WO1992003091A1 - Process for measuring the hyperinsufflation level of a patient under ventilatory assistance - Google Patents
Process for measuring the hyperinsufflation level of a patient under ventilatory assistance Download PDFInfo
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- WO1992003091A1 WO1992003091A1 PCT/FR1991/000666 FR9100666W WO9203091A1 WO 1992003091 A1 WO1992003091 A1 WO 1992003091A1 FR 9100666 W FR9100666 W FR 9100666W WO 9203091 A1 WO9203091 A1 WO 9203091A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
Definitions
- the present invention relates, in general, to devices or installations intended to provide ventilatory assistance to a patient.
- the invention relates more precisely to such devices which comprise a device making it possible, during a phase of insufflation, to introduce into the lungs of the patient a certain quantity of air at constant flow rate, then, during a phase of pause, to interrupt any air flow, and finally, during an expiration phase, to let the air freely escape from the patient's lungs. All of these three phases form a breathing cycle.
- the device repeats the breathing cycle regularly to cause forced breathing of the patient.
- Such ventilatory assistance devices include numerous commands making it possible to vary, depending on certain clinical conditions, the various parameters of ventilation, in particular the flow rate during the insufflation phase and the durations of the insufflation phases, pause and expiration. These devices additionally provide the results of certain measurements carried out continuously during their operation and which may be useful to the medical personnel concerned, because they are representative of certain states or of certain changes in the state of the patient under ventilatory assistance. For example, some devices indicate the pressure developed at the inlet of the respiratory tract during the insufflation phase during which the device imposes a constant rate of insufflation. If this pressure becomes greater than a predetermined threshold, this reveals clinical conditions, in particular an obstruction of certain respiratory tracts. Some devices also offer a measure of the resistance to air flow in the respiratory system during the insufflation phase.
- Hyperinsufflation is an incomplete expiration at the end of the expiration phase.
- Complete expiration an expiration allowing by its duration the rejection of all the air which can be rejected naturally by the patient without that this one performs voluntary action to increase or decrease such a rejection, which is the case if the patient is unconscious. If expiration is not complete at the start of the next insufflation phase, some parts of the lungs remain filled with too much air, which causes poor breathing.
- An object of the present invention is therefore to provide a method for measuring the level of hyperirisufflation of the respiratory system of a patient subjected to ventilatory assistance.
- Another object of the present invention is to provide such a method making it possible to provide such a measurement continuously and in real time during the normal operation of the ventilatory assistance device.
- the present invention provides a method based on the analysis of the pressure at the inlet of the respiratory tract as will be explained in the following description of an exemplary embodiment illustrated by the attached figures among which:
- Figure 1 is a diagram showing the evolution over time of the air flow, d, circulating in the respiratory tract of a patient under ventilatory assistance;
- FIG. 2 is a diagram representing the evolution over time of the pressure P at the level of the entry of the respiratory tracts of a patient subjected to ventilatory assistance and not presenting hyperinsufflation;
- Figure 3 shows a diagram similar to that of Figure 2 but corresponding to a patient with a certain level of hyperinsufflation.
- Figures 1 to 3 correspond to the same breathing cycle conventionally caused by a ventilatory assistance device. This cycle consists of three phases and is repeated during the entire operating time of the ventilator.
- a first phase 1 called the insufflation phase, between instants t0 and t1, the device introduces into the patient's respiratory tract a certain amount of air at constant flow (d1).
- a second phase 2 called the pause phase, between instants t1 and t2, the device interrupts any air circulation at the level of the inlet of the patient's airway (zero flow). The patient is thus in a blocked breathing state after inhaling.
- a third phase 3 called expiration phase, between instants t2 and t3, the device freely lets air escape from the patient's respiratory tract. This expiration occurs naturally, that is to say without special assistance, due to the natural elasticity of the lungs.
- the flow negative compared to the flow d1, gradually decreases and tends towards zero at the end of the cycle.
- the insufflation phase 1 lasts for approximately 2 seconds
- the pause phase 2 lasts for approximately 1 second
- the expiration phase 3 lasts for approximately 3 seconds.
- a full breath cycle therefore takes around 6 seconds.
- FIG. 2 represents, on the same time scale, the evolution of the pressure at the level of the entry of the respiratory tracts of a patient presenting good physical conditions at the level of his respiratory system.
- the Applicant has found that the pressure difference P0 - v P is substantially proportional to the level of hyperinsufflation of the patient, this level being expressed in volume of excess air present in the lungs of the patient at the end of the phase expiration 3.
- the present invention therefore proposes a method for measuring the level of hyperinsufflation of a patient under ventilatory assistance produced by a device whose operating cycle comprises a phase of insufflation at constant flow 1, a phase of pause 2, and an expiration phase 3.
- This method comprises the steps of measuring the pressure P at the inlet of the respiratory tract; at determining the line AB corresponding to the substantially linear part of the pressure variation as a function of time during the insufflation phase 1; determining the value P0 of the pressure for the point on the line AB corresponding to the instant t0 of the start of the insufflation phase; measuring the pressure drop v P occurring during the pause phase; and determining the difference between said value P0 and the pressure drop v P, this difference being substantially proportional to the level of hyperinsufflation of the patient.
- An advantage of the method according to the present invention is that the existing ventilatory assistance devices usually include means for reading the pressure values and even possibly for providing them in digital form and are generally associated with a processing computer.
- the means of implementing the present invention could therefore simply consist of programs intended for this computer, which makes it possible to provide in real time the desired difference and optionally an alarm indication as soon as this difference exceeds a predetermined threshold.
- the medical staff can then immediately intervene to modify the operating cycle of the ventilatory assistance device and / or to apply appropriate chemotherapy to the patient.
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Abstract
Process for measuring the hyperinsufflation level of a patient under ventilatory assistance from a machine, the cycle of which comprises: insufflation (1), during which a constant flow of air is introduced into the patient's respiratory tract, a pause (2) during which respiration is blocked, and expiration (3), during which the patient's respiratory tract is exposed to a natural flow of air. The process involves the following stages: measuring the pressure (P) at the opening of the respiratory tract; determining the line segment (AB) corresponding to the substantially linear part of the pressure variation as a function of time during insufflation; determining the value of the pressure (PO) for the point of the line segment (AB) corresponding to the moment (tO) when insufflation commences; measuring the fall in pressure (?vP) occurring during the pause; and determining the difference between said pressure value and said fall in pressure.
Description
PROCÉDÉ DE MESURE DU NIVEAU D'HYPERINSUFFLATION METHOD FOR MEASURING THE HYPERINSUFFLATION LEVEL
D'UN PATIENT SOUS ASSISTANCE VEMTILATOIRE OF A PATIENT WITH VEMTILATORY ASSISTANCE
La présente invention concerne, de façon générale, des appareils ou installations destinés à effectuer une assistance ventilatαire d'un patient. L'invention concerne plus précisément de tels appareils qui comprennent un dispositif permettant, pendant une phase d'insufflation, d'introduire dans les poumons du patient une certaine quantité d'air à débit constant, puis, pendant une phase de pause, d'interrompre tout débit d'air, et enfin, pendant une phase d'expiration, de laisser s'échapper librement l'air des poumons du patient. L'ensemble de ces trois phases forme un cycle de respiration. L'appareil répète le cycle de respiration régulièrement pour provoquer une respiration forcée du patient. The present invention relates, in general, to devices or installations intended to provide ventilatory assistance to a patient. The invention relates more precisely to such devices which comprise a device making it possible, during a phase of insufflation, to introduce into the lungs of the patient a certain quantity of air at constant flow rate, then, during a phase of pause, to interrupt any air flow, and finally, during an expiration phase, to let the air freely escape from the patient's lungs. All of these three phases form a breathing cycle. The device repeats the breathing cycle regularly to cause forced breathing of the patient.
De tels appareils d'assistance ventilatoire coriprennent de ncmbreuses commandes permettant de faire varier, en fonction de certaines conditions, cliniques, les différents paramètres de la ventilation, en particulier le débit pendant la phase d'insufflation et les durées des phases d'insufflation, de pause et d'expiration. Ces appareils fournissent en plus les résultats de certaines mesures effectuées en continu pendant leur fonctionnement et qui peuvent être utiles au personnel médical concerné, parce qu'elles sont représentatives de certains états ou de certairies évolutions de l'état du patient sous assistance ventilatoire.
Par exemple, certains appareils indiquent la pression développée au niveau de l'entrée des voies respiratoires pendant la phase d'insufflation au cours de laquelle l'appareil impose un débit constant d'insufflation. Si cette pression devient supérieure à un seuil prédéterminé, cela révèle des états cliniques, en particulier une obstruction de certaines voies respiratoires. Certains appareils proposent aussi une mesure de la résistance à l'écoulement de l'air dans le système respiratoire pendant la phase d'insufflation. Such ventilatory assistance devices include numerous commands making it possible to vary, depending on certain clinical conditions, the various parameters of ventilation, in particular the flow rate during the insufflation phase and the durations of the insufflation phases, pause and expiration. These devices additionally provide the results of certain measurements carried out continuously during their operation and which may be useful to the medical personnel concerned, because they are representative of certain states or of certain changes in the state of the patient under ventilatory assistance. For example, some devices indicate the pressure developed at the inlet of the respiratory tract during the insufflation phase during which the device imposes a constant rate of insufflation. If this pressure becomes greater than a predetermined threshold, this reveals clinical conditions, in particular an obstruction of certain respiratory tracts. Some devices also offer a measure of the resistance to air flow in the respiratory system during the insufflation phase.
L'hyperinsufflation correspond à une expiration incomplète à la fin de la phase d'expiration. On appelle "expiration complète" une expiration permettant par sa durée le rejet de tout l'air qui peut être rejeté naturellement par le patient sans que celui-ci n'effectue d'action volontaire pour augmenter ou diminuer un tel rejet, ce qui est le cas si le patient est inconscient. Si l'expiration n'est pas complète au début de la phase d'insufflation suivante,certaines parties des poumons restent remplies d'une trop grande quantité d'air, ce qui provoque une mauvaise respiration. Hyperinsufflation is an incomplete expiration at the end of the expiration phase. We call "complete expiration" an expiration allowing by its duration the rejection of all the air which can be rejected naturally by the patient without that this one performs voluntary action to increase or decrease such a rejection, which is the case if the patient is unconscious. If expiration is not complete at the start of the next insufflation phase, some parts of the lungs remain filled with too much air, which causes poor breathing.
Cependant, aucun appareil d'assistance ventilatoire connu actuellement ne permet de mesurer en continu et de façon fiable le niveau d'hyperinsufflation du système respiratoire du patient soumis à une assistance ventilatoire. However, no ventilatory assistance device known at present makes it possible to continuously and reliably measure the level of hyperinsufflation of the respiratory system of the patient subjected to ventilatory assistance.
En effet, avec les appareils actuels, un praticien ne peut obtenir une mesure du niveau d'hyperinsufflation qu'en cximiandant l'appareil d'assistance ventilatoire pour fermer le conduit d'évacuation d'air des voies respiratoires à l'instant de la fin de la phase d'expiration prévue et en mesurant après un certain temps, par exemple plusieurs secondes, la pression qui s'instaure progressivement et qui correspond à la pression au niveau des poumons du patient. Un tel blocage en fin d'expiration peut être nuisible à un patient qui présente justement une grande fragilité.
Un objet de la présente invention est donc de prévoir un procédé de mesure du niveau d'hyperirisufflation du système respiratoire d'un patient soumis à une assistance ventilatoire. Indeed, with current devices, a practitioner can obtain a measurement of the level of hyperinsufflation only by cximiandant the ventilatory assistance device to close the air evacuation duct of the respiratory tract at the moment of end of the planned expiration phase and by measuring after a certain time, for example several seconds, the pressure which is gradually established and which corresponds to the pressure in the patient's lungs. Such a blockage at the end of expiration can be harmful to a patient who has a very fragile condition. An object of the present invention is therefore to provide a method for measuring the level of hyperirisufflation of the respiratory system of a patient subjected to ventilatory assistance.
Un autre objet de la présente invention est de prévoir un tel procédé permettant de fournir une telle mesure en continu et en temps réel pendant le fonctionnement normal de l'appareil d'assistance ventilatoire. Another object of the present invention is to provide such a method making it possible to provide such a measurement continuously and in real time during the normal operation of the ventilatory assistance device.
Pour atteindre ces objets, la présente invention prévoit un procédé basé sur l'analyse de la pression à l'entrée des voies respixatoires comme cela sera exposé dans la description suivante d'un exemple de réalisation illustré par les figures jointes parmi lesquelles : To achieve these objects, the present invention provides a method based on the analysis of the pressure at the inlet of the respiratory tract as will be explained in the following description of an exemplary embodiment illustrated by the attached figures among which:
la figure 1 est un diagramme représentant l'évolution dans le temps du débit d'air, d, circulant dans les voies respiratoires d'un patient sous assistance ventilatoire ; Figure 1 is a diagram showing the evolution over time of the air flow, d, circulating in the respiratory tract of a patient under ventilatory assistance;
la figure 2 est un diagramme représentant l'évolution dans le temps de la pression P au niveau de l'entrée des voies respiratoires d'un patient soumis à une assistance ventilatoire et ne présentant pas d'hyperinsufflation ; et FIG. 2 is a diagram representing the evolution over time of the pressure P at the level of the entry of the respiratory tracts of a patient subjected to ventilatory assistance and not presenting hyperinsufflation; and
la figure 3 représente un diagramme semblable à celui de la figure 2 mais correspondant à un patient présentant un certain niveau d'hyperinsufflation. Figure 3 shows a diagram similar to that of Figure 2 but corresponding to a patient with a certain level of hyperinsufflation.
Les figures 1 à 3 correspondent à un même cycle de respiration provoqué classiquement par un appareil d'assistance ventilatoire. Ce cycle comprend trois phases et se répète pendant tout le temps de fonctionnement de l'appareil d'assistance ventilatoire. Figures 1 to 3 correspond to the same breathing cycle conventionally caused by a ventilatory assistance device. This cycle consists of three phases and is repeated during the entire operating time of the ventilator.
Comme l'illustre la figure 1, dans une première phase 1 dite phase d'insufflation, entre des instants t0 et t1, l'appareil introduit dans les voies respiratoires du patient une certaine quantité d'air à débit constant (d1). Dans une deuxième phase 2 dite phase de pause, entre des instants t1 et t2, l'appareil interrompt toute circulation d'air au niveau de l'entrée des
voies respiratoires du patient (débit nul). Le patient se trouve ainsi dans un état de blocage de sa respiration après avoir inspiré. Dans une troisième phase 3 dite phase d'expiration, entre des instants t2 et t3, l'appareil laisse échapper librement l'air depuis les voies respiratoires du patient. Cette expiration s'effectue naturellement, c'est-à-dire sans assistance particulière, du fait de l'élasticité raturelle des poumons. Pendant cette troisième phase, le débit, négatif par rapport au débit d1, diminue progressivement et tend vers zéro en fin de cycle. As illustrated in FIG. 1, in a first phase 1 called the insufflation phase, between instants t0 and t1, the device introduces into the patient's respiratory tract a certain amount of air at constant flow (d1). In a second phase 2, called the pause phase, between instants t1 and t2, the device interrupts any air circulation at the level of the inlet of the patient's airway (zero flow). The patient is thus in a blocked breathing state after inhaling. In a third phase 3, called expiration phase, between instants t2 and t3, the device freely lets air escape from the patient's respiratory tract. This expiration occurs naturally, that is to say without special assistance, due to the natural elasticity of the lungs. During this third phase, the flow, negative compared to the flow d1, gradually decreases and tends towards zero at the end of the cycle.
En général, la phase d'insufflation 1 dure environ 2 secondes, la phase de pause 2 dure environ 1 seconde, et la phase d'expiration 3 dure environ 3 secondes. Un cycle complet de respiration dure par conséquent environ 6 secondes. In general, the insufflation phase 1 lasts for approximately 2 seconds, the pause phase 2 lasts for approximately 1 second, and the expiration phase 3 lasts for approximately 3 seconds. A full breath cycle therefore takes around 6 seconds.
La figure 2 représente, selon la même échelle de temps, l'évolution de la pression au niveau de l'entrée des voies respiratoires d'un patient présentant de bonnes conditions physiques au niveau de son système respiratoire. FIG. 2 represents, on the same time scale, the evolution of the pressure at the level of the entry of the respiratory tracts of a patient presenting good physical conditions at the level of his respiratory system.
- Au début de la phase d'insufflation 1, la pression croit rapidement, pour atteindre une valeur PA (point A du diagramme). Ensuite, pendant la durée restante de la phase d'insufflation, la pression augmente de façon sensiblement linéaire pour atteindre une valeur maximum P1 à l'instant t1 de la fin de cette phase (point B du diagramme). Le segment AB occupe la plus grande plage de la phase 1. On appelle P0 la pression associée au point de la droite AB correspondant à l'instant t0. - At the start of insufflation phase 1, the pressure increases rapidly, reaching a value PA (point A in the diagram). Then, during the remaining duration of the insufflation phase, the pressure increases in a substantially linear fashion to reach a maximum value P1 at the instant t1 of the end of this phase (point B of the diagram). The segment AB occupies the largest range of phase 1. The pressure associated with the point of the line AB corresponding to time t0 is called P0.
- Pendant la phase de pause 2, entre les instants tl et t2, la pression chute d'abord rapidement, puis décroît asymptotiquement vers une valeur P2 inférieure à P1. La différence entre les valeurs P1 et P2 est appelée VP. - During pause phase 2, between instants tl and t2, the pressure first drops rapidly, then decreases asymptotically towards a value P2 less than P1. The difference between the values P1 and P2 is called VP.
- Pendant la phase d'expiration 3, la pression chute instantanément à une valeur quasi-nulle, puisque l'appareil met directement à l'air libre l'entrée des voies respiratoires. On
notera que cette pression quasi-nulle est la pression à la sortie des voies respiratoires et non la pression dans les poumons. - During expiration phase 3, the pressure instantly drops to a near-zero value, since the device puts the airway inlet directly into the open air. We note that this near-zero pressure is the pressure leaving the airways, not the pressure in the lungs.
Pour déterminer le niveau éventuel d'hyperinsufflation d'un patient, la demanderesse a effectué une étude théorique et expérimentale de diagrammes du type de ceux des figures 2 et 3 correspondant respectivement à un patient en bonne condition physique et à un patient souffrant d'hyperinsufflation sous assistance respiratoire. To determine the possible level of hyperinsufflation of a patient, the applicant carried out a theoretical and experimental study of diagrams of the type of those of FIGS. 2 and 3 corresponding respectively to a patient in good physical condition and to a patient suffering from hyperinsufflation. under respiratory assistance.
La demanderesse a constaté, à la suite de nombreuses expériences cliniques, que, si le patient ne présentait pas d'hvperirisufflation à l'instant t0 du début de la phase d'insufflation 1, la pression P0 était sensiblement égale à la différence de pression vP. Ceci correspond au fait que la pression PO nécessaire pour ocmmencer de façon significative à insuffler de l'air dans les poumons du patient est sensiblement égale à la chute de pression P1 - P2 = vP qui se produit pendant la pause 2. S'il n'en est pas ainsi, le patient présente un certain niveau d'hyperinsufflation et, à l'instant t0 du début de la phase d'insufflation suivante, il subsiste encore une certaine quantité d'air anormalement présente dans les poumons du patient, et la pression P0 est supérieure à la différence de pression vP. The Applicant has found, after numerous clinical experiments, that, if the patient did not have any peririsufflation at the time t0 of the start of the insufflation phase 1, the pressure P0 was substantially equal to the pressure difference v P. This corresponds to the fact that the pressure PO necessary to start significantly to breathe air into the patient's lungs is substantially equal to the pressure drop P1 - P2 = v P which occurs during pause 2. If this is not the case, the patient has a certain level of hyperinsufflation and, at the instant t0 of the start of the next insufflation phase, there is still a certain amount of abnormally present air in the lungs. of the patient, and the pressure P0 is greater than the pressure difference v P.
Plus particulièrement, la demanderesse a constaté que la différence de pression P0 - vP est sensiblement proportionnelle au niveau d'hyperinsufflation du patient, ce niveau étant exprimé en volume d'air en excès présent dans les poumons du patient à la fin de la phase d'expiration 3. More particularly, the Applicant has found that the pressure difference P0 - v P is substantially proportional to the level of hyperinsufflation of the patient, this level being expressed in volume of excess air present in the lungs of the patient at the end of the phase expiration 3.
En partant de cette analyse, la présente invention propose donc un procédé de mesure du niveau d'hyperinsufflation d'un patient sous assistance ventilatoire produite par un appareil dont le cycle de fonctionnement comprend une phase d'insufflation à débit constant 1, une phase de pause 2, et une phase d'expiration 3. Ce procédé comprend les étapes consistant à mesurer la pression P à l'entrée des voies respiratoires ; à
déterminer la droite AB correspondant à la partie sensiblement linéaire de la variation de pression en fonction du temps pendant la phase d'insufflation 1 ; à déterminer la valeur P0 de la pression pour le point de la droite AB correspondant à l'instant t0 du début de la phase d'insufflation ; à mesurer la chute de pression vP survenant au cours de la phase de pause ; et à déterminer la différence entre ladite valeur P0 et la chute de pression vP, cette différence étant sensiblement proportionnelle au niveau d'hyperinsufflation du patient. On the basis of this analysis, the present invention therefore proposes a method for measuring the level of hyperinsufflation of a patient under ventilatory assistance produced by a device whose operating cycle comprises a phase of insufflation at constant flow 1, a phase of pause 2, and an expiration phase 3. This method comprises the steps of measuring the pressure P at the inlet of the respiratory tract; at determining the line AB corresponding to the substantially linear part of the pressure variation as a function of time during the insufflation phase 1; determining the value P0 of the pressure for the point on the line AB corresponding to the instant t0 of the start of the insufflation phase; measuring the pressure drop v P occurring during the pause phase; and determining the difference between said value P0 and the pressure drop v P, this difference being substantially proportional to the level of hyperinsufflation of the patient.
Un avantage du procédé selon la présente invention est que les appareils existant d'assistance ventilatoire comprennent usuellement des moyens pour relever les valeurs de pression et même éventuellement pour les fournir sous forme numérique et sont généralement associés à un ordinateur de traitement. Les moyens de mise en oeuvre de la présente invention pourrait donc simplement consister en des programmes destinés à cet ordinateur ce qui permet de fournir en temps réel la différence recherchée et optionnellement une indication d'alarme dès que cette différence dépasse un seuil prédéterminé. Le personnel médical pourra alors immédiatement intervenir pour modifier le cycle de fonctionnement de l'appareil d'assistance ventilatoire et/ou pour appliquer au patient une chimiothérapie appropriée.
An advantage of the method according to the present invention is that the existing ventilatory assistance devices usually include means for reading the pressure values and even possibly for providing them in digital form and are generally associated with a processing computer. The means of implementing the present invention could therefore simply consist of programs intended for this computer, which makes it possible to provide in real time the desired difference and optionally an alarm indication as soon as this difference exceeds a predetermined threshold. The medical staff can then immediately intervene to modify the operating cycle of the ventilatory assistance device and / or to apply appropriate chemotherapy to the patient.
Claims
1. Procédé de mesure du niveau d'hyperinsufflation d'un patient sous assistance ventilatoire produite par un appareil dont le cycle de fonctionnement comprend une phase d'insufflation (1) au cours de laquelle de l'air est envoyé dans les voies respiratoires du patient sous un débit constant (d1), une phase de pause (2) au cours de laquelle la respiration est bloquée, et une phase d'expiration (3) au cours de laquelle les voies respiratoires du patient sont mises à l'air libre, ce procédé étant caractérisé en ce qu'il comprend les étapes suivantes : 1. A method of measuring the level of hyperinsufflation of a patient under ventilatory assistance produced by an apparatus whose operating cycle comprises an insufflation phase (1) during which air is sent into the respiratory tract of the patient at a constant flow (d1), a pause phase (2) during which breathing is blocked, and an expiration phase (3) during which the patient's airways are vented , this process being characterized in that it comprises the following stages:
- mesurer la pression (P) à l'entrée des voies respiratoires ; - measure the pressure (P) at the inlet of the respiratory tract;
- déterminer la droite (AB) correspondant à la partie sensiblement linéaire de la variation de pression en fonction du temps pendant la phase d'insufflation ; - determine the straight line (AB) corresponding to the substantially linear part of the pressure variation as a function of time during the insufflation phase;
- déterminer la valeur de pression (P0) pour le point de ladite droite (AB) correspondant à l'instant (t0) du début de la phase d'insufflation ; - determining the pressure value (P0) for the point of said line (AB) corresponding to the instant (t0) of the start of the insufflation phase;
- mesurer la chute de pression (vP) survenant au cours de la phase de pause ; et - measure the pressure drop ( v P) occurring during the pause phase; and
- déterminer la différence entre ladite valeur de pression et ladite chute de pression. - determine the difference between said pressure value and said pressure drop.
2. Procédé de mesure du niveau d'hyperinsufflation d'un patient sous assistance ventilatoire selon la revendication 1, caractérisé en ce qu'il est mis en oeuvre en temps réel par unordinateur programmé. 2. Method for measuring the level of hyperinsufflation of a patient under ventilatory assistance according to claim 1, characterized in that it is implemented in real time by a programmed computer.
3. Procédé de mesure du niveau d'hyperinsufflation d'un patient sous assistance ventilatoire selon la revendication 2, caractérisé en ce que ledit ordinateur programmé fournit une indication d'alarme dès que ladite différence dépasse un seuil prédéterminé. 3. Method for measuring the level of hyperinsufflation of a patient under ventilatory assistance according to claim 2, characterized in that said programmed computer provides an alarm indication as soon as said difference exceeds a predetermined threshold.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR9010740A FR2666012B1 (en) | 1990-08-21 | 1990-08-21 | METHOD FOR MEASURING THE HYPERINSUFFLATION LEVEL OF A PATIENT UNDER VENTILATORY ASSISTANCE. |
| FR90/10740 | 1990-08-21 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO1992003091A1 true WO1992003091A1 (en) | 1992-03-05 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/FR1991/000666 WO1992003091A1 (en) | 1990-08-21 | 1991-08-14 | Process for measuring the hyperinsufflation level of a patient under ventilatory assistance |
Country Status (2)
| Country | Link |
|---|---|
| FR (1) | FR2666012B1 (en) |
| WO (1) | WO1992003091A1 (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| SE9904643D0 (en) | 1999-12-17 | 1999-12-17 | Siemens Elema Ab | Method for assessing pulmonary stress and a breathing apparatus |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2077444A (en) * | 1980-06-06 | 1981-12-16 | Draegerwerk Ag | Determining at least two parameters of a patient's respiratory system |
| EP0046570A2 (en) * | 1980-08-27 | 1982-03-03 | Kabushiki Kaisha Toshiba | Respiration monitoring apparatus |
| GB2133157A (en) * | 1982-10-09 | 1984-07-18 | Richard Bernhard Richardson | Electronic lung function analyser |
-
1990
- 1990-08-21 FR FR9010740A patent/FR2666012B1/en not_active Expired - Lifetime
-
1991
- 1991-08-14 WO PCT/FR1991/000666 patent/WO1992003091A1/en unknown
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2077444A (en) * | 1980-06-06 | 1981-12-16 | Draegerwerk Ag | Determining at least two parameters of a patient's respiratory system |
| EP0046570A2 (en) * | 1980-08-27 | 1982-03-03 | Kabushiki Kaisha Toshiba | Respiration monitoring apparatus |
| GB2133157A (en) * | 1982-10-09 | 1984-07-18 | Richard Bernhard Richardson | Electronic lung function analyser |
Also Published As
| Publication number | Publication date |
|---|---|
| FR2666012A1 (en) | 1992-02-28 |
| FR2666012B1 (en) | 1992-12-04 |
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