CN101757707A - Method for controlling end-expiratory pressure and ventilator using same - Google Patents
Method for controlling end-expiratory pressure and ventilator using same Download PDFInfo
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- CN101757707A CN101757707A CN200810239300A CN200810239300A CN101757707A CN 101757707 A CN101757707 A CN 101757707A CN 200810239300 A CN200810239300 A CN 200810239300A CN 200810239300 A CN200810239300 A CN 200810239300A CN 101757707 A CN101757707 A CN 101757707A
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Abstract
The invention provides a method for controlling an end-expiratory pressure valve and a ventilator using the same. In the invention, the method for controlling the end-expiratory pressure comprises the following steps: the step of setting: setting the sizes of the openings of end-expiratory pressure valve in accordance with the predetermined end-expiratory pressure; the step of detecting: detecting the end-expiratory pressure; the step of comparing: comparing the end-expiratory pressure with the predetermined end-expiratory pressure; the step of adjusting: when the end-expiratory pressure is not equal to the predetermined end-expiratory pressure, changing the sizes of the openings of the end-expiratory pressure valve by the first predetermined value; and repeating the steps of detecting, comparing and adjusting until the end-expiratory pressure is consistent with the predetermined end-expiratory pressure. The effect of accurately controlling the end-expiratory pressure is achieved through the invention.
Description
Technical field
The present invention relates to the electric electricing breathing machine field, more specifically, relate to the respirator of a kind of end-tidal air pressure control method and this method of employing.
Background technology
Electric electricing breathing machine adopts straight moving end-tidal air pressure (positive end-expiratorypressure is called for short PEEP) valve to realize the control to PEEP.This control for PEEP is had higher requirement, and PEEP is meant that when control breathing and assisted respiartion the phase air flue of exhaling keeps malleation, and the end makes airway pressure be higher than atmospheric pressure by means of the devices such as restriction air-flow flap valve that are contained in the end of exhaling exhaling eventually.
For electric electricing breathing machine,,, not only can not keep stable PEEP, and can influence the effect of breathing pattern if bad to the control of PEEP valve owing to there is not continuous flow.Carrying out PCV (pressure control ventilation, when pressure controlled ventilation) pattern is controlled, because the operation curve of piston and the control curve linear relationship complexity of motor, can change in vapour lock that adds the patient and compliance, control to the PCV breathing pattern brings very big difficulty, realizes that by the control of PEEP valve the control of PCV breathing pattern implements simple and reliable.
For the control of the PEEP of electric electricing breathing machine, owing to do not have continuous flow, PEEP to be difficult to keep.At present, the electric pulmotor that has adopts the built-in miniature air pump to transfer PEEP control to continuous flow, obvious like this cost and the complexity of having increased is provided; The electric electricing breathing machine that also has adopts the Direct Action Type outlet valve to realize keeping of PEEP, adopts this method, because machinery control diaphragm is not easy to keep balance, causes the end-tidal shake easily, can't reach the effect of accurate control patient's end-tidal air pressure.
Summary of the invention
In view of above one or more problems, the present invention proposes the respirator of a kind of end-tidal air pressure control method and this method of employing, it can reach the effect of accurate control patient's end-tidal air pressure.
According to an aspect of the present invention, proposed a kind of end-tidal air pressure control method, may further comprise the steps: set step, set the openings of sizes of end-expiratory pressure valve according to end-tidal air pressure predetermined value; Measuring process is measured end-tidal air pressure; Comparison step compares end-tidal air pressure and end-tidal air pressure predetermined value; Regulating step under end-tidal air pressure and the inconsistent situation of end-tidal air pressure predetermined value, changes first scheduled volume with the openings of sizes of end-expiratory pressure valve; And repeated measure step, comparison step and regulating step, consistent up to end-tidal air pressure with end-tidal air pressure predetermined value.
Wherein, set step and may further comprise the steps: the controlling value of setting the valve control module is set the openings of sizes of end-expiratory pressure valve, and wherein, the valve control module is used to control end-expiratory pressure valve.Regulating step may further comprise the steps: under end-tidal air pressure and the inconsistent situation of end-tidal air pressure predetermined value, controlling value is changed second scheduled volume.
This end-tidal air pressure control method can also may further comprise the steps: the frequency n that preestablishes repeated measure step, comparison step and regulating step; And after repeated measure step, comparison step and regulating step frequency n, stop repetition, and notify the user to reset second scheduled volume.End-tidal air pressure control method can also may further comprise the steps: determine the curve linear relationship between end-tidal air pressure predetermined value and the controlling value; And determine controlling value corresponding to end-tidal air pressure predetermined value according to curve linear relationship and end-tidal air pressure predetermined value.Wherein, the valve control module can be a digital analog converter, and controlling value is the control current value I s of digital analog converter output.The consistent absolute value of the difference between end-tidal air pressure and the end-tidal air pressure predetermined value that is meant with end-tidal air pressure predetermined value of end-tidal air pressure is less than predetermined error allowed band.
End-tidal air pressure control method can also may further comprise the steps: with after end-tidal air pressure predetermined value is consistent, close end-expiratory pressure valve at end-tidal air pressure, the variation of monitoring end-tidal air pressure; Surpass under the situation of end-tidal air pressure predetermined value predetermined difference value at end-tidal air pressure, open end-expiratory pressure valve, return to end-tidal air pressure predetermined value up to end-tidal air pressure; And close end-expiratory pressure valve.Wherein, predetermined difference value can be 3 centimeter water columns.
According to another aspect of the present invention, a kind of respirator that adopts said method has also been proposed.
In the present invention, utilize measurement, comparison and regulating step, control breathing end air pressure is consistent with predetermined value effectively.And, by repeated measure step, comparison step and regulating step, realized closed loop control, thereby can reach the effect of controlling end-tidal air pressure more accurately.In addition, by preestablishing number of repetition n, and respirator fault etc. break down or unexpected situation under, can avoid controlling pressure abnormity, thereby guarantee patient's safety.Moreover, by end-tidal air pressure with close end-expiratory pressure valve after end-tidal air pressure predetermined value is consistent, can keep end-tidal air pressure and change during certain little.In addition, open end-expiratory pressure valve, under the situation of thinking initiatively to breathe, can guarantee effectively that patient's breathing is smooth and easy the patient by surpassing under the situation of end-tidal air pressure predetermined value predetermined difference value at end-tidal air pressure.
Description of drawings
Accompanying drawing described herein is used to provide further understanding of the present invention, constitutes the application's a part, and illustrative examples of the present invention and explanation thereof are used to explain the present invention, do not constitute improper qualification of the present invention.In the accompanying drawings:
Fig. 1 is the flow chart according to the end-tidal air pressure control method of exemplary embodiment of the present invention;
Fig. 2 is a flow chart of regulating end-tidal air pressure according to an embodiment of the invention by the controlling value (electric current) of control valve control module;
Fig. 3 is the corresponding relation figure of the PEEP value of the output voltage values of the digital analog converter (DAC) according to exemplary embodiment of the present invention and actual measurement; And
Fig. 4 is according to the pressure at the electric electricing breathing machine interface of exemplary embodiment of the present invention and flow velocity waveform figure.
The specific embodiment
Below with reference to accompanying drawing, describe the specific embodiment of the present invention in detail.
Fig. 1 is the flow chart according to the end-tidal air pressure control method of exemplary embodiment of the present invention.As shown in Figure 1, this method may further comprise the steps:
Step S102 sets step, sets the openings of sizes of end-expiratory pressure valve according to end-tidal air pressure predetermined value;
Step S104, measuring process is measured end-tidal air pressure;
Step S106, comparison step compares end-tidal air pressure and end-tidal air pressure predetermined value;
Step S108, regulating step under end-tidal air pressure and the inconsistent situation of end-tidal air pressure predetermined value, changes first scheduled volume with the openings of sizes of end-expiratory pressure valve; And
Repeated measure step 104 is to step 108, and is consistent with end-tidal air pressure predetermined value up to end-tidal air pressure.
Wherein, set step and may further comprise the steps: the controlling value of setting the valve control module is set the openings of sizes of end-expiratory pressure valve, and wherein, the valve control module is used to control end-expiratory pressure valve.Regulating step may further comprise the steps: under end-tidal air pressure and the inconsistent situation of end-tidal air pressure predetermined value, controlling value is changed second scheduled volume.
This end-tidal air pressure control method can also may further comprise the steps: the frequency n that preestablishes repeated measure step, comparison step and regulating step; And after repeated measure step, comparison step and regulating step frequency n, stop repetition, and notify the user to reset second scheduled volume.End-tidal air pressure control method can also may further comprise the steps: determine the curve linear relationship between end-tidal air pressure predetermined value and the controlling value; And determine controlling value corresponding to end-tidal air pressure predetermined value according to curve linear relationship and end-tidal air pressure predetermined value.Wherein, the valve control module can be a digital analog converter, and controlling value is the control current value I s of digital analog converter output.The consistent absolute value of the difference between end-tidal air pressure and the end-tidal air pressure predetermined value that is meant with end-tidal air pressure predetermined value of end-tidal air pressure is less than predetermined error allowed band.
End-tidal air pressure control method can also may further comprise the steps: with after end-tidal air pressure predetermined value is consistent, close end-expiratory pressure valve at end-tidal air pressure, the variation of monitoring end-tidal air pressure; Surpass under the situation of end-tidal air pressure predetermined value predetermined difference value at end-tidal air pressure, open end-expiratory pressure valve, return to end-tidal air pressure predetermined value up to end-tidal air pressure; And close end-expiratory pressure valve.Wherein, predetermined difference value can be 3 centimeter water columns.
Fig. 2 regulates the flow chart of the method for end-tidal air pressure by the controlling value (electric current) of control valve control module according to an embodiment of the invention.As shown in Figure 2, this method may further comprise the steps:
Step S202 sets initialization fine setting frequency n, wherein n 〉=1; Calculate end-tidal air pressure and set value pairing pressure transducer value Pj; Set fine setting error allowed band Pr;
On respirator, set control current value I s; Set fine steps amount Ix;
Step S204 reads the pressure transducer value Pc of actual measurement; Calculate the absolute value Pabs of the difference of Pj and Pc;
Step S206 judges that Pabs whether greater than Pr, is not more than at Pabs under the situation of Pr, turns back to step S204;
Whether step S208-S212 under the situation of Pabs greater than Pr, judges Pj greater than Pc, under the situation of Pj greater than Pc, will control current value I s and upwards finely tune Ix, under the situation of Pj less than Pc, will control current value I s and finely tune Ix downwards; And
Step S214-S218 will finely tune frequency n and subtract 1, and whether judge n greater than 0, n greater than 0 situation under, turn back to step S204, be not more than at n under 0 the situation, remind user verification Ix again.
According to exemplary embodiment of the present invention, when conduct was used to control the valve control module of PEEP valve, end-tidal air pressure control method may further comprise the steps when adopting digital analog converter (being called for short DAC):
At first, select the fixedly lung of vapour lock and compliance, the pipeline of respirator connects, and finds out the corresponding relation of the PEEP value of digital analog converter output voltage values and actual measurement.Fig. 3 shows the corresponding relation according to the PEEP value of the output voltage values of the DAC of exemplary embodiment of the present invention and actual measurement.
Secondly, according to the PEEP and the matched curve of DAC output voltage values of measuring, the method for matched curve is a method of least square, and this algorithm guarantees that all points all drop near the curve.
Then, when carrying out the control of PEEP, calculate the DAC output voltage predetermined value of needs according to the curve linear relationship that sets value and match obtains.According to this DAC output voltage predetermined value and in this DAC the relation of the control electric current of output voltage and output, determine with this output voltage predetermined value corresponding to control current value I s.Between EEP, set this control current value earlier, obtain the actual value of current PEEP by PEEP monitoring facilities module, by comparing setting value and the actual value of PEEP, judge the fine setting (as shown in Figure 2) of carrying out PEEP control, by fine setting several times, the actual value of PEEP and setting value are consistent, the PEEP of end-tidal control is finished substantially like this.
At last, after the actual value of PEEP and setting value are consistent, before inspiratory cycle arrives, close the PEEP valve next time, make the whole system sealing, it is constant to guarantee that PEEP can maintain setting value.And monitor airway pressure in real time, when airway pressure exceeds PEEP setting value 3cmH
2During O, show that the patient has the desire of expiration, should open the PEEP valve this moment, up to the PEEP value that reaches setting, closes the PEEP valve again, and can keep stable PEEP value so can not influence patient's expiration again.
The method of controlling according to the end-expiratory pressure valve to respirator of exemplary embodiment of the present invention has realized 0-30cmH
2The PEEP control level of O adopts close-loop control mode, even different lungs also can reach identical control level.Such as, setting the PEEP value is 8cmH
2O, actual PEEP measured value can reach 7.9cmH
2O or 8.0cmH
2O.This method adopts different control modes under different breathing patterns, reached the perfect adaptation that realizes PEEP control and breathing pattern, and this method is simple to operate, easily realizes having the good clinical experiment effect.
According to a further aspect in the invention, propose a kind of respirator, adopted above-mentioned end-tidal air pressure control method in this respirator.
Fig. 4 is according to the pressure at the electric electricing breathing machine interface of exemplary embodiment of the present invention and flow velocity waveform figure.As shown in Figure 4, when setting value, PEEP is 10cmH
2O, controlling value and setting value are consistent, and it is relatively good that the end-tidal pressure waveform shows that steadily PEEP keeps.Wherein, Paw represents patient airway pressure with the variation relation of breathing cycle, and the peak value of pressure appears at air-breathing end and exhales beginning moment, and the illustrated pressure platform phase belongs to end expiratory positive pressure and keeps the phase; The last semiaxis of Flow is represented the inspiratory flow rate waveform, and following semiaxis is represented the exhalation flow rate waveform.
In a word, the method of controlling according to the end-expiratory pressure valve to respirator of exemplary embodiment of the present invention can guarantee that with respirator the airway pressure of end-tidal is consistent with end-tidal air pressure setting value, adopt the control mode of closed loop to guarantee that the replacing patient still can meet the demands, can improve patient's lung compliance, prevent that alveolar from withering, functional residual capacity is increased, and gas exchange area increases, and improves ventilation and oxygenate.In the present invention, by repeated measure step, comparison step and regulating step, reached the effect of accurate control end-tidal air pressure.In addition, by preestablishing number of repetition n, and respirator fault etc. break down or unexpected situation under, guaranteed patient's safety.Once more, by end-tidal air pressure with close end-expiratory pressure valve after end-tidal air pressure predetermined value is consistent, kept end-tidal air pressure and changed during certain little.At last, open end-expiratory pressure valve, under the situation of thinking initiatively to breathe, guaranteed that patient's breathing is smooth and easy the patient by surpassing under the situation of end-tidal air pressure predetermined value predetermined difference value at end-tidal air pressure.
The above is the preferred embodiments of the present invention only, is not limited to the present invention, and for a person skilled in the art, the present invention can have various changes and variation.Within the spirit and principles in the present invention all, any modification of being done, be equal to replacement, improvement etc., all should be included within protection scope of the present invention.
Claims (10)
1. an end-tidal air pressure control method is characterized in that, may further comprise the steps:
Set step, set the openings of sizes of described end-expiratory pressure valve according to end-tidal air pressure predetermined value;
Measuring process is measured described end-tidal air pressure;
Comparison step compares described end-tidal air pressure and described end-tidal air pressure predetermined value;
Regulating step under described end-tidal air pressure and the inconsistent situation of described end-tidal air pressure predetermined value, changes first scheduled volume with the described openings of sizes of described end-expiratory pressure valve; And
Repeat described measuring process, described comparison step and described regulating step, consistent up to described end-tidal air pressure with described end-tidal air pressure predetermined value.
2. method according to claim 1 is characterized in that, described setting step may further comprise the steps:
The controlling value of setting the valve control module is set the openings of sizes of described end-expiratory pressure valve, and wherein, described valve control module is used to control described end-expiratory pressure valve.
3. method according to claim 2 is characterized in that, described regulating step may further comprise the steps:
Under described end-tidal air pressure and the inconsistent situation of described end-tidal air pressure predetermined value, described controlling value is changed second scheduled volume.
4. method according to claim 3 is characterized in that, and is further comprising the steps of:
Preestablish the frequency n that repeats described measuring process, described comparison step and described regulating step; And
After repeating described measuring process, described comparison step and the described frequency n of described regulating step, stop repetition, and notify the user to reset described second scheduled volume.
5. method according to claim 4 is characterized in that, and is further comprising the steps of:
Determine the curve linear relationship between described end-tidal air pressure predetermined value and the described controlling value; And
Determine described controlling value according to described curve linear relationship and described end-tidal air pressure predetermined value corresponding to described end-tidal air pressure predetermined value.
6. method according to claim 4 is characterized in that, described valve control module is a digital analog converter, and described controlling value is the control current value I s of described digital analog converter output.
7. method according to claim 1 is characterized in that, described end-tidal air pressure is consistent with described end-tidal air pressure predetermined value to be that the absolute value of the difference between described end-tidal air pressure and the described end-tidal air pressure predetermined value is less than predetermined error allowed band.
8. method according to claim 1 is characterized in that, and is further comprising the steps of:
With after described end-tidal air pressure predetermined value is consistent, close described end-expiratory pressure valve at described end-tidal air pressure, monitor the variation of described end-tidal air pressure;
Surpass under the situation of described end-tidal air pressure predetermined value predetermined difference value at described end-tidal air pressure, open described end-expiratory pressure valve, return to described end-tidal air pressure predetermined value up to described end-tidal air pressure; And
Close described end-expiratory pressure valve.
9. method according to claim 9 is characterized in that, described predetermined difference value is 3 centimeter water columns.
10. respirator that adopts each described method in the claim 1 to 9.
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| CN200810239300.XA CN101757707B (en) | 2008-12-08 | 2008-12-08 | Method for controlling end-expiratory pressure and ventilator using same |
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| CN102266631A (en) * | 2010-12-31 | 2011-12-07 | 北京谊安医疗***股份有限公司 | Method and device for inspecting PEEP (positive end expiratory pressure) valve |
| WO2014101548A1 (en) * | 2012-12-26 | 2014-07-03 | 北京谊安医疗***股份有限公司 | Turbine ventilator pressure-controlled ventilation method |
| WO2014101549A1 (en) * | 2012-12-26 | 2014-07-03 | 北京谊安医疗***股份有限公司 | Ventilator turbine volume-controlled ventilation method |
| CN103908726A (en) * | 2012-12-29 | 2014-07-09 | 北京谊安医疗***股份有限公司 | Electric control breathing machine or anesthesia machine active exhalation valve based automatic calibration method |
| CN104001249A (en) * | 2014-06-13 | 2014-08-27 | 北京易世恒电子技术有限责任公司 | Method and device for controlling positive end expiratory pressure |
| CN104635777A (en) * | 2014-12-30 | 2015-05-20 | 河南西瑞医疗电子技术有限公司 | Precise pneumatic control method for voice coil motor |
| CN104841055A (en) * | 2015-04-21 | 2015-08-19 | 深圳市科曼医疗设备有限公司 | Control method, device and system for breathing machine PEEP valve |
| CN104874083A (en) * | 2014-02-28 | 2015-09-02 | 北京谊安医疗***股份有限公司 | PEEP valve verification method |
| WO2017079860A1 (en) * | 2015-11-10 | 2017-05-18 | 石洪 | Method for respirator pressure control |
| CN109419510A (en) * | 2017-08-23 | 2019-03-05 | 弓场商事株式会社 | Expiratory pressure measuring instrument |
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| DE19849540B4 (en) * | 1998-07-06 | 2006-09-28 | Siemens Ag | Method and mobile network for handling a packet data service |
| CN100594956C (en) * | 2007-12-29 | 2010-03-24 | 北京谊安医疗***股份有限公司 | Expiratory valve system |
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| WO2012089084A1 (en) * | 2010-12-31 | 2012-07-05 | 北京谊安医疗***股份有限公司 | Method and device for calibrating peep valve |
| CN102266631A (en) * | 2010-12-31 | 2011-12-07 | 北京谊安医疗***股份有限公司 | Method and device for inspecting PEEP (positive end expiratory pressure) valve |
| WO2014101548A1 (en) * | 2012-12-26 | 2014-07-03 | 北京谊安医疗***股份有限公司 | Turbine ventilator pressure-controlled ventilation method |
| WO2014101549A1 (en) * | 2012-12-26 | 2014-07-03 | 北京谊安医疗***股份有限公司 | Ventilator turbine volume-controlled ventilation method |
| EA025934B1 (en) * | 2012-12-26 | 2017-02-28 | Бейджин Аеонмед Ко., Лтд. | Lung ventilator turbine volume-controlled ventilation method |
| EA026032B1 (en) * | 2012-12-26 | 2017-02-28 | Бейджин Аеонмед Ко., Лтд. | Lung turbine ventilator pressure-controlled ventilation method |
| CN103908726A (en) * | 2012-12-29 | 2014-07-09 | 北京谊安医疗***股份有限公司 | Electric control breathing machine or anesthesia machine active exhalation valve based automatic calibration method |
| CN104874083A (en) * | 2014-02-28 | 2015-09-02 | 北京谊安医疗***股份有限公司 | PEEP valve verification method |
| CN104001249B (en) * | 2014-06-13 | 2016-06-15 | 北京易世恒电子技术有限责任公司 | Breathe control method and the device of last malleation |
| CN104001249A (en) * | 2014-06-13 | 2014-08-27 | 北京易世恒电子技术有限责任公司 | Method and device for controlling positive end expiratory pressure |
| CN104635777A (en) * | 2014-12-30 | 2015-05-20 | 河南西瑞医疗电子技术有限公司 | Precise pneumatic control method for voice coil motor |
| CN104841055A (en) * | 2015-04-21 | 2015-08-19 | 深圳市科曼医疗设备有限公司 | Control method, device and system for breathing machine PEEP valve |
| WO2017079860A1 (en) * | 2015-11-10 | 2017-05-18 | 石洪 | Method for respirator pressure control |
| CN109419510A (en) * | 2017-08-23 | 2019-03-05 | 弓场商事株式会社 | Expiratory pressure measuring instrument |
| CN110038200A (en) * | 2019-05-07 | 2019-07-23 | 濡新（北京）科技发展有限公司 | A kind of expectoration device and method limiting expectoration tolerance |
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