CN-121971766-A - Integrated synchronous air supply and blocking monitoring system of breathing machine capable of sounding above air bag

CN121971766ACN 121971766 ACN121971766 ACN 121971766ACN-121971766-A

Abstract

The invention discloses a ventilator integrated synchronous air supply and blockage monitoring system for sounding above an air bag, which comprises a ventilator main machine, an ACV branch and a tracheotomy catheter, wherein an air/oxygen mixing module and a main control unit are integrated in the ventilator main machine, and the breathing phase is recognized to control the ACV branch to output gas with set flow in an expiration stage, so that sounding above the air bag is realized. The system collects branch data in real time through the flow sensor and the pressure sensor, builds resistance characteristic quantity based on the relation between flow and pressure, judges the branch blocking or leakage state, and executes alarm and air supply cutting under abnormal conditions. The system realizes closed-loop operation of air supply control, state monitoring and exception handling, and improves air supply stability and use safety.

Inventors

LIU KAI
ZHANG SHIMIN
Ashar River. Muhetar
Long Songshi
WANG XUJIN
DAI YUYANG
Ju Minjie

Assignees

复旦大学附属中山医院

Dates

Publication Date: 20260505
Application Date: 20260325

Claims (10)

1. The integrated synchronous air supply and blockage monitoring system for the breathing machine with sound production above the air bag is characterized by comprising a breathing machine main machine (600), an ACV branch circuit (800) and a tracheotomy catheter (100) with a channel above the air bag; an air/oxygen mixing module and a main control unit (1600) are integrated in the main machine (600) of the breathing machine, and the main control unit (1600) acquires airway pressure, flow and ventilation valve signals of the breathing machine to identify breathing phases; The ACV branch (800) is sequentially provided with an ACV flow control actuator (900), a flow sensor (1000) and a pressure sensor (1100) along the airflow direction, the main control unit (1600) is connected with the actuator and the sensor through a data bus and is configured to control the actuator to be in a closed state in an inhalation phase, adjust the opening of the actuator according to a target flow in an exhalation phase, construct a resistance characteristic quantity representing the flow state of the branch based on an actual flow signal and a pressure signal in the air supply process, and judge to be in a blocking state and close the actuator and alarm when the resistance characteristic quantity exceeds a preset range or when the actual flow does not reach the target flow and the resistance characteristic quantity is continuously increased when the opening of the actuator is maintained or increased.
2. The ventilator integrated synchronous air supply and blockage monitoring system with sound production above an air bag according to claim 1, wherein the main control unit (1600) constructs a resistance characteristic quantity based on the flow signal and the pressure signal, the resistance characteristic quantity is determined by an instantaneous function relation between a branch pressure signal and a corresponding flow signal and is used for representing the comprehensive flowing resistance state of gas in an ACV branch (800) and a channel above the air bag, the main control unit (1600) calculates the value of the resistance characteristic quantity in each control period and carries out sequence recording on the resistance characteristic quantity in a plurality of continuous control periods to form a characteristic quantity time sequence for subsequent judgment, and the smoothness degree of the branch and the tail end opening of the branch is estimated in real time by comparing the deviation of the current resistance characteristic quantity and a historical normal reference value.
3. The system for integrated synchronous air supply and blockage monitoring of a ventilator with sound production above an air bag according to claim 2, wherein the main control unit (1600) extracts a change trend feature based on the resistance feature time sequence, the trend feature comprises absolute increment change, relative change rate and numerical change direction of the resistance feature in a plurality of continuous control periods, and when the resistance feature is detected to be in a monotonically increasing state in a preset number of continuous control periods and the differential value of the change rate exceeds a preset change threshold, the abnormal increase of the branch resistance is judged and is used as one of logic triggering conditions for judging blockage, so that the dynamic identification of a slow secretion accumulation process and a sudden air passage folding and blockage process is realized.
4. The integrated synchronous air supply and blockage monitoring system for a breathing machine with sound production above an air bag according to claim 3, wherein the main control unit (1600) carries out multi-dimensional comprehensive judgment on the blockage state based on at least three mutually independent criteria, the criteria specifically comprise a hard threshold criterion based on the absolute value of a pressure signal, a flow loss criterion based on the deviation between an actual flow signal and a target flow set value and a trend criterion based on the fluctuation of a resistance characteristic quantity along a time axis, the main control unit (1600) carries out combined calculation on the three criteria through logic operation, and when at least two criteria simultaneously meet preset judgment conditions, the system is confirmed to have physical blockage, so that system false alarms caused by instantaneous pulse noise of a sensor are effectively filtered by utilizing a multi-parameter coupling judgment mechanism.
5. The integrated synchronous air supply and blockage monitoring system for a sound-producing ventilator above an air bag according to claim 4, wherein when the main control unit (1600) executes blockage judging logic, the opening response variable quantity of the ACV flow control actuator (900) is used as one of active intervention judging conditions, when the main control unit (1600) tries to increase the air flow through increasing the duty ratio or the effective opening of an actuator control command in a plurality of continuous control periods, and a feedback flow signal fails to be increased in an expected proportion, a flow blockage state of a branch is judged to exist according to a resistance characteristic variable result synchronously rising at the moment, so that a depth judging mechanism based on mutual coupling verification of active adjustment command behaviors of the main control unit (1600) and a feedback signal of an end sensor is formed.
6. The integrated synchronous air supply and blockage monitoring system for a breathing machine with sound production above an air bag according to claim 5, wherein the main control unit (1600) establishes a system leakage judging model based on a reverse correspondence between flow signals and pressure signals, when detecting that a branch actual flow signal reaches or approaches a target flow set value, but the synchronously collected pressure signal is obviously lower than the lower limit of a preset normal pressure fluctuation range, and the calculated resistance characteristic quantity is also lower than the preset normal running resistance lower limit, the main control unit judges that an ACV branch (800) has a state of pipeline falling, sealing failure or abnormal connection with a channel above the air bag, and outputs a corresponding system leakage grading abnormal type identifier according to the percentage of the pressure falling amplitude.
7. The integrated synchronous air supply and blockage monitoring system for a breathing machine with sound production above an air bag according to claim 6 is characterized in that the main control unit (1600) divides detected abnormal states into at least two stages with different priority treatment levels, wherein the at least two stages comprise an early warning state and an emergency cut-off protection state, when the calculated resistance characteristic quantity exceeds a preset first safety threshold value but does not reach a second safety threshold value, the system enters the early warning state and is accompanied with visual flickering prompt information of a display interface, when the resistance characteristic quantity is further increased and exceeds the preset second safety threshold value, the system immediately enters the emergency cut-off state and forcibly closes a flow control actuator, and the main control unit (1600) executes differentiated safety protection strategies under different abnormal energy levels to realize refined protection of the branch operation state.
8. The integrated synchronous air supply and blockage monitoring system for a breathing machine with sound production above an air bag according to claim 7, wherein the main control unit (1600) maintains a continuous monitoring mode of flow signals, pressure signals and resistance characteristic values after abnormal cutting operation is executed, when all core parameters are automatically restored to a preset normal operation logic range in a continuous period of not less than five control periods, and the change trend characteristic of the parameters is expressed as fluctuation tending to be steady, the system automatically releases the current cutting protection state and sends a normal restoration prompt to a user, and allows the ACV synchronous air supply control logic to be restarted, so that an abnormal detection and system restoration closed loop control mechanism with logic self-healing capability is formed on the premise of ensuring the safety of patients.
9. The integrated synchronous air supply and blockage monitoring system for the air bag-above-sounding breathing machine is characterized in that hardware sampling frequencies of an ACV flow sensor (1000) and an ACV pressure sensor (1100) are set to be high-frequency acquisition modes not lower than 100Hz, a system control period of a main control unit (1600) is limited within a fixed time interval between 10ms and 30ms so as to ensure capturing capability of transient complex airflow change, a real-time change trend of resistance characteristic quantity is calculated in a rolling iteration mode based on historical data of not less than three continuous control periods after processing by a sliding window algorithm, and logic stability of a discrimination result in a complex breathing environment is ensured by a data smoothing filter processing strategy.
10. The integrated synchronous air supply and blockage monitoring system of a breathing machine with sound production above an air bag according to claim 5, wherein the main control unit (1600) executes a staged adjustment strategy according to a preset progressive flow buffering control rule when adjusting the dynamic opening of the ACV flow control actuator (900) in an exhalation phase, so that the valve clack opening change of the actuator presents controlled stepwise or S-shaped curve slope change in a continuous micro control period, and strictly limits the maximum opening adjustment increment in a unit time step, thereby effectively limiting the instantaneous change rate of the gas output flow, and aiming at reducing the physical impact force of ACV airflow mutation on mucous membranes in sensitive areas above the air bag of a patient to the greatest extent.

Description

Integrated synchronous air supply and blocking monitoring system of breathing machine capable of sounding above air bag Technical Field The invention relates to the technical field of medical respiratory support equipment, in particular to a ventilator integrated synchronous air supply and blockage monitoring system capable of sounding above an air bag. Background The sound producing (Above Cuff Vocalisation, ACV) technology above the air sac is an important auxiliary means for recovering the sound energy of a patient with tracheotomy, and the basic principle is that in the inflated state of the air sac of the tracheotomy catheter, a certain flow of gas is conveyed to a channel above the air sac, so that the air flow vibrates through the glottis of the throat, and the sound production of the patient is realized. The technology is gradually applied to the fields of intensive care, long-term mechanical ventilation and rehabilitation medicine, and has positive significance in improving the communication capacity of patients, reducing the incidence rate of delirium and improving the overall treatment experience. In the prior art, as shown in fig. 1, sounding above the air bag is usually realized by adopting an external air source mode, namely, through a centralized oxygen supply or compressed air system of a hospital, after being regulated by devices such as a pressure reducing valve, a flowmeter and the like, the air bag is connected to a channel port above the air bag of the tracheotomy catheter through a hose, and an air supply switch is manually controlled by medical staff to realize intermittent air supply. The technical proposal has the characteristics of external air supply and manual operation, and can realize the sounding function to a certain extent, but has the following defects: 1. The air supply control mode is extensive and lacks an accurate adjustment mechanism. The existing scheme depends on a mechanical flowmeter and manual adjustment, so that stable and repeatable flow output is difficult to realize, and air flow fluctuation is large, so that controllable sounding training conditions are not formed; 2. An effective safety monitoring means is lacking. The existing system is not provided with a special pressure or flow monitoring device, when the conditions of upper airway secretion blockage, pipeline folding, abnormal interface connection and the like occur, the air supply pressure can be abnormally increased or the air flow can not be normally output, the medical staff can not easily detect the air flow in time, and certain safety risks exist; 3. The air supply process is not synchronized with the ventilator ventilation phase. The existing external air supply mode does not generally distinguish an inspiration period from an expiration period, and can still continuously supply air in the inspiration period, so that the condition that the air flow of a breathing machine is in conflict is easy to generate, and the problems of discomfort of a patient, incorrect gas entering the alimentary canal, even abdominal distension and the like are caused; 4. The system has low integration level and depends on manual operation. In the prior art, the sounding air supply system and the breathing machine body are mutually independent, lack of a unified control and linkage mechanism, require continuous observation and manual intervention by medical staff, increase clinical workload, and are difficult to realize data recording and process tracing; 5. The lack of connection identification and misconnection prevention structures. Under the multi-pipeline environment, the problem that the existing connection mode is easy to misconnect or unstable in connection further increases the clinical use risk. In view of this, the invention proposes a ventilator integrated synchronous air supply and blockage monitoring system sounding above the air bag. Disclosure of Invention The invention aims to provide a ventilator integrated synchronous air supply and blockage monitoring system for sounding above an air bag, and aims to solve the problems of insufficient safety and stability caused by asynchronous air supply and breathing phases and lack of blockage monitoring in the existing sounding technology above the air bag. The invention provides a ventilator integrated synchronous air supply and blockage monitoring system with sounding above an air bag, which comprises a ventilator main machine, an ACV branch and a tracheotomy catheter, wherein the tracheotomy catheter is provided with an air bag upper channel communicated with an air bag upper region below a glottis, an air/oxygen mixing module and a main control unit are integrated inside the ventilator main machine, the air/oxygen mixing module comprises a proportional regulating unit and a mixing cavity and is used for outputting mixed gas with set oxygen concentration, the main control unit is used for acquiring an airway pressure signal, an airway flow signal and a ventilat