CN109730681B - Method and device for judging obstruction of patient airway and medical breathing equipment - Google Patents
Method and device for judging obstruction of patient airway and medical breathing equipment Download PDFInfo
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- 230000029058 respiratory gaseous exchange Effects 0.000 title claims abstract description 23
- 238000000034 method Methods 0.000 title claims abstract description 19
- 208000000884 Airway Obstruction Diseases 0.000 claims abstract description 22
- 230000003434 inspiratory effect Effects 0.000 claims abstract description 16
- 238000009423 ventilation Methods 0.000 claims abstract description 8
- 244000144985 peep Species 0.000 claims description 9
- 230000007721 medicinal effect Effects 0.000 abstract description 11
- 230000009286 beneficial effect Effects 0.000 abstract description 2
- 238000003745 diagnosis Methods 0.000 description 7
- 230000037396 body weight Effects 0.000 description 4
- 206010002091 Anaesthesia Diseases 0.000 description 3
- 230000037005 anaesthesia Effects 0.000 description 3
- 238000002627 tracheal intubation Methods 0.000 description 3
- 238000010586 diagram Methods 0.000 description 2
- 230000004075 alteration Effects 0.000 description 1
- 230000002950 deficient Effects 0.000 description 1
- 230000006698 induction Effects 0.000 description 1
- 238000000968 medical method and process Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000000241 respiratory effect Effects 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 210000003437 trachea Anatomy 0.000 description 1
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Abstract
The invention provides a method and a device for judging obstruction of an airway of a patient and medical breathing equipment, wherein the method comprises the following steps: calculating a standard compliance value corresponding to the patient according to the weight of the patient; during ventilation of the medical breathing apparatus, calculating an actual compliance value corresponding to the patient based on the actually monitored inspiratory tidal volume, peak airway pressure, and positive end expiratory pressure; and judging whether the patient has the airway obstruction or not according to the standard compliance value and the actual compliance value. The invention can accurately judge the obstruction condition of the patient airway, is beneficial to assisting doctors to diagnose and take measures, thereby ensuring the safety of the patient and improving the medical effect.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to a method and a device for judging obstruction of an airway of a patient and medical breathing equipment.
Background
In the medical processes of anesthesia induction and the like, when trachea intubation is carried out, an airway needs to be opened, and smooth intubation is ensured. If the patient's airway is obstructed, difficult intubation situations can occur. Therefore, it is of great significance to judge whether the patient has airway obstruction and take corresponding measures clinically.
At present, the main way of judging the airway obstruction is to manually check by a doctor and then judge according to personal experience, which requires that the doctor has relatively rich clinical experience and is limited by relatively deficient resources of qualified doctors, so that the accuracy of the judgment result of the airway obstruction is not high at present. In addition, due to the influence of various factors in the clinical operation process, even a qualified physician can have inaccurate judgment, so that the medical effect is influenced.
Disclosure of Invention
The present invention is directed to solving at least one of the above problems.
Therefore, the first objective of the present invention is to provide a method for determining obstruction of an airway of a patient, which can accurately determine the obstruction of the airway of the patient, and is beneficial to assist physicians in diagnosis and taking measures, so as to ensure the safety of the patient and improve the medical effect.
The second purpose of the invention is to provide a device for judging obstruction of the air passage of a patient.
A third object of the invention is to propose a medical breathing apparatus.
In order to achieve the above object, an embodiment of the first aspect of the present invention provides a method for determining obstruction of an airway of a patient, including the following steps: calculating a standard compliance value corresponding to a patient according to the weight of the patient; during ventilation of a medical respiratory device, calculating an actual compliance value corresponding to the patient based on the actual monitored inspiratory tidal volume, peak airway pressure, and positive end expiratory pressure; and judging whether the patient has the airway obstruction according to the standard compliance value and the actual compliance value.
According to the method for judging the obstruction of the airway of the patient, disclosed by the embodiment of the invention, the standard compliance value corresponding to the patient is obtained according to the weight of the patient, then the actual compliance value of the patient is determined according to the actually monitored inspiration tidal volume, peak airway pressure and positive end expiratory pressure, the standard compliance value and the actual compliance value are compared, and further, the obstruction condition of the airway of the patient is objectively and accurately judged according to the comparison result, so that diagnosis and measures are favorably assisted by a doctor, the safety of the patient is ensured, and the medical effect is improved.
In addition, the method for judging the obstruction of the airway of the patient according to the above embodiment of the present invention may further have the following additional technical features:
in some examples, the determining whether the patient presents an airway obstruction based on the standard compliance value and the actual compliance value includes: judging whether the actual compliance value is smaller than the product of the standard compliance value and a preset value; if so, determining that the patient has an airway obstruction.
In some examples, the standard compliance value is calculated by the following formula:
C1＝M*T/Q
where C1 is a standard compliance value corresponding to the patient, M is the patient's weight, T is inspiratory tidal volume per unit weight, and Q is a preset airway pressure.
In some examples, the actual compliance value is calculated by the following equation:
C2＝Vti/(P–Peep)
where C2 is the actual compliance value for the patient, Vti is the actual monitored inspiratory tidal volume, P is the actual monitored peak airway pressure, and Peep is the actual monitored positive end expiratory pressure.
In order to achieve the above object, an embodiment of a second aspect of the present invention provides an apparatus for determining obstruction of an airway of a patient, including: the first calculation module is used for calculating a standard compliance value corresponding to a patient according to the weight of the patient; the second calculation module is used for calculating an actual compliance value corresponding to the patient according to the actually monitored inspiratory tidal volume, the peak airway pressure and the positive end expiratory pressure in the ventilation process of the medical breathing equipment; and the judging module is used for judging whether the patient has the airway obstruction according to the standard compliance value and the actual compliance value.
According to the device for judging the obstruction of the airway of the patient, disclosed by the embodiment of the invention, the standard compliance value corresponding to the patient is obtained according to the weight of the patient, then the actual compliance value of the patient is determined according to the actually monitored inspiration tidal volume, peak airway pressure and positive end expiratory pressure, the standard compliance value and the actual compliance value are compared, and further, the obstruction condition of the airway of the patient is objectively and accurately judged according to the comparison result, so that diagnosis and measures are favorably assisted by a doctor, the safety of the patient is ensured, and the medical effect is improved.
In addition, the device for judging obstruction of the airway of the patient according to the above embodiment of the present invention may further have the following additional technical features:
in some examples, the determination module is to: and judging whether the actual compliance value is smaller than the product of the standard compliance value and a preset value, and judging that the patient has the airway obstruction when the actual compliance value is smaller than the product of the standard compliance value and the preset value.
In some examples, the standard compliance value is calculated by the following formula:
C1＝M*T/Q
where C1 is a standard compliance value corresponding to the patient, M is the patient's weight, T is inspiratory tidal volume per unit weight, and Q is a preset airway pressure.
In some examples, the actual compliance value is calculated by the following equation:
C2＝Vti/(P–Peep)
where C2 is the actual compliance value for the patient, Vti is the actual monitored inspiratory tidal volume, P is the actual monitored peak airway pressure, and Peep is the actual monitored positive end expiratory pressure.
In order to achieve the above object, a third aspect of the present invention provides a medical breathing apparatus, including a device for determining obstruction of an airway of a patient according to the second aspect of the present invention.
According to the medical breathing equipment disclosed by the embodiment of the invention, the obstruction condition of the airway of the patient can be objectively and accurately judged effectively, and the diagnosis and the measure taking of doctors are facilitated, so that the safety of the patient is ensured, and the medical effect is improved.
Additional aspects and advantages of the invention will be set forth in part in the description which follows and, in part, will be obvious from the description, or may be learned by practice of the invention.
Drawings
The above and/or additional aspects and advantages of the present invention will become apparent and readily appreciated from the following description of the embodiments, taken in conjunction with the accompanying drawings of which:
FIG. 1 is a flow chart of a method of determining obstruction of a patient's airway in accordance with one embodiment of the present invention;
fig. 2 is a block diagram of a device for determining obstruction of an airway of a patient according to an embodiment of the present invention.
Detailed Description
Reference will now be made in detail to embodiments of the present invention, examples of which are illustrated in the accompanying drawings, wherein like or similar reference numerals refer to the same or similar elements or elements having the same or similar function throughout. The embodiments described below with reference to the accompanying drawings are illustrative only for the purpose of explaining the present invention, and are not to be construed as limiting the present invention.
In the description of the present invention, it is to be understood that the terms "central," "longitudinal," "lateral," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," and the like are used in the orientation or positional relationship indicated in the drawings for convenience in describing the invention and for simplicity in description, and are not intended to indicate or imply that the device or element being referred to must have a particular orientation, be constructed and operated in a particular orientation, and are therefore not to be considered as limiting. Furthermore, the terms "first" and "second" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the present invention, it should be noted that, unless otherwise explicitly specified or limited, the terms "mounted," "connected," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.
The following describes a method and a device for judging obstruction of an airway of a patient and a medical breathing device according to an embodiment of the invention with reference to the accompanying drawings.
FIG. 1 is a flow chart of a method of determining obstruction of an airway of a patient according to one embodiment of the present invention. As shown in fig. 1, the method comprises the steps of:
step S1: a standard compliance value corresponding to the patient is calculated from the patient's weight.
Specifically, the standard compliance value is calculated by the following formula:
C1＝M*T/Q
where C1 is the standard compliance value for the patient, M is the weight of the patient, and T is the inspiratory tidal volume per unit weight, i.e., tidal volume per kilogram. In a specific example, T is in a range of 6-10ml/kg, for example, T is 8ml/kg, that is, during normal ventilation, the tidal volume of inspiration required by the patient per kilogram of body weight is 8ml/kg, and assuming that the body weight of the patient is 60kg, the tidal volume of inspiration required to be provided to the patient is 480 ml. Q is a preset airway pressure, and in a specific example, Q is in a range of 15-25cmH20, for example, and Q is generally 20cmH 20.
Taking T as 8ml/kg, Q as 20cmH20, and M as 60kg, the standard compliance values for the patient are: c1 ═ 60 × 8/20 ═ 24.
Step S2: during ventilation of the medical breathing apparatus, an actual compliance value corresponding to the patient is calculated based on the actual monitored inspiratory tidal volume, peak airway pressure, and positive end expiratory pressure. In a particular embodiment, medical breathing apparatus refers to apparatus that may be used for medical assisted breathing, such as anesthesia machines, ventilators, and the like.
Specifically, the actual compliance value is calculated by the following formula:
C2＝Vti/(P–Peep)
where C2 is the actual compliance value for the patient, Vti is the actual monitored inspiratory tidal volume, P is the actual monitored peak airway pressure, and Peep is the actual monitored positive end expiratory pressure. It should be noted that Vti, P, Peep are all values actually monitored by corresponding sensors in the medical breathing apparatus.
Step S3: and judging whether the patient has the airway obstruction or not according to the standard compliance value and the actual compliance value.
Specifically, in step S3, determining whether the patient has an airway obstruction according to the standard compliance value and the actual compliance value includes: judging whether the actual compliance value is smaller than the product of the standard compliance value and the preset value; if so, judging that the patient has obstruction of the air passage. Wherein the preset value is, for example, 20% to 40%. Specifically, compare the value of C1 and C2 promptly, if C2< C1 default, it is lower to explain actual tidal volume, and the pressure is higher than, reflects that there is the air flue to obstruct the condition and takes place, judges that the patient appears the air flue to obstruct promptly, and then can send out reminding information, reminds medical personnel to take countermeasure in time to guarantee patient's safety, improve medical effect.
For example, table 1 below shows measured data relating to a medical breathing apparatus in one embodiment.
TABLE 1
As shown in table 1, taking the data in the first row as an example, the standard compliance value C1 is set to 50, the Vti actually monitored is 500, P is 11, and Peep is 0, then the actual compliance value C2 is 500/(11-0) 45.4, and 45.4>50 × the preset value, i.e., C2> C1, so that it is determined that the patient has not suffered from airway obstruction. Taking the 5 th behavior example in table 1, the standard compliance value C1 is set to 50, the actually monitored Vti is 221, P is 73, and Peep is 1, then the actual compliance value C2 is 221/(73-1) is 3.07, and 3.07 is less than 50 × the preset value, i.e., C2 is less than C1, and therefore, it is determined that the patient has airway obstruction. For other examples, please refer to table 1, which is not repeated here.
As can be seen from table 1, the gradual increase of the air resistance used in table 1 indicates the occurrence of the airway obstruction, and as can be seen from table 1, when the standard compliance C1 is set to 50ml/cmH20, the air resistance is increased from 5 to 100, and when the standard compliance C1 reaches 100, the calculated actual compliance C2 value is already lower than the preset value of the standard C1 value, the occurrence of the airway obstruction is judged; when the standard compliance C1 is set to be 20ml/cmH20, the air resistance is increased from 50 to 100, and when the standard compliance C1 reaches 100, the calculated actual compliance C2 value is lower than the preset value of the standard C1 value, and the airway obstruction is judged to occur.
According to the method for judging the obstruction of the airway of the patient, disclosed by the embodiment of the invention, the standard compliance value corresponding to the patient is obtained according to the weight of the patient, then the actual compliance value of the patient is determined according to the actually monitored inspiration tidal volume, peak airway pressure and positive end expiratory pressure, the standard compliance value and the actual compliance value are compared, and further, the obstruction condition of the airway of the patient is objectively and accurately judged according to the comparison result, so that diagnosis and measures are favorably assisted by a doctor, the safety of the patient is ensured, and the medical effect is improved.
The invention further provides a device for judging the obstruction of the airway of the patient.
Fig. 2 is a block diagram of a device for determining obstruction of an airway of a patient according to an embodiment of the present invention. As shown in fig. 2, the device 100 for determining obstruction of an airway of a patient includes: a first calculation module 110, a second calculation module 120, and a determination module 130.
The first calculation module 110 is configured to calculate a standard compliance value corresponding to the patient according to the weight of the patient.
Specifically, the standard compliance value is calculated by the following formula:
C1＝M*T/Q
where C1 is the standard compliance value for the patient, M is the weight of the patient, and T is the inspiratory tidal volume per unit weight, i.e., tidal volume per kilogram. In a specific example, T is in a range of 6-10ml/kg, for example, T is 8ml/kg, that is, during normal ventilation, the tidal volume of inspiration required by the patient per kilogram of body weight is 8ml/kg, and assuming that the body weight of the patient is 60kg, the tidal volume of inspiration required to be provided to the patient is 480 ml. Q is a preset airway pressure, and in a specific example, Q is in a range of 15-25cmH20, for example, and Q is generally 20cmH 20.
Taking T as 8ml/kg, Q as 20cmH20, and M as 60kg, the standard compliance values for the patient are: c1 ═ 60 × 8/20 ═ 24.
The second calculation module 120 is configured to calculate an actual compliance value corresponding to the patient during ventilation of the medical breathing apparatus based on the actually monitored inspiratory tidal volume, peak airway pressure, and positive end expiratory pressure. In a particular embodiment, a medical breathing apparatus refers to an apparatus that may be used for medical assisted breathing, such as an anesthesia machine, a ventilator, or the like.
Specifically, the actual compliance value is calculated by the following formula:
C2＝Vti/(P–Peep)
where C2 is the actual compliance value for the patient, Vti is the actual monitored inspiratory tidal volume, P is the actual monitored peak airway pressure, and Peep is the actual monitored positive end expiratory pressure. It should be noted that Vti, P, Peep are all values actually monitored by corresponding sensors in the medical breathing apparatus.
The determining module 130 is used for determining whether the patient has an airway obstruction according to the standard compliance value and the actual compliance value.
Specifically, the determining module 130 is configured to: and judging whether the actual compliance value is smaller than the product of the standard compliance value and the preset value, and judging that the patient has the airway obstruction when the actual compliance value is smaller than the product of the standard compliance value and the preset value. Specifically speaking, compare the value of C1 and C2 promptly, if C2< C1 default, it is low on the low side to explain actual tidal volume, and pressure is on the high side, reflects that there is the air flue to obstruct the condition and takes place, judges that the patient appears the air flue to obstruct promptly, and then can send out warning information, reminds medical personnel to in time take counter-measure to guarantee patient's safety, improve medical effect.
It should be noted that a specific implementation manner of the device for determining an airway obstruction of a patient according to the embodiment of the present invention is similar to a specific implementation manner of the method for determining an airway obstruction of a patient according to the embodiment of the present invention, and please refer to the description of the method part specifically, and details are not repeated here in order to reduce redundancy.
According to the device for judging the obstruction of the airway of the patient, disclosed by the embodiment of the invention, the standard compliance value corresponding to the patient is obtained according to the weight of the patient, then the actual compliance value of the patient is determined according to the actually monitored inspiration tidal volume, peak airway pressure and positive end expiratory pressure, the standard compliance value and the actual compliance value are compared, and further, the obstruction condition of the airway of the patient is objectively and accurately judged according to the comparison result, so that diagnosis and measures are favorably assisted by a doctor, the safety of the patient is ensured, and the medical effect is improved.
A further embodiment of the present invention also provides a medical breathing apparatus including the device for determining obstruction of an airway of a patient according to any one of the above embodiments of the present invention.
According to the medical breathing equipment disclosed by the embodiment of the invention, the obstruction condition of the airway of the patient can be objectively and accurately judged effectively, and the diagnosis and the measure taking of doctors are facilitated, so that the safety of the patient is ensured, and the medical effect is improved.
In the description herein, references to the description of the term "one embodiment," "some embodiments," "an example," "a specific example," or "some examples," etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above do not necessarily refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.
While embodiments of the invention have been shown and described, it will be understood by those of ordinary skill in the art that: various changes, modifications, substitutions and alterations can be made to the embodiments without departing from the principles and spirit of the invention, the scope of which is defined by the claims and their equivalents.
Claims (4)
1. A device for determining obstruction of an airway of a patient, comprising:
the first calculation module is used for calculating a standard compliance value corresponding to a patient according to the weight of the patient;
the second calculation module is used for calculating an actual compliance value corresponding to the patient according to the actually monitored inspiratory tidal volume, the peak airway pressure and the positive end expiratory pressure in the ventilation process of the medical breathing equipment;
a judging module for judging whether the patient has airway obstruction according to the standard compliance value and the actual compliance value, wherein the judging module is used for: and judging whether the actual compliance value is smaller than the product of the standard compliance value and a preset value, and judging that the patient has the airway obstruction when the actual compliance value is smaller than the product of the standard compliance value and the preset value, wherein the preset value is 20-40%.
2. The apparatus for determining the obstruction of an airway in a patient according to claim 1, wherein the standard compliance value is calculated by the following formula:
C1＝M*T/Q
where C1 is a standard compliance value corresponding to the patient, M is the patient's weight, T is inspiratory tidal volume per unit weight, and Q is a preset airway pressure.
3. The apparatus for determining obstruction of an airway of a patient according to claim 1, wherein said actual compliance value is calculated by the following equation:
C2＝Vti/(P–Peep)
where C2 is the actual compliance value for the patient, Vti is the actual monitored inspiratory tidal volume, P is the actual monitored peak airway pressure, and Peep is the actual monitored positive end expiratory pressure.
4. A medical breathing apparatus comprising a device for determining obstruction of a patient's airway according to any of claims 1 to 3.
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| US7890342B1 (en) * | 2002-08-27 | 2011-02-15 | Ric Investments, Llc | Method and system for tracking and monitoring patient compliance with medical device usage prescription |
| CN101511417A (en) * | 2006-08-30 | 2009-08-19 | 雷斯梅德有限公司 | Distinguishing closed and open respiratory airway apneas by complex admittance values |
| WO2009143259A2 (en) * | 2008-05-20 | 2009-11-26 | 5I Sciences | Device and method for opening an airway |
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| EP2985710A1 (en) * | 2014-08-11 | 2016-02-17 | Mindray Medical Sweden AB | Control device for medical ventilators |
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