CN105771047A - Method for adjusting positive pressure of breathing machine airway - Google Patents
Method for adjusting positive pressure of breathing machine airway Download PDFInfo
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- CN105771047A CN105771047A CN201610246465.4A CN201610246465A CN105771047A CN 105771047 A CN105771047 A CN 105771047A CN 201610246465 A CN201610246465 A CN 201610246465A CN 105771047 A CN105771047 A CN 105771047A
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- respirator
- index feature
- breathing
- positive airway
- airway pressure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3331—Pressure; Flow
- A61M2205/3344—Measuring or controlling pressure at the body treatment site
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/40—Respiratory characteristics
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- Emergency Medicine (AREA)
- Pulmonology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Life Sciences & Earth Sciences (AREA)
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- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Respiratory Apparatuses And Protective Means (AREA)
Abstract
The invention provides a method for adjusting positive pressure of a breathing machine airway. The method comprises a step S01 of adopting respiratory signals during users'breathing; a step S02 of extracting breathing index characteristic signals; a step S03 of adjusting the airway positive pressure of a breathing machine at an expiration stage; a step S04 of collecting adjusted user respiratory signals; a step S05 of judging whether adjusted breathing index characteristics deteriorate, performing contrastive analysis on the adjusted breathing index characteristic signals in the step S04 and breathing index characteristic signals in the step S02, and if the breathing index characteristics have no deterioration, skipping to the step S03; and if the breathing index characteristics deteriorate, stopping increasing the lower probing degree of the airway positive pressure of the breathing machine at the expiration stage. According to the adjusting method, the airway positive pressure of the breathing machine at the expiration stage can be automatically adjusted to an appropriate value, so that users expire more smoothly, and users'use comfort degree is improved.
Description
Technical field
The present invention relates to field of medical technology, particularly to a kind of respirator Positive Airway Pressure control method.
Background technology
At present, using noninvasive ventilation treatment COPD (chronicobstructivepulmonarydisease, chronic obstructive pulmonary disease) disease time, rely primarily on the pressure support ventilation that noninvasive ventilator provides sufficient, in order to ensure that patient obtains enough ventilations, one of invasive ventilation intervention COPD treatment it is important that guarantee that patient obtains enough ventilations, and the demand size of ventilation is to vary with each individual, and in whole therapeutic process, impact due to the health of patient and local environment, the pressure support ventilation needed is not necessarily unalterable, but need at any time to carry out a degree of adjustment.Traditional respirator is when treating, provide only the EPAP EPAP (expiratorypositiveairwaypressure) and inspiratory positive airway pressure IPAP (inspiratorypositiveairwaypressure) of setting, therefore, respirator remains the malleation EPAP of offer when user exhales, although EPAP value is general not high, but owing to it blows out, for a user, remain big resistance when it is exhaled from respirator.If EPAP pressure can adjust desired value when exhaling, the expiration of user will be more smooth and easy, and the comfort of use will be greatly promoted.
Summary of the invention
The technical problem to be solved in the present invention is: providing a kind of respirator Positive Airway Pressure control method, the expiration phase Positive Airway Pressure of respirator can be adjusted desired value by automatically so that the expiration of user is more smooth and easy, improves the comfort of user.
The solution of the present invention is achieved in that a kind of respirator Positive Airway Pressure control method, comprises the following steps:
Step S01, gathers breath signal when user breathes, gathers user's breath signal in preset time period by harvester；
Step S02, extracts and breathes index feature signal, extract the breathing index feature signal of user from described breath signal；
Step S03, adjusts the expiration phase Positive Airway Pressure of respirator, increases the test degree of the expiration phase Positive Airway Pressure of respirator with pre-set velocity；
Step S04, gathers the user's breath signal after adjusting, and extracts the breathing index feature signal after adjustment；
Step S05, judge whether the breathing index feature after adjusting worsens, breathing index feature signal after adjusting in step S04 is analyzed with breathing index feature signal in step S02, if described breathing index feature is without deterioration, then jumps to step S03；If deterioration occurs in described breathing index feature, then stop increasing the test degree of the expiration phase Positive Airway Pressure of respirator.
So, by gathering breath signal when user breathes in preset time period, and after therefrom extracting breathing index feature signal, automatically adjust the expiration phase Positive Airway Pressure of respirator again by preset value after, breathing index feature signal after adjustment and the breathing index feature signal before adjustment are contrasted, if without deterioration, then adjusting the expiration phase Positive Airway Pressure of respirator further, and the breathing index feature signal after adjusting is monitored again, form circulation；If occurring worsening, then stop increasing the test degree of the expiration phase Positive Airway Pressure of respirator, it is prevented that inadaptable sense occurs in user, and respirator expiration phase Positive Airway Pressure now is the desired value that user now needs.Therefore, the expiration phase Positive Airway Pressure of respirator can be adjusted desired value by described respirator expiration phase Positive Airway Pressure control method automatically so that the expiration of user is more smooth and easy, improves the comfort of user.
Another technical scheme of the present invention is in that on above-mentioned basis, in described step S05, if deterioration occurs in described breathing index feature, also the expiration phase Positive Airway Pressure pressure test degree of respirator is gone back up to a upper adjusted value.
Another technical scheme of the present invention is in that on above-mentioned basis, and in described step S05, if deterioration occurs in described breathing index feature, quickly go up a preset value by the expiration phase Positive Airway Pressure pressure test degree of respirator.
Another technical scheme of the present invention is in that on above-mentioned basis, in described step S05, if deterioration occurs in described breathing index feature, after the expiration phase Positive Airway Pressure pressure of respirator is stopped adjustment, jumps to step S01.
Another technical scheme of the present invention is in that on above-mentioned basis, and in described step S01, described breath signal includes flow signal when user breathes, pressure signal and/or respiratory frequency.
Another technical scheme of the present invention is in that, on above-mentioned basis, described harvester includes flow transducer, pressure transducer and/or temperature sensor.
Another technical scheme of the present invention is in that on above-mentioned basis, after described step S01, before step S02, also includes breath signal filter step, by Filter and Filltering algorithm, described breath signal is carried out noise reduction, filtering.
Another technical scheme of the present invention is in that on above-mentioned basis, in described step S02, extracts breathing index feature signal and includes at least one in tidal volume, respiratory frequency, air-breathing expiratory duration ratio, air-breathing maximum peak flow velocity, expiration lowest speed.
Another technical scheme of the present invention is in that on above-mentioned basis, described step S02 also include by breathing index feature linearly matching, each extraction in preset time period is breathed index feature signal and carries out linear fit, obtain this kind and breathe a matched curve of index feature signal.
Another technical scheme of the present invention is in that on above-mentioned basis, in described step S05, when the breathing index feature signal negative sense after at least one adjustment deviates the matched curve that this kind breathes index feature signal, then judge that deterioration occurs in the breathing index feature after adjusting.
Accompanying drawing explanation
The accompanying drawing constituting the part of the present invention is used for providing a further understanding of the present invention, and the schematic description and description of the present invention is used for explaining the present invention, is not intended that inappropriate limitation of the present invention.
Fig. 1 is the flow chart representing the respirator Positive Airway Pressure control method involved by a kind of embodiment of this patent；
Fig. 2 to Fig. 4 is the flow chart representing the respirator Positive Airway Pressure control method involved by the another several embodiments of this patent；
Fig. 5 carries out the pressure schematic diagram of pressure test adjustment when being and exhale；
Fig. 6 is the flow waveform figure of respiration；
Fig. 7 is the matched curve figure of air-breathing maximum peak flow velocity in a period of time.
Detailed description of the invention
Describing the present invention below in conjunction with accompanying drawing, the description of this part is only exemplary and explanatory, and protection scope of the present invention should not have any restriction effect.Additionally, the description that those skilled in the art are according to presents, it is possible to the feature in embodiment in presents and in different embodiment is carried out respective combination.
The embodiment of the present invention is as follows, refers to Fig. 1, a kind of respirator Positive Airway Pressure control method, comprises the following steps:
Step S01, gathers breath signal when user breathes, gathers user's breath signal in preset time period by harvester；
Step S02, extracts and breathes index feature signal, extract the breathing index feature signal of user from described breath signal；
Step S03, adjusts the expiration phase Positive Airway Pressure of respirator, increases the test degree of the expiration phase Positive Airway Pressure of respirator with pre-set velocity, as shown in Figure 5；
Step S04, gathers the user's breath signal after adjusting, and extracts the breathing index feature signal after adjustment；
Step S05, judge whether the breathing index feature after adjusting worsens, breathing index feature signal after adjusting in step S04 is analyzed with breathing index feature signal in step S02, if described breathing index feature is without deterioration, then jumps to step S03；If deterioration occurs in described breathing index feature, then stop increasing the test degree of the expiration phase Positive Airway Pressure of respirator.
In use procedure, user has worn face shield as requested and has connected respirator, and user opens treatment.Wherein, preset time period can set as required, such as 5 minutes, 10 minutes, 15 minutes, 30 minutes etc. can, as a rule preset time period from 1 minute to a few hours can, as long as disclosure satisfy that follow-up determination requirement.Respirator is after work preset time period, begin at the test carrying out pressure time user exhales, as shown in Figure 5, when user exhales, originally pressure is to drop to EPAP, but pressure is now dropped to below EPAP by respirator, then goes back up to EPAP, be conducive to the smooth and easy and raising comfort level that user exhales.Shown in Fig. 5 is only that signal effect is stated in order to convenient, pressure test is regarded as a straight line, but is frequently not straight when actual enforcement, but the class parabolic curve of an opening upwards.In this preset time period that user uses, the harvesters such as flow transducer, pressure transducer and/or temperature sensor can be used, gather breath signal when user breathes, this breath signal can include flow signal when user breathes, pressure signal and/or respiratory frequency etc., it is possible to is used for judging that the breath signal whether user's breathing state worsens can.The concrete breath signal method gathered when user breathes, at disclosed patent CN105457135A, respirator pressure method of adjustment, device and respirator, CN103736184A, a kind of home ventilator flow transducer error correction method, CN104750129A, the documents such as the control system of the ventilation flow rate of respirator and control method there is introduction, does not repeat them here.
In the present embodiment, to use the flow signal that flow transducer gathers when user breathes to illustrate, due to sensor acquisition to numerical value usually there is (being generally white Gaussian noise interference) of noise jamming, therefore flow waveform presents jagged interference, subsequent extracted can be breathed the steps such as index feature signal and be produced large effect by the existence of these interference, it is thus desirable to flow waveform is filtered, interference is minimized.In the present embodiment, using bank of filters algorithm and AR model algorithm, these algorithms are the common algorithms in filtering field, but other similar filtering algorithms should may be used in the present invention.Those skilled in the art should understand that the calculating process of these algorithms, within the rule go out these algorithms detailed process, after filtering, flow curve presents smooth ideal state.
As shown in Figure 6, for the flow waveform figure of user's respiration.Carry out breathing index feature signal extraction and computational analysis for this waveform, flow waveform according to respiration, can calculating breathing index feature signal in need, described breathing index feature signal includes at least one in tidal volume, respiratory frequency, air-breathing expiratory duration ratio, air-breathing maximum peak flow velocity, expiration lowest speed.Wherein, cycle starting point is shown to be the air-breathing starting point of respiration, cycle terminal is shown to be the expiration end point of respiration, and the time between these 2 is exactly total duration T0 of respiration, frequency computing formula can show that 1 minute interior respiratory frequency is about: f=60/T0.Cycle midpoint is the timing node that air-breathing terminates to turn to expiration, it is inspiration time before this, it it is expiration duration after this: inspiration time=cycle midpoint-cycle starting point, expiration duration=cycle terminal-cycle midpoint, thus can release air-breathing expiratory duration ratio is: inspiration time: expiration duration.Tidal volume calculates the integration being flow curve expiration phase, it is not derived at this.Those skilled in the art should understand that these breathe the extraction of index feature signal and analysis process, does not repeat them here.
In the present embodiment, illustrating for air-breathing maximum peak flow velocity, it is similar with the calculating process of air-breathing maximum peak flow velocity that other breathe index feature signal, does not tire out one by one at this and states.For the preset time period of 15 minutes, by detecting the respiratory flow of during this period of time user, extract all of air-breathing maximum peak flow speed value, (can certainly calculate with the breathing cycle of other quantity with every 6 breathing cycles for one group, here 6 breathing cycles are not logarithm quantitative limitations), calculate the meansigma methods of the air-breathing maximum peak flow speed characteristic data in these 6 cycles: avgF=(F1+F2+F3+F4+F5+F6)/6, with 15 minutes for boundary, whole average peak flow velocitys that 15 minutes interior are put together, go forward side by side line linearity matching, obtain a matched curve, it is user's trend curve at the air-breathing maximum peak flow velocity of this period of time, as shown in Figure 7.
After 15 min, respirator starts to be gradually increased the test degree of the expiration phase Positive Airway Pressure of respirator with pre-set velocity, the concrete speed increased can be steady state value: 0.5cmH2O/min, can also be that other any form of are pushed the speed, as long as gradually transition user will not be caused pushing the speed of bigger sense of discomfort.As: first accelerate to increase the test degree of the expiration phase Positive Airway Pressure of respirator, after slow down the test degree of expiration phase Positive Airway Pressure increasing respirator gradually, or be gradually increased the test degree of the expiration phase Positive Airway Pressure of respirator with rules such as linear function, quadratic function, cubic function or exponential functions.
Then, gather the user's breath signal after adjusting again, and extract the breathing index feature signal after adjustment, and judge whether the breathing index feature after adjusting worsens, if described breathing index feature is without deterioration, then jump to step S03, be gradually increased the test degree of the expiration phase Positive Airway Pressure of respirator further with pre-set velocity；If when the breathing index feature signal negative sense after at least one adjustment deviates the matched curve that this kind breathes index feature signal, then judge that deterioration occurs in the breathing index feature after adjusting, then stop increasing the test degree of the expiration phase Positive Airway Pressure of respirator.Certainly, in order to improve the accuracy of judgement, can also set when the breathing index feature signal having two or three or more than four kind occurs that negative sense deviates the matched curve that this kind breathes index feature signal, then judge that deterioration occurs in the breathing index feature after adjusting, is not described in detail at this.
So, by gathering breath signal when user breathes in preset time period, and after therefrom extracting breathing index feature signal, automatically adjust the expiration phase Positive Airway Pressure of respirator again by preset value after, breathing index feature signal after adjustment and the breathing index feature signal before adjustment are contrasted, if without deterioration, then adjusting the expiration phase Positive Airway Pressure of respirator further, and the breathing index feature signal after adjusting is monitored again, form circulation；If occurring worsening, then stop increasing the test degree of the expiration phase Positive Airway Pressure of respirator, it is prevented that inadaptable sense occurs in user, and respirator expiration phase Positive Airway Pressure now is the desired value that user now needs.Therefore, the expiration phase Positive Airway Pressure of respirator can be adjusted desired value by described respirator expiration phase Positive Airway Pressure control method automatically so that the expiration of user is more smooth and easy, improves the comfort of user.
On the basis of above-described embodiment, in another embodiment of the present invention, as in figure 2 it is shown, in described step S05, if deterioration occurs in described breathing index feature, also the expiration phase Positive Airway Pressure pressure test degree of respirator is gone back up to a upper adjusted value.So can reduce the sense of discomfort of user further so that the expiration of user is more smooth and easy.
Another technical scheme of the present invention is in that on above-mentioned basis, as it is shown on figure 3, in described step S05, if deterioration occurs in described breathing index feature, quickly go up a preset value by the expiration phase Positive Airway Pressure pressure test degree of respirator.This preset value can be a fixed value, as 0.5cmH2O, 1cmH2O or with the default value regulating the speed into certain relation in step S03, such as proportional etc..So can reduce the sense of discomfort of user further so that the expiration of user is more smooth and easy.
Another technical scheme of the present invention is in that on above-mentioned basis, as shown in Figure 4, in described step S05, if deterioration occurs in described breathing index feature, after the expiration phase Positive Airway Pressure pressure of respirator is stopped adjustment, jumps to step S01.As such, it is possible to keep current expiration phase Positive Airway Pressure pressure test degree, Resurvey user breath signal in preset time period, carry out breathing index feature signal extraction, obtain new matched curve etc., be sequentially carried out other steps, form circulation.So can solve user in the different use ages, the expiration phase Positive Airway Pressure pressure size adapted to most is likely to different situations, method of adjustment thereby through above-mentioned circulation, what the expiration phase Positive Airway Pressure pressure making respirator was in user all the time is best suitable for size, from without user, parameter being configured and the behavior of respirator being adapted to, respirator can adapt to various user automatically, under the premise that enough pressure support ventilation is provided, moreover it is possible to farthest give users'comfort.
The above is only the preferred embodiment of the present invention; it should be pointed out that, for those skilled in the art, under the premise without departing from the principles of the invention; can also making some improvements and modifications, these improvements and modifications also should be regarded as protection scope of the present invention.
Claims (10)
1. a respirator Positive Airway Pressure control method, it is characterised in that comprise the following steps:
Step S01, gathers breath signal when user breathes, gathers user's breath signal in preset time period by harvester；
Step S02, extracts and breathes index feature signal, extract the breathing index feature signal of user from described breath signal；
Step S03, adjusts the expiration phase Positive Airway Pressure of respirator, increases the test degree of the expiration phase Positive Airway Pressure of respirator with pre-set velocity；
Step S04, gathers the user's breath signal after adjusting, and extracts the breathing index feature signal after adjustment；
Step S05, judge whether the breathing index feature after adjusting worsens, breathing index feature signal after adjusting in step S04 is analyzed with breathing index feature signal in step S02, if described breathing index feature is without deterioration, then jumps to step S03；If deterioration occurs in described breathing index feature, then stop increasing the test degree of the expiration phase Positive Airway Pressure of respirator.
2. respirator Positive Airway Pressure control method according to claim 1, it is characterized in that, in described step S05, if deterioration occurs in described breathing index feature, also the expiration phase Positive Airway Pressure pressure test degree of respirator is gone back up to a upper adjusted value.
3. respirator Positive Airway Pressure control method according to claim 1, it is characterized in that, in described step S05, if deterioration occurs in described breathing index feature, quickly go up a preset value by the expiration phase Positive Airway Pressure pressure test degree of respirator.
4. respirator Positive Airway Pressure control method according to any one of claim 1 to 3, it is characterized in that, in described step S05, if deterioration occurs in described breathing index feature, after the expiration phase Positive Airway Pressure pressure of respirator is stopped adjustment, jump to step S01.
5. respirator Positive Airway Pressure control method according to any one of claim 1 to 3, it is characterised in that in described step S01, described breath signal includes flow signal when user breathes, pressure signal and/or respiratory frequency.
6. respirator Positive Airway Pressure control method according to claim 5, it is characterised in that described harvester includes flow transducer, pressure transducer and/or temperature sensor.
7. respirator Positive Airway Pressure control method according to claim 5, it is characterised in that after described step S01, before step S02, also include breath signal filter step, by Filter and Filltering algorithm, described breath signal is carried out noise reduction, filtering.
8. respirator Positive Airway Pressure control method according to any one of claim 1 to 3, it is characterized in that, in described step S02, extract breathing index feature signal and include at least one in tidal volume, respiratory frequency, air-breathing expiratory duration ratio, air-breathing maximum peak flow velocity, expiration lowest speed.
9. respirator Positive Airway Pressure control method according to claim 8, it is characterized in that, described step S02 also include by breathing index feature linearly matching, each extraction in preset time period is breathed index feature signal and carries out linear fit, obtain this kind and breathe a matched curve of index feature signal.
10. respirator Positive Airway Pressure control method according to claim 9, it is characterized in that, in described step S05, when the breathing index feature signal negative sense after at least one adjustment deviates the matched curve that this kind breathes index feature signal, then judge that deterioration occurs in the breathing index feature after adjusting.
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| CN111632241A (en) * | 2020-06-08 | 2020-09-08 | 山东科技大学 | Control system of humidification therapeutic instrument |
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| CN113769213A (en) * | 2021-08-19 | 2021-12-10 | 北京怡和嘉业医疗科技股份有限公司 | Ventilation control method, device, system, terminal equipment and readable storage medium |
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| CN112827030B (en) * | 2021-01-06 | 2023-02-28 | 北京谊安医疗系统股份有限公司 | Expiratory pressure automatic titration method and system based on expiratory airflow limitation index |
| CN113769213A (en) * | 2021-08-19 | 2021-12-10 | 北京怡和嘉业医疗科技股份有限公司 | Ventilation control method, device, system, terminal equipment and readable storage medium |
| CN113769213B (en) * | 2021-08-19 | 2024-05-03 | 北京怡和嘉业医疗科技股份有限公司 | Ventilation control method, device, system, terminal equipment and readable storage medium |
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Application publication date: 20160720 |