JP3269177B2 - Ventilator - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a ventilator, and more particularly to a ventilator provided with a function that does not impose a burden on a patient's physiological spontaneous respiration.

[0002]

2. Description of the Related Art Conventionally, for example, Japanese Patent Application No. 63-283918.
As described in Japanese Unexamined Patent Publication (Kokai) Publication No. 2002-214, a rotary switching valve connected between a pressure source (blower) and a breathing path provides:
A ventilator has been proposed in which a respiratory path is alternately communicated with a blower outlet and a blower inlet to provide high-frequency respiratory vibration to the respiratory path. The ventilator described in the publication,
As shown in FIG. 8, the regulating mechanism 52 provided with a casing 50 and stretch film 51 is disposed in the middle portion of the oscillating circuit connected to the respiratory pathway, the regulating mechanism 52, generated by the ventilator body intake Phase ( phase for artificially pushing air into the patient's lungs) /
The structure is such that the stretchable film 51 expands and contracts passively in accordance with the expiration phase ( phase in which air is artificially extracted from the patient's lungs). In the figure, an arrow Y1 indicates the movement of positive and negative pressure air generated by the ventilator main body, and an arrow Y2 indicates the movement of air sent to the patient.

[0003]

However, the above-mentioned prior art has the following problems. In a normal state (a state in which the patient does not make an inspiratory effort), as shown in FIG. 9, the movement of the air generated by the ventilator body (waveform H1)
Is converted into the movement of air (waveform H2) sent to the patient via the stretchable film 51. In this case, ΔtA ≒ ΔtB, and the amplitude S of the waveform H2 is normally constant for a stroke.

However, in a state where the patient makes an inspiratory effort, as shown in FIG.
Since the stretchable film 51 of the patient remains in a stretched state, a negative pressure A1 is generated in the respiratory circuit on the patient side, and the stretchable film 51 is kept crushed with the expiration following the patient's inhalation. Abnormal positive pressure in the side breathing circuit. Therefore, in the section K1, a disordered state continues without forming a normal rhythm inspiratory phase / expiratory phase for a while, and a phenomenon occurs in which a normal rhythm inspiratory phase / expiratory phase is formed after the section K1. (Section K2). For this reason,
The conventional regulation mechanism has a problem that a burden is imposed on the physiological spontaneous respiration of the patient.

[0005]

SUMMARY OF THE INVENTION The object of the present invention is to remedy the inconveniences of the prior art described above, in particular, by maintaining the patient's respiratory circuit constantly in a stable positive pressure state, thereby placing a burden on the patient's physiological spontaneous respiration. The purpose is to provide a ventilator that has not been installed.

[0006]

SUMMARY OF THE INVENTION The present invention comprises an inspiratory circuit connected to a source of oxygen storing oxygen to be supplied to a patient's lungs;
An exhalation circuit having an air release adjustment valve that is open to the atmosphere and adjusts the degree of release to the atmosphere; a common circuit having one end connected to the inspiration circuit and the expiration circuit and the other end connected to the mouth of the patient; A respiratory vibration generating mechanism that is connected to one end of the common circuit and applies high-frequency respiratory vibration to the patient's lungs;
A diaphragm connected between the respiratory vibration generating mechanism and one end of the common circuit and displaced toward the common circuit or the respiratory vibration generating mechanism in response to respiratory vibration generated by the respiratory vibration generating mechanism; A ventilator provided with a diaphragm mechanism having a case partitioned by the diaphragm, wherein the ventilator is disposed between the common circuit side case and the oxygen source of the diaphragm mechanism, and is provided in the common circuit side case. An oxygen source regulating valve for supplying / stopping oxygen from an oxygen source, a light emitting unit which is provided in a case of the diaphragm mechanism and emits light to the diaphragm,
A detection device is provided in the case of the diaphragm mechanism, and detects light reflected from the diaphragm as a voltage change and outputs a voltage corresponding to the displacement of the diaphragm. A determining function of determining whether or not the diaphragm is displaced beyond the normal displacement to the common circuit side or the respiratory vibration generating mechanism side based on an output voltage of the detection means; and When it is determined that the displacement exceeds the normal displacement, a first control function for opening the oxygen source adjustment valve and closing the atmosphere release adjustment valve, and a normal displacement of the diaphragm toward the respiratory vibration generation mechanism side. When it is determined that the displacement has exceeded, the control means has a second control function of closing the oxygen source adjustment valve and opening the atmosphere release adjustment valve. This aims to achieve the above-mentioned object.

[0007]

According to the present invention, when light is emitted from the light emitting means to the diaphragm, the emitted light is reflected by the diaphragm and detected by the detecting means as a voltage change corresponding to the displacement of the diaphragm. The control means determines, based on the voltage output from the detection means, whether or not the diaphragm has been displaced beyond the normal displacement to the common circuit side or the respiratory vibration generating mechanism side. Thereafter, when the diaphragm is displaced beyond the regular displacement to the common circuit side, the control means opens the oxygen source regulating valve and closes the atmospheric release regulating valve, while the diaphragm causes the regular displacement to the respiratory vibration generating mechanism side. When the displacement is exceeded, the oxygen source adjustment valve is closed and the air release adjustment valve is opened.
As a result, the pressure of the common circuit connected to the mouth of the patient can be constantly maintained in a stable state, so that even if the patient physiologically spontaneously breathes, a burden is imposed on the patient's natural breathing Disappears. Therefore, the patient can easily perform physiological spontaneous breathing while assisting breathing by the respirator.

[0008]

Embodiments of the present invention will be described below with reference to the drawings.

First, the overall system of the ventilator of the present embodiment will be described with reference to FIG. 2. A respiratory system A of the ventilator includes a common circuit 1, an inspiration circuit 2, and an expiration circuit 3, and a common circuit. One end is airtightly connected to the mouth of the patient, while the other end is connected to the inspiration circuit 2 and the expiration circuit 3. The inspiratory circuit 2 is connected to an oxygen source 4 storing clean air to be supplied to a patient, and a known flow meter 5 and a humidifier 6 are connected in the middle of the oxygen source 4. The exhalation circuit 3 is open to the atmosphere, and the degree of opening is adjusted by an air release adjusting valve 7.

The respiratory system A is connected to a respiratory vibration generator B for generating high-frequency respiratory vibration. The respiratory vibration generator B includes a blower 8 as a pressure generating source and a rotary switching valve mechanism 9 having a rotary valve 9a (hereinafter abbreviated as a rotary valve mechanism).
The pressurization generated at a and the negative pressure generated at the suction port 8b are alternately applied to the vibration circuit 10 by the rotary valve mechanism 9.

The oscillating circuit 10 is connected to the respiratory system A near the connection between the common circuit 1, the inspiratory circuit 2 and the expiratory circuit 3.
Is forced to breathe at a respiration rate corresponding to the frequency at In addition, an electromagnetic variable throttle 11 and a regulating mechanism 12 are sequentially connected to the vibration circuit 10 from the rotary valve mechanism 9 side. Further, between the space formed by the case 33 of the regulating mechanism 12 and the diaphragm 34 (see FIG. 1) and the oxygen source 4, an oxygen source adjustment that is controlled to open and close based on a control signal output from the control unit 16 described later. A valve 13 is provided. In the figure, reference numeral 14 denotes a blower driving motor, and reference numeral 15 denotes a rotary valve mechanism driving motor.

In this case, when a patient who is unable to breathe naturally is inspired by a ventilator, the air release adjusting valve 7 is closed, and an oxygen source is generated based on the breathing vibration generated by the breathing vibration generator. The oxygen supplied from 4 is sent to the lungs of the patient. On the other hand, when exhalation is performed by a ventilator for a patient who cannot breathe spontaneously, the air release adjustment valve 7 is opened to discharge the patient's lungs based on the respiratory vibration generated by the respiratory vibration generator. The air is sent to the atmosphere.

The control section 16 detects a pressure / flow rate sensor 17 for measuring the actual respiratory volume of the patient, a rotation sensor 18 for detecting the rotation state of the blower driving motor 14, and a rotation state of the rotary valve mechanism driving motor 15. Rotation sensor 19,
A switch 20 for setting the respiratory rate given to the respiratory system A, a switch 21 for setting the average pressure of the high frequency vibration applied to the respiratory system A, a switch 22 for setting the respiratory capacity to the patient, and a PSD element 39 of the regulating mechanism 12 , And output control signals to the atmosphere release control valve 7 and the oxygen source control valve 13, respectively. Each switch 20 ~
Reference numeral 22 is provided on the operation unit of the respirator. Reference numeral 23 in the figure denotes an alarm device including a lamp and the like.

Next, the structure of the regulating mechanism 12 provided in the ventilator according to the present embodiment will be described with reference to FIG. 1. The regulating mechanism 12 is provided inside a pair of cases 32 and 33 fixed by bolts 30 and 31. , A pipe 35 connected to the mouth of the patient, and a pipe 36 connected to the ventilator main body, and the reflected light from the diaphragm 34 is detected and converted into a voltage. PSD (secondary position detection element) 37 and LE that emits light to diaphragm 34
D (light emitting diode) 38. In this case, a white or silver reflective piece that easily reflects light is attached to the center of the diaphragm 34.

The PSD 37 includes a PSD element 39, a holder lens 40, a lens 41, and a main body 42.
8 includes an LED element 43 and a main body 44, and the PSD 37 and the LED 38 are controlled by the controller 16. LED element 43 of LED 38
The light emitted from the lens is reflected by the center of the diaphragm 34, and then the holder lens 40 and the lens 4 of the PSD 39.
1 and arrives at an arbitrary one-dimensional position on the PSD element 39 according to the angle of incidence, the PSD element 39 outputs to the control unit 16 a voltage corresponding to the one-dimensional position where the light has reached. Has become. The control section 16 determines the position of the diaphragm 34 based on the output voltage, and controls the movement of the diaphragm 34 as appropriate.

The diaphragm 34 of the regulating mechanism 12 swings right and left in FIG. 1 following the pulsation generated from the respiratory vibration generator. When the diaphragm 34 is at the center position P1, light emitted from the LED element 43 of the LED 38 passes through the path K1 and passes through the PSD element 3 of the PSD 37.
9, when the diaphragm 34 is at the position P2, the light emitted from the LED element 43 of the LED 38 is incident on the PSD element 39 of the PSD 37 through the path K2,
When the diaphragm 34 is at the position P3, the LED 38
The light emitted from the LED element 43 passes through the path K3 and
The light is incident on the PSD element 39 of the SD 37.

The position (runout) of the diaphragm 34 and the PSD
The voltage output from the element 39 is in a one-to-one proportional relationship, and has the characteristics shown in FIG. That is, when the diaphragm 34 swings from the center position (position P1 in FIG. 1) to the mouth of the patient (position P2 in FIG. 1), the PSD voltage takes a negative value, and the diaphragm 34 moves to the center position (position P1 in FIG. 1). )
From the ventilator body side (position P3 in FIG. 1)
The PSD voltage takes a positive value.

Further, in this embodiment, as shown in FIG.
38 are arranged symmetrically, so that the LED element 4
3 suppresses the influence of fluctuations in the reflected light amounts of the light A and the light B which are emitted according to the expansion and contraction of the diaphragm 34 and enter the PSD element 39, thereby improving the measurement accuracy of the position of the diaphragm 34. . In this case, as shown in FIG. 5, the PSD 37 'is positioned with respect to the center line of the diaphragm 34'.
And the LED 38 ′ are arranged asymmetrically (arrangement by triangulation), the diaphragm 3 radiated from the LED element 43 ′
Since the reflected light amounts of the light A 'and the light B' which are reflected by the expansion and contraction of 4 'and enter the PSD element 39' are different from each other, the measurement accuracy is affected.

Next, the operation of the embodiment constructed as described above will be described.

When the patient wearing the ventilator performs an inspiratory operation (step S1), the diaphragm 34 of the regulating mechanism 12 swings (extends) from the center position P1 to the position P2 in FIG. 1 is reflected at the center of the diaphragm 34 through the path K2 in FIG. 1 and then refracted by the holder lens 40 and the lens 41 of the PSD 37 to reach a one-dimensional position of the PSD element 39. As a result, the voltage output from the PSD element 39 shows the same negative value for a certain period of time when the diaphragm 34 is fully extended (step S2).

In this case, when the patient makes a sudden inspiratory operation, the diaphragm 34 of the regulating mechanism 12 expands abruptly, so that the voltage output from the PSD 37 changes abruptly outside the pulsation rhythm of the ventilator. Indicates a negative value with.

When the PSD element 39 outputs to the control unit 16 a voltage corresponding to the light arrival position described above, the control unit 1
6 outputs a control signal to the oxygen source control valve 13 to open the release valve 13 and outputs a control signal to the atmosphere release control valve 7 to close the control valve 7 (step S3). That is,
When the extension of the diaphragm 34 continues for an abnormally long time (in a fully extended state) or when the extension of the pulsation rhythm of the respiratory vibration generating device is extremely deviated, the oxygen source regulating valve 13 and the atmosphere opening regulating valve 7 are controlled. The common circuit 1 on the patient side
Is prevented from being in a negative pressure state for a long time.

When the pressure / flow rate sensor 17 outputs a positive pressure state detection signal to the control unit 16 as the abnormal negative pressure state of the common circuit 1 on the patient side is eliminated , the control unit 16
Outputs a control signal to the oxygen source control valve 13 to close the open valve 13, and outputs a control signal to the atmosphere release control valve 7 to open and close the control valve 7 appropriately, thereby allowing the patient-side common circuit 1 to open and close. Is finely adjusted (step S4).

Thereafter, based on the output of the pressure / flow rate sensor 17, the control section 16 determines whether or not the pressure of the common circuit 1 on the patient side has been recovered (step S5). If it is determined that there is no pressure, the alarm device 23 is activated to give an alarm (step S6), while if it is determined that pressure recovery has been recognized, the process proceeds to step S7 and subsequent steps.

Next, after the above-described inspiratory operation, the patient starts an exhalation operation (step S7), and the diaphragm 34 of the regulating mechanism 12 swings (shrinks) toward the position P3 in FIG. The light emitted from the element 43 is reflected at the center of the diaphragm 34 through the path K3 in FIG. 1, then refracted by the holder lens 40 and the lens 41 of the PSD 37, and reaches the one-dimensional position of the PSD element 39. I do. As a result, the voltage output from the PSD 37 shows the same positive value for a certain period of time when the diaphragm 34 is fully contracted (step S8).

In this case, when the patient suddenly exhales, the diaphragm 34 of the regulating mechanism 12 contracts rapidly, and the voltage output from the PSD 37 changes suddenly outside the pulsation rhythm of the ventilator. Indicates a positive value with

When the PSD element 39 outputs a voltage corresponding to the above-mentioned light arrival position to the control unit 16, the control unit 1
6 outputs a control signal to the oxygen source control valve 13 to close the open valve 13 and outputs a control signal to the atmospheric release control valve 7 to open the control valve 7 (step S9). That is,
When the contraction of the diaphragm 34 continues for an abnormally long time (in a state where the diaphragm 34 is completely contracted) or when the contraction is extremely out of the pulsation rhythm of the respiratory vibration generator, the oxygen source regulating valve 13 and the atmosphere opening regulating valve 7 are controlled. The common circuit 1 on the patient side
Prevents a positive pressure state for a long time.

When the pressure / flow rate sensor 17 outputs a positive pressure state detection signal to the control unit 16 as the abnormal positive pressure state of the common circuit 1 on the patient side is eliminated, the control unit 16 The control signal is output to the source adjustment valve 13 to close the release valve 13, and the control signal is output to the atmosphere release adjustment valve 7 to open and close the adjustment valve 7 appropriately to reduce the pressure of the common circuit 1 on the patient side. Fine adjustment is made (step S10).

Thereafter, based on the output of the pressure / flow rate sensor 17, the control section 16 determines whether or not the recovery of the pressure of the common circuit 1 on the patient side has been recognized (step S11). If it is determined that there is no pressure, the alarm device 23 is activated to give an alarm (step S12), while if it is determined that the pressure has been recovered, the diaphragm 34 is adjusted according to the pulsation rhythm of the respiratory vibration generator in FIG. Center position P1
It is monitored whether it swings symmetrically with respect to (step S13). The above-described series of controls is repeated according to the inspiratory operation / expiratory operation of the patient.

As described above, according to the present embodiment, the control unit 16 of the ventilator uses the oxygen source adjustment valve 13 and the atmosphere release adjustment valve 7 based on the voltage output from the PSD element 39.
Is appropriately opened and closed to control the displacement of the diaphragm 34, so that the pressure of the common circuit 1 on the patient side is always maintained in a stable positive pressure state. No more strain on natural breathing. Therefore, the patient can easily perform physiological spontaneous respiration while receiving the assist of respiration by the artificial respirator, so that a patient-friendly artificial respirator can be provided.

According to the present embodiment, the control unit 16 of the ventilator constantly monitors whether the diaphragm 34 swings symmetrically from the center position P1 in accordance with the pulsation rhythm of the ventilator. The alarm device 23 is activated when an abnormality occurs in the deflection of the diaphragm 34. For example, if the diaphragm 34 is deteriorated or the diaphragm 34 is broken for any reason, the alarm device 23 immediately informs the outside. The notification can be made, and as a result, the reliability of the ventilator can be improved.

Further, according to this embodiment, since the PSD 37 and the LED 38 are arranged symmetrically with respect to the center line of the diaphragm 34, when the LED 38 emits light to the diaphragm 34, the amount of light reflected from the diaphragm 34 Of the diaphragm 34 can be suppressed.
It is possible to improve the measurement accuracy when measuring the position of.

[0033]

As described above, according to the ventilator of the present invention, when the diaphragm is displaced beyond the normal displacement to the common circuit side, the oxygen source regulating valve is opened and the atmospheric release regulating valve is closed. When the diaphragm is displaced beyond the normal displacement to the respiratory vibration generating mechanism side, the oxygen source adjustment valve is closed and the air release adjustment valve is opened, so the pressure of the common circuit connected to the patient's mouth is always stable. It is possible to maintain the natural breathing of the patient, even if the patient caused natural breathing physiologically,
Therefore, a remarkable effect that the patient can easily perform physiological spontaneous breathing while assisting breathing by the artificial respirator can be provided. In addition, if the diaphragm has a monitoring function of monitoring whether or not the diaphragm is displaced in accordance with the respiratory vibration rhythm of the respiratory vibration generating mechanism, it is possible to accurately grasp whether or not an abnormality has occurred in the diaphragm, This has the effect. Further, when the light emitting means and the detecting means are arranged symmetrically with respect to the center of the diaphragm and a light emission control function for emitting light from the light emitting means to the center of the diaphragm is provided, the fluctuation of the amount of light reflected from the diaphragm is provided. And the effect of detecting the displacement of the diaphragm by the detecting means can be improved.

[Brief description of the drawings]

FIG. 1 is a cross-sectional view illustrating a configuration of a regulating mechanism according to an embodiment of the present invention.

FIG. 2 is a schematic diagram illustrating a configuration of a respirator according to the present embodiment.

FIG. 3 is an explanatory diagram illustrating a relationship between an output voltage of a PSD and a deflection of a diaphragm in the present embodiment.

FIG. 4 shows a PSD for a diaphragm in the present embodiment.
FIG. 4 is an explanatory diagram showing an arrangement state of LEDs and LEDs.

FIG. 5 is an explanatory diagram showing an arrangement state of PSDs and LEDs with respect to a diaphragm by triangulation.

FIG. 6 is a flowchart of diaphragm control in the embodiment.

FIG. 7 is a flowchart of diaphragm control in the embodiment.

FIG. 8 is a cross-sectional view illustrating a configuration of a regulating mechanism in a conventional example.

FIG. 9 is an explanatory diagram showing the movement of air generated by a ventilator and air sent to a patient in a conventional example.

FIG. 10 is an explanatory view showing a pressure state of a breathing circuit of a patient in a conventional example.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Common circuit 2 Inspiration circuit 3 Expiration circuit 4 Oxygen source 7 Atmospheric release adjustment valve 8 Blower as respiration vibration generation mechanism 9 Rotary valve mechanism as respiration vibration generation mechanism 10 Oscillation circuit 12 Regulatory mechanism as diaphragm mechanism 13 Oxygen source adjustment valve Reference Signs List 16 control section 17 control section 17 pressure / flow sensor 23 alarm device 32, 33 case 34 diaphragm 39 PSD element as detecting means 43 LED element as light emitting means

Continuation of front page (56) References JP-A-5-245204 (JP, A) Patent 2858131 (JP, B2) Patent 2798259 (JP, B2) Patent 2798257 (JP, B2) Patent 2798256 (JP, B2) Patent 2569147 (JP, B2) (58) Field surveyed (Int. Cl. ⁷ , DB name) A61M 16/00

Claims (3)

(57) [Claims] An inspiratory circuit connected to an oxygen source storing oxygen to be supplied to a patient's lungs, an exhalation circuit having an air release adjusting valve which is opened to the atmosphere and adjusts the degree of release to the atmosphere, and one end of which is connected to the exhalation circuit. A common circuit connected to the inspiratory circuit and the expiratory circuit and having the other end connected to the mouth of the patient, a respiratory vibration generating mechanism connected to one end of the common circuit and applying high-frequency respiratory vibration to the lungs of the patient; A diaphragm connected between the respiratory vibration generating mechanism and one end of the common circuit, and displaced to the common circuit side or the respiratory vibration generating mechanism according to the respiratory vibration generated by the respiratory vibration generating mechanism; A ventilator provided with a diaphragm mechanism having a case partitioned by a diaphragm, wherein the ventilator is disposed between the common circuit side case of the diaphragm mechanism and the oxygen source; An oxygen source adjusting valve for supplying / stopping oxygen from the oxygen source into the common circuit side case; a light emitting unit which is provided in the case of the diaphragm mechanism and emits light to the diaphragm; and a case of the diaphragm mechanism Detecting means for detecting the light reflected from the diaphragm as a voltage change and outputting a voltage corresponding to the displacement of the diaphragm, wherein the diaphragm detects the light reflected from the diaphragm based on the output voltage of the diaphragm. A determination function for determining whether the displacement has exceeded the normal displacement to the respiratory vibration generating mechanism side, and adjusting the oxygen source when determining that the diaphragm has shifted beyond the normal displacement to the common circuit side; A first control function for opening the valve and closing the air release adjusting valve, and the diaphragm forcing a regular displacement to the respiratory vibration generating mechanism side; A ventilator comprising: a control unit having a second control function of closing the oxygen source adjustment valve and opening the atmosphere release adjustment valve when it is determined that the displacement has exceeded the maximum. 2. The apparatus according to claim 1, wherein said control means has a monitoring function of monitoring whether or not said diaphragm is displaced in accordance with a respiratory vibration rhythm of said respiratory vibration generating mechanism. Ventilator. 3. A light emitting control function for arranging the light emitting means and the detecting means symmetrically with respect to the center of the diaphragm, and wherein the control means emits light from the light emitting means to the center of the diaphragm. The respirator according to claim 1, wherein the respirator is provided.