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WO2011000359A1 - Dispositif respiratoire - Google Patents

Dispositif respiratoire Download PDF

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Publication number
WO2011000359A1
WO2011000359A1 PCT/DE2010/000741 DE2010000741W WO2011000359A1 WO 2011000359 A1 WO2011000359 A1 WO 2011000359A1 DE 2010000741 W DE2010000741 W DE 2010000741W WO 2011000359 A1 WO2011000359 A1 WO 2011000359A1
Authority
WO
WIPO (PCT)
Prior art keywords
ventilation
valve
pressure
pressure sensor
inspiratory
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/DE2010/000741
Other languages
German (de)
English (en)
Other versions
WO2011000359A4 (fr
Inventor
Peter Schaller
Wolfgang Braun
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
F STEPHAN GmbH MEDIZINTECHNIK
Original Assignee
F STEPHAN GmbH MEDIZINTECHNIK
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by F STEPHAN GmbH MEDIZINTECHNIK filed Critical F STEPHAN GmbH MEDIZINTECHNIK
Publication of WO2011000359A1 publication Critical patent/WO2011000359A1/fr
Publication of WO2011000359A4 publication Critical patent/WO2011000359A4/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • 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. ventilators; Tracheal tubes
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A61M16/201—Controlled valves
    • A61M16/202—Controlled valves electrically actuated
    • A61M16/203—Proportional
    • A61M16/205—Proportional used for exhalation control
    • 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. ventilators; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A61M16/024—Control means therefor including calculation means, e.g. using a processor
    • 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. ventilators; Tracheal tubes
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A61M16/201—Controlled valves
    • A61M16/202—Controlled valves electrically actuated
    • A61M16/203—Proportional
    • A61M16/204—Proportional used for inhalation control
    • 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. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
    • 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. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit

Definitions

  • the invention relates to a ventilation device with a source for delivering a ventilation volume flow or a ventilation pressure, at least comprising a control loop, which comprises at least one ventilation pressure sensor and a control and regulating unit, which is at least to determine the pressure deviation of the ventilation pressure with respect to the pressure setpoint a dependent control variable of a ventilation valve is designed to change its flow cross section for the ventilation volume flow.
  • Volume flow sensors are used, which are placed between the so-called Y-piece and the breathing tube. Especially in the ventilation of
  • a volumetric flow sensor is arranged within the inspiratory and within the expiratory tube, whereby the volumetric flow to the patient can be determined from the difference between the two volumetric flows.
  • the change in volume of the thorax is used via externally applied around the rib cage sensors.
  • a pressure capsule detects the activity of the respiratory muscles and controls the beginning of insufflation of the ventilator.
  • the object of the invention is now to propose a respiration device, the dead space, so without additional flow sensors, only by utilizing already existing in the ventilation device
  • the respiration device with a source for delivering a ventilation volume flow or a ventilation pressure comprises at least one control circuit, which comprises at least one respiration pressure sensor and a control and regulation unit which determines the pressure deviation of the ventilation pressure from the pressure setpoint and for generating at least one dependent control variable of a ventilation valve is designed to change its flow cross section for the ventilation volume flow.
  • the control and regulating unit is designed in such a way to determine the ventilation volume flow from the control variable or a signal which is mathematically related to the flow cross-section of the ventilation valve.
  • the essence of the invention lies essentially in the fact that the ventilation valve has a high pneumatic resistance as a member of the control circuit for the ventilation pressure, whereby changes in the volume flow through this ventilation valve, for example as a result of spontaneous breathing of a patient due to the speed of the pressure control loop to a near Immediate adjustment of the flow cross-section of the ventilation valve lead with the result that the ventilation pressure is kept constant.
  • the ventilation pressure detected by the ventilation pressure sensor is also consulted.
  • a respiratory valve an inspiratory valve, an expiratory valve or a combined inspiratory / expiratory valve is provided in the context of the invention.
  • An even more precise determination of the ventilation volume flow is achieved according to the invention by taking into account the respective differential pressure of two pressure sensors applied across the ventilation valve, wherein "in the case of the design of the ventilation valve as an inspiration valve
  • the respiratory pressure sensor is arranged upstream of the expiratory valve and a second pressure sensor is provided, which is placed in the flow direction downstream of the exhalation valve and
  • the ventilation pressure sensor is located between the outlet of the inspiratory valve and the inlet of the inspiratory valve
  • Exspirationsventil - preferably at the Y-piece - is arranged, and a second pressure sensor is provided, which is placed in the flow direction in front of the inspiratory valve, and a third pressure sensor is provided, which is placed in the flow direction after the exhalation valve.
  • the control variable or the signal which is mathematically related to the flow cross-section of the ventilation valve is preferably an electrical, magnetic, pneumatic or mechanical signal, which either directly or indirectly influenced the flow cross-section of the ventilation valve or can be tapped at this.
  • Respiratory valve signals are all those signals that are understood in the signal chain, starting at the output of the control and
  • Respiratory valve up to the signal corresponding to the flow cross-section of the ventilation valve, can be detected.
  • the determined measured variables are used particularly advantageously using a calculation algorithm for determining the ventilation volume flow.
  • V ' f (w, Pv1, Pv2, a, b, c), in order also to be able to determine quantitatively the volumetric flow.
  • V denote the volume flow
  • Pv1 and Pv2 the pressures before and after the ventilation valve
  • w the opening width or the flow cross-section of the ventilation valve
  • a, b, c further derived from the geometry of the valve parameters
  • the number may be different.
  • the temperature, air pressure and humidity of the respiratory gas can additionally be taken into account.
  • As a mechanical parameter instead of the opening width w of the valve it is also possible, for example, to use the position s of the movable valve body (eg valve piston) of the ventilation valve.
  • the aforementioned signal s is accordingly a position signal of the valve body of the ventilation valve which is movable relative to the valve housing.
  • the location for measuring the pressure before and after the ventilation valve does not necessarily have to be selected directly on the ventilation valve.
  • the measurement of the pressure Pv2 immediately after the ventilation valve but for example, only at a distance of 1, 5 m from the ventilation valve, z. B. in the area of the Y-piece.
  • a simplified volume flow is calculated only from the opening width or from the flow cross section w of the ventilation valve or the position s of its valve body, from which in turn a simplified trigger time can be calculated.
  • a measured variable or a signal which represents the flow cross section or the opening width of the ventilation valve - in conjunction with the pressures at the inlet and at the outlet of the ventilation valve - is a measure of the volume flow of the respiration and can, after further evaluation, inter alia be used as a triggering signal for triggering the mechanical insufflation by the control unit.
  • the control unit is thus designed such that it uses the calculated volume flow signal for further evaluation within the ventilation device and / or used to trigger a mechanical breath.
  • the way of the inventive idea is also not left, if other signals are derived using mathematical models. Decisive for the invention are therefore all signals that, apart from a temporal dependence, in a mathematical Connection, preferably proportional to the opening width of the valve stand.
  • control of a ventilation device is carried out by the method steps:
  • an algorithm is added to the method, which allows to suppress erroneous recognition of the patient's inspiration. Furthermore, the algorithm includes a method to change the sensitivity of the recognition of the inspiratory effort.
  • the determined ventilation volume flow can be used for triggering the mechanical insufflation.
  • the ventilation device is inexpensive and less susceptible to interference, since no volume flow sensors must be used.
  • FIG. 1 shows a schematic representation of the inspiratory branch of a ventilation device according to the invention
  • FIG. 2 is a schematic representation of the expiratory branch of a ventilation device according to the invention.
  • FIG 3 shows a schematic representation of the combination of an expiratory branch and an inspiratory branch of a ventilation device according to the invention.
  • the inspiratory branch essentially comprises a respiratory pressure source 5.1, which is coupled on the output side to the input of the respiration valve 6 designed as an inspiratory valve 6.
  • the inspiratory valve 6.1 in turn is connected on the output side via the inspiratory output 7 and the inspiratory tube 8 to the first stub of the Y-piece 9.
  • the second branch of the Y-piece 9 is connected to the expiratory tube 11 and leads to the only hinted expiratory input 12 of the ventilation device.
  • the central third socket of the Y-piece 9 leads to the symbolically represented patient 10.
  • Two pressure sensors 2.1 and 2.2 are used, of which the respiration pressure sensor 2.1 measures the respiratory pressure P2.1 between the output of the inspiration valve 6.1 and the inspiration output 7 and the pressure sensor 2.2 measures the upstream pressure P2.2 upstream of the inspiration valve 6.1.
  • the Distance measuring system 4 measures the position of the valve body of the inspiratory valve 6.1 with respect to its housing as a measure of the flow cross section, ie, a defined position is assigned a defined flow cross section.
  • the outputs of the pressure sensors 2.1 and 2.2 and the output of the displacement measuring system 4 are signal-conducting connected to the associated inputs of the control and regulating device 1.
  • the control and regulating device 1 has the task of regulating the ventilation pressure P2.1 to the desired value Psoll.
  • control and regulation device 1 calculates, according to a theoretically or experimentally determined algorithm from the pressures P2.1, P2.2 and the control signal Ust, the inspiratory volume flow V and from there, according to another algorithm, the trigger time for starting the next mechanical insufflation.
  • the inspiratory volume flow is derived only from the control signal Ust and from there the trigger time; however, without considering the pressures P2.1 and P2.2.
  • FIG. 2 shows a schematic representation of the expiratory branch of a ventilation device according to the invention, when there is no pressure source in the form of the pressure source 5.1 at the entrance, but a volume flow source in the form of a volume flow source 5.2, which provides a constant flow rate V'insO. This is z.
  • the expiratory branch essentially comprises the volumetric flow source 5.2, which is connected on the output side via the inspiratory outlet 7 and the inspiration tube 8 to the first port of the Y-piece 9.
  • the second branch of the Y-piece 9 is connected to the expiratory tube 11 and leads via the expiration input 12 of the ventilation device to the inlet of the expiration valve 6.2.
  • the expiratory valve 6.2 is the output side coupled by way of example with a pressure source 13, which is formed in this case by an injector for generating a negative pressure.
  • a pressure source 13 which is formed in this case by an injector for generating a negative pressure.
  • Two pressure sensors 2.1 and 2.3 are used, of which the respiratory pressure sensor 2.1 measures the respiratory pressure P2.1 before the expiration valve 6.2 and the pressure sensor 2.3 measures the pressure P2.3 after the expiration valve 6.2.
  • the further processing of the signals is identical to the description of FIG. 1, wherein in each case the pressure sensor 2.2 is to be replaced by the pressure sensor 2.3.
  • the essential difference is that, in contrast to FIG. 1, where the volume flow was determined by the inspiratory valve 6.1, the volume flow is determined by the expiratory valve 6.2.
  • the calculated volume flow V'ex must be subtracted from the feed volume flow VO by the expiration valve 6.2.
  • FIG. 3 shows a schematic representation of the combination of an expiratory branch and an inspiratory branch of a ventilation device according to the invention.
  • the inspiration valve 6.1 and the expiratory valve 6.2 complement each other to form a structural unit, the inspiratory valve 6.1 and the expiration valve 6.2 being mechanically firmly coupled to one another and acting in opposite directions.
  • the mechanical coupling 14 is symbolized by the dashed line. It acts as input again the pressure source 5.1.
  • the inspiratory volume flow is determined in analogy to FIG. 1 and the expiratory volume flow in analogy to FIG. 2.
  • the measurement of the respiratory pressure P2.1 in this case takes place directly on the Y-piece 9.
  • the actuator used equally for both valves 6.1 and 6.2 3 and the distance measuring system 4 are symbolically associated with the inspiratory valve 6.1.
  • the volume flow to the patient 10 is calculated from the difference between the inspiratory volume flow and the expiratory volume flow.

Landscapes

  • Health & Medical Sciences (AREA)
  • 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)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Respiratory Apparatuses And Protective Means (AREA)

Abstract

L'invention concerne un dispositif respiratoire présentant une source (5) destinée à fournir un flux volumique de ventilation ou une pression de ventilation, comprenant au moins un circuit de régulation présentant au moins un capteur de pression de ventilation (2.1) et une unité de commande et de régulation (1) qui est configurée pour la détermination de l'écart de pression, de la pression de ventilation par rapport à la valeur prescrite de pression, et pour la production d'au moins une grandeur de commande qui en dépend, d'une soupape de ventilation (6), pour la variation de sa section d'écoulement pour le flux volumique. L'invention est caractérisée en ce que l'unité de commande et de régulation (1) est configurée de manière à déterminer, à partir de la grandeur de commande ou d'un signal en relation mathématique avec la section d'écoulement de la soupape de ventilation, le flux volumique de ventilation.
PCT/DE2010/000741 2009-07-03 2010-06-28 Dispositif respiratoire Ceased WO2011000359A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102009031826.7 2009-07-03
DE102009031826A DE102009031826B4 (de) 2009-07-03 2009-07-03 Beatmungseinrichtung

Publications (2)

Publication Number Publication Date
WO2011000359A1 true WO2011000359A1 (fr) 2011-01-06
WO2011000359A4 WO2011000359A4 (fr) 2011-03-17

Family

ID=42990127

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE2010/000741 Ceased WO2011000359A1 (fr) 2009-07-03 2010-06-28 Dispositif respiratoire

Country Status (2)

Country Link
DE (1) DE102009031826B4 (fr)
WO (1) WO2011000359A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104203320A (zh) * 2012-03-21 2014-12-10 皇家飞利浦有限公司 用于在吹排气期间控制吹气压力的系统与方法
CN116085507A (zh) * 2021-11-08 2023-05-09 中国石油天然气股份有限公司 一种便携先导式呼吸阀在线校验仪

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3961627A (en) * 1973-09-07 1976-06-08 Hoffmann-La Roche Inc. Automatic regulation of respirators
GB2026326A (en) * 1978-07-17 1980-02-06 Draegerwerk Ag Respiratory apparatus
FR2573658A1 (fr) * 1984-11-26 1986-05-30 Air Liquide Dispositif de pression expiratoire positive

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1579882A1 (fr) * 2004-03-26 2005-09-28 Stephan Dr. Böhm Procède non invasif pour l'optimisation de la respiration de poumons atélectasiques

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3961627A (en) * 1973-09-07 1976-06-08 Hoffmann-La Roche Inc. Automatic regulation of respirators
GB2026326A (en) * 1978-07-17 1980-02-06 Draegerwerk Ag Respiratory apparatus
FR2573658A1 (fr) * 1984-11-26 1986-05-30 Air Liquide Dispositif de pression expiratoire positive

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104203320A (zh) * 2012-03-21 2014-12-10 皇家飞利浦有限公司 用于在吹排气期间控制吹气压力的系统与方法
CN104203320B (zh) * 2012-03-21 2017-05-03 皇家飞利浦有限公司 用于在吹排气期间控制吹气压力的系统与方法
US10500356B2 (en) 2012-03-21 2019-12-10 Koninklijke Philips N.V. System and method for controlling insufflation pressure during inexsufflation
CN116085507A (zh) * 2021-11-08 2023-05-09 中国石油天然气股份有限公司 一种便携先导式呼吸阀在线校验仪

Also Published As

Publication number Publication date
WO2011000359A4 (fr) 2011-03-17
DE102009031826A1 (de) 2011-01-13
DE102009031826B4 (de) 2011-06-22

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