JPS59145967A - Method and device for measuring information on internal respiration by automatic analysis - Google Patents

Abstract

PURPOSE:To enable an exact analysis of information on internal respeiration in a short time with a small amt. of blood by providing an analyzer A for gas in blood, a CO oxymeter B and an informtion processing unit C and processing the respective values obtd. from the devices A, B in a real time with the unit C. CONSTITUTION:The oxygen partial pressure, CO2, pH, HCO3<->, etc. in blood are analyzed at 37 deg.C+ or -1 deg.C with an automatic analyzer (A) for gas in blood, and are outputted simultaneously together with the values corrected with the patient's bodily temp. On the other hand, the content of oxygen in the hemoglobin (O2Hb), COHb, MetHb in the blood and THb (total hemoglobin) totalling these Hb are measured with a CO oxymeter (B). The outputs from the devices A, B are put into a minicomputer or the like of an information processing unit C (''If 800 Mod 30'' produced by Oki Electric Co.) and are processed in accordance with the procedure determined by the interface card D of RS-232C inserted in the unit, by which the automatic, quick and exact analysis of the information on the atient's internal respiration is made possible. The results are displayed on a CRT and the data is made recordable and keepable.

Description

[Detailed Description of the Invention] This invention is a method for scientifically measuring and analyzing human blood (similar to the blood of various animals), and providing diagnostic information to diagnosticians (2). and an automatic analysis device and method for internal respiration information based on blood ζ1 (these two are related).

Hemoglobin, the most heavily loaded component in blood (Hb
) exist for the purpose of transporting the oxygen that is received by the lungs (2) to each tissue in the living body. However, this Hb cannot be released completely by the tissues that have been bound by the lungs (2), and even in normal people. Only about 25 to 30 units can be released.

This Hb-to-oxygen binding and release capacity is determined by the individual patient's ability to bind and release Hb to oxygen.
own ability, blood pH, amount of carbon dioxide, body temperature, etc.
2 Expressed by the relationship between the 02 partial pressure of blood and the 02 Hb or 02 content gtt% The vertical axis is the oxygen content of hemoglobin φ02T (b Yokozuna (taking the dioxygen partial pressure P o z, P
When O2 is changed from zero to 150 mm) Ig, a unique S-shaped force as shown in Figure 1 (= broken line (A), solid line (B), and dashed line (C)) is generated. This is ffi I (r-element equilibrium curve (OEC) of b or acid dissociation curve of Hb, J(01)C)
In order to tell how much oxygen meter can be released at the minimum required oxygen partial pressure maintained by the tissue (
2 (This is a very important indicator.The number of patients receiving infusions from a friend's stored blood or a smoker at this time) (2) The entire OEC is tilted to the left, i.e. In a case like the broken line (A) in the figure, even a low 1] o2 temperature can cause a lot of H
b is acid f hisa F? , the 02 binding capacity is high, but if the tissue side P o 2 is around, only pickled 02 can be released, and even if the oxygen content in the blood is high enough, this oxygen cannot be utilized, so general oxygen therapy is It becomes impossible. On the other hand, this O
If EC is tilted to the right, that is, if (c) f constant j in the AL1 diagram is uniform, the 02 bonding force in the theoretical f-play Mj will be low, but the 02 minute in the lung (Y) The pressure is 10011
Since the culm degree is sufficiently high at 1g, the 0□ bond C2 is hardly affected by iB, and even if the 1) O2 on the tissue side is relatively (1) high, sufficient oxygen can be released, causing some anemia-like deafness and respiratory problems. Diseases, etc. (2) means that it is possible to live well even with a low arterial blood oxygen partial pressure.
2 is on the OEC curve, %02Hb50%N'' - the corresponding P o 2, that is, 50ch of the total Hb is 02Hbl
Because it is two, it is expressed as 02 partial pressure and written as pso (it is two.

As mentioned above, this -DEC and P5o are important not only for the individual functions of Hb itself, but also for the blood pH2 carbon dioxide partial pressure (PC
O2), body temperature etc. C2 changes by 1 (2) Conventionally, these articles P+ are pH near, 4, PCO2: 40 Dragon W
.

Body temperature: standard conditions of 37°C (flEc, P for two specified cases)
In determining 5o, it was customary to consider only the 02-carrying capacity of Hb itself. However, individual patients
＋iM Even if it is determined that the body has 11 different abilities in order to prevent the infection from occurring due to However, in order to examine the function of l(b) itself, it was not practical to use these data.
It is called tedOEC-) P2O and the actual bug eye Ei Note (-0EIII of that box in -), (hereinafter ac
tual OE
-vDo2), the actual gas diffusion gradient of 02 (A-aDo2) between the active and venous blood in the living body (=oxygen consumed (a-vl)o2), carried out inside and outside the alveoli).
) Actual clinical management, such as % alveolar pi/mass rate index 5hunt rate, etc. The new measuring equipment and foot measurement method are said to be an emergency.

Therefore, we will describe the details of this invention (which we have just arrived at).
I will explain the main points of the method and methods and clarify their shortcomings.

41211, measurement methods that have been used conventionally] 6;
This is the most basic method.
, I(g, -Po2 in the range of 0 to 1501!lllHg) Prepare 40 to 50 types of smoke-like gases, perform tonometry on the blood at each gas concentration, and use a blood gas analysis instrument. Oxygen, Nork P o 2 vs. S O 2 'Z stone P in If the actual value of the stone P in will vary depending on the pH 12, so we supplemented it using the formula a11'-1 C2 on the Y axis, 5o2k
, take "Po2't" on the X axis, and measure 40 to 5071?
Section 50 (two corresponding P o 2 P,. and f i). Since the probability that the point of S O250% is ν is small at the time of −1]ill, the S
O25,0% (75% to "harvest the corresponding Po")
Perform tOg conversion on each of P Q 2 and SO2'2'', bring the straight line [2 closer together, and then use the method of recursive line 1 to find the corresponding Po of 5o50% (2, and set it as P5o2. In this case, the entire surface With a liquid interval of 10 ~ 20 buttons, even when determining the value of P5o only, %50C of blood is required, and the second method is the ``U &method'') P co 2
' 40 YHg, P O2' (same as J < Pc
o2:40pmrig, Po2'200~300
Prepare two types of gases, perform nidometry, and mix the same and anaerobic gases of blood, measure the Po2 at that time, and set it as P50. When you get a straight line with P5Q only (I use it, but it requires skill and 5 Seihen is not good) Corpse 84 cell (connect 202 electric, 568rm+) signal 48
As a standard, change f of the signal of 560 nrl on the Y axis + 2,
0 □ Change in partial pressure All This method (2) enters the blood inside the cell and adjusts the pH to 7.4 (21) There are two types: one that is done on the entire surface, and one that is done on the entire surface. Since the pH of the blood changes during the measurement, it is difficult to obtain an accurate nacurb and pr, oh. The influence of the drift of 02M% cannot be investigated.7
First, calibration: 1 body C and 2 in that song is 1
This method takes over 18L of time, so this method is also used in clinical practice.
Based on actual measurements, the calculation formula [-OE C
, P 5 (This is a method to find 1. This method (- is the type of expression (Fukui) There are four types as follows. Now that you've reached that point, let's put together a SO2, 50 explosion.
Waste twenty? r, it is possible to do this, but at the low points and low points of SO□, there will be errors depending on the town, so based on these actual measurements 1.
1 also causes a town-specific minus, i0 difference.

Hb+no2- of Hb between R which is a tetramer! Hb(o
2) In order to explain n well (this is a formula that has been considered twice, and 4
Requires the Adair coefficient of the species. In other words, since it is calculated from actual measured plots of 4 points or more, it is highly variable (2 is ±1.2
Second, Ike's method (albeit more expensive than the one-tonometry method mentioned above) has the disadvantage that it requires almost as much effort, and the calculations are complex and time-consuming.

(c), LutsO formula Although it is possible to always pass the actual measurement point of arterial blood by modifying the Hill formula, P,,O has the disadvantage that it causes the same error as Equation 11 (d), Aberman 0 formula This is a method of drawing a curve by calculating the difference between the standard curve and the actual measurement points in a proportional manner. This method is effective for standard curves, but it cannot draw the entire curve, it cannot pass the arterial blood point, etc.
Generally (two is not used).

As mentioned above [2] ζ2, analysis of conventional internal reference information,
In particular, various devices and methods have been developed to investigate the oxygen carrying capacity of Hb, but the operation of the bow is cumbersome, and it is difficult to obtain the data for the test. The method requires at least 1 hour (- Therefore, 6 tons, 6 to 8 hours, 1 fr, etc.), and it requires a lot of time, especially (- In clinical settings where blood transfusion is required, the urgency is high), so it is not used at all. Therefore, it is used exclusively as a subject for academic fishing gear (not more than 1).Also, even if the measurement time is shortened by the provisional IJ (-) simple method, it is difficult to measure reliability and accumulation. However, it is not possible to use it with confidence in a clinical setting. Tsutakko's invention aims to overcome the various difficulties mentioned above and to obtain a device and method that provide the required data accurately and in a short time. This invention has been made for this purpose.Hereinafter, one embodiment of the present invention will be described in detail with reference to Drawing 2.

Preface (-1) Outline the structure and function of the blood gas analyzer (hereinafter referred to as device A) and the structure and function of the CO oximeter (hereinafter referred to as device B) that were put into practical use in this Example C2. , and a method of introducing data into the second information processing device (L:J, referred to as C device below).

A device: Blood gas analyzer (IL system, 1303m
,) This device measures oxygen partial pressure, Co□ partial pressure, and pH5 in blood.
bicarbonate ion mco3. Index of acid-base balance ability 10B
E, Co2 content, the pond at the same time (=37°±0.1℃
It is a device that can simultaneously output two types of values: the value at 37°C and the value corrected by the temperature of the specified 7 people.

B Device 200 Oximeter (IL282 model) This device measures 02Hb, C0Hb, λ4etHb in blood.

Alternatively, THb (total hemoglobin), which is the sum of these H and b, and 02 content can be measured within 1 minute using a small amount of blood of 300 μt (two at the same time). If 800 Mof, 30
(manufactured by Oki Electric) This device is a so-called mini computer, with 280 BCP.
U, main memory copy size 128KB is used as standard equipment, CR
T, Flinter, ■BMFJ Standard oar with semi-type double floppy disk. In, type information place +! J! It is at t4 position.

Each value analyzed by the above-mentioned device A and device B [2] is
C device τ to provide real-time information of a defined type
RS-232C interface card D
Insert and perform the prescribed move 111--accordingly. In this case, the operator +1Fj is sequentially displayed on the CRT. By linking as a single system using a standard interface card D, the following two statements can be made.9
Coupled with devising the method as a measuring method, we established a system with completely new functions and the 1.
Four methods of measuring internal call information using a C device and a D8-card (two methods will be explained) FIG. 2 is a block diagram showing an embodiment of the present invention, and FIG. Fig. 1 is a block diagram showing the internal functions of the information processing device used in the embodiment (Fig.
is A device, (2) is B device, (3) is C device, (4)
indicates a D card.

D card (4) is an RS232C interface skirt. Now, let's talk about how to use this system as a combination of these devices. Factor (02Hb,
COHb. Met. Hb,) - reduced Hb
．． (Red Hb), C0Hb, Met
Hb, etc. 02 transport (2 versus invalid T (b e Excluding effective Hb CX
))To)”(Met)To)) =・・・・=・■
Actual force 2 = (02Hb/Re number bird 2Hb)xlooo
・・・・・・－・・・・・・・・・－・・・■This SO□
If we take Poz, which is corrected by the patient's body (obtained by the A device) on the Y axis of the O
EC) One point above is determined.

Based on this point, [2, There seems to be (2,
With this method, accurate P5o can only be obtained by comparing SO2 around 50 cm as an actual measurement point.
Also, even if the SO2 in the vicinity of 5 () is given as an actual measurement, if the overall oh; .

The actual range of venous dish SO2 is wide, from 20 to 80 cm, so even if you use just one of the above equations to calculate Ps[+ and 0FJCk, there is a high probability of error, and it is impossible to use it in the field of late ripening. be. Therefore, in this invention, SO? modified by %C0Hb-[ii? A relational expression for pair n was determined. This S0
Using the relational expression of 7 vs.
and C01 (H whose value changes automatically depending on the value of b)
A new calculation method for the il1 formula was devised. Based on this method, the Po2 value corresponding to 80250% from the point found on the XY coordinates of the vein 1 under the birth condition, that is, the actual P5o
? When calculated, P5o=exp(log(K)/n)...
・-・・-■ For the entire curve, use the formula to set 5O20,l-100% between arbitrary intervals (use the relational formula of PO2 vs. n corresponding to SO2 given in part.Ps[1 is the above) The obtained Pso value is used.

XYJ with this kind of method! 4! If you plot all SO2 vs. PO2 values determined at altitude, you will get accurate actw!
-0JI;C(i-Can be drawn.

In addition, the patient temperature and PL (, PCO2 are not affected by Y)
In order to analyze the performance of the lb itself, the conventionally determined tl
, conditions (PH; 7.4, PCO240mmJg body depth 3
correctcd OE at 7° (0ICC at -2)
We must find C'fr.

There, each individual determined by 37C is introduced from the blood gas analyzer at A@m. Combined with f, PH1PC (h is not necessarily within the specified conditions, so the following formula is changed to Hh
Correct it.

PO2 after correction = Actual PO2X rxp +o(0,4
8x (ntoi-7,4)-0,1 JOB bite IC)...
・・・・■PO2 and actual
P! By plotting the actual mll SO2k XY coordinates used in +11 calculation, one point of correctedol DC is determined. Based on this point, the above ActualOEC,
Correct, e using the same method as Ps n f.
dOECXPso'.

Next, based on this corrected OECf, the artery (
(190 rrmhg.

St'a-VDo2'r *3 Stk-VDo2=1.39 x (Hbx%Ds O
2/], (J O)+0.155 (7). Ko\de*1.2.3.4 are as follows.

*j: When there is 1g of H, b per surface 00CC, it is theoretically possible to combine 02i/ec *2: Effective Hb Ib x (l(%COHb-f-Me tHb)/
1.00 (enthronement was g7100cc)...
......-■*3: %Dso2=(Po29
0mmhg K, %S02] - (po 24f1
%502 corresponding to mmhg)...■ *4: (Dissolved oxygen in PO290mmhgiC 1-(Po240mmhg Dissolved oxygen in VC)
−・・・(Unit: 1jcc)・・・・・・・・・・・・・−・
······················[phase]
This completes the routine decoup analysis using only veins + rlL, but depending on the purpose, Po2 corresponding to 5O275% can be used.
, that is, P75 can also be determined using the same method as P2O. All these data are displayed on the CRT of the information processing device of the C device, and are also made into hard copies along with the input data.

If all of this data needs to be stored within the data processing contract, it will be stored in memory based on the instructions, and CR1 will be displayed at any time in the same condition as at the time of measurement. I can do it.

(#l Actual a-vDo2, A-aDo
2.5 A method of measuring artery +111 e along with vein [111] to obtain hunt rate, etc.

All the vein information analyzed by the A device (11 and B device (2)) is stored in the AC device, and then introduced into the A and B devices according to the instructions on the CRT of the C device. 1. When this artery+m information is introduced into the C device, it is combined with the previously accumulated information on the vein I11, and the same steps as in the case of information processing of only the vein rot are performed to perform RCt 11 Fl l OEC and P!10% correctedQE(: and Pbo,
St'a = vDo 2 k is calculated, but in this case, two points are given: the venous surface point and the artery + m yjP India, so theoretically higher accuracy can be obtained, but there is a significant difference from the one-point method. has not occurred.

Based on this actual measurement data of the arterial and venous surfaces, actua
] a-vDo2, A-af)o 2.5hunt rate, etc. are determined by the following method.

Ko\de◆5.5ao2: Artery 1fIIS□z*6.5
vO2: Central vein 1111 S o 2, Qin 7, PaO
・2: Arterial blood P02° *8, PVo2 ° Central arterial blood PO2, Ko\de *9, F
i O2・Intake 02% *10. BP: atmospheric drought hg *shellfish PH20: saturated water vapor at body temperature *12, Pac02: arterial blood carbon dioxide molecules, *13,
R: Gas exchange rate (i) Sao 2 = 100%, S Q o 2 =
When 100% 'jat=0.0"6"x'g-aDo
2 a-vDo 2 ×lOO”' @(ji)SV
When O2<100%, 5*14.5 (PaO2): 802 of alveoli 1111
Furthermore, when comparing the analysis accuracy of the oxygen equilibrium curve OEC, P5o, which forms the center of the automatic analysis method for call number information, with the tonometry method, which is currently the most reliable, under the most severe conditions, the correlation is Y = 0. 2481+0.9855 X・・・・・・
・・・・・・・・・・・・・・・＠R=0.9865,
N=120. This relationship is as shown in FIG.

Here, R is the correlation coefficient and N is the number of samples.

Equation 0 is drawn into a straight line, and the correlation is clear.

In other words, it shows that it is safe to accept that there is a correlation of 98.65%.

As explained above, if this device and method are used, the measurement of OF:, C and Pbo, which conventional measurement methods require for a long time of one hour or more and is completely unusable in clinical practice, will be possible. It has the advantage that it can be measured accurately and can be applied clinically.

[Brief explanation of drawings]

Figure 1 is an explanatory diagram of the hemoglobin oxygen equilibrium curve OEC;
FIG. 2 is a block diagram of a device showing an embodiment of the present invention, FIG. 3 is a block diagram of internal functions of an information processing device used in this embodiment, and FIG. 4 is a block diagram of a C RT according to this embodiment.
An example of the oxygen balance curve and data table printed on the display and notebook copy, FIG.
! FIG. In the figure, [11...A device: blood gas analysis device, (2)--
...B device: CO oximeter, (3)...
- C device: information processing device, (4)... D゛interface card. J Patent Shojin - Autopsy Associate Control Involved Company Agent Patent Attorney Hide Sato Akiyoshi Sol: J5. / (ZJ
tsO2: 9B,E (%)**O*Boll
Curtain 0\'YGE/υ10υILrBR ding IJMcυR
VE γoAroo↓1* Sf:tgrdard a
-v (X)2: , S'+2.4! Manual
sb cup

Claims (1)

[Claims] (11 Blood oxygen meter, carbon dioxide needle, hydrogen ion concentration (
Tabata bicarbonate ion (HCOI), total hemoglobin and total hemoglobin (2) contained factors (%02) (b
, %Q)Hb, %MetHb, the song) etc. is 74
The various analytical devices that are used, and the interface card that accepts the output from these devices and configures the internal connections of the information processing device Δ, and the interface card that accepts the output from these devices and configures the internal connections. Completed and equipped with an information processing device that automatically carries out predetermined information processing,
Introducing the blood in the ossicles as the object to be measured (1) Analyzing the oxygen carrying capacity of the blood under standard conditions and in vivo conditions (2) (-lungs and blood) Automatically analyzes information related to the internal breathing area,
An apparatus for automatically analyzing and measuring internal call branch information, characterized in that it has a function of displaying on a CRT, outputting it as a hard copy, accumulating all of these data, and outputting it as necessary. (2)-1 Automatic 11fl analysis of internal respiration information 5] We used an information processing device to perform various analyzes such as blood oxygen and acid, hemoglobin, etc. The oxygen balance curve that shows the oxygen transport of hemoglobin (Hb) under standard conditions (-1), which is determined when blood is the measurement target, and the enzyme fraction corresponding to the 02F-(b50) [To0su,) is P, .St6.-v I) o2 arrangement- which represents the theoretical 02 1 general possibility of the value and the blood concerned.
The second step is to complete the measurement using only venous blood of α℃ and P5o, and perform various analysis results obtained from this venous blood (1'1) through the information processing described above. The storage part of the device (two accumulation stages and the same method as the venous blood analysis described above)
2. Therefore, the analytical values of arterial blood obtained by the total information processing device (2) are introduced, and 3.
St'a-v I) together with o2 (-actual 50' state of OEC, P5 (1% history (a-v representing the actual (2) consumed oxygen between the arterial and venous blood in the two living trees) I)o
2. 02 gas diffusion difference A-a that takes place inside and outside the alveoli
I) Internal respiration performed through the lungs and blood, such as the 5hunt rate, which is an index of the o2 alveolar, gui, and gas rate (2) Automatic C-analysis of various information related to
Given, respectively, the stage of displaying (=displaying in a predetermined form as CRT and hard copy) and the need to store and display all these data; 1. A method for automatic analysis and measurement of internal respiration information, comprising steps.