WO2017063498A1 - 咳痰系统 - Google Patents

咳痰系统 Download PDF

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Publication number
WO2017063498A1
WO2017063498A1 PCT/CN2016/100104 CN2016100104W WO2017063498A1 WO 2017063498 A1 WO2017063498 A1 WO 2017063498A1 CN 2016100104 W CN2016100104 W CN 2016100104W WO 2017063498 A1 WO2017063498 A1 WO 2017063498A1
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WO
WIPO (PCT)
Prior art keywords
coughing
joint
air pump
valve
port
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Application number
PCT/CN2016/100104
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English (en)
French (fr)
Chinese (zh)
Inventor
许庆宾
徐恒谦
白海波
韩广
Original Assignee
濡新（北京）科技发展有限公司
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Filing date
Publication date
Application filed by 濡新（北京）科技发展有限公司 filed Critical 濡新（北京）科技发展有限公司
Priority to AU2016339393A priority Critical patent/AU2016339393B2/en
Priority to JP2018519860A priority patent/JP6715924B2/ja
Priority to KR1020187012310A priority patent/KR102135746B1/ko
Publication of WO2017063498A1 publication Critical patent/WO2017063498A1/zh

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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
    • 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
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • 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
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • 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
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M16/0009—Accessories therefor, e.g. sensors, vibrators, negative pressure with sub-atmospheric pressure, e.g. during expiration
    • 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
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • 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
    • A61M16/022—Control means therefor
    • A61M16/024—Control means therefor including calculation means, e.g. using a processor
    • 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
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816—Joints or connectors
    • A61M16/0833—T- or Y-type connectors, e.g. Y-piece
    • 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
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A61M16/201—Controlled valves
    • 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
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A61M16/201—Controlled valves
    • A61M16/202—Controlled valves electrically actuated

Definitions

  • 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.
  • ARDS respiratory distress syndrome
  • 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).
  • VAP ventilator-associated pneumonia
  • the conventional suction method is suction tube suction, which uses a small catheter through the tracheal intubation or tracheotomy tube, inserted into the patient's airway, through the continuous negative pressure suction in the small catheter, the sputum from the patient Aspirate in the body. When the catheter is close to the secretions, the secretions are aspirated.
  • this method of suction is also obvious.
  • 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. The more you smoke, the more you smoke.
  • aggravating hypoxemia can not immediately remove sputum, increasing the risk of infection and bleeding. It is a very painful experience for most patients.
  • Another way to remove airway secretions from mechanically ventilated patients is to use a common coughing machine, such as a Philippine Pu's coughassist, when coughing, first, the patient's lungs inhale the air close to the maximum tidal volume, then quickly and suddenly exhale the air inhaled into the lungs at the highest rate, because the air is at a very high rate from the patient's lungs Exhaled, the airflow will carry the secretions up and out at a very high flow rate from the patient's airway to achieve the purpose of clearing the patient's secretions.
  • a common coughing machine such as a Philippine Pu's coughassist
  • Its clearing of secretions is essentially a way of simulating 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.
  • 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.
  • the suction tube can only approach the larger air passage, and for those smaller and larger levels of branch gas. Road, there is nothing to do.
  • 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.
  • the coughing machine uses a periodic cycle to stop the patient's inhalation phase, which can cause problems because the volumetric or flow-circulation mode is safer and more effective for ventilated patients.
  • 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.
  • PEEP positive end expiratory 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.
  • the coughing machine does not have an alarm system equipped with life support equipment, and the safety of use cannot be guaranteed.
  • 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.
  • the coughing machine uses the same fan for inhalation 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 cough. Instead of a fan inside the machine, a ventilator that mechanically ventilates the patient is used. 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 ⁇ line is closed.
  • 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 circulates accordingly.
  • 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.
  • the invention of WO2007054829 still has many problems in the implementation, such as excessive noise, poor heat dissipation, affecting the work of the ventilator and even the alarm when coughing, the safety of the system has hidden dangers, and the ability to adapt to the clinic is poor.
  • the invention effectively solves the problems existing in the invention of WO2007054829, is an engineering implementation of the block diagram scheme of the invention, and further refines, enriches and perfects the WO2007054829 patent.
  • the present invention provides a cough system comprising: a coughing machine and a coughing tube,
  • the coughing tube includes a throttling device and a balloon valve, wherein the balloon valve is a two-way valve, one port is a ventilator port, connected to the ventilator through a throttling device, and the other port is divided into two, one for a coughing machine port, connected to a coughing machine, and the other is a patient port to connect the patient;
  • the coughing machine includes a main line assembly, a gas pump assembly, and a control system, and the main line assembly includes a negative pressure generating a fan 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 a control system that controls the main line assembly and the air pump assembly, and controls
  • the system includes a first sensor and a microcomputer control unit for measuring air pressure at the throttle device;
  • the microcomputer control unit determines that the patient is in the breathing phase or the inhalation phase by the air pressure difference detected by the first sensor, and the microcomputer control unit controls the balloon of the first air pump to the balloon valve when the patient is in the inhalation phase to the exhalation phase.
  • 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.
  • FIG. 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.
  • Figure 3 is a gas path connection diagram of the pneumatic circuit assembly.
  • 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 circuit 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 sensors. Data collection is performed, and at the same time, under the control of the coughing machine 1, the airway switching between the ventilator-patient and the coughing machine-patient is completed.
  • the throttling device 21 of the coughing line 20 has an interface A and an interface B thereon.
  • the interface A is connected to a second air pump 3 of the air pump assembly 2 (described in detail below) in the coughing machine 1, and the second air pump 3 can supply air to the interface A.
  • the interface B is connected to the third air pump 5 of the air pump assembly 2 in the coughing machine 1, and the third air pump 5 can supply air to the interface A.
  • 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.
  • 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, so that the pressure sensor 12 and the pressure sensor 11 constitute substantially Differential pressure flow meter.
  • the balloon valve 19 is a two-way valve that includes a ventilator port that connects to the ventilator, and the other end is divided into two, one is a coughing machine port that connects the coughing machine, and the other is a patient port that connects the patient.
  • the passages of the ventilator port and the patient port are 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 machine port and the patient port 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.
  • 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 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).
  • 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. Or narrowing the breathing tube to endanger the patient's life (see Figure 2).
  • the gas released from the balloon valve 19 can also be used to detect the pressure of the patient port (C in Figure 1).
  • the measuring and controlling pipeline of the pressure sensor 9 (third sensor) is purged 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 assembly 2, a pneumatic circuit assembly 22, a main line assembly 15, a control system 8, and a noise reduction and noise reduction system 18.
  • the air pump assembly 2 includes 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.
  • ventilator alarms In addition to avoiding ventilator alarms.
  • 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 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 from affecting the sensor. jobs.
  • 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.
  • two high-pressure second air pumps 3 and 5 are used in parallel to supply air to meet the demand of instantaneous large flow.
  • an air pump may be used to simultaneously supply air to the interface A and the interface B of the throttling device 21.
  • 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 assembly 22 may further 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 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.
  • a shutter valve 17 Preferably, high-decibel rotating noise is generated due to the operation of the negative-pressure fan 16 when exhausting
  • the eddy current noise, main line component 15 also includes a noise reduction noise reduction system 18 for effectively reducing the environmental impact of noise.
  • 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 can also be any other type of mass flow meter, such as differential pressure, thermal, turbine, ultrasonic, etc., preferably a differential pressure 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.
  • the pressure sensors 11, 12 monitor the pressure and differential pressure on both sides of the throttle device 21 in real time, that is, the pressure sensor 11 detects the pressure at the interface A of the throttle device 21, and the pressure sensor 12 The pressure at the interface B of the throttling device 21 is detected and the data is transmitted 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 data for whether or not to open the coughing device.
  • control system 8 preferably further comprises a pressure sensor 9 which detects the pressure at the patient port of the balloon valve 19 (at C in Figure 1) in real time and transmits the data to the microcomputer control unit.
  • 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 a threshold (for example, 5 Cm water column)
  • the microcomputer control unit alarms, 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 make the balloon valve deflate, which will cause If the ventilator line is blocked and the patient cannot be supplied with air, the control system 8 will alarm and inform the staff to immediately check the system to give the patient a third protection.
  • the control system 8 preferably further comprises a pressure sensor 10 (fourth sensor), pressure sensing
  • the device 10 is used to detect 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.
  • a pressure sensor 10 (second pressure sensor) is added at the outlet of the first air pump 6, and the rotational speed of the first air pump 6 is automatically adjusted according to the outlet pressure of the first air pump 6 by means of a PWM method (ie, the air pump outlet pressure is low)
  • a PWM method ie, the air pump outlet pressure is low
  • the pump speed is reduced or stopped, so that the output of the first air pump 6 is maintained at a constant pressure to ensure the safety of the air pump.
  • 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 assembly 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.
  • 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 in communication with an input port of the differential pressure sensor 12, and by this path, pressure data acquisition by the differential pressure sensor 12 at point A on the throttling device 21 is achieved.
  • 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 pressure difference is achieved.
  • the sensor 12 collects pressure data from port B on the throttling device 21.
  • 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 port 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. Detect here The pressure is very useful, 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.
  • the solenoid valve 4 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.
  • 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 off, and the solenoid valve 7 can be placed in the balloon in time. The gas 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 passes.
  • the eighth joint 228 enters the first port of the solenoid valve 7 ("1" in Fig. 3).
  • the solenoid valve 7 since the solenoid valve 7 is energized, the first port and the second port ("2" in Fig. 3) are turned on. 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.
  • 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), and once the time is up, the automatic coughing machine enters a standby state, and the system starts. Test whether the patient meets the cough condition, and 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. At the end, 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.
  • the control system 8 monitors the pressure of the throttling device 21 collected by the sensors 11, 12 to monitor the inspiratory flow.
  • the balloon valve 19 is not inflated and is normally open, and the shutter valve 17 It 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:
  • 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 between -10 cmH2O and -200 cmH2O. Preferably, it is between -50 cmH2O and -150 cmH2O, more preferably between -60 cmH2O and -120 mH2O.
  • 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.
  • the pressure sensor 11 inside the control system 8 monitors the pressure at the interface A of the throttle device 21 in real time
  • the differential pressure sensor 12 monitors the pressure at the interface B of the throttle device 21 in real time and transmits the data to the microcomputer control unit.
  • the instantaneous flow rate and pressure in the coughing tube 20 calculated by the microcomputer control unit analyzes and judges whether the patient is in the inhalation phase or the expiratory phase, and captures the transition time point at which the inhalation is over and the exhalation is about to start.
  • the control system 8 turns on the first air pump 6, the two-position three-way solenoid valve 4 is energized, and the air path of the first air pump 6 and the balloon valve 19 is turned on, and the balloon valve 19 is turned on. Inflation causes the balloon valve 19 to close, cutting off the ventilation path of the ventilator to the patient.
  • the normally closed shutter valve 17 is quickly opened by the control system 8, and the negative pressure line of the fan 16 is in communication with the patient's airway. This will result in a rapid, sudden expiratory flow that is ejected from the patient's lungs. Relevant practical and theoretical studies have shown that when the flow rate is greater than 170L/Min, it will be effective for coughing.
  • the flow sensor 14 detects the patient's expiratory flow and transmits the data to the microcomputer control unit.
  • the microcomputer control unit closes the shutter valve 17, and at the same time, the two-position three-way solenoid valve 4 is lost. Electric, the balloon valve 19 begins to deflate, and the internal gas flows into the patient's main breathing circuit through the three-way solenoid valve, and the balloon valve 19 is thus opened, and the ventilator is connected to the patient.
  • the ventilator is triggered, and the patient continues normal mechanical ventilation as before the cough, indicating that a cough has been completed.
  • the shutter valve 17, the ideal value of the threshold can be adjusted according to the hardware device of the coughing line and the physiological characteristics of the patient, for example, generally can be set to 17L/Min or more.
  • 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.
  • 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 is gathered by the medical staff. Drop or clear regularly.
  • the system can work in an automatic mode, that is, an operator, usually a medical staff, sets an interval time. Once the time is up, the automatic coughing machine enters a standby state, the fan starts, and the system starts to detect the patient. Whether it meets the cough condition, once it meets, 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 fan starts. The coughing machine starts coughing when the patient inhales and the coughing condition is met before the patient begins to breathe.

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Hematology (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Emergency Medicine (AREA)
  • Pulmonology (AREA)
  • Vascular Medicine (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • External Artificial Organs (AREA)
  • Respiratory Apparatuses And Protective Means (AREA)
PCT/CN2016/100104 2015-10-12 2016-09-26 咳痰系统 WO2017063498A1 (zh)

Priority Applications (3)

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AU2016339393A AU2016339393B2 (en) 2015-10-12 2016-09-26 Inexsufflation system
JP2018519860A JP6715924B2 (ja) 2015-10-12 2016-09-26 喀痰システム
KR1020187012310A KR102135746B1 (ko) 2015-10-12 2016-09-26 객담 시스템

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CN201510657436.2A CN105343944B (zh) 2015-10-12 2015-10-12 咳痰系统

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RU2804286C2 (ru) * 2022-11-11 2023-09-26 Владимир Викторович Михайлов Комплекс устройств для проведения паротепловой процедуры, способ проведения паротепловой процедуры

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CN106730193A (zh) * 2016-11-11 2017-05-31 濡新（北京）科技发展有限公司 一种呼吸机
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CN111888596B (zh) * 2018-05-02 2022-04-05 北京雅果科技有限公司 无创呼吸机
CN110101945B (zh) * 2019-05-07 2022-09-02 濡新（北京）科技发展有限公司 一种同步自动咳痰方法和系统
CN110038200B (zh) * 2019-05-07 2022-03-11 濡新（北京）科技发展有限公司 一种限制咳出气量的咳痰装置和方法
CN110038199B (zh) * 2019-05-07 2021-09-24 濡新（北京）科技发展有限公司 一种在线同步咳痰方法和系统
CN111658939B (zh) * 2020-05-19 2023-10-03 中国科学院合肥物质科学研究院 一种用于拔管防喷溅智能化中央吸引装置及其使用方法
CN215504938U (zh) * 2021-04-15 2022-01-14 深圳市安保科技有限公司 一种具有排痰功能的新型呼吸机
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CN105343944A (zh) 2016-02-24
AU2016339393A1 (en) 2018-05-24
JP6715924B2 (ja) 2020-07-01
KR102135746B1 (ko) 2020-07-21
CN105343944B (zh) 2017-08-25
AU2016339393B2 (en) 2019-05-30
JP2018531100A (ja) 2018-10-25
TW201713373A (zh) 2017-04-16

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