TWI605841B - Control method, control system and processing apparatus for ventilator - Google Patents

Description

Respirator control method, control system and processing device

The present invention relates to a method of controlling a respirator, and more particularly to a method, a control system and a processing apparatus for a respirator in a spontaneous breathing assist mode.

A respirator is a mechanical device that replaces the function of the human respiratory organs. Its main purpose is to provide ventilation and oxygenation to patients with respiratory failure, while reducing work-to-breathing to maintain proper The amount of carbon dioxide and oxygen in the blood, so that the patient can breathe effortlessly.

The respirator may have several modes of ventilation, such as Continuous Mandatory Ventilation (CMV), Pressure Control Ventilation (PCV), Synchronized Intermittent Mandatory Ventilation (SIMV), And a Pressure Support Ventilation (PSV) (hereinafter referred to as PS mode) or other spontaneous breathing assistance mode that allows the user to control the start and end of the breathing.

The respirators produced by Hamilton use the Adaptive Support Ventilation (ASV) model, which is based on the Otis theory and combines the pressure control (PC) mode with the PS mode to control each Minute Volume (MV) and respiratory rate are used to meet the needs of the patient.

In the ASV mode, it has often been necessary to adjust the respirator through medical staff with empirical estimates to allow the patient to get the appropriate ventilation per minute. The Taiwan Patent No. I260219 "The artificial respirator and its method for automatically regulating the ventilation per minute" proposes a method of automatically regulating the ventilation per minute based on the ASV mode, so as to avoid the manipulation of the person to achieve the appropriate ventilation per minute for the patient. the amount. That is to say, in the prior art, in addition to the ASV mode, there is no other document that discloses a technique for adjusting an appropriate per minute ventilation based on other ventilation modes.

How to measure the minute ventilation and its required amount for the minute ventilation supplied to the patient's respirator is still a very important and controversial issue. As early as 1991, scholars have mentioned that respirator patients need to monitor breathing parameters and measure minute ventilation. However, since the aforementioned measurement methods are not standardized, the measured minute ventilation is often overestimated or underestimated, thereby affecting the prognosis of the predicted patient. Therefore, the current technology requires a method that can find the minute ventilation required by the patient.

The invention provides a control method, a control system and a processing device for a respirator, which enable the respirator to obtain an optimal optimal minute ventilation (OMV) suitable for the user in the spontaneous breathing assistance mode.

The present invention provides a method of controlling a respirator in a spontaneous breathing assist mode, and the control method includes the following steps. Receive and detect breathing parameters. Calculate several target Ortis curves. Determine whether to adjust the breathing assistance level of the respirator so that the breathing parameters meet one of the target Otis curves. If the breathing parameter meets one of the target Otis curves, the optimal per minute ventilation is obtained. For example: prompting to prepare the patient, this prompt option may include confirmation of artificial airway patency, artificial airway balloon and respirator tube without air leakage, current spontaneous breathing, sufficient oxygenation, giving a quiet and interference-free environment. Turn on the spontaneous breathing mode of the respirator, and the inspiratory assist pressure is initially at, for example, 10 cmH2O. Next, the patient's current breathing parameters are received. After obtaining a few breathing parameters, find out where the current ventilation per minute falls (for example, 11.2 liters, etc.) and calculate the target Otis curve. The target tidal volume of the target Otis curve is used to determine whether to adjust the spontaneous breathing assistance level of the respirator so that the current breathing parameters conform to the target Otis curve. In addition, it is determined whether the patient's breathing is slowed down by the target number of breaths. If so, determine the optimal amount of ventilation per minute. If not, then calculate the new target Otis curve, and then repeat the previous steps.

The present invention provides a control system for a respirator. This control system includes a respirator and a processing device. The respirator is in spontaneous breathing assistance mode and is used to receive breathing parameters. The processing device is coupled to the respirator. The processing device receives and detects the breathing parameter through the respirator, calculates the target Otis curve, determines whether the breathing aid is adjusted to the respirator, so that the breathing parameter meets one of the target Otis curves, and if the breathing parameter meets the target One of the Tis curves, in turn, determines whether the patient's spontaneous breathing slows down to the target number of breaths and is maintained (eg, the variation over time does not exceed the threshold). If so, the optimal per minute ventilation requirement is obtained. If not, calculate the new target Otis curve and repeat the previous steps.

The present invention provides a respirator processing device coupled to a respirator in a spontaneous breathing assistance mode, and includes a signal receiving module and a processing unit. The signal receiving module receives and detects breathing parameters from the respirator. The processing unit receives the receiving module, receives the breathing parameter from the signal receiving module, calculates the target Otis curve, and determines whether the breathing aid is adjusted to the breathing apparatus so that the breathing parameter meets one of the target Otis curves, and if The breathing parameter conforms to one of the target Otis curves, and then determines whether the patient's spontaneous breathing is slowed down by the target number of breaths. If so, the optimal per minute ventilation requirement is obtained. If not, calculate the new target Otis curve and repeat the previous steps.

Based on the above, the embodiment of the present invention provides a control method, a control system, and a processing device for a respirator, which can adjust the respiratory assist level (for example, the pressure value of the pressure assist mode) in the spontaneous breathing assist mode. Let the breathing parameters approach the selected target Otis curve. And when the patient's breathing is slowed down and maintained, the best minute ventilation is achieved. Thereby, as long as the respirator capable of providing the spontaneous breathing assist mode is used, the patient can find the optimal per minute ventilation through the embodiment of the present invention, that is, after the patient is finely adjusted, the spontaneous breathing is slowed down. While maintaining the amount of ventilation required per minute.

The above described features and advantages of the invention will be apparent from the following description.

The theory of Otis is to show that the amount of Respiratory Rate (RR) of a person under natural breathing depends on the person who needs to achieve the minimum Work of Breathing (WOB). Under any minute ventilation (MV), there is an infinite variety of Tidal Volume values and the number of breaths, ie, the breath per minute is equal to the tidal volume value in one breath multiplied by one minute of breath. frequency. The number of breaths and the work of inhalation show a J-shaped curve. Accordingly, the embodiment of the present invention allows the respirator to adjust the degree of respiratory assistance in the spontaneous breathing assist mode so that the current spontaneous breathing number and the current spontaneous tidal volume volume can be approximated (for example, the difference is less than 10%). , 15%, etc.) target, and to get the best per minute ventilation (OMV) of this user. A plurality of embodiments in accordance with the spirit of the present invention are set forth below, and those applying the present embodiment can be appropriately adjusted according to their needs, and are not limited to the contents described in the following description.

1 is a block diagram showing a control system in accordance with an embodiment of the present invention. Referring to FIG. 1 , the control system 100 includes a respirator 110 and a processing device 150 .

Respirator 110 may be any type or brand of respirator that supports spontaneous breathing assistance (eg, PS mode, volume support, etc.) mode to receive multiple breathing parameters from the user. Respirator 110 can also provide oxygen to the patient. Specifically, the tubing of the respirator 110 can be connected to the patient's respiratory organs through an artificial tracheal intubation or a gas-cutting tube to allow the respirator 110 to provide patient ventilation, and the respirator 110 is also provided with respect to the patient's respiratory condition. Instant information (such as flow, resistance and pressure, etc.), which is the breathing parameter. In addition, the respirator 110 can be connected to a flow sensor to measure the patient's breathing parameters and output breathing parameters.

The processing device 150 can be an electronic device such as a desktop computer, a notebook computer, a smart phone, a tablet computer, or a workstation. The processing device 150 includes a signal receiving module 151, a display unit 152, and a processing unit 153. The signal receiving module 151 is configured to receive and detect respiratory parameters from the respirator 110. These breathing parameters include Oxyhemoglobin Saturation by Pulse Oximetry (SPO2), current spontaneous tidal volume values, and current spontaneous respiratory counts. According to different design requirements, the respiratory parameters may include positive end expiratory pressure (PEEP), airway resistance (Rexp), expiratory flow (Fexp) and its call. Air flow waveform information, etc., and is not limited to this.

The signal receiving module 151 is connected to the respirator 100 through a connector having a communication interface such as RS232 or a universal serial bus (USB), and is automatically set every predetermined time (for example, 0.5, 0.2 seconds, etc.). The respirator 100 accesses the above breathing parameters.

The display unit 152 is, for example, a liquid crystal display (LCD), a Light-Emitting Diode (LED) display, a Field Emission Display (FED), or a display of other types of displays. The display unit 152 is used to present the breathing parameters and the target Otis curve, and the target Otis curve will be described in the following embodiment.

The processing unit 153 is, for example, a central processing unit (CPU), or other programmable general purpose or special purpose microprocessor (Microprocessor), digital signal processor (DSP), programmable A controller, an Application Specific Integrated Circuit (ASIC), a system on chip (SoC), or the like, or a combination of the above. The processing unit 153 is coupled to the signal receiving module 151 and the display unit 152. In the embodiment, the processing unit 153 is configured to process all the operations of the processing device 150 of the embodiment.

In order to facilitate the understanding of the operation flow of the embodiment of the present invention, the control method of the respirator 110 in the embodiment of the present invention will be described in detail below by way of various embodiments. 2 is a flow chart illustrating a control method in accordance with an embodiment of the invention. Referring to FIG. 2, the method of the present embodiment is applicable to the respirator 110 and the processing device 150 of FIG. Hereinafter, the method described in the embodiments of the present invention will be described in conjunction with various components and modules in the respirator 110 and the processing device 150. The various processes of the method can be adjusted accordingly according to the implementation situation, and are not limited thereto.

In step S210, the processing unit 153 of the processing device 150 receives and detects the breathing parameter through the respirator 110 by controlling the signal receiving module 151. These breathing parameters include at least the current spontaneous tidal volume value and the current number of spontaneous respirations per minute. The respirator 110 is set in the PS mode. The processing unit 153, for example, calculates the breathing parameters of each breath taken by the respirator 110 in real time.

It should be noted that, after the step of receiving and detecting the breathing parameter in step S210, the processing unit 153 further determines whether the blood oxygen saturation is sufficient. Specifically, the processing unit 153 determines whether the blood oxygen saturation is greater than a blood oxygen threshold (for example, 85 % , 90 %, etc.). If the oxygen saturation is greater than the blood oxygen threshold, the subsequent steps are continued. On the other hand, if the blood oxygen saturation is not greater than the blood oxygen threshold, step S210 is continued. In addition, the processing unit 153 further determines whether the currently detected patient has the ability to spontaneously breathe. In addition, the processing unit 153 can present the prompting option of at least one of the following or a combination thereof through the display unit 152: confirming the artificial airway is unobstructed, confirming whether the artificial airway is leaking, confirming whether the respirator tube is leaking, confirming that there is spontaneous breathing at present. No apnea, confirm that oxygen is adequate and/or give a quiet, undisturbed environment.

With the assistance of the current respirator 110, the processing unit 153 begins to calculate the current minute ventilation and calculates the minute ventilation and its percentage based on the user's ideal weight. This percentage is taken as 100% by multiplying the ideal body weight (kg) by 0.1 liters per minute of ventilation. If the current perioperative ventilation of spontaneous breathing is higher than the specific percentage of the user's ideal body weight (IBW) (eg, 100% to 130%) per minute ventilation (eg, approximately every In 10 minutes (L/min) or more, the amount of breathing required by the user under spontaneous breathing (ie, minute ventilation (MV)) is further measured. For example, the patient has spontaneous breathing and has a blood oxygen saturation (SPO2) of 95%, while the current ventilation per minute is 12 liters per minute. At an ideal weight of 70 kg, the ideal body weight per minute ventilation is 7 liters, the percentage is 100%, and 180% is 12.6 liters.

In step S230, the processing unit 153 calculates a plurality of target Otis curves. In the present embodiment, the processing unit 153 calculates the ideal body weight per minute ventilation and the different percentages of minute ventilation according to the ideal weight of the user providing the breathing parameters. The calculated per minute ventilation is compared to the current spontaneous per minute ventilation to calculate the target Otis curve. Specifically, the processing unit 153 acquires a parameter input operation of receiving an ideal weight from an input unit (for example, a display unit 152 having a touch function, a keyboard, a mouse, etc.). The ideal body weight of a man is calculated as (height (cm) -80) x 0.7, while the ideal weight of a woman is calculated as (height (cm) -70) x 0.6. Next, the processing unit 153 substitutes the ideal body weight into the Otis equation (1): …(1) The minimum number of target breaths for breathing work, a is the constant of the sinusoidal flow (for example, (2π^2)/60), and RCe is the time constant (respiratory resistance (Rexp) and respiratory compliance (respiratory compliance) The product (for example, 0.1 second, 0.5 second, etc.), MinVol is the ventilation per minute (for an ideal weight of 70 kg (kg), the ventilation per minute is 100% × 70 (kg) × 0.1 (per Minute liters/kg (l/min/kg) = 7 (L/min), f is the number of breaths per minute under ideal body weight, and Vd is the volume of the dead space.

The number of breaths f can be determined according to the initial respiratory pattern for adults in Table (1), and the number of breaths under Synchronized Intermittent Mandatory Ventilation (SIMV) corresponding to the ideal weight of the user can be utilized. . For example, if the ideal weight is 60 kg, the number of breaths f is 10 times per minute. In addition, the number of breaths f can also directly use the current number of spontaneous breathing. It should be noted that the numerical values in Table (1) are only for illustrative purposes, and are not intended to limit the present invention. Table 1)         <TABLE border="1" borderColor="#000000" width="85%"><TBODY><tr><td> ideal weight (kg) </td><td> inspiratory pressure (cmH2O) </td ><td> Inspiratory time (seconds) </td><td> Number of breaths under SIMV (number of times / minute) </td><td> Minimum number of target breaths (number of times / minute) </td></tr ><tr><td> 30 to 39 </td><td> 15 </td><td> 1 </td><td> 14 </td><td> 7 </td></tr> <tr><td> 40 to 49 </td><td> 15 </td><td> 1 </td><td> 12 </td><td> 6 </td></tr>< Tr><td> 50 to 59 </td><td> 15 </td><td> 1 </td><td> 10 </td><td> 5 </td></tr><tr ><td> 60 to 69 </td><td> 18 </td><td> 1.5 </td><td> 10 </td><td> 5 </td></tr><tr> <td> greater than 100 </td><td> 20 </td><td> 1.5 </td><td> 10 </td><td> 5 </td></tr></TBODY>< /TABLE>

This target Otis curve is a parameter corresponding to the tidal volume value and the number of breaths. The target Ortis curve, which is based on the ideal weight, is the 100% target Otis curve. Next, the processing unit 153 calculates other percentages according to the 100% target Otis curve (for example, 110% and 90% of the target Otis curve, etc., at 10% or other percentage intervals (eg, 5%, 15%, etc.) Interval), and calculate the current spontaneous per minute ventilation according to the current spontaneous tidal volume value and the current spontaneous respiratory rate, and fit the Otis curve (that is, the closest to the current respiratory parameters in the Ortis curve) An Otis curve and corresponds to the current spontaneous per minute ventilation).

Next, in step S250, the processing unit 153 determines whether the breathing assistance level is adjusted to the respirator 110 such that the breathing parameter conforms to one of the target Otis curves. In the present embodiment, the processing unit 153 selects a selected target curve in the target Otis curve according to the current spontaneous tidal volume value, and compares the current spontaneous tidal volume value with the target tidal volume value of the selected target curve. Specifically, the processing unit 153 further selects a target range of the target range per minute ventilation (for example, ±10%, ±15%, etc.) from the plurality of target Otis curve selection portions calculated in step S230. Curve. Next, the processing unit 153 selects, from the selected target Otis curves, a selected target curve (or a decision target curve) that is closest to and higher than the tidal volume value corresponding to the current Otis curve.

For example, if the patient's IBW is 70 kg, then 100% of the minute ventilation is 7 liters per minute, ..., 160% of the minute ventilation is 11.2 liters per minute, and 170% of the ventilation per minute is 11.9 liters per minute, 180% of ventilation per minute is 12.6 liters per minute... and so on. When the respirator 110 is adjusted to the pressure assisted (PS) mode, its current spontaneous breathing has a per minute ventilation of 12 liters per minute. The processing unit 153 will select a target Otis curve (ie, 160%, 170%, 180% three target Otis curves) with a specific range (for example, 10%, 15%, etc.) corresponding to a percentage of 12 liters per minute. (The three target Ortis curves cover the current range of 12 liters per minute). Next, the processing unit 153 calculates the target per minute ventilation, the target respiratory number, the target tidal volume value corresponding to the three target Otis curves, and the target with the closest target tidal volume volume value higher than the current spontaneous tidal volume value. The Tis curve is used as the selected target curve. For example, the target curve is selected to be a 180% target Otis curve with a target per minute ventilation of 12.6 liters per minute, a target number of breaths of 19, and a target tidal volume value of 663 milliliters.

In one embodiment, the processing device 153 presents the breathing parameters and the target Otis curves on the display unit 152 in a spontaneous breathing times-tidal volume coordinate map. For example, Figure 3 is an example of a user interface with an Otis curve. Referring to FIG. 3 , the user interface 300 is presented on the display unit 152 , and the user interface 300 includes a respiratory number-tidal volume coordinate map 310 , a data presentation block 320 , and a communication interface and a parameter setting block 350 . The number of breaths - tidal volume coordinate map 310 presents the current breathing parameters 301, 170% target Otis curve 311, 160% target Otis curve 313, 180% target Otis curve 315 and current cooperation Ortis Curve 317. The data presentation block 320 presents different percentages of minute ventilation, tidal volume values, and respirator parameters in numerical values and graphs (breathing times - tidal volume coordinate map 310). The communication interface and parameter setting block 350 is used to display the setting of the communication interface, the parameter of the ideal weight, the setting of the ventilation per minute, and the like. In this way, the operator can easily know the graphical parameter performance and facilitate subsequent operations.

It is worth mentioning that, depending on the design requirements, the target tidal volume values of different target Otis curves may be selected for comparison, and are not limited thereto. Moreover, the numerical values and curves in FIG. 3 are for illustrative purposes only, and are not intended to limit the invention.

In yet another embodiment, the processing unit 153 calculates the current Otis curve by taking the current per minute ventilation of the user as an initial calculation and substituting the current per minute ventilation into the Otis equation (1). For example, when the respirator 110 is set to the PS mode, if the per minute ventilation of the current spontaneous breathing is 12 liters per minute, the processing unit 153 substitutes the per minute ventilation into the Otis equation (1) to calculate The target number of breaths was 18 and the target tidal volume value was 667 ml.

Next, the processing unit 153 calculates a difference between the current spontaneous tidal volume value and the target tidal volume value of the selected target curve (eg, the difference between the current spontaneous tidal volume value and the target tidal volume value of the selected target curve is divided by the target tidal volume The volume value) and determine whether the difference between the current spontaneous tidal volume value and the target tidal volume value is less than the tidal volume value range (eg, 5%, 10%, etc.).

In one embodiment, if the difference between the current spontaneous tidal volume value and the target tidal volume value is not less than the tidal volume value range, the processing device 150 adjusts the respiratory assistance level to the ventilator 110. That is, the current spontaneous tidal volume value does not meet the target tidal volume value, and the current spontaneous tidal volume volume value needs to be adjusted to meet the target tidal volume value by adjusting the respiratory assistance level. The processing unit 153 adjusts the degree of respiratory assistance by transmitting a control signal through a breathing assistance adjustment module (not shown, built-in or externally disposed to the processing device 150). For example, the breathing assistance adjustment module can control the knob for the degree of breathing assistance in the respirator 110, or directly increase or decrease the degree of breathing assistance (eg, pressure value). Alternatively, the respirator 110 can directly receive the user's adjustment operation to adjust the degree of breathing assistance.

In an embodiment, if the difference between the current spontaneous tidal volume value and the target tidal volume value is not less than the tidal volume value range, if the current spontaneous tidal volume value is greater than the target tidal volume value, the processing unit 153 is The ventilator 110 lowers the degree of respiratory assistance, and if the current spontaneous tidal volume value is less than the target tidal volume value, the processing unit 153 raises the respiratory assist level to the ventilator 110. Assuming that the respirator 110 is in the PS mode, the processing unit 153 transmits a down-conversion (eg, a decrease in the inspiratory pressure of 5, 10, or 15 cmH2O) or a rise (eg, an increase of 5, 10, or 15 by the respiratory assist adjustment module). The inspiratory pressure of cmH2O) the control signal of the respiratory assist level to the respirator 110. The respirator 110 can also adjust the degree of breathing assistance according to the control signal. Then, the processing unit 153 receives the breathing parameter from the respirator 110 through the signal receiving module 151 (for example, obtains the breathing parameter of the user's next or two breaths), and re-compares whether the current spontaneous tidal volume value meets the target tidal volume value. .

For example, the current patient is spontaneous breathing, and the respirator 110 uses the PS mode with a pressure of 15 cmH2O. The processing unit 153 calculates that the patient's current spontaneous tidal volume value is 422 milliliters and the target tidal volume value is 667 milliliters. Next, the respirator 110 is fed back by 3 cmH2O (at this time the pressure is 18 cmH2O). If the current tidal volume value obtained for the next breath is 788 ml and the target tidal volume value is 667 ml, the respirator 110 is reduced by 2 cm H2O (at this time the pressure is 16 cmH2O). Similarly, if the current spontaneous tidal volume value falls within ±10% of the target tidal volume, stop adjusting the pressure value and proceed to the next step (ie, between the current spontaneous tidal volume value and the target tidal volume value). The difference is less than the range of tidal volume values).

That is, if the current spontaneous tidal volume value does not meet the target tidal volume value, the control system 100 needs to continuously adjust the respiratory assistance level to make the current spontaneous tidal volume value conform to the target tidal volume value (ie, the difference between the differences is less than The range of tidal volume values). The current breathing parameter 301 shown in FIG. 3 is shifted to the left in the spontaneous breathing number-tidal volume coordinate map as the breathing assistance level is increased, and is shifted to the right as the breathing assistance level is lowered.

In one embodiment, if the difference between the current spontaneous tidal volume value and the target tidal volume value is less than the tidal volume value range, the processing unit 153 compares the current spontaneous breathing number with the target breathing number of the selected target curve. In this embodiment, if the current spontaneous respiratory rate is slowed down (for example, the number of changes is less than the threshold of the number of changes) and the difference between the number of target breaths is less than the range of respiratory numbers (eg, 5%, 10%, etc.) and the difference is If the change range of the time is less than the change threshold (ie, the smoother is maintained), the processing unit 153 determines the optimal minute ventilation, and if the difference between the current spontaneous breathing number and the target respiratory number is not less than the respiratory number range, then The processing unit 153 adjusts the target Otis curve and receives and detects the breathing parameters through the respirator 110 again. Specifically, if the current difference between the number of spontaneous breathing and the target number of breathing is not less than the range of breathing times, the currently set per minute ventilation is still not the most suitable optimal minute ventilation for the user. The processing unit 153 will recalculate and present the target Otis curve (re-execution of step S250) (eg, a target Otis curve that increases by 10% over the range of breaths (eg, from 170% to 180%), or The subsequent breathing parameters are directly obtained to compare the current spontaneous tidal volume value with the target tidal volume value.

For example, the current patient is spontaneous breathing, and the respirator 110 uses a PS mode with a pressure of 16 cmH2O. The processing unit 153 calculates that the current spontaneous tidal volume value of the patient falls within ±10% of the target tidal volume value (667 ml), the current spontaneous respiration number is 23 times per minute, and the target respiratory number is 18 times per minute. (ie, you need to increase the target Otis curve by 10%). Next, the processing unit 153 recalculates the target tidal volume value of the adjusted target Otis curve and the target number of breaths, and further determines whether the assisted breathing degree needs to be adjusted.

If the current number of spontaneous breathing is slowed down (for example, maintaining a change in the time of one or two times and less than three or four times, the difference between the number of times of breathing and the target number of breaths is less than the range of breathing times and Smooth (for example, maintaining a variation range of 5c/o, 10c/o, etc., and less than 15c/o, 18c/o, etc.), then in step S270, if the breathing parameter meets the target Otis curve In one case, the processing unit 153 obtains the optimal per minute ventilation. That is to say, the current number of spontaneous breathing and the current spontaneous tidal volume value can meet the selected target curve. Since the target Otis curve is the number of spontaneous respirations that can meet the minimum respiratory effort of the user, the current spontaneous tidal volume volume and the target tidal volume volume are in line with the tidal volume value range, if the current spontaneous The number of breaths that can fall within the target number of breaths indicates that the minute breath provided by the current respirator 110 is the number of spontaneous breaths that the user can maintain the most comfortable.

For example, the current patient is spontaneous breathing, and the respirator 110 uses the PS mode with a pressure of 18 cmH2O. The processing unit 153 calculates that the patient's current spontaneous tidal volume value (660 ml) falls within ±10% of the target tidal volume value (667 ml), and the current spontaneous respiration rate is 19 times per minute, and the target number of respirations It is 18 times per minute (ie, falls within ±10% of the number of breaths) and is stable. Next, the processing unit 153 determines that the current breath rate per minute falls within the range of the optimal minute ventilation.

That is, when the person is spontaneously breathing, at the same minute ventilation and overcoming the airway resistance and the chest elastic load, the number of breaths will be achieved at the minimum number of breaths for the inspiratory effort. When the airway resistance becomes worse (the number of breaths increases), it is necessary to achieve a slower number of breaths, which is more labor-saving. When the thoracic elasticity is worse (the number of breaths is reduced), the number of breaths is achieved by taking the number of breaths as fast and saving effort. At the same time, in the embodiment of the present invention, the patient receiving the respirator 110 knows the ventilation per minute (that is, the actual required amount) when the respirator 110 is used, and the oxygen saturation is sufficient and the spontaneous breathing is performed. Compared to previous studies, the focus is on the absence of respirators, self-loading of breathing, or even the clinical staff's own estimates for patients.

Next, processing unit 153 multiplies the current spontaneous tidal volume value by the current number of spontaneous breaths to produce an optimal minute ventilation. In addition, processing unit 153 may further divide this optimal minute ventilation volume from the 100% target Otis curve to produce an optimal percentage of ventilation per minute.

For example, when the user's spontaneous breathing times are comfortable and slowed down due to the assist of the breathing apparatus 110, the current tidal volume tends to increase, and the current spontaneous breathing times tend to slow down (for example, may be 12 to 16 times per minute). Area range). In the past, the non-ASV mode respirator can not exhibit the forced control of the number of breaths. However, the embodiment of the present invention can present the forced control breath number through the display unit 152 in the PS mode to facilitate the operator to determine the optimal per minute ventilation.

On the other hand, if the breathing parameter does not meet one of the target Otis curves, the processing device 150 is required to adjust the degree of breathing assistance of the respirator 110 (eg, the pressure value of the PS mode).

It should be noted that the foregoing control method can be operated by a software type (for example, an application, a firmware, etc.), the software is stored in a storage unit (not shown), and the processing unit 153 can be a self-storage unit (not shown). Access and load this software.

In order to help understand the steps of the foregoing embodiments, an operational flow of applying the embodiments of the present invention will be described below. In this example, the assumption is made in the configuration diagram of FIG. Referring to FIG. 4, the control system includes a respirator 401, a simulated lung 403, a computer 405, and a knob control circuit 407 (an embodiment of a breathing assist adjustment module). The respirator 401 can be connected to the computer 405 via a USB cable, and the computer 405 can adjust the breathing assistance level of the respirator 401 by transmitting a control signal to control the knob control circuit 407. It should be noted that the control system can also be applied clinically, that is, the user wears a respirator 401 to perform breathing regulation on the human lung.

FIG. 5 is a flow chart illustrating a control method according to an embodiment of the invention. Referring to FIG. 5, the method of the present embodiment is applied to the control system of FIG. Hereinafter, the method described in the embodiments of the present invention will be described in conjunction with various devices, components, and modules in the control system. The various processes of the method can be adjusted accordingly according to the implementation situation, and are not limited thereto.

The computer 405 presents a reminder option (for example, whether the artificial airway is unobstructed? Is there any air leak in the artificial airway?) (step S501), and determines whether the blood oxygen saturation is sufficient (step S505), and enters when the blood oxygen saturation is sufficient. The next step (ie, step S510). The respirator 401 is set to be used in the PS mode (step S510), and the computer 405 receives the ideal weight input by the user's parameter input operation, and takes the breathing parameter from the respirator 401 (step S520). The computer 405 can calculate the target Otis curve based on the ideal weight and present these target Otis curves and current breathing parameters on the screen (step S530).

For example, Figure 6 is an example of a user interface. Referring to FIG. 6, the user interface 600 includes a communication interface and a parameter setting block 610, an indication block 630 for optimal minute ventilation, and a data presentation block 650. The communication interface and parameter setting block 610 is used to display the setting of the communication interface and the received signal, the parameters of the ideal weight, the ventilation setting per minute, the percentage of ventilation per minute, and the like. The indicator block 630 for optimal minute ventilation may be presented to obtain an optimal per minute ventilation and an optimal percentage per minute ventilation. The data presentation block 650 further includes a coordinate graph 651 of the spontaneous breathing times-tidal volume coordinate map as shown in FIG. 3 to present the target Otis curve and the current breathing parameters.

Next, the computer 405 substitutes the current breathing parameter into the Otis equation (1), and then selects the target Otis curve (step S540). For example, select 110% of the target Otis curve as the selected target Otis curve. Next, the computer 405 determines the difference between the current spontaneous tidal volume value and the target tidal volume value (step S545). If the tidal volume value ranges outside of ±10%, the computer 405 determines whether the current spontaneous tidal volume value is greater than the target tidal volume value (step S549).

If the current spontaneous tidal volume value is not greater than the target tidal volume value, the computer 405 raises the respiratory assist level (eg, increases the 5 cm H 2 O pressure value) to the respirator 401 through the knob control circuit 407 (step S550). On the other hand, if the current spontaneous tidal volume value is greater than the target tidal volume value, the computer 405 lowers the respiratory assist level (for example, by 5 cm H 2 O) to the respirator 401 through the knob control circuit 407 (step S560). Next, the computer 405 obtains the current spontaneous tidal volume value of the next breath (step S570), and returns to step S545.

If the difference between the current spontaneous tidal volume value and the target tidal volume value is within ±10%, the computer 405 compares whether the difference between the current spontaneous breathing number and the target breathing number is within ±10% (step S547). If the difference between the current spontaneous breathing number and the target breathing number is greater than ±10%, the process returns to step S530. On the other hand, if the difference between the current spontaneous breathing number and the target breathing number is less than ±10%, the computer 405 multiplies the current spontaneous breathing number by the current tidal volume value to obtain the optimal minute ventilation (step S590).

The optimal per minute ventilation obtained in the embodiment of the present invention can be used as a new indicator of "puffing", and it is judged whether the per minute ventilation provided by the current respirator is the most comfortable amount for the user. According to the literature (Study on the correlation between the percentage of per minute ventilation and mechanical ventilation patients in the Chang Gung University Institute of Clinical Medicine, author Wu Shufen, Republic of China, March, 104), using patients who use respirators in intensive care units, The percentage of optimal minute ventilation measured was significantly associated with mortality and respiratory detachment failure rates. The best percentage of ventilation per minute is more effective as a percentage of the patient's non-breathing and spontaneous breathing, as opposed to knowing whether to exceed a single threshold (eg, 10 liters per minute). The prediction of patient prognosis has a certain degree of correlation.

In summary, the control method, the control system and the processing device of the respirator according to the embodiment of the present invention are different from the conventional ASV mode, and the breathing parameters obtained according to the ideal weight are obtained when the respirator is in the PS mode. The resulting target Ortis curve is compared to determine if the level of breathing assistance needs to be adjusted so that the breathing parameters can conform to the target Ortis curve. If the current spontaneous tidal volume volume and the current number of spontaneous respirations can meet the judgment criteria, the optimal per minute ventilation can be further obtained. Thereby, most of the respirator supporting the spontaneous breathing assistance mode like the PS mode can be controlled by the processing device of the embodiment of the present invention to achieve the optimal per minute ventilation.

Although the present invention has been disclosed in the above embodiments, it is not intended to limit the present invention, and any one of ordinary skill in the art can make some changes and refinements without departing from the spirit and scope of the present invention. The scope of the invention is defined by the scope of the appended claims.

100: control system 405: computer 110, 401: respirator 407: knob control circuit 150: processing device 630: optimal per minute ventilation indication block 151: signal receiving module 651: coordinate map 152: display unit 153: Processing units S210-S270, S501-S590: Steps 300, 600: User interface 301: Current breathing parameter 310: Number of breaths - Tidal volume coordinate map 311, 313, 315: Target Ortis curve 317: Current cooperation with Ortis Curves 320, 650: data presentation block 350, 610: communication interface and parameter setting block 403: simulated lung

1 is a block diagram showing a control system in accordance with an embodiment of the present invention. 2 is a flow chart illustrating a control method in accordance with an embodiment of the invention. Figure 3 is an example of a user interface with an Otis curve. FIG. 4 is a schematic diagram showing the configuration of a control system according to an embodiment of the invention. FIG. 5 is a flow chart illustrating a control method according to an embodiment of the invention. Figure 6 is an example of a user interface.

S210～S270: Steps

Claims (17)

A method of controlling a respirator, wherein the respirator is in a spontaneous breathing assist mode, the method comprising: receiving and detecting a plurality of breathing parameters; calculating a plurality of different targets of Otis (Otis) a curve; determining whether to adjust a breathing assistance level of the respirator such that the breathing parameters meet one of the target Otis curves to measure an optimal per minute required by the user under spontaneous breathing Optimal Minute Volume (OMV); and if the breathing parameters meet one of the target Otis curves, the optimal minute ventilation required by the user under spontaneous breathing is obtained. The control method of claim 1, wherein the calculating the different percentages of the target Otis curves comprises: calculating different percentages according to an ideal weight of the user providing one of the breathing parameters Target Ortis curve. The control method of claim 2, wherein after the step of calculating a different percentage of the target Otis curves according to the ideal body weight of the user providing the breathing parameters, the method further comprises: The Sexual Breathing Number - Tidal Volume Coordinates plots the breathing parameters and the Otis curves for the targets. The control method of claim 1, wherein the breathing parameters include a current spontaneous tidal volume value, and determining whether to adjust the breathing assistance The step of causing the breathing parameters to conform to one of the target Otis curves includes: selecting a selected target curve of the target Otis curves according to the current spontaneous tidal volume value; and comparing the current The spontaneous tidal volume value and a target tidal volume value of the selected target curve. The control method of claim 4, wherein the breathing parameters include a current spontaneous breathing number, and after comparing the current spontaneous tidal volume value with the target tidal volume value of the selected target curve, The method further includes: if the current spontaneous tidal volume volume value and the target tidal volume volume value are not less than a tidal volume volume range, adjusting the respiratory assistance level; and if the current spontaneous tidal volume volume value and the target tidal volume volume The difference between the values is less than the range of tidal volume values, and the current number of spontaneous breathing and a target number of breathing of the selected target curve are compared. The control method of claim 5, wherein if the breathing parameters meet one of the target Otis curves, the step of obtaining the optimal minute ventilation includes: if the current spontaneous breathing a gap between the number of times and the number of breaths of the target is less than a range of breaths, and the difference is less than a threshold value for a period of time, determining the optimal minute ventilation; and if the current spontaneous breathing times If the difference between the number of breaths of the target is not less than the range of the number of breaths, the target Otis curve is adjusted. The control method of claim 4, wherein the breathing parameters include an oxygen saturation, and after the step of receiving and detecting the breathing parameters, further comprising: determining whether the blood oxygen saturation is sufficient. The control method of claim 5, wherein if the gap between the current spontaneous tidal volume value and the target tidal volume value is not less than the tidal volume value range, the step of adjusting the respiratory assistance level comprises: If the current spontaneous tidal volume value is greater than the target tidal volume value, the respiratory assistance level is decreased; and if the current spontaneous tidal volume value is less than the target tidal volume value, the respiratory assistance level is increased. A respirator control system includes: a respirator in a spontaneous breathing assistance mode and configured to receive a plurality of breathing parameters; a processing device coupled to the respirator, and the processing device receives the respirator through the respirator Detecting the breathing parameters, calculating a plurality of target Otis curves of different percentages, determining whether to adjust a breathing assistance level to the respirator so that the breathing parameters meet one of the target Otis curves, Measure the optimal per minute ventilation required by the user under spontaneous breathing, and if the breathing parameters meet one of the target Otis curves, then the user is required to have spontaneous breathing The best per minute ventilation. The control system of claim 9, wherein the processing device calculates different percentages of the target Otis curves according to an ideal weight of the user providing one of the breathing parameters. The control system of claim 10, wherein the processing device presents the breathing parameters and the target Otis curves on a display unit in a spontaneous breathing number-tidal volume coordinate map. The control system of claim 9, wherein the breathing parameters include a current spontaneous tidal volume value, and the processing device selects one of the target Otis curves according to the current spontaneous tidal volume value. A target curve is selected and the current spontaneous tidal volume value and a target tidal volume value of the selected target curve are compared. The control system of claim 12, wherein the breathing parameters include a current spontaneous breathing number, and if a difference between the current spontaneous tidal volume value and the target tidal volume value is not less than a tidal volume a range of values, the processing device adjusts the degree of respiratory assistance to the ventilator, and if the difference between the current spontaneous tidal volume value and the target tidal volume value is less than the tidal volume value range, the processing device compares the current The number of spontaneous breaths and a target number of breaths for the selected target curve. The control system of claim 13, wherein if the gap between the current spontaneous breathing number and the target breathing number is less than a respiratory number range, and the difference is less than a change threshold for a period of time Value, the processing device determines the optimal minute ventilation, and if the current spontaneous breathing time The difference between the number and the number of breaths of the target is not less than the range of the number of breaths, and the processing device adjusts the target Otis curves. The control system of claim 12, wherein the breathing parameters comprise an oxygen saturation, and the processing device further determines whether the blood oxygen saturation is sufficient. The control system of claim 13, wherein if the current spontaneous tidal volume value is greater than the target tidal volume value, the processing device lowers the respiratory assist level to the ventilator, and if the current spontaneity If the tidal volume value is less than the target tidal volume value, the processing device raises the respiratory assist level for the ventilator. A respirator processing device coupled to a respirator in a spontaneous breathing assistance mode, comprising: a signal receiving module, receiving and detecting a plurality of breathing parameters from the respirator; and a processing unit coupled Receiving the signal receiving module, wherein the processing unit receives the breathing parameters from the signal receiving module, calculates a plurality of target Otis curves of different percentages, and determines whether to adjust a breathing assistance level to the breathing apparatus to enable the The breathing parameters are consistent with one of the target Otis curves to measure an optimal per minute ventilation required by the user under spontaneous breathing, and if the breathing parameters meet the target Ortis curve In one of them, the optimal per minute ventilation required by the user under spontaneous breathing is obtained.