WO2022016428A1 - Procédé de réglage de fraction d'oxygène inspiré, et dispositif d'assistance respiratoire - Google Patents

Procédé de réglage de fraction d'oxygène inspiré, et dispositif d'assistance respiratoire Download PDF

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Publication number
WO2022016428A1
WO2022016428A1 PCT/CN2020/103598 CN2020103598W WO2022016428A1 WO 2022016428 A1 WO2022016428 A1 WO 2022016428A1 CN 2020103598 W CN2020103598 W CN 2020103598W WO 2022016428 A1 WO2022016428 A1 WO 2022016428A1
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Prior art keywords
blood oxygen
oxygen
adjustment
data
oxygen concentration
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English (en)
Chinese (zh)
Inventor
黄志文
刘京雷
周小勇
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Shenzhen Mindray Bio Medical Electronics Co Ltd
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Shenzhen Mindray Bio Medical Electronics Co Ltd
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Priority to PCT/CN2020/103598 priority Critical patent/WO2022016428A1/fr
Priority to PCT/CN2021/104195 priority patent/WO2022017156A1/fr
Priority to CN202180060450.8A priority patent/CN116249482B/zh
Priority to CN202511135528.4A priority patent/CN120884783A/zh
Publication of WO2022016428A1 publication Critical patent/WO2022016428A1/fr
Anticipated expiration legal-status Critical
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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. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/14542—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue for measuring blood gases
    • 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
    • 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
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/20—Blood composition characteristics
    • A61M2230/205—Blood composition characteristics partial oxygen pressure (P-O2)

Definitions

  • the application relates to the technical field of respiratory physiology in medical equipment, and in particular, to a method for adjusting the concentration of inhaled oxygen and a respiratory support device.
  • ventilators are widely used in various treatment processes.
  • the fraction of inspired oxygen (FiO2) is directly related to the oxygen content in the patient's inhaled gas, which in turn affects the oxygen content in the patient's alveoli and blood. content, further affecting the patient's tissue oxygen supply. Therefore, in the actual use process, the inhaled oxygen concentration needs to be adjusted according to the specific physiological condition of the patient, so that the patient can reach the normal target oxygenation level.
  • the most common way to adjust the inhaled oxygen concentration is to adjust the inhaled oxygen concentration according to the blood oxygen saturation (SpO2) measured by the pulse oximeter during the adjustment interval.
  • SpO2 is measured in real time by pulse oximeter. If SpO2 is lower than a certain limit, the switch of the oxygen valve on the ventilator is automatically controlled to open, so as to realize the adjustment of the inhaled oxygen concentration.
  • the adjustment interval of this method is usually a fixed interval, which can only cope with small changes in blood oxygen. It is feasible for patients with relatively stable blood oxygen status, but for patients with unstable blood oxygen status, if there is an acute blood oxygen drop during the adjustment interval, the method of the prior art has no effect on the inspired oxygen concentration. There is no quick response when adjusting.
  • the embodiments of the present application provide a method for adjusting the concentration of inhaled oxygen and a respiratory support device, so as to realize the purpose of adjusting the concentration of inhaled oxygen in a rapid response when a patient's blood oxygen changes rapidly.
  • a first aspect of the present application discloses a method for adjusting the concentration of inhaled oxygen, the adjusting method comprising:
  • the severity refers to the degree to which the blood oxygen data deviates from the treatment target zone, and the condition for triggering the adjustment of the inhaled oxygen concentration in advance includes the severity.
  • the degree of blood oxygen tends to increase, and the selected blood oxygen partition and the treatment target partition each correspond to a pre-divided blood oxygen data range;
  • the operation of adjusting the intake oxygen concentration is performed in advance; otherwise, after the timing of the current adjustment interval is over, the operation of adjusting the intake oxygen concentration is normally performed.
  • the judging whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance including:
  • the number of blood oxygen data obtained in the current adjustment interval whose severity is greater than the severity of the blood oxygen data in the reference blood oxygen zone exceeds the preset number, which satisfies the requirement to trigger the adjustment of inhaled oxygen in advance. Concentration conditions, otherwise, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are not met.
  • the judging whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance including:
  • the adjustment of the inhaled oxygen concentration is triggered in advance according to the adjustment strategy corresponding to the uncertain blood oxygen triggering mode, otherwise, it is continued to judge whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance.
  • the triggering adjustment of the inhaled oxygen concentration according to the adjustment strategy corresponding to the uncertain blood oxygen triggering mode includes:
  • the total weight is compared with a first weight threshold and a second weight threshold, where the first weight threshold is used to indicate an increase in the oxygen concentration and the first adjusted amount of the inspired oxygen concentration, and the second weight threshold The threshold is used to indicate the reduced oxygen concentration and the second adjusted amount of the inspired oxygen concentration, and the first weighted threshold is greater than the second weighted threshold;
  • the adjustment amount for maintaining the current inhaled oxygen concentration is determined.
  • the method further includes:
  • the judging whether the associated data meets preset requirements includes:
  • the pulse rate change rate threshold If the change rate of the pulse rate is higher than the pulse rate change rate threshold, the pulse rate does not meet the blood oxygen reliability requirement, otherwise, the pulse rate meets the blood oxygen reliability requirement; and/or,
  • the pulse rate is lower than the pulse rate threshold, the pulse rate does not meet the blood oxygen reliability requirement, otherwise, the pulse rate meets the blood oxygen reliability requirement; and/or,
  • the perfusion index If the perfusion index is lower than the perfusion index threshold, the perfusion index does not meet the blood oxygen reliability requirement; otherwise, the perfusion index meets the blood oxygen reliability requirement;
  • the blood oxygen signal quality is lower than the blood oxygen signal quality threshold, the blood oxygen signal quality does not meet the blood oxygen reliability requirement; otherwise, the blood oxygen signal quality meets the blood oxygen reliability requirement.
  • the operation of adjusting the inhaled oxygen concentration includes:
  • the designated blood oxygen partition refers to the selected blood oxygen partition that contains the blood oxygen data with the most severe severity in each blood oxygen partition determined in the current adjustment interval;
  • the blood oxygen change trend is determined based on the specified blood oxygen zone, and the inhaled oxygen concentration is adjusted according to the adjustment strategy corresponding to the blood oxygen change trend.
  • the determining of the blood oxygen change trend based on the specified blood oxygen zone includes:
  • the oxygen change trend is the deterioration trend of blood oxygen
  • the trend of oxygen change is the trend of blood oxygen improvement
  • the blood oxygen type corresponding to the oxygen zone is non-severe hypoxia or severe hyperoxia, and it is determined that the blood oxygen change trend in the current adjustment interval is the blood oxygen stability trend;
  • the blood oxygen types include at least severe hypoxia, severe hyperoxia, moderate hypoxia, moderate hyperoxia, mild hypoxia, mild hyperoxia, and normal state.
  • the adjustment of the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend includes:
  • the inhaled oxygen concentration is adjusted according to the preset maximum single oxygen concentration adjustment amount, and the duration of the next adjustment interval is changed to a fifth duration, the preset maximum
  • the single oxygen concentration adjustment amount is correspondingly set to different adjustment amounts based on different patient types, and the fifth duration is less than the duration of the conventional adjustment interval;
  • the first oxygen concentration target adjustment amount is greater than the preset maximum single oxygen concentration adjustment amount, adjust the inhaled oxygen concentration with the preset maximum single oxygen concentration adjustment amount, and adjust the first oxygen concentration target adjustment amount
  • the difference between the adjustment amount and the preset maximum single-time oxygen concentration adjustment amount is used as the remaining adjustment amount, and is added to the cumulative adjustment amount of the designated blood oxygen zone.
  • the described adjustment strategy according to the blood oxygen change trend corresponding to adjusting the inhaled oxygen concentration including:
  • the offset of the upper and lower blood oxygen data boundaries of the target zone becomes smaller or unchanged, and the blood oxygen change trend in the last time is the difference between the blood oxygen stability trend or the blood oxygen improvement trend.
  • a preset adjustment amount is added to obtain a second oxygen concentration target adjustment amount, and the intake oxygen concentration is adjusted based on the second oxygen concentration target adjustment amount, and the second oxygen concentration target adjustment amount The adjustment amount is not greater than the preset minimum oxygen concentration adjustment amount.
  • the adjustment of the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend includes:
  • the upper and lower blood oxygen data in the treatment target zone are offset based on the blood oxygen data in the designated blood oxygen zone.
  • the offset of the data boundary and the accumulated adjustment amount of the designated blood oxygen zone are used to obtain a third oxygen concentration target adjustment amount, and the inspired oxygen concentration is adjusted based on the third oxygen concentration target adjustment amount.
  • the adjustment of the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend includes:
  • the region where the blood oxygen data is located in the treatment target zone determines the region where the blood oxygen data is located in the treatment target zone, and the region at least includes the downstream region , midstream region and upstream region;
  • the blood oxygen data is in the midstream region, start a first timer, and when the first timer ends, adjust the inhaled oxygen concentration according to the preset minimum oxygen concentration adjustment amount;
  • a second timing is started, and when the second timing ends, the inhaled oxygen concentration is adjusted according to the preset minimum oxygen concentration adjustment amount, and the second timing is greater than the first timing.
  • a second aspect of the present application discloses a respiratory support device, comprising:
  • a ventilation device which is used for providing an inhaled gas to a patient through a breathing circuit and a breathing accessory, and the inhaled gas is an oxygen-containing gas;
  • a processor in signal connection with the ventilation device to control the flow of inspiratory gas provided by the ventilation device to the patient;
  • the processor is also configured to:
  • the severity refers to the degree to which the blood oxygen data deviates from the treatment target zone, and the condition for triggering the adjustment of the inhaled oxygen concentration in advance includes the severity.
  • the degree of blood oxygen tends to increase, and the selected blood oxygen partition and the treatment target partition each correspond to a pre-divided blood oxygen data range;
  • the processor for judging whether the severity of each blood oxygen data meets the condition for triggering the adjustment of the inhaled oxygen concentration in advance is specifically used for:
  • the number of blood oxygen data obtained in the current adjustment interval whose severity is greater than the severity of the blood oxygen data in the reference blood oxygen zone exceeds the preset number, which satisfies the requirement to trigger the adjustment of inhaled oxygen in advance. Concentration conditions, otherwise, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are not met.
  • the processor for judging whether the severity of each blood oxygen data meets the condition for triggering the adjustment of the inhaled oxygen concentration in advance is specifically used for:
  • the processor is further configured to:
  • the adjustment of the inhaled oxygen concentration is triggered according to the adjustment strategy corresponding to the uncertain blood oxygen trigger mode, otherwise, it is continued to judge whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance.
  • triggering the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the uncertain blood oxygen triggering mode is specifically used for:
  • the total weight is compared with a first weight threshold and a second weight threshold, where the first weight threshold is used to indicate an increase in the oxygen concentration and the first adjusted amount of the inspired oxygen concentration, and the second weight threshold The threshold is used to indicate the reduced oxygen concentration and the second adjusted amount of the inspired oxygen concentration, and the first weighted threshold is greater than the second weighted threshold;
  • the adjustment amount for maintaining the current inhaled oxygen concentration is determined.
  • the processor is further configured to:
  • each blood oxygen data obtained by the obtaining device After receiving each blood oxygen data obtained by the obtaining device, obtain the associated data that affects the blood oxygen reliability in the blood oxygen data; determine whether the associated data meets the blood oxygen reliability requirements; if so, determine The blood oxygen zone corresponding to the blood oxygen data; if not satisfied, continue to obtain the blood oxygen data.
  • the processor for judging whether the associated data meets preset requirements is specifically used for:
  • the pulse rate change rate threshold If the change rate of the pulse rate is higher than the pulse rate change rate threshold, the pulse rate does not meet the blood oxygen reliability requirement, otherwise, the pulse rate meets the blood oxygen reliability requirement; and/or,
  • the pulse rate is lower than the pulse rate threshold, the pulse rate does not meet the blood oxygen reliability requirement, otherwise, the pulse rate meets the blood oxygen reliability requirement; and/or,
  • the perfusion index If the perfusion index is lower than the perfusion index threshold, the perfusion index does not meet the blood oxygen reliability requirement; otherwise, the perfusion index meets the blood oxygen reliability requirement;
  • the blood oxygen signal quality is lower than the blood oxygen signal quality threshold, the blood oxygen signal quality does not meet the blood oxygen reliability requirement; otherwise, the blood oxygen signal quality meets the blood oxygen reliability requirement.
  • the processor is further configured to:
  • the processor that performs the operation of adjusting the inhaled oxygen concentration is specifically used for:
  • the designated blood oxygen partition refers to the selected blood oxygen partition that contains the blood oxygen data with the most severe severity in each blood oxygen partition determined in the current adjustment interval;
  • the blood oxygen change trend is determined based on the specified blood oxygen zone, and the inhaled oxygen concentration is adjusted according to the adjustment strategy corresponding to the blood oxygen change trend.
  • the processor for determining the blood oxygen change trend based on the specified blood oxygen partition is specifically used for:
  • the first blood oxygen type is severe hypoxia or severe hyperoxia, determining that the blood oxygen change trend in the current adjustment interval is a blood oxygen deterioration trend;
  • the blood oxygen type is more severe than the blood oxygen type indicated by the second blood oxygen type, it is determined that the blood oxygen change trend in the current adjustment interval is a blood oxygen deterioration trend, and the blood oxygen type At least include severe hypoxia, severe hyperoxia, moderate hypoxia, moderate hyperoxia, mild hypoxia, mild hyperoxia and normal state;
  • the first blood oxygen type and the second blood oxygen type are consistent and neither is severe hypoxia or severe hyperoxia, determining that the blood oxygen change trend within the current adjustment interval is a blood oxygen stability trend;
  • the blood oxygen change trend within the current adjustment interval is a blood oxygen improvement trend.
  • the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
  • the inhaled oxygen concentration is adjusted according to the preset maximum single oxygen concentration adjustment amount, and the duration of the next adjustment interval is changed to a fifth duration, the preset maximum
  • the single oxygen concentration adjustment amount is correspondingly set to different adjustment amounts based on different patient types, and the fifth duration is less than the duration of the conventional adjustment interval;
  • the first oxygen concentration target adjustment amount is greater than the preset maximum single oxygen concentration adjustment amount, adjust the inhaled oxygen concentration with the preset maximum single oxygen concentration adjustment amount, and adjust the first oxygen concentration target adjustment amount
  • the difference between the adjustment amount and the preset maximum single-time oxygen concentration adjustment amount is used as the remaining adjustment amount, and is added to the cumulative adjustment amount of the designated blood oxygen zone.
  • the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
  • the offset of the upper and lower blood oxygen data boundaries of the target zone becomes smaller or unchanged, and the blood oxygen change trend in the last time is the difference between the blood oxygen stability trend or the blood oxygen improvement trend.
  • a preset adjustment amount is added to obtain a second oxygen concentration target adjustment amount, and the intake oxygen concentration is adjusted based on the second oxygen concentration target adjustment amount, and the second oxygen concentration target adjustment amount The adjustment amount is not greater than the preset minimum oxygen concentration adjustment amount.
  • the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
  • the upper and lower blood oxygen data in the treatment target zone are offset based on the blood oxygen data in the designated blood oxygen zone.
  • the offset of the data boundary and the accumulated adjustment amount of the designated blood oxygen zone are used to obtain a third oxygen concentration target adjustment amount, and the inspired oxygen concentration is adjusted based on the third oxygen concentration target adjustment amount.
  • the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
  • the region where the blood oxygen data is located in the treatment target zone determines the region where the blood oxygen data is located in the treatment target zone, and the region at least includes the downstream region , midstream region and upstream region;
  • the blood oxygen data is in the midstream region, start a first timer, and when the first timer ends, adjust the inhaled oxygen concentration according to the preset minimum oxygen concentration adjustment amount;
  • a second timing is started, and when the second timing ends, the inhaled oxygen concentration is adjusted according to the preset minimum oxygen concentration adjustment amount, and the second timing is greater than the first timing.
  • a third aspect of the present application discloses a respiratory support device, comprising:
  • a ventilation device which is used for providing an inhaled gas to a patient through a breathing circuit and a breathing accessory, and the inhaled gas is an oxygen-containing gas;
  • a processor in signal connection with the ventilation device to control the flow of inspiratory gas provided by the ventilation device to the patient;
  • the processor is also configured to:
  • the blood oxygen zone corresponding to the real-time obtained blood oxygen data of the patient; the blood oxygen zone is pre-divided according to the blood oxygen saturation, and includes a treatment target zone ;
  • an inspired oxygen concentration adjustment operation is performed in advance to adjust the blood oxygen level of the patient within the treatment target zone.
  • a method for adjusting the inhaled oxygen concentration and a respiratory support device disclosed in the embodiments of the present application acquire each blood oxygen data at the current adjustment interval in real time, determine the selected blood oxygen zone in which each blood oxygen data is located; Whether the severity meets the conditions for triggering the adjustment of the inspired oxygen concentration in advance, the severity refers to the degree to which the blood oxygen data deviates from the treatment target zone, the conditions for triggering the adjustment of the inspired oxygen concentration in advance include that the severity tends to increase, so
  • the selected blood oxygen zone and the treatment target zone respectively correspond to a pre-divided blood oxygen data range; when the condition of triggering the adjustment of the inhaled oxygen concentration in advance is satisfied, the operation of adjusting the inhaled oxygen concentration is performed, otherwise, the operation of adjusting the inhaled oxygen concentration is performed normally.
  • 1 is a schematic flowchart of a method for adjusting the concentration of inhaled oxygen disclosed in an embodiment of the application;
  • FIG. 2 is an exemplary diagram of a division of a blood oxygen zone disclosed in an embodiment of the present application
  • FIG. 3 is a schematic flow chart of adjusting the concentration of inhaled oxygen disclosed in an embodiment of the application
  • FIG. 4 is an exemplary diagram of another blood oxygen partition disclosed in an embodiment of the present application.
  • FIG. 5 is an exemplary diagram of another blood oxygen partition disclosed in an embodiment of the present application.
  • FIG. 6 is a schematic flowchart of determining the severity of each blood oxygen data disclosed in an embodiment of the present application.
  • FIG. 7 is another schematic flowchart of determining the severity of each blood oxygen data disclosed in an embodiment of the present application.
  • FIG. 8 is a schematic flowchart of adjusting the inhaled oxygen concentration based on the adjustment strategy A disclosed in the embodiment of the present application;
  • FIG. 9 is a schematic flowchart of another method for adjusting the inhaled oxygen concentration disclosed in the embodiment of the application.
  • FIG. 10 is a schematic flowchart of analyzing a blood oxygen change trend disclosed in an embodiment of the application.
  • FIG. 11 is a schematic flow chart of a blood oxygen trend analysis under moderate hypoxia disclosed in an embodiment of the application.
  • FIG. 12 is a schematic flow chart of a blood oxygen trend analysis under moderate superoxidation disclosed in an embodiment of the application.
  • FIG. 13 is a schematic flowchart of a blood oxygen trend analysis under mild hypoxia disclosed in an embodiment of the application.
  • FIG. 14 is a schematic flowchart of a blood oxygen trend analysis under mild peroxidation disclosed in an embodiment of the application.
  • 15 is a schematic flowchart of adjusting the inhaled oxygen concentration based on the adjustment strategy B or C disclosed in the embodiment of the present application;
  • FIG. 16 is a schematic structural diagram of a respiratory support device disclosed in an embodiment of the present application.
  • FiO2 fraction of oxygen concentration in inhaled air, inhaled oxygen concentration
  • FiO2 is an extremely important adjustment parameter in the process of patient receiving ventilator treatment.
  • FiO2 needs to be adjusted according to the specific physiological condition of the patient. The goal of adjustment is to bring the patient to a normal target oxygenation level.
  • the setting of FiO2 is made by medical staff with reference to the patient's arterial partial pressure of oxygen (PaO2) or arterial oxygen saturation (SaO2) and other related oxygenation indicators based on experience. set.
  • the embodiment of the present application discloses a method for adjusting the inhaled oxygen concentration and a respiratory support device.
  • the conditions for adjusting the inhaled oxygen concentration are set in advance to trigger,
  • the blood oxygen data obtained in real time is in the selected blood oxygen zone where it is located, and the blood oxygen state corresponding to the selected blood oxygen zone satisfies the condition for triggering the adjustment of the inhaled oxygen concentration in advance, trigger the adjustment of the inhaled oxygen concentration in advance, and Based on the adjustment strategy corresponding to the blood oxygen change trend in the current adjustment interval, the adjustment of the inspired oxygen concentration is realized.
  • the specific implementation is described in detail through the following embodiments.
  • FIG. 1 it is a schematic flowchart of a method for adjusting the concentration of inhaled oxygen disclosed in an embodiment of the present application.
  • the method for adjusting the concentration of inhaled oxygen can be applied to various types of respiratory support equipment, such as a ventilator, an anesthesia machine, and the like.
  • the method for adjusting the inhaled oxygen concentration mainly includes the following steps:
  • Step 101 Acquire each blood oxygen data of the current adjustment interval in real time, and determine the selected blood oxygen zone in which each blood oxygen data is located.
  • a pulse oximeter may be used to acquire blood oxygen data in real time.
  • the adjustment interval between the two operations of adjusting the inhaled oxygen concentration before and after is an adjustment interval.
  • the duration of the interval can be preset according to the empirical value. Normally, the adjustment interval is the regular adjustment interval.
  • the blood oxygen saturation can be specifically obtained by using the blood oxygen data.
  • the blood oxygen data obtained in real time can be obtained by processing the blood oxygen data to reflect the blood oxygen saturation level of the blood oxygen data. Both can indicate the amount of oxygen in the blood.
  • the selected blood oxygen zone refers to the blood oxygen zone where the collected blood oxygen data is located.
  • the blood oxygen partition is a partition obtained in advance based on the blood oxygen saturation range (blood oxygen data range).
  • the concentration in order to identify the severity of the patient's blood oxygen state according to the degree of deviation from the treatment target zone set by the doctor, so as to determine different inhaled oxygen according to the different degrees of severity. Adjusting the concentration; and determining whether to trigger the adjustment of the inhaled oxygen concentration in advance according to the change in the severity of the blood oxygen state in the region where the patient's blood oxygen is located, it is necessary to divide the overall blood oxygen into several regions. Each region has its own corresponding pre-divided blood oxygen saturation range, or has its own corresponding pre-divided blood oxygen data range.
  • the area outside the treatment target zone set by the doctor is further divided into at least two block areas.
  • the treatment target zone set by the doctor is used to indicate that the blood oxygen level is in a normal state.
  • the blood oxygen zone includes a treatment target zone, that is, when treating a patient, it is necessary to restore or maintain the physiological parameters corresponding to the patient in the treatment target zone, and when the corresponding blood oxygen data (physiological parameters) are in the treatment target zone.
  • the blood oxygen data can be considered to be in a normal state.
  • the blood oxygen saturation range formed by the first lower limit blood oxygen saturation and the first upper limit blood oxygen saturation determine the lower limit blood oxygen saturation of the treatment target zone and the upper limit blood oxygen saturation of the treatment target zone.
  • the area between the first lower limit blood oxygen saturation and the lower limit blood oxygen saturation of the treatment target zone is divided into a hypoxia zone, where the hypoxia zone is used to indicate that the blood oxygen level is in a hypoxic state.
  • the area between the upper blood oxygen saturation level of the treatment target zone and the first upper blood oxygen saturation value is divided into a peroxygen zone, where the peroxygen zone is used to indicate that the blood oxygen level is in a peroxygen state.
  • FIG. 2 it is an example diagram of a blood oxygen partition shown in an embodiment of the present application.
  • 0% refers to the first lower limit blood oxygen saturation
  • 100% is the first upper limit blood oxygen saturation
  • 87% is the lower limit blood oxygen saturation of the treatment target zone
  • 92% is the upper limit blood oxygen saturation of the treatment target zone.
  • 90% is the currently monitored blood oxygen saturation of the patient.
  • the range of the hypoxia zone is: [0%, 87%).
  • the range of the peroxygen zone is: (92%, 100%].
  • FIG. 2 is only an example given in the embodiment of the present application, and the division of the blood oxygen zone in the embodiment of the present application is not limited to the blood oxygen saturation level given above.
  • the determined selected blood oxygen zone is also constantly updated.
  • each blood oxygen zone corresponds to a blood oxygen state.
  • the blood oxygen state is different according to the different blood oxygen saturation ranges corresponding to the blood oxygen zones.
  • the blood oxygen state corresponding to the treatment target zone is a normal state.
  • the blood oxygen state corresponding to the hypoxic zone is the hypoxic state.
  • the blood oxygen state corresponding to the peroxygen zone is the peroxygen state.
  • Step 102 Determine whether the severity of each blood oxygen data satisfies the condition for triggering the adjustment of the inhaled oxygen concentration in advance, if yes, go to Step 103; if not, go to Step 104.
  • the severity of the blood oxygen data refers to the degree to which the blood oxygen data deviates from the treatment target zone. The further away from the treatment target zone, the higher the severity of the blood oxygen data.
  • the conditions for the early triggering of the adjustment of the inspired oxygen concentration include a tendency for the severity to increase. That is to say, there is at least a situation where the severity of the blood oxygen data tends to increase, that is, the condition for triggering the adjustment of the inhaled oxygen concentration in advance is met.
  • Step 103 Perform an operation of adjusting the inhaled oxygen concentration in advance under the condition that the adjustment of the inhaled oxygen concentration is triggered in advance.
  • Step 104 After the timing of the current adjustment interval ends, the operation of adjusting the inhaled oxygen concentration is normally performed.
  • a corresponding adjustment strategy is used to perform the operation of adjusting the inhaled oxygen concentration.
  • FIG. 3 the operation of adjusting the inhaled oxygen concentration is shown in FIG. 3 , including:
  • Step 301 Acquire a designated blood oxygen partition of the current adjustment interval, where the designated blood oxygen partition refers to a selected blood oxygen partition that includes the blood oxygen data with the most severe severity among the blood oxygen partitions determined in the current adjustment interval.
  • the designated blood oxygen partition of the current adjustment interval refers to the selected blood oxygen partition containing the blood oxygen data with the most severe severity determined in the current adjustment interval, and is used to indicate the overall blood oxygen partition result in the current adjustment interval.
  • the severity of the blood oxygen data obtained in the current adjustment interval can be compared at every preset time period, and the selected blood oxygen zone containing the blood oxygen data with the most severe severity can be determined as the designated blood oxygen partition. Until triggering to perform the operation of adjusting the inhaled oxygen concentration in advance or to perform the operation of adjusting the inhaled oxygen concentration normally, to finally determine the selected blood oxygen zone containing the blood oxygen data with the most severe severity as the designated blood oxygen zone in the current adjustment interval.
  • the inhaled oxygen concentration operation or the normal execution of the adjustment of the inhaled oxygen concentration operation is performed to finally determine the selected blood oxygen zone containing the blood oxygen data with the most severe severity as the designated blood oxygen zone within the current adjustment interval.
  • the minimum number of blood oxygen data that can be obtained in the current interval is 20.
  • the selected blood oxygen zone in which the first blood oxygen data is located is determined as the designated blood oxygen zone within the current adjustment interval.
  • Step 302 Determine the blood oxygen change trend based on the designated blood oxygen zone, and adjust the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend.
  • the blood oxygen change trend includes the blood oxygen deterioration trend, the blood oxygen stability trend and the blood oxygen improvement trend.
  • a worsening trend in blood oxygen indicates that the patient's blood oxygen further deviates from the therapeutic target zone.
  • the stable blood oxygen trend indicates that the patient's blood oxygen has no obvious tendency to change towards the therapeutic target zone or to deviate from the target blood oxygen range.
  • the trend of blood oxygen improvement indicates that the patient's blood oxygen is changing towards the therapeutic target zone.
  • a corresponding adjustment strategy is determined based on the change trend of blood oxygen, and the inspired oxygen concentration is adjusted according to the adjustment strategy.
  • Execute the operation of adjusting the inhaled oxygen concentration disclosed in the embodiment of the present application and determine an adjustment strategy suitable for the patient's inhaled oxygen concentration according to the blood oxygen change trend of different patients, so that the operation of adjusting the inhaled oxygen concentration disclosed in the embodiment of the present application can be used in different blood oxygen concentrations. used between patients in the state. It can avoid the disadvantages of using a fixed adjustment amount or a fixed adjustment target in the prior art to adjust the inhaled oxygen concentration for patients with different blood oxygen states. Further, there is no need to distinguish which patients can be used and which cannot be used.
  • a response is made whether to trigger the adjustment of the inhaled oxygen concentration in advance according to the change in the severity of the blood oxygen data of the patient, and when it is determined that the adjustment of the inhaled oxygen concentration is triggered in advance
  • the inhaled oxygen concentration is adjusted in time based on the adjustment strategy corresponding to the blood oxygen change trend in the current adjustment interval.
  • the blood oxygen partition in step 101 is divided into a treatment target partition, a hypoxia partition and a hyperoxia partition.
  • the treatment target zone can be divided into multiple regions.
  • the treatment target zone can be divided into a downstream region, a midstream region and an upstream region.
  • the division of the treatment target zone in the embodiment of the present application is not limited to three zones.
  • treatment target partition can be divided into regions with equal proportions, and can also be divided into regions with unequal proportions.
  • hypoxia partition can also continue to be divided. Specifically:
  • the first boundary blood oxygen saturation is less than the lower limit blood oxygen saturation of the treatment target zone, and the first boundary blood oxygen saturation is greater than the second boundary blood oxygen saturation.
  • the area between the lower limit blood oxygen saturation of the treatment target zone and the first boundary blood oxygen saturation is divided into a mild hypoxia zone, which is used to indicate that the blood oxygen level is in a mild hypoxia state .
  • a region between the first boundary blood oxygen saturation level and the second boundary blood oxygen saturation level is divided into a moderate hypoxia zone, where the moderate hypoxia zone is used to indicate that the blood oxygen level is in a moderate hypoxia state.
  • a region between the second boundary blood oxygen saturation level and the first lower limit blood oxygen saturation level is divided into a severe hypoxia zone, where the severe hypoxia zone is used to indicate that the blood oxygen level is in a severe hypoxia state.
  • the third type obtain the first historical blood oxygen saturation corresponding to the moderate hypoxia state and the second historical blood oxygen saturation corresponding to the severe hypoxia state; determine the first boundary blood oxygen saturation according to the first historical blood oxygen saturation , and the second boundary blood oxygen saturation is determined according to the second historical blood oxygen saturation.
  • FIG. 5 shows that the blood oxygen saturation of the first boundary of the hypoxic zone is 84%, and the blood oxygen saturation of the second boundary of the hypoxic zone is 81%.
  • the range of moderate hypoxia zones was: [81%, 84%).
  • the range of severe hypoxia zone is: [0%, 81%).
  • the division of the peroxygen zone may continue. Specifically:
  • the third boundary blood oxygen saturation is greater than the upper limit blood oxygen saturation of the treatment target zone, and the third boundary blood oxygen saturation is smaller than the fourth boundary blood oxygen saturation.
  • the area between the upper blood oxygen saturation level of the treatment target zone and the third boundary blood oxygen saturation value is a mild hyperoxia zone, and the mild hyperoxygen zone is used to indicate that the blood oxygen level is in a mild hyperoxygen state.
  • the area between the third boundary blood oxygen saturation level and the fourth boundary blood oxygen saturation level is defined as a moderate hyperoxia zone, which is used to indicate that the blood oxygen level is in a moderate hyperoxia state.
  • the area between the fourth boundary blood oxygen saturation level and the first upper limit blood oxygen saturation level is defined as a severe hyperoxygen zone, and the severe hyperoxygen zone is used to indicate that the blood oxygen level is in a severe hyperoxygen state.
  • the third type obtain the third historical blood oxygen saturation corresponding to the moderate superoxide state and the fourth historical blood oxygen saturation corresponding to the severe superoxidation state; determine the third boundary blood oxygen saturation according to the third historical blood oxygen saturation , and the fourth boundary blood oxygen saturation is determined according to the fourth historical blood oxygen saturation.
  • FIG. 5 shows that the blood oxygen saturation of the third boundary of the peroxygen zone is 94%, and the blood oxygen saturation of the fourth boundary of the hypoxic zone is 96%.
  • the range of the moderate hyperoxia partition is: (94%, 96%].
  • the severity of the patient's blood oxygen condition is identified according to the degree of deviation from the target blood oxygen range.
  • the severity of the oxygen state determines different adjustment strategies, and according to the change of the blood oxygen state of the blood oxygen zone where the patient's blood oxygen data is located, it is decided whether to trigger the adjustment of the inhaled oxygen concentration in advance.
  • the blood oxygen state with higher severity adopts a higher amount of adjustment of the inspired oxygen concentration and a shorter adjustment interval, so as to obtain the increase of the severity of the blood oxygen state of the patient.
  • the density adjustment intensity is the effect of increasing the intensity adjustment in steps.
  • step 102 various methods can be used to analyze the severity of each blood oxygen data, so as to judge in real time whether the severity of the blood oxygen data meets the requirements in advance. Triggers the conditions that regulate the concentration of inspired oxygen.
  • the embodiments of the present application provide the following three ways, but the embodiments of the present application are not limited to the following three ways to determine the severity of each blood oxygen data.
  • the first way is:
  • the reference blood oxygen partition containing the blood oxygen data with the highest severity in the previous adjustment interval and compare the severity of the blood oxygen data obtained in the current adjustment interval with the severity of the blood oxygen data of the reference blood oxygen partition in real time; Before the timing of the current adjustment interval ends, the number of blood oxygen data obtained in the current adjustment interval whose severity is greater than the severity of the blood oxygen data in the reference blood oxygen zone exceeds the preset number, and the condition for triggering the adjustment of the inhaled oxygen concentration in advance is met. , otherwise, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are not met.
  • duration of the last adjustment interval and the current adjustment interval are not necessarily the same.
  • the specific implementation process of the first mode is shown in FIG. 6 , including the following steps:
  • Step 601 Determine the reference blood oxygen zone that contains the blood oxygen data with the highest severity in the last adjustment interval.
  • the reference blood oxygen partition that contains the blood oxygen data with the highest severity in the last adjustment interval determined in step 601 is the result of the overall blood oxygen partition in the last adjustment interval.
  • the result of the overall division of blood oxygen in the last adjustment interval refers to the overall division of blood oxygen when the operation of adjusting the inhaled oxygen concentration is performed within the last adjustment interval or after the end of the last adjustment interval, and the overall division of blood oxygen is used to represent the last adjustment Overall status of blood oxygen in the interval.
  • the blood oxygen data obtained in one adjustment interval has different corresponding blood oxygen partitions
  • the blood oxygen partition is used as a reference blood oxygen partition for subsequent use.
  • the "peroxygen zone” is " More important blood oxygen zoning events".
  • the "peroxygen zone” is used as a reference blood oxygen zone for subsequent use.
  • different strategies may also be used to determine the overall state of blood oxygen within a certain adjustment interval.
  • the following steps are performed cyclically in the current interval until it is determined whether the severity of each blood oxygen data acquired in the current adjustment interval triggers the condition for adjusting the inhaled oxygen concentration in advance.
  • Step 602 Determine whether the timing of the current adjustment interval has ended, and if so, determine that the condition for triggering the adjustment of the inhaled oxygen concentration in advance is not met. If not completed, acquire the next blood oxygen data, and execute step 603 .
  • Step 603 Compare the severity of the currently acquired blood oxygen data with the severity of the blood oxygen data of the reference blood oxygen partition, if the severity of the currently acquired blood oxygen data is greater than the severity of the blood oxygen data of the reference blood oxygen partition , go to step 604 ; if the severity of the currently acquired blood oxygen data is not greater than the severity of the blood oxygen data of the reference blood oxygen partition, go to step 605 .
  • step 603 it may also be determined that, based on the currently acquired blood oxygen data, the selected blood oxygen partition including the blood oxygen data with the most severe severity is determined as the designated blood oxygen partition within the current adjustment interval.
  • the severity of each currently obtained blood oxygen data is compared, and the selected blood oxygen partition including the blood oxygen data with the most serious severity is determined, which is used as the designated blood oxygen partition.
  • the selected blood oxygen partition including the blood oxygen data with the most serious severity is determined, which is used as the designated blood oxygen partition.
  • it can be understood as evaluating an overall blood oxygen partition to summarize the "more important blood oxygen partition events" in the adjustment interval.
  • Step 604 Accumulate the number of severity levels of the blood oxygen data acquired in the current adjustment interval that are greater than the severity of the blood oxygen data in the reference blood oxygen zone.
  • Step 605 Determine whether the current accumulated number exceeds the preset number, and if it exceeds, the condition for triggering the inhaled oxygen concentration in advance is met; if not, step 602 is performed.
  • step 605 the comparison with the previous adjustment interval is determined by judging the number of the blood oxygen data obtained in the current accumulated current adjustment interval whose severity is greater than the severity of the blood oxygen data in the reference blood oxygen partition. Whether there is an incremental change in the severity of the blood oxygen data, and whether the change is an incidental event. If the current accumulated number does not exceed the preset number, it may be an accidental event, or in other words, it has not reached the level of triggering the adjustment of the inhaled oxygen concentration in advance, then return to step 602 to continue to determine whether the timing of the current adjustment interval is End, if it ends, it means that it is in the state of normal adjustment of the inhaled oxygen concentration. If not finished, continue to acquire the next blood oxygen data.
  • the current accumulated number exceeds the preset number, it means that before the timing of the current interval expires, the level of triggering the adjustment of the inhaled oxygen concentration in advance has been reached, and the condition for triggering the inhaled oxygen concentration in advance is satisfied.
  • the preset number is 15. If the current accumulated number is 16, the condition for triggering the inhaled oxygen concentration in advance is met.
  • step 605 the determination is made based on the number of the blood oxygen data obtained in step 604 whose severity is greater than the severity of the blood oxygen data in the reference blood oxygen zone. It can be understood as:
  • the accumulated number it is determined whether the overall state of blood oxygen in the current adjustment interval has changed compared with the reference blood oxygen partition determined in the previous adjustment interval. If the severity of the accumulated blood oxygen data obtained in the current adjustment interval is greater than If the number of severity levels of the blood oxygen data in the reference blood oxygen zone is greater than the preset number, it means that the patient's blood oxygen state may deteriorate, which requires great attention, and the adjustment of the inhaled oxygen concentration can be triggered in advance.
  • the accumulated severity of the blood oxygen data acquired in the current adjustment interval is greater than the severity of the blood oxygen data in the reference blood oxygen zone and not greater than the preset number, it means that the blood oxygen state of the patient may be improving.
  • the timing of the current adjustment interval has not ended, continue to obtain the next blood oxygen data, continue to judge, until it is determined that the operation of adjusting the inhaled oxygen concentration can be triggered in advance or the timing ends, and the normal operation of adjusting the inhaled oxygen concentration is performed.
  • the designated blood oxygen partition of the current adjustment interval can be determined in real time while performing step 603, or after the current adjustment interval is timed, or preset.
  • the specified blood oxygen zone within the time period that determines the current conditioning interval.
  • the technical solution for judging whether the current accumulated number exceeds the preset number in step 605 can also be determined by judging the proportion of the severity of the currently acquired blood oxygen data greater than the severity of the blood oxygen data of the reference blood oxygen partition. It is specifically: based on the total number N of blood oxygen data that can be obtained at the current adjustment interval, and the number n of blood oxygen data currently obtained that is greater than the severity of the blood oxygen data of the reference blood oxygen zone, based on formula (1 ) to calculate to get the proportion K. It is determined whether the ratio exceeds the preset ratio, and if it exceeds, the condition for triggering the inhaled oxygen concentration in advance is satisfied; if not, step 602 is executed.
  • the minimum number of blood oxygen data that can be obtained in the current interval is 20, and the preset proportion is 60%.
  • the proportion K 50%, and the proportion K is less than 60%, which does not meet the conditions for triggering the inhaled oxygen concentration in advance.
  • the proportion K 65%, and the proportion K is greater than 60%, then the condition for triggering the inhaled oxygen concentration in advance is satisfied.
  • the second way is:
  • the first duration is less than the duration of the current adjustment interval, and may be an empirical value.
  • the condition for triggering the operation of adjusting the inhaled oxygen concentration in advance is also satisfied.
  • the first duration is 30 seconds.
  • the blood oxygen data was in the hypoxia zone for the last 30 seconds, after 30 seconds, it continued to deviate from the treatment target zone, and the severity increased. After another 30 seconds, it continued to deviate from the treatment target zone, and the severity continued to increase.
  • Pre-triggered conditions for regulating the operation of the inspired oxygen concentration are 30 seconds.
  • the third way is:
  • the third duration is greater than the second duration and less than or equal to the duration of the current adjustment interval.
  • half the duration of the regular adjustment interval may be used as the third duration.
  • the duration of the current adjustment interval is 120 seconds
  • the third duration is 60 seconds
  • the second duration is 15 seconds.
  • the hypoxia zone is further divided into mild hypoxia zone, moderate hypoxia zone and severe hypoxia zone.
  • the duration of the mild hypoxia zone does not exceed 15 seconds, it further deviates from the treatment target zone and moves to the moderate hypoxia zone, also in the duration of the moderate hypoxia zone. It did not exceed 15 seconds, and it shifted back to the mild hypoxia zone. This situation continued for more than 60 seconds.
  • the strategy is triggered in advance to regulate the inspired oxygen concentration.
  • the specific implementation process of the third mode is shown in FIG. 7 , including the following steps:
  • Step 701 Determine in real time whether the duration of the currently obtained blood oxygen data in the selected blood oxygen zone is less than or equal to the second duration, if not, clear the continuous timer and go to Step 702 ; if so, go to Step 706 .
  • Step 702 Determine whether the timing of the current adjustment interval has ended, and if so, it is determined that the condition for triggering the adjustment of the inhaled oxygen concentration in advance is not met. If not completed, acquire the next blood oxygen data, and execute step 703 .
  • Step 703 Compare the severity of the currently acquired blood oxygen data with the severity of the blood oxygen data of the reference blood oxygen partition, if the severity of the currently acquired blood oxygen data is greater than the severity of the blood oxygen data of the reference blood oxygen partition , go to step 704 ; if the severity of the currently acquired blood oxygen data is greater than the severity of the blood oxygen data of the reference blood oxygen partition, go to step 705 .
  • step 703 it may also be determined that, based on the currently acquired blood oxygen data, the selected blood oxygen partition including the blood oxygen data with the most severe severity is determined as the designated blood oxygen partition within the current adjustment interval.
  • Step 704 Accumulate the number of the severity of the blood oxygen data acquired in the current adjustment interval that is greater than the severity of the blood oxygen data of the reference blood oxygen zone.
  • Step 705 determine whether the current accumulated number exceeds the preset number, and if it exceeds, the condition for triggering the inhaled oxygen concentration in advance is met; if not, step 702 is performed.
  • Step 706 Continue timing, determine whether the duration of the continuous timing exceeds the third duration, if it exceeds, go to Step 707, if not, go to Step 701.
  • step 706 it is determined whether the duration of the continuous timing exceeds the third duration, because if the duration of the blood oxygen data in the selected blood oxygen zone where the blood oxygen data is continuously obtained within the current adjustment interval is less than or equal to the second duration, the situation is always occurring , indicating that the patient's blood oxygen fluctuation may be in a large and frequent state at this time, and the blood oxygen partition may be repeatedly changed. Therefore, it is necessary to judge the uncertainty of blood oxygen, that is, to judge whether the blood oxygen data is in the place where the blood oxygen data is. Whether the duration of the selected blood oxygen partition is less than or equal to the second duration has continued for the third duration, and if so, it means that the blood oxygen uncertainty occurs in the current adjustment interval, and the inhaled oxygen concentration also needs to be adjusted at this time.
  • Step 707 Adjust the inhaled oxygen concentration according to the adjustment strategy A corresponding to the uncertain blood oxygen trigger mode.
  • Step 707 is specifically implemented.
  • the process of adjusting the inhaled oxygen concentration according to the adjustment strategy A is shown in FIG. 8 , including the following steps:
  • Step 801 Accumulate and calculate the weights of each selected blood oxygen partition to obtain a total weight.
  • step 801 the divided blood oxygen zones are assigned values in advance, and each blood oxygen zone is assigned a weight coefficient.
  • the blood oxygen zones corresponding to different blood oxygen states have different weights, and the size of the weight is determined by the severity of the blood oxygen data.
  • the complete blood oxygen is divided into the treatment target zone, the severe hypoxia zone, the moderate hypoxia zone, the mild hypoxia zone, the severe hyperoxia zone, the moderate hyperoxia zone and the mild hyperoxia zone.
  • Weights +1, +2, +3 can be assigned to mild hypoxia, moderate hypoxia, and severe hypoxia, respectively, and mild, moderate, and severe hyperoxia. Given weights -1, -2, -3, those within the treatment target partition do not participate in the cumulative partition (or the cumulative weight is 0).
  • step 701 is executed to determine the cumulative calculation weight of each blood oxygen zone. value, the total weight is: 4.
  • performing 801 to accumulate and calculate the weights of each selected blood oxygen partition, and the time to obtain the total weight is the time recorded by the first timer exceeding the third duration in performing step 706 in FIG. 7 above.
  • step 706 the time recorded by the first timer exceeding the third duration is 20 seconds. Then, the weights of each selected blood oxygen zone accumulated here are the weights of the selected blood oxygen zone where the blood oxygen data obtained within the 20 seconds are located.
  • Step 802 Compare the total weight with the first weight threshold and the second weight threshold respectively. If the total weight is greater than or equal to the first weight threshold, go to step 803; if the total weight is less than or equal to the second weight threshold, go to step 804; if the total weight is less than the first weight threshold, it is greater than the second weight threshold, go to step 805.
  • the first weighted threshold is used to indicate the increase of the oxygen concentration and the first adjusted amount of the inspired oxygen concentration
  • the second weighted threshold is used to indicate the decreased oxygen concentration and the second adjusted amount of the inspired oxygen concentration
  • the first weighted threshold greater than the second weight threshold
  • the first intake oxygen concentration adjustment amount indicated by the first weight threshold value may be any adjustment amount from 1% to 5%.
  • the adjustment amount is not limited to this range.
  • the second inhaled oxygen concentration adjustment amount indicated by the second weight threshold value may be any adjustment amount among -1% to -5%.
  • the adjustment amount is not limited to this range.
  • Step 803 Determine to increase the adjustment amount of the first inspired oxygen concentration.
  • Step 804 Determine to reduce the second adjusted amount of the inspired oxygen concentration.
  • Step 805 Determine to maintain the current inspired oxygen concentration.
  • the first weighted threshold is 10
  • the first adjusted amount of the intake oxygen concentration indicated by the first weighted threshold is 1%
  • the second weighted threshold is -10
  • the second inhaled oxygen concentration adjustment amount indicated by the second weighted threshold is -1%
  • the time used to determine blood oxygen with uncertainty in the adjustment interval is 20 seconds.
  • the total weight value is less than the second weight value threshold value, then it is determined that the oxygen concentration needs to be reduced at this time, and the inspired oxygen concentration is reduced by 1% (-1%).
  • weight thresholds may be set based on the blood oxygen partition type, and corresponding weight thresholds may be set according to different weight thresholds. Different oxygen concentration adjustment amount. Then accumulate the weights corresponding to the selected blood oxygen partitions determined in the case of uncertain blood oxygen in the adjustment interval, and compare the accumulated results with multiple weight thresholds, and select different oxygen concentration adjustments according to the comparison. quantity.
  • the blood oxygen data in the selected blood oxygen zone is frequently changed within 20 seconds, and cannot be stabilized in one zone, and the calculation result of the total weight is greater than or equal to 30, It means that at least half of the blood oxygen data is located in the severe hypoxia zone. At this time, a 3% oxygen concentration adjustment is given, and the adjustment direction is oxygenation; if the calculation result of the total weight is between 20 and 30, it means that the current blood oxygen The data are mainly concentrated in the moderate hypoxia zone. At this time, a 2% oxygen concentration adjustment amount is given, and the adjustment direction is oxygenation.
  • the adjustment direction is oxygen reduction, and different oxygen concentration adjustment amounts and adjustment directions are given according to the comparison result between the total weight value and the weight threshold value.
  • the calculation result of the total weight is between -10 and 10
  • the current inhaled oxygen concentration is maintained, and the oxygen concentration is not adjusted.
  • the patient's blood oxygen data is outside the treatment target zone, even if the patient's blood oxygen data fluctuates frequently and the blood oxygen trend is unclear, it is still possible to determine the location of all blood oxygen data within the adjustment interval according to the The oxygen concentration of the blood determines the amount and direction of the adjustment of the oxygen concentration.
  • the calculation result of the total weight is between -10 and 10
  • the adjustment strategy A is used to first calculate the weight accumulation result of the blood oxygen partition determined in the current adjustment interval, and then determine the inspired oxygen concentration according to the accumulated result. Adjust the direction and amount of adjustment. Thus, the adjustment of the inspired oxygen concentration is completed.
  • the embodiment of the present application also discloses another method for adjusting the intake oxygen concentration.
  • the intake oxygen concentration includes the following steps:
  • Step 901 Determine whether valid blood oxygen data is obtained at the current adjustment interval. If the blood oxygen data is not obtained or the obtained blood oxygen data is invalid, continue to obtain blood oxygen data. If valid blood oxygen data is obtained, go to step 902 .
  • step 901 if the blood oxygen data cannot be obtained at the current adjustment interval, or the obtained blood oxygen data is invalid, that is, the blood oxygen data is not within the range of 0 to 100%, which is an invalid value, it means that the blood oxygen data cannot be obtained. Measure, and time it at this time. If the blood oxygen data is obtained within the current adjustment interval, and the obtained blood oxygen data is within the range of 0 to 100%, which is a valid value, it means that the blood oxygen data is measurable.
  • Step 902 Acquire the associated data that affects the blood oxygen reliability in the blood oxygen data, and determine whether the associated data meets the blood oxygen reliability requirement; if so, go to step 905 ; if not, go to step 903 .
  • step 902 if it is satisfied, it means that the blood oxygen data is credible, and if not, it means that the blood oxygen data is not credible.
  • the correlation data includes at least pulse rate and/or perfusion index and/or blood oxygen signal quality.
  • the blood oxygen signal quality in the correlated data is the comprehensive judgment result of the blood oxygen signal strength, time domain waveform, and frequency domain waveform.
  • the blood oxygen signal quality is low, it means that the blood oxygen signal strength is low, or the waveform disturbance is strong.
  • the pulse rate is lower than the pulse rate threshold; if so, the pulse rate does not meet the blood oxygen reliability requirement; if not, the pulse rate meets the blood oxygen reliability requirement, and the blood oxygen data is determined to be reliable data.
  • the associated data includes a perfusion index
  • the associated data includes blood oxygen signal quality, then:
  • the associated data includes pulse rate and perfusion index
  • the pulse rate determines whether the pulse rate is lower than the pulse rate threshold; if so, the pulse rate does not meet the blood oxygen reliability requirement; if not, the pulse rate meets the blood oxygen reliability requirement.
  • the perfusion index determines whether the perfusion index is lower than the perfusion index threshold; if so, the perfusion index does not meet the blood oxygen reliability requirement; if not, the perfusion index meets the blood oxygen reliability requirement.
  • the associated data includes any combination of pulse rate, perfusion index and blood oxygen signal quality, for example: pulse rate and blood oxygen signal quality; or, perfusion index and blood oxygen signal quality; or, pulse rate, perfusion index and blood oxygen signal quality; or, pulse rate, perfusion index and
  • pulse rate perfusion index
  • the blood oxygen signal quality is determined, when the judgment for any data in the combination is no, it is determined that the blood oxygen data is reliable data, and if the judgment for any data in the combination is yes, it is determined that the blood oxygen data is not reliable.
  • Step 903 judging whether the result of the unreliable blood oxygen data is continuous and the duration of continuous occurrence exceeds the fourth duration, if yes, go to step 904 , if not, continue to acquire blood oxygen data, and go to step 902 .
  • the reason for performing step 903 is that because the blood oxygen data is unreliable, the automatic adjustment of the inhaled oxygen concentration is in an unadjustable state for a long time, which will cause more serious problems. Therefore, an alarm prompt and manual intervention are required.
  • the unreliable result of the blood oxygen data determined in step 903 when the associated data of the unreliable result is different, that is, any one or combination of pulse rate, perfusion index and blood oxygen signal quality, according to the correlation The content contained in the data is different.
  • the fourth time period for determining whether to perform the operation of prompting the user to adjust the current state may be different.
  • Step 904 Execute an alarm operation.
  • the alarm operation mainly prompts the user that the current automatic adjustment of the inhaled oxygen concentration is in a suspended state.
  • the form of prompting the user of the current adjustment state of the oxygen concentration of the inhaled oxygen should at least include prompts through character strings and/or graphics and/or sounds.
  • the content of the prompt should include the current adjustment state and/or the reasons for the current adjustment state. When multiple conditions are satisfied at the same time, all reasons can be prompted, or you can choose to prompt according to the built-in condition priority, and prompt the cause with the highest priority.
  • the user may be prompted that the current automatic adjustment of the inhaled oxygen concentration is in a suspended state through an alarm string, an alarm sound, and a detailed string displayed on the system operation interface.
  • the reason for the suspension state may be prompted to the user according to the judgment result of the associated data used in judging whether the blood oxygen data is credible.
  • the user will be prompted that "the current adjustment is paused because the perfusion index is too low for a long time".
  • the prompt words displayed on the specific system operation interface can be set by a technician.
  • the prompt priority of the blood oxygen signal quality is higher than that of the perfusion index, it can prompt "the current adjustment is suspended, and the reason for the suspension is that the perfusion index is too low for a long time".
  • the user can be authorized or started to manually set the inhaled oxygen concentration.
  • the function of automatically adjusting the inhaled oxygen concentration will inform the user that the current automatic adjustment is suspended due to some factors.
  • the user can manually set a new inhaled oxygen concentration until the blood oxygen data is restored to be credible.
  • the system can use the new inhaled oxygen concentration manually set by the user as the control value, and continue to adjust on the basis of the control value; The concentration is used as the control value, and the subsequent adjustment is continued on the basis of the control value.
  • any control value of the inhaled oxygen concentration disclosed in the above-mentioned embodiment of the present application will be displayed on the user interface of the system, prompting the user that the current automatic Control value result for adjusted inspired oxygen concentration.
  • the user can also manually set the inhaled oxygen concentration.
  • the inhaled oxygen concentration manually set by the user during the automatic adjustment of the inspiratory oxygen concentration the automatic adjustment of the inspiratory oxygen concentration will continue to adjust the inhaled oxygen concentration newly set by the user.
  • the inhaled oxygen concentration can be changed manually by setting the inhaled oxygen concentration; After the automatic adjustment of the inhaled oxygen concentration is enabled, the inlet of the original manual setting of the oxygen concentration displays the result of the inhaled oxygen concentration of the current automatic adjustment of the inspiratory oxygen concentration.
  • the user operation interface and the display interface of the system can be set separately or combined.
  • the area where the user manually sets the inhaled oxygen concentration can be separated from the display area of the automatically adjusted inhaled oxygen concentration results.
  • the user only sets the inhaled oxygen concentration from one inlet, and reads the automatically adjusted inhaled oxygen concentration from the other inlet. result of oxygen concentration.
  • Step 905 Determine the blood oxygen zone corresponding to each blood oxygen data.
  • step 905 and the involved blood oxygen partition are the same as the execution principle and involved blood oxygen partition of step 101.
  • step 101 please refer to the above description of step 101, which will not be repeated here.
  • Step 906 Determine whether the severity of each blood oxygen data meets the condition for triggering the adjustment of the inhaled oxygen concentration in advance, if yes, go to Step 907 ; if not, go to Step 908 .
  • Step 907 Execute the operation of adjusting the intake oxygen concentration in advance under the condition that the adjustment of the intake oxygen concentration is triggered in advance.
  • Step 908 After the timing of the current adjustment interval expires, the operation of adjusting the inhaled oxygen concentration is normally performed.
  • steps 906 to 908 are the same as the execution principles of the foregoing steps 102 to 104.
  • steps 102 to 104 please refer to the above descriptions about the steps 102 to 104, which will not be repeated here.
  • the judgment of the reliability of the blood oxygen data is increased, and the change of the severity of the credible blood oxygen data is used to make a response to whether to trigger the adjustment of the inhaled oxygen concentration in advance.
  • the inhaled oxygen concentration is adjusted in time based on the adjustment strategy corresponding to the blood oxygen change trend in the current adjustment interval.
  • the system operating state can also be acquired in parallel to determine whether the system operating state is not. An operation in a normal operating state.
  • system operating state is in the normal operating state, it means that there is no state that may affect the normal operation of the system. If it is satisfied, it means that the system operating state is normal;
  • the abnormal operating state includes the failure of the respiratory support equipment, the abnormal state of the connection between the equipment and the patient, etc., at least including the equipment's abnormality in pressure, flow rate control or monitoring, the equipment mixing air and oxygen to generate new oxygen Abnormality of the concentration gas control process, abnormality of the equipment's monitoring function of the gas oxygen concentration, excessive gas leakage or blockage during the gas supply process, and disconnection of the gas supply pipeline between the equipment and the patient.
  • the first blood oxygen type indicated by the designated blood oxygen zone and the second blood oxygen type indicated by the reference blood oxygen zone are determined.
  • the blood oxygen types include at least severe hypoxia, severe hyperoxia, moderate hypoxia, moderate hyperoxia, mild hypoxia, mild hyperoxia, and normal state.
  • the blood oxygen type can be determined by the blood oxygen saturation range of the blood oxygen zone.
  • the current blood oxygen variation trend can be obtained according to the first blood oxygen type indicated by the designated blood oxygen zone and the second blood oxygen type indicated by the reference blood oxygen zone.
  • the first blood oxygen type is severe hypoxia or severe hyperoxia
  • it is determined that the blood oxygen change trend in the current adjustment interval is the blood oxygen deterioration trend.
  • the blood oxygen change trend in the current adjustment interval is the blood oxygen deterioration trend.
  • the blood oxygen change trend in the current adjustment interval is the blood oxygen stability trend.
  • the blood oxygen change trend within the current adjustment interval is the blood oxygen improvement trend.
  • the judgment of the first blood oxygen type in this embodiment of the present application may be performed from severe to mild or from mild to severe.
  • the following is just an example.
  • FIG. 10 a A schematic flow chart of analyzing the trend of blood oxygen changes, including the following steps:
  • Step 1001 Acquire a first blood oxygen type corresponding to a specified blood oxygen zone and a second blood oxygen type corresponding to a reference blood oxygen zone.
  • Step 1002 Determine whether the first blood oxygen type is severe hypoxia, and if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen deterioration trend; if not, go to step 1003.
  • Step 1003 Determine whether the first blood oxygen type is severe peroxygen, and if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen deterioration trend; if not, go to step 1004.
  • the first blood oxygen type indicated by the control blood oxygen zone is severe hypoxia or severe hyperoxia: it is determined that the blood oxygen change trend in the current adjustment interval is the blood oxygen deterioration trend.
  • Step 1004 determine whether the first blood oxygen type is moderate hypoxia, and if so, execute the blood oxygen trend analysis under moderate hypoxia; if not, execute step 1005 .
  • the blood oxygen trend analysis under moderate hypoxia is shown in Figure 11, and mainly includes the following steps:
  • Step 1101 Determine whether the second blood oxygen type is severe hypoxia, and if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen improvement trend; if not, go to step 1102.
  • Step 1102 Determine whether the second blood oxygen type is moderate hypoxia, if yes, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen stability trend; if not, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen worsening trend.
  • step 1102 is performed on the basis of first performing step 1101 to determine that the second blood oxygen type is not severe hypoxia, and it is obtained that the second blood oxygen type is not moderate hypoxia, then it can be obtained that the second blood oxygen type may be mild.
  • severe hypoxia or normal state the blood oxygen state is in a worsening trend relative to the moderate hypoxia indicated by the current first blood oxygen type.
  • Step 1005 Determine whether the first blood oxygen type is moderate hyperoxia, and if so, execute the blood oxygen trend analysis under the moderate hyperoxia; if not, execute step 1006 .
  • the blood oxygen trend analysis under moderate superoxidation is shown in FIG. 12 , which mainly includes the following steps:
  • Step 1201 Determine whether the second blood oxygen type is severe peroxygen, and if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen improvement trend; if not, go to step 1202 .
  • Step 1202 Determine whether the second blood oxygen type is moderate hyperoxia, if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen stability trend, if not, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen worsening trend.
  • step 1202 is performed on the basis of first performing step 1201 to determine that the second blood oxygen type is not severe peroxygen, and it is obtained that the second blood oxygen type is not moderate peroxidation, then it can be obtained that the second blood oxygen type may be light.
  • Peroxygen or normal state the blood oxygen state is in a worsening trend relative to the moderate superoxygen indicated by the current first blood oxygen type.
  • Step 1006 Determine whether the first blood oxygen type is mild hypoxia, and if so, execute the blood oxygen trend analysis under mild hypoxia; if not, execute Step 1007 .
  • the blood oxygen trend analysis under mild hypoxia is shown in FIG. 13 , which mainly includes the following steps:
  • Step 1301 Determine whether the second blood oxygen type is severe hypoxia or moderate hypoxia, if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen improvement trend; if not, go to step 1302.
  • Step 1302 Determine whether the second blood oxygen type is mild hypoxia, if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen stable trend; if not, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen worsening trend.
  • the second blood oxygen type can be obtained.
  • the blood oxygen type may be in a normal state, and the blood oxygen state is in a worsening trend relative to the mild hypoxia indicated by the current first blood oxygen type.
  • Step 1007 Determine whether the first blood oxygen saturation is mild peroxidation, and if so, perform the blood oxygen trend analysis under mild peroxidation; if not, determine the control blood oxygen partition as the treatment target partition.
  • the blood oxygen trend analysis under mild peroxidation is shown in FIG. 14 , which mainly includes the following steps:
  • Step 1401 Determine whether the second blood oxygen type is severe or moderate hyperoxia, and if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen improvement trend; if not, go to step 1402 .
  • Step 1402 Determine whether the second blood oxygen type is mild peroxidation, if so, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen stable trend; if not, determine that the blood oxygen change trend in the current adjustment interval is the blood oxygen worsening trend.
  • the second blood oxygen type can be obtained.
  • the blood oxygen type may be in a normal state, and the blood oxygen state is in a worsening trend relative to the mild hypoxia indicated by the current first blood oxygen type.
  • the corresponding adjustment strategy B or C is determined based on the blood oxygen change trend.
  • the situation where the adjustment strategy B needs to be implemented is: the current change of the patient's blood oxygen is characterized by that the blood oxygen data continues to change in the direction of deviating from the treatment target zone, but the patient's blood oxygen level is not too dangerous.
  • the adjustment strategy B is: according to the blood oxygen data in the designated blood oxygen zone, the offset of the upper and lower blood oxygen data boundaries of the treatment target zone, the blood oxygen change rate when the inhaled oxygen concentration was adjusted last time, and the preset maximum single oxygen concentration adjustment amount to obtain the first oxygen concentration target adjustment amount; when the first oxygen concentration target adjustment amount is less than or equal to the preset maximum single oxygen concentration adjustment amount, the inhaled oxygen concentration is adjusted with the first oxygen concentration target adjustment amount; When the target adjustment amount of oxygen concentration is greater than the preset maximum single oxygen concentration adjustment amount, adjust the inhaled oxygen concentration with the preset maximum single oxygen concentration adjustment amount, and compare the first oxygen concentration target adjustment amount with the preset maximum single oxygen concentration The difference of the adjustment amount is added to the accumulated adjustment amount of the designated blood oxygen zone as the remaining adjustment amount.
  • the preset maximum single oxygen concentration adjustment amount can be built in the machine by the medical staff according to the type of the patient.
  • the preset maximum single oxygen concentration adjustment amount can be correspondingly set to different adjustment amounts based on different types of patients.
  • the preset maximum single-time oxygen concentration adjustment amount is set to 3%.
  • the preset maximum single oxygen concentration adjustment amount is set to 4%.
  • the preset maximum single oxygen concentration adjustment amount is set to 6%.
  • the cumulative adjustment added to the specified blood oxygen zone is used to calculate the target adjustment for the next adjustment interval. That is, if there is an accumulated adjustment amount in the designated blood oxygen zone where the inspired oxygen concentration needs to be adjusted in the next adjustment interval, if the adjustment is still performed in the designated blood oxygen zone in the next adjustment interval, the accumulated adjustment amount of the designated blood oxygen zone will be used. It is accumulated into the target adjustment amount, and the accumulated target adjustment amount is compared with the preset maximum single-time oxygen concentration adjustment amount.
  • the current patient's blood oxygen change is characterized by the fact that the blood oxygen zone where the blood oxygen data is located is far from the treatment target zone, indicating that the patient's current blood oxygen situation is not optimistic.
  • the adjustment strategy C is: adjust the inhaled oxygen concentration according to the preset maximum single oxygen concentration adjustment amount, and change the duration of the next adjustment interval to a fifth duration.
  • the fifth duration is less than the duration of the regular adjustment interval.
  • Adjustment strategy C adopts a shorter adjustment interval to adjust the inspired oxygen concentration according to a fixed oxygen concentration adjustment amount.
  • the oxygen concentration adjustment can be achieved more quickly.
  • the process of adjusting the inhaled oxygen concentration according to the adjustment strategy B or C, as shown in FIG. 15 includes:
  • Step 1501 Analyze whether the deterioration trend of the blood oxygen deterioration trend is severe hypoxia or severe hyperoxia, if yes, go to step 1502; if not, go to steps 1503 and 1504.
  • Step 1502 Change the duration of the current adjustment interval to a fifth duration, and adjust the inhaled oxygen concentration according to the preset maximum single oxygen concentration adjustment amount.
  • Step 1502 corresponds to the adjustment strategy C. Execute the adjustment strategy C, and adjust based on the preset maximum single oxygen concentration adjustment amount until the target adjustment amount is completed, or until a new, smaller target adjustment amount is generated.
  • Step 1503 Calculate the difference between the blood oxygen saturation in the designated blood oxygen zone and the upper limit blood oxygen saturation in the treatment target zone to obtain a first difference.
  • the blood oxygen saturation in the designated blood oxygen zone is the blood oxygen data in the designated blood oxygen zone, and the blood oxygen data can be represented by the blood oxygen saturation.
  • the designated blood oxygen partition refers to a selected blood oxygen partition that includes the blood oxygen data with the most severe severity in the current interval, and the blood oxygen data with the most severe severity is acquired in the current interval.
  • the difference between the blood oxygen data in the designated blood oxygen zone and the upper limit blood oxygen data of the treatment target zone can also be calculated to obtain the first difference.
  • Step 1504 Calculate the difference between the first blood oxygen saturation and the lower limit blood oxygen saturation of the treatment target zone to obtain a second difference.
  • Step 1505 Calculate according to the blood oxygen change rate, the first difference and the second difference when adjusting the inhaled oxygen concentration in the previous time to obtain the first oxygen concentration target adjustment amount.
  • Step 1506 Compare the size of the first oxygen concentration target adjustment amount with the preset maximum single oxygen concentration adjustment amount, if the first oxygen concentration target adjustment amount is greater than the preset maximum single oxygen concentration adjustment amount, perform step 1507; The target adjustment amount of the oxygen concentration is not greater than the preset maximum single oxygen concentration adjustment amount, and step 1509 is executed.
  • Step 1507 Adjust the inhaled oxygen concentration according to the preset maximum single oxygen concentration adjustment amount, and obtain the remaining amount obtained by subtracting the preset maximum single oxygen concentration adjustment amount from the first oxygen concentration target adjustment amount.
  • Step 1508 Add the remaining amount to the accumulated adjustment amount of the designated blood oxygen zone.
  • step 1508 the remaining amount is added to the accumulated adjustment amount of the designated blood oxygen zone, so that the adjustment amount of the designated blood oxygen zone will be used when calculating the target adjustment amount of the designated blood oxygen zone in the next adjustment interval.
  • the first oxygen concentration target adjustment amount is 8% according to the blood oxygen change rate, the first difference and the second difference in the previous adjustment of the inhaled oxygen concentration, and the preset maximum single oxygen concentration adjustment amount is 8%, the current interval adopts 5%, the remaining amount is 3%, and the remaining amount 3% is added to the cumulative adjustment amount of the designated blood oxygen zone.
  • a 3% adjustment amount needs to be accumulated. If the accumulated first oxygen concentration target adjustment amount is still greater than the preset maximum single oxygen concentration Adjustment amount, continue to adjust with the preset maximum single oxygen concentration adjustment amount, and add the remaining amount this time to the cumulative adjustment amount of the designated blood oxygen zone. And so on until the adjustment is completed.
  • Step 1509 Adjust the intake oxygen concentration according to the first oxygen concentration target adjustment amount.
  • Steps 1503 to 1509 correspond to the adjustment strategy B, and the intake oxygen concentration is adjusted based on the first oxygen concentration target adjustment amount until the target adjustment amount is completed, or until a new, smaller target adjustment amount is generated.
  • the coefficients used to calculate the target adjustment amount are also different under the results of the overall division of blood oxygen in different current intervals.
  • the coefficient when the overall division of blood oxygen in the current interval is "moderate hypoxia” will be larger than the coefficient when the overall division is "mild hypoxia", so as to obtain a larger adjustment amount, thereby ensuring that in In different degrees of hypoxia or hyperoxia, the intensity of the adjustment of the inspired oxygen concentration is different.
  • a corresponding adjustment strategy D is determined based on the blood oxygen change trend.
  • the situation that the adjustment strategy D needs to be implemented is: the blood oxygen data of the patient is continuously stable within a blood oxygen partition indicating the current blood oxygen change trend, the blood oxygen data remains unchanged or changes in the direction of the treatment target partition, but still not Conditions within the therapeutic target zone.
  • the adjustment strategy D is: obtain the adjustment amount for adjusting the inhaled oxygen concentration within the adjustment interval when the last blood oxygen change trend is the blood oxygen stability trend or the blood oxygen improvement trend, and then increase the preset adjustment amount on the basis of the adjustment amount to obtain The second oxygen concentration target adjustment amount, and the intake oxygen concentration is adjusted based on the second oxygen concentration target adjustment amount.
  • the second oxygen concentration target adjustment amount is not greater than the preset minimum oxygen concentration adjustment amount.
  • the adjustment strategy D every time an adjustment interval in which the blood oxygen change trend is the blood oxygen stability trend or the blood oxygen improvement trend is experienced, a small preset adjustment is accumulated on the basis of the adjustment amount of the adjustment interval in the same situation last time. until the accumulated result exceeds the preset minimum oxygen concentration adjustment amount.
  • the preset minimum oxygen concentration adjustment amount represents the minimum oxygen concentration setting value that can be distinguished by the machine when adjusting the inspired oxygen concentration.
  • the minimum oxygen concentration setting value is usually 1%.
  • the preset adjustment amount used for accumulative use in the adjustment strategy D may also select adjustment amounts of different sizes according to the current overall division of blood oxygen. For example, for a patient whose blood oxygen is in a "mild hypoxia" state for a long time, a 0.5% adjustment amount will be accumulated in each adjustment cycle; for a patient whose blood oxygen is in a "moderate hypoxia” state for a long time, the In other words, an adjustment amount of 0.67% will be accumulated in each adjustment cycle.
  • the adjustment strategy D is executed to adjust the inspired oxygen concentration
  • the designated blood oxygen zone to be adjusted at this time also has the unfinished remaining amount of the previous adjustment cycle described in the adjustment strategy B, and the adjustment strategy D is executed. , the accumulated adjustment amount and the remaining adjustment amount will be added together for the inspired oxygen concentration.
  • a corresponding adjustment strategy E is determined based on the blood oxygen change trend.
  • the situation where the adjustment strategy E needs to be implemented is: the patient's blood oxygen data is continuously stable within a blood oxygen zone indicating the current blood oxygen change trend, but the blood oxygen data changes in a direction deviating from the treatment target zone, and is still not in the treatment target. situation within the partition.
  • the blood oxygen data of the patient may continue to change in the direction of deviating from the treatment target zone, but because the blood oxygen data still does not deviate from the current designated area.
  • the current offset is small, but the offset may indicate that the patient's blood oxygen status may be further deteriorated, so the adjustment strategy E is implemented.
  • the adjustment strategy E is as follows: based on the blood oxygen data in the designated blood oxygen partition, the offset of the upper and lower blood oxygen data boundaries of the treatment target partition and the cumulative adjustment amount of the designated blood oxygen partition, the third oxygen concentration target adjustment amount is obtained, based on The third oxygen concentration target adjustment amount adjusts the inhaled oxygen concentration.
  • the cumulative adjustment amount of the designated blood oxygen zone may be the adjustment amount accumulated in the designated blood oxygen zone for multiple adjustment intervals.
  • a corresponding adjustment strategy F or G is determined based on the blood oxygen change trend.
  • the situation that the adjustment strategy F or G needs to be executed is: the patient is in the treatment target zone for a long time, and the blood oxygen data of the patient is normal.
  • the use of oxygen can be reduced while ensuring that the patient's blood oxygen data is within the target range.
  • the dependence of the patient on oxygen concentration can be reduced, and the weaning can be assisted.
  • the process of adjusting the inhaled oxygen concentration according to the adjustment strategy F or G includes:
  • the region of the treatment target zone includes at least a downstream region, a midstream region and an upstream region;
  • the adjustment strategy F is executed, the first timer is started, and when the first timer ends, the inhaled oxygen concentration is reduced according to the preset minimum oxygen concentration adjustment amount.
  • the adjustment strategy G is executed, the second timing is started, and when the second timing ends, the inhaled oxygen concentration is reduced according to the preset minimum oxygen concentration adjustment amount.
  • the second timing is greater than the first timing.
  • the first timing and the second timing may be positive timings or countdown timings.
  • the timing is alternately used, and the timing is suspended when the blood oxygen data of the patient appears in the downstream area. Therefore, for patients whose blood oxygen data is maintained in the midstream region of the treatment target zone for a long time, deoxygenation will be triggered after a long period of observation. For patients whose blood oxygen data is maintained in the upstream region of the treatment target zone for a long time, the observation time for triggering deoxygenation will be shortened, thereby preventing the patient's blood oxygen data from further deviating from the upper limit of the treatment target zone.
  • the first timing and the second timing may be set by medical staff according to experience, or may be set differently by medical staff according to patient types.
  • the duration of the first timing may be set to 90 seconds.
  • the automatically adjusted inhaled oxygen concentration is adjusted within the range of the inhaled oxygen concentration set by the user, that is, the adjustment result will not exceed the user The set range, but in some cases, the upper limit of the inhaled oxygen concentration set by the user is too low. In this case, after the automatic adjustment function is adjusted to the upper limit, the patient's blood oxygen is still lower than the target, and the oxygen concentration set by the user will be exceeded. The upper concentration limit continues to adjust the oxygen concentration upwards.
  • the user can set the range of the oxygen concentration in the automatic adjustment process, that is, the result of the automatic adjustment of the oxygen concentration will be guaranteed to be within the set range, thereby improving the safety of the process.
  • the inhaled oxygen concentration range includes two values: a lower limit value of the oxygen concentration range and an upper limit value of the oxygen concentration range.
  • the user when the result of automatic adjustment of the inhaled oxygen concentration has reached the upper limit of the oxygen concentration range set by the user, and the patient's blood oxygen data is still lower than the treatment target zone, and continues for more than the fifth time period, the user will be prompted to appear in the above state.
  • the prompting methods include, but are not limited to, the methods of appearing character strings, graphic indications, and sounds on the user interface.
  • the inspired oxygen concentration can be temporarily adjusted without being limited by the upper limit of the inspired oxygen concentration range set by the user.
  • the severity of the blood oxygen state of the patient is identified by the change in the severity of the blood oxygen state of the blood oxygen zone where the blood oxygen data is located, so that the subsequent adjustment of the inhaled oxygen concentration is performed.
  • different adjustment strategies can be determined according to the severity of the blood oxygen state corresponding to the blood oxygen zone, and the inhaled oxygen concentration should be adjusted in time according to the corresponding adjustment strategy.
  • the purpose of adjusting the inhaled oxygen concentration when the patient's blood oxygen changes rapidly can be achieved more accurately and quickly.
  • an embodiment of the present application also discloses a respiratory support device.
  • the respiratory support device may be a ventilator.
  • FIG. 16 it is a schematic structural diagram of a respiratory support device disclosed in an embodiment of the present application.
  • the respiratory support device 1600 includes a ventilation device 1601 and a processor 1602 .
  • the ventilation device 1601 is used to provide inhaled gas to the patient through a breathing circuit and breathing accessories, and the inhaled gas is oxygen-containing gas.
  • the breathing circuit consists of an expiratory branch and an inspiratory branch.
  • the breathing accessory includes at least a pneumatic system and a patient interface, and the patient interface is mostly a mask. Specifically, one end of the pneumatic system of the ventilation device 1601 is signally connected to the processor 1602, and the other end is connected to the patient interface through the expiratory branch and the inspiratory branch.
  • the processor 1602 is in signal connection with the ventilation device 1601 to control the flow of inspiratory gas provided by the ventilation device 1601 to the patient.
  • the processor 1602 is configured with a sensor itself, or is interconnected with an external detection device.
  • the external detection device in one embodiment, may be a pulse oximeter, a monitor, or the like.
  • the processor 1602 acquires blood oxygen data based on a sensor configured by itself or through an interconnected external detection device.
  • the processor 1602 is configured to determine the blood oxygen partition corresponding to each blood oxygen data, and the blood oxygen partition is pre-divided based on the blood oxygen saturation.
  • the processor 1602 is configured to acquire each blood oxygen data of the current adjustment interval in real time, and determine the selected blood oxygen zone in which each blood oxygen data is located. Determine whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance, the severity refers to the degree to which the blood oxygen data deviates from the treatment target zone, and the conditions for the early triggering of the adjustment of the inhaled oxygen concentration include that the severity tends to increase , the selected blood oxygen partition and the treatment target partition each correspond to a pre-divided blood oxygen data range.
  • the processor 1602 may be a host computer, a controller, or a control device in a ventilator.
  • the processor 1602 that performs the operation of adjusting the inhaled oxygen concentration is specifically used for:
  • the designated blood oxygen partition refers to the selected blood oxygen partition that contains the blood oxygen data with the most severe severity in each blood oxygen partition determined in the current adjustment interval;
  • the blood oxygen change trend is determined based on the specified blood oxygen zone, and the inhaled oxygen concentration is adjusted according to the adjustment strategy corresponding to the blood oxygen change trend.
  • the processor 1602 for judging whether the severity of each blood oxygen data satisfies the condition for triggering the adjustment of the inhaled oxygen concentration in advance is specifically used for:
  • the severity of the blood oxygen data acquired in the current adjustment interval is compared in real time with the severity of the blood oxygen data of the reference blood oxygen zone.
  • the severity of the blood oxygen data obtained in the current adjustment interval is greater than the severity of the blood oxygen data of the reference blood oxygen zone exceeds the preset number, which meets the requirements for triggering the adjustment of the inhaled oxygen concentration in advance. conditions, otherwise, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are not met.
  • the processor 1602 for judging whether the severity of each blood oxygen data satisfies the condition for triggering the adjustment of the inhaled oxygen concentration in advance is specifically used for:
  • the severity of the blood oxygen data corresponding to each acquired blood oxygen data is continuously increased every first time length, and the first time length is less than the time length of the current adjustment interval. If there is a continuous increase, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are met; otherwise, the conditions for triggering the adjustment of the inhaled oxygen concentration in advance are not met.
  • the processor 1602 is also used for:
  • the adjustment of the inhaled oxygen concentration is triggered according to the adjustment strategy corresponding to the uncertain blood oxygen trigger mode, otherwise, it is continued to judge whether the severity of each blood oxygen data meets the conditions for triggering the adjustment of the inhaled oxygen concentration in advance.
  • triggering the processor 1602 for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the uncertain blood oxygen triggering mode is specifically used for:
  • the total weight is compared with the first weight threshold and the second weight threshold, the first weight threshold is used to indicate the increase of the oxygen concentration and the adjustment amount of the first inspired oxygen concentration, and the second weight threshold is used to indicate The oxygen concentration and the second inspired oxygen concentration adjustment amount are reduced, and the first weighted threshold is greater than the second weighted threshold.
  • the total weight is greater than or equal to the first weight threshold, it is determined to increase the first inspired oxygen concentration adjustment amount.
  • the total weight is less than or equal to the second weight threshold, it is determined to reduce the second adjusted amount of the inspired oxygen concentration.
  • the adjustment amount for maintaining the current inspired oxygen concentration is determined.
  • the processor 1602 is also used for:
  • each blood oxygen data obtained by the obtaining device After receiving each blood oxygen data obtained by the obtaining device, obtain the associated data in the blood oxygen data that affects the blood oxygen reliability; determine whether the associated data meets the blood oxygen reliability requirements; if so, determine that the blood oxygen data corresponds to If not satisfied, continue to obtain blood oxygen data.
  • the processor 1602 for judging whether the correlated data meets preset requirements is specifically used for:
  • the pulse rate change rate is higher than the pulse rate change rate threshold, the pulse rate does not meet the blood oxygen confidence requirement, otherwise, the pulse rate meets the blood oxygen reliability requirement; and/or,
  • the pulse rate is lower than the pulse rate threshold, the pulse rate does not meet the blood oxygen confidence requirement, otherwise, the pulse rate meets the blood oxygen confidence requirement; and/or,
  • the perfusion index is lower than the perfusion index threshold, the perfusion index does not meet the blood oxygen confidence requirement, otherwise, the perfusion index meets the blood oxygen confidence requirement; and/or,
  • the blood oxygen signal quality is lower than the blood oxygen signal quality threshold, the blood oxygen signal quality does not meet the blood oxygen reliability requirements; otherwise, the blood oxygen signal quality meets the blood oxygen reliability requirements.
  • the processor 1602 is also used for:
  • the processor 1602 is also used for:
  • the acquisition of blood oxygen data is triggered, and an alarm message for suspending the adjustment of the inhaled oxygen concentration is generated.
  • the processor 1602 for determining the blood oxygen change trend based on the specified blood oxygen zone is specifically used for:
  • the first blood oxygen type is severe hypoxia or severe hyperoxia, it is determined that the blood oxygen change trend within the current adjustment interval is the blood oxygen deterioration trend;
  • the blood oxygen type at least includes severe hypoxia Oxygen, Severe Peroxidation, Moderate Hypoxia, Moderate Peroxidation, Mild Hypoxia, Mild Peroxidation and Normal State;
  • the first blood oxygen type and the second blood oxygen type are consistent and neither is severe hypoxia or severe hyperoxia, determining that the blood oxygen change trend within the current adjustment interval is a blood oxygen stability trend;
  • the blood oxygen change trend within the current adjustment interval is a blood oxygen improvement trend.
  • the processor 1602 that determines the blood oxygen change trend based on the designated blood oxygen partition can also execute the method for determining the blood oxygen change trend based on the designated blood oxygen partition disclosed in the above embodiments of the present invention.
  • the processor 1602 for adjusting the inhaled oxygen concentration according to the adjustment strategy is specifically used for:
  • the adjustment amount is correspondingly set to different adjustment amounts based on different patient types, and the fifth duration is less than the duration of the regular adjustment interval;
  • the first oxygen concentration target adjustment amount is greater than the preset maximum single oxygen concentration adjustment amount, adjust the inhaled oxygen concentration with the preset maximum single oxygen concentration adjustment amount, and compare the first oxygen concentration target adjustment amount with the preset maximum single oxygen concentration adjustment amount
  • the difference between the oxygen concentration adjustment amounts is added to the accumulated adjustment amount of the designated blood oxygen zone as the remaining adjustment amount.
  • the processor for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
  • the offset of the upper and lower blood oxygen data boundaries of the target zone becomes smaller or unchanged, and the blood oxygen change trend in the last time is the difference between the blood oxygen stability trend or the blood oxygen improvement trend.
  • a preset adjustment amount is added to obtain a second oxygen concentration target adjustment amount, and the intake oxygen concentration is adjusted based on the second oxygen concentration target adjustment amount, and the second oxygen concentration target adjustment amount The adjustment amount is not greater than the preset minimum oxygen concentration adjustment amount.
  • the processor 1602 for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
  • the offset of the upper and lower blood oxygen data boundaries of the treatment target zone is offset based on the blood oxygen data in the specified blood oxygen zone.
  • the shift amount and the accumulated adjustment amount of the designated blood oxygen zone are obtained to obtain a third oxygen concentration target adjustment amount, and the inhaled oxygen concentration is adjusted based on the third oxygen concentration target adjustment amount.
  • the processor 1602 for adjusting the inhaled oxygen concentration according to the adjustment strategy corresponding to the blood oxygen change trend is specifically used for:
  • the zone where the blood oxygen data is located in the treatment target zone determine the zone where the blood oxygen data is located in the treatment target zone, and the zone includes at least the downstream zone, the midstream zone and the upstream zone;
  • the blood oxygen data is in the midstream region, start the first timer, and when the first timer ends, adjust the inhaled oxygen concentration according to the preset minimum oxygen concentration adjustment amount;
  • a second timer is started, and when the second timer ends, the inhaled oxygen concentration is adjusted according to the preset minimum oxygen concentration adjustment amount, and the second timer is greater than the first timer.
  • the processor 1602 acquires the blood oxygen data of the patient in real time based on the self-configured sensor or an interconnected external detection device, and controls the ventilation device 1601 to a fixed value according to the blood oxygen data. At intervals, the inhaled oxygen concentration adjustment operation is performed periodically to adjust the oxygen concentration in the inhaled gas.
  • the processor 1602 is configured to determine the blood oxygen partition corresponding to the blood oxygen data of the patient acquired in real time within the current inhaled oxygen concentration adjustment cycle; the blood oxygen partition is obtained by pre-dividing according to the blood oxygen saturation, and includes a treatment target partition.
  • the treatment target zone is the treatment target zone.
  • the processor 1602 is configured to determine the blood oxygen change trend of the patient according to the blood oxygen zone corresponding to the patient's real-time blood oxygen data; when it is determined that the patient's blood oxygen change trend is gradually deviating from the treatment target zone, the inhaled oxygen concentration adjustment operation is performed in advance , to adjust the patient's blood oxygen level to the therapeutic target zone.
  • the severity of the blood oxygen state of the patient is identified by the change in the severity of the blood oxygen state of the blood oxygen zone where the blood oxygen data is located, so that when the subsequent operation of adjusting the inhaled oxygen concentration is performed, Different adjustment strategies can be determined according to the severity of the blood oxygen state corresponding to the blood oxygen zone, and the inhaled oxygen concentration should be adjusted in time according to the corresponding adjustment strategy.
  • the purpose of adjusting the inhaled oxygen concentration when the patient's blood oxygen changes rapidly can be achieved more accurately and quickly.

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Abstract

Procédé de réglage de fraction d'oxygène inspiré, et dispositif d'assistance respiratoire. Le procédé comprend : au moyen de l'acquisition de chaque élément de données d'oxygène sanguin dans l'intervalle de réglage actuel en temps réel, la détermination d'une partition d'oxygène sanguin élue où chaque élément de données d'oxygène sanguin est situé (101) ; la détermination quant à savoir si la gravité de chaque élément de données d'oxygène sanguin satisfait une condition pour déclencher le réglage d'une fraction d'oxygène inspiré à l'avance (102) ; et l'exécution d'une opération de réglage de la fraction d'oxygène inspiré lorsque la condition de déclenchement du réglage de la fraction d'oxygène inspiré à l'avance est satisfaite (103). Une réponse à savoir s'il faut déclencher le réglage de la fraction d'oxygène inspiré à l'avance est réalisée en fonction d'un changement de la gravité des données d'oxygène sanguin d'un patient, ce qui permet de répondre rapidement au réglage de la fraction d'oxygène inspiré lorsque l'oxygène sanguin du patient change rapidement.
PCT/CN2020/103598 2020-07-22 2020-07-22 Procédé de réglage de fraction d'oxygène inspiré, et dispositif d'assistance respiratoire Ceased WO2022016428A1 (fr)

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PCT/CN2020/103598 WO2022016428A1 (fr) 2020-07-22 2020-07-22 Procédé de réglage de fraction d'oxygène inspiré, et dispositif d'assistance respiratoire
PCT/CN2021/104195 WO2022017156A1 (fr) 2020-07-22 2021-07-02 Procédé de réglage de fraction d'oxygène inspiré, et dispositif d'assistance respiratoire
CN202180060450.8A CN116249482B (zh) 2020-07-22 2021-07-02 吸入氧气浓度的调节方法和呼吸支持设备
CN202511135528.4A CN120884783A (zh) 2020-07-22 2021-07-02 吸入氧气浓度的调节方法和呼吸支持设备

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