WO2022105586A1 - Medical device system and ventilation treatment assistance device - Google Patents

Medical device system and ventilation treatment assistance device Download PDF

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Publication number
WO2022105586A1
WO2022105586A1 PCT/CN2021/128001 CN2021128001W WO2022105586A1 WO 2022105586 A1 WO2022105586 A1 WO 2022105586A1 CN 2021128001 W CN2021128001 W CN 2021128001W WO 2022105586 A1 WO2022105586 A1 WO 2022105586A1
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Prior art keywords
ventilation
parameter
oxygenation
comparison result
index
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PCT/CN2021/128001
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French (fr)
Chinese (zh)
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王慧华
潘瑞玲
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深圳迈瑞生物医疗电子股份有限公司
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Priority to CN202180078228.0A priority Critical patent/CN116685368A/en
Publication of WO2022105586A1 publication Critical patent/WO2022105586A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10Preparation of respiratory gases or vapours
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10Preparation of respiratory gases or vapours
    • A61M16/12Preparation of respiratory gases or vapours by mixing different gases

Definitions

  • the invention relates to the technical field of medical equipment, in particular to a medical equipment system and an auxiliary device for ventilation therapy.
  • an auxiliary device for ventilation therapy including:
  • a parameter acquisition device used for acquiring physiological parameters and ventilation parameters of a patient in ventilation therapy
  • the processor is configured to start timing the ventilation treatment under the current ventilation strategy of the patient when it is detected that the timing condition is met, obtain the ventilation treatment time according to the timing, and generate an oxygenation corresponding to the ventilation treatment time according to the physiological parameters and the ventilation parameters Respiratory index, the oxygenation respiratory index is used to evaluate the ventilation treatment effect within the corresponding ventilation treatment time;
  • a comparison result between the oxygenation breathing index and at least one first oxygenation breathing index threshold value is obtained, and the ventilation parameter and at least one oxygenation breathing index are obtained.
  • a first ventilation parameter comparison result of the first ventilation parameter threshold obtaining the first physiological parameter comparison result of the physiological parameter and at least one first physiological parameter threshold;
  • a corresponding first treatment suggestion is output.
  • an auxiliary device for ventilation therapy including:
  • a parameter acquisition device used for acquiring physiological parameters and ventilation parameters of a patient in ventilation therapy
  • the processor is configured to start timing the ventilation treatment under the current ventilation strategy of the patient when it is detected that the timing condition is met, obtain the ventilation treatment time according to the timing, and generate an oxygenation corresponding to the ventilation treatment time according to the physiological parameters and the ventilation parameters Respiratory index, the oxygenation respiratory index is used to evaluate the ventilation treatment effect within the corresponding ventilation treatment time;
  • the oxygenation respiration index is compared with the oxygenation respiration index threshold to obtain the oxygenation respiration index comparison result
  • the physiological parameter is compared with the physiological parameter threshold to obtain the physiological parameter Compare the result, compare the ventilation parameter with the ventilation parameter threshold, obtain the ventilation parameter comparison result, and obtain the ventilation parameter comparison result according to the oxygenation respiration index comparison result, the physiological parameter comparison result and the ventilation parameter comparison result Output disposition recommendations.
  • an embodiment provides a medical device system, comprising:
  • Respiratory support equipment to provide ventilation therapy to patients
  • a display device for displaying treatment suggestions output by the ventilation therapy aid device.
  • an embodiment provides a medical device system, comprising:
  • a plurality of medical devices at least one of the plurality of medical devices has a parameter acquisition device, and the parameter acquisition device is used to obtain the physiological parameters and ventilation parameters of the patient during the ventilation treatment;
  • At least one medical device in the plurality of medical devices is used to start timing the ventilation treatment under the patient's current ventilation strategy when it is detected that the timing condition is met, obtain the ventilation treatment time according to the timing, and generate a ventilation treatment time according to the physiological parameter and the ventilation parameter.
  • the oxygenation respiration index corresponding to the ventilation treatment time, the oxygenation respiration index is used to evaluate the ventilation treatment effect within the corresponding ventilation treatment time;
  • the oxygenation respiration index is compared with the oxygenation respiration index threshold to obtain the oxygenation respiration index comparison result
  • the physiological parameter is compared with the physiological parameter threshold to obtain the physiological parameter Compare the result, compare the ventilation parameter with the ventilation parameter threshold, obtain the ventilation parameter comparison result, and obtain the ventilation parameter comparison result according to the oxygenation respiration index comparison result, the physiological parameter comparison result and the ventilation parameter comparison result Output disposition recommendations.
  • the physiological parameters and the ventilation parameters are combined to generate a new parameter for comprehensively judging or presetting the effectiveness of ventilation therapy: the oxygenation breathing index.
  • the oxygenation breathing index After comparing the oxygenation breathing index, physiological parameters and ventilation parameters with the corresponding thresholds, it can provide users with corresponding ventilation treatment suggestions, so as to help medical staff judge or predict the ventilation effect, and prompt medical staff to switch the ventilation treatment mode in time to shorten the time. The effect of patient on-board time and improved prognosis.
  • FIG. 1 is a schematic diagram of a medical device system according to an embodiment
  • FIG. 2 is a schematic diagram of giving different treatment suggestions in different situations by an auxiliary ventilation therapy device according to an embodiment.
  • connection and “connection” mentioned in this application, unless otherwise specified, include both direct and indirect connections (connections).
  • a medical equipment system including a respiratory support device 10 , a ventilation therapy auxiliary device 20 and a display device 30 , and the respiratory support device 10 is used to provide ventilation therapy for a patient
  • Ventilation therapy refers to providing respiratory support for patients by means of mechanical ventilation.
  • the respiratory support device 10 may be a ventilator, an anesthesia machine, an oxygen therapy apparatus, and the like.
  • the ventilation strategy includes at least one of a ventilation mode and a ventilation mode. The ventilation mode can be changed while maintaining the current ventilation mode, or the ventilation mode can be changed and the ventilation mode can be changed.
  • the ventilation mode includes but Not limited to conventional (low-flow) oxygen therapy, high-flow oxygen therapy, non-invasive ventilation, invasive ventilation, high-frequency ventilation and ECMO
  • ventilation modes include but are not limited to continuous positive airway pressure, volume-controlled ventilation , Pressure Controlled Ventilation, Pressure Support Ventilation, Biphasic Positive Airway Pressure, Bilevel Positive Airway Pressure, Airway Pressure Release Ventilation, Pressure Modulation Volume Controlled Ventilation, Volume Support Ventilation, Synchronized Intermittent Mandatory Ventilation, Volume Guaranteed Pressure Support ventilation as well as closed-loop ventilation.
  • the above ventilation modes and ventilation modes are common in the art, and those skilled in the art can determine the specific meanings of each ventilation mode and ventilation mode without any doubt.
  • the ventilation therapy aid 20 at least includes a parameter acquisition device 21 and a processor 22 .
  • the parameter acquisition device 21 is used to acquire the physiological parameters and ventilation parameters of the patient during the ventilation treatment process.
  • the above-mentioned physiological parameters include but are not limited to blood oxygen saturation, heart rate, blood pressure, and end-tidal carbon dioxide.
  • the ventilation parameters include oxygen concentration, inhalation Parameters that can be directly measured or set, such as oxygen partial pressure, airway flow rate, airway pressure, tidal volume, and respiratory rate, also include parameters obtained through certain calculations based on these parameters, such as minute ventilation (MV), etc.
  • MV minute ventilation
  • the parameters can also be classified in other ways.
  • the parameters involved in the present application can be divided into blood oxygen pulse parameters and respiratory parameters.
  • the blood oxygen pulse parameters include but are not limited to blood oxygen saturation, heart rate, and blood pressure.
  • respiratory parameters include but are not limited to respiratory rate, end-tidal carbon dioxide, oxygen concentration, partial pressure of inspired oxygen, airway flow rate, airway pressure, tidal volume, and minute ventilation.
  • the parameter acquisition device 21 may include a sensor 21a for real-time or interval acquisition of physiological parameters and ventilation parameters, and the sensor 21a may include a plurality of, for example, a pressure sensor for acquiring airway pressure and a flow sensor for acquiring airway flow rate.
  • the parameter acquisition device 21 includes a communication device 21b for receiving physiological parameters and ventilation parameters, that is to say, the ventilation therapy auxiliary device 20 does not collect data itself.
  • the respiratory support device 10 can acquire the data obtained by itself.
  • Physiological parameters and ventilation parameters are sent to the communication device 21b in real time or at intervals, and if some ventilation parameters are set by the user, the respiratory support device 10 can directly send the parameter values of the set ventilation parameters to the communication device 21b
  • the respiratory support device 10 is a ventilator
  • the user can set the oxygen supply concentration during the ventilation therapy
  • the ventilator can send the set value of the oxygen supply concentration to the communication device 21b for the ventilation therapy auxiliary device 20 for subsequent processing.
  • the parameter acquisition device 21 may include both a sensor 21a and a communication device 21b, that is, the ventilation therapy aid 20 may collect some parameters by itself, and may also receive parameters sent from other medical devices,
  • the blood oxygen saturation may come from blood gas measurement, percutaneous measurement, or pulse oximeter measurement.
  • the processor 22 is configured to start timing the ventilation treatment under the current ventilation strategy of the patient when it is detected that the timing condition is met, and obtain the ventilation treatment time according to the timing.
  • the timing condition may be to start ventilation therapy, for example, start timing when the respiratory support device 10 starts to work; it may also be a timing start instruction input by the user; it may also be that the patient's physiological parameters and ventilation parameters meet preconditions.
  • the precondition can be set as PaO2/FiO2 (or SpO2/FiO2) > 150 mmHg.
  • PaO2 is the partial pressure of oxygen in arterial blood
  • FiO2 is the partial pressure of inspired oxygen
  • SpO2 is the blood oxygen saturation.
  • the precondition can be set as 200mmHg ⁇ PaO2/FiO2 (or SpO2/FiO2) ⁇ 300mmHg.
  • the current transnasal high-flow oxygen therapy has a basis for evaluating the efficacy. If the patient does not currently meet the preconditions, it is considered that the efficacy of transnasal high-flow oxygen therapy cannot be performed The evaluation or evaluation result has a large error.
  • the processor 22 While obtaining the ventilation treatment time, the processor 22 also generates an oxygenation respiration index corresponding to the ventilation treatment time according to the physiological parameters and the ventilation parameters, and the oxygenation respiration index is used to evaluate the ventilation treatment effect in the corresponding ventilation treatment time.
  • the oxygenation respiration index includes at least one of ROX index, oxygenation index (P/F), oxygen index (OI), and pulse oxygen saturation index (OSI). Among them, the calculation formula of ROX index is:
  • the calculation formula of oxygenation index is PaO2/FiO2
  • the calculation formula of oxygen index is: FiO2*mean airway pressure*100/PaO2
  • the calculation formula of pulse oxygen saturation index is: FiO2*mean airway pressure*100/SpO2.
  • the processor 22 is further configured to compare the oxygenation respiration index with the oxygenation respiration index threshold when it is detected that the evaluation condition is met, obtain the oxygenation respiration index comparison result, and compare the physiological parameter with the physiological parameter threshold to obtain Physiological parameter comparison results: Compare ventilation parameters with ventilation parameter thresholds to obtain ventilation parameter comparison results, and output treatment suggestions according to oxygenation breathing index comparison results, physiological parameter comparison results, and ventilation parameter comparison results.
  • the treatment suggestion may be output to the display device 30 for display.
  • the ventilation therapy aid 20 also includes a display, which can then display the treatment recommendation.
  • the respiratory support device 10 also includes a display, and treatment recommendations are also displayed on the respiratory support device 10 .
  • the physiological parameter and the ventilation parameter are combined to obtain a new index: the oxygenation respiration index.
  • the oxygenation breathing index as well as physiological parameters and ventilation parameters, relevant treatment suggestions or predictions are given, which provides an effective reference for the user's subsequent operations.
  • the above evaluation condition may be that the processor 22 starts timing the ventilation treatment, that is, based on the start of timing, the oxygenation respiration index comparison result, the physiological parameter comparison result and the ventilation parameter comparison result are obtained in real time; the evaluation condition is also It can be that at least one of the physiological parameter and the ventilation parameter meets a preset condition and lasts for a preset period of time. For example, when the patient's blood oxygen saturation continues to be greater than 90% for one hour, the respiratory index comparison result, the physiological parameter comparison result and the ventilation start to be obtained. Parameter comparison result; or the ratio of physiological parameters and/or ventilation parameters that meet preset conditions reaches a preset ratio threshold.
  • the obtained physiological parameters include blood oxygen saturation and respiratory rate
  • the obtained ventilation parameters include inhalation Oxygen concentration
  • the evaluation condition can also be that the ventilation treatment time reaches the preset time.
  • the duration threshold for example, if the preset duration threshold includes 2 hours and 8 hours, the oxygenation and respiratory index comparison results, the physiological parameter comparison results, and the ventilation parameter comparison results can be obtained when the ventilation treatment time reaches 2 hours, and the ventilation treatment time can be obtained. Oxygenation respiration index comparison results, physiological parameters comparison results and ventilation parameters comparison results when the time reaches 8 hours.
  • the ventilation method in the ventilation strategy is nasal high-flow oxygen therapy
  • the oxygenation respiration index is the ROX index
  • the oxygenation respiration index threshold is the ROX index threshold
  • the physiological parameter is blood oxygen saturation (SpO2)
  • the physiological parameter threshold is the blood oxygen saturation threshold
  • the ventilation parameter is the respiration rate (RR)
  • the ventilation parameter threshold is the respiratory rate threshold.
  • SpO2 blood oxygen saturation
  • RR respiration rate
  • more or less oxygenation respiration index thresholds may be included than those exemplified below, as well as more or fewer types of physiological parameter thresholds and/or Ventilation parameter thresholds.
  • a patient is receiving high-flow nasal oxygen therapy
  • the flow rate of high-flow nasal oxygen therapy is set to 40-50 L/min
  • FiO2 is set to 100%, when the processor 22 detects that the patient satisfies 200mmHg ⁇ PaO2/ When the precondition of FiO2 (or SpO2/FiO2) ⁇ 300mmHg, start timing.
  • the first duration threshold is 2 hours
  • the first ROX index threshold includes the first ROX safety threshold and the first ROX threshold.
  • the first ROX safety threshold is set to 3.85
  • the first ROX risk threshold is set to 2.85
  • the processor 22 also obtains the first blood oxygen saturation and the first blood oxygen saturation threshold.
  • a blood oxygen saturation comparison result in this embodiment, the first blood oxygen saturation threshold is set to 93%
  • the processor 22 also obtains the first breathing rate comparison result between the breathing rate and the first breathing rate threshold.
  • a respiration rate threshold includes a first respiration rate safety threshold and a first respiration rate risk threshold. In this embodiment, the first respiration rate safety threshold is set to 25 times/min, and the first respiration rate risk threshold is set to 30 times /min.
  • the processor 22 outputs a corresponding first treatment suggestion according to the first ROX index comparison result, the first respiratory rate comparison result and the first blood oxygen saturation level comparison result.
  • the first treatment suggestion can be "Continue HFNC treatment"
  • the first treatment suggestion can be "change ventilation strategy"
  • the patient is accompanied by disturbance of consciousness, malignant arrhythmia, severe shock, acute respiratory acidosis, etc., it can be recommended to switch from HFNC to invasive mechanical ventilation. If the patient does not have the above symptoms, it can be recommended to switch from HFNC to non-invasive ventilation; 3. 12.85 ⁇ ROX index ⁇ 3.85 or 2blood oxygen saturation ⁇ 93% and respiratory rate>25 times/min, the first treatment suggestion can be: "Continue to maintain HFNC for 6h and closely monitor the condition and vital signs".
  • the user can follow the recommendation for re-ventilation therapy for 6 hours, that is, the second duration threshold is 8 hours, and it is determined that the ventilation therapy time reaches the first
  • the comparison result of the second ROX index between the ROX index and the second ROX threshold is obtained.
  • the second ROX index threshold includes the second ROX safety threshold and the second ROX risk threshold.
  • the second ROX safety threshold The threshold is set to 4.88
  • the second ROX risk threshold is set to 3.85
  • the processor 22 also obtains the second blood oxygen saturation comparison result between the blood oxygen saturation and the second blood oxygen saturation threshold.
  • the second oxygen saturation threshold is set to 93%, and the processor 22 also obtains a second respiratory rate comparison result between the respiratory rate and a second respiratory rate threshold, where the second respiratory rate threshold includes a second respiratory rate safety threshold and a second respiratory rate Rate risk threshold, in this embodiment, the second respiratory rate safety threshold is set to 25 times/min, and the second respiratory rate risk threshold is set to 30 times/min.
  • the processor 22 outputs a corresponding second treatment suggestion according to the second ROX index comparison result, the second respiratory rate comparison result, and the second blood oxygen saturation level comparison result. In this embodiment, there are several situations for the second treatment suggestion: 1.
  • the second treatment recommendation is “continue to maintain HFNC for 12 hours, and closely monitor the condition and vital signs"
  • the user can follow the recommendation for re-ventilation therapy for 12 hours, that is, the third duration threshold is 20 hours, and it is determined that the ventilation therapy time reaches the first
  • the comparison result of the third ROX index between the ROX index and the third ROX threshold is obtained.
  • the third ROX index threshold includes the third ROX risk threshold.
  • the third ROX risk threshold is set to 4.88.
  • the processor 22 also obtains a third blood oxygen saturation comparison result between the blood oxygen saturation and the third blood oxygen saturation threshold.
  • the third blood oxygen saturation threshold is set to 93%, and the processor 22 also Obtain the third respiratory rate comparison result between the respiratory rate and the third respiratory rate threshold.
  • the third respiratory rate threshold includes the third respiratory rate risk threshold.
  • the third respiratory rate risk threshold is set to 25 times/min .
  • the processor 22 outputs a corresponding third treatment suggestion according to the third ROX index comparison result, the third respiratory rate comparison result, and the third blood oxygen saturation level comparison result. In this embodiment, there are several situations for the third treatment suggestion: 1.
  • the settings of the above thresholds can be built in advance by the system, or set by the user before a ventilation treatment, and can also be modified during the ventilation treatment based on the operation instructions input by the user, for example, when the ventilation treatment time is at 0.
  • the user can set the corresponding oxygenation breathing index threshold, physiological parameter threshold and ventilation parameter threshold between 2 hours and 8 hours.
  • the oxygenation respiration index comparison result, the ventilation parameter comparison result and the physiological parameter comparison result can also be obtained in real time or at intervals, and the oxygenation respiration index comparison result for a certain period of ventilation treatment time can also be obtained.
  • Ventilation parameter comparison results and physiological parameters comparison results are counted, according to the statistical results of the oxygenation breathing index comparison results, the ventilation parameter comparison results and the physiological parameters comparison results, the oxygenation breathing index can be determined during the ventilation treatment time.
  • the intensity or frequency of fluctuations in ventilation parameters or physiological parameters and the processor can output corresponding treatment suggestions or predictions according to the statistical results.
  • the oxygenation respiration index threshold is the first reference threshold
  • the ventilation parameter threshold is the second reference threshold
  • the physiological parameter threshold is the third reference threshold.
  • the oxygenation respiration index comparison results within the first duration threshold can be counted. If the number, proportion or duration of the oxygenated breathing index exceeding the first reference threshold exceeds the set threshold, it means that the intensity or frequency of the fluctuation of the oxygenation breathing index exceeds the acceptable range, and the treatment of "change ventilation strategy" can be output at this time. It is suggested that, in the same way, through the comparison between the ventilation parameters and the second reference threshold, and the comparison between the physiological parameters and the third reference threshold, it can be determined whether the intensity or frequency of fluctuations of the physiological parameters and the ventilation parameters exceeds the acceptable range. Based on this, corresponding treatment suggestions are given.
  • the above treatment suggestions are only examples.
  • the treatment suggestions can include recommending to continue the current ventilation strategy, changing to a ventilation strategy with stronger respiratory support, or changing to a ventilation strategy with weaker respiratory support, or prompting the user to adjust the ventilation strategy. Adjust the parameters or use other treatment methods such as lung recruitment.
  • the present application also provides another medical device system
  • the medical device includes multiple medical devices, and the multiple medical devices may include but are not limited to ventilators, anesthesia machines, oxygen therapy instruments, monitors, Central station, medical information system and medical mobile terminal.
  • the medical information system can be, for example, a HIS
  • the medical mobile terminal can be a PDA held by a medical staff, a mobile PC, a mobile phone, or the like.
  • At least one medical device among the plurality of medical devices can collect the physiological parameters and ventilation parameters of the patient during the ventilation treatment, and the meanings of the physiological parameters and the ventilation parameters are the same as in the previous embodiment.
  • a medical device can include a ventilator, a monitor, and a central station
  • the ventilator can obtain the patient's ventilation parameters and send the ventilation parameters to the central station
  • the monitor can obtain the patient's physiological parameters and also send the physiological parameters to the central station
  • the central station can start timing the ventilation treatment under the patient's current ventilation strategy when it detects that the timing conditions are met, obtain the ventilation treatment time according to the timing, and generate an oxygenation respiration index corresponding to the ventilation treatment time according to the physiological parameters and ventilation parameters
  • the central station when the central station still detects that the evaluation conditions are met, it compares the oxygenation respiration index with the oxygenation respiration index threshold to obtain the oxygenation respiration index comparison result, and compares the physiological parameters with the physiological parameter threshold to obtain the physiological parameters Compare the results, compare the ventilation parameters with the ventilation parameter thresholds, obtain the ventilation parameter comparison results, and output treatment suggestions according
  • a new index to assist in evaluating the ventilation therapy effect can be obtained according to the physiological parameters and ventilation parameters: the oxygenation respiration index, and can According to the follow-up comparison, corresponding treatment suggestions are given.
  • the obtained physiological parameters and ventilation parameters can be effectively used to provide users with corresponding ventilation treatment suggestions, thereby helping medical staff to judge or predict the ventilation effect, and prompting medical staff to switch ventilation treatment modes in time, so as to shorten the time for patients to be on the machine. and improved prognosis.
  • the program can also be stored in a server, another computer, a magnetic disk, an optical disk, a flash disk or a mobile hard disk and other storage media, and saved by downloading or copying All or part of the functions in the above embodiments can be implemented when the program in the memory is executed by the processor.

Abstract

A medical device system and a ventilation treatment assistance device. The ventilation treatment assistance device comprises: a parameter acquisition apparatus, which is used for acquiring a physiological parameter and a ventilation parameter of a patient during ventilation treatment; and a processor, which is used for starting timing for the ventilation treatment of the patient under a current ventilation strategy, obtaining a ventilation treatment time according to the timing, and generating an oxygenation respiration index; and for comparing the oxygenation respiration index with an oxygenation respiration index threshold value to acquire an oxygenation respiration index comparison result, comparing the physiological parameter with a physiological parameter threshold value to acquire a physiological parameter comparison result, comparing the ventilation parameter with a ventilation parameter threshold value to acquire a ventilation parameter comparison result, and outputting a management suggestion according to the oxygenation respiration index comparison result, the physiological parameter comparison result and the ventilation parameter comparison result.

Description

一种医疗设备系统以及通气治疗辅助设备A medical device system and ventilation therapy aids 技术领域technical field
本发明涉及医疗设备技术领域,具体涉及一种医疗设备系统,以及一种通气治疗辅助设备。The invention relates to the technical field of medical equipment, in particular to a medical equipment system and an auxiliary device for ventilation therapy.
背景技术Background technique
现代呼吸治疗在保证疗效的前提下,越来越重视患者通气管理的精细化,以便达到更好的治疗效果。临床上,各种呼吸辅助治疗的手段(氧疗、无创通气、有创通气、ECMO等)的目的多是纠正患者的低血氧症。一般临床人员会根据患者的病理或病情进展设计或改变呼吸辅助治疗策略。On the premise of ensuring the curative effect, modern respiratory therapy pays more and more attention to the refinement of patient ventilation management in order to achieve a better therapeutic effect. Clinically, the purpose of various respiratory assistance treatments (oxygen therapy, non-invasive ventilation, invasive ventilation, ECMO, etc.) is mostly to correct the patient's hypoxemia. General clinical staff will design or change the respiratory assistance treatment strategy according to the patient's pathology or disease progression.
呼吸辅助治疗的手段多种多样,医生在应用这些呼吸辅助治疗的时候,面临的一个主要临床挑战就是缺乏判断或预测呼吸辅助治疗效果的手段,该手段的缺乏会造成呼吸支持治疗方式不当或切换不及时,从而导致预后较差或患者上机时间过长使得感染风险上升等临床问题。There are various methods of respiratory assistance therapy. One of the main clinical challenges faced by doctors when applying these respiratory assistance therapy is the lack of means to judge or predict the effect of respiratory assistance therapy. If it is not timely, it will lead to clinical problems such as poor prognosis or increased risk of infection caused by patients being on the machine for too long.
发明内容SUMMARY OF THE INVENTION
根据第一方面,一种实施例中提供了一种通气治疗辅助设备,包括:According to a first aspect, an embodiment provides an auxiliary device for ventilation therapy, including:
参数获取装置,用于获取患者在通气治疗中的生理参数和通气参数;A parameter acquisition device, used for acquiring physiological parameters and ventilation parameters of a patient in ventilation therapy;
处理器,用于在检测到满足计时条件时,对患者当前通气策略下的通气治疗开始计时,根据计时得到通气治疗时间,以及根据所述生理参数和通气参数生成与通气治疗时间对应的氧合呼吸指数,所述氧合呼吸指数用于评价其所对应通气治疗时间内的通气治疗效果;以及The processor is configured to start timing the ventilation treatment under the current ventilation strategy of the patient when it is detected that the timing condition is met, obtain the ventilation treatment time according to the timing, and generate an oxygenation corresponding to the ventilation treatment time according to the physiological parameters and the ventilation parameters Respiratory index, the oxygenation respiratory index is used to evaluate the ventilation treatment effect within the corresponding ventilation treatment time; and
确定到所述通气治疗时间达到第一时长阈值时,获取所述氧合呼吸指数与至少一个第一氧合呼吸指数阈值的第一氧合呼吸指数比对结果,获取所述通气参数与至少一个第一通气参数阈值的第一通气参数比对结果,获取所述生理参数与至少一个第一生理参数阈值的第一生理参数比对结果;When it is determined that the ventilation treatment time reaches a first duration threshold, a comparison result between the oxygenation breathing index and at least one first oxygenation breathing index threshold value is obtained, and the ventilation parameter and at least one oxygenation breathing index are obtained. a first ventilation parameter comparison result of the first ventilation parameter threshold, obtaining the first physiological parameter comparison result of the physiological parameter and at least one first physiological parameter threshold;
根据所述第一氧合呼吸指数比对结果、第一通气参数比对结果和第一生理参数比对结果,输出相应的第一处置建议。According to the comparison result of the first oxygenation respiration index, the comparison result of the first ventilation parameter, and the comparison result of the first physiological parameter, a corresponding first treatment suggestion is output.
根据第二方面,一种实施例中提供了一种通气治疗辅助设备,包括:According to a second aspect, an embodiment provides an auxiliary device for ventilation therapy, including:
参数获取装置,用于获取患者在通气治疗中的生理参数和通气参数;A parameter acquisition device, used for acquiring physiological parameters and ventilation parameters of a patient in ventilation therapy;
处理器,用于在检测到满足计时条件时,对患者当前通气策略下的通气治疗开始计时,根据计时得到通气治疗时间,以及根据所述生理参数和通气参数生成与通气治疗时间对应的氧合呼吸指数,所述氧合呼吸指数用于评价其所对应通气治疗时间内的通气治疗效果;以及The processor is configured to start timing the ventilation treatment under the current ventilation strategy of the patient when it is detected that the timing condition is met, obtain the ventilation treatment time according to the timing, and generate an oxygenation corresponding to the ventilation treatment time according to the physiological parameters and the ventilation parameters Respiratory index, the oxygenation respiratory index is used to evaluate the ventilation treatment effect within the corresponding ventilation treatment time; and
在检测到满足评估条件时,将所述氧合呼吸指数与氧合呼吸指数阈值进行比对,获取氧合呼吸指数比对结果,将所述生理参数与生理参数阈值进行比对,获取生理参数比对结果,将所述通气参数与通气参数阈值进行比对,获取通气参数比对结果,根据所述氧合呼吸指数比对结果、所述生理参数比对结果和所述通气参数比对结果输出处置建议。When it is detected that the evaluation conditions are met, the oxygenation respiration index is compared with the oxygenation respiration index threshold to obtain the oxygenation respiration index comparison result, and the physiological parameter is compared with the physiological parameter threshold to obtain the physiological parameter Compare the result, compare the ventilation parameter with the ventilation parameter threshold, obtain the ventilation parameter comparison result, and obtain the ventilation parameter comparison result according to the oxygenation respiration index comparison result, the physiological parameter comparison result and the ventilation parameter comparison result Output disposition recommendations.
根据第三方面,一种实施例中提供了一种医疗设备系统,包括:According to a third aspect, an embodiment provides a medical device system, comprising:
呼吸支持设备,用于为患者提供通气治疗;Respiratory support equipment to provide ventilation therapy to patients;
上述第一方面或第二方面中的通气治疗辅助设备;The ventilation therapy aid in the first aspect or the second aspect;
显示设备,用于显示所述通气治疗辅助设备输出的处置建议。A display device for displaying treatment suggestions output by the ventilation therapy aid device.
根据第四方面,一种实施例中提供了一种医疗设备系统,包括:According to a fourth aspect, an embodiment provides a medical device system, comprising:
多个医疗设备,所述多个医疗设备中至少一个医疗设备具有参数获取装置,所述参数获取装置用于获取患者在通气治疗中的生理参数和通气参数;A plurality of medical devices, at least one of the plurality of medical devices has a parameter acquisition device, and the parameter acquisition device is used to obtain the physiological parameters and ventilation parameters of the patient during the ventilation treatment;
所述多个医疗设备中至少一个医疗设备用于在检测到满足计时条件时,对患者当前通气策略下的通气治疗开始计时,根据计时得到通气治疗时间,以及根据所述生理参数和通气参数生成与通气治疗时间对应的氧合呼吸指数,所述氧合呼吸指数用于评价其所对应通气治疗时间内的通气治疗效果;以及At least one medical device in the plurality of medical devices is used to start timing the ventilation treatment under the patient's current ventilation strategy when it is detected that the timing condition is met, obtain the ventilation treatment time according to the timing, and generate a ventilation treatment time according to the physiological parameter and the ventilation parameter. The oxygenation respiration index corresponding to the ventilation treatment time, the oxygenation respiration index is used to evaluate the ventilation treatment effect within the corresponding ventilation treatment time; and
在检测到满足评估条件时,将所述氧合呼吸指数与氧合呼吸指数阈值进行比对,获取氧合呼吸指数比对结果,将所述生理参数与生理参数阈值进行比对,获取生理参数比对结果,将所述通气参数与通气参数阈值进行比对,获取通气参数比对结果,根据所述氧合呼吸指数比对结果、所述生理参数比对结果和所述通气参数比对结果输出处置建议。When it is detected that the evaluation conditions are met, the oxygenation respiration index is compared with the oxygenation respiration index threshold to obtain the oxygenation respiration index comparison result, and the physiological parameter is compared with the physiological parameter threshold to obtain the physiological parameter Compare the result, compare the ventilation parameter with the ventilation parameter threshold, obtain the ventilation parameter comparison result, and obtain the ventilation parameter comparison result according to the oxygenation respiration index comparison result, the physiological parameter comparison result and the ventilation parameter comparison result Output disposition recommendations.
上述实施例中将生理参数和通气参数结合,生成了一个新的综合判断或预设通气治疗有效性的参数:氧合呼吸指数。将氧合呼吸指数、生理参数和通气参数分别与对应阈值比较后,可向用户提供相应的通气处置建议,从而帮助医护人员判断或预测通气效果,并提示医护人员及时切换通气治疗模式,达到缩短患者上机时间以及改良预后等效果。In the above embodiment, the physiological parameters and the ventilation parameters are combined to generate a new parameter for comprehensively judging or presetting the effectiveness of ventilation therapy: the oxygenation breathing index. After comparing the oxygenation breathing index, physiological parameters and ventilation parameters with the corresponding thresholds, it can provide users with corresponding ventilation treatment suggestions, so as to help medical staff judge or predict the ventilation effect, and prompt medical staff to switch the ventilation treatment mode in time to shorten the time. The effect of patient on-board time and improved prognosis.
附图说明Description of drawings
图1为一种实施例的医疗设备系统的示意图;1 is a schematic diagram of a medical device system according to an embodiment;
图2为一种实施例的通气治疗辅助设备在不同情况下给出不同处置建议的示意图。FIG. 2 is a schematic diagram of giving different treatment suggestions in different situations by an auxiliary ventilation therapy device according to an embodiment.
具体实施方式Detailed ways
下面通过具体实施方式结合附图对本发明作进一步详细说明。其中不同实施方式中类似元件采用了相关联的类似的元件标号。在以下的实施方式中,很多细节描述是为了使得本申请能被更好的理解。然而,本领域技术人员可以毫不费力的认识到,其中部分特征在不同情况下是可以省略的,或者可以由其他元件、材料、方法所替代。在某些情况下,本申请相关的一些操作并没有在说明书中显示或者描述,这是为了避免本申请的核心部分被过多的描述所淹没,而对于本领域技术人员而言,详细描述这些相关操作并不是必要的,他们根据说明书中的描述以及本领域的一般技术知识即可完整了解相关操作。The present invention will be further described in detail below through specific embodiments in conjunction with the accompanying drawings. Wherein similar elements in different embodiments have used associated similar element numbers. In the following embodiments, many details are described so that the present application can be better understood. However, those skilled in the art will readily recognize that some of the features may be omitted under different circumstances, or may be replaced by other elements, materials, and methods. In some cases, some operations related to the present application are not shown or described in the specification, in order to avoid the core part of the present application from being overwhelmed by excessive description, and for those skilled in the art, these are described in detail. The relevant operations are not necessary, and they can fully understand the relevant operations according to the descriptions in the specification and general technical knowledge in the field.
另外,说明书中所描述的特点、操作或者特征可以以任意适当的方式结合形成各种实施方式。同时,方法描述中的各步骤或者动作也可以按照本领域技术人员所能显而易见的方式进行顺序调换或调整。因此,说明书和附图中的各种顺序只是为了清楚描述某一个实施例,并不意味着是必须的顺序,除非另有说明其中某个顺序是必须遵循的。Additionally, the features, acts, or characteristics described in the specification may be combined in any suitable manner to form various embodiments. At the same time, the steps or actions in the method description can also be exchanged or adjusted in order in a manner obvious to those skilled in the art. Therefore, the various sequences in the specification and drawings are only for the purpose of clearly describing a certain embodiment and are not meant to be a necessary order unless otherwise stated, a certain order must be followed.
本文中为部件所编序号本身,例如“第一”、“第二”等,仅用于区分所描述的对象,不具有任何顺序或技术含义。而本申请所说“连接”、“联接”,如无特别说明,均包括直接和间接连接(联接)。The serial numbers themselves, such as "first", "second", etc., for the components herein are only used to distinguish the described objects, and do not have any order or technical meaning. The "connection" and "connection" mentioned in this application, unless otherwise specified, include both direct and indirect connections (connections).
请参照图1所示的实施例,该实施例中提供了一种医疗设备系统,包括呼吸支持设备10、通气治疗辅助设备20以及显示设备30,呼吸支持设备10用于为患者提供通气治疗,通气治疗指的是以机械通气的方式为患者进行呼吸支持,在通气治疗中可以有不同的通气策略,相应的,呼吸支持设备10可以是呼吸机、麻醉机以及氧疗仪等。在本申请中,通气策略包括了通气模式和通气方式中的至少一个,可以在保持当前通气方式的情况下改变通气模式,也可以改变通气方式并改变通气模式,本申请中,通气方式包括但不限于常规(低流量)氧疗、高流量氧疗、无创通气、有创通气、高频通气以及叶克膜(ECMO),通气模式包括但不限于持续气道正压通气、容控模式通气、压控模式通气、压力支持通气、 双相气道正压通气、双水平气道正压通气、气道压力释放通气、压力调节容量控制通气、容量支持通气、同步间歇指令通气、容量保障压力支持通气以及闭环通气。上述通气方式以及通气模式均为本领域中常见的,本领域的技术人员可以毫无疑义的确定各通气方式以及通气模式的具体含义。Please refer to the embodiment shown in FIG. 1 , a medical equipment system is provided in this embodiment, including a respiratory support device 10 , a ventilation therapy auxiliary device 20 and a display device 30 , and the respiratory support device 10 is used to provide ventilation therapy for a patient, Ventilation therapy refers to providing respiratory support for patients by means of mechanical ventilation. There may be different ventilation strategies in ventilation therapy. Correspondingly, the respiratory support device 10 may be a ventilator, an anesthesia machine, an oxygen therapy apparatus, and the like. In this application, the ventilation strategy includes at least one of a ventilation mode and a ventilation mode. The ventilation mode can be changed while maintaining the current ventilation mode, or the ventilation mode can be changed and the ventilation mode can be changed. In this application, the ventilation mode includes but Not limited to conventional (low-flow) oxygen therapy, high-flow oxygen therapy, non-invasive ventilation, invasive ventilation, high-frequency ventilation and ECMO, ventilation modes include but are not limited to continuous positive airway pressure, volume-controlled ventilation , Pressure Controlled Ventilation, Pressure Support Ventilation, Biphasic Positive Airway Pressure, Bilevel Positive Airway Pressure, Airway Pressure Release Ventilation, Pressure Modulation Volume Controlled Ventilation, Volume Support Ventilation, Synchronized Intermittent Mandatory Ventilation, Volume Guaranteed Pressure Support ventilation as well as closed-loop ventilation. The above ventilation modes and ventilation modes are common in the art, and those skilled in the art can determine the specific meanings of each ventilation mode and ventilation mode without any doubt.
通气治疗辅助设备20至少包括参数获取装置21和处理器22。The ventilation therapy aid 20 at least includes a parameter acquisition device 21 and a processor 22 .
参数获取装置21用于获取患者在通气治疗过程中的生理参数和通气参数,上述生理参数包括但不限于血氧饱和度、心率、血压以及呼气末二氧化碳,通气参数则包括给氧浓度、吸入氧分压、气道流速、气道压力、潮气量以及呼吸率等可以直接测得或者设置的参数,还包括根据这些参数通过一定的计算得到的参数,例如分钟通气量(MV)等。需要说明的是,生理参数与通气参数的分类仅为了更简洁地对本申请的技术方案进行说明,不应理解为对于本申请中参数类别的限定。在其他实施例中,也可以以其他方式对参数进行分类,例如,可以本申请涉及的参数分为血氧脉搏参数和呼吸参数,血氧脉搏参数包括但不限于血氧饱和度、心率以及血压,呼吸参数则包括但不限于呼吸率、呼气末二氧化碳、给氧浓度、吸入氧分压、气道流速、气道压力、潮气量以及分钟通气量等。The parameter acquisition device 21 is used to acquire the physiological parameters and ventilation parameters of the patient during the ventilation treatment process. The above-mentioned physiological parameters include but are not limited to blood oxygen saturation, heart rate, blood pressure, and end-tidal carbon dioxide. The ventilation parameters include oxygen concentration, inhalation Parameters that can be directly measured or set, such as oxygen partial pressure, airway flow rate, airway pressure, tidal volume, and respiratory rate, also include parameters obtained through certain calculations based on these parameters, such as minute ventilation (MV), etc. It should be noted that the classification of physiological parameters and ventilation parameters is only for the purpose of describing the technical solutions of the present application more concisely, and should not be construed as a limitation on the types of parameters in the present application. In other embodiments, the parameters can also be classified in other ways. For example, the parameters involved in the present application can be divided into blood oxygen pulse parameters and respiratory parameters. The blood oxygen pulse parameters include but are not limited to blood oxygen saturation, heart rate, and blood pressure. , and respiratory parameters include but are not limited to respiratory rate, end-tidal carbon dioxide, oxygen concentration, partial pressure of inspired oxygen, airway flow rate, airway pressure, tidal volume, and minute ventilation.
参数获取装置21可以包括用于实时或间隔采集生理参数和通气参数的传感器21a,传感器21a可以包括多个,例如用于采集气道压力的压力传感器以及用于采集气道流速的流量传感器。在一些实施例中,参数获取装置21包括用于接收生理参数和通气参数的通信装置21b,也就是说通气治疗辅助设备20本身并不采集数据,例如,呼吸支持设备10可以将自身获取到的生理参数和通气参数实时或间隔地发送至通信装置21b,并且,如果某些通气参数是用户设定的,那么呼吸支持设备10可以直接将设定好的通气参数的参数值发送至通信装置21b,例如,呼吸支持设备10是呼吸机,用户可以设定通气治疗过程中的给氧浓度,呼吸机可以将设定好的给氧浓度的数值发送至通信装置21b,以供通气治疗辅助设备20进行后续处理。在另一实施例中,参数获取装置21可以既包括传感器21a,也包括通信装置21b,也就是说,通气治疗辅助设备20可以自身采集一部分参数,又可以接收其他医疗设备发送而来的参数,其中,血氧饱和度可以来自于血气测量、经皮测量,或脉氧仪测量。The parameter acquisition device 21 may include a sensor 21a for real-time or interval acquisition of physiological parameters and ventilation parameters, and the sensor 21a may include a plurality of, for example, a pressure sensor for acquiring airway pressure and a flow sensor for acquiring airway flow rate. In some embodiments, the parameter acquisition device 21 includes a communication device 21b for receiving physiological parameters and ventilation parameters, that is to say, the ventilation therapy auxiliary device 20 does not collect data itself. For example, the respiratory support device 10 can acquire the data obtained by itself. Physiological parameters and ventilation parameters are sent to the communication device 21b in real time or at intervals, and if some ventilation parameters are set by the user, the respiratory support device 10 can directly send the parameter values of the set ventilation parameters to the communication device 21b For example, the respiratory support device 10 is a ventilator, the user can set the oxygen supply concentration during the ventilation therapy, and the ventilator can send the set value of the oxygen supply concentration to the communication device 21b for the ventilation therapy auxiliary device 20 for subsequent processing. In another embodiment, the parameter acquisition device 21 may include both a sensor 21a and a communication device 21b, that is, the ventilation therapy aid 20 may collect some parameters by itself, and may also receive parameters sent from other medical devices, Wherein, the blood oxygen saturation may come from blood gas measurement, percutaneous measurement, or pulse oximeter measurement.
处理器22用于在检测到满足计时条件时,对患者当前通气策略下的 通气治疗开始计时,根据计时得到通气治疗时间。计时条件可以为开始通气治疗,例如检测到呼吸支持设备10开始工作就开始计时;也可以为接收到用户输入的计时启动指令;还可以为患者的生理参数和通气参数满足前置条件。例如在经鼻高流速氧疗(HFNC)中,前置条件可以设置为PaO2/FiO2(或SpO2/FiO2)>150mmHg。其中,PaO2为动脉血氧分压,FiO2为吸入氧分压,SpO2为血氧饱和度。在某些情况下,可以将前置条件设置为200mmHg≤PaO2/FiO2(或SpO2/FiO2)<300mmHg。一般在临床治疗上,满足这样的前置条件,才会认为当次经鼻高流速氧疗有可以进行疗效评估的基础,如果患者当前不满足前置条件,则认为无法进行经鼻高流速氧疗疗效评估或者评估结果误差很大。The processor 22 is configured to start timing the ventilation treatment under the current ventilation strategy of the patient when it is detected that the timing condition is met, and obtain the ventilation treatment time according to the timing. The timing condition may be to start ventilation therapy, for example, start timing when the respiratory support device 10 starts to work; it may also be a timing start instruction input by the user; it may also be that the patient's physiological parameters and ventilation parameters meet preconditions. For example, in high-flow nasal oxygen therapy (HFNC), the precondition can be set as PaO2/FiO2 (or SpO2/FiO2) > 150 mmHg. Among them, PaO2 is the partial pressure of oxygen in arterial blood, FiO2 is the partial pressure of inspired oxygen, and SpO2 is the blood oxygen saturation. In some cases, the precondition can be set as 200mmHg≤PaO2/FiO2 (or SpO2/FiO2)<300mmHg. Generally, in clinical treatment, if such preconditions are met, it is considered that the current transnasal high-flow oxygen therapy has a basis for evaluating the efficacy. If the patient does not currently meet the preconditions, it is considered that the efficacy of transnasal high-flow oxygen therapy cannot be performed The evaluation or evaluation result has a large error.
在得到通气治疗时间的同时,处理器22还根据生理参数和通气参数生成与通气治疗时间对应的氧合呼吸指数,氧合呼吸指数用于评价其所对应通气治疗时间内的通气治疗效果。氧合呼吸指数包括ROX指数、氧合指数(P/F)、氧指数(OI)以及脉氧饱和度指数(OSI)中的至少一个。其中,ROX指数的计算公式为:While obtaining the ventilation treatment time, the processor 22 also generates an oxygenation respiration index corresponding to the ventilation treatment time according to the physiological parameters and the ventilation parameters, and the oxygenation respiration index is used to evaluate the ventilation treatment effect in the corresponding ventilation treatment time. The oxygenation respiration index includes at least one of ROX index, oxygenation index (P/F), oxygen index (OI), and pulse oxygen saturation index (OSI). Among them, the calculation formula of ROX index is:
Figure PCTCN2021128001-appb-000001
Figure PCTCN2021128001-appb-000001
其中,SpO2和PaO2、SaO2可以相互替代使用,假设某患者的SpO2=100%,FiO2=60%,RR=24/min,那么该患者的ROX指数是6.9。Among them, SpO2, PaO2, and SaO2 can be used interchangeably. Assuming that a patient's SpO2=100%, FiO2=60%, and RR=24/min, then the patient's ROX index is 6.9.
氧合指数的计算公式为PaO2/FiO2,氧指数的计算公式为:FiO2*平均气道压*100/PaO2;脉氧饱和度指数的计算公式为:FiO2*平均气道压*100/SpO2。The calculation formula of oxygenation index is PaO2/FiO2, the calculation formula of oxygen index is: FiO2*mean airway pressure*100/PaO2; the calculation formula of pulse oxygen saturation index is: FiO2*mean airway pressure*100/SpO2.
处理器22还用于在检测到满足评估条件时,将氧合呼吸指数与氧合呼吸指数阈值进行比对,获取氧合呼吸指数比对结果,将生理参数与生理参数阈值进行比对,获取生理参数比对结果,将通气参数与通气参数阈值进行比对,获取通气参数比对结果,根据氧合呼吸指数比对结果、生理参数比对结果和通气参数比对结果输出处置建议。该处置建议可以输出至显示设备30上进行显示。在一些实施例中,通气治疗辅助设备20还包括显示器,则显示器可以显示该处置建议。在另一些实施例中,呼吸支持设备10也包括显示器,处置建议还有显示在呼吸支持设备10上。The processor 22 is further configured to compare the oxygenation respiration index with the oxygenation respiration index threshold when it is detected that the evaluation condition is met, obtain the oxygenation respiration index comparison result, and compare the physiological parameter with the physiological parameter threshold to obtain Physiological parameter comparison results: Compare ventilation parameters with ventilation parameter thresholds to obtain ventilation parameter comparison results, and output treatment suggestions according to oxygenation breathing index comparison results, physiological parameter comparison results, and ventilation parameter comparison results. The treatment suggestion may be output to the display device 30 for display. In some embodiments, the ventilation therapy aid 20 also includes a display, which can then display the treatment recommendation. In other embodiments, the respiratory support device 10 also includes a display, and treatment recommendations are also displayed on the respiratory support device 10 .
也就是说,本实施例中结合了生理参数和通气参数,得到了一个新的指标:氧合呼吸指数。根据该氧合呼吸指数,以及生理参数和通气参数,给出了相关的处置建议或预测,为用户后续的操作提供了有效的参 考。That is to say, in this embodiment, the physiological parameter and the ventilation parameter are combined to obtain a new index: the oxygenation respiration index. According to the oxygenation breathing index, as well as physiological parameters and ventilation parameters, relevant treatment suggestions or predictions are given, which provides an effective reference for the user's subsequent operations.
上述评估条件可以是处理器22开始对通气治疗开始计时,也就是说,基于计时的开始,实时地获取氧合呼吸指数比对结果、生理参数比对结果以及通气参数比对结果;评估条件还可以是生理参数和通气参数至少一个满足预设条件并持续预设时长,例如,当患者的血氧饱和度持续大于90%一个小时才开始获取呼吸指数比对结果、生理参数比对结果以及通气参数比对结果;又或者是生理参数和/或通气参数中满足预设条件的参数比例达到预设比例阈值,例如,获取的生理参数包括血氧饱和度和呼吸率,获取的通气参数包括吸入氧浓度,这三类参数中的两个满足对应阈值时就开始获取氧合呼吸指数比对结果、生理参数比对结果以及通气参数比对结果;评估条件还可以是通气治疗时间达到了预设时长阈值,例如,预设时长阈值包括2小时和8小时,则可以获取通气治疗时间达到2小时的氧合呼吸指数比对结果、生理参数比对结果以及通气参数比对结果,以及获取通气治疗时间达到8小时的氧合呼吸指数比对结果、生理参数比对结果以及通气参数比对结果。下面结合图2举一个实例说明如何给出处置建议,在下面的例子中,通气策略中的通气方式为经鼻高流速氧疗,氧合呼吸指数为ROX指数,氧合呼吸指数阈值为ROX指数阈值,生理参数为血氧饱和度(SpO2),生理参数阈值为血氧饱和度阈值,通气参数为呼吸率(RR),通气参数阈值为呼吸率阈值。对于其他通气治疗方式以及其他类型的氧合呼吸指数,可以包括比下面所举例子更多或更少的氧合呼吸指数阈值,也可以包括更多类型或更少类型的生理参数阈值和/或通气参数阈值。The above evaluation condition may be that the processor 22 starts timing the ventilation treatment, that is, based on the start of timing, the oxygenation respiration index comparison result, the physiological parameter comparison result and the ventilation parameter comparison result are obtained in real time; the evaluation condition is also It can be that at least one of the physiological parameter and the ventilation parameter meets a preset condition and lasts for a preset period of time. For example, when the patient's blood oxygen saturation continues to be greater than 90% for one hour, the respiratory index comparison result, the physiological parameter comparison result and the ventilation start to be obtained. Parameter comparison result; or the ratio of physiological parameters and/or ventilation parameters that meet preset conditions reaches a preset ratio threshold. For example, the obtained physiological parameters include blood oxygen saturation and respiratory rate, and the obtained ventilation parameters include inhalation Oxygen concentration, when two of these three types of parameters meet the corresponding threshold, the oxygenation and breathing index comparison results, the physiological parameter comparison results and the ventilation parameter comparison results are obtained; the evaluation condition can also be that the ventilation treatment time reaches the preset time. The duration threshold, for example, if the preset duration threshold includes 2 hours and 8 hours, the oxygenation and respiratory index comparison results, the physiological parameter comparison results, and the ventilation parameter comparison results can be obtained when the ventilation treatment time reaches 2 hours, and the ventilation treatment time can be obtained. Oxygenation respiration index comparison results, physiological parameters comparison results and ventilation parameters comparison results when the time reaches 8 hours. In the following example, the ventilation method in the ventilation strategy is nasal high-flow oxygen therapy, the oxygenation respiration index is the ROX index, and the oxygenation respiration index threshold is the ROX index threshold. , the physiological parameter is blood oxygen saturation (SpO2), the physiological parameter threshold is the blood oxygen saturation threshold, the ventilation parameter is the respiration rate (RR), and the ventilation parameter threshold is the respiratory rate threshold. For other ventilation therapy modalities and other types of oxygenation respiration indices, more or less oxygenation respiration index thresholds may be included than those exemplified below, as well as more or fewer types of physiological parameter thresholds and/or Ventilation parameter thresholds.
本实施例中,一个患者正在接受经鼻高流速氧疗,经鼻高流速氧疗的流速被设置为40-50L/分,FiO2被设置为100%,当处理器22检测到患者满足200mmHg≤PaO2/FiO2(或SpO2/FiO2)<300mmHg的前置条件时,开始计时。确定到通气治疗时间达到第一时长阈值时,获取ROX指数与第一ROX阈值的第一ROX指数比对结果,第一时长阈值为2小时,第一ROX指数阈值包括第一ROX安全阈值和第一ROX风险阈值,在本实施例中,第一ROX安全阈值被设置为3.85,第一ROX风险阈值被设置为2.85,处理器22还获取血氧饱和度与第一血氧饱和度阈值的第一血氧饱和度比对结果,本实施例中,第一血氧饱和度阈值被设置为93%,处理器22还获取呼吸率与第一呼吸率阈值的第一呼吸率比对结果,第一呼吸率阈值包括第一呼吸率安全阈值和第一呼吸率风险阈值,在本实施例中, 第一呼吸率安全阈值被设置为25次/min,第一呼吸率危险阈值被设置为30次/min。之后,处理器22根据第一ROX指数比对结果、第一呼吸率比对结果和第一血氧饱和度比对结果,输出相应的第一处置建议。在本实施例中,第一处置建议有几种情况:一、①ROX指数≥3.85或者②血氧饱和度≥93%且呼吸率<25次/min,预示HFNC成功率高,第一处置建议可以是“继续HFNC治疗”;二、①ROX指数<2.85或②血氧饱和度<93%且呼吸率>30次/min,预设HFNC效果不好,第一处置建议可以是“更改通气策略”,用户在看到该处置建议后,可以再观察患者的临床状态,如果患者伴有意识障碍、恶性心律失常、严重休克、急性呼吸性酸中毒等,则可以建议从HFNC转换为有创机械通气,如果患者没有以上症状,则可以建议从HFNC转换为无创通气;三、①2.85≤ROX指数<3.85或者②血氧饱和度≥93%且呼吸率>25次/min,则第一处置建议可以是“继续保持HFNC 6h,并密切监测病情和生命体征”。In this embodiment, a patient is receiving high-flow nasal oxygen therapy, the flow rate of high-flow nasal oxygen therapy is set to 40-50 L/min, and FiO2 is set to 100%, when the processor 22 detects that the patient satisfies 200mmHg≤PaO2/ When the precondition of FiO2 (or SpO2/FiO2) < 300mmHg, start timing. When it is determined that the ventilation treatment time reaches the first duration threshold, the first ROX index comparison result between the ROX index and the first ROX threshold is obtained, the first duration threshold is 2 hours, and the first ROX index threshold includes the first ROX safety threshold and the first ROX threshold. A ROX risk threshold. In this embodiment, the first ROX safety threshold is set to 3.85, the first ROX risk threshold is set to 2.85, and the processor 22 also obtains the first blood oxygen saturation and the first blood oxygen saturation threshold. A blood oxygen saturation comparison result, in this embodiment, the first blood oxygen saturation threshold is set to 93%, and the processor 22 also obtains the first breathing rate comparison result between the breathing rate and the first breathing rate threshold. A respiration rate threshold includes a first respiration rate safety threshold and a first respiration rate risk threshold. In this embodiment, the first respiration rate safety threshold is set to 25 times/min, and the first respiration rate risk threshold is set to 30 times /min. Afterwards, the processor 22 outputs a corresponding first treatment suggestion according to the first ROX index comparison result, the first respiratory rate comparison result and the first blood oxygen saturation level comparison result. In this embodiment, there are several situations for the first treatment suggestion: 1. ① ROX index ≥ 3.85 or ② blood oxygen saturation ≥ 93% and respiratory rate < 25 times/min, indicating that the success rate of HFNC is high, and the first treatment suggestion can be "Continue HFNC treatment"; 2. ①ROX index <2.85 or ②Oxygen saturation <93% and respiratory rate>30 breaths/min, the default HFNC effect is not good, the first treatment suggestion can be "change ventilation strategy", After seeing the treatment suggestion, the user can observe the clinical status of the patient. If the patient is accompanied by disturbance of consciousness, malignant arrhythmia, severe shock, acute respiratory acidosis, etc., it can be recommended to switch from HFNC to invasive mechanical ventilation. If the patient does not have the above symptoms, it can be recommended to switch from HFNC to non-invasive ventilation; 3. ①2.85≤ROX index <3.85 or ②blood oxygen saturation ≥93% and respiratory rate>25 times/min, the first treatment suggestion can be: "Continue to maintain HFNC for 6h and closely monitor the condition and vital signs".
在第一处置建议是“继续保持HFNC 6h,并密切监测病情和生命体征”时,则用户可以依照建议再通气治疗6h,也就是说,第二时长阈值为8h,确定到通气治疗时间达到第二时长阈值时,获取ROX指数与第二ROX阈值的第二ROX指数比对结果,第二ROX指数阈值包括第二ROX安全阈值和第二ROX风险阈值,在本实施例中,第二ROX安全阈值被设置为4.88,第二ROX风险阈值被设置为3.85,处理器22还获取血氧饱和度与第二血氧饱和度阈值的第二血氧饱和度比对结果,本实施例中,第二血氧饱和度阈值被设置为93%,处理器22还获取呼吸率与第二呼吸率阈值的第二呼吸率比对结果,第二呼吸率阈值包括第二呼吸率安全阈值和第二呼吸率风险阈值,在本实施例中,第二呼吸率安全阈值被设置为25次/min,第二呼吸率危险阈值被设置为30次/min。之后,处理器22根据第二ROX指数比对结果、第二呼吸率比对结果和第二血氧饱和度比对结果,输出相应的第二处置建议。在本实施例中,第二处置建议有几种情况:一、①ROX指数≥4.88或者②血氧饱和度≥93%且呼吸率<25次/min,预示HFNC成功率高,第二处置建议可以是“继续HFNC治疗”;二、①ROX指数<3.85或②血氧饱和度<93%且呼吸率>30次/min,预设HFNC效果不好,第二处置建议可以是“立即插管进行有创机械通气”;三、①3.85≤ROX指数<4.88或者②血氧饱和度≥93%且呼吸率>25次/min,则第二处置建议可以是“继续保持HFNC 12h,并密切监测病情和生命体征”。When the first treatment recommendation is "continue to maintain HFNC for 6 hours, and closely monitor the condition and vital signs", the user can follow the recommendation for re-ventilation therapy for 6 hours, that is, the second duration threshold is 8 hours, and it is determined that the ventilation therapy time reaches the first When there are two time duration thresholds, the comparison result of the second ROX index between the ROX index and the second ROX threshold is obtained. The second ROX index threshold includes the second ROX safety threshold and the second ROX risk threshold. In this embodiment, the second ROX safety threshold The threshold is set to 4.88, the second ROX risk threshold is set to 3.85, and the processor 22 also obtains the second blood oxygen saturation comparison result between the blood oxygen saturation and the second blood oxygen saturation threshold. The second oxygen saturation threshold is set to 93%, and the processor 22 also obtains a second respiratory rate comparison result between the respiratory rate and a second respiratory rate threshold, where the second respiratory rate threshold includes a second respiratory rate safety threshold and a second respiratory rate Rate risk threshold, in this embodiment, the second respiratory rate safety threshold is set to 25 times/min, and the second respiratory rate risk threshold is set to 30 times/min. After that, the processor 22 outputs a corresponding second treatment suggestion according to the second ROX index comparison result, the second respiratory rate comparison result, and the second blood oxygen saturation level comparison result. In this embodiment, there are several situations for the second treatment suggestion: 1. ① ROX index ≥ 4.88 or ② blood oxygen saturation ≥ 93% and respiratory rate < 25 times/min, indicating that the success rate of HFNC is high, and the second treatment suggestion can be is "continue HFNC treatment"; 2. ① ROX index < 3.85 or ② oxygen saturation < 93% and respiratory rate > 30 breaths/min, the preset HFNC effect is not good, and the second treatment suggestion can be "immediate intubation for some Invasive mechanical ventilation"; 3. ①3.85≤ROX index <4.88 or ②Blood oxygen saturation ≥93% and respiratory rate>25 breaths/min, the second treatment suggestion can be "continue to maintain HFNC for 12 hours, and closely monitor the condition and vital signs".
在第二处置建议是“继续保持HFNC 12h,并密切监测病情和生命体征”时,则用户可以依照建议再通气治疗12h,也就是说,第三时长阈值为20h,确定到通气治疗时间达到第三时长阈值时,获取ROX指数与第三ROX阈值的第三ROX指数比对结果,第三ROX指数阈值包括第三ROX风险阈值,在本实施例中,第三ROX风险阈值被设置为4.88。处理器22还获取血氧饱和度与第三血氧饱和度阈值的第三血氧饱和度比对结果,本实施例中,第三血氧饱和度阈值被设置为93%,处理器22还获取呼吸率与第三呼吸率阈值的第三呼吸率比对结果,第三呼吸率阈值包括第三呼吸率风险阈值,在本实施例中,第三呼吸率危险阈值被设置为25次/min。之后,处理器22根据第三ROX指数比对结果、第三呼吸率比对结果和第三血氧饱和度比对结果,输出相应的第三处置建议。在本实施例中,第三处置建议有几种情况:一、①ROX指数≥4.88或者②血氧饱和度≥93%且呼吸率<25次/min,预示HFNC成功率高,第三处置建议可以是“继续HFNC治疗并密切观察生命体征”;二、①ROX指数<4.88或②血氧饱和度≥93%且呼吸率>25次/min,预设HFNC效果不好,第三处置建议可以是“立即插管进行有创机械通气”。When the second treatment recommendation is "continue to maintain HFNC for 12 hours, and closely monitor the condition and vital signs", the user can follow the recommendation for re-ventilation therapy for 12 hours, that is, the third duration threshold is 20 hours, and it is determined that the ventilation therapy time reaches the first When there are three time duration thresholds, the comparison result of the third ROX index between the ROX index and the third ROX threshold is obtained. The third ROX index threshold includes the third ROX risk threshold. In this embodiment, the third ROX risk threshold is set to 4.88. The processor 22 also obtains a third blood oxygen saturation comparison result between the blood oxygen saturation and the third blood oxygen saturation threshold. In this embodiment, the third blood oxygen saturation threshold is set to 93%, and the processor 22 also Obtain the third respiratory rate comparison result between the respiratory rate and the third respiratory rate threshold. The third respiratory rate threshold includes the third respiratory rate risk threshold. In this embodiment, the third respiratory rate risk threshold is set to 25 times/min . After that, the processor 22 outputs a corresponding third treatment suggestion according to the third ROX index comparison result, the third respiratory rate comparison result, and the third blood oxygen saturation level comparison result. In this embodiment, there are several situations for the third treatment suggestion: 1. ① ROX index ≥ 4.88 or ② blood oxygen saturation ≥ 93% and respiratory rate < 25 times/min, indicating that the success rate of HFNC is high, and the third treatment suggestion can be It is "continue HFNC treatment and closely observe vital signs"; 2. ① ROX index < 4.88 or ② oxygen saturation ≥ 93% and respiration rate > 25 breaths/min, the default effect of HFNC is not good, the third treatment suggestion can be " Immediately intubate for invasive mechanical ventilation."
上述各阈值的设置可以是系统提前内置的,也可以是在一次通气治疗前用户设定好的,还可以基于用户输入的操作指令在通气治疗的过程中进行修改,例如当通气治疗时间在0小时到2小时之间时,用户可以设置2小时到8小时之间对应的氧合呼吸指数阈值、生理参数阈值和通气参数阈值。The settings of the above thresholds can be built in advance by the system, or set by the user before a ventilation treatment, and can also be modified during the ventilation treatment based on the operation instructions input by the user, for example, when the ventilation treatment time is at 0. When it is between 2 hours and 2 hours, the user can set the corresponding oxygenation breathing index threshold, physiological parameter threshold and ventilation parameter threshold between 2 hours and 8 hours.
在另一些实施例中,还可以实时或者间隔地获取氧合呼吸指数比对结果、通气参数比对结果和生理参数比对结果,并对某一段通气治疗时间内的氧合呼吸指数比对结果、通气参数比对结果和生理参数比对结果进行统计,根据氧合呼吸指数比对结果、通气参数比对结果和生理参数比对结果的统计结果能够确定该段通气治疗时间内氧合呼吸指数、通气参数或生理参数波动的剧烈程度或频繁程度,处理器可以根据该统计结果输出相应的处置建议或预测。例如,氧合呼吸指数阈值为第一参考阈值,通气参数阈值为第二参考阈值,生理参数阈值则为第三参考阈值,可以统计第一时长阈值内的氧合呼吸指数比对结果,如果氧合呼吸指数超过第一参考阈值的次数、比例或时长超过设定的阈值,那么意味着氧合呼吸指数波动的剧烈程度或频繁程度超过可接受范围,此时可以输出“改变通气策略”的处置建议,同理,通过通气参数与第二参考阈值的 比对情况,生理参数与第三参考阈值的比对情况,可以确定生理参数和通气参数波动的剧烈程度或频繁程度是否超过可接受范围,并基于此给出相应的处置建议。In other embodiments, the oxygenation respiration index comparison result, the ventilation parameter comparison result and the physiological parameter comparison result can also be obtained in real time or at intervals, and the oxygenation respiration index comparison result for a certain period of ventilation treatment time can also be obtained. , Ventilation parameter comparison results and physiological parameters comparison results are counted, according to the statistical results of the oxygenation breathing index comparison results, the ventilation parameter comparison results and the physiological parameters comparison results, the oxygenation breathing index can be determined during the ventilation treatment time. , the intensity or frequency of fluctuations in ventilation parameters or physiological parameters, and the processor can output corresponding treatment suggestions or predictions according to the statistical results. For example, the oxygenation respiration index threshold is the first reference threshold, the ventilation parameter threshold is the second reference threshold, and the physiological parameter threshold is the third reference threshold. The oxygenation respiration index comparison results within the first duration threshold can be counted. If the number, proportion or duration of the oxygenated breathing index exceeding the first reference threshold exceeds the set threshold, it means that the intensity or frequency of the fluctuation of the oxygenation breathing index exceeds the acceptable range, and the treatment of "change ventilation strategy" can be output at this time. It is suggested that, in the same way, through the comparison between the ventilation parameters and the second reference threshold, and the comparison between the physiological parameters and the third reference threshold, it can be determined whether the intensity or frequency of fluctuations of the physiological parameters and the ventilation parameters exceeds the acceptable range. Based on this, corresponding treatment suggestions are given.
上述处置建议也仅为示例,处置建议既可以包括建议沿用当前通气策略、更改为呼吸支持能力更强的通气策略或更改为呼吸支持能力更弱的通气策略,还可以是提示用户对通气策略中的参数进行调节或者采用肺复张等其他治疗手段等。The above treatment suggestions are only examples. The treatment suggestions can include recommending to continue the current ventilation strategy, changing to a ventilation strategy with stronger respiratory support, or changing to a ventilation strategy with weaker respiratory support, or prompting the user to adjust the ventilation strategy. Adjust the parameters or use other treatment methods such as lung recruitment.
在另一实施例当中,本申请还提供了另一种医疗设备系统,该医疗设备包括多个医疗设备,多个医疗设备可以包括但不限于呼吸机、麻醉机、氧疗仪、监护仪、中央站、医疗信息系统和医疗移动终端。医疗信息系统可以例如是HIS,医疗移动终端则可以是医护人员手持的PDA又或是移动PC、移动电话等。多个医疗设备中至少一个医疗设备能够采集患者在通气治疗中的生理参数和通气参数,生理参数与通气参数的含义与上一实施例相同。In another embodiment, the present application also provides another medical device system, the medical device includes multiple medical devices, and the multiple medical devices may include but are not limited to ventilators, anesthesia machines, oxygen therapy instruments, monitors, Central station, medical information system and medical mobile terminal. The medical information system can be, for example, a HIS, and the medical mobile terminal can be a PDA held by a medical staff, a mobile PC, a mobile phone, or the like. At least one medical device among the plurality of medical devices can collect the physiological parameters and ventilation parameters of the patient during the ventilation treatment, and the meanings of the physiological parameters and the ventilation parameters are the same as in the previous embodiment.
本实施例与上一实施例的区别在于,本实施例中的一个或多个医疗设备共同配合起到了上一实施例中通气治疗辅助设备20的作用。例如,医疗设备可以包括呼吸机、监护仪和中央站,呼吸机可以获取患者的通气参数并将通气参数发送至中央站,监护仪可以获取患者的生理参数并将生理参数也发送至中央站,中央站可以在检测到满足计时条件时,对患者当前通气策略下的通气治疗开始计时,根据计时得到通气治疗时间,以及根据生理参数和通气参数生成与通气治疗时间对应的氧合呼吸指数,并且,中央站还在检测到满足评估条件时,将氧合呼吸指数与氧合呼吸指数阈值进行比对,获取氧合呼吸指数比对结果,将生理参数与生理参数阈值进行比对,获取生理参数比对结果,将通气参数与通气参数阈值进行比对,获取通气参数比对结果,根据氧合呼吸指数比对结果、生理参数比对结果和通气参数比对结果输出处置建议。中央站对于生理参数和通气参数的处理与上一实施例中通气治疗辅助设备20对于通气参数和生理参数的处理基本一致。The difference between this embodiment and the previous embodiment is that one or more medical devices in this embodiment cooperate together to play the role of the ventilation therapy auxiliary device 20 in the previous embodiment. For example, a medical device can include a ventilator, a monitor, and a central station, the ventilator can obtain the patient's ventilation parameters and send the ventilation parameters to the central station, and the monitor can obtain the patient's physiological parameters and also send the physiological parameters to the central station, The central station can start timing the ventilation treatment under the patient's current ventilation strategy when it detects that the timing conditions are met, obtain the ventilation treatment time according to the timing, and generate an oxygenation respiration index corresponding to the ventilation treatment time according to the physiological parameters and ventilation parameters, and , when the central station still detects that the evaluation conditions are met, it compares the oxygenation respiration index with the oxygenation respiration index threshold to obtain the oxygenation respiration index comparison result, and compares the physiological parameters with the physiological parameter threshold to obtain the physiological parameters Compare the results, compare the ventilation parameters with the ventilation parameter thresholds, obtain the ventilation parameter comparison results, and output treatment suggestions according to the oxygenation respiration index comparison results, the physiological parameter comparison results, and the ventilation parameter comparison results. The processing of the physiological parameters and the ventilation parameters by the central station is basically the same as the processing of the ventilation parameters and the physiological parameters by the ventilation therapy auxiliary device 20 in the previous embodiment.
由此可以看出,虽然本实施例中医疗设备系统中未设置通气治疗辅助设备20,但是还是可以根据生理参数和通气参数得到一个辅助评价通气治疗效果的新指标:氧合呼吸指数,并可以根据后续的比对给出相应的处置建议。It can be seen from this that, although the ventilation therapy auxiliary device 20 is not set in the medical equipment system in this embodiment, a new index to assist in evaluating the ventilation therapy effect can be obtained according to the physiological parameters and ventilation parameters: the oxygenation respiration index, and can According to the follow-up comparison, corresponding treatment suggestions are given.
上述实施例中可有效利用得到的生理参数和通气参数,向用户提 供相应的通气处置建议,从而帮助医护人员判断或预测通气效果,并提示医护人员及时切换通气治疗模式,达到缩短患者上机时间以及改良预后等效果。In the above embodiment, the obtained physiological parameters and ventilation parameters can be effectively used to provide users with corresponding ventilation treatment suggestions, thereby helping medical staff to judge or predict the ventilation effect, and prompting medical staff to switch ventilation treatment modes in time, so as to shorten the time for patients to be on the machine. and improved prognosis.
本领域技术人员可以理解,上述实施方式中各种方法的全部或部分功能可以通过硬件的方式实现,也可以通过计算机程序的方式实现。当上述实施方式中全部或部分功能通过计算机程序的方式实现时,该程序可以存储于一计算机可读存储介质中,存储介质可以包括:只读存储器、随机存储器、磁盘、光盘、硬盘等,通过计算机执行该程序以实现上述功能。例如,将程序存储在设备的存储器中,当通过处理器执行存储器中程序,即可实现上述全部或部分功能。另外,当上述实施方式中全部或部分功能通过计算机程序的方式实现时,该程序也可以存储在服务器、另一计算机、磁盘、光盘、闪存盘或移动硬盘等存储介质中,通过下载或复制保存到本地设备的存储器中,或对本地设备的系统进行版本更新,当通过处理器执行存储器中的程序时,即可实现上述实施方式中全部或部分功能。Those skilled in the art can understand that all or part of the functions of the various methods in the foregoing embodiments may be implemented by means of hardware or by means of computer programs. When all or part of the functions in the above embodiments are implemented by means of a computer program, the program may be stored in a computer-readable storage medium, and the storage medium may include: read-only memory, random access memory, magnetic disk, optical disk, hard disk, etc. The computer executes the program to realize the above-mentioned functions. For example, the program is stored in the memory of the device, and when the program in the memory is executed by the processor, all or part of the above functions can be realized. In addition, when all or part of the functions in the above-mentioned embodiments are realized by means of a computer program, the program can also be stored in a server, another computer, a magnetic disk, an optical disk, a flash disk or a mobile hard disk and other storage media, and saved by downloading or copying All or part of the functions in the above embodiments can be implemented when the program in the memory is executed by the processor.
以上应用了具体个例对本发明进行阐述,只是用于帮助理解本发明,并不用以限制本发明。对于本发明所属技术领域的技术人员,依据本发明的思想,还可以做出若干简单推演、变形或替换。The above specific examples are used to illustrate the present invention, which are only used to help understand the present invention, and are not intended to limit the present invention. For those skilled in the art to which the present invention pertains, according to the idea of the present invention, several simple deductions, modifications or substitutions can also be made.

Claims (13)

  1. 一种通气治疗辅助设备,其特征在于,包括:A ventilation therapy auxiliary device, characterized in that it comprises:
    参数获取装置,用于获取患者在通气治疗中的生理参数和通气参数;A parameter acquisition device, used for acquiring physiological parameters and ventilation parameters of a patient in ventilation therapy;
    处理器,用于在检测到满足计时条件时,对患者当前通气策略下的通气治疗开始计时,根据计时得到通气治疗时间,以及根据所述生理参数和通气参数生成与通气治疗时间对应的氧合呼吸指数,所述氧合呼吸指数用于评价其所对应通气治疗时间内的通气治疗效果;以及The processor is configured to start timing the ventilation treatment under the current ventilation strategy of the patient when it is detected that the timing condition is met, obtain the ventilation treatment time according to the timing, and generate an oxygenation corresponding to the ventilation treatment time according to the physiological parameters and the ventilation parameters Respiratory index, the oxygenation respiratory index is used to evaluate the ventilation treatment effect within the corresponding ventilation treatment time; and
    确定到所述通气治疗时间达到第一时长阈值时,获取所述氧合呼吸指数与至少一个第一氧合呼吸指数阈值的第一氧合呼吸指数比对结果,获取所述通气参数与至少一个第一通气参数阈值的第一通气参数比对结果,获取所述生理参数与至少一个第一生理参数阈值的第一生理参数比对结果;When it is determined that the ventilation treatment time reaches a first duration threshold, a comparison result between the oxygenation breathing index and at least one first oxygenation breathing index threshold value is obtained, and the ventilation parameter and at least one oxygenation breathing index are obtained. a first ventilation parameter comparison result of the first ventilation parameter threshold, obtaining the first physiological parameter comparison result of the physiological parameter and at least one first physiological parameter threshold;
    根据所述第一氧合呼吸指数比对结果、第一通气参数比对结果和第一生理参数比对结果,输出相应的第一处置建议。According to the comparison result of the first oxygenation respiration index, the comparison result of the first ventilation parameter, and the comparison result of the first physiological parameter, a corresponding first treatment suggestion is output.
  2. 如权利要求1所述的设备,其特征在于,所述第一处置建议包括下面至少一种:The device of claim 1, wherein the first treatment suggestion comprises at least one of the following:
    改变所述通气策略;changing the ventilation strategy;
    继续以当前通气策略对患者进行通气治疗;Continue to ventilate the patient with the current ventilation strategy;
    继续以当前通气策略对患者进行通气治疗,直到所述通气治疗时间达到第二时长阈值。Continue to perform ventilation therapy on the patient with the current ventilation strategy until the ventilation therapy time reaches the second duration threshold.
  3. 如权利要求2所述的设备,其特征在于,所述处理器还用于:确定到所述通气治疗时间达到第二时长阈值时,获取所述氧合呼吸指数与至少一个第二氧合呼吸指数阈值的第二氧合呼吸指数比对结果,获取所述通气参数与至少一个第二通气参数阈值的第二通气参数比对结果,获取所述生理参数与至少一个第二生理参数阈值的第二生理参数比对结果,所述第二氧合呼吸指数比对结果、第二通气参数比对结果和第二生理参数比对结果,输出相应的第二处置建议。The device according to claim 2, wherein the processor is further configured to: obtain the oxygenation respiration index and at least one second oxygenation respiration when the ventilation therapy time reaches a second duration threshold. The comparison result of the second oxygenation respiration index of the index threshold is obtained, the comparison result of the ventilation parameter and the second ventilation parameter of the at least one second ventilation parameter threshold is obtained, and the first comparison result between the physiological parameter and the at least one second physiological parameter threshold is obtained. Two physiological parameter comparison results, the second oxygenation respiration index comparison result, the second ventilation parameter comparison result and the second physiological parameter comparison result, and the corresponding second treatment suggestion is output.
  4. 如权利要求3所述的设备,其特征在于,所述第二处置建议包括下面至少一种:The device of claim 3, wherein the second treatment suggestion includes at least one of the following:
    改变所述通气策略;changing the ventilation strategy;
    继续以当前通气策略对患者进行通气治疗;Continue to ventilate the patient with the current ventilation strategy;
    继续以当前通气策略对患者进行通气治疗,直到所述通气治疗时间达到第三时长阈值。Continue to perform ventilation treatment on the patient with the current ventilation strategy until the ventilation treatment time reaches a third duration threshold.
  5. 如权利要求4所述的设备,其特征在于,所述处理器还用于:确定到所述通气治疗时间达到第三时长阈值时,获取所述氧合呼吸指数与至少一个第三氧合呼吸指数阈值的第三氧合呼吸指数比对结果,获取所述通气参数与至少一个第三通气参数阈值的第三通气参数比对结果,获取所述生理参数与至少一个第三生理参数阈值的第三生理参数比对结果,所述第三氧合呼吸指数比对结果、第三通气参数比对结果和第三生理参数比对结果,输出相应的第三处置建议。The device according to claim 4, wherein the processor is further configured to: obtain the oxygenation respiration index and at least one third oxygenation respiration when the ventilation therapy time reaches a third duration threshold. The comparison result of the third oxygenation respiration index of the index threshold is obtained, the comparison result of the ventilation parameter and the third ventilation parameter of the at least one third ventilation parameter threshold is obtained, and the third ventilation parameter of the physiological parameter and the at least one third physiological parameter threshold is obtained. Three physiological parameter comparison results, the third oxygenation respiration index comparison result, the third ventilation parameter comparison result and the third physiological parameter comparison result, output the corresponding third treatment suggestion.
  6. 如权利要求5所述的设备,其特征在于,所述第三处置建议包括:The device of claim 5, wherein the third treatment suggestion comprises:
    改变所述通气策略或继续以所述通气策略对患者进行通气治疗。Change the ventilation strategy or continue to ventilate the patient with the ventilation strategy.
  7. 如权利要求1至6中任一项所述的设备,其特征在于,所述氧合呼吸指数包括ROX指数、氧合指数、氧指数以及脉氧饱和度指数中的至少一个;所述生理参数包括血氧饱和度、心率、血压、呼气末二氧化碳中的至少一个;所述通气参数包括给氧浓度、吸入氧分压、气道流速、气道压力、呼吸率、潮气量和分钟通气量中至少一个。The device according to any one of claims 1 to 6, wherein the oxygenation respiration index comprises at least one of ROX index, oxygenation index, oxygen index and pulse oxygen saturation index; the physiological parameter Including at least one of blood oxygen saturation, heart rate, blood pressure, end-tidal carbon dioxide; the ventilation parameters include oxygen concentration, partial pressure of inspired oxygen, airway flow rate, airway pressure, respiratory rate, tidal volume and minute ventilation at least one of them.
  8. 如权利要求1所述的设备,其特征在于,所述通气策略包括通气方式和/或通气模式,所述通气方式包括常规氧疗、高流量氧疗、无创通气、有创通气、高频通气以及体外膜肺氧合中的至少一个,所述通气模式包括持续气道正压通气、容控模式通气、压控模式通气、压力支持通气、双相气道正压通气、双水平气道正压通气、气道压力释放通气、压力调节容量控制通气、容量支持通气、同步间歇指令通气、容量保障压力支持通气以及闭环通气中的至少一个。The device according to claim 1, wherein the ventilation strategy includes ventilation modes and/or ventilation modes, and the ventilation modes include conventional oxygen therapy, high-flow oxygen therapy, non-invasive ventilation, invasive ventilation, and high-frequency ventilation and at least one of extracorporeal membrane oxygenation, the ventilation modes include continuous positive airway pressure, volume-controlled mode ventilation, pressure-controlled mode ventilation, pressure support ventilation, biphasic positive airway pressure, bilevel positive airway pressure at least one of pressure ventilation, airway pressure release ventilation, pressure modulated volume control ventilation, volume support ventilation, synchronized intermittent mandatory ventilation, volume guaranteed pressure support ventilation, and closed loop ventilation.
  9. 一种通气治疗辅助设备,其特征在于,包括:A ventilation therapy auxiliary device, characterized in that it comprises:
    参数获取装置,用于获取患者在通气治疗中的生理参数和通气参数;A parameter acquisition device, used for acquiring physiological parameters and ventilation parameters of a patient in ventilation therapy;
    处理器,用于在检测到满足计时条件时,对患者当前通气策略下的通气治疗开始计时,根据计时得到通气治疗时间,以及根据所述生理参数和通气参数生成与通气治疗时间对应的氧合呼吸指数,所述氧合呼吸指数用于评价其所对应通气治疗时间内的通气治疗效果;以及The processor is configured to start timing the ventilation treatment under the current ventilation strategy of the patient when it is detected that the timing condition is met, obtain the ventilation treatment time according to the timing, and generate an oxygenation corresponding to the ventilation treatment time according to the physiological parameters and the ventilation parameters Respiratory index, the oxygenation respiratory index is used to evaluate the ventilation treatment effect within the corresponding ventilation treatment time; and
    在检测到满足评估条件时,将所述氧合呼吸指数与氧合呼吸指数阈值进行比对,获取氧合呼吸指数比对结果,将所述生理参数与生理参数阈值进行比对,获取生理参数比对结果,将所述通气参数与通气参数阈值进行比对,获取通气参数比对结果,根据所述氧合呼吸指数比对结果、所述生理参数比对结果和所述通气参数比对结果输出处置建议。When it is detected that the evaluation conditions are met, the oxygenation respiration index is compared with the oxygenation respiration index threshold to obtain the oxygenation respiration index comparison result, and the physiological parameter is compared with the physiological parameter threshold to obtain the physiological parameter Compare the result, compare the ventilation parameter with the ventilation parameter threshold, obtain the ventilation parameter comparison result, and obtain the ventilation parameter comparison result according to the oxygenation respiration index comparison result, the physiological parameter comparison result and the ventilation parameter comparison result Output disposition recommendations.
  10. 如权利要求9所述的设备,其特征在于,所述评估条件包括所述通气治疗时间达到预设时长阈值,其中,所述预设时长阈值包括多个,多个预设时长阈值均具有对应的氧合呼吸指数阈值、通气参数阈值以及生理参数阈值;或者The device according to claim 9, wherein the evaluation condition includes that the ventilation treatment time reaches a preset duration threshold, wherein the preset duration threshold includes a plurality of preset duration thresholds, and each of the multiple preset duration thresholds has a corresponding Oxygenation Respiratory Index Threshold, Ventilation Parameter Threshold, and Physiological Parameter Threshold; or
    所述评估条件为所述处理器开始对所述通气治疗开始计时;或者The evaluation condition is that the processor starts timing the start of the ventilation therapy; or
    所述评估条件为所述生理参数和/或所述通气参数满足预设条件并持续预设时长;或者The evaluation condition is that the physiological parameter and/or the ventilation parameter meets a preset condition and lasts for a preset period of time; or
    所述评估条件为所述生理参数和/或所述通气参数中满足预设条件的参数比例达到预设比例阈值。The evaluation condition is that the ratio of the physiological parameters and/or the ventilation parameters satisfying the preset condition reaches a preset ratio threshold.
  11. 一种医疗设备系统,其特征在于,包括:A medical device system, comprising:
    呼吸支持设备,用于为患者提供通气治疗;Respiratory support equipment to provide ventilation therapy to patients;
    权利要求1至10中任一项所述的通气治疗辅助设备;The ventilation therapy assisting device of any one of claims 1 to 10;
    显示设备,用于显示所述通气治疗辅助设备输出的处置建议。A display device for displaying treatment suggestions output by the ventilation therapy aid device.
  12. 一种医疗设备系统,其特征在于,包括:A medical device system, comprising:
    多个医疗设备,所述多个医疗设备中至少一个医疗设备具有参数获取装置,所述参数获取装置用于获取患者在通气治疗中的生理参数和通气参数;A plurality of medical devices, at least one of the plurality of medical devices has a parameter acquisition device, and the parameter acquisition device is used to obtain the physiological parameters and ventilation parameters of the patient during the ventilation treatment;
    所述多个医疗设备中至少一个医疗设备用于在检测到满足计时条件时,对患者当前通气策略下的通气治疗开始计时,根据计时得到通气治疗时间,以及根据所述生理参数和通气参数生成与通气治疗时间对应的氧合呼吸指数,所述氧合呼吸指数用于评价其所对应通气治疗时间内的通气治疗效果;以及At least one medical device in the plurality of medical devices is used to start timing the ventilation treatment under the patient's current ventilation strategy when it is detected that the timing condition is met, obtain the ventilation treatment time according to the timing, and generate a ventilation treatment time according to the physiological parameter and the ventilation parameter. The oxygenation respiration index corresponding to the ventilation treatment time, the oxygenation respiration index is used to evaluate the ventilation treatment effect within the ventilation treatment time corresponding to it; and
    在检测到满足评估条件时,将所述氧合呼吸指数与氧合呼吸指数阈值进行比对,获取氧合呼吸指数比对结果,将所述生理参数与生理参数阈值进行比对,获取生理参数比对结果,将所述通气参数与通气参数阈值进行比对,获取通气参数比对结果,根据所述氧合呼吸指数比对结果、所述生理参数比对结果和所述通气参数比对结果输出通气处置建议。When it is detected that the evaluation conditions are met, the oxygenation respiration index is compared with the oxygenation respiration index threshold to obtain the oxygenation respiration index comparison result, and the physiological parameter is compared with the physiological parameter threshold to obtain the physiological parameter Compare the result, compare the ventilation parameter with the ventilation parameter threshold, obtain the ventilation parameter comparison result, and obtain the ventilation parameter comparison result according to the oxygenation respiration index comparison result, the physiological parameter comparison result and the ventilation parameter comparison result Output ventilation disposition recommendations.
  13. 如权利要求12所述的系统,其特征在于,所述医疗设备系统包括呼吸机、麻醉机、氧疗仪、监护仪、中央站、医疗信息系统和医疗移动终端中的至少一个。The system of claim 12, wherein the medical equipment system comprises at least one of a ventilator, an anesthesia machine, an oxygen therapy apparatus, a monitor, a central station, a medical information system and a medical mobile terminal.
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