CN119345544A - A high-frequency ventilator working method based on flow control and high-frequency ventilator - Google Patents
A high-frequency ventilator working method based on flow control and high-frequency ventilator Download PDFInfo
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- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
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Abstract
The invention relates to the technical field of high-frequency respirators and discloses a high-frequency respirator working method based on flow control, wherein the high-frequency respirator sequentially outputs a plurality of average airway flows with the same or different sizes and the same or different action time periods according to a set period rule, the airway flows output in an exhalation phase and an inhalation phase are stable, the average airway flows with the same or different sizes can be output in different inhalation phases and exhalation phases, the output gas flows of the high-frequency respirator can be independently regulated between different ventilation flow levels in different action time periods, in high-frequency ventilation, the high-frequency ventilation method based on flow control can accurately control the flow and time of gas, the flow control ventilation can better control the change of the airway pressure, and the air supply volume of equipment can be accurately estimated by setting the proper flow and time so as to reduce the pressure and risk of the airway and reduce the possibility of air pressure injury.
Description
Technical Field
The invention relates to the technical field of high-frequency respirators, in particular to a high-frequency respirator working method based on flow control and a high-frequency respirator.
Background
High frequency ventilation (High Frequency Ventilation, HFV) refers to a mechanical ventilation mode where the ventilation frequency is more than 4 times higher than the normal breathing frequency, while the tidal volume is near or below the anatomical dead space volume. Common high frequency ventilation is mainly pressure control and volume control. The high-frequency pressure control ventilation is divided into three modes of high-frequency positive pressure ventilation, high-frequency oscillation ventilation and high-frequency jet ventilation, and the high-frequency capacity control ventilation is divided into three modes of high-frequency capacity control ventilation, oscillation capacity control ventilation and high-frequency limited capacity ventilation. Dispersion and convection play a major role in the gas exchange process, but under normal conditions, normal blood gas cannot be maintained by dispersion alone. When the high-frequency air flows forwards at the far end of the air passage, the flow velocity profile is parabolic, the air in the center of the air passage flows faster than the air in the periphery, and the exchange interface between the sucked fresh air and the air in the air passage is enlarged along with the forward extension of the parabolic curve, so that the transverse air diffusion is increased. When diffusion combines with convection, gas propagation and communication will increase substantially. Meanwhile, the high-frequency vibration has a stirring effect on gas molecules, and is also beneficial to gas exchange. Currently, high frequency ventilation is widely used in clinic, and is suitable for diagnosis and treatment of patients with serious respiratory diseases, such as airway surgery, bronchoscopy, neonatal respiratory distress syndrome, severe pneumonia, ARDS (acute respiratory distress syndrome) and the like, and can improve ventilation and oxygenation functions, reduce respiratory burden, provide better gas exchange and help patients to recover.
However, high frequency ventilation also has some drawbacks:
(1) The current high-frequency ventilation is difficult to ensure the coordination of a high-frequency breathing machine and a patient, cannot ensure the breathing synchronization with the patient, and is easy to cause discomfort of the patient.
(2) The airway pressure is not convenient to control, the possibility of air pressure injury is increased, the respiratory muscle fatigue is easy to be caused, and the ventilation treatment effect is poor;
(3) The high frequency ventilation mode is single, and the adaptability of different patients or diseases is limited, so that the specific respiratory requirements of the patients cannot be met rapidly.
Disclosure of Invention
Aiming at the defects existing in the prior art, the invention aims to provide a high-frequency breathing machine working method based on flow control, the high-frequency ventilation method based on flow control can accurately control the flow and time of gas, the flow control ventilation can better control the change of airway pressure, and the pressure and risk of the airway can be reduced and the possibility of air pressure injury can be reduced by setting proper flow and time.
In order to achieve the above object, the present invention is realized by the following technical scheme:
According to the high-frequency breathing machine working method based on flow control, the high-frequency breathing machine sequentially outputs a plurality of average airway flows with the same or different sizes and the same or different working time periods according to a set period rule, the airway flows output in an inspiratory phase and an inspiratory phase are stable, the average airway flows with the same or different sizes are output in different inspiratory phases and expiratory phases, the output gas flow of the high-frequency breathing machine can be independently adjusted between different ventilation flow levels in different working time periods, the output gas flow of the high-frequency breathing machine can be switched between different average airway flow levels in different working time periods, the average airway flow is carried out on a basic average airway flow level, and each average airway flow can be independently adjusted.
As a further implementation, one or more breathing cycles may be included in each active period, and the different flow switching is time controlled, but the breathing switching may be switched by autonomous or time control.
As a further implementation, the mean airway flow of the exhalation phase is at least the base mean airway flow, and the mean airway flow of the inhalation phase is the sum of the base mean airway flow and the mean support airway flow of the inhalation phase.
As a further implementation mode, the breathing pipe of the high-frequency breathing machine is connected with an electromagnetic high-frequency jet connector and an electromagnetic high-frequency oscillator in parallel, so that three ventilation modes are formed, including high-frequency constant-current ventilation, variable-flow high-frequency oscillation ventilation and variable-flow high-frequency jet ventilation, and the corresponding ventilation modes are selected according to different requirements.
As a further implementation, in different ventilation modes, based on a plurality of base mean airway flows of the same or different sizes, the respective mean support airway flows of the inspiratory phases are superimposed on each other, and ventilation is performed according to the respective periods of action.
The high-frequency constant-current ventilation mode is characterized in that the controller is used for controlling and adjusting output airflow, output flow waveforms are square waves, the variable-flow high-frequency oscillation ventilation mode is used for generating high-frequency airflow through the electromagnetic high-frequency oscillator and transmitting the high-frequency airflow into the respiratory pipeline, output pressure is sinusoidal waves, and the variable-flow high-frequency jet ventilation mode is used for driving the jet needle to jet the high-frequency airflow into the respiratory pipeline through the electromagnetic high-frequency jet connector by utilizing electromagnetic force, and the output flow waveforms are triangular waves.
As a further implementation, for different ventilation modes, the triggering is the initiation of control, assistance, support or spontaneous ventilation by the timing of the high frequency ventilator or when inhalation reaches a set flow threshold.
As a further implementation mode, the flow sensor is used for acquiring gas flow information to generate a flow-time image, the pressure sensor is used for acquiring pressure information to generate a pressure-time image, the gas flow monitoring and adjusting device is used for monitoring and adjusting airway flow, and the working parameters of the high-frequency respirator are adjusted according to the flow-time image curve, the pressure-time image curve and blood gas analysis.
The high-frequency breathing machine works by the high-frequency breathing machine working method based on flow control, and comprises a breathing pipeline, wherein an electromagnetic high-frequency jet connector and an electromagnetic oscillator are installed on the breathing pipeline in parallel, the breathing pipeline is connected with an air-oxygen-nitrogen mixer through a heating and humidifying device, a pressure sensor and a flow sensor are arranged on a pipeline between the air-oxygen-nitrogen mixer and the heating and humidifying device, the sensor and the flow regulating and monitoring device are arranged in parallel, and the electromagnetic high-frequency jet connector, the electromagnetic oscillator, the sensor and the flow regulating and monitoring device are connected with a display through a controller.
As a further implementation manner, the air-oxygen-nitrogen mixer is connected with an axial flow fan through an air filter.
The beneficial effects of the invention are as follows:
1. In the high-frequency ventilation, the high-frequency ventilation method based on flow control can accurately control the volume of gas output by the equipment, the flow control ventilation can better control the change of the pressure of the air passage, and the pressure and risk of the air passage can be reduced by setting proper flow and time, so that the possibility of air pressure injury is reduced.
2. In the high-frequency ventilation, the high-frequency ventilation method based on flow control can improve the coordination between the breathing machine and the patient, and the flow control ventilation has better requirements on the coordination between the patient and the breathing machine. By precisely controlling the gas flow rate and time, it is possible to better synchronize with the patient's breathing, reducing discomfort and uncoordinated conditions.
3. In high-frequency ventilation, the high-frequency ventilation method based on flow control reduces respiratory power consumption, reduces respiratory muscle fatigue, shortens the offline time of a respirator, and further reduces the risk of infection in a hospital and reduces the degree of lung injury caused by the respirator.
4. The high-frequency ventilation multi-mode switching device can realize high-frequency ventilation multi-mode switching, increase the convenience of high-frequency ventilation, shorten the switching time, reduce accidents, provide great convenience for medical staff, and accurately control the output concentration and flow and the proportion of an oxygen source and a nitric oxide source in the high-frequency ventilation process.
Drawings
The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the invention.
FIG. 1 is a schematic view of the overall structure of a high frequency ventilator according to an embodiment of the present invention;
FIG. 2 is a schematic diagram of ventilation of the high frequency ventilator in VFHFOV mode in accordance with an embodiment of the present invention;
FIG. 3 is a schematic diagram of ventilation of the high frequency ventilator in VFHFJV mode in accordance with an embodiment of the present invention;
fig. 4 is a schematic diagram of ventilation of the high frequency ventilator in HFCFV mode according to an embodiment of the present invention.
In the drawings, the mutual spacing or size is exaggerated for showing the positions of the parts, and the schematic drawings are only schematic.
The device comprises a pressure reducing valve 1, a proportional valve 2, an axial flow fan 3, an air filter 4, an air-oxygen-nitrogen mixer 5, a pressure sensor 6, a flow sensor 7, a heating and humidifying device 8, a flow monitoring and regulating device 9, a respiratory pipeline 10, an electromagnetic high-frequency injection joint 11, an electromagnetic high-frequency oscillator 12, a patient 13, a controller 14, a display 15 and a safety valve 16.
Detailed Description
It should be noted that the following detailed description is illustrative and is intended to provide further explanation of the invention. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs.
Term interpretation:
VFHFOV variable-flow high-frequency oscillation ventilation;
VFHFJV variable flow high frequency jet aeration;
HFCFV high-frequency constant-current ventilation;
duration1, first action period;
duration2, second period of action;
duration3, third period of action;
BMAF, basal mean airway flow;
ISMAF inspiratory phase supports mean airway flow.
Example 1
In an exemplary embodiment of the present invention, referring to fig. 1, a high-frequency ventilator operating method based on flow control is shown, where the high-frequency ventilator sequentially outputs a plurality of average airway flows with the same or different sizes and with the same or different operation time periods (Duration 1, duration 2, and Duration 3.) according to a set period rule, the airway flows output in the respiratory phase and the inspiratory phase are stable, the average airway flows with the same or different sizes can be output in the different inspiratory phases and the respiratory phase, the output gas flows of the high-frequency ventilator can be independently adjusted between different ventilation flow levels in different operation time periods, the output gas flows can be switched between different average airway flow levels in different operation time periods, the average airway flows are performed on a base average airway flow level, and each average airway flow can be independently adjusted.
One and more respiratory cycles may be included in each active period, i.e., one or more inspiratory switches, and the different flow switches are time controlled, but the inspiratory switches in each active period are autonomously controlled or time controlled by the patient.
Under the working method of the high-frequency breathing machine, the high-frequency breathing machine can output three high-frequency ventilation modes, namely variable-flow high-frequency oscillation ventilation (VFHFOV), variable-flow high-frequency jet ventilation (VFHFJV) and high-frequency constant-current ventilation (HFCFV), according to the instruction of a controller of the high-frequency breathing machine, and the three modes are VFHFOV, VFHFJV and HFCFV for short.
The high frequency ventilator ventilation of the present embodiment is based on flow control, and can output mean airway flow, including mean airway flow in the expiratory phase and mean airway flow in the inspiratory phase.
The mean airway flow of the expiration phase is the mean airway flow input to the patient according to the set action time period in the expiration phase, and the mean airway flow of the expiration phase is at least the basic mean airway flow. The basic mean airway flow is the initial mean airway flow output by the high frequency ventilator after receiving the control system high frequency ventilation instruction.
The mean airway flow during the inspiratory phase is the mean airway flow that is input to the patient during the inspiratory phase for a set period of time of action. The mean airway flow of the vapor phase is a mean support airway flow of the vapor phase superimposed on the base mean airway flow (ISMAF). The mean airway flow of the inspiration phase and the mean airway flow of the expiration phase are alternately output.
It is understood that the base mean airway flow refers to the initial mean airway flow output by the high frequency ventilator after receiving the controller high frequency ventilation instructions. Inhalation phase mean support airway flow (ISMAF) is the mean airway flow superimposed on the base mean airway flow output by the inhalation phase after the high frequency ventilator receives the high frequency ventilation instructions. The basic mean airway flow and inspiratory phase mean support airway flow can be further configured and adjusted based on EIT monitoring data, arterial blood gas results (e.g., paO 2、PaCO2), end-tidal carbon dioxide partial pressure, percutaneous tissue oxygen partial pressure, percutaneous tissue carbon dioxide partial pressure, and patient condition.
Electromagnetic high-frequency jet connectors and electromagnetic high-frequency oscillators can be connected in parallel at the interfaces of the high-frequency breathing machine and a patient, a VFHFJV mode is realized through the electromagnetic high-frequency jet connectors, a VFHFOV mode is realized through the electromagnetic high-frequency oscillators, the electromagnetic high-frequency jet connectors and the electromagnetic high-frequency oscillators are closed, a HFCFV mode can be realized by adjusting the breathing frequency, the breathing ratio and the like, and according to different requirements, medical staff can select corresponding ventilation modes, so that the adaptability of different patients or conditions is met, and the specific breathing requirements of the patients are met.
The high-frequency breathing machine can independently work in each ventilation mode respectively, can be mutually switched, is matched with the corresponding breathing pipeline in each ventilation mode, and is provided with a plurality of interfaces with the patient end.
In VFHFOV mode, the electromagnetic high-frequency oscillator drives the piston to vibrate back and forth by utilizing electromagnetic force to generate high-frequency airflow, and the high-frequency airflow is conveyed to the respiratory pipeline to reach the respiratory system of a patient, and the output pressure waveform is sine wave. Inhalation phase mean airway flow is produced by a sinusoidal waveform flow output by the ventilator, while exhalation phase mean airway flow is caused by the ventilator actively drawing gas out.
An electromagnetic driving device is arranged in the electromagnetic high-frequency oscillator and consists of an electromagnetic coil and a piston. The electromagnetic coil generates a magnetic field when receiving current, and the magnetic field acts on the piston to push the piston to move, so that the precision and the adjustability are high.
The electromagnetic high-frequency oscillator also comprises an oscillating airflow generating device which is generally composed of an air source, a pressure regulating device, a filtering device, an airflow transmission pipeline and the like. The controller sends out instructions, and the electromagnetic driving device drives the piston to move back and forth by the electromagnetic driving device so as to generate oscillating force in the oscillating airflow generating device, so that the high-frequency breathing machine oscillates at a certain frequency and works under the tidal volume of the anatomic ineffective cavity.
In VFHFJV mode, the electromagnetic high-frequency jet connector is used for driving the jet needle to jet high-frequency air flow into the respiratory pipeline to reach the airway of the patient by utilizing electromagnetic force, and the output flow waveform is triangular wave. Inhalation phase mean airway flow is produced by the triangular waveform flow output by the ventilator, while exhalation phase mean airway flow is caused by the patient's exhalation and ventilator output flows acting together. The electromagnetic high-frequency jet connector consists of an electromagnetic jet needle, a needle seat and a connecting pipe, the controller sends out instructions to electromagnetically drive the jet needle to work, and the breathing machine outputs high-frequency air flow to be jetted into an air passage through the jet needle to finish ventilation.
In HFCFV mode, the output flow waveform is a square wave, with the controller controlling and regulating the output airflow. The average airway flow of the inspiration phase is generated by the air flow output by the breathing machine, and the average airway flow of the expiration phase is caused by the combined action of the expiration of the patient and the air flow output by the breathing machine, and in addition, the HFCFV ventilation mode can perform constant-frequency and constant-current ventilation (the ventilation frequency is about 12-24 times/min).
In the three modes, the ventilator trigger-ventilation-switch is independent, and the trigger is the triggering of control, assistance, support or spontaneous ventilation by ventilator timing or patient inhalation reaching a trigger threshold (flow trigger). During ventilation, inspiratory flow is governed by flow, i.e., ventilation restriction is performed by setting flow (pressure variable), by which ventilator ventilation is set at each cycle, flow-based ventilator ventilation is achieved. Ventilation is terminated by patient discretion or set time, i.e., inspiratory switch is determined by patient discretion or set inspiratory time, reducing patient discomfort.
And under different ventilation modes, realizing that the average supporting airway flow of each inhalation phase is overlapped on the inhalation phase based on a plurality of basic average airway flows with the same or different sizes, and carrying out ventilation operation according to each action time period.
In the high-frequency ventilation process, the high-frequency breathing machine can output one or more than one inhalation phase average airway flow and exhalation phase average airway flow with different sizes in one time period, the inhalation phase and the exhalation phase are alternately output, the high-frequency breathing machine has a plurality of same or different time periods, and the same or different time periods can be correspondingly set according to patient vital signs, arterial blood gas analysis indexes and other disease monitoring indexes.
The basal mean airway flow and inspiratory mean support airway flow may be set and adjusted based on EIT, arterial blood gas outcome (e.g., paO 2、PaCO2), end-tidal carbon dioxide partial pressure, percutaneous tissue oxygen partial pressure and percutaneous carbon dioxide partial pressure, and patient condition feedback.
The high frequency ventilation time variation and magnitude is set according to lung function parameters including magnitude of elastic resistance and inelastic resistance, magnitude of lung compliance.
Under the ventilation method, according to the instruction of the controller, the high-frequency breathing machine can output 3 high-frequency ventilation modes which are VFHFOV, VFHFJV, HFCFV respectively, work independently in each ventilation mode respectively, can be switched mutually, and each ventilation mode is matched with a corresponding breathing pipeline.
As shown in fig. 2 to 4, for convenience of description, only BMAF1, BMAF2, and BMAF3 are described below.
When the high-frequency breathing machine works under BMAF1, in the expiration phase, the output average airway flow is at least the basic average airway flow 1 (BMAF 1), in the inspiration phase, the output average airway flow is the sum of the basic average airway flow 1 (BMAF 1) and the inspiration support average airway flow 1 (ISMAF), the inspiration phase and the expiration phase are alternately output along with the inspiration period, and the inspiration phase average airway flow and the expiration phase average airway flow can respectively work in Duration 1,Duration 2,Duration 3, the. BMAF 2 and BMAF 3 are the same.
The high-frequency breathing machine provided by the invention has the ventilation working method. Parameters related to the ventilation method of the high-frequency ventilator may be set, including basic average airway flow (BMAF 1, BMAF 2, BMAF3, BMAF 4.) and inspiratory phase support average airway flow (ISMAF 1, ISMAF, ISMAF, ismaf 4.), respective durations (Duration 1,Duration 2,Duration 3, the..), tidal volume (Vt), basic airflow (Bias flow), inspiratory oxygen concentration (FiO 2), oscillation flow amplitude (Δf), oscillation frequency (Hz), inspiratory time ratio (1%), inspiratory NO concentration, variable-flow high-frequency ventilation mode switching module, trigger sensitivity, and the like. The ventilation system comprises a monitoring feedback module, an alarm module, a display and the like, wherein gas flow information is acquired through a flow sensor in the ventilation process to generate a flow-time image, pressure information is acquired through a pressure sensor to generate a pressure-time image, airway flow is monitored and regulated through a gas flow monitoring and regulating device, working parameters of the high-frequency breathing machine are regulated according to a flow-time image curve, a pressure-time image curve and blood gas analysis, tidal volume, minute ventilation volume, end-tidal carbon dioxide partial pressure, percutaneous tissue oxygen and carbon dioxide partial pressure, carbon dioxide diffusion coefficient, inhaled NO concentration and the like are monitored through feedback to a monitoring interface, and relevant parameters are regulated according to the numerical value of the monitoring interface to achieve the treatment target in the ventilation mode.
The ventilation method provided by the invention realizes ventilation work according to respective action time periods (Duration 1, duration2, duration 3.) by superposing respective inhalation support average airway flows (ISMAF 1, ISMAF2, ism af3.) on the basis of a plurality of base average flows (BMAF 1, BMAF 2, BMAF 3.) with different or same sizes.
Basic Mean Airway Flow (BMAF), inspiratory Support Mean Airway Flow (ISMAF), and corresponding Duration of action (Duration 1,Duration 2,Duration 3.) the expiratory phase and inspiratory phase Duration of action are set reasonably according to patient condition needs. The basal mean flow (BMAF) setting may range from 0cmH 2 O to the maximum safe ventilation flow that the patient can withstand, as does the Inspiratory Support Mean Airway Flow (ISMAF).
As shown in fig. 2, the output airway flow waveform of the high-frequency breathing machine in VFHFOV modes is sinusoidal, the horizontal axis is time, the vertical axis is mean airway flow, including mean airway flow in inspiration phase (base mean airway flow+mean airway flow in inspiration support), and mean airway flow in expiration phase (base mean airway flow), which are only exemplified by Duration1, duration2, and Duration 3.
As shown in fig. 3, the high frequency ventilator outputs the airway flow waveform as a triangle wave in VFHFJV mode. The horizontal axis represents time, and the vertical axis represents mean airway flow, including mean airway flow in the inspiratory phase (base mean airway flow+mean airway flow in the inspiratory support) and mean airway flow in the expiratory phase (base mean airway flow), which are illustrated by Duration1, duration2, and Duration 3.
As shown in fig. 4, the output airway flow waveform of the high frequency ventilator is a square wave in HFCFV mode. The horizontal axis represents time, and the vertical axis represents mean airway flow, including mean airway flow in the inspiratory phase (base mean airway flow+mean airway flow in the inspiratory support) and mean airway flow in the expiratory phase (base mean airway flow), which are illustrated by Duration1, duration2, and Duration 3.
In fig. 2-4, in the three high-frequency ventilation modes, the horizontal axis is time, the vertical axis is airway flow, and the size of the airway flow is specifically set according to the patient's condition before ventilation.
Example two
The high-frequency breathing machine comprises a breathing pipeline, and as shown in fig. 1, the structure of the high-frequency breathing machine mainly comprises a pressure reducing valve 1, a proportional valve 2, an axial flow fan 3, an air filter 4, an air-oxygen-nitrogen mixer 5, a pressure sensor 6, a flow sensor 7, a heating and humidifying device 8, a flow monitoring and adjusting device 9, a breathing pipeline 10, an electromagnetic high-frequency injection joint 11, an electromagnetic high-frequency oscillator 12, a patient 13, a controller 14, a display 15 and a safety valve 16.
An electromagnetic high-frequency jet connector 11 and an electromagnetic oscillator 12 are arranged on one end of the breathing pipeline 10 close to the patient 13 in parallel, and the breathing pipeline 10 is connected with the air-oxygen-nitrogen mixer 5 through a heating and humidifying device 8 and a corresponding pipeline. The pipeline from the air-oxygen-nitrogen mixer 5 to the heating and humidifying device 8 is sequentially provided with an electromagnetic valve 16, a pressure sensor 6 and a flow sensor 7, and the respiratory pipeline is also provided with a safety valve 15. The flow monitoring and adjusting device 9 is arranged between the electromagnetic valve 16 and the heating and humidifying device 8 and is connected with the pressure sensor 6 and the flow sensor 7 in parallel.
The air-oxygen-nitrogen mixer 5 is connected with the axial flow fan 3 through the air filter 4, and the electromagnetic high-frequency injection joint 11, the electromagnetic oscillator 12, the sensor, the flow regulating and monitoring device 9, the electromagnetic valve 16, the safety valve 15 and the axial flow fan 3 are connected with the display 15 through the controller 14. The air-oxygen-nitrogen mixer 5 is also connected with an air source through the proportional valve 2 and the pressure reducing valve 1, the air source is O 2 and NO, the air source can be connected with an oxygen source and a nitric oxide source, and the two gases can be output independently or mixed and output in a certain proportion. The corresponding monitoring piece is arranged, so that the high-frequency respirator has the functions of ventilation and parameter monitoring feedback (airway mean pressure and airway flow).
The controller 14 of the present embodiment includes a control system having a control function and a monitoring feedback function, and adjusts the parameters of the high-frequency ventilator according to the patient feedback, the flow-time image curve, the pressure-time image curve, the tidal volume-time image, the blood gas analysis, and the like, so as to achieve the therapeutic goal in the ventilation mode. The controller 14 is an electric control system that provides ventilation according to the set parameters (set parameters) and feedback information (monitor parameters). The display may set ventilator parameters and display monitoring parameters.
The control system of the high-frequency breathing machine can operate 3 ventilation modes, including variable-flow high-frequency oscillation ventilation (VFHFOV) based on flow control, variable-flow high-frequency jet ventilation (VFHFJV) based on flow control and high-frequency constant-current ventilation (HFCFV) based on flow control, and the 3 modes can be switched according to the needs of a patient and independently work in the mode of the first embodiment.
The air-oxygen-nitrogen mixer 5 controls the concentration of inhaled oxygen, the concentration of inhaled NO and the ventilation flow through the proportional valve 2 and the pressure reducing valve 1, and the heating and humidifying device 8 heats and humidifies the oscillating airflow, the jet airflow and the like.
The controller of the high-frequency breathing machine is provided with a monitoring module which is used for monitoring the running state of the high-frequency breathing machine under different modes and corresponding parameters and feeding back the parameters to the display, wherein the monitoring module comprises a terminal carbon dioxide partial pressure monitoring module and a percutaneous tissue oxygen/carbon dioxide partial pressure monitoring module, and further comprises a corresponding parameter monitoring module and the like.
The connection end of the breathing pipeline and the patient can be connected with various interfaces, such as an endotracheal tube, a tracheostomy tube, a nasal interface and a mask. The endotracheal tube and tracheostomy tube are dual lumen tubes, one lumen for ventilation and one lumen for monitoring airway pressure and airway flow. The mask may be an oral nasal mask or a full face mask.
The switching of the different modes and the setting of the corresponding parameters can be set by the setting module through the display.
The parameter settings include Basal Mean Airway Flow (BMAF), inspiratory Support Mean Airway Flow (ISMAF), tidal volume (Vt), basal flow (Bias flow), inspiratory oxygen concentration (FiO 2), oscillation flow amplitude (Δf), oscillation frequency (Hz), inspiratory time ratio (1%), respiratory rate (F), inspiratory NO concentration, variable flow high frequency ventilation mode switching module, duration of action (Duration), trigger sensitivity, alarm device, etc.
The controller can control the gas path, the gas flow monitoring and adjusting device, the electromagnetic HFO oscillator and the electromagnetic high-frequency injection joint through a control algorithm to control the flow, the concentration of inhaled oxygen, the concentration of inhaled NO and the working time required by output.
The average airway flow monitoring is to transmit the airway flow signals in the monitored ventilation pipeline to the controller through the flow sensor, and then transmit the airway flow signals to the display through the controller to form average airway flow data and flow-time images.
The mean airway pressure monitoring is to transmit the airway pressure signals in the monitored airway tube to the controller through the pressure sensor, and then transmit the airway pressure signals to the display through the controller to form airway pressure data and pressure-time images.
The output form of the monitored ventilator operating parameters may be a breathing waveform, a breathing loop, specific values, etc.
Parameters monitored by the parameter monitoring module include Basal Mean Airway Flow (BMAF), inspiratory Support Mean Airway Flow (ISMAF), inspiratory oxygen concentration (FiO 2), oscillation flow amplitude (Δf), oscillation frequency (Hz), inspiratory time(s), respiratory frequency (F), mean airway flow-time curve waveform and size, minute Ventilation (MV), carbon dioxide diffusion coefficient (DCO 2), tidal volume (Vt), end tidal carbon dioxide partial pressure, percutaneous tissue oxygen/carbon dioxide partial pressure, inspiratory NO monitored concentration, and the like.
The oscillation flow amplitude of the high-frequency oscillation ventilation refers to the peak flow difference of the oscillation airflow, namely the difference between the maximum flow and the minimum flow when the airflow oscillates, and represents the intensity of the airflow oscillation in the respiratory cycle. The oscillation frequency (Hz) of the high frequency oscillation vents is the number of oscillations per minute.
The high-frequency breathing machine of the embodiment realizes ventilation based on flow control based on the working method of the embodiment, the high-frequency breathing machine is stable in flow of the airway output to a patient in the expiratory phase and the inspiratory phase, the output airway flow of different expiratory phases can be the same or different, the inspiratory phase is also the same, in different action time periods, the output gas flow can be periodically switched between different average airway flow levels, the average airway flow is carried out on the basic average airway flow level, and each average airway flow can be independently adjusted, namely the high-frequency ventilation method based on flow control.
The output gas sequence of the breathing machine is that the axial flow fan 3 generates high-speed air flow, then the high-speed air flow is concentrated with an oxygen source and an NO source in the air-oxygen-nitrogen mixer 5, the inhaled oxygen concentration and the inhaled NO concentration are regulated according to the proportional valve 2, the controller 14 controls the axial flow fan 3 to output high-speed constant air flows with different sizes, then the electromagnetic oscillator 12 or the electromagnetic jet probe 11 can normally operate in different modes, the gas flow monitoring and regulating device 9 is used for monitoring and regulating the flow of the air passage, the air filter 4 is used for filtering impurities in the air-oxygen-nitrogen mixed gas, the impurities are output to the breathing pipeline 10 through the heating and humidifying device 8, and the breathing pipeline 10 is connected with the air passage of a patient 13 through an interface with the end of the patient. The flow signal acquisition module in the controller feeds back the gas flow signal in the breathing pipeline monitored by the flow sensor 7 to the control module to form an air flow closed-loop control system, and the pipeline pressure signal acquisition module in the controller feeds back the air pressure signal in the breathing pipeline monitored by the pressure sensor to the control module to form an air pressure closed-loop system.
Basic average airway flow (BMAF 1, BMAF 2, BMAF 3.) and inspiratory phase support average airway flow (ISMAF 1, ISMAF, ISMAF 3.) are set through a human-machine operation interface on a display, respective Duration (Duration 1,Duration 2,Duration 3, the use), tidal volume (Vt), basic airflow (Bias flow), inhaled oxygen concentration (FiO 2), oscillation flow amplitude (delta F), oscillation frequency (Hz), inhalation time proportion (1%), inhaled NO concentration, variable-frequency ventilation mode switching module, trigger sensitivity, alarm device and other basic parameters are set, and meanwhile, monitoring parameters such as operation parameters of the high-frequency breathing machine, carbon dioxide dispersion coefficient (DCO 2), tidal volume (Vt) and the like are fed back to the human-machine monitoring interface. And adjusting the parameters of the high-frequency breathing machine according to the results and algorithms of the patient feedback, the flow-time image curve, the pressure-time image curve, the blood gas analysis and the like fed back by the monitoring system, so as to achieve the treatment target in the ventilation mode.
The above description is only of the preferred embodiments of the present invention and is not intended to limit the present invention, but various modifications and variations can be made to the present invention by those skilled in the art. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (10)
1. A high-frequency breathing machine working method based on flow control is characterized in that the high-frequency breathing machine sequentially outputs a plurality of average airway flows with the same or different sizes and the same or different working time periods according to a set period rule, the airway flows output in an exhalation phase and an inhalation phase are stable, the average airway flows with the same or different sizes can be output in different inhalation phases and exhalation phases, the output gas flow of the high-frequency breathing machine can be independently regulated between different ventilation flow levels in different working time periods, the output gas flow of the high-frequency breathing machine can be periodically switched between different average airway flow levels in different working time periods, the average airway flow is carried out on a basic average airway flow level, and each average airway flow can be independently regulated.
2. A method of operating a flow control based high frequency ventilator according to claim 1 wherein each active time period comprises one or more breathing cycles and the different flow switching is time controlled but the breathing switching is switched by autonomous or time control.
3. The flow control-based high frequency ventilator operating method of claim 1, wherein the mean airway flow in the exhalation phase is at least a base mean airway flow, and the mean airway flow in the inhalation phase is a sum of the base mean airway flow and the mean support airway flow in the inhalation phase.
4. A method of operating a flow control based high frequency ventilator according to claim 3 wherein an electromagnetic high frequency jet connector and an electromagnetic high frequency oscillator are connected in parallel to the breathing circuit of the high frequency ventilator to form three ventilation modes including high frequency constant current ventilation, variable flow high frequency oscillation ventilation and variable flow high frequency jet ventilation, the corresponding ventilation modes being selected according to different requirements.
5. The method of claim 4, wherein in different ventilation modes, based on a plurality of base mean airway flows of the same or different sizes, the respective inspiratory phase mean support airway flows are superimposed on the inspiratory phase, and ventilation is performed according to the respective time periods of action.
6. The high-frequency respirator working method based on flow control according to claim 4 is characterized in that the high-frequency constant-current ventilation mode is used for controlling and adjusting output airflow through a controller, output flow waveforms are square waves, the variable-flow high-frequency oscillation ventilation mode is used for generating high-frequency airflow through an electromagnetic high-frequency oscillator and conveying the high-frequency airflow into a respiratory pipeline, output pressure is sine waves, and variable-flow high-frequency jet ventilation is used for driving a jet needle to jet the high-frequency airflow into the respiratory pipeline through an electromagnetic high-frequency jet connector by utilizing electromagnetic force, and output flow waveforms are triangular waves.
7. A method of operating a flow control based high frequency ventilator according to claim 4 wherein for different ventilation modes, the triggering is by the high frequency ventilator timing or inhalation to initiate control, assist, support or spontaneous ventilation when a set flow threshold is reached.
8. The flow control-based high-frequency ventilator working method according to claim 1, wherein the flow sensor is used for acquiring gas flow information to generate a flow-time image, the pressure sensor is used for acquiring pressure information to generate a pressure-time image, the gas flow monitoring and adjusting device is used for monitoring and adjusting airway flow, and the high-frequency ventilator working parameters are adjusted according to the flow-time image curve, the pressure-time image curve and blood gas analysis.
9. The high-frequency breathing machine is characterized by working by a high-frequency breathing machine working method based on flow control according to any one of claims 1-8, and comprises a breathing pipeline, wherein an electromagnetic high-frequency jet connector and an electromagnetic oscillator are arranged on the breathing pipeline in parallel, the breathing pipeline is connected with an air-oxygen-nitrogen mixer through a heating and humidifying device, a pressure sensor and a flow sensor are arranged on a pipeline between the air-oxygen-nitrogen mixer and the heating and humidifying device, the sensors and a flow regulating and monitoring device are arranged in parallel, and the electromagnetic high-frequency jet connector, the electromagnetic oscillator, the sensor and the flow regulating and monitoring device are connected with a display through a controller.
10. The high frequency ventilator of claim 9, wherein the air-oxygen-nitrogen mixer is connected to the axial flow fan through an air filter.
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