CN109718441A - Respiration parameter adjusting method, device and the Breathing Suppotion equipment of Breathing Suppotion equipment - Google Patents
Respiration parameter adjusting method, device and the Breathing Suppotion equipment of Breathing Suppotion equipment Download PDFInfo
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Abstract
Respiration parameter adjusting method, device and the Breathing Suppotion equipment of present invention proposition Breathing Suppotion equipment, method includes the following steps: in venting process, the essential information of patient and the respiration parameter of Breathing Suppotion equipment are obtained in real time, wherein, the essential information of patient includes at least blood pressure, blood oxygen saturation and illness, and respiration parameter includes at least: fraction of inspired oxygen and end-expiratory positive pressure；According to essential information and respiration parameter, respiration parameter is adjusted using corresponding parameter regulation strategy, wherein, parameter regulation strategy includes that acute respiratory distress syndrome adjusts strategy, chronic obstructive pulmonary disease adjusts strategy, low blood pressure adjusts strategy and Stress index adjusts strategy.The present invention can automatically, quickly and accurately adjust Breathing Suppotion device parameter, to quickly correct hypoxemia blood oxygen disease, so that the ventilation being conducive to patient assists in the treatment of, improve off line success rate and safety.
Description
Technical field
The present invention relates to field of medical technology, in particular to the respiration parameter adjusting method, device of Breathing Suppotion equipment and
Breathing Suppotion equipment.
Background technique
Acute respiratory distress syndrome (Acute Respiratory Distress Syndrome, ARDS) is by intrapulmonary
Caused by reason and/or extrapulmonary reason, using intractable hypoxemia as the clinical syndrome of notable feature, due to high case fatality rate again
It is concerned.The cause of disease of acute respiratory distress syndrome is various, different pathogeny induced Acute Respiratory Distress Syndrome(RDS) pathogenesis
It has nothing in common with each other.Clinical manifestation is in Acute onset, respiratory distress more and is difficult to hypoxemia of conventional oxygen therapy correction etc..
The treatment of acute respiratory distress syndrome includes Failure Treated with Mechanical Ventilation and on-mechanical ventilation therapy two major classes.Machinery is logical
Gas is the essential therapeutic arsenals of Patients with ARDS.Currently, being directed to the machine of Patients with ARDS
Tool ventilation strategies mainly include the following contents: lung preversation ventilation strategies (small tidal volume ventilation, pressure limit ventilation, permission property
Hypercapnia, inverse ventilation, PEEP (Positive End Expiratory Pressure, PEEP) application etc.), lung it is open
Strategy (particular technique includes: lung recruitment, best PEEP application and selection of Mechanical Ventilation Modes etc.) and mechanical ventilation are auxiliary
Help treatment.
And clinically, how to be adjusted by Breathing Suppotion device parameter quickly to correct hypoxemia blood oxygen disease, in protopathy
After improvement again how off line safely and fast, be still by the experience of doctor and carry out.And there are in the industry rich experiences, adjust
Accurate doctor's resource is very limited, therefore, the disadvantage for causing the generally existing low efficiency in this part, accuracy low, and then cause
Off line success rate and safety are lower.
Summary of the invention
The present invention is directed at least solve one of above-mentioned technical problem.
For this purpose, the first purpose of this invention is to propose a kind of respiration parameter adjusting method of Breathing Suppotion equipment, it should
Method can automatically, quickly and accurately adjust Breathing Suppotion device parameter, so that hypoxemia blood oxygen disease is quickly corrected, to be conducive to
To the ventilation adjuvant treatment of patient, off line success rate and safety are improved.
Second object of the present invention is to propose a kind of respiration parameter regulating device of Breathing Suppotion equipment.
Third object of the present invention is to propose a kind of Breathing Suppotion equipment.
To achieve the goals above, the embodiment of first aspect present invention proposes a kind of breathing ginseng of Breathing Suppotion equipment
Number adjusting method, comprising the following steps: in venting process, obtain the essential information of patient and exhaling for Breathing Suppotion equipment in real time
Inhale parameter, wherein the essential information of the patient includes at least blood pressure, blood oxygen saturation and illness, and the respiration parameter is at least
It include: fraction of inspired oxygen and end-expiratory positive pressure；According to the essential information and respiration parameter, using corresponding parameter regulation strategy
The respiration parameter to be adjusted, wherein the parameter regulation strategy include acute respiratory distress syndrome adjust strategy,
Chronic obstructive pulmonary disease adjusts strategy, low blood pressure adjusts strategy and Stress index adjusts strategy.
The respiration parameter adjusting method of Breathing Suppotion equipment according to an embodiment of the present invention, can be according to the basic letter of patient
The respiration parameter of breath and Breathing Suppotion equipment, chooses suitable parameter regulation strategy respiration parameter to be adjusted, can
Automatically, Breathing Suppotion device parameter is quickly and accurately adjusted, so that hypoxemia blood oxygen disease is quickly corrected, to be conducive to patient's
Ventilation adjuvant treatment, improves off line success rate and safety.
In addition, the respiration parameter adjusting method of Breathing Suppotion equipment according to the above embodiment of the present invention can also have as
Under additional technical characteristic:
In some instances, described according to the essential information and respiration parameter, using corresponding parameter regulation strategy come
The respiration parameter is adjusted, further comprises: when the blood pressure is lower than the lower limit value of default blood pressure range, using institute
It states low blood pressure and adjusts strategy；When the blood pressure is in the default blood pressure range and the illness as acute respiratory distress syndrome
When, strategy is adjusted using the acute respiratory distress syndrome；When the blood pressure is in the default blood pressure range and the disease
Disease is not acute respiratory distress syndrome, and Breathing Suppotion equipment is used in when holding control mode and patient does not have autonomous respiration
The Stress index adjusts strategy, otherwise adjusts strategy using the chronic obstructive pulmonary disease.
In some instances, it includes: when the fraction of inspired oxygen and institute that the acute respiratory distress syndrome, which adjusts strategy,
The value for stating end-expiratory positive pressure is adjusted in table in preset acute respiratory distress syndrome to be corresponded to, then embarrassed referring to the acute respiration
Compel syndrome and adjust table, when the blood oxygen saturation is lower than the lower limit value of default blood oxygen saturation range, by the sucking
The value of oxygen concentration and the end-expiratory positive pressure is adjusted to the right, when the blood oxygen saturation is within the scope of default blood oxygen saturation,
The value of the fraction of inspired oxygen and the end-expiratory positive pressure is adjusted to the left；When the fraction of inspired oxygen and the end-expiratory positive pressure
Value adjust in table and do not correspond in the acute respiratory distress syndrome, and the blood oxygen saturation is in default blood oxygen saturation
When in range, then by the value of the fraction of inspired oxygen and the end-expiratory positive pressure to intermediate regulations, until the fraction of inspired oxygen
It adjusts in table and corresponds in the acute respiratory distress syndrome with the value of the end-expiratory positive pressure, when the blood oxygen saturation is low
When the lower limit value of default blood oxygen saturation range, by the higher value in position in the fraction of inspired oxygen and the end-expiratory positive pressure
It remains unchanged, the lower value in position is gradually adjusted up.
In some instances, it includes: when the fraction of inspired oxygen and end-tidal that the chronic obstructive pulmonary disease, which adjusts strategy,
The value of positive pressure is adjusted in table in the acute respiratory distress syndrome and is corresponded to, then is based on preset acute respiratory distress syndrome
Table is adjusted, when blood oxygen saturation is higher than the lower limit value of default blood oxygen saturation range, the fraction of inspired oxygen is down to most
It is low, lower the value of the end-expiratory positive pressure；When the value of the fraction of inspired oxygen and the end-expiratory positive pressure is in the acute respiration
Distress syndrome is adjusted not to be corresponded in table, and the blood oxygen saturation then sucks oxygen when presetting within the scope of blood oxygen saturation
The value of concentration and end-expiratory positive pressure is to intermediate regulations, until the value of the fraction of inspired oxygen and the end-expiratory positive pressure is in the urgency
Property Respiratory Distress Syndrome(RDS) adjust it is corresponding in table, when the blood oxygen saturation is lower than the lower limit value of default blood oxygen saturation range
When, the higher value in position in the fraction of inspired oxygen and the end-expiratory positive pressure is remained unchanged, gradually by the lower value in position
It is adjusted up.
In some instances, it includes: in respiration parameter adjustment process, if adjusted for the first time that the low blood pressure, which adjusts strategy,
The blood pressure is lower than the lower limit value of default blood pressure range afterwards, then is adjusted to the end-expiratory positive pressure minimum；Otherwise, by the expiration
Last positive pressure adjusts table according to the acute respiratory distress syndrome and adjusts a value to the left；If the blood oxygen saturation is greater than pre-
If the upper limit value of blood oxygen saturation range then keeps fraction of inspired oxygen constant；If the blood oxygen saturation is less than default blood oxygen
The fraction of inspired oxygen is then adjusted to the right a value by the lower limit value of saturation degree range, until the blood pressure meets default blood pressure model
It encloses.
In some instances, it includes: acquisition Stress index that the Stress index, which adjusts strategy, and according to the Stress index
Value the end-expiratory positive pressure is adjusted；Compare the blood oxygen saturation and default blood oxygen saturation range, and according to than
The fraction of inspired oxygen is adjusted in relatively result.
In some instances, further includes: when the blood pressure is lower than the lower limit value of default blood pressure range and blood oxygen saturation
When degree is within the scope of default blood oxygen saturation, the first prompt information is issued；When institute's blood pressure is lower than under default blood pressure range
When limit value and the blood oxygen saturation are lower than the lower limit value of default blood oxygen saturation range, the second prompt information is issued.
To achieve the goals above, the embodiment of second aspect of the present invention proposes a kind of breathing ginseng of Breathing Suppotion equipment
Number regulating device, comprising: module is obtained, for obtaining the essential information of patient in real time and Breathing Suppotion being set in venting process
Standby respiration parameter, wherein the essential information of the patient includes at least blood pressure, blood oxygen saturation and illness, the breathing ginseng
Number includes at least: fraction of inspired oxygen and end-expiratory positive pressure；Adjustment module, for adopting according to the essential information and respiration parameter
The respiration parameter is adjusted with corresponding parameter regulation strategy, wherein the parameter regulation strategy includes acute exhales
Inhale Distress syndrome adjusting strategy, chronic obstructive pulmonary disease adjusts strategy, low blood pressure adjusts tactful and Stress index and adjusts strategy.
The respiration parameter regulating device of Breathing Suppotion equipment according to an embodiment of the present invention, can be according to the basic letter of patient
The respiration parameter of breath and Breathing Suppotion equipment, chooses suitable parameter regulation strategy respiration parameter to be adjusted, can
Automatically, Breathing Suppotion device parameter is quickly and accurately adjusted, so that hypoxemia blood oxygen disease is quickly corrected, to be conducive to patient's
Ventilation adjuvant treatment, improves off line success rate and safety.
In addition, the respiration parameter regulating device of Breathing Suppotion equipment according to the above embodiment of the present invention can also have as
Under additional technical characteristic:
In some instances, the adjustment module is used for: when the blood pressure is lower than the lower limit value of default blood pressure range, being adopted
Strategy is adjusted with the low blood pressure；It is that acute respiratory distress is comprehensive when the blood pressure is in the default blood pressure range and the illness
When simulator sickness, strategy is adjusted using the acute respiratory distress syndrome；When the blood pressure is in the default blood pressure range and institute
Stating illness is not acute respiratory distress syndrome, and Breathing Suppotion equipment is in and holds control mode and when patient does not have autonomous respiration,
Strategy is adjusted using the Stress index, strategy is otherwise adjusted using the chronic obstructive pulmonary disease.
To achieve the goals above, the embodiment of third aspect present invention proposes a kind of Breathing Suppotion equipment, including this
Invent the respiration parameter regulating device of Breathing Suppotion equipment described in above-mentioned second aspect embodiment.
Breathing Suppotion equipment according to an embodiment of the present invention, can be according to the essential information of patient and Breathing Suppotion equipment
Respiration parameter is chosen suitable parameter regulation strategy respiration parameter to be adjusted, can automatically, quickly and accurately be adjusted
Breathing Suppotion device parameter is saved, to quickly correct hypoxemia blood oxygen disease, so that the ventilation being conducive to patient assists in the treatment of, is improved de-
Machine success rate and safety.
Additional aspect and advantage of the invention will be set forth in part in the description, and will partially become from the following description
Obviously, or practice through the invention is recognized.
Detailed description of the invention
Above-mentioned and/or additional aspect of the invention and advantage will become from the description of the embodiment in conjunction with the following figures
Obviously and it is readily appreciated that, in which:
Fig. 1 is the flow chart of the respiration parameter adjusting method of Breathing Suppotion equipment according to an embodiment of the invention；
Fig. 2 is the structural block diagram of the respiration parameter regulating device of Breathing Suppotion equipment according to an embodiment of the invention.
Specific embodiment
The embodiment of the present invention is described below in detail, examples of the embodiments are shown in the accompanying drawings, wherein from beginning to end
Same or similar label indicates same or similar element or element with the same or similar functions.Below with reference to attached
The embodiment of figure description is exemplary, and for explaining only the invention, and is not considered as limiting the invention.
In the description of the present invention, it is to be understood that, term " center ", " longitudinal direction ", " transverse direction ", "upper", "lower",
The orientation or positional relationship of the instructions such as "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outside" is
It is based on the orientation or positional relationship shown in the drawings, is merely for convenience of description of the present invention and simplification of the description, rather than instruction or dark
Show that signified device or element must have a particular orientation, be constructed and operated in a specific orientation, therefore should not be understood as pair
Limitation of the invention.In addition, term " first ", " second " are used for description purposes only, it is not understood to indicate or imply opposite
Importance.
In the description of the present invention, it should be noted that unless otherwise clearly defined and limited, term " installation ", " phase
Even ", " connection " shall be understood in a broad sense, for example, it may be being fixedly connected, may be a detachable connection, or be integrally connected；It can
To be mechanical connection, it is also possible to be electrically connected；It can be directly connected, can also can be indirectly connected through an intermediary
Connection inside two elements.For the ordinary skill in the art, above-mentioned term can be understood at this with concrete condition
Concrete meaning in invention.
Respiration parameter adjusting method, the device of Breathing Suppotion equipment according to an embodiment of the present invention are described below in conjunction with attached drawing
And Breathing Suppotion equipment.Breathing Suppotion equipment in the present invention can be ventilator, Anesthesia machine etc. with Breathing Suppotion function
Machinery equipment.
Fig. 1 is the flow chart of the respiration parameter adjusting method of Breathing Suppotion equipment according to an embodiment of the invention.Such as
Shown in Fig. 1, method includes the following steps:
Step S1: in venting process, obtaining the essential information of patient and the respiration parameter of Breathing Suppotion equipment in real time,
In, the essential information of patient includes at least blood pressure, blood oxygen saturation and illness, and respiration parameter includes at least: fraction of inspired oxygen and
End-expiratory positive pressure.
Specifically, real-time monitoring blood pressure and blood oxygen saturation SpO i.e. in venting process2Numerical value, and determine patient
Illness, such as illness type.If blood oxygen saturation SpO2Lower than normal range (NR) (i.e. default blood oxygen saturation range), then pass through tune
Section fraction of inspired oxygen FiO2 and end-expiratory positive pressure PEEP adjusts SpO to reach2Purpose.Optionally, sufferer type may include
ARDS can also include ARDS and COPD simultaneously.
Step S2: according to essential information and respiration parameter, respiration parameter is carried out using corresponding parameter regulation strategy
It adjusts, wherein parameter regulation strategy includes that acute respiratory distress syndrome (ARDS) adjusts strategy, chronic obstructive pulmonary disease
(COPD) strategy is adjusted, low blood pressure adjusts strategy and Stress index adjusts strategy.
Specifically, in step s 2, according to essential information and respiration parameter, using corresponding parameter regulation strategy come to exhaling
It inhales parameter to be adjusted, further comprises: when blood pressure is lower than the lower limit value of default blood pressure range, plan being adjusted using low blood pressure
Slightly；When blood pressure is in default blood pressure range and illness is acute respiratory distress syndrome, using acute respiratory distress syndrome
Adjust strategy；When blood pressure is in default blood pressure range and illness is not acute respiratory distress syndrome, and at Breathing Suppotion equipment
When holding control mode and patient does not have autonomous respiration, strategy is adjusted using Stress index, otherwise uses chronic obstructive pulmonary disease tune
Section strategy.In other words, preferential that low blood pressure is selected to adjust plan when blood pressure low (i.e. lower limit value of the blood pressure lower than default blood pressure range)
Slightly；It when blood pressure normal (i.e. blood pressure is in default blood pressure range) and is patient ARDS (i.e. illness is acute respiratory distress syndrome)
When, then prior applicability ARDS adjusts strategy (i.e. acute respiratory distress syndrome adjusts strategy)；When blood pressure is normal, (i.e. blood pressure is in
Default blood pressure range) and be non-patient ARDS (i.e. illness is not acute respiratory distress syndrome), and work as control breathing and controlled to hold
Mode and when not having autonomous respiration, is adjusted using Stress index plan and is omited, otherwise adopted COPD and adjust tactful (i.e. chronic obstructive pulmonary disease
Adjust strategy).In other words, respiration parameter adjusting strategy can be according to patient condition real-time change in venting process.Optionally,
The lower limit value of default blood pressure range is, for example, 70 or 120, and for example, 70 correspond to diastolic pressure, and 120 correspond to systolic pressure, when
The diastolic pressure of patient is lower than 70 or systolic pressure is lower than 120, then determines that blood pressure is lower than the lower limit value of default blood pressure range, explanation
The patients' blood is lower.
In one embodiment of the invention, above-mentioned acute respiratory distress syndrome adjusts strategy (i.e. ARDS adjusting plan
It slightly) include: to be corresponded to when the value of fraction of inspired oxygen and end-expiratory positive pressure is adjusted in table in preset acute respiratory distress syndrome,
Table then is adjusted referring to preset acute respiratory distress syndrome, when blood oxygen saturation is lower than under default blood oxygen saturation range
When limit value, the value of fraction of inspired oxygen and end-expiratory positive pressure is adjusted to the right, when blood oxygen saturation is in default blood oxygen saturation range
When interior, the value of fraction of inspired oxygen and end-expiratory positive pressure is adjusted to the left；When the value of fraction of inspired oxygen and end-expiratory positive pressure is acute
Respiratory Distress Syndrome(RDS) is adjusted not to be corresponded in table, and blood oxygen saturation will then be sucked when presetting within the scope of blood oxygen saturation
The value of oxygen concentration and end-expiratory positive pressure is to intermediate regulations, until the value of fraction of inspired oxygen and end-expiratory positive pressure is in acute respiratory distress
Syndrome is adjusted in table and is corresponded to, dense by oxygen is sucked when blood oxygen saturation is lower than the lower limit value of default blood oxygen saturation range
The higher value in position remains unchanged in degree and end-expiratory positive pressure, and the lower value in position is gradually adjusted up.In other words, according to
ARDS table (i.e. preset acute respiratory distress syndrome adjusts table), as blood oxygen saturation SpO2(i.e. lower than normal range (NR)
Blood oxygen saturation is lower than the lower limit value of default blood oxygen saturation range) when, fraction of inspired oxygen FiO2With end-expiratory positive pressure PEEP's
Value is turned right tune, and SpO is worked as2After reaching target value (i.e. within the scope of default blood oxygen saturation), FiO2With PEEP according to above table
It adjusts to the left；Work as FiO2With the value of PEEP in the table not to it is corresponding when and SpO2Satisfied (the i.e. blood oxygen saturation SpO of value2Default
Within the scope of blood oxygen saturation), then by two value (i.e. FiO2With the value of PEEP) to intermediate regulations, until FiO2Exist with the value of PEEP
It is corresponding in table, work as SpO2Value be unsatisfied with (i.e. blood oxygen saturation SpO2Lower than the lower limit value of default blood oxygen saturation range) when,
Then by FiO2Constant with the higher value in position in PEEP, the lower value in position is gradually adjusted up.Optionally, blood oxygen saturation is preset
Spending the range for example, lower limit value of [95,100] namely default blood oxygen saturation range is 95.
In specific example, above-mentioned preset acute respiratory distress syndrome adjusts specific example such as the following table 1 institute of table
Show.
| FiO2 | 0.3 | 0.4 | 0.4 | 0.5 | 0.5 | 0.6 | 0.7 | 0.7 | 0.7 | 0.8 | 0.9 | 0.9 | 0.9 | 1.0 | 1.0 | 1.0 |
| PEEP | 5 | 5 | 8 | 8 | 10 | 10 | 10 | 12 | 14 | 14 | 14 | 16 | 18 | 20 | 22 | 24 |
Table 1
In one embodiment of the invention, it includes: to work as fraction of inspired oxygen that above-mentioned chronic obstructive pulmonary disease, which adjusts strategy,
It adjusts in table and corresponds in acute respiratory distress syndrome with the value of end-expiratory positive pressure, then it is comprehensive based on preset acute respiratory distress
Simulator sickness adjusts table, and when blood oxygen saturation is higher than the lower limit value of default blood oxygen saturation range, fraction of inspired oxygen is down to most
It is low, lower the value of end-expiratory positive pressure；When the value of fraction of inspired oxygen and end-expiratory positive pressure adjusts table in acute respiratory distress syndrome
It is not corresponded in lattice, and when blood oxygen saturation is within the scope of default blood oxygen saturation, then the value of fraction of inspired oxygen and end-expiratory positive pressure
To intermediate regulations, corresponded to until the value of fraction of inspired oxygen and end-expiratory positive pressure is adjusted in table in acute respiratory distress syndrome,
When blood oxygen saturation is lower than the lower limit value of default blood oxygen saturation range, by position in fraction of inspired oxygen and end-expiratory positive pressure compared with
High value remains unchanged, and the lower value in position is gradually adjusted up.In other words, chronic obstructive pulmonary disease adjusts strategy (i.e.
COPD adjusts strategy) it is similar with the adjusting of above-mentioned acute respiratory distress syndrome strategy (i.e. ARDS adjusts strategy), difference exists
In in ARDS adjusting strategy, when lower than normal range (NR), (i.e. blood oxygen saturation is lower than default blood oxygen and is saturated blood oxygen saturation SpO2
Spend the lower limit value of range) when, end-expiratory positive pressure PEEP remains unchanged, and fraction of inspired oxygen FiO2 first drops, after FiO2 is preferably minimized,
The value of PEEP is gradually lowered again.In specific example, fraction of inspired oxygen FiO2 is minimized, such as refer to and drop fraction of inspired oxygen
Down to 30%-40% oxygen concentration.
In one embodiment of the invention, above-mentioned low blood pressure adjust strategy include: in respiration parameter adjustment process,
If blood pressure is lower than the lower limit value of default blood pressure range after adjusting for the first time, end-expiratory positive pressure is adjusted to minimum；Otherwise, it will exhale
Last positive pressure adjusts table according to acute respiratory distress syndrome and adjusts a value to the left；If it is full that blood oxygen saturation is greater than default blood oxygen
With the upper limit value of degree range, then keep fraction of inspired oxygen constant；If blood oxygen saturation is less than default blood oxygen saturation range
Fraction of inspired oxygen is then adjusted to the right a value by lower limit value, until blood pressure meets default blood pressure range.In other words, it was adjusting
Cheng Zhong, when occur blood pressure it is low when, if it is what is occurred after initial setting up, then set minimum for PEEP；If not being derived from
PEEP is then adjusted a value by initial setting up to the left according to above table, if SpO2 value is higher than target zone (i.e. blood oxygen saturation
Greater than the upper limit value of default blood oxygen saturation range), then keep FiO2 constant, if SpO2 value miss the mark range (i.e. blood
Oxygen saturation is less than the lower limit value of default blood oxygen saturation range), then fraction of inspired oxygen FiO2 is adjusted into the right a value.Further
Ground then reverts to original adjusting strategy after blood pressure restores normal.In specific example, by end-expiratory positive pressure PEEP tune
It is extremely minimum, such as refer to and PEEP is reduced to 5cmH2O.
In one embodiment of the invention, it includes: acquisition Stress index that above-mentioned Stress index, which adjusts strategy, and according to
End-expiratory positive pressure is adjusted in the value of Stress index；Compare blood oxygen saturation and default blood oxygen saturation range, and according to than
Relatively fraction of inspired oxygen is adjusted in result.Specifically, as previously mentioned, working as patient does not have autonomous respiration, and control breathing is
When holding control mode, strategy is adjusted using Stress index and is adjusted.It is adjusted in strategy in Stress index, PEEP is adjusted and FiO2 tune
Section is mutually indepedent, and whether PEEP is 1 to be adjusted according to Stress index；Whether FiO2 reaches target according to the value of blood oxygen saturation
The adjusting that range (i.e. the comparison result of blood oxygen saturation and default blood oxygen saturation range) is increasedd or decreased.
In one embodiment of the invention, this method further include: when blood pressure be lower than the lower limit value of default blood pressure range and
When blood oxygen saturation is within the scope of default blood oxygen saturation, the first prompt information is issued；When institute's blood pressure is lower than default blood pressure range
Lower limit value and blood oxygen saturation when being lower than the lower limit value of default blood oxygen saturation range, issue the second prompt information.In other words,
That is blood pressure low (i.e. blood pressure be lower than default blood pressure range lower limit value) and normal (i.e. blood oxygen saturation is saturated blood oxygen in default blood oxygen
Spend in range) when, " off-capacity supplements colloid, and asks the blood pressure (i.e. the first prompt information) of survey in every five minutes " should be prompted,
When low (i.e. it is full to be lower than default blood oxygen to blood oxygen to blood pressure low (i.e. blood pressure be lower than default blood pressure range lower limit value) for blood oxygen saturation simultaneously
With the lower limit value of degree range) when, it prompts " colloidal solution please be supplement, please add spend adrenaline when necessary, increase blood pressure (i.e. as early as possible
Second prompt information) ".
It should be noted that the control interval time is shorter under normal circumstances.In adjustment process, it is saturated if there is blood oxygen
Spend SpO2It reduces suddenly, does not then wait until that timing completion can be adjusted；If adjusting is shaken, control interval is increased,
It is adjusted again.Wherein, the adjustable range of end-expiratory positive pressure PEEP meets lung protective ventilation, fraction of inspired oxygen FiO2 tune
Adjusting range is 30-100.
The respiration parameter adjusting method of Breathing Suppotion equipment according to an embodiment of the present invention, can be according to the basic letter of patient
The respiration parameter of breath and Breathing Suppotion equipment, chooses suitable parameter regulation strategy respiration parameter to be adjusted, can
Automatically, Breathing Suppotion device parameter is quickly and accurately adjusted, so that hypoxemia blood oxygen disease is quickly corrected, to be conducive to patient's
Ventilation adjuvant treatment, improves off line success rate and safety.
Further embodiment of the present invention also proposed a kind of respiration parameter regulating device of Breathing Suppotion equipment.
Fig. 2 is the structural block diagram of the respiration parameter regulating device of Breathing Suppotion equipment according to an embodiment of the invention.
As shown in Fig. 2, the respiration parameter regulating device 100 of the Breathing Suppotion equipment includes: to obtain module 110 and adjustment module 120.
Wherein, it obtains module 110 to be used in venting process, obtains the essential information and Breathing Suppotion equipment of patient in real time
Respiration parameter, wherein the essential information of patient includes at least blood pressure, blood oxygen saturation and illness, and respiration parameter includes at least:
Fraction of inspired oxygen and end-expiratory positive pressure.Specifically, real-time monitoring blood pressure and blood oxygen saturation SpO i.e. in venting process2's
Numerical value, and determine the illness of patient, such as illness type.If blood oxygen saturation SpO2Lower than normal range (NR) (i.e. default blood oxygen saturation
Spend range), then SpO is adjusted to reach by adjusting fraction of inspired oxygen FiO2 and end-expiratory positive pressure PEEP2Purpose.Optionally,
Sufferer type may include ARDS, can also simultaneously include ARDS and COPD.
Adjustment module 120 is used for according to essential information and respiration parameter, using corresponding parameter regulation strategy come to breathing
Parameter is adjusted, wherein parameter regulation strategy includes that acute respiratory distress syndrome adjusts strategy, chronic obstructive pulmonary disease tune
Section strategy, low blood pressure adjust strategy and Stress index adjusts strategy.
Specifically, in one embodiment of the invention, adjustment module 120 is used to be lower than default blood pressure range when blood pressure
When lower limit value, strategy is adjusted using low blood pressure；Blood pressure range and illness are preset when blood pressure is in as acute respiratory distress syndrome
When, strategy is adjusted using acute respiratory distress syndrome；When blood pressure is in default blood pressure range and illness is not that acute respiration is embarrassed
Compel syndrome, and Breathing Suppotion equipment adjusts strategy using Stress index in when holding control mode and patient does not have autonomous respiration,
Otherwise strategy is adjusted using chronic obstructive pulmonary disease.In other words, low (i.e. lower limit of the blood pressure lower than default blood pressure range of blood pressure
Value) when, it is preferential that low blood pressure is selected to adjust strategy；It when blood pressure normal (i.e. blood pressure is in default blood pressure range) and is patient ARDS
When (i.e. illness is acute respiratory distress syndrome), then prior applicability ARDS adjusts tactful (i.e. acute respiratory distress syndrome tune
Section strategy)；When blood pressure normal (i.e. blood pressure is in default blood pressure range) and (i.e. illness is not that acute respiration is embarrassed for non-patient ARDS
Compel syndrome), and when control breathing is holds control mode and do not have autonomous respiration, it is adjusted and is omited using Stress index plan, otherwise adopted
COPD adjusts strategy (i.e. chronic obstructive pulmonary disease adjusts strategy).In other words, respiration parameter adjusts strategy in venting process
It can be according to patient condition real-time change.Optionally, the lower limit value for presetting blood pressure range is, for example, 70 or 120, for example, 70 pairs
Systolic pressure should be corresponded in diastolic pressure, 120, when patient diastolic pressure is lower than 70 or systolic pressure is lower than 120, then determine blood pressure
Lower than the lower limit value of default blood pressure range, illustrate that the patients' blood is lower.
In one embodiment of the invention, above-mentioned acute respiratory distress syndrome adjusts strategy (i.e. ARDS adjusting plan
It slightly) include: to be corresponded to when the value of fraction of inspired oxygen and end-expiratory positive pressure is adjusted in table in preset acute respiratory distress syndrome,
Table then is adjusted referring to preset acute respiratory distress syndrome, when blood oxygen saturation is lower than under default blood oxygen saturation range
When limit value, the value of fraction of inspired oxygen and end-expiratory positive pressure is adjusted to the right, when blood oxygen saturation is in default blood oxygen saturation range
When interior, the value of fraction of inspired oxygen and end-expiratory positive pressure is adjusted to the left；When the value of fraction of inspired oxygen and end-expiratory positive pressure is acute
Respiratory Distress Syndrome(RDS) is adjusted not to be corresponded in table, and when blood oxygen saturation is reached within the scope of default blood oxygen saturation, then will be inhaled
Enter the value of oxygen concentration and end-expiratory positive pressure to intermediate regulations, until the value of fraction of inspired oxygen and end-expiratory positive pressure is embarrassed in acute respiration
Compel to correspond in syndrome adjusting table, when blood oxygen saturation is lower than the lower limit value of default blood oxygen saturation range, oxygen will be sucked
The higher value in position remains unchanged in concentration and end-expiratory positive pressure, and the lower value in position is gradually adjusted up.In other words, root
According to ARDS table (i.e. preset acute respiratory distress syndrome adjusts table), as blood oxygen saturation SpO2Lower than normal range (NR)
When (i.e. blood oxygen saturation is lower than the lower limit value for presetting blood oxygen saturation range), fraction of inspired oxygen FiO2With end-expiratory positive pressure PEEP
Value turn right tune, work as SpO2Reach target value (i.e. within the scope of default blood oxygen saturation)) after, FiO2With PEEP according to above-mentioned
Table is adjusted to the left；Work as FiO2With the value of PEEP in the table not to it is corresponding when and SpO2Satisfied (the i.e. blood oxygen saturation SpO of value2?
Within the scope of default blood oxygen saturation), then by two value (i.e. FiO2With the value of PEEP) to intermediate regulations, until FiO2With PEEP's
Value corresponds in the table, works as SpO2Value be unsatisfied with (i.e. blood oxygen saturation SpO2Lower than the lower limit of default blood oxygen saturation range
Value) when, then by FiO2Constant with the higher value in position in PEEP, the lower value in position is gradually adjusted up.Optionally, blood is preset
The oxygen saturation range for example, lower limit value of [95,100] namely default blood oxygen saturation range is 95.
In one embodiment of the invention, it includes: to work as fraction of inspired oxygen that above-mentioned chronic obstructive pulmonary disease, which adjusts strategy,
It adjusts in table and corresponds in acute respiratory distress syndrome with the value of end-expiratory positive pressure, then it is comprehensive based on preset acute respiratory distress
Simulator sickness adjusts table, and when blood oxygen saturation is higher than the lower limit value of default blood oxygen saturation range, fraction of inspired oxygen is down to most
It is low, lower the value of end-expiratory positive pressure；When the value of fraction of inspired oxygen and end-expiratory positive pressure adjusts table in acute respiratory distress syndrome
It is not corresponded in lattice, and when blood oxygen saturation is within the scope of default blood oxygen saturation, then the value of fraction of inspired oxygen and end-expiratory positive pressure
To intermediate regulations, corresponded to until the value of fraction of inspired oxygen and end-expiratory positive pressure is adjusted in table in acute respiratory distress syndrome,
When blood oxygen saturation is lower than the lower limit value of default blood oxygen saturation range, by position in fraction of inspired oxygen and end-expiratory positive pressure compared with
High value remains unchanged, and the lower value in position is gradually adjusted up.In other words, chronic obstructive pulmonary disease adjusts strategy (i.e.
COPD adjusts strategy) it is similar with the adjusting of above-mentioned acute respiratory distress syndrome strategy (i.e. ARDS adjusts strategy), difference exists
In in ARDS adjusting strategy, when lower than normal range (NR), (i.e. blood oxygen saturation is lower than default blood oxygen and is saturated blood oxygen saturation SpO2
Spend the lower limit value of range) when, end-expiratory positive pressure PEEP remains unchanged, and fraction of inspired oxygen FiO2 first drops, after FiO2 is preferably minimized,
The value of PEEP is gradually lowered again.In specific example, fraction of inspired oxygen FiO2 is minimized, such as refer to and drop fraction of inspired oxygen
Down to 30%-40% oxygen concentration.
In one embodiment of the invention, above-mentioned low blood pressure adjust strategy include: in respiration parameter adjustment process,
If blood pressure is lower than the lower limit value of default blood pressure range after adjusting for the first time, end-expiratory positive pressure is adjusted to minimum；Otherwise, it will exhale
Last positive pressure adjusts table according to acute respiratory distress syndrome and adjusts a value to the left；If it is full that blood oxygen saturation is greater than default blood oxygen
With the upper limit value of degree range, then keep fraction of inspired oxygen constant；If blood oxygen saturation is less than default blood oxygen saturation range
Fraction of inspired oxygen is then adjusted to the right a value by lower limit value, until blood pressure meets default blood pressure range.In other words, it was adjusting
Cheng Zhong, when occur blood pressure it is low when, if it is what is occurred after initial setting up, then set minimum for PEEP；If not being derived from
PEEP is then adjusted a value by initial setting up to the left according to above table, if SpO2 value is higher than target zone (i.e. blood oxygen saturation
Greater than the upper limit value of default blood oxygen saturation range), then keep FiO2 constant, if SpO2 value miss the mark range (i.e. blood
Oxygen saturation is less than the lower limit value of default blood oxygen saturation range), then FiO2 is adjusted to the right to a value.Further, work as blood pressure
After restoring normal, then original adjusting strategy is reverted to.In specific example, end-expiratory positive pressure PEEP is adjusted to minimum, example
Such as refer to and PEEP is reduced to 5cmH2O.
In one embodiment of the invention, it includes: acquisition Stress index that above-mentioned Stress index, which adjusts strategy, and according to
End-expiratory positive pressure is adjusted in the value of Stress index；Compare blood oxygen saturation and default blood oxygen saturation range, and according to than
Relatively fraction of inspired oxygen is adjusted in result.Specifically, as previously mentioned, working as patient does not have autonomous respiration, and control breathing is
When holding control mode, strategy is adjusted using Stress index and is adjusted.It is adjusted in strategy in Stress index, PEEP is adjusted and FiO2 tune
Section is mutually indepedent, and whether PEEP is 1 to be adjusted according to Stress index；Whether FiO2 reaches target according to the value of blood oxygen saturation
The adjusting that range (i.e. the comparison result of the full range of blood oxygen saturation and default blood oxygen) is increasedd or decreased.
In one embodiment of the invention, adjustment module 120 is also used to: when blood pressure is lower than the lower limit of default blood pressure range
It is worth and blood oxygen saturation is when presetting within the scope of blood oxygen saturation, issues the first prompt information；When institute's blood pressure is lower than default blood pressure
When the lower limit value and blood oxygen saturation of range are lower than the lower limit value of default blood oxygen saturation range, the second prompt information is issued.It changes
Yan Zhi, i.e. blood pressure low (i.e. blood pressure be lower than default blood pressure range lower limit value) and normal (i.e. blood oxygen saturation is in default blood for blood oxygen
Within the scope of oxygen saturation) when, should prompt " off-capacity, supplement colloid, and ask and survey within every five minutes (the i.e. first prompt of a blood pressure
Information) ", when low (i.e. blood oxygen saturation is lower than pre- for blood oxygen simultaneously for blood pressure low (i.e. blood pressure be lower than default blood pressure range lower limit value)
If the lower limit value of blood oxygen saturation range) when, it prompts " colloidal solution please be supplement, please add spend adrenaline when necessary, increase as early as possible
Blood pressure (i.e. the second prompt information) ".
It should be noted that the control interval time is shorter under normal circumstances.In adjustment process, it is saturated if there is blood oxygen
Spend SpO2It reduces suddenly, does not then wait until that timing completion can be adjusted；If adjusting is shaken, control interval is increased,
It is adjusted again.Wherein, the adjustable range of end-expiratory positive pressure PEEP meets lung protective ventilation, fraction of inspired oxygen FiO2 tune
Adjusting range is 30-100.
It should be noted that the specific implementation side of the respiration parameter regulating device of the Breathing Suppotion equipment of the embodiment of the present invention
Formula is similar with the specific implementation of respiration parameter adjusting method of Breathing Suppotion equipment of the embodiment of the present invention, specifically refers to
The description of method part, in order to reduce redundancy, details are not described herein again.
The respiration parameter regulating device of Breathing Suppotion equipment according to an embodiment of the present invention, can be according to the basic letter of patient
The respiration parameter of breath and Breathing Suppotion equipment, chooses suitable parameter regulation strategy respiration parameter to be adjusted, can
Automatically, Breathing Suppotion device parameter is quickly and accurately adjusted, so that hypoxemia blood oxygen disease is quickly corrected, to be conducive to patient's
Ventilation adjuvant treatment, improves off line success rate and safety.
Further embodiment of the present invention also proposed a kind of Breathing Suppotion equipment, including any one above-mentioned reality of the present invention
Apply the respiration parameter regulating device of Breathing Suppotion equipment described in example.
Breathing Suppotion equipment according to an embodiment of the present invention, can be according to the essential information of patient and Breathing Suppotion equipment
Respiration parameter is chosen suitable parameter regulation strategy respiration parameter to be adjusted, can automatically, quickly and accurately be adjusted
Breathing Suppotion device parameter is saved, to quickly correct hypoxemia blood oxygen disease, so that the ventilation being conducive to patient assists in the treatment of, is improved de-
Machine success rate and safety.
In the description of this specification, reference term " one embodiment ", " some embodiments ", " example ", " specifically show
The description of example " or " some examples " etc. means specific features, structure, material or spy described in conjunction with this embodiment or example
Point is included at least one embodiment or example of the invention.In the present specification, schematic expression of the above terms are not
Centainly refer to identical embodiment or example.Moreover, particular features, structures, materials, or characteristics described can be any
One or more embodiment or examples in can be combined in any suitable manner.
Although an embodiment of the present invention has been shown and described, it will be understood by those skilled in the art that: not
A variety of change, modification, replacement and modification can be carried out to these embodiments in the case where being detached from the principle of the present invention and objective, this
The range of invention is by claim and its equivalent limits.
Claims (10)
1. a kind of respiration parameter adjusting method of Breathing Suppotion equipment, which comprises the following steps:
In venting process, the essential information of patient and the respiration parameter of Breathing Suppotion equipment are obtained in real time, wherein the patient
Essential information include at least blood pressure, blood oxygen saturation and illness, the respiration parameter includes at least: fraction of inspired oxygen and expiration
Last positive pressure；
According to the essential information and respiration parameter, the respiration parameter is adjusted using corresponding parameter regulation strategy
Section, wherein the parameter regulation strategy includes that acute respiratory distress syndrome adjusts strategy, chronic obstructive pulmonary disease adjusts plan
Slightly, low blood pressure adjusts strategy and Stress index adjusts strategy.
2. the respiration parameter adjusting method of Breathing Suppotion equipment according to claim 1, which is characterized in that described according to institute
Essential information and respiration parameter are stated, the respiration parameter is adjusted using corresponding parameter regulation strategy, is further wrapped
It includes:
When the blood pressure is lower than the lower limit value of default blood pressure range, strategy is adjusted using the low blood pressure；
When the blood pressure is in the default blood pressure range and the illness is acute respiratory distress syndrome, using the urgency
Property Respiratory Distress Syndrome(RDS) adjust strategy；
When the blood pressure is in the default blood pressure range and the illness is not acute respiratory distress syndrome, and Breathing Suppotion
Equipment is in when holding control mode and patient and not having autonomous respiration, strategy is adjusted using the Stress index, otherwise using described slow
Property obstructive lung disease adjust strategy.
3. the respiration parameter adjusting method of Breathing Suppotion equipment according to claim 2, which is characterized in that described acute to exhale
Inhaling Distress syndrome adjusting strategy includes:
When the value of the fraction of inspired oxygen and the end-expiratory positive pressure is adjusted in table in preset acute respiratory distress syndrome
It is corresponding, then table is adjusted referring to the acute respiratory distress syndrome, when the blood oxygen saturation is lower than default blood oxygen saturation
When the lower limit value of range, the value of the fraction of inspired oxygen and the end-expiratory positive pressure is adjusted to the right, when the blood oxygen saturation
When within the scope of default blood oxygen saturation, the value of the fraction of inspired oxygen and the end-expiratory positive pressure is adjusted to the left；
When the value of the fraction of inspired oxygen and the end-expiratory positive pressure is adjusted in table not in the acute respiratory distress syndrome
It is corresponding, and when the blood oxygen saturation is within the scope of default blood oxygen saturation, then by the fraction of inspired oxygen and the end-tidal
The value of positive pressure is to intermediate regulations, until the value of the fraction of inspired oxygen and the end-expiratory positive pressure is comprehensive in the acute respiratory distress
Simulator sickness is adjusted in table and is corresponded to, when the blood oxygen saturation is lower than the lower limit value of default blood oxygen saturation range, by the suction
Enter the higher value in position in oxygen concentration and the end-expiratory positive pressure to remain unchanged, the lower value in position is gradually adjusted up.
4. the respiration parameter adjusting method of Breathing Suppotion equipment according to claim 2, which is characterized in that the chronic resistance
Plug property tuberculosis adjusts strategy
It is corresponded to when the value of the fraction of inspired oxygen and end-expiratory positive pressure is adjusted in table in the acute respiratory distress syndrome, then
Table is adjusted based on preset acute respiratory distress syndrome, when blood oxygen saturation is higher than the lower limit of default blood oxygen saturation range
When value, the fraction of inspired oxygen is minimized, lowers the value of the end-expiratory positive pressure；
When the value of the fraction of inspired oxygen and the end-expiratory positive pressure is adjusted in table not in the acute respiratory distress syndrome
It is corresponding, and when the blood oxygen saturation is within the scope of default blood oxygen saturation, then the value of fraction of inspired oxygen and end-expiratory positive pressure to
Intermediate regulations, until the value of the fraction of inspired oxygen and end-expiratory positive pressure is adjusted in table in the acute respiratory distress syndrome
It is corresponding, when the blood oxygen saturation is lower than the lower limit value of default blood oxygen saturation range, by the fraction of inspired oxygen and described
The higher value in position remains unchanged in end-expiratory positive pressure, and the lower value in position is gradually adjusted up.
5. the respiration parameter adjusting method of Breathing Suppotion equipment according to claim 3 or 4, which is characterized in that described low
Blood pressure control strategy includes:
It, will if the blood pressure is lower than the lower limit value of default blood pressure range after adjusting for the first time in respiration parameter adjustment process
The end-expiratory positive pressure is adjusted to minimum；
Otherwise, the end-expiratory positive pressure is adjusted into table according to the acute respiratory distress syndrome and adjusts a value to the left；If
The blood oxygen saturation is greater than the upper limit value of default blood oxygen saturation range, then keeps fraction of inspired oxygen constant；If the blood
Oxygen saturation is less than the lower limit value of default blood oxygen saturation range, then the fraction of inspired oxygen is adjusted to the right a value, until institute
It states blood pressure and meets default blood pressure range.
6. the respiration parameter adjusting method of Breathing Suppotion equipment according to claim 2, which is characterized in that the stretching refers to
Number adjusts strategy
Stress index is obtained, and the end-expiratory positive pressure is adjusted according to the value of the Stress index；
Compare the blood oxygen saturation and default blood oxygen saturation range, and the fraction of inspired oxygen is carried out according to comparison result
It adjusts.
7. the respiration parameter adjusting method of Breathing Suppotion equipment according to claim 3, which is characterized in that further include:
When the blood pressure is lower than the lower limit value for presetting blood pressure range and the blood oxygen saturation within the scope of default blood oxygen saturation
When, issue the first prompt information；
When institute's blood pressure is lower than the lower limit value for presetting blood pressure range and the blood oxygen saturation lower than default blood oxygen saturation model
When the lower limit value enclosed, the second prompt information is issued.
8. a kind of respiration parameter regulating device of Breathing Suppotion equipment characterized by comprising
Module is obtained, in venting process, obtaining the essential information of patient and the respiration parameter of Breathing Suppotion equipment in real time,
Wherein, the essential information of the patient includes at least blood pressure, blood oxygen saturation and illness, and the respiration parameter includes at least: inhaling
Enter oxygen concentration and end-expiratory positive pressure；
Adjustment module, for being exhaled described using corresponding parameter regulation strategy according to the essential information and respiration parameter
It inhales parameter to be adjusted, wherein the parameter regulation strategy includes that acute respiratory distress syndrome adjusts strategy, chronic obstructive
Tuberculosis adjusts strategy, low blood pressure adjusts strategy and Stress index adjusts strategy.
9. the respiration parameter regulating device of Breathing Suppotion equipment according to claim 8, which is characterized in that the adjusting mould
Block is used for:
When the blood pressure is lower than the lower limit value of default blood pressure range, strategy is adjusted using the low blood pressure；
When the blood pressure is in the default blood pressure range and the illness is acute respiratory distress syndrome, using the urgency
Property Respiratory Distress Syndrome(RDS) adjust strategy；
When the blood pressure is in the default blood pressure range and the illness is not acute respiratory distress syndrome, and Breathing Suppotion
Equipment is in when holding control mode and patient and not having autonomous respiration, strategy is adjusted using the Stress index, otherwise using described slow
Property obstructive lung disease adjust strategy.
10. a kind of Breathing Suppotion equipment, which is characterized in that including the described in any item Breathing Suppotion equipment of such as claim 8-9
Respiration parameter regulating device.
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Application publication date: 20190507 |