The invention relates to medical equipment, namely, devices for artificial ventilation of the lungs, and is intended for use in the departments of surgery, anesthesiology and intensive care. The apparatus provides respiratory unit, the control unit and the power supply of the breathing gas. Respiratory unit includes a dividing fur, twin with fur smaller effective area. Fur strengthened between the movable and stationary plates. In the area of the protrusion cover limit switches. Respiratory unit contains two pneumatic switch, electric switch and diaphragm valve. Movement of the cover is ensured by the mechanism during rotation of the rotor of the motor is controlled by the signal controller. In the inspiration line the respiratory unit is equipped with a check valve and in line exhale diaphragm valve, which is supplied through the switch of the signal generator pneumatic pulses. Line and exhalation flexible hoses connected to the tee of the patient. The control unit contains a membrane valve, motor, pneumatic generator pulses, the pressure transducer and controller. The power supply of the breathing gas includes a dispenser gays bag-receiver enters the fur through the valve. Electric power control unit is provided by a pulsed power supply. Patented apparatus enables accurate dosing of respiratory capacity in a wide range (from 20 to 2000 ml) and has enhanced functionality. 2 Il.
The invention relates to medical equipment, namely, devices for artificial lung ventilation (ALV), and will find application in the departments of surgery, anesthesiology and intensive care.
Known ventilator (RF patent No. 2128493, And 61 N 31/02), containing a block of high pressure with the pressure regulator, injector, regulator, gas flow and pressure switches, block the fur regulator of respiratory volumes and limit switch injector, a pressure transducer, pneumomechanical, breathing circuit and the control unit.
Known ventilator has significant drawbacks: move the dividing fur is medical gas (oxygen or air) supplied from the pneumatic actuator of the apparatus, moreover, pneumomechanical serving in a pneumatic apparatus for switching gas flows during operation t is its performance.
Also known ventilator (application No. 2002128416, And 61 N 31/02, the decision to grant a patent of the Russian Federation from, 16.07.03) containing the control unit with electric and pressure transducer pneumatically connected with the tee of the patient, respiratory unit, comprising dividing the fur, which is connected through the transmission of “screw-nut” with electric lines and exhalation of the patient connected to the patient y-piece. Line of the breath is pneumatically connected with the separation fur. The unit contains a check valve installed in the inspiration line, and diaphragm controlled valves that are installed on the lines of the inhalation and exhalation of the patient-driven generators pneumatic pulses in the form of a membrane with a Central nozzle and valve, kinematically connected with the armature of an electromagnet. Namebrand cavity generators is pneumatically connected with the respective diaphragm-controlled valves on the lines of inhalation and exhalation, and podobrannaya cavity - output batcher gas mixtures and breathing bag. The power supply of the breathing gas apparatus includes a dispenser of the gas mixture, the inlet of which is pneumatically connected with a source of compressed medical gases, and out - breathing bag, a safety valve and a suction valve Atmos significant deficiencies which greatly limit the effectiveness of its use in medical practice. Thus, in particular, a significant design flaw of the considered device is the impossibility of accurate dosing of respiratory capacity in a wide range required when the apparatus is used in adults, children and infants (required range from 20 to 2000 ml). To supply the minimum volume of breathing mixture must be precisely set the amplitude of the displacement of the movable cover fur less than 1 mm, which is a significant technical difficulties. In case of installation of a minute ventilation of inertia of the movable cover bellows and mechanical transmission components makes it difficult to stop exactly at a given initial position. The large internal volume of the separation fur greatly increases internal compliance system, which complicates dosing of small volumes given the low values and the variability of the elasticity of the lungs of children and infants.
In addition, a permanent connection to the camera generator pneumatic pulses breathing bag for overlapping lines exhalation during ventilation of a patient manual breathing bag can create a dangerous situation, alapana.
The present invention solves the problem of providing accurate dosing of respiratory capacity in a wide range (from 20 to 2000 ml), and increase the reliability and safety of mechanical ventilation.
The solution of this problem is achieved in the following way. In the device of artificial ventilation of the lungs that contains the control unit comprising the actuator and the pressure transducer pneumatically coupled to the tee of the patient, respiratory unit, comprising dividing the fur, which is connected through the transmission of “screw-nut” with the drive line of the breath, which is connected to the tee of the patient and through the check valve and controlled diaphragm valve pneumatically connected with the separation fur, line exhalation, which is connected to the tee of the patient and connected to the diaphragm valve, pneumatic generator pulses in the form of a membrane with a Central nozzle and valve, kinematically connected with the armature of an electromagnet, included in the generator pneumatic pulses, namebrand cavity generator pneumatic pulses pneumatically connected with a controllable valve in the exhalation line, and the power supply of breathing mixture comprising dosing the gas mixture, the inlet of which is connected to odasa air and through the non-return valve, with the separation fur respiratory unit, according to the present invention, between the fixed and movable lids separation fur respiratory unit has a second fur with a smaller effective area. Dividing fur greater effective area is pneumatically connected to the line of the breath through the pneumatic switch, which is connected with the atmosphere.
According to the invention the control unit is entered, the controller, the first input connected to the output of the pressure transducer, a second input to an electrical switch, which is connected to a pneumatic switch, and the output of the controller is connected respectively to the generator pneumatic pulses to the controlled membrane valve and the actuator.
In accordance with the present invention respiratory unit is equipped with two electric limit switches, which are connected to the second input of the controller and mounted with the possibility of interaction with a movable lid separation fur respiratory unit, and the line between exhalation diaphragm valve and pneumatic generator pulses is set pneumatic switch pneumatically connected with the output of the block is owned by the pressure transducer, to the third input of the controller, limit switch and power switch.
The technical result of the present invention is that the patented apparatus enables accurate dosing of respiratory capacity in a wide range (from 20 to 2000 ml), while the patented apparatus has enhanced functionality. Thus, the apparatus allows the ventilation support constant pressure without release of the respiratory gas in the atmosphere, has a large adjustment range of the volume provides ventilation in one unit both children and adults, allows you to monitor the status of the patient during ventilation manual, has the ability to implement a wide range of ventilation modes from controlled mechanical ventilation to spontaneous breathing with continuous positive pressure and at the same time ensures the reliability and safety of mechanical ventilation for the patient.
Summary of the invention explained in the description of example of a specific implementation of the ventilator and drawings, on which:
Fig.1 is a pneumatic circuit patentable ventilator;
Fig.2 - enlarged block-diagram of the algorithm of work of the device.
The apparatus And the set 1 contains, for example, coaxially, fur 4 less space and dividing the fur 5 larger area. Constructive dignity patentable ventilator is the fact that, as a generator of breath used dual mech 4 and 5, which allows ventilation of the lungs as adults and children alike. This design is economical and high efficiency. Fur strengthened between the common fixed cover 6 and the movable lid 7. In the area of the protrusion 8 of the movable lid 7 limit switches 9 and 10 (for example, in the form of opto-couplers), so that the limit switch 9 is activated at full extension bellows 4 and 5, and the limit switch 10 is approximately three millimeters to full extension bellows.
Respiratory unit 1 includes a pneumatic switch 11 connected to the outputs of the bellows 4 and 5, as well as an input electrically controlled diaphragm valve 12. Pneumatic switch 11 is introduced to achieve an accurate dosing of the respiratory volume during ventilation of children with fur 4. In the form shown in Fig.1 position pneumatic switch 11 connects fur 4 and 5 to work in another position of the switch 11 is used only mech 4, and the output of the fur 5 is connected with the atmosphere.
The TP is passing “screw-nut”, when the rotor of the electric motor 14 controlled by signals from the controller 23.
In the inspiration line the respiratory unit 1, a check valve 15 and line expiratory this unit is pneumatically operated diaphragm valve 16, through which the pneumatic switch 17 is fed managing a signal generator pneumatic pulses 18. Line and exhalation flexible hoses 19 and 20 connected to the tee of the patient 21.
The control unit 2 contains electrically-controlled diaphragm valve 12 (for example, see R. I. Burlakov, S. W. Halpern, C. M. Yurevich “ventilation” (principles, methods, equipment). - M.: Medicine, 1986. - 240 S., S. 92, Fig.18), software-controlled electric motor 14, for example of the type DST-90, generator pneumatic pulses 18 (for example, see the prototype application No. 2002128416, And 61 N 31/02, the decision to grant a patent of the Russian Federation from, 16.07.03), the pressure transducer 22 into an electrical signal used to control the apparatus and alarms (which can be used a type Converter 2010 MPX DP MOTOROLA), and the controller 23 based on a microprocessor controller, such as ATMEL AT 90 103 mega (see, for example, Reference “Products and components, predvigatelnoj mixture includes a dispenser of the gas mixture 24, which is pneumatically connected with the valve of the suction of atmospheric air 25, breathing bag receiver 26 and the safety valve 27. The gas from the bag-receiver 26 receives in furs 4 and 5 through the valve 28. The output unit 3 supply of breathing mixture is pneumatically connected to the pneumatic switch 17.
Electrical power elements of the control unit 2 is provided by a pulsed power supply unit 29, for example SP-150-15 firms MEAN WELL.
The controller 23 performs all operations management apparatus, including calculations, logical operations, processing of the analog signal from the pressure transducer into an electrical signal 22, the formation of signals necessary for the implementation of adaptive management by the motor 14, the control of the generator pneumatic pulse 18, the diaphragm valve 12, the signals from the limit switches 9 and 10, as well as from the electrical switch 30 connected to the pneumatic switch 11 respiratory unit 1 and is connected to the second input of the controller 23 and to the pulse power supply unit 29. Electrical switch 30 switches the unit on adult or children's modes of operation depending on the switching of pneumatic switch 11. Electr westfleet management apparatus in accordance with the developed program. Enlarged block-diagram of the algorithm of operation of the apparatus shown in Fig.2. Complete and detailed documentation about the software works patentable ventilator is contained in the technical documentation of the applicant (see the technical documentation of the applicant ATHENS.941622.010 THEM).
The ventilator operates as follows. Consider implemented by the apparatus of the phase ventilation, various combination of which provides a wide range of modes of mechanical ventilation.
The breath. In accordance with the specified operator settings mode, the controller sets the rotation of the rotor of the electric motor 14, which through the mechanism 13 causes movement of the movable lid 7 and the compression of the bellows 4 and 5. It is calculated from their fully extended position, which is determined by the actuation of limit switch 9.
In the form shown in Fig.1 position pneumatic switch 11 “ADULT” both fur combined, and gas from them through a normally open electrically controlled diaphragm valve 12 and the check valve 15 is supplied to the lungs of the patient. Line expiratory 20 blocked pneumatically operated diaphragm valve 16 under the action of pressure coming from the electrically operated generator pneumatic pulses 18 via the pneumatic switch is MESI 3 is prevented by the valve 28.
The length of the inhale is determined by the controller 23 on the basis of parameters set by the operator of the ventilation mode. At the end of inspiratory time, or when the alarm on exceeding the upper limit of the maximum pressure controller 23 starts the expiratory phase.
Exhalation. At the end of the inhale program controlled motor through the mechanism 13 by the movement of the movable lid 7 stretches fur 4 and 5, the suction of fresh gas from the breathing bag receiver 26 through the valve 28. The ledge 8 of the movable lid 7 sequentially closes the limit switch 10 and 9 so that the limit switch 10 is activated in approximately three millimeters to full extension bellows, and the limit switch 9 is at full extension bellows 4 and 5. This technical solution allows to reduce the influence of the inertia of the movable cover bellows and mechanical transmission components to stop furs accurately in a predetermined initial position.
At this time, opens pneumatically operated diaphragm valve 16 and the gas from the lungs of the patient through the patient y-piece 21, line 20 and exhale valve 16 comes out. The ingress of gas from the lungs to the fur 4 and 5 prevents the check valve 15.
The duration of exhalation is also determined by the controller 23 on the basis of pairs of the time.
The expectation. After the next actuation of the limit switch 9, the motor 14 is stopped, the electrically-controlled diaphragm valve 12 is activated and cuts away from the patient's fur, and pneumatically operated diaphragm valve 16 separates the line of exhalation. The attempt of the patient to inhale reduces perceived by the Converter 22, the pressure in the remaining part of the breathing circuit to a specified value, resulting in electrically-controlled diaphragm valve 12 connects to the inspiration line of fur, which begin to shrink.
Based on the parameters set by the operator of the ventilation mode, the controller 23 determines the duration of the phase out. If in this period of time breathing attempts has not occurred, the controller 23 starts the phase of inhalation and exhalation, respectively.
Independent ventilation. The patented design of the device allows the patient to breathe through the device. This can be achieved oxygenation, heating, humidifying, and filtering the inhaled gas. Generator pneumatic pulse is de-energized and through the pneumatic switch 17 connects the control chamber is pneumatically controlled diaphragm valve 16 with the atmosphere, which reduces its soprotivlyaemost valves 15 and 16. The patient inhales from the bag 26 through the valve 28 and a normally open electrically controlled diaphragm valve 12, furs 4 and 5 are held in the stretched condition braked by the engine 14. Exhalation of the patient performs through pneumatically operated diaphragm valve 16. When this check valve 15 prevents the penetration of the exhaled gas in furs 4 and 5.
Independent ventilation can be carried out with a constant component of the pressure variations in the breathing circuit (SDPD), at the same time with independent breathing through the breathing circuit (valves 12, 15, 16, and 28) is leaking gas out of the bag 26.
Because fur 4 and 5 remain stationary, and electrically-controlled diaphragm valve 12 and the generator pneumatic pulses 18 is de-energized, the implementation of self-ventilation is possible and when the phone is turned off, in this case, of course, not used in the measurement.
In the case of ventilation of the patient, hand bag 26 pneumatic switch 17 is other than shown in the diagram (Fig.1), the position IVL MANUAL connecting the control chamber is pneumatically controlled diaphragm valve 16 with a line of fresh mixture. The mode can be performed when the equipment is turned on, when use the breathing bag receiver 26 through the valve 15, 28 and electrically-controlled diaphragm valve 12 is supplied to the patient, and the line exhaling overlapped by the pressure transmitted through the pneumatic switch 17 in the control chamber is pneumatically controlled diaphragm valve 16.
After the termination of the compression of the breathing bag receiver 26, the pressure therein decreases, therefore pneumatically operated diaphragm valve 16 opens and the patient exhales, and a breathing bag receiver 26 is again filled.
If instead the breathing bag receiver connect samoraspadayutsya bag to ventilate the patient manually and in the absence of oxygen, because the unfolding of the bag he filled with air through a valve suction of atmospheric air 25.
For the implementation of the ventilation apparatus kids pneumatic switch 11 is put in position “CHILDREN”, mech 5 with a larger effective area opens into the atmosphere and ventilation is only fur 4 with a smaller effective area that provides the exact job of the respiratory volumes less than 250 ml.
Thus, patented ventilator allows to implement a wide range of different operating modes (controlled mechanical ventilation controlled mechanical ventilation+sigh, a ventilator, and the positive pressure, spontaneous breathing and other - description of the modes, see Galperin Y. S., Burlakov, P. I. “Anesthetic and respiratory equipment. The device, development, operation), CJSC “VNIIMP-VITA”, 2002 - 50 C.) defined by the program controller 23 in a wide range of respiratory volumes, and continue to significantly expand its functionality without any structural changes.
The ventilator containing the control unit comprising the actuator and the pressure transducer pneumatically coupled to the tee of the patient, respiratory unit, comprising dividing the fur, which is connected through the transmission of the screw - nut with electric line of the breath, which is connected to the tee of the patient and through the check valve and controlled diaphragm valve pneumatically connected with the separation fur, line exhalation, which is connected to the tee of the patient and connected to the diaphragm valve, pneumatic generator pulses in the form of a membrane with a Central nozzle and valve, kinematically connected with the armature of an electromagnet included in the generator pneumatic pulses, namebrand cavity of the generator pneumatice the th mixture, includes dispenser of the gas mixture, the inlet of which is connected to a source of compressed medical gases, and out - breathing bag, a safety valve, valve suction of atmospheric air through the check valve with the separation fur respiratory unit, characterized in that between the fixed and movable lids separation fur respiratory unit has a second fur with a smaller effective area, dividing the fur greater effective area is pneumatically connected to the line of the breath through the pneumatic switch, which is connected to atmosphere, the control unit is entered, the controller, the first input connected to the output of the pressure transducer, a second input to an electrical switch, which is connected to a pneumatic switch, and the output of the controller is connected respectively to the generator pneumatic pulses to the controlled membrane valve and the actuator, while the respiratory unit is equipped with two electric limit switches, which are connected to the second input of the controller and mounted with the possibility of interaction with a movable lid separation fur respiratory unit, the line between exhalation diaphragm valve and what hodom block the supply of the breathing gas, the pulsed power supply is connected respectively to the pressure transducer to a third input of the controller, limit switch and power switch.
FIELD: medical engineering.
SUBSTANCE: device has flow generator, compressed oxygen source, gas distribution device, patient T-branch, control system having microprocessor controller connected to the gas distribution device with all its outlets, flow velocity and upper airway pressure sensors pneumatically connected to the patient T-branch. The device has unit containing arterial blood pressure sensor, heart beat rate sensor, sensor of hemoglobin saturation with oxygen, electric output terminals of which form data bus with those of flow velocity and upper airway pressure sensors. The control system is additionally provided with fuzzy controller and three memory units having their inputs connected via electrical link to fuzzy controller output and their outputs to microprocessor controller input, to data bus output and fuzzy controller input connected to PC with its input.
EFFECT: enhanced effectiveness of treatment; accelerated transition to natural breathing.
FIELD: medical engineering.
SUBSTANCE: device has oxygen inhalation sets and artificial lung ventilation means enclosed into dust- and moisture-proof envelopes usable as oxygen-delivery unit. Portable thermochemical oxygen-producing units are connected to the means. Every thermochemical oxygen-producing unit is cylindrical and has casing and cover which flanges are connected to each other via sealing ring by means of removable yoke. The casing has three metal cups inserted one into another and fixed in upper part in the flange. Reactor cartridge provided with hard oxygen-containing composition for setting starter device having striking mechanism is placed in the internal cup. The external cup is perforated and serves as protection casing. Oxygen production unit cover is divided into two parts one of which has safety valve connected to the first output of the reactor cartridge, dust collection filter connected to the second reactor cartridge output on one side and connected to additional cleaning filter via heat exchange unit on the other side, heat exchanger, gas connection nipples, guide member usable in striking mechanism, safety valve and dust collection filter are fixed on cover flange. Additional cleaning filter body is placed on the second part of oxygen production unit cover. Cavity for letting striking mechanism guide pass is arranged along central axis of the additional cleaning filter body. Nipple for releasing oxygen is available on the additional cleaning filter body cover. The nipple has captive nut for making connection to feeding pipe. Starter unit is fixed on the oxygen-producing unit cover and has capsule. The striking mechanism has striker and spring arranged in guiding tube. Air-convection heat exchange unit has coiled pipe manufactured from copper tube. Reflexogenic therapy instrument is available for making anesthesia of wounded person.
EFFECT: enhanced effectiveness of complex treatment with delivering oxygen anesthesia.
2 cl, 4 dwg
SUBSTANCE: method involves applying auxiliary non-invasive lung ventilation with air-and-oxygen mixture in PSV mode with supporting pressure being equal to 8-12 cm of water column at inspiration phase, FiO2 0.25-0.3, positive pressure at expiration phase end equal to 2-4 cm of water column being applied. Inspiration trigger sensitivity being equal to 15-2 cm of water column relative to positive pressure at expiration phase end level to reach tidal respiratory volume not less than 6-7 ml/kg under SpO2 and blood gases control.
EFFECT: prevented acute respiratory insufficiency; improved alveolar ventilation; reduced venous bypass.
SUBSTANCE: method involves applying dosed load to cardiac respiration system due to compressed gas working pressure being reduced by 0.4 kg/m2 keeping it constant during 5-20 min. Then, the working pressure is reduced depending on patient state starting with a rate of 0.02-0.08 kg/m2/min. Gas exchange and hemodynamic parameters being in norm, the selected rate is increased. The parameters deviating from a norm, the selected rate is adjusted by increasing working pressure to reach their normal values. Optimum gas flow rate is determined and the working pressure is reduced at this rate, continuing to adjust its value under unchanged gas exchange and hemodynamic parameter values or their deviation from norm.
EFFECT: accelerated treatment course.
FIELD: medicine; artificial respiration apparatuses.
SUBSTANCE: apparatus has support, actuating mechanism and drive. Support is made in form of frame provided with rigid wheels, four bosses provided hole and placed in pairs in opposite and symmetrically to longitudinal axis extendable bed onto solid rollers; bed is provided with head support and lock. Actuating mechanism is mounted onto top part of frame and has four guides having smooth part inserted into hole of bosses, four elastic elements put onto smooth parts of guides, breast cuff placed among guides, arm with ears which has bushings to be housed onto threaded part of guides, working tool placed above breast cuff. Working tool is made of disc provided with axis which has ends to be embedded into rollers of ears of the arm. Apparatus also has aid for influencing breast cuff which aid is fixed onto disc for movement relatively the axis. Breast cuff has elastic sheet made in form of rectangle provided with bushings at the angles, solid plank fastened in the middle of the sheet, two cords which have first ends to fasten to opposite side faces. Drive has electric motor, redactor provided with speed gear-box, coupling and chain gear with bridle. Elastic elements are made in form of coil cylindrical or conical springs. Aid for influencing breast cuff has Π-shaped groove in the middle and slot at side surfaces. Slot has length determined by ratio of Λ=2D, where Λ is length of slot and D is diameter of disc. Width of slot allows moving axes and screws inside it.
EFFECT: simplified kinematical design of apparatus.
SUBSTANCE: method involves setting respirator operation parameter values taking into account height h, age a and patient body mass m; proper value of thoracic pulmonary extensibility Cprop is determined with patient body mass taken into account. Positive pressure at the end of expiration as forced ventilation characteristic with thoracic pulmonary extensibility taken into account. Then, forced volume-controlled artificial pulmonary ventilation is carried out. Breathing frequency and inhaled volume are adjusted to achieve normal lung ventilation followed by auxiliary lung ventilation.
EFFECT: reduced negative influence upon lungs, systemic and cerebral hemodynamic characteristics; retained pulmonary gas exchange.
4 cl, 3 dwg
SUBSTANCE: method involves introducing catheter via nasal passage into the rhinopharynx and fixed above the entrance to larynx and artificial high frequency jet ventilation is carried out with frequency of 140-150 cycles per min in three stages. Compressed gas working pressure is increased at the first stage to 2.0-2.5 kg of force/cm2 during 7-10 min. The compressed gas working pressure is supported at this level to the moment the clinic manifestations of pulmonary edema being removed and gas exchange normalization being achieved at the second stage. The working pressure is stepwise dropped during 1-2 h at the third stage hold during 10-15 min at each step.
EFFECT: enhanced effectiveness in normalizing hemodynamics.
FIELD: medicine, pediatrics, anesthesiology.
SUBSTANCE: at induction of general anesthesia one should conduct traditional two-lung ventilation at the mode of positive pressure at the end of expiration, on visualizing pleural cavity one should change for high-frequency pulmonary ventilation at respiration frequency being 130-150 cycles/min, respiratory volume of 3-6 l, the ratio of inhalation to expiration being 1:1 and fractional content of oxygen being 0.7-0.8. During performing the stage requiring lung's stillness it is necessary to conduct artificial ventilation in counter-lateral lung at the mode of positive pressure being at the end of expiration, on finishing that stage one should start high-frequency artificial ventilation; operation should be finished with traditional two-lung ventilation. The innovation provides stabilization of hemodynamics and safety of gaseous homeostasis.
EFFECT: higher efficiency.
SUBSTANCE: method involves treating biological object placed in medium containing at least one gas, with gas mixture containing oxygen as one of its ingredients. The treatment is carried out during at least one procedure in cyclic mode keeping given pattern providing saturation and/or desaturation of at least one gas mixture ingredient in biological object tissue cells according to given algorithm. The number of procedures and their periodicity are selected depending on the number of saturated and/or desaturated gases and their saturation and/or desaturation degree.
EFFECT: activated oxidation-reduction and energetic processes.
SUBSTANCE: method involves increasing respiration minute volume after applying carbodioxyperitoneum in a way that CO2 concentration is to be within 32-38 mm of mercury column and remaining at this level during the carbodioxyperitoneum treatment course. The CO2 concentration is supported at 30-32 mm of mercury column for 5-10 min after canceling the carbodioxyperitoneum with following respiration minute volume reduction until CO2 concentration reaches normal values.
EFFECT: reduced frequency of postoperative nausea and vomiting attacks.
1 dwg, 4 tbl