WO2015003509A1 - Procédé et système de surveillance de la profondeur d'une compression thoracique externe et défibrillateur - Google Patents

Procédé et système de surveillance de la profondeur d'une compression thoracique externe et défibrillateur Download PDF

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Publication number
WO2015003509A1
WO2015003509A1 PCT/CN2014/074069 CN2014074069W WO2015003509A1 WO 2015003509 A1 WO2015003509 A1 WO 2015003509A1 CN 2014074069 W CN2014074069 W CN 2014074069W WO 2015003509 A1 WO2015003509 A1 WO 2015003509A1
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Prior art keywords
chest
compression
depth
impedance signal
signal
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PCT/CN2014/074069
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English (en)
Chinese (zh)
Inventor
李传林
王启
李利亚
左鹏飞
岑建
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深圳迈瑞生物医疗电子股份有限公司
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Publication of WO2015003509A1 publication Critical patent/WO2015003509A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
    • A61B5/0809—Detecting, measuring or recording devices for evaluating the respiratory organs by impedance pneumography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7271—Specific aspects of physiological measurement analysis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
    • A61H31/005—Heart stimulation with feedback for the user
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3904—External heart defibrillators [EHD]
    • A61N1/39044—External heart defibrillators [EHD] in combination with cardiopulmonary resuscitation [CPR] therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3925—Monitoring; Protecting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5084—Acceleration sensors

Definitions

  • the invention belongs to the field of medical devices and relates to cardiopulmonary resuscitation (Cariopulmonary Resuscitation, CPR) A method of monitoring the depth of chest compressions, a monitoring system, and a defibrillator including the monitoring system.
  • CPR cardiopulmonary resuscitation
  • Cardiopulmonary resuscitation is a key rescue measure for emergency patients with cardiac arrest.
  • the basic life support procedures for adults, children, and babies recommended in the 2010 American Heart Association Cardiopulmonary Resuscitation and Cardiovascular First Aid Guide are CAB (chest).
  • External compression - open airway - artificial respiration which emphasizes the important role of chest compressions in improving patient survival.
  • the CPR pressing parameters mainly include the magnitude of the pressing, the frequency, and the interval between pressing and the like. Obtaining these parameters and monitoring them in real time to the rescuer can guide the rescuer to complete the CPR operation correctly and with high quality.
  • the existing CPR parameter monitoring techniques and their disadvantages are as follows:
  • An acceleration sensor is used to measure the compression depth.
  • external acceleration interference such as CPR during patient transfer
  • the road surface undulation will superimpose other motion acceleration disturbances.
  • the measured value of the acceleration sensor cannot reflect the actual compression acceleration, so the compression depth cannot be accurately measured.
  • An acceleration sensor is used to measure the depth of the press, and a force sensor is used to measure the magnitude of the pressing pressure.
  • the acceleration sensor signal is used to calculate the compression depth, and the correlation between the pressure magnitude and the compression depth is established.
  • the actual compression depth is calculated using the magnitude of the pressure and its dependence on the depth of compression while the patient is in motion. This method adds a set of force sensors and their detection circuits, which increases the system complexity.
  • a method for monitoring the depth of chest compression comprising:
  • the compression depth of the chest compression measurement process is calculated using the real-time chest impedance signal and the determined correlation.
  • a monitoring system for chest compression depth comprising:
  • a signal acquisition unit configured to obtain a reference acceleration signal and a reference chest impedance signal of the chest compression calibration process, and a real-time chest impedance signal for acquiring the chest compression measurement process
  • a correlation determining unit configured to calculate a reference pressing depth using the reference acceleration signal, and determine a correlation between the reference chest impedance signal and the reference pressing depth
  • a defibrillator comprising a defibrillator body, and an acceleration sensor electrically coupled to the defibrillator body and at least two electrode sheets.
  • the acceleration sensor is configured to collect a reference acceleration signal of a chest compression calibration process
  • the electrode piece is used to collect a reference chest impedance signal of the chest compression calibration process and a real-time chest impedance signal of the chest compression measurement process.
  • the defibrillator body also includes the above-described monitoring system for chest compression depth.
  • the monitoring system and the defibrillator including the monitoring system, since the signal acquisition process can be completed by the acceleration sensor and the electrode piece provided by the defibrillator, no additional hardware configuration or modification is required. System complexity is significantly reduced. Further, since the thoracic impedance signal is not easily affected by external motion interference, after the chest compression calibration process determines the correlation between the thoracic impedance and the compression depth, the thoracic impedance signal is used in the measurement of the chest compression and its correlation with the compression depth.
  • the monitoring of the depth of compression can basically avoid the interference of external motion, and can more accurately monitor the effect of CPR implementation, thereby more effectively controlling the defibrillation intensity, thereby obtaining more accurate monitoring results and providing better guidance effects.
  • FIG. 1 is a flow chart of a method for monitoring chest compression depth according to an embodiment
  • FIG. 2 is a flow chart of a method for monitoring a chest-external compression depth according to another embodiment
  • FIG. 3 is a flow chart of a method for monitoring a chest-external compression depth according to an embodiment
  • FIG. 4 is a schematic view of a monitoring system for chest compression depth according to an embodiment
  • FIG. 5 is a schematic diagram of a monitoring system for a chest-external compression depth according to another embodiment
  • FIG. 6 is an exemplary block diagram of a defibrillator of an embodiment
  • Fig. 7 is a schematic diagram showing an acceleration sensor and an electrode sheet of a defibrillator applied to an object to be monitored according to an embodiment.
  • the present invention provides a correlation based on chest impedance and compression depth to monitor CPR compression parameters
  • the system and method (hereinafter referred to as monitoring system and monitoring method), and provides a defibrillator with the above monitoring performance.
  • 'correlation' refers to the correlation (or proportional relationship) of both the chest impedance signal (the measured value or the change value) and the compression depth calculated by the acceleration.
  • the correlation established by the measured value of the thoracic impedance signal and the depth of compression is hereinafter referred to as direct correlation
  • the correlation established by the change value of the thoracic impedance signal and the depth of compression is referred to as indirect correlation.
  • the thoracic impedance signal is not easily interfered by external motion factors. Therefore, as long as the correlation between the compression depth and the chest impedance signal can be accurately determined, the measurement of the compression depth can be performed indirectly by measuring the chest impedance signal.
  • step S11 The reference chest impedance signal and the reference acceleration signal of the chest cavity being pressed during the calibration of the chest compression are obtained respectively.
  • This signal acquisition process typically yields a curve that reflects the reference acceleration and reference chest impedance as a function of time.
  • Correlation analysis is performed on the change value of the reference thoracic impedance signal and the reference compression depth during the chest compression calibration process to determine the indirect correlation between the thoracic impedance and the compression depth (step S12):
  • a double integral operation is performed on the reference acceleration signal obtained during the chest compression calibration process to obtain a reference compression depth.
  • the compression depth calculated according to the acceleration signal can be implemented by a software algorithm, or can be implemented by a hardware circuit.
  • the integral calculation formula corresponding to the pressing speed v(t) and the (reference) pressing displacement S(t) is (a represents the value of the (reference) acceleration signal, v represents (reference) pressing speed, and S represents (reference) pressing Displacement):
  • the change value referred to herein refers to the difference between the measured value of the reference thoracic impedance signal acquired during chest compression and the initial value of the reference thoracic impedance signal acquired before chest compression (ie, measured value - initial value).
  • the initial value of the reference thoracic impedance signal before chest compression is a fixed value
  • the measured value of the reference thoracic impedance signal during a single chest compression is a variable that can be represented by a curve, so
  • the change value of the reference chest impedance signal obtained based on the above calculation method is also a variable in a single compression process.
  • the present invention can obtain the reference acceleration signal and the reference chest impedance signal of the chest compression calibration process according to a specific frequency.
  • the reference chest impedance signal (Z T1 ) at time T1 is obtained , and the change value ⁇ Z1 (Z T1 -Z initial ) of the reference chest impedance signal at the time point is calculated, and the reference compression depth S1 corresponding to the time point T1 is calculated;
  • the ratio of the reference compression depth to the change value of the reference chest impedance signal (S1/ ⁇ Z1) is the K2 value corresponding to the change value of the reference chest impedance signal.
  • the real-time chest impedance signal of the monitored subject during the chest compression measurement process is acquired in the next step S13.
  • ⁇ Z) Calculate the compression depth of the chest compression measurement process.
  • the calculation of the change value of the real-time thoracic impedance signal is the same as the calculation of the change value of the reference thoracic impedance signal in step S12, and thus the compression depth calculated based on the determined correlation is also a variable.
  • the curve of the compression depth can be obtained, which plays a role of real-time monitoring.
  • the pressing frequency and the pressing time interval are further calculated by pressing the peak time of the depth curve.
  • step S22 the correlation value of the reference chest impedance signal and the reference compression depth are directly analyzed during the chest compression calibration process (step S22), so when monitoring the compression depth
  • the measurement of the real-time chest impedance signal is used directly for calculation.
  • the reference acceleration signal and the reference thoracic impedance signal of the chest compression calibration process can be obtained according to the specific frequency according to the monitoring accuracy.
  • the measured value of the reference chest impedance signal at the time point T1 is obtained, and the reference pressing depth S1 corresponding to the time point T1 is calculated; the ratio (S1/Z1) of the reference pressing depth to the measured value of the reference chest impedance signal is the reference chest cavity.
  • the K1 value corresponding to the measured value of the impedance signal can be obtained by taking N values.
  • the determined correlation can be obtained in the following ways: 1.
  • the K1/K2 value is correlated with the thoracic impedance signal (measurement) a smooth curve of change in value or change value; 2. a line of K1/K2 value that varies with the chest impedance signal (measured value or change value); 3. a correspondence between the K1/K2 value and the chest impedance signal (measured value or change value) table.
  • Manner 1 The value of N times is used to obtain N corresponding K1/K2 values.
  • the measured value or change value of the thoracic impedance signal is the abscissa, and the corresponding N points are obtained on the x-y coordinate system corresponding to the K1 value or the K2 value as the ordinate.
  • a smooth curve is used to connect the above N points, that is, a smooth curve reflecting the change of the K1 value or the K2 value corresponding to the measured value or the change value of the chest impedance signal.
  • Manner 2 Take N values for N corresponding K1/K2 values. Taking the measured value or change value of the thoracic impedance signal as the abscissa, corresponding to the K1 value or the K2 value as the ordinate, obtaining the corresponding N points on the xy coordinate system, and establishing the fitting curve of the above N points; fitting The curve is also a smooth curve reflecting the change in the K1 value or the K2 value corresponding to the measured or changed value of the chest impedance signal.
  • Manner 3 Take N values for N corresponding K1/K2 values.
  • the measured value or change value of the thoracic impedance signal is the abscissa, and the corresponding N points are obtained on the x-y coordinate system corresponding to the K1 value or the K2 value as the ordinate.
  • the two adjacent points are connected, that is, a line indicating that the K1 value or the K2 value corresponds to the measured value or the change value of the chest impedance signal.
  • Method 4 Establish a correspondence table between the measured value/variation value of the thoracic impedance signal and the K1 value/K2 value.
  • the above four K1/K2 values are determined only to clarify the technical solution of the present invention, and do not constitute any limitation to the present invention.
  • the curve obtained by the method can better reflect the variation of the K1/K2 value on the one hand, and avoid the thoracic impedance signal (or its variation value) during the calibration of the chest compression on the other hand.
  • the maximum value is smaller than the actual measured value.
  • the monitoring method proposed by the present invention focuses on the one-to-one correspondence between the chest impedance signal and the compression depth which is not affected by the external environment, and further determines the compression depth by acquiring the thoracic impedance signal. Therefore, regardless of the operational transformation of the thoracic impedance signal, such as square, integral, etc., as long as the correlation (or the corresponding relationship) of the two can be established, the accurate monitoring desired by the present invention can be achieved.
  • the "chest external compression calibration process” involved in the above monitoring method may be a process in which the rescuer performs the first complete CPR chest compression operation on the monitored object, and may be preset, and the rescuer implements the monitored object.
  • the Nth CPR chest compression operation may be a preset N-th CPR chest compression operation performed by the rescuer on the subject to be monitored.
  • the present invention preferably uses the first chest compression operation as its calibration process.
  • the "thoracic compression measurement process” involved in the above monitoring method may be a chest compression operation performed after or at the same time determining the correlation between the chest impedance change and the compression depth, that is, may be a subsequent operation or a parallel operation.
  • the output monitoring value discards the compression depth generated by the first chest compression; if the measurement process is set to parallel operation, the compression obtained by the calibration process is obtained. Depth is taken as the first measurement. It should be noted that when the K1/K2 value is obtained by the second method described above, if the measurement process is set to operate in parallel, it is necessary to further recalculate the compression depth of the calibration process using the established correlation.
  • the monitoring method of the above embodiment uses the thoracic impedance signal to complete the monitoring after determining the correlation between the thoracic impedance and the compression depth. Since the thoracic impedance signal is not interfered by external motion, the above monitoring method can well solve the prior art acceleration sensor. Defects in the depth of compression cannot be accurately measured in a moving environment.
  • the monitoring method of the present embodiment further includes acquiring a real-time acceleration signal of the chest compression measurement process (step S34) and determining the chest compression measurement process.
  • the external environment step S35).
  • the real-time acceleration signal acquired during the chest compression measurement process is also the change associated with the chest impedance signal.
  • determining an external environment of the chest compression measurement process includes determining whether the external environment of the process is a motion environment, that is, whether there is interference of external motion acceleration. If the obtained real-time acceleration signal is non-zero and the real-time chest impedance signal changes at the same time, it is judged that the external environment at this time is a static environment; if the acquired real-time acceleration signal is non-zero, and the real-time chest impedance signal is simultaneously If it remains unchanged, it is judged that the external environment at this time is a sports environment. This is because the external motion acceleration can only affect the measured value of the real-time acceleration signal without causing a change in the real-time chest impedance. This step does not involve new sensor components, which is advantageous for cost control of the monitoring process of the present invention.
  • the signal basis for the subsequent calculation of the depth of compression during the measurement of the chest compression is determined.
  • the acquired real-time acceleration signal has low noise, which can reflect the acceleration information actually implemented on the monitored object, and can also determine the compression depth through the real-time acceleration signal.
  • the object to be monitored is in a sports environment, such as an ambulance transport and other pre-hospital emergency situations, the motion acceleration caused by the motion of the road surface is disturbed by the actual acceleration signal, so that the real-time acceleration signal is noisy and cannot be directly applied to the compression depth. Accurate monitoring.
  • the chest compression depth is directly calculated using the acquired real-time acceleration signal (S36a). As described above, the real-time acceleration signal is double-integrated to obtain the compression depth, and the pressing frequency and the pressing time interval are further calculated by pressing the peak time of the depth curve.
  • the compression depth and other compression parameters are calculated using the real-time chest impedance signal and the correlation determined in step S32. Since the correlation between the measured value or the change value of the thoracic impedance signal and the compression depth has been established, when the real-time thoracic impedance signal is acquired, the real-time compression depth of the chest compression measurement process can be calculated by the correlation determined above. Then, other parameter values such as the pressing frequency are also calculated by pressing the peak time of the depth curve.
  • the monitoring method described above may further include a monitored object determining step.
  • the thoracic impedance reflects the physiological parameter values of a particular monitored object, and must have individual differences, and thus have different correlations with respect to the same acceleration signal.
  • the monitoring method further determines whether the monitored object has changed. If a change occurs, the correlation between chest impedance and compression depth needs to be redefined. Preferably, the subject being monitored is judged once a single chest compression is completed.
  • the present invention does not impose any restrictions on how to determine whether a monitored object has changed.
  • the present invention can compare the chest impedance signal at the beginning of each chest compression without adding any sensors or signal acquisition units.
  • the thoracic impedance signal of the same monitored subject at the beginning of chest compression should remain unchanged; if the change exceeds a certain range (for example, 5%), the thoracic impedance signals of different monitored subjects are considered to be acquired.
  • the present invention may require input of the monitored object ID, acquisition of fingerprint information of a specific monitored object, time at which a measurement signal can be detected or acquired, and the like before the first chest compression is performed.
  • the present invention is capable of acquiring parameter values reflecting the unique attributes of the monitored object, it is possible to determine whether the monitored object changes based on a simple comparison of the parameter values.
  • the above monitoring method further considers the external environment of the chest compression calibration process.
  • the initial environmental environment type of the chest compression calibration process is first determined.
  • the role of determining the starting external environment is to perform a correlation analysis (ie, re-determine the K1/K2 of the chest compression calibration process) if the external environment of the subsequent measurement process changes from the initial motion environment to the stationary environment. Value) and update the results of the correlation analysis.
  • the correlation obtained in the static environment can more accurately reflect the relationship between the two variables of the chest impedance and the compression depth because there is no external disturbance. Therefore, the present invention preferably uses the correlation analysis result obtained in a static environment.
  • the monitoring system includes a signal acquisition unit 11, a correlation determination unit 12, and a compression depth calculation unit 13.
  • the signal acquisition unit 11 is configured to acquire a reference acceleration signal and a reference chest impedance signal of the chest compression calibration process, and a real-time chest impedance signal for acquiring the chest compression measurement process.
  • the above signals acquired by the signal acquisition unit 11 are all variables that vary with time.
  • the reference acceleration signal and the reference thoracic impedance signal are used for correlation analysis of chest impedance and compression depth
  • the real-time chest impedance signal is the signal basis for calculating the compression depth.
  • the correlation determination unit 12 is for determining the correlation between the chest impedance and the compression depth.
  • the determining operation includes calculating a change value of the reference chest impedance signal, calculating a reference compression depth using the reference acceleration signal, and determining a proportional relationship (ie, a K2 value) of the reference compression depth to a change value of the reference chest impedance signal.
  • a K2 value a proportional relationship of the reference compression depth to a change value of the reference chest impedance signal.
  • the pressing depth calculation unit 13 is for pressing the calculation operation of the depth. After determining the K2 value, the calculation unit can determine the compression depth by calculating the change value of the real-time chest impedance signal.
  • the correlation determining unit itself can complete the calculation of the change value of the reference chest impedance signal and the reference pressing depth
  • the change value of the chest impedance signal can also be performed only by the pressing depth calculating unit in the monitoring system.
  • the calculation operation of the compression depth (including the calibration process and the correlation calculation of the measurement process), the correlation determination unit acquires the required calculation result by interaction with the compression depth calculation unit.
  • the correlation determining unit can also directly establish the correlation between the reference chest impedance signal and the reference pressing depth; the pressing depth calculating unit thus directly calculates the pressing depth using the obtained real-time chest impedance signal (as in the second embodiment).
  • the correlation determining unit may have the operability to determine the above direct correlation or indirect correlation.
  • the monitoring system at this time may further include a correlation mode selection unit for selecting whether to use the chest impedance signal or the change value as a signal basis in the correlation determination process, and thus the calculation operation of the compression depth calculation unit.
  • the monitoring system of another embodiment includes a signal acquisition unit 11, an external environment determination unit 14, a correlation determination unit 12, and a compression depth calculation unit 13.
  • the example lower signal acquisition unit 11 is further configured to acquire a real-time acceleration signal of the chest compression measurement process
  • the external environment determination unit 14 determines the external environment of the chest compression measurement process according to the acquired real-time acceleration signal and the real-time chest impedance signal. Specifically, when the real-time acceleration signal is non-zero and the real-time chest impedance signal changes, it is determined that the external environment of the chest compression measurement process is a stationary environment. When the real-time acceleration signal is non-zero and the real-time chest impedance signal remains unchanged, the external environment of the chest compression measurement process is determined to be a sports environment; the real-time acceleration acquired at this time is not generated by chest compression.
  • the monitoring system may further include a monitored object determining unit.
  • the monitored object determining unit is configured to determine whether the monitored object has changed.
  • the monitored object determination unit may employ the above-described signal acquisition unit to determine whether the monitored object has changed by comparing the chest impedance signal before the start of the chest compression.
  • the correlation determining unit is further configured to re-determine the correlation between the chest impedance and the compression depth when the monitored object changes.
  • FIG. 6 further illustrates a defibrillator comprising an embodiment of the above described monitoring system.
  • the defibrillator 10 includes a defibrillator body 101, and an acceleration sensor 102 and at least two electrode sheets 103, 104 electrically connected to the defibrillator body 101.
  • the defibrillator body 101 further includes the above-described monitoring system for the chest compression depth.
  • the monitoring system of the chest compression depth includes the signal acquisition unit 11, the correlation determination unit 12, and the compression depth calculation unit 13.
  • the signal acquisition unit 11 of the chest compression depth monitoring system is connected to the acceleration sensor 102 and the electrode sheets 103, 104.
  • the monitoring system may further include an external environment determining unit not illustrated. The monitoring system has been described in detail in Figure 4-5 and will not be repeated here.
  • the acceleration sensor 102 and the electrode sheets 103, 104 are electrically connected to the defibrillator body 101, so that the auxiliary measurement of the pressing parameter can be realized by the defibrillator.
  • the acceleration sensor 102 is used to obtain a reference acceleration signal of the chest compression calibration process.
  • the acceleration sensor 102 can also be used to acquire a real-time acceleration signal of the chest compression measurement process.
  • the electrode sheets 103, 104 are used to obtain a reference chest impedance signal of the chest compression calibration process and a real-time chest impedance signal of the chest compression measurement process.
  • the acceleration sensor and the electrode sheets (for example, two) applied to the object to be monitored during the monitoring are as shown in FIG.
  • the acceleration sensor is disposed directly above the chest of the object to be monitored, and the rescuer applies pressure to the object to be monitored through the acceleration sensor 102.
  • the two electrode sheets 103, 104 are respectively disposed outside the chest of the object to be monitored, and the impedance measurement circuit of the defibrillator body 101 itself is used to measure the chest impedance.
  • the measurement of the thoracic impedance signal does not require a separate set of sensors and detection circuits, and the system complexity can be significantly reduced compared to the prior art using the acceleration sensor and the force sensor.
  • the defibrillator main body 101 further includes a defibrillation intensity adjusting unit electrically connected to the pressing depth calculating unit 13. Chest compression is usually performed before defibrillation in vitro, and the CPR effect can be reflected to some extent by monitoring the compression depth. In the initial defibrillation, the amount of defibrillation current can be appropriately adjusted according to the specific value and/or the trend of the compression depth, and the defibrillation effect is ensured while the damage to the myocardium is minimized.
  • the defibrillator 10 of the present invention can provide a more reliable guiding effect for the regulation of defibrillation intensity by improving the accuracy of the compression depth monitoring.
  • the present invention can also monitor parameters such as artificial respiratory ventilation. Feedback of these compression parameters to the rescuer in a timely manner can guide the rescuer to implement high quality CPR first aid measures.
  • the correlation between the chest impedance and the compression depth is described above, since the compression depth is calculated from the acceleration signal, the correlation between the chest impedance and the compression depth may also indirectly reflect the correlation between the chest impedance and the acceleration signal.
  • the correlation determining step or correlation determining unit of the present invention is not limited to determining only the correlation between the pressing depth and the chest impedance, and the pressing parameter monitoring based on the correlation of the chest impedance and the acceleration signal is also included in the scope of the present invention.

Abstract

La présente invention concerne un procédé et un système permettant de surveiller la profondeur d'une compression thoracique externe. Le système de surveillance comprend : une unité (11) d'acquisition de signaux permettant d'acquérir un signal d'accélération de référence et un signal d'impédance de cavité thoracique de référence lors de l'étalonnage de la compression thoracique externe et d'acquérir un signal d'impédance de cavité thoracique en temps réel lors de la mesure de la compression thoracique externe; une unité (12) de détermination de corrélation permettant de calculer une profondeur de compression de référence à l'aide du signal d'accélération de référence et de déterminer la corrélation entre le signal d'impédance de cavité thoracique de référence et la profondeur de compression de référence; et une unité (13) de calcul de profondeur de compression permettant de calculer une profondeur de compression pendant la mesure de la compression thoracique externe à l'aide du signal d'impédance de cavité thoracique en temps réel et de la corrélation déterminée. Etant donné qu'un signal d'impédance de cavité thoracique ne peut pas être facilement brouillé par un mouvement externe, la surveillance d'une profondeur de compression à l'aide de l'impédance de cavité thoracique et de sa corrélation avec une profondeur de compression peut éviter efficacement l'interférence d'une accélération externe et permettre d'obtenir un résultat de surveillance plus précis. Lors de la mesure d'un signal d'impédance de cavité thoracique, il est inutile d'ajuster excessivement le matériel et le logiciel du système de surveillance, ce qui réduit la complexité du système.
PCT/CN2014/074069 2013-07-07 2014-03-26 Procédé et système de surveillance de la profondeur d'une compression thoracique externe et défibrillateur WO2015003509A1 (fr)

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