WO2019210469A1 - Système de ventilation et procédé et dispositif de surveillance respiratoire synchrone - Google Patents

Système de ventilation et procédé et dispositif de surveillance respiratoire synchrone Download PDF

Info

Publication number
WO2019210469A1
WO2019210469A1 PCT/CN2018/085388 CN2018085388W WO2019210469A1 WO 2019210469 A1 WO2019210469 A1 WO 2019210469A1 CN 2018085388 W CN2018085388 W CN 2018085388W WO 2019210469 A1 WO2019210469 A1 WO 2019210469A1
Authority
WO
WIPO (PCT)
Prior art keywords
human
machine
time
degree
ventilation
Prior art date
Application number
PCT/CN2018/085388
Other languages
English (en)
Chinese (zh)
Inventor
刘玲
王慧华
杨毅
潘瑞玲
潘纯
刘京雷
谢剑峰
周小勇
刘松桥
邱海波
Original Assignee
东南大学附属中大医院
深圳迈瑞生物医疗电子股份有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 东南大学附属中大医院, 深圳迈瑞生物医疗电子股份有限公司 filed Critical 东南大学附属中大医院
Priority to CN201880008243.6A priority Critical patent/CN110290824A/zh
Priority to PCT/CN2018/085388 priority patent/WO2019210469A1/fr
Publication of WO2019210469A1 publication Critical patent/WO2019210469A1/fr

Links

Images

Classifications

    • 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
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or 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
    • 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
    • A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
    • 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
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502—User interfaces, e.g. screens or keyboards
    • 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
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/40—Respiratory characteristics

Definitions

  • the invention relates to a medical device, in particular to a ventilation system and a respiratory synchronization monitoring method and device.
  • the breathing process of the organism includes an inhalation phase of inhaling air or oxygen and an expiratory phase of exhaled air or carbon dioxide, and an adjacent inhalation phase and exhalation phase become a breathing cycle.
  • a ventilator is usually provided to provide respiratory support or assistance to the organism (eg, a patient or other patient).
  • the ventilator When the patient does not have a spontaneous breathing effort, the ventilator assumes full responsibility for ventilating the patient. In this case, the ventilator establishes an inspiratory phase and an expiratory phase for the patient according to the inspiratory trigger point and the inspiratory end point set by the patient, and delivers air or oxygen to the patient by adjusting the airflow in the airway, and causes the patient to exhale air or carbon dioxide. . There is no human-machine confrontation in this case.
  • the patient When the patient has a spontaneous breathing effort, the patient has its own inspiratory phase and expiratory phase. In this case, the inhalation phase and the expiratory phase of the ventilator are required to be synchronized with the patient's own inhalation phase and expiration phase. If it is not synchronized, there will be human-machine confrontation, which will cause discomfort to the patient.
  • some ventilators designed a detection technology that the human-machine is not synchronized, compares the detected parameters with the set thresholds, determines whether there is respiratory unsynchronization, and outputs the judgment result to prompt the doctor to intervene.
  • the doctor sees an alarm message that the breathing is not synchronized or abnormal activity of the patient's discomfort
  • the usual practice is to inject the patient with a sedative, which may alleviate the patient's discomfort, but may delay the time of weaning.
  • the present application provides a ventilation system and a respiratory synchronization monitoring method and apparatus to visually display the degree of human-machine synchronization, and provide a reference for the formulation of a ventilation strategy.
  • an embodiment provides a ventilation system comprising:
  • a gas flow providing device for generating a ventilating gas stream
  • a patient interface that communicates with the airflow providing device through the breathing circuit and is attached to the patient to deliver the ventilation airflow generated by the airflow providing device to the airway of the patient;
  • a ventilation detecting device disposed on the breathing circuit or the patient interface for detecting ventilation parameters
  • a patient detecting device for detecting respiratory trigger information of the patient
  • a data processing device configured to acquire ventilation parameters and respiratory trigger information, and calculate human-machine synchronization state information according to the ventilation parameters and respiratory trigger information
  • a human-machine interaction device includes a display for displaying human-machine synchronization status information output by the data processing device.
  • an embodiment provides a respiratory synchronization monitoring method, including:
  • an embodiment provides a respiratory synchronization monitoring apparatus, including:
  • a calculation module configured to calculate human-machine synchronization state information according to ventilation parameters and respiratory trigger information
  • An output module for outputting human-machine synchronization status information to the display for display.
  • an embodiment provides a computer readable storage medium comprising a program executable by a processor to implement the respiratory synchronization monitoring method described above.
  • the human-machine synchronization state information is calculated according to the obtained ventilation parameter of the airflow providing device and the patient's respiratory trigger information, and the human-machine synchronization state information is displayed. Therefore, it is possible to visually display the degree of unsynchronization of the human-machine, so that the doctor can select an appropriate intervention according to this.
  • FIG. 1 is a schematic structural view of a ventilation system according to an embodiment of the present invention.
  • FIG. 2 is a schematic structural view of a respiratory synchronization monitoring device according to an embodiment of the present invention.
  • FIG. 3 is a flowchart of a respiratory synchronization monitoring method according to an embodiment of the present invention.
  • FIG. 5 is an analysis diagram of a degree of synchronization of a human-machine corresponding to any coordinate point according to an embodiment of the present invention
  • FIG. 6 is a distribution diagram of displaying synchronization information of a human-machine in an embodiment of the present invention.
  • FIG. 7 is another distribution diagram of displaying human-machine synchronization state information according to an embodiment of the present invention.
  • FIG. 8 is a trend table diagram showing information about synchronization status of a human-machine in an embodiment of the present invention.
  • FIG. 9 is another trend chart showing the synchronization state information of the human-machine in the embodiment of the present invention.
  • FIG. 10 is a diagram showing a change trend of the degree of synchronization state of each type of human-machine in the embodiment of the present invention.
  • FIG. 11 is a comparison diagram of changes in the degree of synchronization of various types of human-machines according to an embodiment of the present invention.
  • FIG. 12 is a schematic diagram of selecting a time period in a two-dimensional trend point map according to an embodiment of the present invention.
  • 13 is a data comparison analysis table of the degree of synchronization of human-machines in any two periods of time according to an embodiment of the present invention
  • 15 is a three-dimensional distribution diagram of a degree of synchronization of a human-machine corresponding to any two periods of time in an embodiment of the present invention
  • FIG. 16 is a three-dimensional comparative distribution diagram of the degree of synchronization of human-machines in any two periods of time according to an embodiment of the present invention.
  • the human-machine synchronization state information is calculated according to the obtained ventilation parameter of the ventilation system and the respiratory trigger information of the patient, and the human-machine synchronization state information is displayed, and the human-machine synchronization state information is used to represent the human-machine The degree of out of sync.
  • FIG. 1 is a schematic structural diagram of a ventilation system according to an embodiment. As shown in FIG. 1 , the ventilation system includes an airflow providing device 1 and a breathing pipeline 2 .
  • the airflow providing device 1 is in communication with the patient interface 3 via a breathing circuit 2, and the patient interface 3 may include a mask, a nasal mask, a nasal cannula, a tracheal tube, etc., attached to the patient, capable of delivering a ventilation airflow generated by the airflow providing device 1 to the airway of the patient;
  • the ventilation detection device 4 is disposed on the respiratory conduit 2 or the patient interface 3,
  • a ventilation parameter for example, detecting at least one of a pressure, a flow rate, and a volume waveform of the ventilation airflow;
  • the patient detection device 5 is configured to detect a respiratory trigger information of the patient, wherein the respiratory trigger information includes a respiratory mechanics parameter or a respiratory electrical parameter, For example, esophageal pressure, diaphragmatic muscle, etc., these parameters may be numerical values, waveforms, icons or other forms;
  • the human-machine interaction device 7 further includes an input device through which the user can set various parameters and select and control the display interface of the display to realize information interaction between the human and the machine.
  • the data processing device 6 can obtain the time of the patient's inhalation trigger and the time of the inhalation end according to the collected respiratory trigger information, and can also obtain the inspiratory triggering time of the respiratory system and the inhalation end time according to the collected ventilation parameters.
  • the human-machine interaction device 7 can display the human-machine synchronization state information through at least one of text, data, a table, a trend graph, a distribution map, and an analysis graph.
  • the embodiment of the present invention further provides a respiratory synchronization monitoring device, which can be applied to a respiratory mechanics module, a ventilator, an anesthesia machine, and a ventilation monitoring instrument with a ventilation function monitor.
  • 2 is a schematic structural diagram of a respiratory synchronization monitoring device.
  • the respiratory synchronization monitoring device includes an acquisition module 01, a calculation module 02, and an output module 03.
  • the acquisition module 01 is configured to acquire a ventilation parameter and a respiratory trigger.
  • the ventilation parameter includes at least one of a pressure, a flow rate, and a volume waveform of the ventilation airflow
  • the respiratory trigger information includes a respiratory mechanics parameter or a respiratory electrical parameter, such as an esophageal pressure, a diaphragmatic muscle, etc., and the parameters may be values, waveforms, icons, or
  • the calculation module 02 is configured to calculate the human-machine synchronization state information according to the ventilation parameter and the respiratory trigger information acquired by the acquisition module 01
  • the output module 03 is configured to output the human-machine synchronization state information calculated by the calculation module 02 to the display for display.
  • the human-machine synchronization state information includes a degree of inhalation trigger difference and an inhalation end difference degree, and may also include one or more of a chart, a number, a color, a character, etc., and the human-machine synchronization state information can visually represent the person. The degree of unsynchronization of the machine so that the medical staff can choose the appropriate intervention accordingly.
  • the calculation module 02 is further configured to obtain, according to the collected respiratory trigger information, a time of the patient's inhalation trigger and a time of inhalation, and obtain a time of the inspiratory trigger of the respiratory system and a time of inhalation according to the collected ventilation parameter.
  • the output module 03 is configured to output the human-machine synchronization status information to the display, so that the display displays the human-machine synchronization status information through at least one of text, data, a table, a trend graph, a distribution map, and an analysis graph.
  • the respiratory synchronization monitoring device can be a separate module attached to various ventilation systems (eg, respiratory mechanics modules, ventilators, anesthesia machines, with ventilation function monitors), or integrated into the data processing device of the ventilation system, such as In the data processing device 6 shown in FIG.
  • the embodiment of the present invention provides a respiratory synchronization monitoring method
  • FIG. 3 shows a flowchart of the respiratory synchronization monitoring method.
  • the respiratory synchronization monitoring method may include The following steps:
  • Step S11 Acquire ventilation parameters and respiratory trigger information.
  • the data processing device 6 or the acquisition module 01 of the respiratory synchronization monitoring device acquires the ventilation parameter detected by the ventilation detecting device 4 and the respiratory trigger information of the patient detected by the patient detecting device 5, wherein the ventilation parameter includes the pressure, flow rate and volume of the ventilation airflow.
  • the respiratory trigger information includes a respiratory mechanics parameter or a respiratory electrical parameter, such as esophageal pressure, diaphragmatic electromyography, etc., which may be a numerical value or a waveform.
  • Step S12 Calculate the human-machine synchronization state information.
  • the calculation module 02 of the data processing device 6 or the respiratory synchronization monitoring device calculates the human-machine synchronization state information according to the ventilation parameter and the respiratory trigger information, and the human-machine synchronization state information includes the inhalation trigger difference degree and the inhalation end difference degree, and may also include One or more of charts, numbers, colors, characters, etc., used to visually characterize the degree of human-machine out of sync.
  • the degree of difference between the inhalation trigger and the degree of end of the inhalation are used to characterize the degree of unsynchronization of the human-machine, and may be expressed by a time difference or by a ratio.
  • the difference of the inhalation trigger is the time difference of the inhalation trigger, and the difference of the end of the inhalation is the time difference of the inhalation end; or, the difference of the inspiratory trigger is the ratio of the time difference of the inhalation trigger to the duration of the inhalation phase of the patient, suction
  • the difference in the end of the gas is the ratio of the time difference between the end of inspiration and the length of the patient's expiratory phase; or, the difference in the inspiratory trigger is the ratio of the time difference between the inspiratory trigger and the duration of the inspiratory phase of the ventilation system, and the difference in inspiratory end is the suction
  • the time difference of the inspiratory trigger refers to the inspiratory trigger time of the ventilation system and the patient inhalation trigger.
  • the time difference between the times and the time difference between the end of inhalation refers to the time difference between the inhalation end time of the ventilation system and the end time of the patient inhalation.
  • the acquisition of the time at which the patient inhales the trigger and the time at which the inhalation is triggered, and the timing of the inspiratory trigger of the ventilation system and the timing of the end of the inhalation may be acquired by the data processing device 6 or the calculation module 02 of the respiratory synchronization monitoring device.
  • the breathing trigger information obtains the time at which the patient inhales the trigger and the time at which the inhalation ends, and the time of the inhalation trigger of the ventilation system and the time of the end of the inhalation are obtained according to the collected ventilation parameters.
  • the data processing device 6 or the calculation module 02 of the respiratory synchronization monitoring device may first obtain a respiratory trigger information waveform that changes with time according to the collected respiratory trigger information, and then read the time of the patient's inhalation trigger according to the respiratory trigger information waveform.
  • the time at which the inhalation ends; or, the time at which the patient inhales the trigger and the time at which the inhalation ends can be calculated directly based on the collected respiratory trigger information.
  • the waveform of the ventilation parameter that changes with time can be obtained according to the collected ventilation parameter, and then the time of the inhalation trigger of the ventilation system and the time of inhalation end are read according to the waveform of the ventilation parameter; or, according to the acquisition,
  • the ventilation parameters calculate the time of the inspiratory trigger of the ventilation system and the moment of inspiration.
  • Step S13 Display man-machine synchronization state information.
  • the output module 03 of the human-machine interaction device 7 or the respiratory synchronization monitoring device outputs the human-machine synchronization state information to the display, so that the display displays the synchronization state of the human-machine through at least one of text, data, table, trend, distribution, and analysis. information.
  • the trend graph is a distribution of the degree of synchronization of the human-machine synchronization state in each predetermined time period along the time axis, and the distribution of the degree of the synchronization state of the human-machine includes the distribution position or the number of times, and the distribution position may be in the middle of the cell.
  • the trend graph may include at least one of a two-dimensional trend point map, a trend table graph, and a change trend comparison graph.
  • the distribution map is a three-dimensional map between the degree of inspiratory trigger difference, the degree of end of inspiration, and time over any period of time.
  • the analysis chart includes a human-machine synchronization state degree analysis map at a selected time and/or a difference comparison analysis diagram of the human-machine synchronization state for at least two periods of time.
  • the two-dimensional trend point map is a two-dimensional map of the degree of difference in the degree of difference in inspiration triggering with time and the degree of difference in the degree of inhalation end as a function of time.
  • FIG. 4 is a schematic diagram showing the synchronization state information of the human-machine in a two-dimensional trend point diagram. As shown in FIG.
  • the coordinate system is established by using the time as the horizontal axis and the degree of the suction trigger difference as the vertical axis, and each point in the figure represents A breathing cycle in which the change in position of the point in the graph over time represents a change in the degree of difference in inspiratory triggering over time during the predetermined period of time; likewise, the difference in time between the horizontal axis and the end of inspiration
  • the degree is the vertical axis to establish a coordinate system.
  • Each point in the figure represents a breathing cycle.
  • the change of the position of the point in the graph with time represents the change of the degree of inspiration at the end of the predetermined time period. .
  • the two two-dimensional trend point maps in Figure 4 are generally displayed in pairs to facilitate observation, comparison, and analysis by the medical staff, in which the degree of difference between the inspiratory trigger and the degree of end of inspiration are expressed as a percentage.
  • the range of tolerable differences can be displayed in the form of colors, boundaries, etc.
  • the tolerable difference range is displayed in a shaded area, which can tolerate the difference range such as setting 30% of soil, if two at the same time If the points in the figure fall within the area, it means that the degree of difference between the inhalation trigger and the end of the inhalation at this moment can be tolerated.
  • the degree of synchronization of the human-machine at that moment is in the state of synchronization between human and machine.
  • the person does not need to implement any intervention measures; if the point in the figure falls outside the area, the degree of synchronization of the human-machine at that moment is considered to be in a state of unsynchronized man-machine, resulting in man-machine confrontation, and the position of the point deviates from the area.
  • the medical staff can judge whether the ventilation setting is unreasonable according to the severity of the human-machine synchronization, or Whether the patient's condition changes, and then choose appropriate interventions to reduce or eliminate human-machine confrontation and make the patient comfortable.
  • a coordinate point represents a breathing cycle
  • any coordinate point can be selected to display a human-machine synchronization state degree analysis map of the breathing cycle corresponding to the coordinate point, which includes the respiratory trigger information waveform and ventilation of the selected coordinate point.
  • Parameter waveform for example, selecting the A coordinate point in Fig. 4, the degree of synchronization of the human-machine synchronization state of the A coordinate point can be analyzed, and the analysis chart is displayed; FIG.
  • FIG. 5 shows the esophageal pressure corresponding to the selected respiratory cycle (Pes The waveform of the waveform and the flow rate of the ventilating airflow, wherein the upper graph is a waveform diagram of the esophageal pressure (Pes) corresponding to the respiratory cycle, and is used to reflect the respiratory condition of the patient, and the lower graph corresponds to the respiratory cycle.
  • the flow rate of the ventilating airflow is used to reflect the ventilation of the ventilation system; as shown in Fig. 5, in the waveform diagram of the esophageal pressure, the positions of the broken line a and the broken line b represent the time and suction of the patient's inhalation trigger, respectively.
  • the positions where the dotted line a and the broken line b are located are respectively compared with the inhalation triggering timing a' of the ventilation system in the lower flow velocity waveform diagram and the inhalation ending timing b' of the ventilation system.
  • Line comparison by analyzing the difference to feedback whether the inspiratory and exhalation between the patient and the ventilation system are synchronized and the degree of their synchronization; the analysis of Fig. 5 shows that for the A coordinate point, the inspiratory triggering moment of the ventilation system and The inspiratory end time is delayed compared to the patient's inspiratory triggering time and inspiratory end time.
  • the inhalation trigger difference is delayed by 20%, and the inspiratory end difference is delayed by 25%.
  • the result can be digital, Text, forms, etc. are displayed directly on the display screen so that the medical staff can intuitively understand the degree of unsynchronized man-machine; the result is within 30% of the tolerable difference range set in Figure 4, at this time Although the machine is not synchronized, the degree of unsynchronization is within the allowable range. At this time, the medical staff can not implement the intervention.
  • the “previous record” and “next record” menus may also be set on the display interface of FIG. 5 to facilitate viewing of the history.
  • the cursor can also be selected from the waveform diagram shown in FIG. 4 for any period of time.
  • two vertical lines c and d respectively represent the selected start time and end time, and then display this.
  • the period of time (2017/10/2017:12:00 ⁇ 2017/10/2017:20:00) corresponds to the degree of synchronization of the human-machine.
  • the inhalation trigger difference degree value and the inhalation end difference degree value corresponding to the position coordinate point may be displayed, as shown in FIG. 4, 28% and 10%.
  • Figure 4 shows the human-machine synchronization state information in the form of a two-dimensional trend point map. In actual application, it can also be displayed in the form of a distribution map, which is the degree of inhalation trigger difference and end of inspiration during any period of time.
  • a three-dimensional map of the degree of difference and time. 6 is a distribution diagram showing the synchronization state information of the human-machine, which is described by using 30 minutes as a predetermined time period. As shown in FIG. 6, the distribution map has a degree of difference in the end of the inhalation as the horizontal axis and the inhalation trigger.
  • the degree of difference is the coordinate system established by the vertical axis, and the degree of synchronization of the human-machine state is represented by the position of the point in the coordinate system.
  • the map is divided into four regions according to the quadrant of the coordinate system, representing four different types of human-machine synchronization state levels, specifically: the first quadrant (upper right corner region) represents the inspiratory trigger and the inspiratory end delay, and the second The quadrant (upper left corner area) represents the inspiratory trigger delay and the inspiration ends too early, the third quadrant (lower left corner area) represents the inspiratory trigger and the inspiratory end is too early, and the fourth quadrant (lower right corner area) represents the inspiratory trigger Early and inhalation is delayed.
  • the distribution map is provided with a preset area indicating the synchronization state of the human-machine, as shown in the shaded area in FIG.
  • Fig. 6 is to establish a coordinate system with the degree of difference in the end of inspiration as the horizontal axis and the degree of difference in the inspiratory trigger as the vertical axis.
  • the degree of difference in the inspiratory trigger can be established as the horizontal axis and the difference in the end of inspiration is the vertical axis.
  • the coordinate system is not limited here.
  • a setting menu that can tolerate a range of differences can be set on the display interface of FIG. 4 or FIG. 6 , and the setting menu is used to set an allowable range of the degree of unsynchronized man-machine, that is, used to set FIG. 4 and The size of the shaded area in Fig. 6; for example, the "tolerable difference degree range" menu shown in Fig. 6, the specific percentage value can be set by the medical staff as needed, for example, set to 30%.
  • the figures shown in Figures 4-6 can be displayed separately on the display screen, or can be displayed in any combination.
  • the display screen can also be displayed in text, data and/or characters in the preset display area. The total number of breathing cycles, the most recent measurement of the degree of unsynchronized man-machines, and the number of human-machine asynchronous events, so that medical personnel can more intuitively understand the degree of human-machine synchronization.
  • FIG. 7 shows another distribution diagram showing the synchronization state information of the human-machine.
  • the four quadrants and the preset regions indicating the synchronization state of the human-machine can be distinguished by different colors, and the figure is provided with A comparison table of the number of colors and the number of dots, different colors correspond to the number of different points; the area of the dotted circle in the figure is the distribution of points represented by colors, and the positions of the colors are compared and the number of points and colors are compared.
  • the comparison table can be used to know the synchronization status information of the human-machine, thereby obtaining the degree of synchronization of the human-machine.
  • the man-machine synchronization state information can also be displayed in the form of a trend table diagram.
  • the degree of synchronization of the man-machine is qualitatively represented by a point or a number in each cell of the table. , or quantify the degree of human-machine synchronization status by the position of the point in the cell.
  • FIG. 8 shows a trend table showing the synchronization status information of the human-machine.
  • the synchronization state information of the human-machine is reflected by the degree of synchronization of the human-machine, and the degree of synchronization of the human-machine includes the inhalation trigger.
  • the time resolution selects a single breathing cycle, here a single breathing cycle of 8s is taken as an example.
  • FIG. 8 the table shown in FIG.
  • These two coordinate values define the allowable range of the degree of human-computer unsynchronization within 30%.
  • the position of the drawn point in the cell can quantitatively indicate the degree of difference.
  • the numerical unit of each cell is a percentage.
  • the point in each cell may be in the center of the cell, thereby qualitatively showing the degree of synchronization of the human-machine.
  • FIG. 9 is a diagram showing another trend table for displaying the synchronization state information of the human-machine.
  • the degree of synchronization state of the human-machine is the same as that of FIG. 8, and the temporal resolution is selected to be not a single breathing cycle, generally greater than one.
  • the duration of the period for example, 1h; the number in the cell indicates the number of occurrences of the degree of synchronization of each type of human-machine corresponding to the unit time, thereby qualitatively indicating the degree of synchronization of the human-machine.
  • the trend of the degree of synchronization state of various types of human-machines can be displayed in the form of a line graph
  • FIG. 10 shows the trend of the degree of synchronization of various types of human-machines, as shown in FIG.
  • the trend graph can more intuitively reflect the trend of the degree of synchronization of various types of human-machines over time in the trend duration.
  • FIG. 11 shows a comparison trend of the trend of the degree of synchronization of various types of human-machines, as shown in FIG.
  • the graph shows the degree of synchronization of each type of man-machine synchronization with time, so that the medical staff can conduct comparative analysis and intuitively understand the trend of the degree of synchronization of human-machines, so as to judge whether the ventilation setting is reasonable.
  • the patient's condition is evaluated, wherein the fold line 1 represents the inspiratory trigger and the end of the inhalation is too early, the fold line 2 represents the inspiratory trigger too early and the inspiratory end delay, the fold line 3 represents the human-machine synchronization state, and the fold line 4 represents the inspiratory trigger. Delay and inhalation end too early, and line 5 represents the inspiratory trigger and inspiration end delay. In practical applications, different lines can be distinguished by different colors.
  • At least two periods of time can be selected by the cursor, and a difference comparison analysis diagram of the synchronization state of the human-machine synchronization state of the at least two periods of time is displayed on the display, and the difference comparison analysis graph can be a data comparison analysis table including a degree of synchronization of the human-machine synchronization state of the at least two periods of time, a comparison pie chart of the degree of synchronization of the human-machine synchronization state of the at least two periods of time, a three-dimensional distribution map corresponding to the at least two periods of time, and the at least two At least one of the three-dimensional profiles of the segment time in the same coordinate system, but is not limited to these representations.
  • FIG. 12 shows a schematic diagram of selecting a time period in a two-dimensional trend point map.
  • vertical lines a1 and b1 are time-segment cursors, respectively indicating time.
  • the start time and end time of the segment 1 the vertical lines a2 and b2 are the cursors of the time segment 2, respectively indicating the start time and the end time of the time segment 2, and the cursor passing through the time segment 1 and the time segment 2 can be from the second Any two periods of time are selected from the dimension trend map to compare and analyze the degree of synchronization between the two machines.
  • the position where the cursor stops can display the difference between the inhalation trigger difference and the end of the inhalation end corresponding to the position.
  • the cursor b1 in FIG. 12 stops at 2017/10/20 17:10:00.
  • the degree of inspiratory trigger difference of the time is displayed as -10%, and the inspiratory end of the time is displayed at the coordinate point of the corresponding inhalation end difference degree.
  • the difference is 38%.
  • the operation menu of the cursor of the time period 1 and the operation menu of the cursor of the time period 2 can also be displayed on the display interface, and the operations of switching and controlling the two cursors can be realized through the operation menu.
  • the time segment 1 is selected from 2017/10/20 17:00:00 to 2017/10/20 17:10:00 by the cursor of time period 1 and the cursor of time period 2, and time period 2 is 2017. /10/20 17:20:00 to 2017/10/20 17:30:00
  • the comparative analysis of the degree of synchronization between man and machine during these two periods can be compared with data comparison analysis table, comparison pie chart, three-dimensional distribution Graphs, three-dimensional contrast maps, etc. show comparative analysis results.
  • the medical staff judges the ventilating system or the patient through appropriate interventions through the human-machine synchronization state information of the time period 1 to determine the ventilating setting is unreasonable, the human-machine synchronization of the time period 2 is synchronized.
  • the comparison of the status information with the human-machine synchronization status information of time period 1 can help determine whether the interventions implemented by the medical staff are correct and effective, thereby providing reference information for the formulation of the ventilation strategy, effectively helping the medical personnel to set the ventilation parameters and evaluating the patient.
  • the condition further improves the effectiveness of ventilation therapy and patient comfort.
  • FIG. 13 shows a data comparison analysis table of the degree of human-machine synchronization state of any two periods, as shown in FIG. 13, with time period 1 as 2017/10/20 17:00:30 to 2017/10/20 17: 10:32 and time period 2 are 2017/10/20 17:20:30 to 2017/10/20 17:30:32, for example, the number of breathing cycles in these two periods is 60, the duration is 10min; In time period 1, by analyzing and counting the number of invalid triggers, double triggers, automatic triggers and premature switchings occurring in 60 breathing cycles, the number of unsynchronized times is 12 times, accounting for 20%, corresponding to the man-machine. The number of synchronization is 48, accounting for 80%, and the probability of human-machine asynchronous synchronization (AI) is 20%.
  • time period 1 as 2017/10/20 17:00:30 to 2017/10/20 17: 10:32 and time period 2 are 2017/10/20 17:20:30 to 2017/10/20 17:30:32, for example, the number of breathing cycles in these two periods is 60, the duration is 10min; In
  • time period 2 the number of unsynchronized human-machines is 6 times, accounting for 10%, corresponding to the man-machine.
  • the number of synchronizations is 54 times, accounting for 90%, and the probability of human-machine asynchronous synchronization (AI) is also 10%.
  • AI human-machine asynchronous synchronization
  • the comparative analysis chart of the two time periods can also be displayed in the form of a comparative pie chart, and FIG. 14 shows a comparative pie chart of the degree of synchronization of the human-machine state at any two time periods, as shown in FIG.
  • the types of human-machine synchronization state are represented by different colors, and the area occupied by each color in the entire pie chart represents the proportion of the type of human-machine synchronization state represented by the color in the total number of respiratory cycles.
  • the contrasting pie chart interface can also directly display the probability of human-machine out-of-synchronization by numbers, characters and/or characters, for example, “AI: 20%” and “AI: 10%” shown in FIG. 14 So that the medical staff can more intuitively understand the degree of synchronization of the human-machine.
  • the comparison analysis diagram of the two time periods may also be displayed in the form of a three-dimensional distribution diagram shown in FIG. 6.
  • FIG. 15 shows a three-dimensional distribution diagram of the degree of synchronization of the human-machine corresponding to any two periods of time, as shown in FIG.
  • time period 1 as 2017/10/20 17:00:30 ⁇ 2017/10/20 17:10:32
  • time period 2 is 2017/10/20 17:20:30 to 2017/10/20 17:
  • time period 1 shows a three-dimensional distribution diagram of the degree of synchronization of the human-machine corresponding to any two periods of time, as shown in FIG.
  • time period 1 shows 2017/10/20 17:00:30 ⁇ 2017/10/20 17:10:32
  • time period 2 is 2017/10/20 17:20:30 to 2017/10/20 17:
  • time period 1 shows a three-dimensional distribution diagram of the degree of synchronization of the human-machine corresponding to any two periods of time, as shown in FIG.
  • time period 1 shows 2017/10/20 17:00:30 ⁇ 2017/10/20 17:10:
  • each point is basically within the shaded area, indicating that the time period is in a state of synchronization between humans and machines, further indicating that the intervention of the medical staff for time period 1 is correct and effective. , thereby improving the comfort level of the patient.
  • the three-dimensional distribution map corresponding to the two periods shown in FIG. 15 may represent a three-dimensional contrast distribution map in the same coordinate system
  • FIG. 16 shows a three-dimensional contrast distribution of the degree of human-machine synchronization state in any two periods.
  • the dotted circle E represents the distribution point of the time period 1
  • the dotted circle F represents the distribution point of the time period 2
  • the distribution points are circled with E and F only for the convenience of distinction and description, and are not intended to limit the present invention, In practical applications, different colors can be used to distinguish the points corresponding to the two time segments.
  • the various trend graphs, maps and analysis graphs described above can be displayed separately on the display screen, or can be displayed on the monitor screen in any combination, which provides tools and kanban for analysis and comparison.
  • the monitoring and analysis of the synchronization of human-machines enables medical personnel to visually observe the synchronization of human-machines, thereby assisting medical personnel in setting ventilation parameters, assessing the patient's condition, etc., and implementing appropriate interventions to improve patient comfort. .
  • the ventilation system and the respiratory synchronization monitoring method and device provided by the embodiments of the present invention calculate the human-machine synchronization state information according to the obtained ventilation parameter and the patient's respiratory trigger information, and display the human-machine synchronization state information, thereby being intuitive
  • the ground shows the degree of unsynchronized man-machines so that doctors can choose the appropriate intervention accordingly.
  • the human-machine synchronization state information may include a degree of inhalation trigger difference and a degree of inhalation end difference, and may further include one or more of a chart, a number, a color, a character, and the like for characterizing the degree of unsynchronization of the human-machine; Visually displaying the synchronization information of the human-machine through at least one of text, data, table, trend, distribution, and analysis, providing the medical staff with tools and kanban for analysis and comparison, enabling medical personnel to visually observe And to understand the severity of the unsynchronized man-machine, and then help the medical staff to determine whether the ventilation setting is reasonable, to assess the patient's condition, etc., thereby providing a reference for the formulation and adjustment of the ventilation strategy, and assisting the medical staff to select appropriate interventions to achieve Reduce or eliminate the purpose of human-computer out of sync, improve the effectiveness of ventilation therapy and patient comfort, and help reduce mechanical ventilation time.
  • the program may be stored in a computer readable storage medium, and the storage medium may include: a read only memory, a random access memory, a magnetic disk, an optical disk, a hard disk, etc.
  • the computer executes the program to implement the above functions.
  • the program is stored in the memory of the device, and when the program in the memory is executed by the processor, all or part of the above functions can be realized.
  • the program may also be stored in a storage medium such as a server, another computer, a magnetic disk, an optical disk, a flash disk or a mobile hard disk, and may be saved by downloading or copying.
  • the system is updated in the memory of the local device, or the system of the local device is updated.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Primary Health Care (AREA)
  • Anesthesiology (AREA)
  • Medical Informatics (AREA)
  • General Business, Economics & Management (AREA)
  • Business, Economics & Management (AREA)
  • Emergency Medicine (AREA)
  • Pulmonology (AREA)
  • Epidemiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

Système de ventilation et procédé et dispositif de surveillance respiratoire synchrone, comprenant : un dispositif d'alimentation en flux d'air (1) pour la génération d'un flux d'air de ventilation ; un conduit respiratoire (2) ; une interface patient (3) qui est en communication avec le dispositif d'alimentation en flux d'air (1) par l'intermédiaire du conduit respiratoire (2) de façon à amener le flux d'air de ventilation jusqu'aux voies respiratoires d'un patient ; un dispositif de détection concernant la ventilation (4) qui est disposé sur le conduit respiratoire (2) ou l'interface patient (3) et qui est utilisé pour détecter des paramètres de ventilation ; un dispositif de détection concernant le patient (5) pour la détection d'informations de déclenchement de la respiration du patient ; un dispositif de traitement de données (6) utilisé pour acquérir les paramètres de ventilation et les informations de déclenchement de la respiration et pour calculer, en conséquence, des informations d'état de synchronisation homme-machine ; et un dispositif d'interaction homme-machine (7), comprenant un dispositif d'affichage pour afficher les informations d'état de synchronisation homme-machine délivrées par le dispositif de traitement de données (6). Les informations d'état de synchronisation homme-machine sont utilisées pour exprimer dans quelle mesure l'homme et la machine sont désynchronisés. Grâce à l'affichage visuel des informations d'état de synchronisation homme-machine, le personnel médical peut déterminer si les réglages de ventilation sont satisfaisants, évaluer l'état d'un patient, puis sélectionner des mesures d'intervention appropriées pour réduire ou éliminer l'antagonisme homme-machine et faire en sorte que le patient se sente bien.
PCT/CN2018/085388 2018-05-02 2018-05-02 Système de ventilation et procédé et dispositif de surveillance respiratoire synchrone WO2019210469A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CN201880008243.6A CN110290824A (zh) 2018-05-02 2018-05-02 一种通气系统和呼吸同步监测方法、装置
PCT/CN2018/085388 WO2019210469A1 (fr) 2018-05-02 2018-05-02 Système de ventilation et procédé et dispositif de surveillance respiratoire synchrone

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CN2018/085388 WO2019210469A1 (fr) 2018-05-02 2018-05-02 Système de ventilation et procédé et dispositif de surveillance respiratoire synchrone

Publications (1)

Publication Number Publication Date
WO2019210469A1 true WO2019210469A1 (fr) 2019-11-07

Family

ID=68001275

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2018/085388 WO2019210469A1 (fr) 2018-05-02 2018-05-02 Système de ventilation et procédé et dispositif de surveillance respiratoire synchrone

Country Status (2)

Country Link
CN (1) CN110290824A (fr)
WO (1) WO2019210469A1 (fr)

Families Citing this family (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112969486B (zh) * 2019-10-10 2023-02-28 深圳迈瑞生物医疗电子股份有限公司 一种通气切换控制方法及装置、医用通气设备、存储介质
DE102020124834A1 (de) * 2020-09-23 2022-03-24 Drägerwerk AG & Co. KGaA Ausgabevorrichtung für ein Beatmungsgerät
CN116438609A (zh) * 2020-12-24 2023-07-14 深圳迈瑞生物医疗电子股份有限公司 医疗通气设备及通气监测方法
CN116711020A (zh) * 2020-12-24 2023-09-05 深圳迈瑞生物医疗电子股份有限公司 一种通气设备及其显示方法
CN113539398A (zh) * 2021-06-25 2021-10-22 中国科学院深圳先进技术研究院 一种呼吸机人机异步分类方法、系统、终端以及存储介质
CN113769213B (zh) * 2021-08-19 2024-05-03 北京怡和嘉业医疗科技股份有限公司 通气控制方法、装置、系统、终端设备及可读存储介质
CN113642512B (zh) * 2021-08-30 2023-10-24 深圳先进技术研究院 呼吸机人机异步检测方法、装置、设备及存储介质

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101337101A (zh) * 2007-07-06 2009-01-07 深圳迈瑞生物医疗电子股份有限公司 麻醉机和呼吸机的通气系统及压力监控方法
US20110094518A1 (en) * 2009-04-02 2011-04-28 Breathe Technologies, Inc. Methods, systems and devices for non-invasive ventilation including a non-sealing ventilation interface with a free space nozzle feature
CN103656814A (zh) * 2012-08-31 2014-03-26 通用电气公司 呼吸器同步指示器
CN203861719U (zh) * 2014-05-14 2014-10-08 沈阳新松医疗科技股份有限公司 同步触发与节氧技术装置
CN106840734A (zh) * 2017-04-11 2017-06-13 湖南明康中锦医疗科技发展有限公司 一种呼吸机跟随性能的评估方法、装置以及无创呼吸机
CN107961423A (zh) * 2017-12-15 2018-04-27 湖南明康中锦医疗科技发展有限公司 呼吸机触发吸气的方法及应用

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN100998902B (zh) * 2006-01-13 2010-12-08 深圳迈瑞生物医疗电子股份有限公司 流量监测与控制的装置
CN103340630B (zh) * 2013-06-18 2015-04-15 东南大学 一种双水平呼吸机的呼吸状态识别装置及其识别方法
CN105664313B (zh) * 2014-11-21 2019-11-19 中国医学科学院北京协和医院 一种呼吸机及其通气控制装置和方法

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101337101A (zh) * 2007-07-06 2009-01-07 深圳迈瑞生物医疗电子股份有限公司 麻醉机和呼吸机的通气系统及压力监控方法
US20110094518A1 (en) * 2009-04-02 2011-04-28 Breathe Technologies, Inc. Methods, systems and devices for non-invasive ventilation including a non-sealing ventilation interface with a free space nozzle feature
CN103656814A (zh) * 2012-08-31 2014-03-26 通用电气公司 呼吸器同步指示器
CN203861719U (zh) * 2014-05-14 2014-10-08 沈阳新松医疗科技股份有限公司 同步触发与节氧技术装置
CN106840734A (zh) * 2017-04-11 2017-06-13 湖南明康中锦医疗科技发展有限公司 一种呼吸机跟随性能的评估方法、装置以及无创呼吸机
CN107961423A (zh) * 2017-12-15 2018-04-27 湖南明康中锦医疗科技发展有限公司 呼吸机触发吸气的方法及应用

Also Published As

Publication number Publication date
CN110290824A (zh) 2019-09-27

Similar Documents

Publication Publication Date Title
WO2019210469A1 (fr) Système de ventilation et procédé et dispositif de surveillance respiratoire synchrone
US11642042B2 (en) Systems and methods for missed breath detection and indication
US11229759B2 (en) Systems and methods for monitoring, managing, and preventing fatigue during ventilation
US20190255268A1 (en) Use of multiple spontaneous breath types to promote patient ventilator synchrony
US7784461B2 (en) Three-dimensional waveform display for a breathing assistance system
CA2788781C (fr) Detection de retard basee sur un evenement et commande de systemes en reseau dans la ventilation medicale
US20120055479A1 (en) Respirator and adjustment method for same
EP3656431B1 (fr) Systèmes de ventilation spontanée de pression d'entraînement
US20120185792A1 (en) Pictorial Representation Of Patient Condition Trending
US20100218766A1 (en) Customizable mandatory/spontaneous closed loop mode selection
US10350374B2 (en) Ventilator system and method
RU2594808C2 (ru) Система и способ для лечения синдрома гиповентиляции при ожирении
WO2013016608A1 (fr) Procédés et systèmes pour une ventilation assistée proportionnelle transformée basée sur un modèle
US11554230B2 (en) Ventilator-initiated decision support and waveform capture during ventilation
US20210244901A1 (en) Method and apparatus for determining a regional compliance of a lung during spontaneous respiration
US10821247B2 (en) Ventilator and operating method for a ventilator with a determination of cough attacks
US20190125994A1 (en) Ventilators and systems for performing automated ventilation procedures
WO2022105555A1 (fr) Appareil d'assistance respiratoire, appareil de suivi, système d'appareil médical et procédé de traitement de paramètres
US20150013674A1 (en) System and method for monitoring and reporting status of a ventilated patient
JP2018521712A (ja) 胸部収縮の欠落を監視する人工換気装置
CN112789683B (zh) 基于事件的医疗决策支持系统
CN109805913A (zh) 血压监测方法及系统
US20240148993A1 (en) Patient-ventilator asynchrony dashboard
CN109621121B (zh) 机控通气状态的检测方法和检测系统
JP7381363B2 (ja) 生体情報取得装置

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 18917508

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 18917508

Country of ref document: EP

Kind code of ref document: A1