CN114470377A - Intelligent ECMO treatment device and control method of system based on rolling blood pump - Google Patents
Intelligent ECMO treatment device and control method of system based on rolling blood pump Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1601—Control or regulation
- A61M1/1603—Regulation parameters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1621—Constructional aspects thereof
- A61M1/1645—Constructional aspects thereof with mechanically linked peristaltic dialysis fluid pumps one upstream, the other one downstream of the dialyser
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- A—HUMAN NECESSITIES
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- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1698—Blood oxygenators with or without heat-exchangers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/104—Extracorporeal pumps, i.e. the blood being pumped outside the patient's body
- A61M60/109—Extracorporeal pumps, i.e. the blood being pumped outside the patient's body incorporated within extracorporeal blood circuits or systems
- A61M60/113—Extracorporeal pumps, i.e. the blood being pumped outside the patient's body incorporated within extracorporeal blood circuits or systems in other functional devices, e.g. dialysers or heart-lung machines
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/20—Type thereof
- A61M60/247—Positive displacement blood pumps
- A61M60/253—Positive displacement blood pumps including a displacement member directly acting on the blood
- A61M60/268—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders
- A61M60/279—Peristaltic pumps, e.g. roller pumps
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Abstract
The invention provides an intelligent ECMO (endothelial cell necrosis factor) rescue device based on a rolling blood pump and a control method of a system, wherein the intelligent ECMO rescue device comprises a venous cannula, the rolling blood pump, a membrane lung and an arterial cannula, and the intelligent ECMO rescue device comprises a venous cannula, a rolling blood pump, a membrane lung and an arterial cannula, wherein: the venous cannula is connected to an inlet of the rolling type blood pump through a first connecting pipe, and a venous pressure sensor is arranged on the first connecting pipe; the exit of the rolling type blood pump is connected to the entrance of the membrane lung through an arteriovenous bridge tube, an arterial overpressure sensor is arranged on the arteriovenous bridge tube, an air-oxygen mixer and a temperature changer are further connected to the membrane lung, the exit of the membrane lung is connected to the arterial cannula through a second connecting tube, and the venous pressure sensor and the arterial overpressure sensor are respectively connected with the rolling type blood pump through a central processing unit. The invention can intelligently and accurately control the perfusion pressure, and finally achieves constant-flow perfusion.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to an intelligent ECMO treatment device based on a rolling blood pump and a control method of the system.
Background
ECMO is an english abbreviation for extracorporeal membrane oxygenation (extracorporeal membrane oxygenation), which is an extracorporeal circulation technique that walks out of the heart operating room. The principle is that the venous blood in the body is led out of the body, and is injected into the artery or vein system of a patient after being oxygenated by an artificial cardiopulmonary bypass made of special materials, so that the function of partial cardiopulmonary replacement is achieved, and the oxygenation blood supply of the visceral organs and tissues of the human body is maintained. At present, centrifugal blood pumps are mostly adopted for domestic ECMO treatment, but centrifugal pumps and matched equipment used in China are all imported products (Meidunli and Michelin), the equipment is expensive, disposable consumables are not universal, the cost is high, the doctor training is not popularized, and the expansion of clinical application is limited. It is difficult to arrange in emergency treatment or ICU room of each large hospital in China.
Disclosure of Invention
The invention aims to provide a control method of an intelligent ECMO rescue device based on a rolling blood pump, aiming at the technical defects in the prior art.
Another object of the present invention is to provide a control method of the intelligent ECMO rescue system based on a rolling blood pump.
The technical scheme adopted for realizing the purpose of the invention is as follows:
a control method of an intelligent ECMO rescue apparatus based on a rolling blood pump, the intelligent ECMO rescue apparatus comprising a venous cannula, a rolling blood pump, a membranopropulus, an arterial cannula, wherein: the venous cannula is connected to an inlet of the rolling type blood pump through a first connecting pipe, and a venous pressure sensor is arranged on the first connecting pipe; the exit of the rolling type blood pump is connected to the entrance of the membrane lung through an arteriovenous bridge tube, an arterial overpressure sensor is arranged on the arteriovenous bridge tube, an air-oxygen mixer and a temperature changer are also connected to the membrane lung, the exit of the membrane lung is connected to the arterial cannula through a second connecting tube, and the venous pressure sensor and the arterial overpressure sensor are respectively connected with the rolling type blood pump through a central processing unit;
when the absolute value of the negative pressure suction pressure detected by the venous pressure sensor is higher than the absolute value of the first-stage negative pressure set value, the flow of the rolling type blood pump is reduced by a set percentage, when the absolute value of the negative pressure suction pressure is higher than the absolute value of the second-stage negative pressure set value, the flow of the rolling type blood pump is reduced by the set percentage again, and when the absolute value of the negative pressure suction pressure is higher than the third-stage negative pressure set value, the flow of the rolling type blood pump is continuously reduced by the set percentage or the pump is stopped;
the arterial overpressure sensor monitors the perfusion pressure, when the perfusion pressure is higher than a first-stage positive pressure set value, the flow of the rolling type blood pump is reduced by a set percentage, when the perfusion pressure is higher than a second-stage positive pressure set value, the flow of the rolling type blood pump is reduced by the set percentage again, and when the perfusion pressure is higher than a third-stage positive pressure set value, the flow of the rolling type blood pump is continuously reduced by the set percentage or the pump is stopped.
In the technical scheme, the set percentage is 30-35%;
the first-stage negative pressure set value is-30 to-50 mmHg, the second-stage negative pressure set value is-50 to-80 mmHg, and the third-stage negative pressure set value is-80 to-120 mmHg;
the first-stage positive pressure setting value is 120-150 mmHg, the second-stage positive pressure setting value is 150-180 mmHg, and the third-stage positive pressure setting value is 180-240 mmHg.
In the technical scheme, a vein negative pressure measuring connector is arranged on the first connecting pipe, the vein pressure sensor is connected to the vein negative pressure measuring connector, an artery perfusion pressure measuring connector is arranged on the second connecting pipe, the artery perfusion pressure measuring connector is used for being connected with an artery pressure sensor, an overpressure pressure measuring connector is arranged on the arteriovenous bridge pipe to be connected with the artery overpressure sensor, and the vein pressure sensor and the artery overpressure sensor are respectively and electrically connected with the central processing unit;
the temperature changer is communicated with the temperature changing water tank.
In the above technical scheme, the first connecting pipe and the second connecting pipe are both provided with an oxyhemoglobin saturation probe, and the oxyhemoglobin saturation probes are both electrically connected with an oxyhemoglobin saturation monitor.
In the above technical scheme, intelligent ECMO treatment device still includes first temperature sensor and second temperature sensor, first temperature sensor gathers patient's nasopharynx temperature in order to measure patient's body temperature, second temperature sensor sets up the blood delivery outlet of membrane lung, second temperature sensor with alternating temperature water tank communication is connected, first temperature sensor and second temperature sensor respectively with central processing unit electricity be connected.
In the above technical solution, a micro-plug filter is arranged on the second connecting pipe.
In the technical scheme, the central processing unit is a programmable controller, and eight digital input ports, four analog input ports and eight digital output ports are arranged on the programmable controller;
among the eight digital input ports: the three input ports are rotating speed adjusting input ports and are respectively connected with a motor of the rolling blood pump to input rotating speed; the three input ports are driver control signal input ports which are respectively connected with a driver of the rolling blood pump so as to input control signals; one input port is a pump head cover opening and stopping protection input port of the rolling blood pump and is connected with the rolling blood pump so as to input a pump head cover opening signal; one input port is an overspeed protection input port and is connected with a rolling blood pump to input an overspeed signal;
the four analog quantity input ports are respectively connected with a venous pressure sensor, an arterial overpressure sensor, a first temperature sensor and a second temperature sensor;
and four of the eight digital quantity output ports are respectively connected with a driver of the rolling blood pump, one output port is a pump head cover for controlling an opening-closing stop interface to be connected with the rolling blood pump, one output port is a driver for controlling an overspeed protection interface to be connected with the rolling blood pump, and the other output port is an overpressure alarm interface.
In the technical scheme, the programmable controller is connected with the human-computer interface display screen through the R485 communication interface.
In another aspect of the invention, a control method of an intelligent ECMO treatment system based on rolling blood pumps comprises the intelligent ECMO treatment device and another rolling blood pump, wherein the two rolling blood pumps are connected in parallel;
the two rolling type blood pumps are respectively a first rolling type blood pump and a second rolling type blood pump, an inlet of the first rolling type blood pump is communicated with the first connecting pipe through a first branch pipe, an outlet of the first rolling type blood pump is communicated with the arteriovenous bridge pipe through a second branch pipe, an inlet of the second rolling type blood pump is communicated with the first connecting pipe through a third branch pipe, and an outlet of the second rolling type blood pump is communicated with the arteriovenous bridge pipe through a fourth branch pipe;
the first rolling blood pump is used to block the third branch pipe and the fourth branch pipe connected with the second rolling blood pump, when the running time of a perfusion pipeline in the pump head of the first rolling blood pump is close to the expiration date, the third branch pipe and the fourth branch pipe are communicated, and simultaneously the first branch pipe and the second branch pipe of the first rolling blood pump are blocked, so that blood flows through the second rolling blood pump to continue running.
In the technical scheme, the first branch pipe, the second branch pipe, the third branch pipe and the fourth branch pipe are blocked or communicated through blocking pincers.
Compared with the prior art, the invention has the beneficial effects that:
1. according to the invention, the blood of a patient is drained out through the venous cannula, the blood of the patient is perfused to the membrane lung through the rolling type blood pump, oxygen and air are mixed in the membrane lung, and the blood is conveyed back to the body of the patient through the arterial cannula through the micro-suppository filter to complete the extracorporeal circulation process.
2. The invention can intelligently and accurately control the perfusion pressure, realizes the accurate control of the blood flow by monitoring the pressure at the inlet and the outlet of the rolling pump, simultaneously considers the balance state of the pre-load and the post-load during operation, and finally achieves constant-flow perfusion, thereby becoming a beneficial choice for short-time ECMO application.
3. The intelligent ECMO treatment device of the present invention can rescue a patient in a transport process, an emergency room or an ICU room, such as: the transfer process from the emergency room to the operating room can carry out emergency treatment on sudden cardiac arrest of a patient, and in addition, the transfer process can also be applied to refractory cardiac arrest of rescue treatment (ECPE), systemic hyperthermia treatment, organ tumor thermotherapy, liver and kidney transplantation, organ transfer and storage, battlefield rescue and the like, and the application range is wide.
4. Most hospitals in China are equipped with rolling blood pumps used in conventional CPB cardiac surgery, the rolling blood pumps and matched equipment thereof have high integrity rate and high use frequency, disposable consumables can be general and low in price, and doctors have sufficient training, so that the rolling pumps can be widely applied to the popularization and application of ECMO.
Drawings
FIG. 1 is a schematic diagram of an intelligent ECMO rescue apparatus.
Fig. 2 is a schematic structural diagram of an intelligent ECMO rescue apparatus.
Fig. 3 is a diagram of an intelligent ECMO rescue system with two rolling blood pumps connected in parallel.
In the figure: 1-venous cannula, 2-rolling blood pump, 3-membrana lung, 4-arterial cannula, 5-first connecting tube, 6-venous pressure sensor, 7-arteriovenous bridge tube, 8-air-oxygen mixer, 9-temperature changing water tank, 10-second connecting tube, 11-bracket, 12-venous negative pressure measuring joint, 13-arterial perfusion pressure measuring joint, 14-second temperature sensor, 15-venous oxygen saturation probe, 16-arterial oxygen saturation probe, 17-micro-plug filter, 18-overpressure pressure measuring joint, 19-arterial overpressure sensor, 20-fourth branch tube, 21-first branch tube, 22-second branch tube and 23-third branch tube.
Detailed Description
The invention is described in further detail below with reference to the figures and specific examples. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
Example 1
An intelligent ECMO rescue device based on a rolling blood pump comprises a venous cannula 1, a rolling blood pump 2, a membrane lung 3 and an arterial cannula 4, wherein the venous cannula 1 and the arterial cannula 4 are respectively connected with veins and arteries of a heart of a patient, and when the heart of the patient stops beating, the rolling blood pump 2 provides arterial blood for organs of a human body to maintain the life of the patient;
wherein: the venous cannula 1 is connected to the inlet of the rolling blood pump 2 through a first connecting pipe 5, a venous negative pressure measuring connector 12 is arranged on the first connecting pipe 5, a venous pressure sensor 6 is arranged on the venous negative pressure measuring connector 12 (the venous pressure sensor 6 is shared with an external monitor, such as a monitor in an operating room), the device takes venous blood out of the heart of a patient through the venous cannula 1 for extracorporeal circulation, the venous blood enters the rolling blood pump 2 through the first connecting pipe 5, and the rolling blood pump 2 provides power for the blood; the exit of the rolling blood pump 2 is connected to the entrance of the membrane lung 3 through an arteriovenous bridge tube 7, an overpressure pressure measuring joint 18 is arranged on the arteriovenous bridge tube 7 to connect an arterial overpressure sensor 19, the rolling blood pump 2 conveys venous blood to the membrane lung 3, an air-oxygen mixer 8 is also connected to the membrane lung 3, the air-oxygen mixer 8 mixes oxygen and air in a certain proportion and inputs the mixture into the membrane lung 3, venous blood of a patient is changed into arterial blood through the membrane lung 3, and oxygen required by the patient is provided to maintain the life of the patient, a temperature changer is also arranged on the membrane lung 3 and communicated with a temperature changing water tank 9, so that the body temperature of the patient is kept at normal body temperature (preferably 36.5-38 ℃, and further preferably 37-37.5 ℃); the export of membrane lung 3 is connected to through second connecting pipe 10 artery intubate 4, be equipped with artery perfusion pressure measurement joint 13 on the second connecting pipe 10, artery perfusion pressure measurement joint 13 is used for connecting arterial pressure sensor (can adopt the arterial pressure sensor of outside monitor, for example the monitor in the operating room), and arterial blood is in second connecting pipe 10 back, and the rethread artery intubate 4 sends back to the patient internal.
The pipe diameter of a pipeline connected with the rolling type blood pump 2 is 6-12mm or the English pipe diameter is 1/4-1/2 inches. The flow rate of the rolling blood pump 2 is 0-10L/min, and the set range of perfusion pressure is 0-500 mmHg; the negative pressure is set in the range of-500 mmHg to 0 mmHg.
The temperature setting range of the variable temperature water tank 9 is 15-41 ℃, the warm water in the variable temperature water tank 9 heats the blood of a patient through the temperature changer and keeps the temperature of the patient, the temperature of the variable temperature water tank 9 keeping the temperature of the patient is 36.5-38 ℃, when the temperature of the patient is lower than 36.5 ℃, the monitored temperature is fed back to the variable temperature water tank 9, and the controller of the variable temperature water tank 9 automatically tracks the body temperature of the patient to be restored to the set temperature error within +/-0.3 ℃ through the monitored temperature.
The venous pressure sensor 6 is used for measuring the pressure of the input port of the rolling pump, the arterial overpressure sensor 19 is used for measuring the pressure of the output port of the rolling pump, the control of the blood flow is realized through pressure control, the blood pumping pressure and the flow of the rolling blood pump 2 are controlled, the blood flow input into a patient is effectively controlled, the blood in the patient is maintained, and the treatment index set for the patient is reached.
Preferably, the venous negative pressure measuring joint 12, the arterial perfusion pressure measuring joint 13 and the overpressure pressure measuring joint 18 adopt three-way joints.
Preferably, the venous pressure sensor 6 and the arterial overpressure sensor 19 are disposable pressure sensors. The pressure detection range of the disposable pressure sensor is-500 mmHg to +800mmHg, and the pressure change in the perfusion process is monitored to realize the control of the rolling blood pump 2.
Intelligent ECMO treatment device still includes first temperature sensor and second temperature sensor 14, first temperature sensor gathers patient's nasopharynx temperature in order to measure patient's body temperature, second temperature sensor 14 sets up the blood delivery outlet of membrane lung 3, second temperature sensor 14 with alternating temperature water tank 9 communication is connected, and two way temperature detection range is 0-50 ℃, and first temperature sensor is the body temperature change of monitoring patient, and second temperature sensor 14 controls alternating temperature water tank 9's settlement. The second temperature sensor 14 can monitor the blood temperature of the patient to control the output temperature of the variable temperature water tank 9, and when the temperature of the patient monitored by the second temperature sensor 14 is lower than a set value, the output temperature of the variable temperature water tank 9 is automatically adjusted through the monitored temperature to automatically control the body temperature of the patient, so that the patient is kept warm.
The intelligent ECMO treatment device further comprises a central processing unit and a human-computer interface display screen, wherein the central processing unit is electrically connected with the venous pressure sensor 6, the arterial pressure sensor, the arterial overpressure sensor 19, the first temperature sensor, the second temperature sensor 14, the rolling blood pump 2 and the human-computer interface display screen. The human-computer interface display screen displays the input pressure monitored by the venous pressure sensor 6, the output pressure monitored by the arterial pressure sensor, the measured pressure monitored by the arterial overpressure sensor 19, and the opening and closing of overpressure alarm set pressure value, temperature detection and timing monitoring. The arteriovenous pressure during extracorporeal circulation perfusion is monitored to control the perfusion flow, prevent overhigh perfusion pressure and overlow suction pressure and protect the life of a patient.
The first connecting pipe 5 is provided with a venous blood oxygen saturation probe 15, the second connecting pipe 10 is provided with an arterial blood oxygen saturation probe 16, and the venous blood oxygen saturation probe 15 and the arterial blood oxygen saturation probe 16 are in communication connection with a blood oxygen saturation monitor. The oxyhemoglobin saturation probe monitors the oxygen content of the blood of the patient and displays the oxygen content on the oxyhemoglobin saturation monitor to ensure that the patient does not lack oxygen. Preferably, as shown in fig. 2, on the first connection tube 5, a venous oxygen saturation probe 15 is arranged between a venous negative pressure manometry joint 12 and an inlet of the roller compression type blood pump 2, and on the second connection tube 10, an arterial oxygen saturation probe 16 is arranged between an outlet of the membrane lung 3 and the arterial perfusion pressure manometry joint 13.
The second connecting pipe 10 is provided with a micro-thrombus filter 17, which prevents micro-particles from blocking the pipeline of extracorporeal circulation and also prevents thrombus from forming in the body of the patient. The micro-thrombus filter 17 is arranged on the second connecting pipe 10 at the side close to the arterial cannula 4.
The intelligent ECMO treatment device can be used for emergency treatment or treatment of sudden cardiac arrest of a patient in an ICU, the treatment can be carried out on site, one intelligent ECMO treatment device is reserved in an emergency room or an ICU room, and when an event occurs, a trained doctor can immediately carry out intubation treatment to maintain blood supply of each organ of the patient.
Preferably, the intelligent ECMO rescue apparatus further comprises a support 11, and the membrane lung 3 is disposed on the support 11 for positioning.
The positive pressure three-level control and the negative pressure three-level control flow in the embodiment accurately control the output blood flow of the intelligent ECMO rescue device through each level of pressure control.
The venous pressure sensor 6 detects the pressure of negative pressure suction, when the absolute value of the pressure of the negative pressure suction is higher than the absolute value of a first-stage negative pressure set value, the flow of the rolling blood pump 2 is reduced by 30%, when the absolute value of the pressure of the negative pressure suction is higher than the absolute value of a second-stage negative pressure set value, the flow of the rolling blood pump 2 is reduced by 30% again, and when the absolute value of the pressure of the negative pressure suction is higher than a third-stage negative pressure set value, the pump is stopped. The absolute values of the first-stage negative pressure set value, the second-stage negative pressure set value and the third-stage negative pressure set value are gradually increased, preferably, the first-stage negative pressure set value is-30 mmHg, the second-stage negative pressure set value is-50 mmHg and the third-stage negative pressure set value is-80 mmHg, or the absolute values are set by a user according to factors such as the weight, the disease species and the age of a patient.
Monitoring arterial pressure (also called perfusion pressure) at the output end of a perfusion pipeline of the blood pump, monitoring perfusion pressure through an arterial overpressure sensor 19 for preventing the perfusion pressure from being overhigh to the blood vessel of a patient, realizing the control of the flow of the rolling blood pump 2, reducing the flow of the rolling blood pump 2 by 30 percent when the perfusion pressure is higher than a first-stage positive pressure set value, reducing the flow by 30 percent again when the perfusion pressure is higher than a second-stage positive pressure set value, and stopping the pump when the perfusion pressure is higher than a third-stage positive pressure set value. The setting ranges of the first-stage positive pressure setting value, the second-stage positive pressure setting value and the third-stage positive pressure setting value are gradually increased, preferably, the first-stage positive pressure setting value is 120mmHg, the second-stage positive pressure setting value is 150mmHg and the third-stage positive pressure setting value is 180mmHg, or the setting ranges are set by a user according to factors such as the weight, the disease type and the age of a patient.
The overpressure alarm is realized by setting two overpressure alarm pressure values on a human-computer interface, when the perfusion pressure of the arterial pressure (venous pressure) monitored by an arterial overpressure sensor 19 (a venous pressure sensor 6) is greater than (lower than) a first-stage pressure set value, the flow of the rolling blood pump 2 is reduced by 30%, when the perfusion pressure exceeds (is lower than) a second-stage pressure set value, the flow of the rolling blood pump 2 is reduced by 30%, when the perfusion pressure exceeds (is lower than) a third-stage pressure set value, the flow stops outputting, and when the perfusion pressure is lower than (is higher than) each-stage set value, the perfusion pressure automatically recovers to the flow value in a corresponding set range. Whenever the arterial pressure (venous pressure) monitored by the arterial overpressure sensor 19 (venous pressure sensor 6) reaches a primary set value, a corresponding overpressure alarm is performed.
Example 2
The intelligent ECMO rescue apparatus described in embodiment 1 controls the flow rate of the rolling pump by intelligently and precisely controlling the pressure of the perfusion so as to achieve constant-flow perfusion.
In this embodiment, a programmable controller is used as the central processing unit, and the programmable controller includes eight digital input ports, four analog input ports, and eight digital output ports, which are as follows:
eight digital input ports: the three input ports are rotating speed adjusting input ports and are respectively connected with a motor of the rolling blood pump 2 to input rotating speed; the three input ports are driver control signal input ports which are respectively connected with a driver of the rolling blood pump 2 to input control signals; one input port is a pump head cover opening and stopping protection input port of the rolling blood pump 2 and is connected with the rolling blood pump 2 to input a pump head cover opening signal; one input port is an overspeed protection input port and is connected with the rolling blood pump 2 to input an overspeed signal.
The four analog quantity input ports are respectively connected with a venous pressure sensor 6, an arterial overpressure sensor 19, a first temperature sensor and a second temperature sensor 14.
Of the eight digital quantity output ports, four output ports are respectively connected with a driver of the rolling blood pump 2, one output port is a pump head cover for controlling an opening and stopping interface to be connected with the rolling blood pump 2, one output port is a driver of an overspeed protection interface to be connected with the rolling blood pump 2, and the other output port is an overpressure alarm interface, and the two overpressure alarm interfaces are connected to the driver of the rolling blood pump 2 to regulate the rotating speed of the rolling blood pump 2.
The programmable controller is connected with a human-computer interface display screen through an R485 communication interface, 8 digital input quantities of the programmable controller are used as control signals for connection input to control the whole system, and the control of the motor is realized by controlling a driver of the rolling blood pump 2, so that the flow and the rotating speed of the rolling blood pump 2 are controlled. The flow control of the rolling blood pump 2 is realized through the measured pressure value, and when the monitored arterial pressure or venous pressure exceeds a set value, the driver is controlled through a digital output port of the programmable controller, so that the rolling blood pump 2 is decelerated or stopped.
Example 3
Because the operating time of the perfusion pipeline in the pump head of the rolling blood pump 2 is limited, the perfusion pipeline cannot be rolled in the rolling blood pump 2 for a long time, the intelligent ECMO rescue device in the embodiment 1 is generally suitable for short-term rescue and generally completed within 12 hours, in order to prolong the rescue time, the embodiment provides an intelligent ECMO rescue system based on the rolling blood pump, which comprises the intelligent ECMO rescue device in the embodiment 1 and another rolling blood pump, and the two rolling blood pumps are connected in parallel. The intelligent ECMO therapy system of the present embodiment is used for a 2-fold longer time than the ECMO therapy apparatus of embodiment 1.
Specifically, the two rolling blood pumps 2 are respectively a first rolling blood pump 2-1 and a second rolling blood pump 2-2, an inlet of the first rolling blood pump 2-1 is communicated with the first connecting pipe 5 through a first branch pipe 21, an outlet of the first rolling blood pump 2-1 is communicated with the arteriovenous bridge pipe 7 through a second branch pipe 22, an inlet of the second rolling blood pump 2 is communicated with the first connecting pipe 5 through a third branch pipe 23, and an outlet of the second rolling blood pump 2 is communicated with the arteriovenous bridge pipe 7 through a fourth branch pipe 20.
When the system of the embodiment is operated, the first rolling blood pump 2 is firstly used, the third branch pipe 23 and the fourth branch pipe 20 connected with the second rolling blood pump 2 are blocked by the blocking forceps, when the operation time of the perfusion pipeline in the pump head of the first rolling blood pump 2 is close to the expiration date, the two blocking forceps on the third branch pipe 23 and the fourth branch pipe 20 are opened, and meanwhile, the blocking forceps on the first branch pipe 21 and the second branch pipe 22 of the first rolling blood pump 2 are closed, so that blood flows through the second rolling blood pump 2-2 to continue to operate.
Spatially relative terms, such as "upper," "lower," "left," "right," and the like, may be used in the embodiments for ease of description to describe one element or feature's relationship to another element or feature as illustrated in the figures. It will be understood that the spatial terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as "below" other elements or features would then be oriented "above" the other elements or features. Thus, the exemplary term "lower" can encompass both an upper and a lower orientation. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.
Moreover, relational terms such as "first" and "second," and the like, may be used solely to distinguish one element from another element having the same name, without necessarily requiring or implying any actual such relationship or order between such elements.
The foregoing is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and decorations can be made without departing from the principle of the present invention, and these modifications and decorations should also be regarded as the protection scope of the present invention.
Claims (10)
1. The control method of the intelligent ECMO treatment device based on the rolling blood pump is characterized in that the intelligent ECMO treatment device comprises a venous cannula, the rolling blood pump, a membrana pulmonale and an arterial cannula, wherein: the venous cannula is connected to an inlet of the rolling type blood pump through a first connecting pipe, and a venous pressure sensor is arranged on the first connecting pipe; the exit of the rolling type blood pump is connected to the entrance of the membrane lung through an arteriovenous bridge tube, an arterial overpressure sensor is arranged on the arteriovenous bridge tube, an air-oxygen mixer and a temperature changer are also connected to the membrane lung, the exit of the membrane lung is connected to the arterial cannula through a second connecting tube, and the venous pressure sensor and the arterial overpressure sensor are respectively connected with the rolling type blood pump through a central processing unit;
when the absolute value of the negative pressure suction pressure detected by the venous pressure sensor is higher than the absolute value of the first-stage negative pressure set value, the flow of the rolling type blood pump is reduced by a set percentage, when the absolute value of the negative pressure suction pressure is higher than the absolute value of the second-stage negative pressure set value, the flow of the rolling type blood pump is reduced by the set percentage again, and when the absolute value of the negative pressure suction pressure is higher than the third-stage negative pressure set value, the flow of the rolling type blood pump is continuously reduced by the set percentage or the pump is stopped;
the arterial overpressure sensor monitors the perfusion pressure, when the perfusion pressure is higher than a first-stage positive pressure set value, the flow of the roller-type blood pump is reduced by a set percentage, when the perfusion pressure is higher than a second-stage positive pressure set value, the flow of the roller-type blood pump is reduced by the set percentage again, and when the perfusion pressure is higher than a third-stage positive pressure set value, the flow of the roller-type blood pump is continuously reduced by the set percentage or the pump is stopped.
2. The method of claim 1, wherein said set percentage is 30-35%;
the set value of the first-stage negative pressure is-30 to-50 mmHg, the set value of the second-stage negative pressure is-50 to-80 mmHg, and the set value of the third-stage negative pressure is-80 to-120 mmHg;
the first-stage positive pressure setting value is 120-150 mmHg, the second-stage positive pressure setting value is 150-180 mmHg, and the third-stage positive pressure setting value is 180-240 mmHg.
3. The method for controlling an intelligent ECMO rescue apparatus based on a rolling blood pump as claimed in claim 1, wherein a venous negative pressure measuring connector is provided on said first connection tube, said venous pressure sensor is connected to said venous negative pressure measuring connector, an arterial perfusion pressure measuring connector is provided on said second connection tube, said arterial perfusion pressure measuring connector is used for connecting an arterial pressure sensor, an overpressure pressure measuring connector is provided on said arteriovenous bridge tube for connecting said arterial overpressure sensor, said venous pressure sensor and arterial overpressure sensor are respectively electrically connected to said CPU;
the temperature changer is communicated with the temperature changing water tank.
4. The method for controlling the intelligent ECMO rescue apparatus based on a roller blood pump as claimed in claim 1, wherein each of the first connection tube and the second connection tube is provided with a blood oxygen saturation probe, and the blood oxygen saturation probes are electrically connected with a blood oxygen saturation monitor.
5. The method as claimed in claim 1, wherein the intelligent ECMO rescue apparatus further comprises a first temperature sensor and a second temperature sensor, the first temperature sensor collects the temperature of the nasopharynx of the patient to measure the body temperature of the patient, the second temperature sensor is disposed at the blood outlet of the lung membrane, the second temperature sensor is connected to the variable temperature water tank in a communication manner, and the first temperature sensor and the second temperature sensor are respectively electrically connected to the cpu.
6. The method for controlling the intelligent ECMO rescue apparatus based on a roller compaction blood pump as claimed in claim 1, wherein a micro-plug filter is provided on the second connection tube.
7. The method for controlling the intelligent ECMO rescue apparatus based on a roller compaction blood pump as claimed in claim 5, wherein the central processing unit is a programmable controller, and eight digital input ports, four analog input ports and eight digital output ports are arranged on the programmable controller;
among the eight digital input ports: the three input ports are rotating speed adjusting input ports and are respectively connected with a motor of the rolling blood pump to input rotating speed; the three input ports are driver control signal input ports which are respectively connected with a driver of the rolling blood pump so as to input control signals; one input port is a pump head cover opening and stopping protection input port of the rolling blood pump and is connected with the rolling blood pump so as to input a pump head cover opening signal; one input port is an overspeed protection input port and is connected with a rolling blood pump to input an overspeed signal;
the four analog quantity input ports are respectively connected with a venous pressure sensor, an arterial overpressure sensor, a first temperature sensor and a second temperature sensor;
and four of the eight digital quantity output ports are respectively connected with a driver of the rolling type blood pump, one output port is a pump head cover for controlling an opening and closing port to be connected with the rolling type blood pump, one output port is an overspeed protection port to be connected with the driver of the rolling type blood pump, and the other output port is an overpressure alarm port, and the two overpressure alarm ports are connected to the driver of the rolling type blood pump to regulate and control the rotating speed of the rolling type blood pump.
8. The method of claim 7, wherein said programmable controller is connected to a human interface display via an R485 communication interface.
9. A method for controlling an intelligent ECMO rescue system based on a rolling blood pump, wherein the intelligent ECMO rescue system comprises an intelligent ECMO rescue apparatus according to any one of claims 1 to 8 and a further rolling blood pump, the two rolling blood pumps being connected in parallel;
the two rolling type blood pumps are respectively a first rolling type blood pump and a second rolling type blood pump, an inlet of the first rolling type blood pump is communicated with the first connecting pipe through a first branch pipe, an outlet of the first rolling type blood pump is communicated with the arteriovenous bridge pipe through a second branch pipe, an inlet of the second rolling type blood pump is communicated with the first connecting pipe through a third branch pipe, and an outlet of the second rolling type blood pump is communicated with the arteriovenous bridge pipe through a fourth branch pipe;
the first rolling blood pump is used to block the third branch pipe and the fourth branch pipe connected with the second rolling blood pump, when the running time of a perfusion pipeline in the pump head of the first rolling blood pump is close to the expiration date, the third branch pipe and the fourth branch pipe are communicated, and simultaneously the first branch pipe and the second branch pipe of the first rolling blood pump are blocked, so that blood flows through the second rolling blood pump to continue running.
10. The intelligent ECMO rescue system of claim 9, wherein the first leg, the second leg, the third leg, and the fourth leg are blocked or unblocked by a blocking clamp.
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