing line 20 through the ninth joint 229, so that the third air pump 5 blows the B port.

The fifth joint 258 connects the first air pump 6 and the first port of the solenoid valve 4 ((1) in Fig. 3). The eighth joint 228 is connected to the second port of the solenoid valve 4 ((2) in Fig. 3), and is further connected to the balloon valve 19. The sixth joint 205 is connected to the third port ((3) in FIG. 3) of the solenoid valve 4 and the pressure sensor 9. The tenth joint 230 connects the port (3) of the solenoid valve 4 and the patient 埠C. In essence, the joint 205 is in communication with the tenth joint 230, which allows the pressure sensor 9 to monitor the pressure in the main breathing circuit adjacent to the patient end. It is very useful to detect the pressure here, as described above, which can be used to determine if the main breathing circuit is blocked. The compressed air output from the first air pump 6 passes through the fifth joint 258, and enters the electromagnetic valve 4 from the (1) port of the electromagnetic valve 4.

When the solenoid valve 4 is de-energized, it can be seen from Fig. 3 that (1) the port is closed and the gas route is cut off. When the solenoid valve 4 is energized, the ports (1) and (2) are connected, the airflow is from the port (2) of the solenoid valve 4, and the eighth port 228 is directly connected to the balloon valve 19, so that the solenoid valve 4 is passed. The power of the first air pump 6 can inflate the balloon valve 19, and the balloon valve is thus closed to cut off the ventilator line (see Fig. 2). When the balloon valve is required to deflate, the solenoid valve 4 is de-energized, the (2) port of the solenoid valve 4 is connected to the port (3), and the gas in the balloon valve air bag passes through the eighth joint 228 and the solenoid valve 4 (2) The port (3) of the solenoid valve 4 is discharged to reach the tenth joint 230, and the tenth joint 230 communicates with a pressure collecting port of the disposable coughing line 20 near the patient end, so the gas discharged from the balloon valve Eventually through the mouth into the main breathing circuit. The reason why the gas discharged from the balloon valve is not discharged into the atmosphere and discharged into the main breathing circuit has been described above.

As described above, the function of the solenoid valve 7 is that when the solenoid valve 4 fails to switch for some reason, the balloon valve 19 cannot be deflated, causing the ventilator line to be unintentionally cut, and the solenoid valve 7 can timely put the balloon The gas in the room is released to ensure the safety of the patient. The working process is as follows: when the solenoid valve 4 is de-energized, the main system detects that the balloon valve is not exhausted, so the solenoid valve 7 is energized, and the gas in the balloon valve will be After the eighth joint 228 enters the first port of the solenoid valve 7 ("1" in Fig. 3), at this time, the solenoid valve 7 is energized, and the first port and the second port ("2" in Fig. 3) are connected. The gas is discharged from the second port of the solenoid valve 7, passes through the tenth joint 230, and enters the main breathing circuit from the patient pressure detecting port, thereby completing the exhaust of the balloon valve.

As described above, the cough system of the present invention can operate in an automatic mode, that is, an interval is set by an operator (generally a medical professional). Once the time is up, the automatic coughing machine enters a standby state, and the system starts detecting. Whether the patient meets the cough condition, once met, the cough begins. Another way of working is manual mode. The operator is usually a patient with certain mobility. When the patient presses the manual cough button, it does not cough immediately. The automatic coughing machine also enters the standby state until the patient inhales. The coughing machine starts coughing when the patient's breathing begins and the coughing condition is met. Cough is not unconditional. If you do not meet certain conditions, forcing a cough will not only achieve the desired effect, but may also cause harm to the patient.

Referring to Fig. 1, when coughing is not performed, the control system 8 monitors the pressure of the throttling device 21 collected by the sensors 11, 12 to monitor the inspiratory flow. At this time, the balloon valve 19 is not inflated and is normally open, and the shutter valve 17 is normally closed. The ventilator continuously mechanically ventilates the patient at a set respiratory rate. Initiating a cough can be triggered manually by the patient or according to a time interval (eg, 5 minutes) set by the coughing machine operator. The coughing process is as follows:

1. After the cough is activated, the control system 8 turns on the fan 16 inside the coughing machine 1, and the pipeline between the fan 16 and the shutter valve 17 will produce the expected negative pressure, and the negative pressure may be -10 cm-H2O to - Between 200 cm-H2O, preferably between -50 cm-H2O and -150 cm-H2O, more preferably between -60 cm-H2O and -120 m-H2O, at this time, since the shutter valve 17 is closed It will not have any effect on the patient's mechanical ventilation. The pressure sensor 13 immediately detects the fan pressure and transmits it to the control system 8, so that the control system 8 can adjust the pressure of the fan 16.

2. The pressure sensor 11 inside the control system 8 immediately monitors the pressure at the interface A of the throttle device 21, and the differential pressure sensor 12 immediately monitors the pressure at the interface B of the throttle device 21 and transmits the data. To the microcomputer control unit, the microcomputer control unit calculates the instantaneous flow and pressure in the coughing line 20, analyzes and judges whether the patient is in the inhalation phase or the expiratory phase, and captures the end of inspiration, and the exhalation is about to begin. At the switching time point, when the patient is at this switching time point, the control system 8 turns on the first air pump 6, and the two-position three-way solenoid valve 4 is energized to turn on the air path of the first air pump 6 and the balloon valve 19, the ball The bladder valve 19 is inflated, causing the balloon valve 19 to close, cutting off the venting route of the ventilator to the patient, and at about the same time, the normally closed shutter valve 17 is quickly opened by the control system 8, and the negative pressure line of the blower 16 is the same as the patient. The airway is connected, which will result in a rapid, sudden expiratory flow from the patient's lungs. Relevant practical and theoretical studies have shown that when the flow rate is greater than 170L/Min, it will effectively cough. This flow is equivalent to one. Ordinary normal cough . At this time, since the balloon valve 19 is closed, the ventilator will not be exposed to the negative pressure of the fan, but for some ventilators that have the function of detecting the patient's expiratory flow, it may cause an alarm, therefore, in the balloon valve. At the moment when 19 is closed, the second air pumps 3, 5 in the air pump element 2 also start to operate at the same time, and the generated gas enters the breathing circuit through the interface A and the interface B of the throttling device 21, respectively, and exhales to the ventilator. The circuit is able to replace the patient's expiratory flow and avoid ventilator alarms.

3. When the gas flowing out of the patient's lungs is discharged to the atmosphere through the shutter valve 17, the flow sensor 14, the fan 16, and the noise reduction system 18. The flow sensor 14 detects the patient's expiratory flow and transmits the data to the microcomputer control unit. When detecting that the patient's expiratory flow is close to zero, the microcomputer control unit closes the shutter valve 17, and at the same time, the two-position three-way solenoid valve 4 power loss, the balloon valve 19 begins to deflate, the internal gas flows into the patient's main breathing circuit through the three-way solenoid valve, the balloon valve 19 is thus opened, and the ventilator is connected to the patient. At this time, the patient starts to inhale. The ventilator is triggered and the patient continues normal mechanical ventilation as before the cough, indicating that a cough has been completed.

It should also be noted that: theoretically, when the patient's expiratory flow is close to zero, the cough stops. However, since the shutter valve, the balloon valve and the like need response time, if the expiratory flow is close to zero, the command is issued. Excessive pumping may occur, endangering the patient's life. Therefore, during actual operation, the shutter valve and the balloon valve should be closed in advance. When the flow sensor 14 detects that the gas flow rate through the shutter valve 17 is below a threshold, the microcomputer controls The unit closes the shutter valve 17, and the desired value of the threshold can be adjusted according to the hardware of the coughing line and the physiological characteristics of the patient, for example, generally can be set to 17 L/Min or more.

At the same time, for patients with respiratory distress syndrome and other patients requiring high PEEP (expiratory positive end expiratory pressure) ventilation, the shutter valve can be closed earlier, so the flow rate of early closure will be greater than 17L/MIN, so that the patient's lungs The internal pressure remains above atmospheric pressure after the end of the cough to prevent collapse of the alveolar atrophy. This is also an important reason why the cough system can be more widely used in various medical conditions than the Philips coughassist described in the background art.

Through repeated repetition of the above process, the patient's airway secretions can be effectively discharged from the deep part of the lungs to the outside of the body, and then the sputum collection device is collected by the sputum collecting device with negative pressure suction function, and the medical staff regularly Pour or clear.

As described above, the system can work in the automatic mode, that is, the operator, usually the medical staff, sets an interval time. Once the time is up, the automatic coughing machine enters the standby state, the fan starts, and the system starts to detect whether the patient is detecting. In accordance with the cough condition, once met, the cough begins. Another way of working is manual mode. The operator is usually a patient with certain mobility. When the patient presses the manual cough button, it does not cough immediately. Also, the automatic coughing machine enters the standby state, and the fan starts until the patient starts. At the end of inhalation, the coughing machine initiates coughing when the patient's breathing begins and the coughing condition is met.

The embodiments described above are only preferred embodiments of the present invention, and the usual changes and substitutions made by those skilled in the art within the scope of the present invention are included in the scope of the present invention.

1‧‧‧Cough machine
2‧‧‧Air pump components
3‧‧‧Second air pump
4‧‧‧ solenoid valve
5‧‧‧ Third air pump
6‧‧‧First air pump
7‧‧‧ solenoid valve
8‧‧‧Control system
9‧‧‧ Pressure Sensor
10‧‧‧ Pressure Sensor
11‧‧‧ Pressure Sensor
12‧‧‧ Differential Pressure Sensor
13‧‧‧ Pressure Sensor
14‧‧‧Quality flowmeter
15‧‧‧main road components
16‧‧‧Fan
17‧‧‧Shutter valve
18‧‧‧Dust elimination and noise reduction system
19‧‧‧Ball valve
20‧‧‧Cough line
21‧‧‧Throttle device
22‧‧‧ pneumatic components
207‧‧‧First joint
206‧‧‧Second joint
204‧‧‧ third joint
203‧‧‧fourth joint
258‧‧‧ fifth joint
205‧‧‧ sixth joint
226‧‧‧ seventh joint
228‧‧‧ eighth joint
229‧‧‧ ninth joint
230‧‧‧ Tenth joint (1), (2), (3)‧‧‧
A, B, C‧‧ interface

1 is a schematic diagram of a gas path of a fully automatic cough system of the present invention. Figure 2 is a force analysis diagram of the balloon valve. Fig. 3 is a gas path connection diagram of the pneumatic circuit element.

1‧‧‧Cough machine

2‧‧‧Air pump components

3‧‧‧Second air pump

4‧‧‧ solenoid valve

5‧‧‧ Third air pump

6‧‧‧First air pump

7‧‧‧ solenoid valve

8‧‧‧Control system

9‧‧‧ Pressure Sensor

10‧‧‧ Pressure Sensor

11‧‧‧ Pressure Sensor

12‧‧‧ Differential Pressure Sensor

13‧‧‧ Pressure Sensor

14‧‧‧Quality flowmeter

15‧‧‧main road components

16‧‧‧Fan

17‧‧‧Shutter valve

18‧‧‧Dust elimination and noise reduction system

19‧‧‧Ball valve

20‧‧‧Cough line

21‧‧‧Throttle device

22‧‧‧ pneumatic components

(1), (2), (3) ‧‧‧

A, B, C‧‧ interface

Claims (10)

A coughing system comprising: a coughing machine and a coughing tube; the coughing tube comprises a throttling device and a balloon valve, wherein the balloon valve is a two-way valve, one of which is a ventilator, throttling The device is connected to the ventilator, and the other is divided into two, one is a coughing machine, the coughing machine is connected, the other is a patient, and the patient is connected; the coughing machine includes a main road component, a gas pump component, and a control system. The main pipeline component includes a fan that generates a negative pressure and a shutter valve that opens when coughing; the air pump assembly includes a first air pump that supplies air to the balloon valve and a second air pump that supplies air to the throttle device; and the control system is used to control the supervisor a road component and a gas pump component, the control system includes a first sensor for measuring the air pressure at the throttle device, and a microcomputer control unit; wherein the microcomputer control unit determines that the patient is in the breathing phase based on the air pressure difference detected by the first sensor Or in the inhalation phase, when the patient is in the inhalation phase to the exhalation phase, the microcomputer control unit controls the first air pump to supply air to the balloon of the balloon valve to disconnect the ventilator to the patient's fistula, the control system And a shutter to open the fan valve to assist the patient sputum, while the microcomputer control unit controls the second expansion device to the gas pump, during sputum, the ventilator does not stop working. The coughing system of claim 1, wherein the throttling device is provided with an interface A and a interface B along a direction of the ventilating airflow of the ventilator, the air pump component further comprising a third air pump, and the control system further comprises a second sensor Moreover, the first sensor is used to detect the pressure difference at the interface of the throttling device A and B, the second sensor is used to detect the air pressure at the interface B of the throttling device; the second air pump is supplied to the interface A of the throttling device, The third air pump supplies air to the throttling device interface B. The coughing system of claim 2, further comprising a pneumatic component, the pneumatic component comprising a solenoid valve controlled by the microcomputer control unit, the electromagnetic valve being connected between the first air pump and the balloon valve, electromagnetic The valve controls the intake and exhaust of the balloon valve. The cough system of claim 2, wherein the control system further comprises: a third sensor for detecting a pressure at the patient's ankle of the balloon valve, wherein the microcomputer control unit calculates the second sensor and the third sensor When the pressure difference between the pressures detected by the three sensors is greater than a threshold, the microcomputer control unit alarms. The cough system of claim 1, wherein the main line component further comprises a flow meter for detecting a gas flow rate through the shutter valve, and when below a threshold, the microcomputer control unit determines that the cough is over. , the shutter valve is closed, and the threshold is greater than zero. The cough system according to claim 5, wherein the main line component further comprises a fifth pressure sensor for detecting the pressure of the fan, and the microcomputer control unit adjusts according to the pressure detected by the fifth pressure sensor. The speed of the fan. The coughing system of claim 3, wherein the pneumatic circuit component further comprises: a first joint, a second joint, a third joint, a fourth joint, a fifth joint, a sixth joint, a seventh joint, An eighth joint, a ninth joint and a tenth joint, wherein: the first joint is connected to the second air pump at one end, and the other end is connected to the interface A of the throttling device through the seventh joint; the second joint is connected to the first sensor; The third joint is connected to the second sensor; the fourth joint is connected to the third air pump at one end, and the other end is connected to the interface B of the throttle device through the ninth joint; the fifth joint is connected to the first air pump at one end and the electromagnetic pump at the other end The first port of the valve; the sixth joint is connected to the third port of the solenoid valve and connected to the third sensor; the eighth end of the eighth joint is connected to the balloon of the balloon valve, and the other end is connected to the second port of the solenoid valve, the tenth The joint is connected to the third port of the solenoid valve and is connected to the third sensor. The coughing system of claim 7, wherein the pneumatic component further comprises a backup solenoid valve, the first port of the solenoid valve is connected to the eighth connector, and the second port of the solenoid valve is connected to the tenth connector, electromagnetic After the valve is energized, the first port and the second port of the solenoid valve are turned on, and the gas in the balloon of the balloon valve is discharged through the eighth joint and the tenth joint. The cough system of claim 8, wherein the sixth joint is connected to the breathing circuit of the ventilator, and the gas in the balloon of the balloon valve is discharged into the breathing circuit of the ventilator. The cough system of claim 4, wherein the control system further comprises a fourth sensor for detecting the air pressure at the outlet of the first air pump, the fourth sensor being disposed at the outlet of the first air pump, The microcomputer control unit adjusts the rotation speed of the first air pump by a PWM method according to the pressure detected by the fourth sensor, so that the first air pump outputs a constant pressure.