Apparatus for carrying out artificial lung ventilation

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.

2 dwg

 

The invention relates to the field of medical equipment and can be used for mechanical ventilation in intensive care units and intensive care.

Known artificial lung ventilation (ALV)containing the stream generator, the tee of the patient, control system, sensors, flow rate and control in the upper respiratory tract, which is pneumatically connected to the tee of the patient, and electrically connected with the inputs of the control system (U.S. Pat. Of the Russian Federation No. 2119323, CL A61 31/ 02, 1998).

The disadvantage of this apparatus is the possibility of implementing artificial and assisted ventilation (WELL) with controlled volume and airway pressure and lack of opportunities for implementing methods with controlled frequency - artificial and auxiliary high-frequency ventilation (VCELL and WCELL).

There is also known a ventilator, comprising a generator of flow, a source of compressed oxygen, gazoraspredelitelnoj device, tee patient management system, containing mikroprocessornye controller, which has its outputs connected to the gas distribution device, sensors, flow rate and pressure in the upper respiratory tract, pneumatically connected to the tee of the patient (Pat of the Russian Federation No. 2174386, CL AN 31/02, 2001).

The disadvantage of this equipment is that mechanical ventilation is the process of termination of long-term mechanical ventilation is carried out manually based on the empirically established modes depending on changes of the functional state of the cardiovascular and respiratory systems. Therefore, the transition from mechanical ventilation to independent breathing (DM) is a long and laborious process, requiring constant monitoring of physiological parameters of the functional state of the cardiovascular and respiratory systems. The degree of respiratory support at various stages of the process of termination of mechanical ventilation may differ significantly from the optimum, which contributes to the lengthening of the period of cessation of mechanical ventilation, and the desire of the physician to more rapid cessation of mechanical ventilation often leads to the development of decompensation from cardiorespiratory system, the need to resume ventilation, which generally leads to prolonged periods of cessation of mechanical ventilation.

The problem posed by the authors, is to reduce the complexity and duration of cessation of mechanical ventilation by automating this process and enhance the functionality of the device.

To achieve this objective, the ventilator comprising a generator of flow, a source of compressed oxygen, gazoraspredelitelnoj device, tee patient management system, containing mikroprocessornye controller that its you what od is connected with the gas distribution device, the sensors of the flow velocity and pressure in the upper respiratory tract, pneumatically connected to the tee of the patient, it is additionally provided with a pulse oxymeter device containing the sensors, blood pressure, heart rate, hemoglobin saturation with oxygen, the electrical outputs which together with electrical outputs of the sensors of the flow velocity and pressure in the upper respiratory tract are the data bus (SM), and the control system is further provided with a fuzzy controller and three memory devices, United electrical connection of its inputs with the output of fuzzy controller and its outputs to the input of microprocessor controller with output data bus and to the input of the fuzzy controller, whose input connected with a personal computer.

Figure 1 shows the block diagram of the device.

Figure 2 block diagram of the control system. The ventilator comprises a generator 1 stream, a source of compressed oxygen (O2), the gas distribution device 2, the patient y-piece 3, system 4 control modes and settings of the device, the sensor 5 flow

the pressure sensor 6 in the upper respiratory tract of the patient. Additionally, the apparatus further comprises a device 7, made for example in the form of a pulse oximeter (for example, No. 395 firm Nelicor, Switzerland), which VK is uchet sensors blood pressure (BP), heart rate (HR) and hemoglobin saturation with oxygen (Hbo2). Pulse oximeter 7 install on the patient (P).

Performing gas distribution device 2, the tee in 3 patients, pneumatic and electrical connections similar to the patent of Russian Federation № 2174386. Electrical connection of the sensors 5, 6 and unit 7 are the data bus (SM), which is the first electric input system 4 control.

The control system 4 (figure 2) contains the fuzzy controller (NC) 8, made for example in the form of a dual-card W.A.R.P. (firm SGS Tomson), and microprocessor controller (IPC) 9 made in the form, for example, microchip PIC 1674 company Micro Chip, and the memory device 10, recorded in his communications protocols on global communication management, the memory device 11 included in his set of modes and parameters of mechanical ventilation and the memory device 12 is brought into it by the set condition of the patient. SM connects the sensors 5, 6, and the device 7 with fuzzy controller 8 and a microprocessor-based controller 9 of the control system 4, it is her first electrical input. The second electrical connector type RS-232 port is intended for connection of the fuzzy controller 8 system control 4 with a personal computer. The memory device 10,11 and 12 are connected by the electrical connection of its inputs with the output of the fuzzy controller 8, and its in the passages with the input of the microprocessor-based controller with output data bus and to the input of the fuzzy controller. First, second and third electrical outputs IPC 2 are system outputs 4 control (figure 1).

The device is in automatic mode transition from mechanical ventilation to SD can be demonstrated on the example of the auxiliary VCELL.

In the initial state, the patient managed VCELL with a frequency of, for example, 100 to 120 cycles per minute and the ratio of inspiratory time/expiratory equal to 1:2. The working pressure of compressed gas (rrab.) is set at the minimum level at which no respiratory efforts of the patient.

Data about the functional state of the cardio-respiratory system are recorded in the memory device 12 as the source. They set the permissible deviations of these parameters (blood pressure, heart rate, NVO2)as well as the permissible values of the respiratory frequency (BH) attempts of the patient in the process of termination of mechanical ventilation.

The beginning of the process of transition to SD is accomplished by selecting one of the modes WCELL in the form of a certain speed reduction of the rrab. This is done by filing the appropriate signal from the microprocessor controller 9 proportional electropneumatic regulator gas distributing device 2. In the process of termination of mechanical ventilation, if the indicators of the functional state of the cardio-respiratory system remain at the original level or not output is t outside, prescribed by doctor (the control can be carried out continuously or periodically after a certain period of time), automatically switching to one of the higher speeds V reduce the rrab i.e. the acceleration of the process of termination of mechanical ventilation. In the case of one or more monitored physiological parameters for the specified limits, the machine stops decreasing V rrab provides for the increase of rrab 0.15-0.2 kgf/cm2and conducting SPM with a constant level of rrab, and after the return values at a given control range provides a continuation of the process of transition to SD with the installation of a slower V reduce the rrab. Such stepper regulation can be carried out repeatedly, providing search and maintenance of a mode of respiratory support at a minimum level of protection from development of cardiorespiratory decompensation system that provides an approximation of the time consuming process of termination of mechanical ventilation to the optimum level.

Similarly can be implemented other ways a ventilator, thus instead of automated changing the value V reduce the rrab is automated change speed reducing minute ventilation (in particular, by reducing the number of hardware breaths) or the rate of decrease of pressure is Oia airway in the inhalation phase (when using the pressure support - "pressure support").

The use of this device will significantly reduce the process of transferring a patient from mechanical ventilation to spontaneous breathing, which will allow to avoid decompensation cardiorespiratory system during the transition and reduce the time of treatment.

The ventilator containing stream generator, a source of compressed oxygen, a gas distribution device, the patient y-piece, a control system with a microprocessor-based controller, which has its outputs connected to the gas distribution device, sensors, flow rate and pressure in the upper respiratory tract, pneumatically connected to the tee of the patient, characterized in that it is additionally provided with a device containing the sensors, blood pressure, heart rate, hemoglobin saturation with oxygen, the electrical outputs which together with electrical outputs of the sensors of the flow velocity and pressure in the upper respiratory tract are the data bus (SM), and the control system is further provided with a fuzzy controller and three memory devices, United electrical connection of its inputs with the output of fuzzy controller and its outputs with the input of the microprocessor-based controller, with the output data bus and to the input fuzzy to the of ntroller, its input is connected to a personal computer.



 

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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.

2 dwg

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

FIELD: medicine.

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.

FIELD: medicine.

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.

2 cl

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.

11 dwg

FIELD: medicine.

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

FIELD: medicine.

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.

2 ex

FIELD: medicine.

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.

21 cl

FIELD: medicine.

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

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