WO2022017156A1 - 吸入氧气浓度的调节方法和呼吸支持设备 - Google Patents
吸入氧气浓度的调节方法和呼吸支持设备 Download PDFInfo
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- WO2022017156A1 WO2022017156A1 PCT/CN2021/104195 CN2021104195W WO2022017156A1 WO 2022017156 A1 WO2022017156 A1 WO 2022017156A1 CN 2021104195 W CN2021104195 W CN 2021104195W WO 2022017156 A1 WO2022017156 A1 WO 2022017156A1
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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. ventilators; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
- A61B5/14542—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue for measuring blood gases
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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. ventilators; 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. ventilators; Tracheal tubes
- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes operated by electrical means
- A61M16/022—Control means therefor
- A61M16/024—Control means therefor including calculation means, e.g. using a processor
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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
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
- A61M2230/205—Blood composition characteristics partial oxygen pressure (P-O2)
Definitions
- the application relates to the technical field of respiratory physiology in medical equipment, and in particular, to a method for adjusting the concentration of inhaled oxygen and a respiratory support device.
- ventilators are widely used in various treatment processes.
- the fraction of inspired oxygen (FiO2) is directly related to the oxygen content in the patient's inhaled gas, which in turn affects the oxygen content in the patient's alveoli and blood. content, further affecting the patient's tissue oxygen supply. Therefore, in the actual use process, the inhaled oxygen concentration needs to be adjusted according to the specific physiological condition of the patient, so that the patient can reach the normal target oxygenation level.
- the most common way to adjust the inhaled oxygen concentration is to adjust the inhaled oxygen concentration according to the blood oxygen saturation (SpO2) measured by the pulse oximeter during the adjustment interval.
- SpO2 is measured in real time by pulse oximeter. If SpO2 is lower than a certain limit, the switch of the oxygen valve on the ventilator is automatically controlled to open, so as to realize the adjustment of the inhaled oxygen concentration.
- the adjustment interval of this method is usually a fixed interval, which can only cope with small changes in blood oxygen. It is feasible for patients with relatively stable blood oxygen status, but for patients with unstable blood oxygen status, if there is an acute blood oxygen drop during the adjustment interval, the method of the prior art has no effect on the inspired oxygen concentration. There is no quick response when adjusting.
- the embodiments of the present application provide a method for adjusting the concentration of inhaled oxygen and a respiratory support device, so as to realize the purpose of adjusting the concentration of inhaled oxygen in a rapid response when a patient's blood oxygen changes rapidly.
- a first aspect of the present application discloses a method for adjusting the concentration of inhaled oxygen, the adjusting method comprising:
- the severity refers to the degree to which the blood oxygen data deviates from the treatment target zone, and the condition for triggering the adjustment of the inhaled oxygen concentration in advance includes the severity.
- the degree of blood oxygen tends to increase, and the selected blood oxygen partition and the treatment target partition each correspond to a pre-divided blood oxygen data range;
- the operation of adjusting the intake oxygen concentration is performed in advance; otherwise, after the timing of the current adjustment interval is over, the operation of adjusting the intake oxygen concentration is normally performed.
- the judging whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance including:
- the number of blood oxygen data obtained in the current adjustment interval whose severity is greater than the severity of the blood oxygen data in the reference blood oxygen zone exceeds the preset number, which satisfies the requirement to trigger the adjustment of inhaled oxygen in advance. Concentration conditions, otherwise, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are not met.
- the judging whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance including:
- the triggering adjustment of the inhaled oxygen concentration according to the adjustment strategy corresponding to the uncertain blood oxygen triggering mode includes:
- the total weight is compared with a first weight threshold and a second weight threshold, where the first weight threshold is used to indicate an increase in the oxygen concentration and the first adjusted amount of the inspired oxygen concentration, and the second weight threshold The threshold is used to indicate the reduced oxygen concentration and the second adjusted amount of the inspired oxygen concentration, and the first weighted threshold is greater than the second weighted threshold;
- the adjustment amount for maintaining the current inhaled oxygen concentration is determined.
- the method further includes:
- the judging whether the associated data meets preset requirements includes:
- the pulse rate change rate threshold If the change rate of the pulse rate is higher than the pulse rate change rate threshold, the pulse rate does not meet the blood oxygen reliability requirement, otherwise, the pulse rate meets the blood oxygen reliability requirement; and/or,
- the pulse rate is lower than the pulse rate threshold, the pulse rate does not meet the blood oxygen reliability requirement, otherwise, the pulse rate meets the blood oxygen reliability requirement; and/or,
- the perfusion index If the perfusion index is lower than the perfusion index threshold, the perfusion index does not meet the blood oxygen reliability requirement; otherwise, the perfusion index meets the blood oxygen reliability requirement;
- the blood oxygen signal quality is lower than the blood oxygen signal quality threshold, the blood oxygen signal quality does not meet the blood oxygen reliability requirement; otherwise, the blood oxygen signal quality meets the blood oxygen reliability requirement.
- the operation of adjusting the inhaled oxygen concentration includes:
- the designated blood oxygen partition refers to the selected blood oxygen partition that contains the blood oxygen data with the most severe severity in each blood oxygen partition determined in the current adjustment interval;
- the blood oxygen change trend is determined based on the specified blood oxygen zone, and the inhaled oxygen concentration is adjusted according to the adjustment strategy corresponding to the blood oxygen change trend.
- the determining of the blood oxygen change trend based on the specified blood oxygen zone includes:
- the oxygen change trend is the deterioration trend of blood oxygen
- the trend of oxygen change is the trend of blood oxygen improvement
- the blood oxygen type corresponding to the oxygen zone is non-severe hypoxia or severe hyperoxia, and it is determined that the blood oxygen change trend in the current adjustment interval is the blood oxygen stability trend;
- the blood oxygen types include at least severe hypoxia, severe hyperoxia, moderate hypoxia, moderate hyperoxia, mild hypoxia, mild hyperoxia, and normal state.
- the adjustment of the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend includes:
- the inhaled oxygen concentration is adjusted according to the preset maximum single oxygen concentration adjustment amount, and the duration of the next adjustment interval is changed to a fifth duration, the preset maximum
- the single oxygen concentration adjustment amount is correspondingly set to different adjustment amounts based on different patient types, and the fifth duration is less than the duration of the conventional adjustment interval;
- the first oxygen concentration target adjustment amount is greater than the preset maximum single oxygen concentration adjustment amount, adjust the inhaled oxygen concentration with the preset maximum single oxygen concentration adjustment amount, and adjust the first oxygen concentration target adjustment amount
- the difference between the adjustment amount and the preset maximum single-time oxygen concentration adjustment amount is used as the remaining adjustment amount, and is added to the cumulative adjustment amount of the designated blood oxygen zone.
- the described adjustment strategy according to the blood oxygen change trend corresponding to adjusting the inhaled oxygen concentration including:
- the offset of the upper and lower blood oxygen data boundaries of the target zone becomes smaller or unchanged, and the blood oxygen change trend in the last time is the difference between the blood oxygen stability trend or the blood oxygen improvement trend.
- a preset adjustment amount is added to obtain a second oxygen concentration target adjustment amount, and the intake oxygen concentration is adjusted based on the second oxygen concentration target adjustment amount, and the second oxygen concentration target adjustment amount The adjustment amount is not greater than the preset minimum oxygen concentration adjustment amount.
- the adjustment of the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend includes:
- the upper and lower blood oxygen data in the treatment target zone are offset based on the blood oxygen data in the designated blood oxygen zone.
- the offset of the data boundary and the accumulated adjustment amount of the designated blood oxygen zone are used to obtain a third oxygen concentration target adjustment amount, and the inspired oxygen concentration is adjusted based on the third oxygen concentration target adjustment amount.
- the adjustment of the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend includes:
- the region where the blood oxygen data is located in the treatment target zone determines the region where the blood oxygen data is located in the treatment target zone, and the region at least includes the downstream region , midstream region and upstream region;
- the blood oxygen data is in the midstream region, start a first timer, and when the first timer ends, adjust the inhaled oxygen concentration according to the preset minimum oxygen concentration adjustment amount;
- a second timing is started, and when the second timing ends, the inhaled oxygen concentration is adjusted according to the preset minimum oxygen concentration adjustment amount, and the second timing is greater than the first timing.
- a second aspect of the present application discloses a respiratory support device, comprising:
- a ventilation device which is used for providing an inhaled gas to a patient through a breathing circuit and a breathing accessory, and the inhaled gas is an oxygen-containing gas;
- a processor in signal connection with the ventilation device to control the flow of inspiratory gas provided by the ventilation device to the patient;
- the processor is also configured to:
- the severity refers to the degree to which the blood oxygen data deviates from the treatment target zone, and the condition for triggering the adjustment of the inhaled oxygen concentration in advance includes the severity.
- the degree of blood oxygen tends to increase, and the selected blood oxygen partition and the treatment target partition each correspond to a pre-divided blood oxygen data range;
- the processor for judging whether the severity of each blood oxygen data meets the condition for triggering the adjustment of the inhaled oxygen concentration in advance is specifically used for:
- the number of blood oxygen data obtained in the current adjustment interval whose severity is greater than the severity of the blood oxygen data in the reference blood oxygen zone exceeds the preset number, which satisfies the requirement to trigger the adjustment of inhaled oxygen in advance. Concentration conditions, otherwise, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are not met.
- the processor for judging whether the severity of each blood oxygen data meets the condition for triggering the adjustment of the inhaled oxygen concentration in advance is specifically used for:
- the processor is further configured to:
- the adjustment of the inhaled oxygen concentration is triggered according to the adjustment strategy corresponding to the uncertain blood oxygen trigger mode, otherwise, it is continued to judge whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance.
- triggering the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the uncertain blood oxygen triggering mode is specifically used for:
- the total weight is compared with a first weight threshold and a second weight threshold, where the first weight threshold is used to indicate an increase in the oxygen concentration and the first adjusted amount of the inspired oxygen concentration, and the second weight threshold The threshold is used to indicate the reduced oxygen concentration and the second adjusted amount of the inspired oxygen concentration, and the first weighted threshold is greater than the second weighted threshold;
- the adjustment amount for maintaining the current inhaled oxygen concentration is determined.
- the processor is further configured to:
- each blood oxygen data obtained by the obtaining device After receiving each blood oxygen data obtained by the obtaining device, obtain the associated data that affects the blood oxygen reliability in the blood oxygen data; determine whether the associated data meets the blood oxygen reliability requirements; if so, determine The blood oxygen zone corresponding to the blood oxygen data; if not satisfied, continue to obtain the blood oxygen data.
- the processor for judging whether the associated data meets preset requirements is specifically used for:
- the pulse rate change rate threshold If the rate of change of the pulse rate is higher than the pulse rate change rate threshold, the pulse rate does not meet the blood oxygen reliability requirement, otherwise, the pulse rate meets the blood oxygen reliability requirement; and/or,
- the pulse rate is lower than the pulse rate threshold, the pulse rate does not meet the blood oxygen reliability requirement, otherwise, the pulse rate meets the blood oxygen reliability requirement; and/or,
- the perfusion index If the perfusion index is lower than the perfusion index threshold, the perfusion index does not meet the blood oxygen reliability requirement; otherwise, the perfusion index meets the blood oxygen reliability requirement;
- the blood oxygen signal quality is lower than the blood oxygen signal quality threshold, the blood oxygen signal quality does not meet the blood oxygen reliability requirement; otherwise, the blood oxygen signal quality meets the blood oxygen reliability requirement.
- the processor is further configured to:
- the processor that performs the operation of adjusting the inhaled oxygen concentration is specifically used for:
- the designated blood oxygen partition refers to the selected blood oxygen partition that contains the blood oxygen data with the most severe severity in each blood oxygen partition determined in the current adjustment interval;
- the blood oxygen change trend is determined based on the specified blood oxygen zone, and the inhaled oxygen concentration is adjusted according to the adjustment strategy corresponding to the blood oxygen change trend.
- the processor for determining the blood oxygen change trend based on the specified blood oxygen partition is specifically used for:
- the first blood oxygen type is severe hypoxia or severe hyperoxia, determining that the blood oxygen change trend in the current adjustment interval is a blood oxygen deterioration trend;
- the blood oxygen type is more severe than the blood oxygen type indicated by the second blood oxygen type, it is determined that the blood oxygen change trend in the current adjustment interval is a blood oxygen deterioration trend, and the blood oxygen type At least include severe hypoxia, severe hyperoxia, moderate hypoxia, moderate hyperoxia, mild hypoxia, mild hyperoxia and normal state;
- the first blood oxygen type and the second blood oxygen type are consistent and neither is severe hypoxia or severe hyperoxia, determining that the blood oxygen change trend within the current adjustment interval is a blood oxygen stability trend;
- the blood oxygen change trend within the current adjustment interval is a blood oxygen improvement trend.
- the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
- the inhaled oxygen concentration is adjusted according to the preset maximum single oxygen concentration adjustment amount, and the duration of the next adjustment interval is changed to a fifth duration, the preset maximum
- the single oxygen concentration adjustment amount is correspondingly set to different adjustment amounts based on different patient types, and the fifth duration is less than the duration of the conventional adjustment interval;
- the first oxygen concentration target adjustment amount is greater than the preset maximum single oxygen concentration adjustment amount, adjust the inhaled oxygen concentration with the preset maximum single oxygen concentration adjustment amount, and adjust the first oxygen concentration target adjustment amount
- the difference between the adjustment amount and the preset maximum single-time oxygen concentration adjustment amount is used as the remaining adjustment amount, and is added to the cumulative adjustment amount of the designated blood oxygen zone.
- the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
- the offset of the upper and lower blood oxygen data boundaries of the target zone becomes smaller or unchanged, and the blood oxygen change trend in the last time is the difference between the blood oxygen stability trend or the blood oxygen improvement trend.
- a preset adjustment amount is added to obtain a second oxygen concentration target adjustment amount, and the intake oxygen concentration is adjusted based on the second oxygen concentration target adjustment amount, and the second oxygen concentration target adjustment amount The adjustment amount is not greater than the preset minimum oxygen concentration adjustment amount.
- the processor that adjusts the inhaled oxygen concentration according to the corresponding adjustment strategy of the blood oxygen change trend is specifically used for:
- the upper and lower blood oxygen data in the treatment target zone are offset based on the blood oxygen data in the designated blood oxygen zone.
- the offset of the data boundary and the accumulated adjustment amount of the designated blood oxygen zone are used to obtain a third oxygen concentration target adjustment amount, and the inspired oxygen concentration is adjusted based on the third oxygen concentration target adjustment amount.
- the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
- the region where the blood oxygen data is located in the treatment target zone determines the region where the blood oxygen data is located in the treatment target zone, and the region at least includes the downstream region , midstream region and upstream region;
- the blood oxygen data is in the midstream region, start a first timer, and when the first timer ends, adjust the inhaled oxygen concentration according to the preset minimum oxygen concentration adjustment amount;
- a second timing is started, and when the second timing ends, the inhaled oxygen concentration is adjusted according to the preset minimum oxygen concentration adjustment amount, and the second timing is greater than the first timing.
- a third aspect of the present application discloses a respiratory support device, comprising:
- a ventilation device which is used for providing an inhaled gas to a patient through a breathing circuit and a breathing accessory, and the inhaled gas is an oxygen-containing gas;
- a processor in signal connection with the ventilation device to control the flow of inspiratory gas provided by the ventilation device to the patient;
- the processor is also configured to:
- the blood oxygen zone corresponding to the real-time obtained blood oxygen data of the patient; the blood oxygen zone is pre-divided according to the blood oxygen saturation, and includes a treatment target zone ;
- an inspired oxygen concentration adjustment operation is performed in advance to adjust the blood oxygen level of the patient within the treatment target zone.
- a method for adjusting the inhaled oxygen concentration and a respiratory support device disclosed in the embodiments of the present application acquire each blood oxygen data at the current adjustment interval in real time, determine the selected blood oxygen zone in which each blood oxygen data is located; Whether the severity meets the conditions for triggering the adjustment of the inspired oxygen concentration in advance, the severity refers to the degree to which the blood oxygen data deviates from the treatment target zone, the conditions for triggering the adjustment of the inspired oxygen concentration in advance include that the severity tends to increase, so
- the selected blood oxygen zone and the treatment target zone respectively correspond to a pre-divided blood oxygen data range; when the condition of triggering the adjustment of the inhaled oxygen concentration in advance is satisfied, the operation of adjusting the inhaled oxygen concentration is performed, otherwise, the operation of adjusting the inhaled oxygen concentration is performed normally.
- 1 is a schematic flowchart of a method for adjusting the concentration of inhaled oxygen disclosed in an embodiment of the application;
- FIG. 2 is an exemplary diagram of a division of a blood oxygen zone disclosed in an embodiment of the present application
- FIG. 3 is a schematic flow chart of adjusting the concentration of inhaled oxygen disclosed in an embodiment of the application
- FIG. 4 is an exemplary diagram of another blood oxygen partition disclosed in an embodiment of the present application.
- FIG. 5 is an exemplary diagram of another blood oxygen partition disclosed in an embodiment of the present application.
- FIG. 6 is a schematic flowchart of determining the severity of each blood oxygen data disclosed in an embodiment of the present application.
- FIG. 7 is another schematic flowchart of determining the severity of each blood oxygen data disclosed in an embodiment of the present application.
- FIG. 8 is a schematic flowchart of adjusting the inhaled oxygen concentration based on the adjustment strategy A disclosed in the embodiment of the present application;
- FIG. 9 is a schematic flowchart of another method for adjusting the inhaled oxygen concentration disclosed in the embodiment of the application.
- FIG. 10 is a schematic flowchart of analyzing a blood oxygen change trend disclosed in an embodiment of the application.
- FIG. 11 is a schematic flow chart of a blood oxygen trend analysis under moderate hypoxia disclosed in an embodiment of the application.
- FIG. 12 is a schematic flow chart of a blood oxygen trend analysis under moderate superoxidation disclosed in an embodiment of the application.
- FIG. 13 is a schematic flowchart of a blood oxygen trend analysis under mild hypoxia disclosed in an embodiment of the application.
- FIG. 14 is a schematic flowchart of a blood oxygen trend analysis under mild peroxidation disclosed in an embodiment of the application.
- 15 is a schematic flowchart of adjusting the inhaled oxygen concentration based on the adjustment strategy B or C disclosed in the embodiment of the present application;
- FIG. 16 is a schematic structural diagram of a respiratory support device disclosed in an embodiment of the application.
- FIG. 17 is a schematic structural diagram of another method for adjusting the concentration of inhaled oxygen disclosed in an embodiment of the present application.
- FiO2 fraction of oxygen concentration in inhaled air, inhaled oxygen concentration
- FiO2 is an extremely important adjustment parameter in the process of patient receiving ventilator treatment.
- FiO2 needs to be adjusted according to the specific physiological condition of the patient. The goal of adjustment is to bring the patient to a normal target oxygenation level.
- the setting of FiO2 is made by medical staff with reference to the patient's arterial partial pressure of oxygen (PaO2) or arterial oxygen saturation (SaO2) and other related oxygenation indicators based on experience. set.
- the embodiment of the present application discloses a method for adjusting the inhaled oxygen concentration and a respiratory support device.
- the conditions for adjusting the inhaled oxygen concentration are set in advance to trigger,
- the blood oxygen data obtained in real time is in the selected blood oxygen zone where it is located, and the blood oxygen state corresponding to the selected blood oxygen zone satisfies the condition for triggering the adjustment of the inhaled oxygen concentration in advance, trigger the adjustment of the inhaled oxygen concentration in advance, and Based on the adjustment strategy corresponding to the blood oxygen change trend in the current adjustment interval, the adjustment of the inspired oxygen concentration is realized.
- the specific implementation is described in detail through the following embodiments.
- FIG. 1 it is a schematic flowchart of a method for adjusting the concentration of inhaled oxygen disclosed in an embodiment of the present application.
- the method for adjusting the concentration of inhaled oxygen can be applied to various types of respiratory support equipment, such as a ventilator, an anesthesia machine, and the like.
- the method for adjusting the inhaled oxygen concentration mainly includes the following steps:
- Step 101 Acquire each blood oxygen data of the current adjustment interval in real time, and determine the selected blood oxygen zone in which each blood oxygen data is located.
- a pulse oximeter may be used to acquire blood oxygen data in real time.
- the adjustment interval between the two operations of adjusting the inhaled oxygen concentration before and after is an adjustment interval.
- the duration of the interval can be preset according to the empirical value. Normally, the adjustment interval is the regular adjustment interval.
- the blood oxygen saturation can be specifically obtained by using the blood oxygen data.
- the blood oxygen data obtained in real time can be obtained by processing the blood oxygen data to reflect the blood oxygen saturation level of the blood oxygen data. Both can indicate the amount of oxygen in the blood.
- the selected blood oxygen zone refers to the blood oxygen zone where the collected blood oxygen data is located.
- the blood oxygen partition is a partition obtained in advance based on the blood oxygen saturation range (blood oxygen data range).
- the concentration in order to identify the severity of the patient's blood oxygen state according to the degree of deviation from the treatment target zone set by the doctor, so as to determine different inhaled oxygen according to the different degrees of severity. Adjusting the concentration; and determining whether to trigger the adjustment of the inhaled oxygen concentration in advance according to the change in the severity of the blood oxygen state in the region where the patient's blood oxygen is located, it is necessary to divide the overall blood oxygen into several regions. Each region has its own corresponding pre-divided blood oxygen saturation range, or has its own corresponding pre-divided blood oxygen data range.
- the area outside the treatment target zone set by the doctor is further divided into at least two block areas.
- the treatment target zone set by the doctor is used to indicate that the blood oxygen level is in a normal state.
- the blood oxygen zone includes a treatment target zone, that is, when treating a patient, it is necessary to restore or maintain the physiological parameters corresponding to the patient in the treatment target zone, and when the corresponding blood oxygen data (physiological parameters) are in the treatment target zone.
- the blood oxygen data can be considered to be in a normal state.
- the blood oxygen saturation range formed by the first lower limit blood oxygen saturation and the first upper limit blood oxygen saturation determine the lower limit blood oxygen saturation of the treatment target zone and the upper limit blood oxygen saturation of the treatment target zone.
- the area between the first lower limit blood oxygen saturation and the lower limit blood oxygen saturation of the treatment target zone is divided into a hypoxia zone, where the hypoxia zone is used to indicate that the blood oxygen level is in a hypoxic state.
- the area between the upper blood oxygen saturation level of the treatment target zone and the first upper blood oxygen saturation value is divided into a peroxygen zone, where the peroxygen zone is used to indicate that the blood oxygen level is in a peroxygen state.
- FIG. 2 it is an example diagram of a blood oxygen partition shown in an embodiment of the present application.
- 0% refers to the first lower limit blood oxygen saturation
- 100% is the first upper limit blood oxygen saturation
- 87% is the lower limit blood oxygen saturation of the treatment target zone
- 92% is the upper limit blood oxygen saturation of the treatment target zone.
- 90% is the currently monitored blood oxygen saturation of the patient.
- the range of the hypoxia zone is: [0%, 87%).
- the range of the peroxygen zone is: (92%, 100%].
- FIG. 2 is only an example given by the embodiment of the present application, and the division of the blood oxygen zone in the embodiment of the present application is not limited to the blood oxygen saturation level given above.
- the determined selected blood oxygen zone is also constantly updated.
- each blood oxygen zone corresponds to a blood oxygen state.
- the blood oxygen state is different according to the different blood oxygen saturation ranges corresponding to the blood oxygen zones.
- the blood oxygen state corresponding to the treatment target zone is a normal state.
- the blood oxygen state corresponding to the hypoxic zone is the hypoxic state.
- the blood oxygen state corresponding to the peroxygen zone is the peroxygen state.
- Step 102 Determine whether the severity of each blood oxygen data satisfies the condition for triggering the adjustment of the inhaled oxygen concentration in advance, if yes, go to Step 103; if not, go to Step 104.
- the severity of the blood oxygen data refers to the degree to which the blood oxygen data deviates from the treatment target zone. The further away from the treatment target zone, the higher the severity of the blood oxygen data.
- the conditions for the early triggering of the adjustment of the inspired oxygen concentration include a tendency for the severity to increase. That is to say, there is at least a situation where the severity of the blood oxygen data tends to increase, that is, the condition for triggering the adjustment of the inhaled oxygen concentration in advance is met.
- Step 103 Perform an operation of adjusting the inhaled oxygen concentration in advance under the condition that the adjustment of the inhaled oxygen concentration is triggered in advance.
- Step 104 After the timing of the current adjustment interval ends, the operation of adjusting the inhaled oxygen concentration is normally performed.
- a corresponding adjustment strategy is used to perform the operation of adjusting the inhaled oxygen concentration.
- FIG. 3 the operation of adjusting the inhaled oxygen concentration is shown in FIG. 3 , including:
- Step 301 Acquire a designated blood oxygen partition of the current adjustment interval, where the designated blood oxygen partition refers to a selected blood oxygen partition that includes the blood oxygen data with the most severe severity among the blood oxygen partitions determined in the current adjustment interval.
- the designated blood oxygen partition of the current adjustment interval refers to the selected blood oxygen partition containing the blood oxygen data with the most severe severity determined in the current adjustment interval, and is used to indicate the overall blood oxygen partition result in the current adjustment interval.
- the severity of the blood oxygen data obtained in the current adjustment interval can be compared at every preset time period, and the selected blood oxygen zone containing the blood oxygen data with the most severe severity can be determined as the designated blood oxygen partition. Until triggering to perform the operation of adjusting the inhaled oxygen concentration in advance or to perform the operation of adjusting the inhaled oxygen concentration normally, to finally determine the selected blood oxygen zone containing the blood oxygen data with the most severe severity as the designated blood oxygen zone in the current adjustment interval.
- the inhaled oxygen concentration operation or the normal execution of the adjustment of the inhaled oxygen concentration operation is performed to finally determine the selected blood oxygen zone containing the blood oxygen data with the most severe severity as the designated blood oxygen zone within the current adjustment interval.
- the minimum number of blood oxygen data that can be obtained in the current interval is 20.
- the selected blood oxygen zone in which the first blood oxygen data is located is determined as the designated blood oxygen zone within the current adjustment interval.
- Step 302 Determine the blood oxygen change trend based on the designated blood oxygen zone, and adjust the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend.
- the blood oxygen change trend includes the blood oxygen deterioration trend, the blood oxygen stability trend and the blood oxygen improvement trend.
- a worsening trend in blood oxygen indicates that the patient's blood oxygen further deviates from the therapeutic target zone.
- the stable blood oxygen trend indicates that the patient's blood oxygen has no obvious tendency to change towards the therapeutic target zone or to deviate from the target blood oxygen range.
- the trend of blood oxygen improvement indicates that the patient's blood oxygen is changing towards the therapeutic target zone.
- a corresponding adjustment strategy is determined based on the blood oxygen change trend, and the inhaled oxygen concentration is adjusted according to the adjustment strategy.
- Execute the operation of adjusting the inhaled oxygen concentration disclosed in the embodiment of the present application and determine an adjustment strategy suitable for the patient's inhaled oxygen concentration according to the blood oxygen change trend of different patients, so that the operation of adjusting the inhaled oxygen concentration disclosed in the embodiment of the present application can be used in different blood oxygen concentrations. used between patients in the state. It can avoid the disadvantages of using a fixed adjustment amount or a fixed adjustment target in the prior art to adjust the inhaled oxygen concentration for patients with different blood oxygen states. Further, there is no need to distinguish which patients can be used and which cannot be used.
- a response is made whether to trigger the adjustment of the inhaled oxygen concentration in advance according to the change in the severity of the blood oxygen data of the patient, and when it is determined that the adjustment of the inhaled oxygen concentration is triggered in advance
- the inhaled oxygen concentration is adjusted in time based on the adjustment strategy corresponding to the blood oxygen change trend in the current adjustment interval.
- the blood oxygen partition in step 101 is divided into a treatment target partition, a hypoxia partition and a hyperoxia partition.
- the treatment target zone can be divided into multiple regions.
- the treatment target zone can be divided into a downstream region, a midstream region and an upstream region.
- the division of the treatment target zone in the embodiment of the present application is not limited to three zones.
- treatment target partition can be divided into regions with equal proportions, and can also be divided into regions with unequal proportions.
- hypoxia partition can also continue to be divided. Specifically:
- the first boundary blood oxygen saturation is less than the lower limit blood oxygen saturation of the treatment target zone, and the first boundary blood oxygen saturation is greater than the second boundary blood oxygen saturation.
- the area between the lower limit blood oxygen saturation of the treatment target zone and the first boundary blood oxygen saturation is divided into a mild hypoxia zone, which is used to indicate that the blood oxygen level is in a mild hypoxia state .
- a region between the first boundary blood oxygen saturation level and the second boundary blood oxygen saturation level is divided into a moderate hypoxia zone, where the moderate hypoxia zone is used to indicate that the blood oxygen level is in a moderate hypoxia state.
- a region between the second boundary blood oxygen saturation level and the first lower limit blood oxygen saturation level is divided into a severe hypoxia zone, where the severe hypoxia zone is used to indicate that the blood oxygen level is in a severe hypoxia state.
- the third type obtain the first historical blood oxygen saturation corresponding to the moderate hypoxia state and the second historical blood oxygen saturation corresponding to the severe hypoxia state; determine the first boundary blood oxygen saturation according to the first historical blood oxygen saturation , and the second boundary blood oxygen saturation is determined according to the second historical blood oxygen saturation.
- FIG. 5 shows that the blood oxygen saturation of the first boundary of the hypoxic zone is 84%, and the blood oxygen saturation of the second boundary of the hypoxic zone is 81%.
- the range of moderate hypoxia zones was: [81%, 84%).
- the range of severe hypoxia zone is: [0%, 81%).
- the division of the peroxygen zone may continue. Specifically:
- the third boundary blood oxygen saturation is greater than the upper limit blood oxygen saturation of the treatment target zone, and the third boundary blood oxygen saturation is smaller than the fourth boundary blood oxygen saturation.
- the area between the upper blood oxygen saturation level of the treatment target zone and the third boundary blood oxygen saturation value is a mild hyperoxia zone, and the mild hyperoxygen zone is used to indicate that the blood oxygen level is in a mild hyperoxygen state.
- the area between the third boundary blood oxygen saturation level and the fourth boundary blood oxygen saturation level is a moderate hyperoxia subarea, and the medium superoxygen subarea is used to indicate that the blood oxygen level is in a moderate superoxidation state.
- the area between the fourth boundary blood oxygen saturation level and the first upper limit blood oxygen saturation level is defined as a severe peroxygen subarea, which is used to indicate that the blood oxygen level is in a severe hyperoxygen state.
- the third type obtain the third historical blood oxygen saturation corresponding to the moderate superoxide state and the fourth historical blood oxygen saturation corresponding to the severe superoxidation state; determine the third boundary blood oxygen saturation according to the third historical blood oxygen saturation , and the fourth boundary blood oxygen saturation is determined according to the fourth historical blood oxygen saturation.
- FIG. 5 shows that the blood oxygen saturation of the third boundary of the peroxygen zone is 94%, and the blood oxygen saturation of the fourth boundary of the hypoxic zone is 96%.
- the range of the moderate hyperoxia partition is: (94%, 96%].
- the severity of the patient's blood oxygen condition is identified according to the degree of deviation from the target blood oxygen range.
- the severity of the oxygen state determines different adjustment strategies, and according to the change of the blood oxygen state of the blood oxygen zone where the patient's blood oxygen data is located, it is decided whether to trigger the adjustment of the inhaled oxygen concentration in advance.
- the blood oxygen state with higher severity adopts a higher amount of adjustment of the inspired oxygen concentration and a shorter adjustment interval, so as to obtain the increase of the severity of the blood oxygen state of the patient.
- the density adjustment intensity is the effect of increasing the intensity adjustment in steps.
- step 102 various methods can be used to analyze the severity of each blood oxygen data, so as to determine in real time whether the severity of the blood oxygen data meets the requirements in advance. Triggers the conditions that regulate the concentration of inspired oxygen.
- the embodiments of the present application provide the following three ways, but the embodiments of the present application are not limited to the following three ways to determine the severity of each blood oxygen data.
- the first way is:
- the reference blood oxygen partition containing the blood oxygen data with the highest severity in the previous adjustment interval and compare the severity of the blood oxygen data obtained in the current adjustment interval with the severity of the blood oxygen data of the reference blood oxygen partition in real time; Before the timing of the current adjustment interval ends, the number of blood oxygen data obtained in the current adjustment interval whose severity is greater than the severity of the blood oxygen data in the reference blood oxygen zone exceeds the preset number, and the condition for triggering the adjustment of the inhaled oxygen concentration in advance is met. , otherwise, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are not met.
- duration of the last adjustment interval and the current adjustment interval are not necessarily the same.
- the specific implementation process of the first mode is shown in FIG. 6 , including the following steps:
- Step 601 Determine the reference blood oxygen zone that contains the blood oxygen data with the highest severity in the last adjustment interval.
- the reference blood oxygen partition that contains the blood oxygen data with the highest severity in the last adjustment interval determined in step 601 is the result of the overall blood oxygen partition in the last adjustment interval.
- the result of the overall division of blood oxygen in the last adjustment interval refers to the overall division of blood oxygen when the operation of adjusting the inhaled oxygen concentration is performed within the last adjustment interval or after the end of the last adjustment interval, and the overall division of blood oxygen is used to represent the last adjustment Overall status of blood oxygen in the interval.
- the blood oxygen data obtained in one adjustment interval has different corresponding blood oxygen partitions
- the blood oxygen partition is used as a reference blood oxygen partition for subsequent use.
- the "peroxygen zone” is " More important blood oxygen zoning events".
- This "peroxygen zone” is used as a reference blood oxygen zone for subsequent use.
- different strategies may also be used to determine the overall state of blood oxygen within a certain adjustment interval.
- the following steps are performed cyclically in the current interval until it is determined whether the severity of each blood oxygen data acquired in the current adjustment interval triggers the condition for adjusting the inhaled oxygen concentration in advance.
- Step 602 Determine whether the timing of the current adjustment interval has ended, and if so, determine that the condition for triggering the adjustment of the inhaled oxygen concentration in advance is not met. If not completed, acquire the next blood oxygen data, and execute step 603 .
- Step 603 Compare the severity of the currently acquired blood oxygen data with the severity of the blood oxygen data of the reference blood oxygen partition, if the severity of the currently acquired blood oxygen data is greater than the severity of the blood oxygen data of the reference blood oxygen partition , go to step 604 ; if the severity of the currently acquired blood oxygen data is not greater than the severity of the blood oxygen data of the reference blood oxygen partition, go to step 605 .
- step 603 it may also be determined that, based on the currently acquired blood oxygen data, the selected blood oxygen partition including the blood oxygen data with the most severe severity is determined as the designated blood oxygen partition within the current adjustment interval.
- the severity of each currently obtained blood oxygen data is compared, and the selected blood oxygen partition including the blood oxygen data with the most serious severity is determined, which is used as the designated blood oxygen partition.
- the selected blood oxygen partition including the blood oxygen data with the most serious severity is determined, which is used as the designated blood oxygen partition.
- it can be understood as evaluating an overall blood oxygen partition to summarize the "more important blood oxygen partition events" in the adjustment interval.
- Step 604 Accumulate the number of severity levels of the blood oxygen data acquired in the current adjustment interval that are greater than the severity of the blood oxygen data in the reference blood oxygen zone.
- Step 605 Determine whether the current accumulated number exceeds the preset number, and if it exceeds, the condition for triggering the inhaled oxygen concentration in advance is met; if not, step 602 is performed.
- step 605 the comparison with the previous adjustment interval is determined by judging the number of the blood oxygen data obtained in the current accumulated current adjustment interval whose severity is greater than the severity of the blood oxygen data in the reference blood oxygen partition. Whether there is an incremental change in the severity of the blood oxygen data, and whether the change is an incidental event. If the current accumulated number does not exceed the preset number, it may be an accidental event, or in other words, it has not reached the level of triggering the adjustment of the inhaled oxygen concentration in advance, then return to step 602 to continue to determine whether the timing of the current adjustment interval is End, if it ends, it means that it is in the state of normal adjustment of the inhaled oxygen concentration. If not finished, continue to acquire the next blood oxygen data.
- the current accumulated number exceeds the preset number, it means that before the timing of the current interval expires, the level of triggering the adjustment of the inhaled oxygen concentration in advance has been reached, and the condition for triggering the inhaled oxygen concentration in advance is satisfied.
- the preset number is 15. If the current accumulated number is 16, the condition for triggering the inhaled oxygen concentration in advance is met.
- step 605 the determination is made based on the number of the blood oxygen data obtained in step 604 whose severity is greater than the severity of the blood oxygen data in the reference blood oxygen zone. It can be understood as:
- the accumulated number it is determined whether the overall state of blood oxygen in the current adjustment interval has changed compared with the reference blood oxygen partition determined in the previous adjustment interval. If the severity of the accumulated blood oxygen data obtained in the current adjustment interval is greater than If the number of severity levels of the blood oxygen data in the reference blood oxygen zone is greater than the preset number, it means that the patient's blood oxygen state may deteriorate, which requires great attention, and the adjustment of the inhaled oxygen concentration can be triggered in advance.
- the accumulated severity of the blood oxygen data acquired in the current adjustment interval is greater than the severity of the blood oxygen data in the reference blood oxygen zone and not greater than the preset number, it means that the blood oxygen state of the patient may be improving.
- the timing of the current adjustment interval has not ended, continue to obtain the next blood oxygen data, continue to judge, until it is determined that the operation of adjusting the inhaled oxygen concentration can be triggered in advance or the timing ends, and the normal operation of adjusting the inhaled oxygen concentration is performed.
- the designated blood oxygen partition of the current adjustment interval can be determined in real time while performing step 603, or after the current adjustment interval is timed, or preset.
- the specified blood oxygen zone within the time period that determines the current conditioning interval.
- the technical solution for judging whether the current accumulated number exceeds the preset number in step 605 can also be determined by judging the proportion of the severity of the currently acquired blood oxygen data greater than the severity of the blood oxygen data of the reference blood oxygen partition. It is specifically: based on the total number N of blood oxygen data that can be obtained at the current adjustment interval, and the number n of blood oxygen data currently obtained that is greater than the severity of the blood oxygen data of the reference blood oxygen zone, based on formula (1 ) to calculate to get the proportion K. It is judged whether the ratio exceeds the preset ratio, and if it exceeds, the condition for triggering the inhaled oxygen concentration in advance is met; if not, step 602 is executed.
- the minimum number of blood oxygen data that can be obtained in the current interval is 20, and the preset proportion is 60%.
- the proportion K 50%, and the proportion K is less than 60%, which does not meet the conditions for triggering the inhaled oxygen concentration in advance.
- the proportion K 65%, and the proportion K is greater than 60%, then the condition for triggering the inhaled oxygen concentration in advance is satisfied.
- the second way is:
- the first duration is less than the duration of the current adjustment interval, and may be an empirical value.
- the condition for triggering the operation of adjusting the inhaled oxygen concentration in advance is also satisfied.
- the first duration is 30 seconds.
- the blood oxygen data was in the hypoxia zone for the last 30 seconds, after 30 seconds, it continued to deviate from the treatment target zone, and the severity increased. After another 30 seconds, it continued to deviate from the treatment target zone, and the severity continued to increase.
- Pre-triggered conditions for regulating the operation of the inspired oxygen concentration are 30 seconds.
- the third way is:
- the third duration is greater than the second duration and less than or equal to the duration of the current adjustment interval.
- half the duration of the regular adjustment interval may be used as the third duration.
- the duration of the current adjustment interval is 120 seconds
- the third duration is 60 seconds
- the second duration is 15 seconds.
- the hypoxia zone is further divided into mild hypoxia zone, moderate hypoxia zone and severe hypoxia zone.
- the duration of the mild hypoxia zone does not exceed 15 seconds, it further deviates from the treatment target zone and moves to the moderate hypoxia zone, also in the duration of the moderate hypoxia zone. It did not exceed 15 seconds, and it shifted back to the mild hypoxia zone. This situation continued for more than 60 seconds.
- the strategy is triggered in advance to regulate the inspired oxygen concentration.
- the specific implementation process of the third mode is shown in FIG. 7 , including the following steps:
- Step 701 Determine in real time whether the duration of the currently obtained blood oxygen data in the selected blood oxygen zone is less than or equal to the second duration, if not, clear the continuous timer and go to Step 702 ; if so, go to Step 706 .
- Step 702 Determine whether the timing of the current adjustment interval has ended, and if so, it is determined that the condition for triggering the adjustment of the inhaled oxygen concentration in advance is not met. If not completed, acquire the next blood oxygen data, and execute step 703 .
- Step 703 Compare the severity of the currently acquired blood oxygen data with the severity of the blood oxygen data of the reference blood oxygen partition, if the severity of the currently acquired blood oxygen data is greater than the severity of the blood oxygen data of the reference blood oxygen partition , go to step 704 ; if the severity of the currently acquired blood oxygen data is greater than the severity of the blood oxygen data of the reference blood oxygen partition, go to step 705 .
- step 703 it may also be determined that, based on the currently acquired blood oxygen data, the selected blood oxygen partition including the blood oxygen data with the most severe severity is determined as the designated blood oxygen partition within the current adjustment interval.
- Step 704 Accumulate the number of the severity of the blood oxygen data acquired in the current adjustment interval that is greater than the severity of the blood oxygen data of the reference blood oxygen zone.
- Step 705 determine whether the current accumulated number exceeds the preset number, and if it exceeds, the condition for triggering the inhaled oxygen concentration in advance is met; if not, step 702 is executed.
- Step 706 Continue timing, determine whether the duration of the continuous timing exceeds the third duration, if it exceeds, go to Step 707, if not, go to Step 701.
- step 706 it is determined whether the duration of the continuous timing exceeds the third duration, because if the duration of the blood oxygen data in the selected blood oxygen zone where the blood oxygen data is continuously obtained within the current adjustment interval is less than or equal to the second duration, the situation is always occurring , indicating that the patient's blood oxygen fluctuation may be in a large and frequent state at this time, and the blood oxygen partition may be repeatedly changed. Therefore, it is necessary to judge the uncertainty of blood oxygen, that is, to judge whether the blood oxygen data is in the place where the blood oxygen data is. Whether the duration of the selected blood oxygen partition is less than or equal to the second duration has continued for the third duration, and if so, it means that the blood oxygen uncertainty occurs in the current adjustment interval, and the inhaled oxygen concentration also needs to be adjusted at this time.
- Step 707 Adjust the inhaled oxygen concentration according to the adjustment strategy A corresponding to the uncertain blood oxygen trigger mode.
- Step 707 is specifically implemented.
- the process of adjusting the inhaled oxygen concentration according to the adjustment strategy A is shown in FIG. 8 , including the following steps:
- Step 801 Accumulate and calculate the weights of each selected blood oxygen partition to obtain a total weight.
- step 801 the divided blood oxygen zones are assigned values in advance, and each blood oxygen zone is assigned a weight coefficient.
- the blood oxygen zones corresponding to different blood oxygen states have different weights, and the size of the weight is determined by the severity of the blood oxygen data.
- the complete blood oxygen is divided into the treatment target zone, the severe hypoxia zone, the moderate hypoxia zone, the mild hypoxia zone, the severe hyperoxia zone, the moderate hyperoxia zone and the mild hyperoxia zone.
- Weights +1, +2, +3 can be assigned to mild hypoxia, moderate hypoxia, and severe hypoxia, respectively, and mild, moderate, and severe hyperoxia. Given weights -1, -2, -3, those within the treatment target partition do not participate in the cumulative partition (or the cumulative weight is 0).
- step 701 is executed to determine the cumulative calculation weight of each blood oxygen zone. value, the total weight is: 4.
- performing step 801 to accumulate and calculate the weights of each selected blood oxygen zone, and the time to obtain the total weight is the time recorded by the first timer exceeding the third duration in performing step 706 in FIG. 7 .
- step 706 the time recorded by the first timer exceeding the third duration is 20 seconds. Then, the weights of each selected blood oxygen zone accumulated here are the weights of the selected blood oxygen zone where the blood oxygen data obtained within the 20 seconds are located.
- Step 802 Compare the total weight with the first weight threshold and the second weight threshold respectively. If the total weight is greater than or equal to the first weight threshold, go to step 803; if the total weight is less than or equal to the second weight threshold, go to step 804; if the total weight is less than the first weight threshold, it is greater than the second weight threshold, go to step 805.
- the first weighted threshold is used to indicate the increase of the oxygen concentration and the first adjusted amount of the inspired oxygen concentration
- the second weighted threshold is used to indicate the decreased oxygen concentration and the second adjusted amount of the inspired oxygen concentration
- the first weighted threshold greater than the second weight threshold
- the first intake oxygen concentration adjustment amount indicated by the first weight threshold value may be any adjustment amount from 1% to 5%.
- the adjustment amount is not limited to this range.
- the second inhaled oxygen concentration adjustment amount indicated by the second weight threshold value may be any adjustment amount among -1% to -5%.
- the adjustment amount is not limited to this range.
- Step 803 Determine to increase the adjustment amount of the first inspired oxygen concentration.
- Step 804 Determine to reduce the second adjusted amount of the inspired oxygen concentration.
- Step 805 Determine to maintain the current inspired oxygen concentration.
- the first weighted threshold is 10
- the first adjusted amount of the intake oxygen concentration indicated by the first weighted threshold is 1%
- the second weighted threshold is -10
- the second inhaled oxygen concentration adjustment amount indicated by the second weighted threshold is -1%
- the time used to determine blood oxygen with uncertainty in the adjustment interval is 20 seconds.
- the total weight value is less than the second weight value threshold value, then it is determined that the oxygen concentration needs to be reduced at this time, and the inspired oxygen concentration is reduced by 1% (-1%).
- the total weight is less than the first weight threshold and greater than the second weight threshold, and it is determined to maintain the current inhaled oxygen concentration at this time.
- weight thresholds may be set based on the blood oxygen partition type, and corresponding weight thresholds may be set according to different weight thresholds. Different oxygen concentration adjustment amount. Then accumulate the weights corresponding to the selected blood oxygen partitions determined in the case of uncertain blood oxygen in the adjustment interval, and compare the accumulated results with multiple weight thresholds, and select different oxygen concentration adjustments according to the comparison. quantity.
- the blood oxygen data in the selected blood oxygen zone is frequently changed within 20 seconds, and cannot be stabilized in one zone, and the calculation result of the total weight is greater than or equal to 30, It means that at least half of the blood oxygen data is located in the severe hypoxia zone. At this time, a 3% oxygen concentration adjustment is given, and the adjustment direction is oxygenation; if the calculation result of the total weight is between 20 and 30, it means that the current blood oxygen The data are mainly concentrated in the moderate hypoxia zone. At this time, a 2% oxygen concentration adjustment amount is given, and the adjustment direction is oxygenation.
- the adjustment direction is oxygen reduction, and different oxygen concentration adjustment amounts and adjustment directions are given according to the comparison result between the total weight value and the weight threshold value.
- the calculation result of the total weight is between -10 and 10
- the current inhaled oxygen concentration is maintained, and the oxygen concentration is not adjusted.
- the patient's blood oxygen data is outside the treatment target zone, even if the patient's blood oxygen data fluctuates frequently and the blood oxygen trend is unclear, it is still possible to determine the location of all blood oxygen data within the adjustment interval according to the The oxygen concentration of the blood determines the amount and direction of the adjustment of the oxygen concentration.
- the calculation result of the total weight is between -10 and 10
- the adjustment strategy A is used to first calculate the weight accumulation result of the blood oxygen partition determined in the current adjustment interval, and then determine the inspired oxygen concentration according to the accumulated result. Adjust the direction and amount of adjustment. Thus, the adjustment of the inspired oxygen concentration is completed.
- the embodiment of the present application also discloses another method for adjusting the intake oxygen concentration.
- the intake oxygen concentration includes the following steps:
- Step 901 Determine whether valid blood oxygen data is obtained at the current adjustment interval. If the blood oxygen data is not obtained or the obtained blood oxygen data is invalid, continue to obtain blood oxygen data. If valid blood oxygen data is obtained, go to step 902 .
- step 901 if the blood oxygen data cannot be obtained at the current adjustment interval, or the obtained blood oxygen data is invalid, that is, the blood oxygen data is not within the range of 0 to 100%, which is an invalid value, it means that the blood oxygen data cannot be obtained. Measure, and time it at this time. If the blood oxygen data is obtained within the current adjustment interval, and the obtained blood oxygen data is within the range of 0 to 100%, which is a valid value, it means that the blood oxygen data is measurable.
- Step 902 Acquire the associated data that affects the blood oxygen reliability in the blood oxygen data, and determine whether the associated data meets the blood oxygen reliability requirement; if so, go to step 905 ; if not, go to step 903 .
- step 902 if it is satisfied, it means that the blood oxygen data is credible, and if not, it means that the blood oxygen data is not credible.
- the correlation data includes at least pulse rate and/or perfusion index and/or blood oxygen signal quality.
- the blood oxygen signal quality in the correlated data is the comprehensive judgment result of the blood oxygen signal strength, time domain waveform, and frequency domain waveform.
- the blood oxygen signal quality is low, it means that the blood oxygen signal strength is low, or the waveform disturbance is strong.
- the pulse rate is lower than the pulse rate threshold; if so, the pulse rate does not meet the blood oxygen reliability requirement; if not, the pulse rate meets the blood oxygen reliability requirement, and the blood oxygen data is determined to be reliable data.
- the associated data includes a perfusion index
- the associated data includes blood oxygen signal quality, then:
- the associated data includes pulse rate and perfusion index
- the pulse rate determines whether the pulse rate is lower than the pulse rate threshold; if so, the pulse rate does not meet the blood oxygen reliability requirement; if not, the pulse rate meets the blood oxygen reliability requirement.
- the perfusion index determines whether the perfusion index is lower than the perfusion index threshold; if so, the perfusion index does not meet the blood oxygen reliability requirement; if not, the perfusion index meets the blood oxygen reliability requirement.
- the associated data includes any combination of pulse rate, perfusion index and blood oxygen signal quality, for example: pulse rate and blood oxygen signal quality; or, perfusion index and blood oxygen signal quality; or, pulse rate, perfusion index and blood oxygen signal quality; or, pulse rate, perfusion index and
- pulse rate perfusion index
- the blood oxygen signal quality is determined, when the judgment for any data in the combination is no, it is determined that the blood oxygen data is reliable data, and if the judgment for any data in the combination is yes, it is determined that the blood oxygen data is not reliable.
- Step 903 judging whether the result of the unreliable blood oxygen data is continuous and the duration of continuous occurrence exceeds the fourth duration, if yes, go to step 904 , if not, continue to acquire blood oxygen data, and go to step 902 .
- the reason for performing step 903 is that because the blood oxygen data is unreliable, the automatic adjustment of the inhaled oxygen concentration is in an unadjustable state for a long time, which will cause more serious problems. Therefore, an alarm prompt and manual intervention are required.
- the unreliable result of the blood oxygen data determined in step 903 when the associated data of the unreliable result is different, that is, any one or combination of pulse rate, perfusion index and blood oxygen signal quality, according to the correlation The content contained in the data is different.
- the fourth time period for determining whether to perform the operation of prompting the user to adjust the current state may be different.
- Step 904 Execute an alarm operation.
- the alarm operation mainly prompts the user that the current automatic adjustment of the inhaled oxygen concentration is in a suspended state.
- the form of prompting the user of the current adjustment state of the oxygen concentration of the inhaled oxygen should at least include prompting through character strings and/or graphics and/or sounds.
- the content of the prompt should include the current regulation state and/or the reason for the current regulation state.
- the user may be prompted that the current automatic adjustment of the inhaled oxygen concentration is in a suspended state through an alarm string, an alarm sound, and a detailed string displayed on the system operation interface.
- the reason for the suspension state may be prompted to the user according to the judgment result of the associated data used in judging whether the blood oxygen data is credible.
- the user will be prompted that "the current adjustment is paused because the perfusion index is too low for a long time".
- the prompt words displayed on the specific system operation interface can be set by a technician.
- the prompt priority of the blood oxygen signal quality is higher than that of the perfusion index, it can prompt "the current adjustment is suspended, and the reason for the suspension is that the perfusion index is too low for a long time".
- the user when an alarm operation is performed to prompt the user about the current state of automatic adjustment of the inhaled oxygen concentration and the reason, the user can be authorized or started to manually set the inhaled oxygen concentration.
- the function of automatically adjusting the inhaled oxygen concentration will inform the user that the current automatic adjustment is suspended due to some factors. At this time, the user can manually set a new inhaled oxygen concentration until the blood oxygen data is restored to be credible.
- the system can use the new inhaled oxygen concentration manually set by the user as the control value, and continue to adjust on the basis of the control value; The concentration is used as the control value, and the subsequent adjustment is continued on the basis of the control value.
- any control value of the inhaled oxygen concentration disclosed in the above-mentioned embodiment of the present application will be displayed on the user interface of the system, prompting the user that the current automatic Control value result for adjusted inspired oxygen concentration.
- the user can also manually set the inhaled oxygen concentration.
- the inhaled oxygen concentration manually set by the user during the automatic adjustment of the inspiratory oxygen concentration the automatic adjustment of the inspiratory oxygen concentration will continue to adjust with the new inhaled oxygen concentration set by the user.
- the inhaled oxygen concentration can be changed manually by setting the inhaled oxygen concentration; After the automatic adjustment of the inhaled oxygen concentration is enabled, the inlet of the original manual setting of the oxygen concentration displays the result of the inhaled oxygen concentration of the current automatic adjustment of the inspiratory oxygen concentration.
- the user operation interface and the display interface of the system can be set separately or combined.
- the area where the user manually sets the inhaled oxygen concentration can be separated from the display area of the automatically adjusted inhaled oxygen concentration results.
- the user only sets the inhaled oxygen concentration from one inlet, and reads the automatically adjusted inhaled oxygen concentration from the other inlet. result of oxygen concentration.
- Step 905 Determine the blood oxygen zone corresponding to each blood oxygen data.
- step 905 and the involved blood oxygen partition are the same as the execution principle and involved blood oxygen partition of step 101.
- step 101 please refer to the above description of step 101, which will not be repeated here.
- Step 906 Determine whether the severity of each blood oxygen data meets the condition for triggering the adjustment of the inhaled oxygen concentration in advance, if yes, go to Step 907 ; if not, go to Step 908 .
- Step 907 Execute the operation of adjusting the intake oxygen concentration in advance under the condition that the adjustment of the intake oxygen concentration is triggered in advance.
- Step 908 After the timing of the current adjustment interval expires, the operation of adjusting the inhaled oxygen concentration is normally performed.
- steps 906 to 908 are the same as the execution principles of the foregoing steps 102 to 104.
- steps 102 to 104 please refer to the above descriptions about the steps 102 to 104, which will not be repeated here.
- the judgment of the reliability of the blood oxygen data is increased, and the change of the severity of the credible blood oxygen data is used to make a response to whether to trigger the adjustment of the inhaled oxygen concentration in advance.
- the inhaled oxygen concentration is adjusted in time based on the adjustment strategy corresponding to the blood oxygen change trend in the current adjustment interval.
- the system operating state can also be acquired in parallel to determine whether the system operating state is not. An operation in a normal operating state.
- system operating state is in the normal operating state, it means that there is no state that may affect the normal operation of the system. If it is satisfied, it means that the system operating state is normal;
- the abnormal operating state includes the failure of the respiratory support equipment, the abnormal state of the connection between the equipment and the patient, etc., at least including the equipment's abnormality in pressure, flow rate control or monitoring, the equipment mixing air and oxygen to generate new oxygen Abnormality of the concentration gas control process, abnormality of the equipment's monitoring function of the gas oxygen concentration, excessive gas leakage or blockage during the gas supply process, and disconnection of the gas supply pipeline between the equipment and the patient.
- the first blood oxygen type indicated by the designated blood oxygen zone and the second blood oxygen type indicated by the reference blood oxygen zone are determined.
- the blood oxygen types include at least severe hypoxia, severe hyperoxia, moderate hypoxia, moderate hyperoxia, mild hypoxia, mild hyperoxia, and normal state.
- the blood oxygen type can be determined by the blood oxygen saturation range of the blood oxygen zone.
- the current blood oxygen variation trend can be obtained according to the first blood oxygen type indicated by the designated blood oxygen zone and the second blood oxygen type indicated by the reference blood oxygen zone.
- the first blood oxygen type is severe hypoxia or severe hyperoxia
- it is determined that the blood oxygen change trend in the current adjustment interval is the blood oxygen deterioration trend.
- the blood oxygen change trend in the current adjustment interval is the blood oxygen deterioration trend.
- the blood oxygen change trend in the current adjustment interval is the blood oxygen stability trend.
- the blood oxygen change trend within the current adjustment interval is the blood oxygen improvement trend.
- the judgment of the first blood oxygen type in this embodiment of the present application may be performed from severe to mild or from mild to severe.
- the following is just an example.
- FIG. 10 a A schematic flow chart of analyzing the trend of blood oxygen changes, including the following steps:
- Step 1001 Acquire a first blood oxygen type corresponding to a specified blood oxygen zone and a second blood oxygen type corresponding to a reference blood oxygen zone.
- Step 1002 Determine whether the first blood oxygen type is severe hypoxia, and if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen deterioration trend; if not, go to step 1003.
- Step 1003 Determine whether the first blood oxygen type is severe peroxygen, and if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen deterioration trend; if not, go to step 1004.
- the first blood oxygen type indicated by the control blood oxygen zone is severe hypoxia or severe hyperoxia: it is determined that the blood oxygen change trend in the current adjustment interval is the blood oxygen deterioration trend.
- Step 1004 determine whether the first blood oxygen type is moderate hypoxia, and if so, execute the blood oxygen trend analysis under moderate hypoxia; if not, execute step 1005 .
- the blood oxygen trend analysis under moderate hypoxia is shown in FIG. 11 , which mainly includes the following steps:
- Step 1101 Determine whether the second blood oxygen type is severe hypoxia, and if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen improvement trend; if not, go to step 1102.
- Step 1102 Determine whether the second blood oxygen type is moderate hypoxia, if yes, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen stability trend; if not, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen worsening trend.
- step 1102 is performed on the basis of first performing step 1101 to determine that the second blood oxygen type is not severe hypoxia, and it is obtained that the second blood oxygen type is not moderate hypoxia, then it can be obtained that the second blood oxygen type may be mild.
- severe hypoxia or normal state the blood oxygen state is in a worsening trend relative to the moderate hypoxia indicated by the current first blood oxygen type.
- Step 1005 Determine whether the first blood oxygen type is moderate hyperoxia, and if so, execute the blood oxygen trend analysis under the moderate hyperoxia; if not, execute step 1006 .
- the blood oxygen trend analysis under moderate superoxidation is shown in FIG. 12 , which mainly includes the following steps:
- Step 1201 Determine whether the second blood oxygen type is severe peroxygen, and if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen improvement trend; if not, go to step 1202 .
- Step 1202 Determine whether the second blood oxygen type is moderate hyperoxia, if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen stability trend, if not, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen worsening trend.
- step 1202 is performed on the basis of first performing step 1201 to determine that the second blood oxygen type is not severe peroxygen, and it is obtained that the second blood oxygen type is not moderate peroxidation, then it can be obtained that the second blood oxygen type may be light.
- Peroxygen or normal state the blood oxygen state is in a worsening trend relative to the moderate superoxygen indicated by the current first blood oxygen type.
- Step 1006 Determine whether the first blood oxygen type is mild hypoxia, and if so, execute the blood oxygen trend analysis under mild hypoxia; if not, execute Step 1007 .
- the blood oxygen trend analysis under mild hypoxia is shown in FIG. 13 , which mainly includes the following steps:
- Step 1301 Determine whether the second blood oxygen type is severe hypoxia or moderate hypoxia, if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen improvement trend; if not, go to step 1302 .
- Step 1302 Determine whether the second blood oxygen type is mild hypoxia, if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen stable trend; if not, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen worsening trend.
- the second blood oxygen type can be obtained.
- the blood oxygen type may be in a normal state, and the blood oxygen state is in a worsening trend relative to the mild hypoxia indicated by the current first blood oxygen type.
- Step 1007 Determine whether the first blood oxygen saturation is mild peroxidation, and if so, perform the blood oxygen trend analysis under mild peroxidation; if not, determine the control blood oxygen partition as the treatment target partition.
- the blood oxygen trend analysis under mild peroxidation is shown in FIG. 14 , which mainly includes the following steps:
- Step 1401 Determine whether the second blood oxygen type is severe or moderate hyperoxia, and if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen improvement trend; if not, go to step 1402 .
- Step 1402 Determine whether the second blood oxygen type is mild peroxidation, if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen stable trend; if not, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen worsening trend.
- the second blood oxygen type can be obtained.
- the blood oxygen type may be in a normal state, and the blood oxygen state is in a worsening trend relative to the mild hypoxia indicated by the current first blood oxygen type.
- the corresponding adjustment strategy B or C is determined based on the blood oxygen change trend.
- the situation where the adjustment strategy B needs to be implemented is: the current change of the patient's blood oxygen is characterized by that the blood oxygen data continues to change in a direction deviating from the treatment target zone, but the patient's blood oxygen level is not too dangerous.
- the adjustment strategy B is: according to the blood oxygen data in the designated blood oxygen zone, the offset of the upper and lower blood oxygen data boundaries of the treatment target zone, the blood oxygen change rate when the inhaled oxygen concentration was adjusted last time, and the preset maximum single oxygen concentration adjustment amount to obtain the first oxygen concentration target adjustment amount; when the first oxygen concentration target adjustment amount is less than or equal to the preset maximum single oxygen concentration adjustment amount, the inhaled oxygen concentration is adjusted with the first oxygen concentration target adjustment amount; When the target adjustment amount of oxygen concentration is greater than the preset maximum single oxygen concentration adjustment amount, adjust the inhaled oxygen concentration with the preset maximum single oxygen concentration adjustment amount, and compare the first oxygen concentration target adjustment amount with the preset maximum single oxygen concentration The difference of the adjustment amount is added to the accumulated adjustment amount of the designated blood oxygen zone as the remaining adjustment amount.
- the preset maximum single oxygen concentration adjustment amount can be built in the machine by the medical staff according to the type of the patient.
- the preset maximum single oxygen concentration adjustment amount can be correspondingly set to different adjustment amounts based on different types of patients.
- the preset maximum single-time oxygen concentration adjustment amount is set to 3%.
- the preset maximum single oxygen concentration adjustment amount is set to 4%.
- the preset maximum single oxygen concentration adjustment amount is set to 6%.
- the cumulative adjustment added to the specified blood oxygen zone is used to calculate the target adjustment for the next adjustment interval. That is, if there is an accumulated adjustment amount in the designated blood oxygen zone where the inspired oxygen concentration needs to be adjusted in the next adjustment interval, if the adjustment is still performed in the designated blood oxygen zone in the next adjustment interval, the accumulated adjustment amount of the designated blood oxygen zone will be used. It is accumulated into the target adjustment amount, and the accumulated target adjustment amount is compared with the preset maximum single-time oxygen concentration adjustment amount.
- the current patient's blood oxygen change is characterized by the fact that the blood oxygen zone where the blood oxygen data is located is far from the treatment target zone, indicating that the patient's current blood oxygen situation is not optimistic.
- the adjustment strategy C is: adjust the inhaled oxygen concentration according to the preset maximum single oxygen concentration adjustment amount, and change the duration of the next adjustment interval to a fifth duration.
- the fifth duration is less than the duration of the regular adjustment interval.
- Adjustment strategy C adopts a shorter adjustment interval to adjust the inspired oxygen concentration according to a fixed oxygen concentration adjustment amount.
- the oxygen concentration adjustment can be achieved more quickly.
- the process of adjusting the inhaled oxygen concentration according to the adjustment strategy B or C, as shown in Figure 15, includes:
- Step 1501 Analyze whether the deterioration trend of the blood oxygen deterioration trend is severe hypoxia or severe hyperoxia, if yes, go to step 1502; if not, go to steps 1503 and 1504.
- Step 1502 Change the duration of the current adjustment interval to a fifth duration, and adjust the inhaled oxygen concentration according to the preset maximum single oxygen concentration adjustment amount.
- Step 1502 corresponds to the adjustment strategy C. Execute the adjustment strategy C, and adjust based on the preset maximum single oxygen concentration adjustment amount until the target adjustment amount is completed, or until a new, smaller target adjustment amount is generated.
- Step 1503 Calculate the difference between the blood oxygen saturation in the designated blood oxygen zone and the upper limit blood oxygen saturation in the treatment target zone to obtain a first difference.
- the blood oxygen saturation in the designated blood oxygen zone is the blood oxygen data in the designated blood oxygen zone, and the blood oxygen data can be represented by the blood oxygen saturation.
- the designated blood oxygen partition refers to a selected blood oxygen partition that includes the blood oxygen data with the most severe severity in the current interval, and the blood oxygen data with the most severe severity is acquired in the current interval.
- the difference between the blood oxygen data in the designated blood oxygen zone and the upper limit blood oxygen data of the treatment target zone can also be calculated to obtain the first difference.
- Step 1504 Calculate the difference between the first blood oxygen saturation and the lower limit blood oxygen saturation of the treatment target zone to obtain a second difference.
- Step 1505 Calculate according to the blood oxygen change rate, the first difference and the second difference when adjusting the inhaled oxygen concentration in the previous time to obtain the first oxygen concentration target adjustment amount.
- Step 1506 Compare the size of the first oxygen concentration target adjustment amount with the preset maximum single oxygen concentration adjustment amount, if the first oxygen concentration target adjustment amount is greater than the preset maximum single oxygen concentration adjustment amount, perform step 1507; The target adjustment amount of the oxygen concentration is not greater than the preset maximum single oxygen concentration adjustment amount, and step 1509 is executed.
- Step 1507 Adjust the inhaled oxygen concentration according to the preset maximum single oxygen concentration adjustment amount, and obtain the remaining amount obtained by subtracting the preset maximum single oxygen concentration adjustment amount from the first oxygen concentration target adjustment amount.
- Step 1508 Add the remaining amount to the accumulated adjustment amount of the designated blood oxygen zone.
- step 1508 the remaining amount is added to the accumulated adjustment amount of the designated blood oxygen zone, so that the adjustment amount of the designated blood oxygen zone will be used when calculating the target adjustment amount of the designated blood oxygen zone in the next adjustment interval.
- the first oxygen concentration target adjustment amount is 8% according to the blood oxygen change rate, the first difference and the second difference in the previous adjustment of the inhaled oxygen concentration, and the preset maximum single oxygen concentration adjustment amount is 8%, the current interval adopts 5%, the remaining amount is 3%, and the remaining amount 3% is added to the cumulative adjustment amount of the designated blood oxygen zone.
- a 3% adjustment amount needs to be accumulated. If the accumulated first oxygen concentration target adjustment amount is still greater than the preset maximum single oxygen concentration Adjustment amount, continue to adjust with the preset maximum single oxygen concentration adjustment amount, and add the remaining amount this time to the cumulative adjustment amount of the designated blood oxygen zone. And so on until the adjustment is completed.
- Step 1509 Adjust the intake oxygen concentration according to the first oxygen concentration target adjustment amount.
- Steps 1503 to 1509 correspond to the adjustment strategy B, and the intake oxygen concentration is adjusted based on the first oxygen concentration target adjustment amount until the target adjustment amount is completed, or until a new, smaller target adjustment amount is generated.
- the coefficients used to calculate the target adjustment amount are also different under the results of the overall division of blood oxygen in different current intervals.
- the coefficient when the overall division of blood oxygen in the current interval is "moderate hypoxia” will be larger than the coefficient when the overall division is "mild hypoxia", so as to obtain a larger adjustment amount, thereby ensuring that in In different degrees of hypoxia or hyperoxia, the intensity of the adjustment of the inspired oxygen concentration is different.
- a corresponding adjustment strategy D is determined based on the blood oxygen change trend.
- the situation that the adjustment strategy D needs to be implemented is: the blood oxygen data of the patient is continuously stable within a blood oxygen partition indicating the current blood oxygen change trend, the blood oxygen data remains unchanged or changes in the direction of the treatment target partition, but still not Conditions within the therapeutic target zone.
- the adjustment strategy D is: obtain the adjustment amount for adjusting the inhaled oxygen concentration within the adjustment interval when the last blood oxygen change trend is the blood oxygen stability trend or the blood oxygen improvement trend, and then increase the preset adjustment amount on the basis of the adjustment amount to obtain The second oxygen concentration target adjustment amount, and the intake oxygen concentration is adjusted based on the second oxygen concentration target adjustment amount.
- the second oxygen concentration target adjustment amount is not greater than the preset minimum oxygen concentration adjustment amount.
- the adjustment strategy D every time an adjustment interval in which the blood oxygen change trend is the blood oxygen stability trend or the blood oxygen improvement trend is experienced, a small preset adjustment is accumulated on the basis of the adjustment amount of the adjustment interval in the same situation last time. until the accumulated result exceeds the preset minimum oxygen concentration adjustment amount.
- the preset minimum oxygen concentration adjustment amount represents the minimum oxygen concentration setting value that can be distinguished by the machine when adjusting the inspired oxygen concentration.
- the minimum oxygen concentration setting value is usually 1%.
- the preset adjustment amount used for accumulative use in the adjustment strategy D may also select adjustment amounts of different sizes according to the current overall division of blood oxygen. For example, for a patient whose blood oxygen is in a "mild hypoxia" state for a long time, a 0.5% adjustment amount will be accumulated in each adjustment cycle; for a patient whose blood oxygen is in a "moderate hypoxia” state for a long time, the In other words, an adjustment amount of 0.67% will be accumulated in each adjustment cycle.
- the adjustment strategy D is executed to adjust the inspired oxygen concentration
- the designated blood oxygen zone to be adjusted at this time also has the unfinished remaining amount of the previous adjustment cycle described in the adjustment strategy B, and the adjustment strategy D is executed. , the accumulated adjustment amount and the remaining adjustment amount will be added together for the inspired oxygen concentration.
- a corresponding adjustment strategy E is determined based on the blood oxygen change trend.
- the situation where the adjustment strategy E needs to be implemented is: the patient's blood oxygen data is continuously stable within a blood oxygen zone indicating the current blood oxygen change trend, but the blood oxygen data changes in a direction deviating from the treatment target zone, and is still not in the treatment target. situation within the partition.
- the blood oxygen data of the patient may continue to change in the direction of deviating from the treatment target zone, but because the blood oxygen data still does not deviate from the current designated area.
- the current offset is small, but the offset may indicate that the patient's blood oxygen status may be further deteriorated, so the adjustment strategy E is implemented.
- the adjustment strategy E is as follows: based on the blood oxygen data in the designated blood oxygen partition, the offset of the upper and lower blood oxygen data boundaries of the treatment target partition and the cumulative adjustment amount of the designated blood oxygen partition, the third oxygen concentration target adjustment amount is obtained, based on The third oxygen concentration target adjustment amount adjusts the inhaled oxygen concentration.
- the cumulative adjustment amount of the designated blood oxygen zone may be the adjustment amount accumulated in the designated blood oxygen zone for a plurality of adjustment intervals.
- a corresponding adjustment strategy F or G is determined based on the blood oxygen change trend.
- the situation that the adjustment strategy F or G needs to be executed is: the patient is in the treatment target zone for a long time, and the blood oxygen data of the patient is normal.
- the use of oxygen can be reduced while ensuring that the patient's blood oxygen data is within the target range.
- the dependence of the patient on oxygen concentration can be reduced, and the weaning can be assisted.
- the process of adjusting the inhaled oxygen concentration according to the adjustment strategy F or G includes:
- the region of the treatment target zone includes at least a downstream region, a midstream region and an upstream region;
- the adjustment strategy F is executed, the first timer is started, and when the first timer ends, the inhaled oxygen concentration is reduced according to the preset minimum oxygen concentration adjustment amount.
- the adjustment strategy G is executed, the second timing is started, and when the second timing ends, the inhaled oxygen concentration is reduced according to the preset minimum oxygen concentration adjustment amount.
- the second timing is greater than the first timing.
- the first timing and the second timing may be positive timings or countdown timings.
- the timing is alternately used, and the timing is suspended when the blood oxygen data of the patient appears in the downstream area. Therefore, for a patient whose blood oxygen data is maintained in the midstream region of the treatment target zone for a long time, deoxygenation will be triggered after a long period of observation. For patients whose blood oxygen data is maintained in the upstream area of the treatment target zone for a long time, the observation time for triggering deoxygenation will be shortened, thereby preventing the patient's blood oxygen data from further deviating from the upper limit of the treatment target zone.
- the first timing and the second timing may be set by medical staff according to experience, or may be set differently by medical staff according to patient types.
- the duration of the first timing may be set to 90 seconds.
- the automatically adjusted inhaled oxygen concentration is adjusted within the range of the inhaled oxygen concentration set by the user, that is, the adjustment result will not exceed the user The set range, but in some cases, the upper limit of the inhaled oxygen concentration set by the user is too low. In this case, after the automatic adjustment function is adjusted to the upper limit, the patient's blood oxygen is still lower than the target, and the oxygen concentration set by the user will be exceeded. The upper concentration limit continues to adjust the oxygen concentration upwards.
- the user can set the range of the oxygen concentration in the automatic adjustment process, that is, the result of the automatic adjustment of the oxygen concentration will be guaranteed to be within the set range, thereby improving the safety of the process.
- the inhaled oxygen concentration range includes two values: a lower limit value of the oxygen concentration range and an upper limit value of the oxygen concentration range.
- the user when the result of automatic adjustment of the inhaled oxygen concentration has reached the upper limit of the oxygen concentration range set by the user, and the patient's blood oxygen data is still lower than the treatment target zone, and continues for more than the fifth time period, the user will be prompted to appear in the above state.
- the prompting methods include, but are not limited to, the methods of appearing character strings, graphic indications, and sounds on the user interface.
- the inspired oxygen concentration can be temporarily adjusted without being limited by the upper limit of the inspired oxygen concentration range set by the user.
- the severity of the blood oxygen state of the patient is identified by the change in the severity of the blood oxygen state of the blood oxygen zone where the blood oxygen data is located, so that the subsequent adjustment of the inhaled oxygen concentration is performed.
- different adjustment strategies can be determined according to the severity of the blood oxygen state corresponding to the blood oxygen zone, and the inhaled oxygen concentration should be adjusted in time according to the corresponding adjustment strategy.
- the purpose of adjusting the inhaled oxygen concentration when the patient's blood oxygen changes rapidly can be achieved more accurately and quickly.
- an embodiment of the present application also discloses a respiratory support device.
- the respiratory support device may be a ventilator.
- FIG. 16 it is a schematic structural diagram of a respiratory support device disclosed in an embodiment of the present application.
- the respiratory support device 1600 includes a ventilation device 1601 and a processor 1602 .
- the ventilation device 1601 is used to provide inhaled gas to the patient through a breathing circuit and breathing accessories, and the inhaled gas is oxygen-containing gas.
- the breathing circuit consists of an expiratory branch and an inspiratory branch.
- the breathing accessory includes at least a pneumatic system and a patient interface, and the patient interface is mostly a mask. Specifically, one end of the pneumatic system of the ventilation device 1601 is signally connected to the processor 1602, and the other end is connected to the patient interface through the expiratory branch and the inspiratory branch.
- the processor 1602 is in signal connection with the ventilation device 1601 to control the flow of inspiratory gas provided by the ventilation device 1601 to the patient.
- the processor 1602 is configured with a sensor itself, or is interconnected with an external detection device.
- the external detection device in one embodiment, may be a pulse oximeter, a monitor, or the like.
- the processor 1602 acquires blood oxygen data based on a sensor configured by itself or through an interconnected external detection device.
- the processor 1602 is configured to determine the blood oxygen partition corresponding to each blood oxygen data, and the blood oxygen partition is pre-divided based on the blood oxygen saturation.
- the processor 1602 is configured to acquire each blood oxygen data of the current adjustment interval in real time, and determine the selected blood oxygen zone in which each blood oxygen data is located. Determine whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance, the severity refers to the degree to which the blood oxygen data deviates from the treatment target zone, and the conditions for the early triggering of the adjustment of the inhaled oxygen concentration include that the severity tends to increase , the selected blood oxygen partition and the treatment target partition each correspond to a pre-divided blood oxygen data range.
- the processor 1602 may be a host computer, a controller, or a control device in a ventilator.
- the processor 1602 that performs the operation of adjusting the inhaled oxygen concentration is specifically used for:
- the designated blood oxygen partition refers to the selected blood oxygen partition that contains the blood oxygen data with the most severe severity in each blood oxygen partition determined in the current adjustment interval;
- the blood oxygen change trend is determined based on the specified blood oxygen zone, and the inhaled oxygen concentration is adjusted according to the adjustment strategy corresponding to the blood oxygen change trend.
- the processor 1602 for judging whether the severity of each blood oxygen data satisfies the condition for triggering the adjustment of the inhaled oxygen concentration in advance is specifically used for:
- the severity of the blood oxygen data acquired in the current adjustment interval is compared in real time with the severity of the blood oxygen data of the reference blood oxygen zone.
- the severity of the blood oxygen data obtained in the current adjustment interval is greater than the severity of the blood oxygen data of the reference blood oxygen zone exceeds the preset number, which meets the requirements for triggering the adjustment of the inhaled oxygen concentration in advance. conditions, otherwise, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are not met.
- the processor 1602 for judging whether the severity of each blood oxygen data satisfies the condition for triggering the adjustment of the inhaled oxygen concentration in advance is specifically used for:
- the severity of the blood oxygen data corresponding to each acquired blood oxygen data is continuously increased every first time length, and the first time length is less than the time length of the current adjustment interval. If there is a continuous increase, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are met; otherwise, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are not met.
- the processor 1602 is also used for:
- the adjustment of the inhaled oxygen concentration is triggered according to the adjustment strategy corresponding to the uncertain blood oxygen trigger mode, otherwise, it is continued to judge whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance.
- triggering the processor 1602 for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the uncertain blood oxygen triggering mode is specifically used for:
- the total weight is compared with the first weight threshold and the second weight threshold, the first weight threshold is used to indicate the increase of the oxygen concentration and the adjustment amount of the first inspired oxygen concentration, and the second weight threshold is used to indicate The oxygen concentration and the second inspired oxygen concentration adjustment amount are reduced, and the first weighted threshold is greater than the second weighted threshold.
- the total weight is greater than or equal to the first weight threshold, it is determined to increase the first inspired oxygen concentration adjustment amount.
- the total weight is less than or equal to the second weight threshold, it is determined to reduce the second adjusted amount of the inspired oxygen concentration.
- the adjustment amount for maintaining the current inspired oxygen concentration is determined.
- the processor 1602 is also used for:
- each blood oxygen data obtained by the obtaining device After receiving each blood oxygen data obtained by the obtaining device, obtain the associated data that affects the blood oxygen reliability in the blood oxygen data; determine whether the associated data meets the blood oxygen reliability requirements; if so, determine that the blood oxygen data corresponds to If not satisfied, continue to obtain blood oxygen data.
- the processor 1602 for judging whether the correlated data meets preset requirements is specifically used for:
- the pulse rate change rate is higher than the pulse rate change rate threshold, the pulse rate does not meet the blood oxygen confidence requirement, otherwise, the pulse rate meets the blood oxygen reliability requirement; and/or,
- the pulse rate is lower than the pulse rate threshold, the pulse rate does not meet the blood oxygen reliability requirements, otherwise, the pulse rate meets the blood oxygen reliability requirements; and/or,
- the perfusion index is lower than the perfusion index threshold, the perfusion index does not meet the blood oxygen confidence requirement, otherwise, the perfusion index meets the blood oxygen confidence requirement; and/or,
- the blood oxygen signal quality is lower than the blood oxygen signal quality threshold, the blood oxygen signal quality does not meet the blood oxygen reliability requirements; otherwise, the blood oxygen signal quality meets the blood oxygen reliability requirements.
- the processor 1602 is also used for:
- the processor 1602 is also used for:
- the acquisition of blood oxygen data is triggered, and an alarm message for suspending the adjustment of the inhaled oxygen concentration is generated.
- the processor 1602 for determining the blood oxygen change trend based on the specified blood oxygen zone is specifically used for:
- the first blood oxygen type is severe hypoxia or severe hyperoxia, it is determined that the blood oxygen change trend within the current adjustment interval is the blood oxygen deterioration trend;
- the blood oxygen type at least includes severe hypoxia Oxygen, Severe Peroxidation, Moderate Hypoxia, Moderate Peroxidation, Mild Hypoxia, Mild Peroxidation and Normal State;
- the first blood oxygen type and the second blood oxygen type are consistent and neither is severe hypoxia or severe hyperoxia, determining that the blood oxygen change trend within the current adjustment interval is a blood oxygen stability trend;
- the blood oxygen change trend within the current adjustment interval is a blood oxygen improvement trend.
- the processor 1602 that determines the blood oxygen change trend based on the designated blood oxygen partition may also execute the method for determining the blood oxygen change trend based on the designated blood oxygen partition disclosed in the above embodiments of the present invention.
- the processor 1602 for adjusting the inhaled oxygen concentration according to the adjustment strategy is specifically used for:
- the adjustment amount is correspondingly set to different adjustment amounts based on different patient types, and the fifth duration is less than the duration of the regular adjustment interval;
- the deterioration trend of blood oxygen is not biased towards severe hypoxia or severe hyperoxia, according to the blood oxygen data in the designated blood oxygen zone, the offset of the upper and lower blood oxygen data boundaries of the treatment target zone, the last adjustment of the inhaled oxygen concentration
- the blood oxygen change rate and the preset maximum single oxygen concentration adjustment amount to obtain the first oxygen concentration target adjustment amount
- the first oxygen concentration target adjustment amount is greater than the preset maximum single oxygen concentration adjustment amount, adjust the inhaled oxygen concentration with the preset maximum single oxygen concentration adjustment amount, and compare the first oxygen concentration target adjustment amount with the preset maximum single oxygen concentration adjustment amount
- the difference between the oxygen concentration adjustment amounts is added to the accumulated adjustment amount of the designated blood oxygen zone as the remaining adjustment amount.
- the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
- the offset of the upper and lower blood oxygen data boundaries of the target zone becomes smaller or unchanged, and the blood oxygen change trend in the last time is the difference between the blood oxygen stability trend or the blood oxygen improvement trend.
- a preset adjustment amount is added to obtain a second oxygen concentration target adjustment amount, and the intake oxygen concentration is adjusted based on the second oxygen concentration target adjustment amount, and the second oxygen concentration target adjustment amount The adjustment amount is not greater than the preset minimum oxygen concentration adjustment amount.
- the processor 1602 for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
- the deviation of the upper and lower blood oxygen data boundaries of the treatment target zone based on the blood oxygen data in the designated blood oxygen zone is offset.
- the shift amount and the accumulated adjustment amount of the designated blood oxygen zone are obtained to obtain a third oxygen concentration target adjustment amount, and the inhaled oxygen concentration is adjusted based on the third oxygen concentration target adjustment amount.
- the processor 1602 for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
- the zone where the blood oxygen data is located in the treatment target zone determine the zone where the blood oxygen data is located in the treatment target zone, and the zone includes at least the downstream zone, the midstream zone and the upstream zone;
- the blood oxygen data is in the midstream region, start the first timer, and when the first timer ends, adjust the inhaled oxygen concentration according to the preset minimum oxygen concentration adjustment amount;
- a second timer is started, and when the second timer ends, the inhaled oxygen concentration is adjusted according to the preset minimum oxygen concentration adjustment amount, and the second timer is greater than the first timer.
- the processor 1602 acquires the blood oxygen data of the patient in real time based on a self-configured sensor or an interconnected external detection device, and controls the ventilation device 1601 to a fixed value according to the blood oxygen data. At intervals, the inhaled oxygen concentration adjustment operation is performed periodically to adjust the oxygen concentration in the inhaled gas.
- the processor 1602 is configured to determine the blood oxygen partition corresponding to the blood oxygen data of the patient acquired in real time within the current inhaled oxygen concentration adjustment cycle; the blood oxygen partition is obtained by pre-dividing according to the blood oxygen saturation, and includes a treatment target partition.
- the treatment target zone is the treatment target zone.
- the processor 1602 is configured to determine the blood oxygen change trend of the patient according to the blood oxygen zone corresponding to the patient's real-time blood oxygen data; when it is determined that the patient's blood oxygen change trend is gradually deviating from the treatment target zone, the inhaled oxygen concentration adjustment operation is performed in advance , to adjust the patient's blood oxygen level to the therapeutic target zone.
- the severity of the blood oxygen state of the patient is identified by the change in the severity of the blood oxygen state of the blood oxygen zone where the blood oxygen data is located, so that when the subsequent operation of adjusting the inhaled oxygen concentration is performed, Different adjustment strategies can be determined according to the severity of the blood oxygen state corresponding to the blood oxygen zone, and the inhaled oxygen concentration should be adjusted in time according to the corresponding adjustment strategy.
- the purpose of adjusting the inhaled oxygen concentration when the patient's blood oxygen changes rapidly can be achieved more accurately and quickly.
- the embodiment of the present application also provides another method for adjusting the concentration of inhaled oxygen, and the method for adjusting the concentration of inhaled oxygen can also be applied to the respiratory support apparatus disclosed in the above embodiments of the present application.
- the adjustment method of the inhaled oxygen concentration mainly includes the following steps:
- Step 1701 Ventilate the patient with gas with a preset oxygen concentration.
- Step 1702 Acquire blood oxygen data in real time.
- Step 1703 Determine the triggering moment for the operation of adjusting the inspired oxygen concentration based on the blood oxygen data acquired in real time.
- the patient is ventilated with a preset oxygen concentration gas.
- the blood oxygen data is obtained in real time, and then the blood oxygen data obtained in real time is processed, thereby Determine the current oxygen content in the patient's blood, and if an abnormality in the current blood oxygen content is detected in real time, the trigger moment for adjusting the inhaled oxygen concentration is determined based on the currently acquired blood oxygen data.
- the trigger moment of the operation of adjusting the inspired oxygen concentration in the current observation window is determined based on the blood oxygen data acquired in real time.
- the trigger time is located between the minimum duration threshold and the maximum duration threshold of the observation window.
- the current observation window when the trigger moment of the operation of adjusting the inspired oxygen concentration in the current observation window is not determined based on the blood oxygen data obtained in real time, when the current observation window reaches the preset duration, the current observation window is ended. to enter the next viewing window.
- a corresponding adjustment strategy is used to perform the operation of adjusting the inspired oxygen concentration.
- Step 1704 When the triggering time is reached, perform the adjustment of the inspired oxygen concentration, continue to acquire blood oxygen data in real time after the operation of adjusting the inspired oxygen concentration is completed, and determine the next triggering time for the adjustment of the inspired oxygen concentration.
- step 1704 optionally, at the triggering moment of the current observation window, when the operation of adjusting the concentration of inspired oxygen is completed, the current observation window is ended, the next observation window is entered, and the acquisition of blood oxygen data is continued and determined The next trigger moment for the operation of adjusting the inspired oxygen concentration.
- device operating parameters of the respiratory support device and/or physiological parameters of the patient are also acquired.
- the triggering moment of the operation of adjusting the inhaled oxygen concentration within the current adjustment interval is determined.
- physiological parameters of the patient include, but are not limited to, acquisition through monitoring equipment such as a pulse oximeter and a monitor.
- the method further includes:
- the intervention strategy includes: maintaining the current inhaled oxygen concentration of the respiratory support device.
- Intervention prompts include: outputting alarm information, or outputting prompt information.
- the alarm information is used to indicate that the blood oxygen data is abnormal, and/or is used to indicate that the respiratory support device is abnormal.
- the prompt information is used to instruct information to suspend the adjustment of the inhaled oxygen concentration, and/or to instruct the state information of the setting interface for displaying the oxygen concentration on the user interface of the respiratory support device.
- the first indication information for indicating the suspension of the adjustment of the inhaled oxygen concentration and/or the second indication information for indicating the reason for the suspension is displayed on the information prompt area of the respiratory support device;
- the information prompt display area consists of one information display area, or consists of two independent information sub-display areas, one information sub-display area is used to display the first indication information, and the other information sub-display area is used to display the first information sub-display area.
- the state information of the setting interface displaying the oxygen concentration on the user interface of the respiratory support device is indicated, and the state information includes but is not limited to display state change information.
- the display state change information includes but is not limited to: changing the background color, or displaying information prompting manual setting.
- the prompt manual setting information includes character strings and/or text.
- the method for adjusting the inhaled oxygen concentration disclosed in the embodiment of the present application obtains the blood oxygen data in real time, and then determines the trigger time of the operation for adjusting the inhaled oxygen concentration based on the blood oxygen data obtained in real time, so as to achieve the determination according to the current oxygen content in the patient's blood. Adjust the trigger time of the operation of the inhaled oxygen concentration, so as to realize the dynamic adjustment of the inhaled oxygen concentration.
- an embodiment of the present application also discloses a respiratory support device.
- the respiratory support device may be a ventilator.
- the respiratory support device includes: a ventilation device and a processor.
- the ventilation device is used for providing an inhaled gas to a patient through a breathing circuit and a breathing accessory, and the inhaled gas is an oxygen-containing gas.
- the processor is in signal connection with the ventilation device to control the flow of inspiratory gas provided by the ventilation device to the patient.
- the processor is also configured to:
- the adjustment of the inhaled oxygen concentration is performed, and after the operation of adjusting the inhaled oxygen concentration is completed, the blood oxygen data is continuously acquired in real time and the next trigger moment of the operation of adjusting the inhaled oxygen concentration is determined.
- the processor for determining the trigger moment of the operation of adjusting the inhaled oxygen concentration based on the blood oxygen data obtained in real time is specifically used for:
- the trigger moment of the operation of adjusting the inspired oxygen concentration in the current observation window is determined.
- the processor is further configured to:
- the current observation window is ended and the next observation window is entered.
- the processor is further configured to:
- the triggering moment of the operation of adjusting the inhaled oxygen concentration within the current adjustment interval is determined.
- the processor is further configured to:
- the intervention strategy includes: maintaining the current inhaled oxygen concentration of the respiratory support device;
- the intervention prompt includes: outputting alarm information, or outputting prompt information;
- the alarm information is used to indicate that the blood oxygen data is abnormal, and/or is used to indicate that the respiratory support device is abnormal;
- the prompt information is used to instruct information to suspend the adjustment of the inhaled oxygen concentration, and/or to instruct the state information of the setting interface for displaying the oxygen concentration on the user interface of the respiratory support device.
- the respiratory support device disclosed in the embodiment of the present application can also perform the method for adjusting the concentration of inhaled oxygen disclosed in FIG. 1 .
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- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
Abstract
一种吸入氧气浓度的调节方法和呼吸支持设备,通过实时获取当前调节间隔的各个血氧数据,确定各个血氧数据各自所处的推选血氧分区;判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件;在满足提前触发调节吸入氧气浓度的条件下执行调节吸入氧气浓度操作。在本方案中,通过根据病人的血氧数据的严重度的变化,做出是否提前触发调节吸入氧气浓度的响应,实现在病人血氧发生快速变化时快速响应对吸入氧气浓度调整的目的。还公开了一种吸入氧气浓度的调节方法和呼吸支持设备,通过实时获取血氧数据,再基于实时获取到的血氧数据确定调节吸入氧气浓度操作的触发时刻,从而达到根据患者当前血液中氧气含量确定调节吸入氧气浓度操作的触发时刻,实现动态的调节吸入氧气浓度。
Description
本申请涉及医疗设备中的呼吸生理技术领域,尤其涉及一种吸入氧气浓度的调节方法和呼吸支持设备。
呼吸机作为一种提供机械通气来代替病人自主呼吸的设备,被广泛使用在各种治疗过程中。在病人接受呼吸机治疗的过程中,吸入氧气浓度(Fraction of inspired oxygen,FiO2)作为极为重要的一个调节参数,直接关系到病人吸入气体中氧气的含量,进而影响病人肺泡中与血液中氧气的含量,进一步影响病人的组织供氧情况。因此,在实际使用过程中,吸入氧气浓度需要根据病人的具体生理状况进行调节,以使病人达到正常的目标氧合水平。
目前,最为普遍的一种吸入氧气浓度调节的方式为:在调整间隔内,根据脉搏血氧仪测得的血氧饱和度(Blood oxygen saturation,SpO2)调节吸入氧气浓度。具体的,通过脉搏血氧仪实时测量SpO2,若SpO2低于一定限值,自动控制呼吸机上的氧气阀的开关打开,以实现对吸入氧气浓度的调整。这种方法的调整间隔通常为固定间隔,只能应对血氧变化较小的情况。对于血氧状况较为稳定的病人来说是可行的,但是,对于血氧状况不稳定的病人来说,若在调整间隔期间出现急性血氧下降的情况,现有技术的方法在对吸入氧气浓度调整的时候无法做到快速响应。
因此,亟需一种能够对病人血氧发生快速变化时做到快速响应,实现对吸入氧气浓度调整的调节方案。
发明内容
有鉴于此,本申请实施例提供一种吸入氧气浓度的调节方法和呼吸支持设备,以实现在病人血氧发生快速变化时快速响应对吸入氧气浓度调整的目的。
为实现上述目的,本申请实施例提供如下技术方案:
本申请第一方面公开了一种吸入氧气浓度的调节方法,所述调节方法包括:
实时获取当前调节间隔的各个血氧数据,确定各个血氧数据各自所处的推选血氧分区;
判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,所述严重度指所述血氧数据偏离治疗目标分区的程度,所述提前触发调节吸入氧气浓度的条件包括所述严重度趋于提升,所述推选血氧分区和所述治疗目标分区各自对应预先划分的血氧数据范围;
在满足提前触发调节吸入氧气浓度的条件下提前执行调节吸入氧气浓度操作,否则,在所述当前调节间隔的计时结束后,正常执行调节吸入氧气浓度操作。
可选的,所述判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,包括:
获取上一调节间隔内包含严重度最大的血氧数据的参考血氧分区,所述上一调节间隔和所述当前调节间隔的时长不一定相同;
实时比较当前调节间隔内获取的血氧数据的严重度和所述参考血氧分区的血氧数据的严重度的大小;
在当前调节间隔的计时结束之前,当前调节间隔内获取的血氧数据的严重度大于所述参考血氧分区的血氧数据的严重度的个数超过预设个数,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
可选的,所述判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,包括:
由当前调节间隔的起始时间开始计时,每隔第一时长,判断获取的各个血氧数据的严重度是否连续递增,所述第一时长小于所述当前调节间隔的时长;
若出现连续递增,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
可选的,其特征在于,还包括:
实时判断所述各个血氧数据在所处的所述推选血氧分区的持续时长小于等于第二时长的情况是否已持续第三时长,所述第三时长大于所述第二时长,小于等于当前调节间隔的时长;
若已持续第三时长,根据不确定性血氧触发方式对应的调节策略提前触发调节吸入氧气浓度,否则继续判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件。
可选的,所述根据不确定性血氧触发方式对应的调节策略触发调节所述吸入氧气浓度,包括:
累积计算各个推选血氧分区的权值,得到总权值,其中,对应不同血氧数据范围的推选血氧分区具有不同的权值,所述权值的大小由血氧数据的严重度的大小确定;
分别将所述总权值与第一权值阈值、第二权值阈值进行比较,所述第一权值阈值用于指示增加氧浓度和第一吸入氧浓度调节量,所述第二权值阈值用于指示减少氧浓度和第二吸入氧浓度调节量,所述第一权值阈值大于所述第二权值阈值;
若所述总权值大于或等于所述第一权值阈值,确定增加所述第一吸入氧浓度调节量;
若所述总权值小于或等于所述第二权值阈值,确定减少所述第二吸入氧浓度调节量;
若所述总权值小于所述第一权值阈值,大于所述第二权值阈值,确定维持当前吸入氧气浓度的调节量。
可选的,所述实时获取当前调节间隔的各个血氧数据之后,还包括:
获取所述血氧数据中影响血氧可信度的关联数据;
判断所述关联数据是否满足血氧可信度要求;
若满足,执行确定所述血氧数据对应的血氧分区这一步骤;
若不满足,继续获取血氧数据。
可选的,若所述关联数据至少包括脉率和/或灌注指数和/或血氧信号质量, 所述判断所述关联数据是否满足预设要求,包括:
判断所述脉率的变化率是否高于脉率变化率阈值;
若所述脉率的变化率高于脉率变化率阈值,所述脉率不满足血氧可信度要求,反之,所述脉率满足血氧可信度要求;和/或,
判断所述脉率是否低于脉率阈值;
若所述脉率低于脉率阈值,所述脉率不满足血氧可信度要求,反之,所述脉率满足血氧可信度要求;和/或,
判断所述灌注指数是否低于灌注指数阈值;
若所述灌注指数低于灌注指数阈值,所述灌注指数不满足血氧可信度要求,反之,所述灌注指数满足血氧可信度要求;
和/或,判断所述血氧信号质量是否低于血氧信号质量阈值;
若所述血氧信号质量低于血氧信号质量阈值,所述血氧信号质量不满足血氧可信度要求,反之,所述血氧信号质量满足血氧可信度要求。
可选的,还包括:
若连续判断所述关联数据不满足血氧可信度要求,且连续时长超过第四时长,生成暂停吸入氧气浓度调节的报警信息。
可选的,所述调节吸入氧气浓度操作包括:
获取当前调节间隔的指定血氧分区,所述指定血氧分区指当前调节间隔内确定的各个血氧分区中包含严重度最大的血氧数据的推选血氧分区;
基于所述指定血氧分区确定血氧变化趋势,根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度。
可选的,所述基于所述指定血氧分区确定血氧变化趋势,包括:
获取所述指定血氧分区和上一调节间隔内包含严重度最大的血氧数据的参考血氧分区;
比较处于所述指定血氧分区内的血氧数据的严重度和所述参考血氧分区所包含的严重度最大的血氧数据的严重度;
若处于所述指定血氧分区内的血氧数据的严重度相对于所述参考血氧分 区所包含的严重度最大的血氧数据的严重度趋于提升,确定所述当前调节间隔内的血氧变化趋势为血氧恶化趋势;
若处于所述指定血氧分区所内的血氧数据的严重度相对于所述参考血氧分区所包含的严重度最大的血氧数据的严重度趋于降低,确定所述当前调节间隔内的血氧变化趋势为血氧好转趋势;
若处于所述指定血氧分区内的血氧数据的严重度和所述参考血氧分区所包含的严重度最大的血氧数据的严重度一致,且所述指定血氧分区和所述参考血氧分区所对应的血氧类型为非重度缺氧或重度过氧,确定所述当前调节间隔内的血氧变化趋势为血氧稳定趋势;
所述血氧类型至少包括重度缺氧、重度过氧、中度缺氧、中度过氧、轻度缺氧、轻度过氧和正常状态。
可选的,若所述血氧变化趋势为血氧恶化趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度,包括:
若所述血氧恶化趋势偏向于重度缺氧或重度过氧,根据预设最大单次氧浓度调节量调节吸入氧气浓度,并变更下一调节间隔的时长为第五时长,所述预设最大单次氧浓度调节量基于病人类型不同对应设置为不同的调节量,所述第五时长小于常规调节间隔的时长;
若所述血氧恶化趋势未偏向于重度缺氧或重度过氧,根据处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量、上一次调节吸入氧气浓度的氧浓度变化率和所述预设最大单次氧浓度调节量,得到第一氧浓度目标调节量;
当所述第一氧浓度目标调节量小于或等于所述预设最大单次氧浓度调节量时,以所述第一氧浓度目标调节量调节吸入氧气浓度;
当所述第一氧浓度目标调节量大于所述预设最大单次氧浓度调节量时,以所述预设最大单次氧浓度调节量调节吸入氧气浓度,并将所述第一氧浓度目标调节量与所述预设最大单次氧浓度调节量的差值作为剩余调节量,添加至所述指定血氧分区的累积调节量中。
可选的,若所述血氧变化趋势为血氧稳定趋势或血氧好转趋势,所述根据 所述血氧变化趋势对应的调节策略调节吸入氧气浓度,包括:
若处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量变小或不变,在上一次血氧变化趋势为血氧稳定趋势或血氧好转趋势的调节间隔内的调节吸入氧气浓度的调节量基础上增加预设调节量,得到第二氧浓度目标调节量,基于所述第二氧浓度目标调节量调节吸入氧气浓度,所述第二氧浓度目标调节量不大于预设最低氧浓度调节量。
可选的,若所述血氧变化趋势为血氧稳定趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度,包括:
若处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量变大,基于处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量和所述指定血氧分区的累积调节量,得到第三氧浓度目标调节量,基于所述第三氧浓度目标调节量调节吸入氧气浓度。
可选的,若所述血氧变化趋势为血氧稳定趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度,包括:
若所述处于所述指定血氧分区的血氧数据处于所述治疗目标分区的血氧数据范围内,确定所述血氧数据在治疗目标分区中所处的区域,所述区域至少包括下游区域、中游区域和上游区域;
若所述血氧数据处于所述下游区域,维持当前对所述吸入氧气浓度的调节;
若所述血氧数据处于所述中游区域,启动第一计时,当所述第一计时结束,根据预设最低氧浓度调节量调节吸入氧气浓度;
若所述血氧数据处于所述上游区域,启动第二计时,当所述第二计时结束,根据预设最低氧浓度调节量调节吸入氧气浓度,所述第二计时大于第一计时。
本申请第二方面公开了一种呼吸支持设备,包括:
通气装置,所述通气装置用于通过一呼吸回路和呼吸附件向病人提供吸入气体,所述吸入气体为含氧气体;
处理器,所述处理器与所述通气装置信号连接,以控制所述通气装置对所述病人提供的吸入气体的流量;
所述处理器还配置为:
实时获取当前调节间隔的各个血氧数据,确定各个血氧数据各自所处的推选血氧分区;
判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,所述严重度指所述血氧数据偏离治疗目标分区的程度,所述提前触发调节吸入氧气浓度的条件包括所述严重度趋于提升,所述推选血氧分区和所述治疗目标分区各自对应预先划分的血氧数据范围;
在满足提前触发调节吸入氧气浓度的条件下执行调节吸入氧气浓度操作,否则,正常执行调节吸入氧气浓度操作。
可选的,所述判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件的处理器,具体用于:
获取上一调节间隔内包含严重度最大的血氧数据的参考血氧分区,所述上一调节间隔和所述当前调节间隔的时长不一定相同;实时比较当前调节间隔内获取的血氧数据的严重度和所述参考血氧分区的血氧数据的严重度的大小;
在当前调节间隔的计时结束之前,当前调节间隔内获取的血氧数据的严重度大于所述参考血氧分区的血氧数据的严重度的个数超过预设个数,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
可选的,所述判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件的处理器,具体用于:
由当前调节间隔的起始时间开始计时,每隔第一时长,判断获取的各个血氧数据对应的血氧数据的严重度是否连续递增,所述第一时长小于所述当前调节间隔的时长;
若出现连续递增,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
可选的,其特征在于,所述处理器,还用于:
实时判断所述各个血氧数据在所处的所述推选血氧分区的持续时长小于等于第二时长的情况是否已持续第三时长,所述第三时长大于所述第二时长, 小于等于当前调节间隔的时长;
若已持续第三时长,根据不确定性血氧触发方式对应的调节策略触发调节吸入氧气浓度,否则继续判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件。
可选的,所述根据不确定性血氧触发方式对应的调节策略触发调节所述吸入氧气浓度的处理器,具体用于:
累积计算各个推选血氧分区的权值,得到总权值,其中,对应不同血氧数据范围的推选血氧分区具有不同的权值,所述权值的大小由血氧数据的严重度的大小确定;
分别将所述总权值与第一权值阈值、第二权值阈值进行比较,所述第一权值阈值用于指示增加氧浓度和第一吸入氧浓度调节量,所述第二权值阈值用于指示减少氧浓度和第二吸入氧浓度调节量,所述第一权值阈值大于所述第二权值阈值;
若所述总权值大于或等于所述第一权值阈值,确定增加所述第一吸入氧浓度调节量;
若所述总权值小于或等于所述第二权值阈值,确定减少所述第二吸入氧浓度调节量;
若所述总权值小于所述第一权值阈值,大于所述第二权值阈值,确定维持当前吸入氧气浓度的调节量。
可选的,所述处理器,还用于:
在接收到所述获取装置获取的各个血氧数据之后,获取所述血氧数据中影响血氧可信度的关联数据;判断所述关联数据是否满足血氧可信度要求;若满足,确定所述血氧数据对应的血氧分区;若不满足,继续获取血氧数据。
可选的,若所述关联数据至少包括脉率和/或灌注指数和/或血氧信号质量,所述判断所述关联数据是否满足预设要求的处理器,具体用于:
判断所述脉率的变化率是否高于脉率变化率阈值;
若所述脉率的变化率高于脉率变化率阈值,所述脉率不满足血氧可信度要 求,反之,所述脉率满足血氧可信度要求;和/或,
判断所述脉率是否低于脉率阈值;
若所述脉率低于脉率阈值,所述脉率不满足血氧可信度要求,反之,所述脉率满足血氧可信度要求;和/或,
判断所述灌注指数是否低于灌注指数阈值;
若所述灌注指数低于灌注指数阈值,所述灌注指数不满足血氧可信度要求,反之,所述灌注指数满足血氧可信度要求;
和/或,判断所述血氧信号质量是否低于血氧信号质量阈值;
若所述血氧信号质量低于血氧信号质量阈值,所述血氧信号质量不满足血氧可信度要求,反之,所述血氧信号质量满足血氧可信度要求。
可选的,所述处理器,还用于:
若连续判断所述关联数据不满足血氧可信度要求,且连续时长超过第四时长,生成暂停吸入氧气浓度调节的报警信息。
可选的,所述执行调节吸入氧气浓度操作的处理器,具体用于:
获取当前调节间隔的指定血氧分区,所述指定血氧分区指当前调节间隔内确定的各个血氧分区中包含严重度最大的血氧数据的推选血氧分区;
基于所述指定血氧分区确定血氧变化趋势,根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度。
可选的,所述基于所述指定血氧分区确定血氧变化趋势的处理器,具体用于:
确定所述指定血氧分区对应的第一血氧类型和所述参考血氧分区对应的第二血氧类型;
若所述第一血氧类型为重度缺氧或重度过氧,确定所述当前调节间隔内的血氧变化趋势为血氧恶化趋势;
若所述第一血氧类型相对于所述第二血氧类型所指示的血氧类型趋于严重,确定所述当前调节间隔内的血氧变化趋势为血氧恶化趋势,所述血氧类型至少包括重度缺氧、重度过氧、中度缺氧、中度过氧、轻度缺氧、轻度过氧和正常状态;
若所述第一血氧类型和所述第二血氧类型一致且均非重度缺氧或重度过氧,确定所述当前调节间隔内的血氧变化趋势为血氧稳定趋势;
若所述第一血氧类型相对于所述第二血氧类型所指示的血氧类型趋于好转,确定所述当前调节间隔内的血氧变化趋势为血氧好转趋势。
可选的,若所述血氧变化趋势为血氧恶化趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度的处理器,具体用于:
若所述血氧恶化趋势偏向于重度缺氧或重度过氧,根据预设最大单次氧浓度调节量调节吸入氧气浓度,并变更下一调节间隔的时长为第五时长,所述预设最大单次氧浓度调节量基于病人类型不同对应设置为不同的调节量,所述第五时长小于常规调节间隔的时长;
若所述血氧恶化趋势未偏向于重度缺氧或重度过氧,根据处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量、上一次调节吸入氧气浓度时的血氧变化率和所述预设最大单次氧浓度调节量,得到第一氧浓度目标调节量;
当所述第一氧浓度目标调节量小于或等于所述预设最大单次氧浓度调节量时,以所述第一氧浓度目标调节量调节吸入氧气浓度;
当所述第一氧浓度目标调节量大于所述预设最大单次氧浓度调节量时,以所述预设最大单次氧浓度调节量调节吸入氧气浓度,并将所述第一氧浓度目标调节量与所述预设最大单次氧浓度调节量的差值作为剩余调节量,添加至所述指定血氧分区的累积调节量。
可选的,若所述血氧变化趋势为血氧稳定趋势或血氧好转趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度的处理器,具体用于:
若处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量变小或不变,在上一次血氧变化趋势为血氧稳定趋势或血氧好转趋势的调节间隔内的调节吸入氧气浓度的调节量基础上增加预设调节量,得到第二氧浓度目标调节量,基于所述第二氧浓度目标调节量调节吸入氧气浓度,所述第二氧浓度目标调节量不大于预设最低氧浓度调节量。
可选的,若所述血氧变化趋势为血氧稳定趋势,所述根据所述血氧变化趋 势对应的调节策略调节吸入氧气浓度的处理器,具体用于:
若处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量变大,基于处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量和所述指定血氧分区的累积调节量,得到第三氧浓度目标调节量,基于所述第三氧浓度目标调节量调节吸入氧气浓度。
可选的,若所述血氧变化趋势为血氧稳定趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度的处理器,具体用于:
若所述处于所述指定血氧分区的血氧数据处于所述治疗目标分区的血氧数据范围内,确定所述血氧数据在治疗目标分区中所处的区域,所述区域至少包括下游区域、中游区域和上游区域;
若所述血氧数据处于所述下游区域,维持当前对所述吸入氧气浓度的调节;
若所述血氧数据处于所述中游区域,启动第一计时,当所述第一计时结束,根据预设最低氧浓度调节量调节吸入氧气浓度;
若所述血氧数据处于所述上游区域,启动第二计时,当所述第二计时结束,根据预设最低氧浓度调节量调节吸入氧气浓度,所述第二计时大于第一计时。
本申请第三方面公开了一种呼吸支持设备,包括:
通气装置,所述通气装置用于通过一呼吸回路和呼吸附件向病人提供吸入气体,所述吸入气体为含氧气体;
处理器,所述处理器与所述通气装置信号连接,以控制所述通气装置对所述病人提供的吸入气体的流量;
以及,实时获取所述病人的血氧数据,并根据所述血氧数据控制所述通气装置以一固定间隔时间,周期性地执行吸入氧气浓度调节操作,以调节所述吸入气体中氧浓度;
所述处理器还配置为:
在当前吸入氧气浓度调节周期内,确定所述实时获取到的所述病人的血氧数据对应的血氧分区;所述血氧分区为根据血氧饱和度预先划分得到,并包括一治疗目标分区;
根据所述病人的实时血氧数据对应的血氧分区确定所述病人的血氧变化 趋势;
确定到所述病人的血氧变化趋势为偏离所述治疗目标分区时,提前执行吸入氧气浓度调节操作,以将所述病人的血氧水平调节到所述治疗目标分区内。
本申请实施例公开的一种吸入氧气浓度的调节方法和呼吸支持设备,实时获取当前调节间隔的各个血氧数据,确定各个血氧数据各自所处的推选血氧分区;判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,所述严重度指所述血氧数据偏离治疗目标分区的程度,所述提前触发调节吸入氧气浓度的条件包括所述严重度趋于提升,所述推选血氧分区和所述治疗目标分区各自对应预先划分的血氧数据范围;在满足提前触发调节吸入氧气浓度的条件下执行调节吸入氧气浓度操作,否则,正常执行调节吸入氧气浓度操作。在本方案中,通过根据病人的血氧数据的严重度的变化,做出是否提前触发调节吸入氧气浓度的响应,实现在病人血氧发生快速变化时快速响应对吸入氧气浓度调整的目的。
图1为本申请实施例公开的一种吸入氧气浓度的调节方法流程示意图;
图2为本申请实施例公开的一种血氧分区的划分示例图;
图3为本申请实施例公开的一种调节吸入氧气浓度的流程示意图;
图4为本申请实施例公开的另一种血氧分区的示例图;
图5为本申请实施例公开的另一种血氧分区的示例图;
图6为本申请实施例公开的一种确定各个血氧数据严重度的流程示意图;
图7为本申请实施例公开的另一种确定各个血氧数据严重度的流程示意图;
图8为本申请实施例公开的一种基于调节策略A调节吸入氧气浓度的流程示意图;
图9为本申请实施例公开的另一种吸入氧气浓度的调节方法流程示意图;
图10为本申请实施例公开的一种分析血氧变化趋势的流程示意图;
图11为本申请实施例公开的一种中度缺氧下的血氧趋势分析流程示意图;
图12为本申请实施例公开的一种中度过氧下的血氧趋势分析流程示意图;
图13为本申请实施例公开的一种轻度缺氧下的血氧趋势分析流程示意图;
图14为本申请实施例公开的一种轻度过氧下的血氧趋势分析流程示意图;
图15为本申请实施例公开的一种基于调节策略B或C调节吸入氧气浓度的流程示意图;
图16为本申请实施例公开的一种呼吸支持设备的结构示意图;
图17为本申请实施例公开的另一种吸入氧气浓度的调节方法的结构示意图。
下面将结合本申请实施例中的附图,对本申请实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅仅是本申请一部分实施例,而不是全部的实施例。基于本申请中的实施例,本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例,都属于本申请保护的范围。
在本申请中,诸如第一和第二等之类的关系术语仅仅用来将一个特征、实体或者操作与另一个特征、实体或操作区分开来,不一定要求或者暗示这些特征、实体或操作之间存在任何这种实际的关系或者顺序。术语“包括”、“包含”或者其任何其他变体意在涵盖非排他性的包含,从而使得包括一系列要素的过程、方法、物品或者设备不仅包括那些要素,而且还包括没有明确列出的其他要素,或者是还包括为这种过程、方法、物品或者设备所固有的要素。在没有更多限制的情况下,由语句“包括一个……”限定的要素,并不排除在包括所述要素的过程、方法、物品或者设备中还存在另外的相同要素。
FiO2(吸入气中的氧浓度分数,吸入氧气浓度)作为病人接受呼吸机治疗的过程中极为重要的一个调节参数,在实际使用过程中,FiO2需要根据病人的具体生理状况进行调节,调节的目标是使病人达到正常的目标氧合水平。大部分情况下,FiO2的设置都是由医护人员参考病人动脉血氧分压(Arterial partial pressure of oxygen,PaO2)或动脉血氧饱和度(Arterial oxygen saturation,SaO2)等相关氧合指标后根据经验设定的。但是在实际过程中,往往会由于医院人力资源不足,或者病人数量过多等各种各样的问题,导致医护人员不能及时应对病人氧合状况的变化,调节病人吸入氧气浓度,从而使病人陷入到缺氧或者过 氧的危险当中。而长时间的缺氧会导致病人组织衰竭,加重病情,危及病人生命;而长时间的过氧同样会对病人身体造成损伤。因此,需要在医护人员无法及时出现在病人床边调节吸入氧气浓度时,使呼吸机根据病人生理状况自动调节。
但是,由背景技术可知,现有所使用的根据脉搏血氧仪测得的血氧饱和度(Blood oxygen saturation,SpO2)自动调节吸入氧气浓度的方式在病人血氧发生快速变化时无法做到快速响应,因为其对呼入氧浓度的调节采用的是固定周期。
因此,本申请实施例公开了一种吸入氧气浓度的调节方法和呼吸支持设备,在上文提及的通过固定周期调节吸入氧气浓度的基础上,通过设定提前触发调节吸入氧气浓度的条件,在实时获取到的血氧数据处于自身所在的推选血氧分区的时长,以及该推选血氧分区对应的血氧状态满足该提前触发调节吸入氧气浓度的条件时,提前触发调节吸入氧气浓度,并基于当前调节间隔内的血氧变化趋势对应的调节策略实现对吸入氧气浓度的调节。具体实现方式通过以下实施例进行详细说明。
如图1所示,为本申请实施例公开的一种吸入氧气浓度的调节方法流程示意图,该吸入氧气浓度的调节方法可以适用于各类呼吸支持设备,如呼吸机、麻醉机等。该吸入氧气浓度的调节方法主要包括以下步骤:
步骤101:实时获取当前调节间隔的各个血氧数据,确定各个血氧数据各自所处的推选血氧分区。
在具体实现步骤101的过程中,可以采用脉搏血氧仪实时获取血氧数据。前后两次调节吸入氧气浓度操作之间即为一个调节间隔,对于固定间隔周期,该间隔的时长可以根据经验值预先设置。通常情况下,该调节间隔为常规调节间隔。
在本申请实施例中通过血氧数据可以具体得到血氧饱和度。在实际应用过程中,实时获取到的血氧数据,通过对血氧数据进行处理,可以得到用于体现血氧数据的血氧饱和度。两者都可以指示血液中的氧气含量。
在步骤101中,推选血氧分区指采集到的血氧数据所处的血氧分区。血氧分区为预先基于血氧饱和度范围(血氧数据范围)划分得到的分区。
在具体实现本申请实施例公开的吸入氧气浓度的调节方法之前,为了按照偏离医生设置的治疗目标分区的程度,识别病人血氧状态的严重程度,从而根据严重程度的不同,决定不同的吸入氧气浓度的调节;以及根据病人血氧所在分区的血氧状态的严重程度的变化,确定是否提前触发调节吸入氧气浓度,需要将整体血氧划分为若干区域。每一个区域都有各自对应的预先划分的血氧饱和度范围,或者都有各自对应的预先划分的血氧数据范围。
在一实施例中,基于正常的以血氧饱和度0%~100%表示的血氧范围,将医生设置的治疗目标分区之外的区域至少再划分出两个块区域。其中,医生设置的治疗目标分区用于指示血氧水平处于正常状态。可以理解为,血氧分区包括一治疗目标分区,即对病人进行治疗时,需要将病人对应的生理参数恢复到或保持在该治疗目标分区,当对应的血氧数据(生理参数)处于该治疗目标分区时,可以认为该血氧数据(生理参数)处于正常状态。
具体划分血氧分区的过程为:
在由第一下限血氧饱和度和第一上限血氧饱和度构成的血氧饱和度范围内,确定治疗目标分区的下限血氧饱和度和治疗目标分区的上限血氧饱和度。将第一下限血氧饱和度和治疗目标分区的下限血氧饱和度之间的区域划分为缺氧分区,该缺氧分区用于指示血氧水平处于缺氧状态。将治疗目标分区的上限血氧饱和度和第一上限血氧饱和度之间的区域划分为过氧分区,该过氧分区用于指示血氧水平处于过氧状态。
如图2所示,为本申请一实施例示出的血氧分区的示例图。其中,0%指第一下限血氧饱和度,100%为第一上限血氧饱和度,87%为治疗目标分区的下限血氧饱和度,92%为治疗目标分区的上限血氧饱和度。图2中90%为当前监测到的病人的血氧饱和度。
由此得到,治疗目标分区的范围为:[87%,92%]。
缺氧分区的范围为:[0%,87%)。
过氧分区的范围为:(92%,100%]。
图2仅为本申请实施例所给出的一种示例,本申请实施例对于血氧分区的划分并不局限于上述给出的血氧饱和度。
需要说明的是,在未调节吸入氧气浓度之前,随着读取的最新的血氧数据,所确定的推选血氧分区也一直在更新。
在步骤101中,每一血氧分区对应指示一种血氧状态。
在一实施例中,根据血氧分区所对应的血氧饱和度范围不同,血氧状态有所不同。具体的,治疗目标分区所对应的血氧状态为正常状态。缺氧分区所对应的血氧状态为缺氧状态。过氧分区所对应的血氧状态为过氧状态。
步骤102:判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,若是,则执行步骤103;若否,则执行步骤104。
在步骤102中,血氧数据的严重度指血氧数据偏离治疗目标分区的程度。越偏离治疗目标分区,血氧数据的严重度越高。
该提前触发调节吸入氧气浓度的条件包括所述严重度趋于提升。也就是说,至少存在血氧数据的严重度趋于提升的情况,即满足提前触发调节吸入氧气浓度的条件。
步骤103:在满足提前触发调节吸入氧气浓度的条件下提前执行调节吸入氧气浓度操作。
步骤104:在当前调节间隔的计时结束后,正常执行调节吸入氧气浓度操作。
在步骤103和步骤104中所执行的调节吸入氧气浓度操作,可选的,基于当前调节间隔内的血氧变化趋势,采用对应的调节策略执行调节吸入氧气浓度操作。
在本申请实施例中,该调节吸入氧气浓度操作如图3所示,包括:
步骤301:获取当前调节间隔的指定血氧分区,所述指定血氧分区指当前调节间隔内确定的各个血氧分区中包含严重度最大的血氧数据的推选血氧分区。
在步骤301中,当前调节间隔的指定血氧分区指在当前调节间隔内确定的包含严重度最大的血氧数据的推选血氧分区,用于指示当前调节间隔内的血氧总体分区结果。
在具体实现中,可以每隔预设时间段,比较当前调节间隔内获取到的血氧 数据的严重度进行比较,确定包含严重度最大的血氧数据所处的推选血氧分区为指定血氧分区。直至触发提前执行调节吸入氧气浓度操作或者正常执行调节吸入氧气浓度操作,以最后确定包含严重度最大的血氧数据的推选血氧分区为当前调节间隔内的指定血氧分区。
也可以实时每获取一个血氧数据,将该血氧数据的严重度与其他已获取的血氧数据的严重度进行比较,实时确定出当前调节间隔内的指定血氧分区,直至触发提前执行调节吸入氧气浓度操作或者正常执行调节吸入氧气浓度操作,以最后确定包含严重度最大的血氧数据的推选血氧分区为当前调节间隔内的指定血氧分区。
以实时比较为例,假设当前间隔内可以获取到的血氧数据的最小个数为20个。从进入当前间隔开始,在获取到的第一个血氧数据时,确定该第一个血氧数据所处的推选血氧分区为当前调节间隔内的指定血氧分区,在获取到的第二个血氧数据时,将第二个血氧数据的严重度与第一个血氧数据的严重度进行比较,如果第一个血氧数据的严重度大于第二个血氧数据的严重度,则继续将第一个血氧数据所处的推选血氧分区为当前调节间隔内的指定血氧分区,持续执行上述实时比较,直至提前执行调节吸入氧气浓度操作或者正常执行调节吸入氧气浓度操作,以最后确定包含严重度最大的血氧数据的推选血氧分区为当前调节间隔内的指定血氧分区。
步骤302:基于指定血氧分区确定血氧变化趋势,根据血氧变化趋势对应的调节策略调节吸入氧气浓度。
在步骤302中,血氧变化趋势包括血氧恶化趋势、血氧稳定趋势和血氧好转趋势。
血氧恶化趋势表示病人血氧进一步偏离治疗目标分区。
血氧稳定趋势表示病人血氧没有明显的朝治疗目标分区变化的趋势或偏离目标血氧范围的趋势。
血氧好转趋势表示病人血氧正朝治疗目标分区变化。
然后,基于血氧变化趋势确定对应的调节策略,根据调节策略调节吸入氧气浓度。
执行本申请实施例公开的调节吸入氧气浓度操作,针对不同病人的血氧变化趋势确定适合病人的吸入氧气浓度的调节策略,使得本申请实施例公开的调节吸入氧气浓度操作,可以在不同血氧状态的病人之间使用。能够避免现有技术中采用固定调节量或者固定调节目标,对不同血氧状态的病人进行吸入氧气浓度的调节的弊端。进一步的,也不需要区分哪些病人可以使用,哪些病人不可以使用。
在本申请实施例公开的吸入氧气浓度的调节方法中,通过根据病人的血氧数据的严重度的变化,做出是否提前触发调节吸入氧气浓度的响应,并在确定提前触发调节吸入氧气浓度的情况下,基于当前调节间隔内的血氧变化趋势对应的调节策略及时对吸入氧气浓度的调节。实现在病人血氧发生快速变化时快速响应对吸入氧气浓度调整的目的。
基于上述本申请实施例图1公开的吸入氧气浓度的调节方法,在步骤101中的血氧分区除划分为治疗目标分区、缺氧分区和过氧分区以外。
还可以继续对治疗目标分区进行划分。具体为:可以将治疗目标分区划分为多个区域。优选的,如图4所示,可以将治疗目标分区划分为下游区域、中游区域和上游区域。但本申请实施例对于治疗目标分区的划分并不局限于三个区域。
此外,治疗目标分区可以采用等比例进行区域划分,也可以采用不等比例进行区域划分。
在一实施例中,还可以继续对缺氧分区进行划分。具体为:
首先,确定该缺氧分区的第一边界血氧饱和度和第二边界血氧饱和度,该第一边界血氧饱和度小于治疗目标分区的下限血氧饱和度,该第一边界血氧饱和度大于第二边界血氧饱和度。
然后,将治疗目标分区的下限血氧饱和度与第一边界血氧饱和度之间的区域划分为轻度缺氧分区,该轻度缺氧分区用于指示血氧水平处于轻度缺氧状态。
将第一边界血氧饱和度与第二边界血氧饱和度之间的区域划分为中度缺氧分区,该中度缺氧分区用于指示血氧水平处于中度缺氧状态。
将第二边界血氧饱和度与该第一下限血氧饱和度之间的区域划分为重度缺氧分区,该重度缺氧分区用于指示血氧水平处于重度缺氧状态。
需要说明的是,确定该缺氧分区的第一边界血氧饱和度和第二边界血氧饱和度的方式有很多种。
第一种:获取治疗目标分区中包含的血氧饱和度范围;基于治疗目标分区中包含的血氧饱和度范围、第一下限血氧饱和度和治疗目标分区的下限血氧饱和度进行计算,确定第一边界血氧饱和度和第二边界血氧饱和度。
第二种:获取治疗目标分区中包含的血氧饱和度和血氧报警限值范围;基于治疗目标分区中包含的血氧饱和度、血氧报警限值范围、第一下限血氧饱和度和治疗目标分区的下限血氧饱和度进行计算,确定第一边界血氧饱和度和第二边界血氧饱和度。
第三种:获取中度缺氧状态对应的第一历史血氧饱和度和重度缺氧状态对应的第二历史血氧饱和度;根据第一历史血氧饱和度确定第一边界血氧饱和度,根据第二历史血氧饱和度确定第二边界血氧饱和度。
结合图2,图5给出了该缺氧分区的第一边界血氧饱和度为84%,该缺氧分区的第二边界血氧饱和度为81%。
由此得到,轻度缺氧分区的范围为:[84%,87%)。
中度缺氧分区的范围为:[81%,84%)。
重度缺氧分区的范围为:[0%,81%)。
在一实施例中,还可以继续对过氧分区进行划分。具体为:
首先,确定第三边界血氧饱和度和第四边界血氧饱和度,该第三边界血氧饱和度大于治疗目标分区的上限血氧饱和度,该第三边界血氧饱和度小于第四边界血氧饱和度。
然后,将治疗目标分区的上限血氧饱和度与第三边界血氧饱和度之间的区域为轻度过氧分区,该轻度过氧分区用于指示血氧水平处于轻度过氧状态。
将第三边界血氧饱和度与第四边界血氧饱和度之间的区域为中度过氧分区,该中度过氧分区用于指示血氧水平处于中度过氧状态。
将第四边界血氧饱和度与第一上限血氧饱和度之间的区域为重度过氧分 区,该重度过氧分区用于指示血氧水平处于重度过氧状态。
需要说明的是,确定该缺氧分区的第三边界血氧饱和度和第四边界血氧饱和度的方式有很多种。
第一种:获取治疗目标分区中包含的血氧饱和度范围;基于治疗目标分区中包含的血氧饱和度范围、第一上限血氧饱和度和治疗目标分区的上限血氧饱和度进行计算,确定第三边界血氧饱和度和第四边界血氧饱和度。
第二种:获取治疗目标分区中包含的血氧饱和度和血氧报警限值范围;基于治疗目标分区中包含的血氧饱和度、血氧报警限值范围、第一上限血氧饱和度和治疗目标分区的上限血氧饱和度进行计算,确定第三边界血氧饱和度和第四边界血氧饱和度。
第三种:获取中度过氧状态对应的第三历史血氧饱和度和重度过氧状态对应的第四历史血氧饱和度;根据第三历史血氧饱和度确定第三边界血氧饱和度,根据第四历史血氧饱和度确定第四边界血氧饱和度。
结合图2,图5给出了该过氧分区的第三边界血氧饱和度为94%,该缺氧分区的第四边界血氧饱和度为96%。
由此得到,轻度过氧分区的范围为:(92%,94%]。
中度过氧分区的范围为:(94%,96%]。
重度过氧分区的范围为:(96%,100%]。
在本申请实施例中通过划分血氧分区,按照偏离目标血氧范围的程度,识别病人血氧状况的严重度,从而在后续执行调节吸入氧气浓度操作时,可以根据血氧分区所对应的血氧状态的严重度的不同决定不同的调节策略,以及根据病人血氧数据所在血氧分区的血氧状态的变化,决定是否提前触发调节吸入氧气浓度操作。
进一步的,根据严重度的不同,严重度越高的血氧状态采用更高的吸入氧浓度调节量、以及更短的调节间隔时间,由此得到随病人血氧状态的严重度增加,吸入氧浓度调节强度呈阶梯状递增调整强度的效果。
基于上述本申请实施例图1公开的吸入氧气浓度的调节方法,在步骤102 中,可以采用多种方式分析各个血氧数据的严重度,以此来实时判断血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件。
本申请实施例给出以下三种方式,但本申请实施例并不局限于以下三种方式确定各个血氧数据的严重度。
第一种方式为:
获取上一调节间隔内包含严重度最大的血氧数据的参考血氧分区,实时比较当前调节间隔内获取的血氧数据的严重度和参考血氧分区的血氧数据的严重度的大小;在当前调节间隔的计时结束之前,当前调节间隔内获取的血氧数据的严重度大于参考血氧分区的血氧数据的严重度的个数超过预设个数,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
需要说明的是,上一调节间隔和所述当前调节间隔的时长不一定相同。
在一实施例中,第一种方式的具体实现过程如图6所示,包括如下步骤:
步骤601:确定上一调节间隔内包含严重度最大的血氧数据的参考血氧分区。
在步骤601中所确定的上一调节间隔内包含严重度最大的血氧数据的参考血氧分区为上一调节间隔内血氧总体分区结果。
该上一调节间隔内血氧总体分区结果指在上一调节间隔内或上一调节间隔结束后,执行调节吸入氧气浓度操作时的血氧总体分区,该血氧总体分区用于表示上一调节间隔内的血氧总体状态。
即,在一次调节间隔中获取到的血氧数据各自对应的血氧分区各不相同时,需要评价出一个血氧总体分区来概括表示该调节间隔内“更为重要的血氧分区事件”,也就是说,对应血氧状态的严重度最大的血氧分区。将该血氧分区作为参考血氧分区,以备后续使用。
举例说明,当某一调节间隔内获取到的血氧数据,即存在对应“治疗目标分区”的血氧数据,也存在对应“过氧分区”的血氧数据,那么“过氧分区”就是“更为重要的血氧分区事件”。将该“过氧分区”作为参考血氧分区,以 备后续使用。当然,在其他实施例中,也可以采用不同的策略来确定某一调节间隔内的血氧总体状态。
在当前间隔内循环执行下述步骤,直至确定当前调节间隔内获取到的各个血氧数据的严重度是否提前触发调节吸入氧气浓度的条件。
步骤602:判断当前调节间隔的计时是否结束,若结束,确定不满足提前触发调节吸入氧气浓度的条件。若未结束,获取下一血氧数据,并执行步骤603。
步骤603:将当前获取的血氧数据的严重度与参考血氧分区的血氧数据的严重度进行比较,若当前获取的血氧数据的严重度大于参考血氧分区的血氧数据的严重度,执行步骤604;若当前获取的血氧数据严重度不大于参考血氧分区的血氧数据的严重度,执行步骤605。
在执行步骤603的同时,也可以确定基于当前获取到的血氧数据,确定包含严重度最大的血氧数据的推选血氧分区为当前调节间隔内的指定血氧分区。
具体的,将当前获取到的各个血氧数据的严重度进行比较,确定出包含严重度最大的血氧数据的推选血氧分区,将其作为指定血氧分区。实际上可以理解为评价出一个血氧总体分区来概括表示该调节间隔内“更为重要的血氧分区事件”。
步骤604:累积当前调节间隔内获取的血氧数据的严重度大于所述参考血氧分区的血氧数据的严重度的个数。
步骤605:判断当前累积的个数是否超过预设个数,若超过,满足提前触发吸入氧气浓度的条件;若未超过,执行步骤602。
在步骤605中,通过对当前累积的当前调节间隔内获取的血氧数据的严重度大于所述参考血氧分区的血氧数据的严重度的个数进行判断,来确定与上一调节间隔比较血氧数据的严重度是否出现递增的变化,且该变化是否为偶发事件。若当前累积的个数未超过预设个数,则说明可能是偶发事件,或者说,还未到达提前触发调节所述吸入氧气浓度的程度,则返回执行步骤602继续判断当前调节间隔的计时是否结束,若结束,则说明处于正常调节吸入氧气浓度的 状态。若未结束,则继续获取下一个血氧数据。若当前累积的个数超过了预设个数,则说明在当前间隔的计时未结束前,已经达到提前触发调节所述吸入氧气浓度的程度,满足提前触发吸入氧气浓度的条件。
假设预设个数为15个。若当前累积的个数为16个,则满足提前触发吸入氧气浓度的条件。
在具体实现步骤605的过程中,基于步骤604累积当前调节间隔内获取的血氧数据的严重度大于所述参考血氧分区的血氧数据的严重度的个数进行判断。可以理解为:
通过累积的个数,确定当前调节间隔的血氧总体状态与上一调节间隔内确定的参考血氧分区进行比较是否有变化,若累积的当前调节间隔内获取的血氧数据的严重度大于所述参考血氧分区的血氧数据的严重度的个数大于预设个数,则说明病人的血氧状态可能出现恶化,需要高度关注,可提前触发调节吸入氧气浓度操作。
若累积的当前调节间隔内获取的血氧数据的严重度大于所述参考血氧分区的血氧数据的严重度的个数不大于预设个数,则说明病人的血氧状态可能正处于好转趋势或者维持在上一调节间隔的血氧总体分区对应的血氧状态的趋势。但是,因为当前调节间隔的计时还未结束,则继续获取下一血氧数据,继续判断,直至确定可提前触发调节吸入氧气浓度操作或者计时结束,执行正常的调节吸入氧气浓度操作。
需要说明的是,根据确定当前调节间隔的指定血氧分区的不同方式,可以在执行步骤603的同时实时确定当前调节间隔的指定血氧分区,也可以在当前调节间隔计时结束后,或者预设时间段内确定当前调节间隔的指定血氧分区。
可选的,步骤605中判断当前累积的个数是否超过预设个数的技术方案也可以通过判断当前获取的血氧数据的严重度大于参考血氧分区的血氧数据的严重度的占比数实现,具体为:基于当前调节间隔可获取的血氧数据的总数N、以及当前获取到的大于参考血氧分区的血氧数据的严重度的血氧数据的个数n,基于公式(1)进行计算,得到占比K。判断该占比是否超过预设占比,若 超过,满足提前触发吸入氧气浓度的条件;若未超过,则执行步骤602。
K=n/N (1)
假设当前间隔内可以获取到的血氧数据的最小个数为20个,预设占比为60%。通过实时比较,若当前累积的个数为10个,则占比K=50%,该占比K小于60%,不满足提前触发吸入氧气浓度的条件。若当前累积的个数为13个,则占比K=65%,该占比K大于60%,则满足提前触发吸入氧气浓度的条件。
第二种方式为:
由当前调节间隔的起始时间开始计时,每隔第一时长,判断获取的各个血氧数据的严重度是否连续递增;若出现连续递增,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。该第一时长小于当前调节间隔的时长,可以为一经验值。
也就是说,若血氧数据在短时间内朝着偏离治疗目标分区的方向连续变化时,也满足提前触发调节吸入氧气浓度操作的条件。
举例说明,假设第一时长为30秒。当血氧数据上一个30秒处于缺氧分区,在经历30秒之后,继续偏离治疗目标分区,严重度递增,再经历30秒之后,仍继续偏离治疗目标分区,严重度连续递增,此时满足提前触发调节吸入氧气浓度操作的条件。
第三种方式为:
实时判断各个血氧数据在所处的推选血氧分区的持续时长小于等于第二时长;若小于等于第二时长,再判断各个血氧数据在所处的推选血氧分区的持续时长小于等于第二时长的情况是否已持续第三时长;若已持续第三时长,根据不确定性血氧触发方式对应的调节策略提前触发调节吸入氧气浓度,否则继续判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件。
其中,第三时长大于第二时长,小于等于当前调节间隔的时长。
在一实施例中,可以采用常规调节间隔的一半时长作为第三时长。
举例说明,假设当前调节间隔的时长为120秒,第三时长为60秒,第二时长为15秒。若缺氧分区进一步划分为轻度缺氧分区、中度缺氧分区和重度 缺氧分区。当血氧数据处于轻度缺氧分区,但在该轻度缺氧分区的持续时间不超过15秒,进一步偏离治疗目标分区移动至中度缺氧分区,同样在中度缺氧分区的持续时间也未超过15秒,又偏移回轻度缺氧分区,这种情况持续发生的时长超过60秒,此时可以确定当前无法确定血氧状态,需要根据不确定性血氧触发方式对应的调节策略提前触发调节吸入氧气浓度。
在一实施例中,第三种方式的具体实现过程如图7所示,包括如下步骤:
步骤701:实时判断当前获取到的血氧数据在所处的推选血氧分区的持续时长是否小于等于第二时长,若否,对持续计时清零,执行步骤702;若是,执行步骤706。
步骤702:判断当前调节间隔的计时是否结束,若结束,确定不满足提前触发调节吸入氧气浓度的条件。若未结束,获取下一血氧数据,并执行步骤703。
步骤703:将当前获取的血氧数据的严重度与参考血氧分区的血氧数据的严重度进行比较,若当前获取的血氧数据的严重度大于参考血氧分区的血氧数据的严重度,执行步骤704;若当前获取的血氧数据严重度大于参考血氧分区的血氧数据的严重度,执行步骤705。
在执行步骤703的同时,也可以确定基于当前获取到的血氧数据,确定包含严重度最大的血氧数据的推选血氧分区为当前调节间隔内的指定血氧分区。
步骤704:累积当前调节间隔内获取的血氧数据的严重度大于所述参考血氧分区的血氧数据的严重度的个数。
步骤705:判断当前累积的个数是否超过预设个数,若超过,满足提前触发吸入氧气浓度的条件;若未超过,执行步骤702。
步骤706:持续计时,判断该持续计时的时长是否超过第三时长,若超过,执行步骤707,若未超过,执行步骤701。
在步骤706中,判断持续计时的时长是否超过第三时长,是因为若当前调节间隔内持续获取到血氧数据在所处的推选血氧分区的持续时长小于等于第二时长的情况一直在发生,说明此时病人的血氧波动可能处于较大、较频繁的 状态下,则可能会出现血氧分区反复变换的情况,因此,需要进行血氧不确定性判断,即判断血氧数据在所处的推选血氧分区的持续时长小于等于第二时长的情况是否持续了第三时长,如果是,则说明当前调节间隔内出现血氧不确定性的情况,此时同样需要调节吸入氧气浓度。
步骤707:根据不确定性血氧触发方式对应的调节策略A调节吸入氧气浓度。
具体实现步骤707,根据调节策略A调节吸入氧气浓度的过程如图8所示,包括如下步骤:
步骤801:累积计算各个推选血氧分区的权值,得到总权值。
在步骤801中,预先为划分的血氧分区赋值,每一个血氧分区赋予一个权值系数。对应不同血氧状态的血氧分区具有不同的权值,所述权值的大小由血氧数据的严重度的大小确定。
举例说明,若完整的血氧被划分为治疗目标分区、重度缺氧分区、中度缺氧分区、轻度缺氧分区、重度过氧分区、中度过氧分区和轻度过氧分区。
可以给轻度缺氧分区、中度缺氧分区、重度缺氧分区的分别赋予权值+1、+2、+3,给轻度过氧分区、中度过氧分区、重度过氧分区分别赋予权值-1、-2、-3,在治疗目标分区内的不参与累积分区(或累积权值为0)。
基于上述举例,若当前调节间隔内确定的推选血氧分区为两个轻度缺氧分区、两个治疗目标分区、一个中度缺氧分区,则执行步骤701确定累积计算各个血氧分区的权值,得到总权值为:4。
需要说明的是,执行步骤801累积计算各个推选血氧分区的权值,得到总权值的时间是上述图7中执行步骤706中超过第三时长的第一计时所记录的时间。
举例说明,在若执行步骤706中超过第三时长的第一计时所记录的时间为20秒。则这里所累积的各个推选血氧分区的权值则为这20秒内获取到的血氧数据所处的推选血氧分区的权值。
步骤802:分别将总权值与第一权值阈值、第二权值阈值进行比较。若总 权值大于或等于第一权值阈值,执行步骤803;若总权值小于或等于第二权值阈值,执行步骤804;若总权值小于第一权值阈值,大于第二权值阈值,执行步骤805。
在步骤802中,第一权值阈值用于指示增加氧浓度和第一吸入氧浓度调节量,第二权值阈值用于指示减少氧浓度和第二吸入氧浓度调节量,第一权值阈值大于所述第二权值阈值。
需要说明的是,第一权值阈值所指示的第一吸入氧气浓度调节量可以为1%~5%中的任意一个调节量。该调节量并不仅限于此范围。
第二权值阈值所指示的第二吸入氧气浓度调节量可以为-1%~-5%中的任意一个调节量。该调节量并不仅限于此范围。
步骤803:确定增加所述第一吸入氧浓度调节量。
步骤804:确定减少所述第二吸入氧浓度调节量。
步骤805:确定维持当前吸入氧气浓度。
举例说明,假设第一权值阈值为10,第一权值阈值所指示的第一吸入氧气浓度调节量为1%。第二权值阈值为-10,第二权值阈值所指示的第二吸入氧气浓度调节量为-1%,判断确定该调节间隔内具有不确定性血氧所使用的时间为20秒。
若这20秒内获取到的血氧数据所处的推选血氧分区分别为4个中度缺氧分区和2个重度缺氧分区,则累积后的总权值为(4*2)+(2*3)=14。该总权值大于第一权值阈值,则此时确定需要增加氧浓度,且增加1%的吸入氧气浓度。
若这20秒内获取到的血氧数据所处的推选血氧分区分别为2个中度过氧分区和4个重度过氧分区,则累积后的总权值为(2*-2)+(4*-3)=16。该总权值小于第二权值阈值,则此时确定需要减少氧浓度,且减少1%的吸入氧气浓度(-1%)。
若这20秒内获取到的血氧数据所处的推选血氧分区分别为4个治疗目标分区和2个轻度缺氧分区,则累积后的总权值为(4*0)+(2*1)=2。该总权值小于第一权值阈值,大于第二权值阈值,则此时确定维持当前吸入氧气浓度。
需要说明的是,本申请实施例只给出了设置两个权值阈值的情况,在具体实现中,可以基于血氧分区类型设置多个权值阈值,并根据不同的权值阈值设置对应的不同的氧浓度调节量。再将该调节间隔内具有不确定性血氧的情况下所确定的推选血氧分区对应的权值进行累计,并将累积结果与多个权值阈值进行比较,根据比较选取不同的氧浓度调节量。
举例说明,基于重度缺氧分区、中度缺氧分区、轻度缺氧分区、重度过氧分区、中度过氧分区和轻度过氧分区六种类型的血氧分区,设置30、20、10、-10、-20和-30共六个权值阈值。依次分别对应的氧浓度调节量为3%、2%、1%、-1%、-2%和-3%。正值表示增氧,负值表示减氧。
当确定该调节间隔内具有不确定性血氧所使用的时间20秒内血氧数据所处于的推选血氧分区频繁变换,无法稳定在一个分区内,总权值的计算结果大于等于30时,说明至少有一半的血氧数据位于重度缺氧分区,此时给出3%的氧浓度调节量,调节方向为增氧;若总权值的计算结果在20到30之间,说明当前血氧数据主要集中在中度缺氧分区,此时给出2%的氧浓度调节量,调节方向为增氧。同理,当总权值为负值时,调节方向为减氧,根据总权值与权值阈值的比较结果,给出不同的氧浓度调节量和调节方向。当总权值的计算结果处于在-10到10之间时,维持当前吸入氧气浓度,不予以氧浓度的调节。
通过上述方式,当病人的血氧数据在治疗目标分区之外时,即使在病人的血氧数据波动频繁,血氧趋势不明确的情况下,也仍然可以根据调节间隔内所有血氧数据所处的血氧分区决定氧浓度调节量和调节方向。此外,在总权值的计算结果处于在-10到10之间时,说明有少于一半的血氧数据偏离了治疗目标分区,但偏离程度较小。因此,当处于这样小幅度、短时间的偏离治疗目标分区的情况下,可以维持当前的吸入氧气浓度,不进行吸入氧浓度的过度调节。
在本申请实施例中,在血氧分区具有不确定性时,采用调节策略A首先计算当前调节间隔内确定的血氧分区的权值累积结果,然后再根据这个累积结果来决定吸入氧浓度的调节方向和调节量。从而完成对吸入氧浓度的调节。
在上述图1所示的本申请实施例公开的吸入氧气浓度的调节方法的基础上,本申请实施例还公开了另一种吸入氧气浓度的调节方法,如图9所示,该 吸入氧气浓度的调节方法包括如下步骤:
步骤901:判断当前调节间隔是否获取到有效的血氧数据,若未获取到血氧数据或获取到血氧数据无效,则继续获取血氧数据,若获取到有效的血氧数据,执行步骤902。
在步骤901中,若当前调节间隔无法获取到血氧数据,或者获取到的血氧数据无效,即该血氧数据未处于0至100%的范围内,为无效值,则说明血氧数据不可测,此时进行计时。若当前调节间隔内获取到血氧数据,且获取到的血氧数据处于0至100%的范围内,为有效值,则说明血氧数据可测。
步骤902:获取血氧数据中影响血氧可信度的关联数据,判断关联数据是否满足血氧可信度要求;若满足,执行步骤905;若不满足,执行步骤903。
在步骤902中,若满足指血氧数据可信,若不满足指血氧数据不可信。
在步骤902中,关联数据至少包括脉率和/或灌注指数和/或血氧信号质量。
关联数据中的血氧信号质量是对血氧信号强度、时域波形、频域波形的综合判断结果,当血氧信号质量低时,说明血氧信号强度低,或波形扰动强烈。
在一实施例中,若关联数据包括脉率,则:
判断脉率的变化率是否高于脉率变化率阈值;若是,脉率不满足血氧可信度要求,若否,脉率满足血氧可信度要求,确定血氧数据为可信数据。
或,判断脉率是否低于脉率阈值;若是,脉率不满足血氧可信度要求,若否,脉率满足血氧可信度要求,确定血氧数据为可信数据。
需要说明的是,若既要判断是否高于脉率变化率阈值,又要判断脉率是否低于脉率阈值,当均为否时,即脉率满足血氧可信度要求,确定血氧数据为可信数据。
在一实施例中,若关联数据包括灌注指数,则:
判断灌注指数是否低于灌注指数阈值;若是,灌注指数不满足血氧可信度要求,若否,灌注指数满足血氧可信度要求。
在一实施例中,若关联数据包括血氧信号质量,则:
判断血氧信号质量是否低于血氧信号质量阈值;若是,血氧信号质量不满足血氧可信度要求,若否,血氧信号质量满足血氧可信度要求。
在一实施例中,若关联数据包括脉率和灌注指数,则:
判断脉率的变化率是否高于脉率变化率阈值;若是,脉率不满足血氧可信度要求,若否,脉率满足血氧可信度要求。
和/或,判断脉率是否低于脉率阈值;若是,脉率不满足血氧可信度要求,若否,所述脉率满足血氧可信度要求。
和,判断灌注指数是否低于灌注指数阈值;若是,灌注指数不满足血氧可信度要求,若否,灌注指数满足血氧可信度要求。
需要说明的是,以上针对脉率和灌注指数的判断结果均为否时,即脉率满足血氧可信度要求,灌注指数满足血氧可信度要求,确定血氧数据为可信数据。
同样的,若关联数据包括脉率、灌注指数和血氧信号质量的任意组合时,例如:脉率和血氧信号质量;或者,灌注指数和血氧信号质量;或者,脉率、灌注指数和血氧信号质量时,当针对组合中的任意数据的判断均为否时,确定血氧数据为可信数据,若针对组合中的任一数据的判断为是时,确定血氧数据为不可信数据。
步骤903:判断血氧数据不可信的结果是否连续且连续出现的时长超过第四时长,若是,执行步骤904,若否,继续获取血氧数据,并执行步骤902。
在执行902确定血氧数据不可信之后,执行步骤903的原因是,由于血氧数据不可信导致吸入氧气浓度自动调节长时间处于不可调状态,会引发更为严重的问题。因此需要进行报警提示,人工干预。
需要说明的是,对于步骤903中判断的血氧数据不可信的结果,导致该不可信的结果的关联数据不同时,即脉率、灌注指数和血氧信号质量任意一个或组合时,根据关联数据中包含的内容不同,在步骤903中,用于决定是否执行提示用户当前调节状态操作的第四时长可以各不相同。
步骤904:执行报警操作。
在本申请实施例中,报警操作主要是提示用户当前吸入氧气浓度自动调节处于暂停状态。
需要说明的是,提示用户当前吸入氧气浓度调节状态的形式,至少应包括通过字符串和/或图形和/或声音提示。提示的内容应该包含当前调节状态和/ 或导致当前调节状态的原因。当有多个条件同时满足时,可提示所有的原因,也可选择根据内置的条件优先级进行提示,提示优先级最高的原因。
在一实施例中,可以通过报警字符串、报警音、系统操作界面上显示详细字符串来提示用户当前吸入氧气浓度自动调节处于暂停状态。
在一实施例中,还可以根据上述判断血氧数据是否可信时所使用的关联数据的判断结果提示用户导致该暂停状态的原因。
例如:若是由于灌注指数长时间过低,即灌注指数长时间低于灌注指数阈值导致的,则提示用户“当前调节暂停,暂停原因为灌注指数长时间过低”。在具体实现中,具体系统操作界面上所显示的提示字样可以由技术人员进行设置。
若是由于灌注指数和血氧信号质量长时间过低导致的,则可以同时提示“”“当前调节暂停,暂停原因为灌注指数和血氧信号质量长时间过低”。
若血氧信号质量的提示优先级高于灌注指数,则可以提示“当前调节暂停,暂停原因为灌注指数长时间过低”。
在本申请实施例中,当进行报警操作提示用户当前吸入氧气浓度自动调节状态及其原因后,可以授权或启动用户手动设置吸入氧气浓度的操作,即在血氧数据不可信的特殊状态下,自动调节吸入氧气浓度的功能会告知用户当前自动调节因某些因素处于暂停状态,此时用户可手动设置新的吸入氧气浓度,直到血氧数据恢复可信。
需要说明的是,当自动调节吸入氧气浓度功能恢复时,系统可以将用户手动设置的新的吸入氧气浓度作为控制值,在该控制值的基础上继续后续调节;也可以在恢复之前的吸入氧气浓度作为控制值,在该控制值的基础上继续后续调节。
进一步需要说明的是,当自动调节吸入氧气浓度的功能启用后,基于上述本申请实施例上述公开的任一种吸入氧气浓度的控制值,均会显示于系统的用户界面上,提示用户当前自动调节的吸入氧气浓度的控制值结果。
此时,用户也可以手动设置吸入氧气浓度。对于吸入氧气浓度自动调节期间用户手动设置的吸入氧气浓度,吸入氧气浓度自动调节功能会以用户新设置 的吸入氧气浓度继续调节。
基于上述说明,在系统的用户操作界面上应至少有一处可供用户手动设置氧浓度的入口,当吸入氧气浓度自动调节功能没有启用时,通过手动设置吸入氧气浓度实现对吸入氧气浓度的改变;启用吸入氧气浓度自动调节功能后,原手动设置氧浓度的入口显示当前吸入氧气浓度自动调节功能的吸入氧气浓度的结果。
需要说明的是,系统的用户操作界面和显示界面可以分开设置,也可以合并设置。
在一实施例中,可以将用户手动设置吸入氧气浓度的区域,与自动调节的吸入氧气浓度结果的显示区域分开,用户只从一个入口设置吸入氧气浓度,从另一个入口读取自动调节的吸入氧气浓度的结果。
也可以在上述设置的基础上再增添一个备用氧浓度设置区域,用于在血氧数据长时间不可信的条件下,使用户对这段期间内的吸入氧气浓度进行手动设置。
步骤905:确定各个血氧数据各自对应的血氧分区。
步骤905的执行原理以及所涉及的血氧分区与上述步骤101的执行原理以及所涉及的血氧分区相同,具体可参见上述有关步骤101的说明,这里不再赘述。
步骤906:判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,若是,则执行步骤907;若否,则执行步骤908。
步骤907:在满足提前触发调节吸入氧气浓度的条件下提前执行调节吸入氧气浓度操作。
步骤908:在当前调节间隔的计时结束后,正常执行调节吸入氧气浓度操作。
步骤906至步骤908的执行原理与上述步骤102至步骤104的执行原理相同,具体可参见上述有关步骤102至步骤104的说明,这里不再赘述。
在本申请实施例公开的吸入氧气浓度的调节方法中,增加对血氧数据可信度的判断,采用可信的血氧数据的严重度的变化,做出是否提前触发调节吸入 氧气浓度的响应,并在确定提前触发调节吸入氧气浓度的情况下,基于当前调节间隔内的血氧变化趋势对应的调节策略及时对吸入氧气浓度的调节。能够实现更加精确、更加快速响应病人血氧发生快速变化时对吸入氧气浓度调整的目的。
需要说明的是,基于上述图1和图9所示的本申请实施例公开的吸入氧气浓度的调节方法,在执行上述方法的过程中,还可以同时并行获取系统运行状态,判断系统运行状态是否处于正常运行状态的操作。
若系统运行状态处于正常运行状态,表示未发生任何可能影响系统正常工作的状态,若满足指系统运行状态正常,若不满足指系统运行状态异常。
若系统运行状态处于异常运行状态,该异常运行状态包括呼吸支持设备故障,设备与病人连接状态异常等,至少应包括设备对压力、流速控制或监测的异常、设备混合空气与氧气产生新的氧浓度气体控制过程的异常,设备对气体氧浓度监测功能的异常,送气过程气体泄漏量过大或堵塞,设备与病人之间送气管路断开。
需要说明的是,当系统出现异常时,会影响系统的工作效果,吸入氧浓度的控制效果,进一步可能会影响设备的治疗效果,这个时候采用自动调节氧浓度意义不大,应先解决系统运行的问题。因此,在并行执行获取系统运行状态,判断系统运行状态是否处于正常运行状态的操作的过程中,一旦发现系统运行状态为异常运行状态,则进行报警,使用户优先处理系统运行的问题。
基于上述图1和图9所示的本申请实施例公开的吸入氧气浓度的调节方法,其中,所涉及的调节吸入氧气浓度操作中需要确定当前调节间隔内的血氧变化趋势,然后再根据不同的血氧变化趋势确定不同的调节策略,根据调节策略调节吸入氧气浓度。
具体基于指定血氧分区确定血氧变化趋势的过程,如下:
首先,确定指定血氧分区所指示的第一血氧类型和参考血氧分区所指示的第二血氧类型。
该血氧类型至少包括重度缺氧、重度过氧、中度缺氧、中度过氧、轻度缺 氧、轻度过氧和正常状态。该血氧类型可以通过血氧分区的血氧饱和度范围确定。
然后,根据指定血氧分区所指示的第一血氧类型和参考血氧分区所指示的第二血氧类型可以得到当前的血氧变化趋势。
其中,若第一血氧类型为重度缺氧或重度过氧,确定当前调节间隔内的血氧变化趋势为血氧恶化趋势。
若第一血氧类型相对于第二血氧类型所指示的血氧类型趋于严重,确定当前调节间隔内的血氧变化趋势为血氧恶化趋势。
若第一血氧类型和第二血氧类型一致且均非重度缺氧或重度过氧,确定当前调节间隔内的血氧变化趋势为血氧稳定趋势。
若第一血氧类型相对于第二血氧类型所指示的血氧类型趋于好转,确定当前调节间隔内的血氧变化趋势为血氧好转趋势。
本申请实施例对于第一血氧类型的判断可以由重度至轻度进行,也可以由轻度至重度进行,以下只是一种示例,如图10所示,为本申请实施例给出的一种分析血氧变化趋势的流程示意图,包括如下步骤:
步骤1001:获取指定血氧分区所对应的第一血氧类型和参考血氧分区对应的第二血氧类型。
步骤1002:判断第一血氧类型是否为重度缺氧,若是,确定当前调节间隔内的血氧变化趋势为血氧恶化趋势;若否,执行步骤1003。
步骤1003:判断第一血氧类型是否为重度过氧,若是,确定当前调节间隔内的血氧变化趋势为血氧恶化趋势;若否,执行步骤1004。
也就是说,若该对照血氧分区所指示的第一血氧类型为重度缺氧或重度过氧:确定当前调节间隔内的血氧变化趋势为血氧恶化趋势。
步骤1004:判断第一血氧类型是否为中度缺氧,若是,则执行中度缺氧下的血氧趋势分析;若否,执行步骤1005。
在一实施例中,中度缺氧下的血氧趋势分析如图11所示,主要包括如下步骤:
步骤1101:判断第二血氧类型是否为重度缺氧,若是,确定当前调节间隔内的血氧变化趋势为血氧好转趋势;若否,执行步骤1102。
步骤1102:判断第二血氧类型是否为中度缺氧,若是,确定当前调节间隔内的血氧变化趋势为血氧稳定趋势;若否,确定当前调节间隔内的血氧变化趋势为血氧恶化趋势。
需要说明的是,在先执行步骤1101确定第二血氧类型不是重度缺氧的基础上执行步骤1102,得到第二血氧类型不是中度缺氧,则可以得到第二血氧类型可能为轻度缺氧或正常状态,相对于当前的第一血氧类型指示的中度缺氧,血氧状态处于恶化的趋势。
步骤1005:判断第一血氧类型是否为中度过氧,若是,则执行中度过氧下的血氧趋势分析;若否,执行步骤1006。
在一实施例中,中度过氧下的血氧趋势分析如图12所示,主要包括以下步骤:
步骤1201:判断第二血氧类型是否为重度过氧,若是,确定当前调节间隔内的血氧变化趋势为血氧好转趋势;若否,执行步骤1202。
步骤1202:判断第二血氧类型是否为中度过氧,若是,确定当前调节间隔内的血氧变化趋势为血氧稳定趋势,若否,确定当前调节间隔内的血氧变化趋势为血氧恶化趋势。
需要说明的是,在先执行步骤1201确定第二血氧类型不是重度过氧的基础上执行步骤1202,得到第二血氧类型不是中度过氧,则可以得到第二血氧类型可能为轻度过氧或正常状态,相对于当前的第一血氧类型指示的中度过氧,血氧状态处于恶化的趋势。
步骤1006:判断第一血氧类型是否为轻度缺氧,若是,则执行轻度缺氧下的血氧趋势分析;若否,执行步骤1007。
在一实施例中,轻度缺氧下的血氧趋势分析如图13所示,主要包括如下步骤:
步骤1301:判断第二血氧类型是否为重度缺氧或中度缺氧,若是,确定当前调节间隔内的血氧变化趋势为血氧好转趋势;若否,执行步骤1302。
步骤1302:判断第二血氧类型是否为轻度缺氧,若是,确定当前调节间隔内的血氧变化趋势为血氧稳定趋势;若否,确定当前调节间隔内的血氧变化趋势为血氧恶化趋势。
需要说明的是,在先执行步骤1301判断第二血氧类型不是重度缺氧或中度缺氧的基础上执行步骤1302中,得到第二血氧类型不是轻度缺氧,则可以得到第二血氧类型可能为正常状态,相对于当前的第一血氧类型指示的轻度缺氧,血氧状态处于恶化的趋势。
步骤1007:判断第一血氧饱和度是否为轻度过氧,若是,则执行轻度过氧下的血氧趋势分析;若否,确定对照血氧分区为治疗目标分区。
在一实施例中,轻度过氧下的血氧趋势分析如图14所示,主要包括如下步骤:
步骤1401:判断第二血氧类型是否为重度过氧或中度过氧,若是,确定当前调节间隔内的血氧变化趋势为血氧好转趋势;若否,执行步骤1402。
步骤1402:判断第二血氧类型是否为轻度过氧,若是,确定当前调节间隔内的血氧变化趋势为血氧稳定趋势;若否,确定当前调节间隔内的血氧变化趋势为血氧恶化趋势。
需要说明的是,在先执行步骤1401判断第二血氧类型不是重度过氧或中度过氧的基础上执行步骤1402中,得到第二血氧类型不是轻度缺氧,则可以得到第二血氧类型可能为正常状态,相对于当前的第一血氧类型指示的轻度缺氧,血氧状态处于恶化的趋势。
基于执行上述图10,以及图11至图14示出的血氧趋势分析得到的血氧变化趋势,根据不同的血氧变化趋势确定不同的调节策略,可以得到以下多种调节策略调节吸入氧气浓度。
在一实施例中,若血氧变化趋势为血氧恶化趋势,基于血氧变化趋势确定对应的调节策略B或C。
其中,需要执行调节策略B的情况为:当前病人的血氧的变化特征为,血氧数据朝偏离治疗目标分区的方向继续变化,但病人的血氧水平不至于过于危险的程度。
调节策略B为:根据处于指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量、上一次调节吸入氧气浓度时的血氧变化率和预设最大单次氧浓度调节量,得到第一氧浓度目标调节量;当第一氧浓度目标调节量小于或等于预设最大单次氧浓度调节量时,以第一氧浓度目标调节量调节吸入氧气浓度;当第一氧浓度目标调节量大于预设最大单次氧浓度调节量时,以预设最大单次氧浓度调节量调节吸入氧气浓度,并将第一氧浓度目标调节量与预设最大单次氧浓度调节量的差值作为剩余调节量,添加至指定血氧分区的累积调节量。
其中,预设最大单次氧浓度调节量可以由医护人员根据病人类型在机器中内置。该预设最大单次氧浓度调节量基于病人类型不同可以对应设置为不同的调节量。
例如,对于新生儿,可选的,设置该预设最大单次氧浓度调节量为3%。对于小儿,可选的,设置该预设最大单次氧浓度调节量为4%。对于成人,可选的,设置该预设最大单次氧浓度调节量为6%。
添加至指定血氧分区的累积调节量则用到计算下一个调节间隔的目标调节量中。即若下一个调节间隔需要调节吸入氧浓度的指定血氧分区中存在累积的调节量,则在下一个调节间隔若还是在该指定血氧分区进行调节,则将该指定血氧分区累积的调节量累加到目标调节量中,基于累加后的目标调节量与预设最大单次氧浓度调节量进行比较。
需要执行调节策略C的情况为:当前病人的血氧变化特征为,血氧数据所在的血氧分区距离治疗目标分区比较远,说明病人目前血氧形势处于不乐观的状态。
调节策略C为:根据预设最大单次氧浓度调节量调节吸入氧气浓度,并变更下一调节间隔的时长为第五时长。该第五时长小于常规调节间隔的时长。
调节策略C采用一个更短的调整间隔按固定的氧浓度调节量调节吸入氧浓度,在病人缺氧或过氧程度较为严重时,可以实现更快速地氧浓度调节。
具体的,根据调节策略B或C调节所述吸入氧气浓度的过程,如图15所 示,包括:
步骤1501:分析血氧恶化趋势的恶化趋势是否为重度缺氧或重度过氧,若是,执行步骤1502;若否,执行步骤1503和1504。
步骤1502:变更当前调节间隔的时长为第五时长,根据预设最大单次氧浓度调节量调节吸入氧气浓度。
步骤1502对应调节策略C。执行调节策略C,基于预设最大单次氧浓度调节量去调节,直到完成目标调节量,或者直至产生新的、更小的目标调节量。
步骤1503:计算处于指定血氧分区的血氧饱和度和治疗目标分区的上限血氧饱和度的差值,得到第一差值。
在步骤1503中,这里处于指定血氧分区的血氧饱和度,即为处于指定血氧分区的血氧数据,该血氧数据可以使用血氧饱和度体现。
需要说明的是,该指定血氧分区是指当前间隔内包含严重度最大的血氧数据的推选血氧分区,该严重度最大的血氧数据是在当前间隔内获取的。
可选的,若治疗目标分区的上限采用血氧数据表示,此时也可以计算处于指定血氧分区的血氧数据和治疗目标分区的上限血氧数据的差值,得到第一差值。
步骤1504:计算第一血氧饱和度和治疗目标分区的下限血氧饱和度的差值,得到第二差值。
步骤1505:根据前一次调节吸入氧气浓度时的血氧变化率、第一差值和第二差值计算,得到第一氧浓度目标调节量。
步骤1506:比较第一氧浓度目标调节量与预设最大单次氧浓度调节量的大小,若第一氧浓度目标调节量大于预设的最大单次氧浓度调节量,执行步骤1507;若第一氧浓度目标调节量不大于预设的最大单次氧浓度调节量,执行步骤1509。
步骤1507:根据预设的最大单次氧浓度调节量调节吸入氧气浓度,并获取第一氧浓度目标调节量减去预设的最大单次氧浓度调节量得到的剩余量。
步骤1508:将剩余量添加至指定血氧分区的累积调节量中。
步骤1508中将剩余量添加至指定血氧分区的累积调整量,方便下一个调 节间隔计算该指定血氧分区的目标调节量时会使用到该指定血氧分区的调节量。
例如,假设根据前一次调节吸入氧气浓度时的血氧变化率、第一差值和第二差值计算,得到第一氧浓度目标调节量为8%,预设最大单次氧浓度调节量为8%,则当前间隔采用5%,剩余量为3%,将该剩余量3%添加至指定血氧分区的累积调节量中。继续下一个调节间隔,此时再计算第一氧浓度目标调节量时,需要累加上一个3%的调节量,若累加后得到的第一氧浓度目标调节量仍然大于预设最大单次氧浓度调节量,继续以预设最大单次氧浓度调节量进行调节,将本次的剩余量添加至指定血氧分区的累积调节量中。以此类推,直至完成调节。
步骤1509:根据第一氧浓度目标调节量调节吸入氧气浓度。
步骤1503至步骤1509对应调节策略B,基于该第一氧浓度目标调节量调节吸入氧气浓度直至完成目标调节量,或者直至产生新的、更小的目标调节量。
需要说明的是,在执行调节策略B计算目标调节量时,在不同的当前间隔的血氧总体分区结果下,用来计算目标调节量的系数也不同。
例如,当前间隔的血氧总体分区为“中度缺氧”时的系数,会比总体分区为“轻度缺氧”时的系数要大,以此获得一个更大的调节量,从而保证在不同程度缺氧或过氧情况下,吸入氧浓度的调节的力度有所不同。
在一实施例中,若所述血氧变化趋势为血氧稳定趋势或血氧好转趋势,基于血氧变化趋势确定对应的调节策略D。
其中,需要执行调节策略D的情况为:病人的血氧数据持续稳定在一个指示当前血氧变化趋势的血氧分区以内,血氧数据保持不变或向治疗目标分区的方向变化,但仍然未处于治疗目标分区之内的情况。
调节策略D为:获取上一次血氧变化趋势为血氧稳定趋势或血氧好转趋势的调节间隔内的调节吸入氧气浓度的调节量,然后在该调节量的基础上增加预设调节量,得到第二氧浓度目标调节量,基于该第二氧浓度目标调节量调节吸入氧气浓度。该第二氧浓度目标调节量不大于预设最低氧浓度调节量。
在调节策略D中,每经历一个血氧变化趋势为血氧稳定趋势或血氧好转趋势的调节间隔,就在上一次同样情况的调节间隔的调节量的基础上累加一个很小的预设调节量,直到累加结果超出预设最低氧浓度调节量。
在本申请实施例中,预设最低氧浓度调节量表示在调节吸入氧浓度时,机器可分辨的最小氧浓度设置值。可选的,该最小氧浓度设置值通常为1%。
可选的,调节策略D中用于累积使用的预设调节量也会根据当前血氧总体分区的不同,而选用不同的大小的调节量。例如,对于血氧长时间处于“轻度缺氧”状态的病人而言,会在每个调节周期累加一个0.5%的调节量;对于血氧长时间处于“中度缺氧”状态的病人而言,会在每个调节周期累加一个0.67%的调节量。
需要说明的是,若在执行调节策略D调节吸入氧浓度时,此时所要调整的指定血氧分区也存在调节策略B中所述的上一调节周期未完成的剩余量,在执行调节策略D时,所累加的调节量会与剩余调节量累加到一起进行吸入氧浓度。
在一实施例中,若所述血氧变化趋势为血氧稳定趋势,基于血氧变化趋势确定对应的调节策略E。
其中,需要执行调节策略E的情况为:病人血氧数据持续稳定在一个指示当前血氧变化趋势的血氧分区以内,但血氧数据向偏离治疗目标分区的方向变化,且仍然未处于治疗目标分区之内的情况。
与上述需要执行调节策略D的情况不同,在执行调节策略E时,病人的血氧数据存在向偏离治疗目标分区的方向继续变化的情况,但由于血氧数据仍然未偏离出当前所处的指定血氧分区,可以确定当前的偏移量较小,但该偏移量可能预示病人的血氧状态会出现进一步恶化的可能,因此执行调节策略E。
调节策略E为:基于处于指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量和指定血氧分区的累积调节量,得到第三氧浓度目标调节量,基于第三氧浓度目标调节量调节吸入氧气浓度。
需要说明的是,该指定血氧分区的累积调节量可能是该指定血氧分区持续 多个调节间隔下累积的调节量。
在一实施例中,若所述血氧变化趋势为血氧稳定趋势,基于血氧变化趋势确定对应的调节策略F或G。
其中,需要执行调节策略F或G的情况为:病人长时间处于治疗目标分区内,病人的血氧数据正常。
此时,对于不同的人群或者特殊场景,病人长时间处于治疗目标分区内,也需要考虑根据病人的血氧数据的变化,确定是否可以减少氧气的使用。
例如,针对新生儿患者,避免出现由于氧浓度过高导致的氧中毒。
例如,转运场景下,可以在保证病人的血氧数据在目标范围的情况下,减少氧气的使用。
例如,通过调节策略F或G的调节,可以降低病人对氧浓度的依赖性,辅助撤机。
具体的,根据调节策略F或G调节吸入氧气浓度的过程,包括:
首先,确定血氧数据在治疗目标分区中所处的区域。
在一实施例中,治疗目标分区的区域至少包括下游区域、中游区域和上游区域;
若第二血氧饱和度处于下游区域,维持当前对所述吸入氧气浓度的调节。
若第二血氧饱和度处于中游区域,执行调节策略F,启动第一计时,当第一计时结束,根据预设最低氧浓度调节量减少吸入氧气浓度。
若第二血氧饱和度处于所述上游区域,执行调节策略G,启动第二计时,当第二计时结束,根据预设最低氧浓度调节量减少吸入氧气浓度。
其中,第二计时大于第一计时。该第一计时和第二计时可以是正计时,也可以是倒计时。
需要说明的是,当病人的血氧数据交替出现在上游区域和中游区域时,则交替使用计时,当病人的血氧数据出现在下游区域时暂停计时。由此,对于血氧数据长期维持在治疗目标分区的中游区域位置的病人,会在观察较长的时间之后才触发减氧。对于血氧数据长期维持在治疗目标分区的上游区域位置的病 人,会缩短其触发减氧的观察时间,从而避免病人血氧数据进一步脱离治疗目标分区的上限。在本发明实施例中,第一计时和第二计时可以由医护人员根据经验进行设置,也可以由医护人员根按照病人类型进行不同的设置。可选的,该第一计时的时长可以设置为90秒。
基于上述本发明实施例公开的多种调节策略调节吸入氧气浓度的过程中,一般情况下,自动调节的吸入氧气浓度是在用户设置的吸入氧气浓度范围中进行调节,即调节结果不会超过用户所设置的范围,但是在某些情况下,用户设置的吸入氧气浓度上限偏低,这时候会导致自动调节功能调节到上限后,病人血氧仍低于目标,此时会越过用户设置的氧浓度上限继续向上调节氧浓度。
在一实施例中,用户可设置自动调节过程中氧浓度的范围,即自动调节氧浓度的结果会保证在所设置的范围内,提高过程安全性。可选的,该吸入氧气浓度范围包括两个值:氧浓度范围下限值、氧浓度范围上限值。
当用户设置了明确的吸入氧气浓度范围后,允许出现自动调节的吸入氧气浓度结果已经调节至氧浓度范围的边界值,但此时病人血氧仍在医生设置的治疗目标范围之外的情况。
需进一步说明的是,当自动调节吸入氧气浓度的结果已到达用户设置的氧浓度范围上限,病人血氧数据仍低于治疗目标分区时,且持续超过第五时长,则提示用户出现上述状态,提示方式包括但不仅限于在用户界面上出现字符串、图形示意、声音的方式。在此状态的基础上,若病人血氧数据继续低于一个阈值,且持续超过一个第六时长,则吸入氧气浓度可以暂时不受用户设置的吸入氧浓度范围上限值的限制继续调节。
同样的,当自动调节吸入氧气浓度的结果已到达用户设置的氧浓度范围下限,病人血氧仍高于治疗目标分区时,且持续超过一个时间阈值,则提示用户该状态,提示方式包括但不仅限于在用户界面上出现字符串、图形示意、声音的方式。
在本申请实施例公开的吸入氧气浓度的调节方法中,通过血氧数据所在血氧分区的血氧状态的严重程度的变化,识别病人血氧状况的严重度,从而在后续执行调节吸入氧气浓度操作时,可以根据血氧分区所对应的血氧状态的严重度的不同决定不同的调节策略,应根据对应的调节策略及时对吸入氧气浓度的 调节。能够实现更加精确、更加快速响应病人血氧发生快速变化时对吸入氧气浓度调整的目的。
基于上述本申请实施例提供的吸入氧气浓度的调节方法,本申请实施例还对应公开一种呼吸支持设备,在一实施例中,该呼吸支持设备可以为呼吸机。
如图16所示,为本申请实施例公开的一种呼吸支持设备的结构示意图。该呼吸支持设备1600包括通气装置1601和处理器1602。
通气装置1601,用于通过一呼吸回路和呼吸附件向病人提供吸入气体,所述吸入气体为含氧气体。该呼吸回路由呼气支路和吸气支路构成。该呼吸附件至少包括气动系统和病人接口,该病人接口多为面罩。具体的,通气装置1601的气动系统一端与处理器1602信号连接,一端通过呼气支路和吸气支路与病人接口相连。
处理器1602与通气装置1601信号连接,以控制该通气装置1601对病人提供的吸入气体的流量。
该处理器1602自身配置有传感器,或者与外部检测设备互联。
该外部检测设备,在一实施例中,可以为脉搏血氧仪、监护仪等。
处理器1602基于自身配置的传感器或者通过互联的外部检测设备获取血氧数据。
该处理器1602,用于确定各个血氧数据各自对应的血氧分区,所述血氧分区基于血氧饱和度预先划分得到。
处理器1602,用于实时获取当前调节间隔的各个血氧数据,确定各个血氧数据各自所处的推选血氧分区。判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,该严重度指所述血氧数据偏离治疗目标分区的程度,该提前触发调节吸入氧气浓度的条件包括严重度趋于提升,该推选血氧分区和治疗目标分区各自对应预先划分的血氧数据范围。
在满足提前触发调节吸入氧气浓度的条件下执行调节吸入氧气浓度操作,否则,正常执行调节吸入氧气浓度操作。
该处理器1602,在一实施例中,可以为上位机,也可以为控制器,也可 以为呼吸机中的控制设备。
可选的,执行调节吸入氧气浓度操作的处理器1602,具体用于:
获取当前调节间隔的指定血氧分区,所述指定血氧分区指当前调节间隔内确定的各个血氧分区中包含严重度最大的血氧数据的推选血氧分区;
基于所述指定血氧分区确定血氧变化趋势,根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度。
可选的,判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件的处理器1602,具体用于:
确定上一调节间隔内对应血氧状态的严重度最大的参考血氧分区,上一调节间隔和当前调节间隔的时长不一定相同。
获取上一调节间隔内包含严重度最大的血氧数据的参考血氧分区,上一调节间隔和当前调节间隔的时长不一定相同。
实时比较当前调节间隔内获取的血氧数据的严重度和参考血氧分区的血氧数据的严重度的大小。
在当前调节间隔的计时结束之前,当前调节间隔内获取的血氧数据的严重度大于参考血氧分区的血氧数据的严重度的个数超过预设个数,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
可选的,判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件的处理器1602,具体用于:
由当前调节间隔的起始时间开始计时,每隔第一时长,判断获取的各个血氧数据对应的血氧数据的严重度是否连续递增,该第一时长小于当前调节间隔的时长。若出现连续递增,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
该处理器1602,还用于:
实时判断所述各个血氧数据在所处的推选血氧分区的持续时长小于等于第二时长的情况是否已持续第三时长,该第三时长大于第二时长,小于等于当前调节间隔的时长。
若已持续第三时长,根据不确定性血氧触发方式对应的调节策略触发调节吸入氧气浓度,否则继续判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件。
可选的,该根据不确定性血氧触发方式对应的调节策略触发调节吸入氧气浓度的处理器1602,具体用于:
累积计算各个推选血氧分区的权值,得到总权值,其中,对应不同血氧数据范围的推选血氧分区具有不同的权值,该权值的大小由血氧数据的严重度的大小确定。
分别将总权值与第一权值阈值、第二权值阈值进行比较,该第一权值阈值用于指示增加氧浓度和第一吸入氧浓度调节量,该第二权值阈值用于指示减少氧浓度和第二吸入氧浓度调节量,所述第一权值阈值大于所述第二权值阈值。
若总权值大于或等于第一权值阈值,确定增加第一吸入氧浓度调节量。
若总权值小于或等于第二权值阈值,确定减少第二吸入氧浓度调节量。
若总权值小于所述第一权值阈值,大于第二权值阈值,确定维持当前吸入氧气浓度的调节量。
该处理器1602,还用于:
在接收到所述获取装置获取的各个血氧数据之后,获取血氧数据中影响血氧可信度的关联数据;判断关联数据是否满足血氧可信度要求;若满足,确定血氧数据对应的血氧分区;若不满足,继续获取血氧数据。
若关联数据至少包括脉率和/或灌注指数和/或血氧信号质量,判断关联数据是否满足预设要求的处理器1602,具体用于:
判断脉率的变化率是否高于脉率变化率阈值;
若脉率的变化率高于脉率变化率阈值,脉率不满足血氧可信度要求,反之,脉率满足血氧可信度要求;和/或,
判断脉率是否低于脉率阈值;
若脉率低于脉率阈值,脉率不满足血氧可信度要求,反之,脉率满足血氧可信度要求;和/或,
判断灌注指数是否低于灌注指数阈值;
若灌注指数低于灌注指数阈值,灌注指数不满足血氧可信度要求,反之,灌注指数满足血氧可信度要求;和/或,
判断血氧信号质量是否低于血氧信号质量阈值;
若血氧信号质量低于血氧信号质量阈值,血氧信号质量不满足血氧可信度要求,反之,血氧信号质量满足血氧可信度要求。
该处理器1602,还用于:
获取系统运行状态,判断系统运行状态是否处于正常运行状态,若系统运行状态处于正常运行状态,继续保持运行状态;若系统运行状态处于异常运行状态,进行报警,使用户优先处理系统运行的问题。
该处理器1602,还用于:
若连续判断关联数据不满足血氧可信度要求,且连续时长超过第四时长,触发获取血氧数据,生成暂停吸入氧气浓度调节的报警信息。
可选的,基于指定血氧分区确定血氧变化趋势的处理器1602,具体用于:
确定指定血氧分区对应的第一血氧类型和参考血氧分区对应的第二血氧类型;
若第一血氧类型为重度缺氧或重度过氧,确定当前调节间隔内的血氧变化趋势为血氧恶化趋势;
若第一血氧类型相对于所述第二血氧类型所指示的血氧类型趋于严重,确定当前调节间隔内的血氧变化趋势为血氧恶化趋势,所述血氧类型至少包括重度缺氧、重度过氧、中度缺氧、中度过氧、轻度缺氧、轻度过氧和正常状态;
若第一血氧类型和所述第二血氧类型一致且均非重度缺氧或重度过氧,确定所述当前调节间隔内的血氧变化趋势为血氧稳定趋势;
若第一血氧类型相对于所述第二血氧类型所指示的血氧类型趋于好转,确定所述当前调节间隔内的血氧变化趋势为血氧好转趋势。
需要说明的是,基于指定血氧分区确定血氧变化趋势的处理器1602,也可以执行上述本发明实施例公开的基于指定血氧分区确定血氧变化趋势的方法。
若所述血氧变化趋势为血氧恶化趋势,基于血氧变化趋势确定对应的调节策略,根据调节策略调节吸入氧气浓度的处理器1602,具体用于:
若血氧恶化趋势偏向于重度缺氧或重度过氧,根据预设最大单次氧浓度调节量调节吸入氧气浓度,并变更下一调节间隔的时长为第五时长,预设最大单次氧浓度调节量基于病人类型不同对应设置为不同的调节量,第五时长小于常规调节间隔的时长;
若血氧恶化趋势未偏向于重度缺氧或重度过氧,根据处于指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量、上一次调节吸入氧气浓度时的血氧变化率和所述预设最大单次氧浓度调节量,得到第一氧浓度目标调节量;
当第一氧浓度目标调节量小于或等于预设最大单次氧浓度调节量时,以第一氧浓度目标调节量调节吸入氧气浓度;
当第一氧浓度目标调节量大于预设最大单次氧浓度调节量时,以预设最大单次氧浓度调节量调节吸入氧气浓度,并将第一氧浓度目标调节量与预设最大单次氧浓度调节量的差值作为剩余调节量,添加至指定血氧分区的累积调节量。
若所述血氧变化趋势为血氧稳定趋势或血氧好转趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度的处理器,具体用于:
若处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量变小或不变,在上一次血氧变化趋势为血氧稳定趋势或血氧好转趋势的调节间隔内的调节吸入氧气浓度的调节量基础上增加预设调节量,得到第二氧浓度目标调节量,基于所述第二氧浓度目标调节量调节吸入氧气浓度,所述第二氧浓度目标调节量不大于预设最低氧浓度调节量。
若血氧变化趋势为血氧稳定趋势,根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度的处理器1602,具体用于:
若处于指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量变大,基于处于指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量和所述指定血氧分区的累积调节量,得到第三氧浓度目标调节量,基于第三氧浓度目标调节量调节吸入氧气浓度。
若血氧变化趋势为血氧稳定趋势,根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度的处理器1602,具体用于:
若血氧数据处于治疗目标分区的血氧数据范围内,确定血氧数据在治疗目标分区中所处的区域,区域至少包括下游区域、中游区域和上游区域;
若血氧数据处于所述下游区域,维持当前对吸入氧气浓度的调节;
若血氧数据处于中游区域,启动第一计时,当第一计时结束,根据预设最低氧浓度调节量调节吸入氧气浓度;
若血氧数据处于所述上游区域,启动第二计时,当第二计时结束,根据预设最低氧浓度调节量调节吸入氧气浓度,第二计时大于第一计时。
基于图16公开的呼吸支持设备,在一实施例中,处理器1602基于自身配置的传感器或者互联的外部检测设备实时获取病人的血氧数据,并根据该血氧数据控制通气装置1601以一固定间隔时间,周期性地执行吸入氧气浓度调节操作,以调节吸入气体中氧浓度。
在具体实现中,处理器1602,用于在当前吸入氧气浓度调节周期内,确定实时获取到的病人的血氧数据对应的血氧分区;该血氧分区为根据血氧饱和度预先划分得到,并包括一治疗目标分区。该治疗目标分区即治疗目标分区,对病人进行治疗时,需要将病人对应的生理参数恢复到或保持在该治疗目标分区,当对应的生理参数处于该治疗目标分区时,可以认为该生理参数处于正常状态。
处理器1602,用于根据病人的实时血氧数据对应的血氧分区确定病人的血氧变化趋势;确定到病人的血氧变化趋势为逐渐偏离该治疗目标分区时,提前执行吸入氧气浓度调节操作,以将该病人的血氧水平调节到治疗目标分区内。
上述本申请实施例公开的呼吸支持设备中的处理器所涉及的技术方案和执行原理,可参见上述本申请实施例公开的吸入氧气浓度的调节方法中相应的部分。同样,上述本申请实施例公开的呼吸支持设备中的通气装置所涉及的吸入氧气浓度调节操作的执行原理,可参见上述本申请实施例公开的吸入氧气浓度的调节方法中公开的吸入氧气浓度调节操作的执行原理。
在本申请实施例公开的呼吸支持设备中,通过血氧数据所在血氧分区的血 氧状态的严重程度的变化,识别病人血氧状况的严重度,从而在后续执行调节吸入氧气浓度操作时,可以根据血氧分区所对应的血氧状态的严重度的不同决定不同的调节策略,应根据对应的调节策略及时对吸入氧气浓度的调节。能够实现更加精确、更加快速响应病人血氧发生快速变化时对吸入氧气浓度调整的目的。
本申请实施例还提供了另外一种吸入氧气浓度的调节方法,该吸入氧气浓度的调节方法同样可以应用于上述本申请实施例公开的呼吸支持设备。如图17所示,该吸入氧气浓度的调节方法,主要包括以下步骤:
步骤1701:以预设的氧浓度气体对患者进行通气。
步骤1702:实时获取血氧数据。
步骤1703:基于实时获取到的血氧数据确定调节吸入氧气浓度操作的触发时刻。
在具体执行步骤1701至步骤1703的过程中,以预设的氧气浓度气体对患者进行通气,在通气的过程中,实时获取血氧数据,然后再对实时获取到的血氧数据进行处理,从而确定患者当前血液中的氧气含量,若实时监测到当前血氧中的氧气含量存在异常的情况,则基于当前获取到的血氧数据确定调节吸入氧气浓度操作的触发时刻。
可选的,基于实时获取到的血氧数据确定当前观察窗内调节吸入氧浓度操作的触发时刻。所述触发时刻位于所述观察窗的最小时长阈值和最大时长阈值之间。
可选的,在当前观察窗内,当基于实时获取到的血氧数据未确定到当前观察窗内调节吸入氧浓度操作的触发时刻,则在当前观察窗到达预设时长时,结束当前观察窗,进入下一观察窗。
在本申请实施例中,该调节吸入氧气浓度操作,可选的,基于当前观察窗内的血氧数据的变化趋势,采用对应的调节策略执行调节吸入氧气浓度操作。
具体的调节策略可参见上述本发明实施例公开的调节策略。
步骤1704:在到达所述触发时刻时,执行吸入氧气浓度的调节,并在调节吸入氧气浓度操作结束后继续实时获取血氧数据并确定调节吸入氧气浓度操作的下一触发时刻。
在执行步骤1704的过程中,可选的,在所述当前观察窗的触发时刻,执行完吸入氧浓度调节操作时,结束当前观察窗,进入下一观察窗,继续实施获取血氧数据并确定调节吸入氧气浓度操作的下一触发时刻。
在另一实施例中,除实施获取血氧数据以外,还获取所述呼吸支持设备的设备运行参数和/或患者的生理参数。
然后,基于实时获取到的血氧数据,以及所述设备运行参数和/或所述病理参数确定当前调节间隔内调节吸入氧气浓度操作的触发时刻。
需要说明的是,患者的生理参数包括但不限于通过脉搏血氧仪、监护仪等监护设备获取。
在另一实施例中,可选的,在实时获取当前调节间隔的各个血氧数据之后,还包括:
确定所述血氧数据和/或所述呼吸支持设备的状态是否满足预设条件。若满足预设条件,暂停吸入氧气浓度调节,执行吸入氧气浓度调节的干预策略和/或干预提示。
其中,干预策略包括:使所述呼吸支持设备维持当前吸入氧气浓度。
或,执行备用氧气浓度。
或,获取用户通过用户界面上显示氧浓度的设置界面输入的氧气浓度。
干预提示包括:输出报警信息,或,输出提示信息。
所述报警信息用于指示所述血氧数据异常、和/或用于指示所述呼吸支持设备异常。
所述提示信息用于指示暂停吸入氧气浓度调节的信息、和/或用于指示所述呼吸支持设备的用户界面上的显示氧浓度的设置界面的状态信息。
在具体实现干预提示的过程中,在呼吸支持设备的信息提示区域上显示用于指示暂停吸入氧气浓度调节的第一指示信息和/或用于指示暂停原因的第二指示信息;
其中,所述信息提示显示区域由一个信息显示区域构成,或由两个独立的信息子显示区域构成,一个信息子显示区域用于显示第一指示信息,另一个信息子显示区域用于显示第二指示信息。
需要说明的是,指示所述呼吸支持设备的用户界面上的显示氧浓度的设置 界面的状态信息,该状态信息包括但不限于显示状态变更信息。
该显示状态变更信息包括但不限于:变更背景颜色,或者,显示提示人工设置信息。
该提示人工设置信息包括字符串和/或文字。
本申请实施例公开的吸入氧气浓度的调节方法,通过实时获取血氧数据,再基于实时获取到的血氧数据确定调节吸入氧气浓度操作的触发时刻,从而达到根据患者当前血液中的氧气含量确定调节吸入氧气浓度操作的触发时刻,从而实现动态的调节吸入氧气浓度。
基于上述本申请实施例提供的吸入氧气浓度的调节方法,本申请实施例还对应公开一种呼吸支持设备,在一实施例中,该呼吸支持设备可以为呼吸机。
该呼吸支持设备包括:通气装置和处理器。
该通气装置,用于通过一呼吸回路和呼吸附件向病人提供吸入气体,所述吸入气体为含氧气体。
该处理器,所述处理器与所述通气装置信号连接,以控制所述通气装置对所述病人提供的吸入气体的流量。
所述处理器还配置为:
以预设的氧浓度气体对患者进行通气;
实时获取血氧数据;
基于实时获取到的血氧数据确定调节吸入氧气浓度操作的触发时刻;
在到达所述触发时刻时,执行吸入氧气浓度的调节,并在调节吸入氧气浓度操作结束后继续实时获取血氧数据并确定调节吸入氧气浓度操作的下一触发时刻。
在一实施例中,所述基于实时获取到的血氧数据确定调节吸入氧气浓度操作的触发时刻的处理器,具体用于:
基于实时获取到的血氧数据确定当前观察窗内调节吸入氧浓度操作的触发时刻。
在一实施例中,所述处理器,还用于:
在所述当前观察窗的触发时刻,执行完吸入氧浓度调节操作时,结束当前 观察窗,进入下一观察窗。
在一实施例中,所述处理器,还用于:
获取所述呼吸支持设备的设备运行参数和/或患者的生理参数;
基于实时获取到的血氧数据,以及所述设备运行参数和/或所述病理参数确定当前调节间隔内调节吸入氧气浓度操作的触发时刻。
在一实施例中,所述处理器,还用于:
实时获取当前调节间隔的各个血氧数据之后,确定所述血氧数据和/或所述呼吸支持设备的状态是否满足预设条件;
若满足预设条件,暂停吸入氧气浓度调节,执行吸入氧气浓度调节的干预策略和/或干预提示;
其中,所述干预策略包括:使所述呼吸支持设备维持当前吸入氧气浓度;
或,执行备用氧气浓度;
或,获取用户通过用户界面上显示氧浓度的设置界面输入的氧气浓度;
所述干预提示包括:输出报警信息,或,输出提示信息;
所述报警信息用于指示所述血氧数据异常、和/或用于指示所述呼吸支持设备异常;
所述提示信息用于指示暂停吸入氧气浓度调节的信息、和/或用于指示所述呼吸支持设备的用户界面上的显示氧浓度的设置界面的状态信息。
需要说明的是,本申请实施例公开的该呼吸支持设备同样可执行前述图1公开的吸入氧气浓度的调节方法。
本发明各个实施例采用递进的方式描述,每个实施例重点说明的都是与其他实施例的不同之处,各个实施例之间相同相似部分互相参见即可。对于实施例公开的装置而言,由于其与实施例公开的方法相对应,所以描述的比较简单,相关之处参见方法部分说明即可。
对所公开的实施例的上述说明,使本领域专业技术人员能够实现或使用本发明。对这些实施例的多种修改对本领域的专业技术人员来说将是显而易见的,本文中所定义的一般原理可以在不脱离本发明的精神或范围的情况下,在其它实施例中实现。因此,本发明将不会被限制于本文所示的这些实施例,而是要符合与本文所公开的原理和新颖特点相一致的最宽的范围。
对所公开的实施例的上述说明,使本领域技术人员能够实现或使用本发明。对这些实施例的多种修改对本领域技术人员来说将是显而易见的,本文中所定义的一般原理可以在不脱离本发明的精神或范围的情况下,在其它实施例中实现。因此,本发明将不会被限制于本文所示的这些实施例,而是要符合与本文所公开的原理和新颖特点相一致的最宽的范围。
以上所述仅是本发明的优选实施方式,应当指出,对于本技术领域的普通技术人员来说,在不脱离本发明原理的前提下,还可以做出若干改进和润饰,这些改进和润饰也应视为本发明的保护范围。
Claims (48)
- 一种吸入氧气浓度的调节方法,应用于呼吸支持设备,其特征在于,所述调节方法包括:以预设的氧浓度气体对患者进行通气;实时获取血氧数据;基于实时获取到的血氧数据确定调节吸入氧气浓度操作的触发时刻;在到达所述触发时刻时,执行吸入氧气浓度的调节,并在调节吸入氧气浓度操作结束后继续实时获取血氧数据并确定调节吸入氧气浓度操作的下一触发时刻。
- 根据权利要求1所述的方法,其特征在于,所述基于实时获取到的血氧数据确定调节吸入氧气浓度操作的触发时刻,包括:基于实时获取到的血氧数据确定当前观察窗内调节吸入氧浓度操作的触发时刻。
- 根据权利要求2所述的方法,其特征在于,还包括:在所述当前观察窗的触发时刻,执行完吸入氧浓度调节操作时,结束当前观察窗,进入下一观察窗。
- 根据权利要求2所述的方法,其特征在于,还包括:在所述当前观察窗内,当基于实时获取到的血氧数据未确定到当前观察窗内调节吸入氧浓度操作的触发时刻,则在当前观察窗到达预设时长时,结束当前观察窗,进入下一观察窗。
- 根据权利要求2所述的方法,其特征在于,所述触发时刻位于所述观察窗的最小时长阈值和最大时长阈值之间。
- 根据权利要求1至5中任一项所述的方法,其特征在于,还包括:获取所述呼吸支持设备的设备运行参数和/或患者的生理参数;基于实时获取到的血氧数据,以及所述设备运行参数和/或所述病理参数确定当前调节间隔内调节吸入氧气浓度操作的触发时刻。
- 根据权利要求1至6中任一项所述的方法,其特征在于,所述实时获取当前调节间隔的各个血氧数据之后,还包括:确定所述血氧数据和/或所述呼吸支持设备的状态是否满足预设条件;若满足预设条件,暂停吸入氧气浓度调节,执行吸入氧气浓度调节的干预策略和/或干预提示。
- 根据权利要求7所述的方法,其特征在于,所述干预策略包括:使所述呼吸支持设备维持当前吸入氧气浓度;或,执行备用氧气浓度;或,获取用户通过用户界面上显示氧浓度的设置界面输入的氧气浓度;所述干预提示包括:输出报警信息,或,输出提示信息;所述报警信息用于指示所述血氧数据异常、和/或用于指示所述呼吸支持设备异常;所述提示信息用于指示暂停吸入氧气浓度调节的信息、和/或用于指示所述呼吸支持设备的用户界面上的显示氧浓度的设置界面的状态信息。
- 一种吸入氧气浓度的调节方法,应用于呼吸支持设备,其特征在于,所述调节方法包括:实时获取当前调节间隔的各个血氧数据,确定各个血氧数据各自所处的推选血氧分区;判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,所述严重度指所述血氧数据偏离治疗目标分区的程度,所述提前触发调节吸入氧气浓度的条件包括所述严重度趋于提升,所述推选血氧分区和所述治疗目标分区各自对应预先划分的血氧数据范围;在满足提前触发调节吸入氧气浓度的条件下提前执行调节吸入氧气浓度操作,否则,在所述当前调节间隔的计时结束后,正常执行调节吸入氧气浓度操作。
- 根据权利要求9所述的方法,其特征在于,所述判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,包括:获取上一调节间隔内包含严重度最大的血氧数据的参考血氧分区,所述上一调节间隔和所述当前调节间隔的时长不一定相同;实时比较当前调节间隔内获取的血氧数据的严重度和所述参考血氧分区的血氧数据的严重度的大小;在当前调节间隔的计时结束之前,当前调节间隔内获取的血氧数据的严重度大于所述参考血氧分区的血氧数据的严重度的个数超过预设个数,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
- 根据权利要求9所述的方法,其特征在于,所述判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,包括:由当前调节间隔的起始时间开始计时,每隔第一时长,判断获取的各个血氧数据的严重度是否连续递增,所述第一时长小于所述当前调节间隔的时长;若出现连续递增,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
- 根据权利要求9至11中任一项所述的方法,其特征在于,还包括:实时判断所述各个血氧数据在所处的所述推选血氧分区的持续时长小于等于第二时长的情况是否已持续第三时长,所述第三时长大于所述第二时长,小于等于当前调节间隔的时长;若已持续第三时长,根据不确定性血氧触发方式对应的调节策略提前触发调节吸入氧气浓度,否则继续判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件。
- 根据权利要求9至12中任一项所述的方法,其特征在于,所述实时获取当前调节间隔的各个血氧数据之后,还包括:获取所述血氧数据中影响血氧可信度的关联数据;判断所述关联数据是否满足血氧可信度要求;若满足,执行确定所述血氧数据对应的血氧分区这一步骤;若不满足,继续获取血氧数据。
- 根据权利要求13所述的方法,其特征在于,若所述关联数据至少包括脉率和/或灌注指数和/或血氧信号质量,所述判断所述关联数据是否满足预设要求,包括:判断所述脉率的变化率是否高于脉率变化率阈值;若所述脉率的变化率高于脉率变化率阈值,所述脉率不满足血氧可信度要求,反之,所述脉率满足血氧可信度要求;和/或,判断所述脉率是否低于脉率阈值;若所述脉率低于脉率阈值,所述脉率不满足血氧可信度要求,反之,所述脉率满足血氧可信度要求;和/或,判断所述灌注指数是否低于灌注指数阈值;若所述灌注指数低于灌注指数阈值,所述灌注指数不满足血氧可信度要求,反之,所述灌注指数满足血氧可信度要求;和/或,判断所述血氧信号质量是否低于血氧信号质量阈值;若所述血氧信号质量低于血氧信号质量阈值,所述血氧信号质量不满足血氧可信度要求,反之,所述血氧信号质量满足血氧可信度要求。
- 根据权利要求13或14所述的方法,其特征在于,还包括:若连续判断所述关联数据不满足血氧可信度要求,且连续时长超过第四时长,生成暂停吸入氧气浓度调节的报警信息。
- 根据权利要求15所述的方法,其特征在于,还包括:基于系统操作界面上显示的报警字符串和/或报警音,提示用户当前吸入氧气浓度自动调节处于暂停状态;和/或,所述执行报警提示包括:基于使用所述关联数据的判断结果提示暂停吸入氧气浓度调节的原因。
- 根据权利要求15所述的方法,其特征在于,还包括:授权或启动用户手动设置吸入氧气浓度的操作;在所述血氧数据恢复可信之后,将所述用户手动设置的新的吸入氧气浓度作为控制值,并基于所述控制值,执行实时获取当前调节间隔的各个血氧数据这一步骤。
- 根据权利要求9至15中任一项所述的方法,其特征在于,所述调节吸入氧气浓度操作包括:获取当前调节间隔的指定血氧分区,所述指定血氧分区指当前调节间隔内确定的各个血氧分区中包含严重度最大的血氧数据的推选血氧分区;基于所述指定血氧分区确定血氧变化趋势,根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度。
- 根据权利要求18所述的方法,其特征在于,所述基于所述指定血氧分区确定血氧变化趋势,包括:获取所述指定血氧分区和上一调节间隔内包含严重度最大的血氧数据的参考血氧分区;比较处于所述指定血氧分区内的血氧数据的严重度和所述参考血氧分区所包含的严重度最大的血氧数据的严重度;若处于所述指定血氧分区内的血氧数据的严重度相对于所述参考血氧分区所包含的严重度最大的血氧数据的严重度趋于提升,确定所述当前调节间隔内的血氧变化趋势为血氧恶化趋势;若处于所述指定血氧分区所内的血氧数据的严重度相对于所述参考血氧分区所包含的严重度最大的血氧数据的严重度趋于降低,确定所述当前调节间隔内的血氧变化趋势为血氧好转趋势;若处于所述指定血氧分区内的血氧数据的严重度和所述参考血氧分区所包含的严重度最大的血氧数据的严重度一致,且所述指定血氧分区和所述参考血氧分区所对应的血氧类型为非重度缺氧或重度过氧,确定所述当前调节间隔内的血氧变化趋势为血氧稳定趋势;所述血氧类型至少包括重度缺氧、重度过氧、中度缺氧、中度过氧、轻度缺氧、轻度过氧和正常状态。
- 根据权利要求19所述的方法,其特征在于,若所述血氧变化趋势为血氧恶化趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度,包括:若所述血氧恶化趋势偏向于重度缺氧或重度过氧,根据预设最大单次氧浓度调节量调节吸入氧气浓度,并变更下一调节间隔的时长为第五时长,所述预设最大单次氧浓度调节量基于病人类型不同对应设置为不同的调节量,所述第五时长小于常规调节间隔的时长;若所述血氧恶化趋势未偏向于重度缺氧或重度过氧,根据处于所述指定血 氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量、上一次调节吸入氧气浓度的氧浓度变化率和所述预设最大单次氧浓度调节量,得到第一氧浓度目标调节量;当所述第一氧浓度目标调节量小于或等于所述预设最大单次氧浓度调节量时,以所述第一氧浓度目标调节量调节吸入氧气浓度;当所述第一氧浓度目标调节量大于所述预设最大单次氧浓度调节量时,以所述预设最大单次氧浓度调节量调节吸入氧气浓度,并将所述第一氧浓度目标调节量与所述预设最大单次氧浓度调节量的差值作为剩余调节量,添加至所述指定血氧分区的累积调节量中。
- 根据权利要求19所述的方法,其特征在于,若所述血氧变化趋势为血氧稳定趋势或血氧好转趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度,包括:若处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量变小或不变,在上一次血氧变化趋势为血氧稳定趋势或血氧好转趋势的调节间隔内的调节吸入氧气浓度的调节量基础上增加预设调节量,得到第二氧浓度目标调节量,基于所述第二氧浓度目标调节量调节吸入氧气浓度,所述第二氧浓度目标调节量不大于预设最低氧浓度调节量。
- 根据权利要求19所述的方法,其特征在于,若所述血氧变化趋势为血氧稳定趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度,包括:若处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量变大,基于处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量和所述指定血氧分区的累积调节量,得到第三氧浓度目标调节量,基于所述第三氧浓度目标调节量调节吸入氧气浓度。
- 根据权利要求19所述的方法,其特征在于,若所述血氧变化趋势为血氧稳定趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度,包括:若所述处于所述指定血氧分区的血氧数据处于所述治疗目标分区的血氧 数据范围内,确定所述血氧数据在治疗目标分区中所处的区域,所述区域至少包括下游区域、中游区域和上游区域;若所述血氧数据处于所述下游区域,维持当前对所述吸入氧气浓度的调节;若所述血氧数据处于所述中游区域,启动第一计时,当所述第一计时结束,根据预设最低氧浓度调节量调节吸入氧气浓度;若所述血氧数据处于所述上游区域,启动第二计时,当所述第二计时结束,根据预设最低氧浓度调节量调节吸入氧气浓度,所述第二计时大于第一计时。
- 根据权利要求9所述的方法,其特征在于,还包括:当执行调节吸入氧气浓度的结果到达用户设置的氧浓度范围上限,且患者血氧数据低于所述治疗目标分区所指示的血氧数据的时长超过第五时长时,执行状态提示,所述状态提示至少包括:在所述呼吸支持设备的用户界面上预先划分的状态提示区域显示用于指示患者血氧数据低的状态提示信息,所述状态提示信息至少包括字符串、文字、图像和/或声音;在执行所述状态提示之后,所述患者血氧数据低于所述治疗目标分区所指示的血氧数据的时长超过第六时长时,继续执行调节吸入氧气浓度的操作;或者,当执行调节吸入氧气浓度的结果到达用户设置的氧浓度范围下限,且患者血氧数据高于所述治疗目标分区所指示的血氧数据的时长超过第五时长时,执行状态提示,所述状态提示至少包括:在所述呼吸支持设备的用户界面上预先划分的状态提示区域显示用于指示患者血氧数据高的状态提示信息,所述状态提示信息至少包括字符串、文字、图像和/或声音;在执行所述状态提示之后,所述患者血氧数据高于所述治疗目标分区所指示的血氧数据的时长超过第六时长时,继续执行调节吸入氧气浓度的操作。
- 一种呼吸支持设备,其特征在于,包括:通气装置,所述通气装置用于通过一呼吸回路和呼吸附件向病人提供吸入气体,所述吸入气体为含氧气体;处理器,所述处理器与所述通气装置信号连接,以控制所述通气装置对所述病人提供的吸入气体的流量;所述处理器还配置为:以预设的氧浓度气体对患者进行通气;实时获取血氧数据;基于实时获取到的血氧数据确定调节吸入氧气浓度操作的触发时刻;在到达所述触发时刻时,执行吸入氧气浓度的调节,并在调节吸入氧气浓度操作结束后继续实时获取血氧数据并确定调节吸入氧气浓度操作的下一触发时刻。
- 根据权利要求25所述的设备,其特征在于,所述基于实时获取到的血氧数据确定调节吸入氧气浓度操作的触发时刻的处理器,具体用于:基于实时获取到的血氧数据确定当前观察窗内调节吸入氧浓度操作的触发时刻。
- 根据权利要求26所述的设备,其特征在于,所述处理器,还用于:在所述当前观察窗的触发时刻,执行完吸入氧浓度调节操作时,结束当前观察窗,进入下一观察窗。
- 根据权利要求26所述的设备,其特征在于,所述处理器,还用于:在所述当前观察窗内,当基于实时获取到的血氧数据未确定到当前观察窗内调节吸入氧浓度操作的触发时刻,则在当前观察窗到达预设时长时,结束当前观察窗,进入下一观察窗。
- 根据权利要求26所述的设备,其特征在于,所述触发时刻位于所述观察窗的最小时长阈值和最大时长阈值之间。
- 根据权利要求25所述的设备,其特征在于,所述处理器,还用于:获取所述呼吸支持设备的设备运行参数和/或患者的生理参数;基于实时获取到的血氧数据,以及所述设备运行参数和/或所述病理参数确定当前调节间隔内调节吸入氧气浓度操作的触发时刻。
- 根据权利要求25所述的设备,其特征在于,所述处理器,还用于:实时获取当前调节间隔的各个血氧数据之后,确定所述血氧数据和/或所述呼吸支持设备的状态是否满足预设条件;若满足预设条件,暂停吸入氧气浓度调节,执行吸入氧气浓度调节的干预 策略和/或干预提示;其中,所述干预策略包括:使所述呼吸支持设备维持当前吸入氧气浓度;或,执行备用氧气浓度;或,获取用户通过用户界面上显示氧浓度的设置界面输入的氧气浓度;所述干预提示包括:输出报警信息,或,输出提示信息;所述报警信息用于指示所述血氧数据异常、和/或用于指示所述呼吸支持设备异常;所述提示信息用于指示暂停吸入氧气浓度调节的信息、和/或用于指示所述呼吸支持设备的用户界面上的显示氧浓度的设置界面的状态信息。
- 一种呼吸支持设备,其特征在于,包括:通气装置,所述通气装置用于通过一呼吸回路和呼吸附件向病人提供吸入气体,所述吸入气体为含氧气体;处理器,所述处理器与所述通气装置信号连接,以控制所述通气装置对所述病人提供的吸入气体的流量;所述处理器还配置为:实时获取当前调节间隔的各个血氧数据,确定各个血氧数据各自所处的推选血氧分区;判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件,所述严重度指所述血氧数据偏离治疗目标分区的程度,所述提前触发调节吸入氧气浓度的条件包括所述严重度趋于提升,所述推选血氧分区和所述治疗目标分区各自对应预先划分的血氧数据范围;在满足提前触发调节吸入氧气浓度的条件下执行调节吸入氧气浓度操作,否则,正常执行调节吸入氧气浓度操作。
- 根据权利要求32所述的设备,其特征在于,所述判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件的处理器,具体用于:获取上一调节间隔内包含严重度最大的血氧数据的参考血氧分区,所述上一调节间隔和所述当前调节间隔的时长不一定相同;实时比较当前调节间隔内获取的血氧数据的严重度和所述参考血氧分区的血氧数据的严重度的大小;在当前调节间隔的计时结束之前,当前调节间隔内获取的血氧数据的严重度大于所述参考血氧分区的血氧数据的严重度的个数超过预设个数,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
- 根据权利要求33所述的设备,其特征在于,所述判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件的处理器,具体用于:由当前调节间隔的起始时间开始计时,每隔第一时长,判断获取的各个血氧数据对应的血氧数据的严重度是否连续递增,所述第一时长小于所述当前调节间隔的时长;若出现连续递增,满足提前触发调节吸入氧气浓度的条件,否则,不满足提前触发调节吸入氧气浓度的条件。
- 根据权利要求32至34中任一项所述的设备,其特征在于,所述处理器,还用于:实时判断所述各个血氧数据在所处的所述推选血氧分区的持续时长小于等于第二时长的情况是否已持续第三时长,所述第三时长大于所述第二时长,小于等于当前调节间隔的时长;若已持续第三时长,根据不确定性血氧触发方式对应的调节策略触发调节吸入氧气浓度,否则继续判断各个血氧数据的严重度是否满足提前触发调节吸入氧气浓度的条件。
- 根据权利要求32至35中任一项所述的设备,其特征在于,所述处理器,还用于:在接收到所述获取装置获取的各个血氧数据之后,获取所述血氧数据中影响血氧可信度的关联数据;判断所述关联数据是否满足血氧可信度要求;若满足,确定所述血氧数据对应的血氧分区;若不满足,继续获取血氧数据。
- 根据权利要求36所述的设备,其特征在于,若所述关联数据至少包括脉率和/或灌注指数和/或血氧信号质量,所述判断所述关联数据是否满足预设要求的处理器,具体用于:判断所述脉率的变化率是否高于脉率变化率阈值;若所述脉率的变化率高于脉率变化率阈值,所述脉率不满足血氧可信度要求,反之,所述脉率满足血氧可信度要求;和/或,判断所述脉率是否低于脉率阈值;若所述脉率低于脉率阈值,所述脉率不满足血氧可信度要求,反之,所述脉率满足血氧可信度要求;和/或,判断所述灌注指数是否低于灌注指数阈值;若所述灌注指数低于灌注指数阈值,所述灌注指数不满足血氧可信度要求,反之,所述灌注指数满足血氧可信度要求;和/或,判断所述血氧信号质量是否低于血氧信号质量阈值;若所述血氧信号质量低于血氧信号质量阈值,所述血氧信号质量不满足血氧可信度要求,反之,所述血氧信号质量满足血氧可信度要求。
- 根据权利要求36或37所述的设备,其特征在于,所述处理器,还用于:若连续判断所述关联数据不满足血氧可信度要求,且连续时长超过第四时长,生成暂停吸入氧气浓度调节的报警信息。
- 根据权利要求38所述的设备,其特征在于,所述处理器,还用于:基于系统操作界面上显示的报警字符串和/或报警音,提示用户当前吸入氧气浓度自动调节处于暂停状态;和/或,所述执行报警提示的处理器,具体用于:基于使用所述关联数据的判断结果提示暂停吸入氧气浓度调节的原因。
- 根据权利要求38所述的设备,其特征在于,所述处理器,还用于:执行报警提示之后,授权或启动用户手动设置吸入氧气浓度的操作;在所述血氧数据恢复可信之后,将所述用户手动设置的新的吸入氧气浓度作为控制值,并基于所述控制值,执行实时获取当前调节间隔的各个血氧数据。
- 根据权利要求32至38中任一项所述的设备,其特征在于,所述执行调节吸入氧气浓度操作的处理器,具体用于:获取当前调节间隔的指定血氧分区,所述指定血氧分区指当前调节间隔内 确定的各个血氧分区中包含严重度最大的血氧数据的推选血氧分区;基于所述指定血氧分区确定血氧变化趋势,根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度。
- 根据权利要求41所述的设备,其特征在于,所述基于所述指定血氧分区确定血氧变化趋势的处理器,具体用于:确定所述指定血氧分区对应的第一血氧类型和所述参考血氧分区对应的第二血氧类型;若所述第一血氧类型为重度缺氧或重度过氧,确定所述当前调节间隔内的血氧变化趋势为血氧恶化趋势;若所述第一血氧类型相对于所述第二血氧类型所指示的血氧类型趋于严重,确定所述当前调节间隔内的血氧变化趋势为血氧恶化趋势,所述血氧类型至少包括重度缺氧、重度过氧、中度缺氧、中度过氧、轻度缺氧、轻度过氧和正常状态;若所述第一血氧类型和所述第二血氧类型一致且均非重度缺氧或重度过氧,确定所述当前调节间隔内的血氧变化趋势为血氧稳定趋势;若所述第一血氧类型相对于所述第二血氧类型所指示的血氧类型趋于好转,确定所述当前调节间隔内的血氧变化趋势为血氧好转趋势。
- 根据权利要求42所述的设备,其特征在于,若所述血氧变化趋势为血氧恶化趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度的处理器,具体用于:若所述血氧恶化趋势偏向于重度缺氧或重度过氧,根据预设最大单次氧浓度调节量调节吸入氧气浓度,并变更下一调节间隔的时长为第五时长,所述预设最大单次氧浓度调节量基于病人类型不同对应设置为不同的调节量,所述第五时长小于常规调节间隔的时长;若所述血氧恶化趋势未偏向于重度缺氧或重度过氧,根据处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量、上一次调节吸入氧气浓度时的血氧变化率和所述预设最大单次氧浓度调节量,得到第一氧浓度目标调节量;当所述第一氧浓度目标调节量小于或等于所述预设最大单次氧浓度调节量时,以所述第一氧浓度目标调节量调节吸入氧气浓度;当所述第一氧浓度目标调节量大于所述预设最大单次氧浓度调节量时,以所述预设最大单次氧浓度调节量调节吸入氧气浓度,并将所述第一氧浓度目标调节量与所述预设最大单次氧浓度调节量的差值作为剩余调节量,添加至所述指定血氧分区的累积调节量。
- 根据权利要求42所述的设备,其特征在于,若所述血氧变化趋势为血氧稳定趋势或血氧好转趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度的处理器,具体用于:若处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量变小或不变,在上一次血氧变化趋势为血氧稳定趋势或血氧好转趋势的调节间隔内的调节吸入氧气浓度的调节量基础上增加预设调节量,得到第二氧浓度目标调节量,基于所述第二氧浓度目标调节量调节吸入氧气浓度,所述第二氧浓度目标调节量不大于预设最低氧浓度调节量。
- 根据权利要求42所述的设备,其特征在于,若所述血氧变化趋势为血氧稳定趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度的处理器,具体用于:若处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量变大,基于处于所述指定血氧分区的血氧数据偏移治疗目标分区的上下血氧数据边界的偏移量和所述指定血氧分区的累积调节量,得到第三氧浓度目标调节量,基于所述第三氧浓度目标调节量调节吸入氧气浓度。
- 根据权利要求42所述的设备,其特征在于,若所述血氧变化趋势为血氧稳定趋势,所述根据所述血氧变化趋势对应的调节策略调节吸入氧气浓度的处理器,具体用于:若血氧数据处于所述治疗目标分区的血氧数据范围内,确定所述血氧数据在治疗目标分区中所处的区域,所述区域至少包括下游区域、中游区域和上游区域;若所述血氧数据处于所述下游区域,维持当前对所述吸入氧气浓度的调节;若所述血氧数据处于所述中游区域,启动第一计时,当所述第一计时结束,根据预设最低氧浓度调节量调节吸入氧气浓度;若所述血氧数据处于所述上游区域,启动第二计时,当所述第二计时结束,根据预设最低氧浓度调节量调节吸入氧气浓度,所述第二计时大于第一计时。
- 根据权利要求32所述的设备,其特征在于,所述处理器,还用于:当执行调节吸入氧气浓度的结果到达用户设置的氧浓度范围上限,且患者血氧数据低于所述治疗目标分区所指示的血氧数据的时长超过第五时长时,执行状态提示,所述状态提示至少包括:在所述呼吸支持设备的用户界面上预先划分的状态提示区域显示用于指示患者血氧数据低的状态提示信息,所述状态提示信息至少包括字符串、文字、图像和/或声音;在执行所述状态提示之后,所述患者血氧数据低于所述治疗目标分区所指示的血氧数据的时长超过第六时长时,继续执行调节吸入氧气浓度的操作;或者,当执行调节吸入氧气浓度的结果到达用户设置的氧浓度范围下限,且患者血氧数据高于所述治疗目标分区所指示的血氧数据的时长超过第五时长时,执行状态提示,所述状态提示至少包括:在所述呼吸支持设备的用户界面上预先划分的状态提示区域显示用于指示患者血氧数据高的状态提示信息,所述状态提示信息至少包括字符串、文字、图像和/或声音;在执行所述状态提示之后,所述患者血氧数据高于所述治疗目标分区所指示的血氧数据的时长超过第六时长时,继续执行调节吸入氧气浓度的操作。
- 一种呼吸支持设备,其特征在于,包括:通气装置,所述通气装置用于通过一呼吸回路和呼吸附件向病人提供吸入气体,所述吸入气体为含氧气体;处理器,所述处理器与所述通气装置信号连接,以控制所述通气装置对所述病人提供的吸入气体的流量;以及,实时获取所述病人的血氧数据,并根据所述血氧数据控制所述通气装置以一固定间隔时间,周期性地执行吸入氧气浓度调节操作,以调节所述吸入气体中氧浓度;所述处理器还配置为:在当前吸入氧气浓度调节周期内,确定所述实时获取到的所述病人的血氧数据对应的血氧分区;所述血氧分区为根据血氧饱和度预先划分得到,并包括一治疗目标分区;根据所述病人的实时血氧数据对应的血氧分区确定所述病人的血氧变化趋势;确定到所述病人的血氧变化趋势为偏离所述治疗目标分区时,提前执行吸入氧气浓度调节操作,以将所述病人的血氧水平调节到所述治疗目标分区内。
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| CN116249482B (zh) | 2025-08-08 |
| CN120884783A (zh) | 2025-11-04 |
| CN116249482A (zh) | 2023-06-09 |
| WO2022016428A1 (zh) | 2022-01-27 |
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