JP5411074B2 - Respiratory gas supply device - Google Patents

Description

  The present invention relates to a breathing gas supply apparatus including an automatic opening / closing valve that can be operated according to a breathing cycle of a user. More particularly, it relates to an apparatus for intermittently supplying a therapeutic gas, eg, oxygen gas, to a user in response to a respiratory cycle.

  Conventionally, by supplying oxygen obtained from an oxygen cylinder or oxygen-enriched gas obtained by an oxygen concentrator only at the time of inspiration corresponding to the patient's breathing cycle, wasteful oxygen supply exhausted along with exhalation Has been proposed (Patent Document 1).

  As such a device, an automatic opening / closing valve provided in the middle of the flow path, a so-called demand regulator equipped with a breathing phase detection means is used, and the oxygen opening / closing valve is opened only during the inspiratory period of the user and closed during the expiration period. It is possible to save the amount. Such saving is particularly effective when the patient goes out with an oxygen cylinder, and the travel time can be extended.

  As a respiratory phase detection means used in such an apparatus, a method for detecting a temperature change due to respiration (Patent Document 1), a method for detecting pressure fluctuation (Patent Document 2), and the like have been devised. These respiratory phase detection means are used for recognizing the inspiratory phase starting portion, and when the respiratory signal is on the inspiratory phase side from a predetermined threshold that is on the inspiratory phase side with respect to the reference value or when the respiratory signal changes A method has been devised, such as recognizing the intake phase start portion when the amount exceeds a predetermined change amount threshold (Patent Document 3).

JP 59-8972 A Japanese Patent Laid-Open No. 2-88078 JP 2001-129086 A

  However, when recognizing the inspiratory phase starting part using these respiratory phase detecting means, a part of the inspiratory phase other than the inspiratory phase starting part or a change in the respiratory signal due to vibration, wind, etc. There is a problem in that it is mistakenly recognized and oxygen is supplied. In that case, oxygen is supplied when it is not necessary, and not only wastes oxygen, but also makes the user uncomfortable.

  As a method to avoid misrecognizing the middle part of the inspiratory phase other than the inspiratory phase starting part as the inspiratory phase starting part, it recognizes the next inspiratory phase starting part for a certain period after detecting the inspiratory phase starting part. It is also conceivable to keep it from being performed. However, since the user's respiratory cycle changes from moment to moment, the method of providing a certain period during which the next inspiratory phase start portion is not recognized cannot sufficiently follow the change in the respiratory cycle, and inspiration other than the inspiratory phase start portion. Incorrectly recognizing the middle part of the phase as the inspiratory phase starting part and supplying oxygen when it is unnecessary, or conversely, overlooking the inspiratory phase starting part and failing to supply oxygen when necessary Problems arise.

  Another way to avoid misrecognizing the middle part of the inspiratory phase other than the inspiratory phase starting part as the inspiratory phase starting part is when the value of the respiratory signal is within a certain range near the reference value. Only a method of recognizing the inhalation phase starting portion can be considered.

  However, the size of the user's breathing waveform and the speed of rising vary greatly between individuals, and even the same user changes from moment to moment, so when the value of the breathing signal is within a certain range near the reference value. In the method of recognizing only the inspiratory phase starting part, if the respiratory waveform is small and the rise is slow, the part of the inspiratory phase other than the inspiratory phase starting part falls within the above range and is mistaken for the inspiratory phase starting part. Recognize and supply oxygen when not needed. Conversely, when the respiratory waveform is large and the rise is fast, there is a problem that depending on the sampling period of the respiratory signal, the inspiratory phase start part does not fall within the above range and cannot be supplied with oxygen when necessary.

  As a method for avoiding misrecognition of so-called noise as a change in breathing signal due to vibration or wind, a method for tightening the recognition standard of the inspiratory phase start part, for example, When recognizing an inspiratory phase starting part when the inspiratory phase side is reached from a predetermined threshold value on the inspiratory phase side of the reference value, a method of setting this threshold value higher than the noise or a change in the respiratory signal There is a method of setting the change amount threshold value to be higher than the noise when recognizing the intake phase start portion when the amount exceeds a predetermined change amount threshold value.

  However, when these methods are used, the recognition of the inhalation phase start part is delayed, or the inspiration phase start part cannot be recognized in some cases, so that the oxygen cannot be supplied when the user needs it. Occurs.

  As a result of intensive studies aimed at solving the above problems, the present inventor has provided means for recognizing the user's inspiratory phase start part and expiratory phase start part, and after recognizing the inspiratory phase start part, exhalation The next inspiratory phase start unit is not recognized until the phase start unit is recognized and until a predetermined time has elapsed since the expiration phase start unit was recognized, and the expiratory phase start unit By removing noise at the time of recognition, it is possible to follow changes in the breathing cycle of the user, and the user can recognize the start of the inspiration phase without error and quickly, and wasteful release of oxygen And that the user's discomfort can be reduced.

  That is, the present invention comprises a breathing gas generating means, a conduit means having one end communicating with the generating means and an open-type supply means for the breathing gas at the other end, and an automatic opening / closing valve means in the middle, Breathing-synchronized gas supply comprising breathing phase detecting means capable of detecting at least a part of a predetermined phase in breathing, and control means for controlling opening / closing of the automatic opening / closing valve means based on a breathing signal as a detection result of the detecting means In the apparatus, the control means has recognition means for recognizing the inspiratory phase start part and the expiratory phase start part, and after the recognizing means recognizes the inspiratory phase start part until recognizing the expiratory phase start part. It is an object of the present invention to provide a breath-tuned gas supply device that does not recognize the next inspiratory phase starting portion until a predetermined time elapses after the phase starting portion is recognized.

  Further, according to the present invention, the recognition means uses the value of the respiration signal when the breath-tuned gas supply device is opened to the atmosphere as a reference value, and the respiration signal exceeds the reference value from the inspiratory phase side to the expiratory phase side. It is an object of the present invention to provide a breath-tuned gas supply device characterized by recognizing a time point as an expiration phase start part.

  Further, according to the present invention, the recognition means uses the value of the respiration signal when the breath-tuned gas supply device is opened to the atmosphere as a reference value, and the respiration signal exceeds the reference value from the inspiratory phase side to the expiratory phase side. The time is once recognized as a temporary expiratory phase start unit, and then the time during which the breathing signal is on the expiratory phase side from the predetermined expiratory phase threshold on the expiratory phase side from the reference value is determined in advance. A respiratory tuned gas supply device characterized by recognizing a temporary expiratory phase start unit once recognized as a true expiratory phase start unit when the operation is continued as described above.

  Further, according to the present invention, the recognition means uses the value of the respiration signal when the breath-tuned gas supply device is opened to the atmosphere as a reference value, and the respiration signal exceeds the reference value from the inspiratory phase side to the expiratory phase side. The time is once recognized as a temporary expiration phase start unit, and then the time during which the respiratory signal is on the inspiratory phase side from the reference value or a predetermined noise judgment threshold on the inspiratory phase side from the reference value is determined in advance. If the tentative expiration phase start unit once recognized is discarded as noise, the time when the respiratory signal exceeds the reference value from the inspiratory phase side to the expiratory phase side is determined as the temporary expiration phase start unit. The present invention provides a breath-synchronized gas supply device characterized by re-recognition.

  The respiratory tuned gas supply device of the present invention follows a change in the breathing cycle of the user without erroneously recognizing a part of the inspiratory phase other than the inspiratory phase start part and noise as an inspiratory phase start part, Recognition of the inhalation phase start portion can be performed quickly and without error, and it is possible to reduce wasteful release of oxygen and user discomfort.

The embodiment example of the respiration synchronization type gas supply apparatus of this invention. The figure explaining an example of recognition of the inhalation phase start part and expiration phase start part of the present invention.

  The respiratory-tuned gas supply device of the present invention has means for recognizing the user's inspiratory phase start part and expiratory phase start part, and from recognizing the inspiratory phase start part to recognizing the expiratory phase start part. In addition, the recognition of the next inspiratory phase start unit is not performed until the predetermined time has elapsed after the start of the expiratory phase start unit, and noise is removed when the expiratory phase start unit is recognized. Thus, the user can quickly and quickly recognize the inhalation phase start portion, and in accordance with this, the automatic opening / closing valve is opened, and the breathing gas, for example, oxygen is sucked into the user by a pulse.

  The present invention comprises a breathing gas generating means, a conduit means having one end communicating with the generating means and an open-type supply means for the breathing gas at the other end and an automatic opening / closing valve means in the middle, and the automatic It is basically composed of a demand regulator which is a means for controlling the supply amount of breathing gas by controlling the opening time of the on-off valve means.

  The breathing gas generating means of the present invention comprises a breathing gas generation source, a pressure adjusting means for adjusting the gas from the generation source to a predetermined pressure, that is, a pressure in the vicinity of atmospheric pressure, and a flow rate setting means if necessary. When a cylinder type such as an oxygen cylinder is used as the generation source, the gas from these generation sources is usually supplied at a considerably high pressure. The pressure is reduced to a pressure, for example, 20 kPa to 300 kPa, preferably 100 kPa to 200 kPa.

  The flow rate setting means can be a method of supplying at a maximum flow rate, or a flow rate that can be freely set, and a steady flow with an appropriate flow rate can be used from the breathing gas generating means via the conduit means. Sent to the person or patient.

  One end of the conduit means is connected to the gas generating means, and the other end is a jig such as a nasal cannula or a mouth-nose mask that facilitates the supply of gas into the patient's body. This conduit means passes through an automatic flow path opening / closing means in a demand regulator, which will be described later, and may also be connected to a breathing phase detection means of the demand regulator.

  The control means (demand regulator) for controlling the opening time of the automatic open / close valve means according to the present invention opens and closes the automatic open / close valve means provided in the middle of the conduit means under specific control conditions, thereby providing gas to the patient. It controls the supply amount.

  The demand regulator basically includes a breathing phase detecting means having a function capable of detecting at least a part of a predetermined phase in breathing, a control means for controlling opening / closing of the automatic opening / closing valve means, and the automatic opening / closing valve means. Constructed.

  Conventionally, as the respiratory phase detection means, (a) a method for detecting a temperature difference between inspiration and expiration; (b) a sensor that detects expansion and contraction in a band wound around the chest and converts it into an electrical signal. A system that detects movement of the chest (Respy graph); (c) A flow rate detection system that detects changes in gas flow and pressure by inhalation and exhalation is known. However, it can be conveniently achieved by detecting the gas pressure in the cannula portion at the end of the conduit.

  The automatic opening / closing valve means may be any means as long as the gas flow in the conduit can be stopped or circulated by a signal from the control means. For example, an air valve type that opens and closes the valve by air pressure and an electromagnetic valve that opens and closes the valve by electric energy can be exemplified, but an electromagnetic valve can be used simply.

  The control means includes a means for recognizing the inspiratory phase start part and the expiratory phase start part on the basis of the respiration signal sent from the respiration phase detecting means, a means for setting the open / close time of the automatic open / close valve means, and an open / close adjusting means. Constructed.

  The means for recognizing the inspiratory phase starting part in the present invention can adopt a method for recognizing based on the absolute value of the respiration signal sent from the respiration phase detecting means. For example, when a method of detecting the gas pressure in the cannula portion is used as the respiratory phase detection means, a case where the pressure value is in the vicinity of 0 Pa can be recognized as the inspiratory phase start portion.

  Further, as another recognition method of the inhalation start unit, a method of recognizing based on the absolute value of the respiratory signal sent from the respiratory phase detection means and its temporal change amount can be adopted. For example, when a method for detecting the gas pressure in the cannula portion is used as the breathing phase detection means, the pressure value is in the vicinity of 0 Pa, and the time change amount of the pressure value is not more than a certain value, for example, not more than −50 Pa / sec. In some cases, it can be recognized as an inspiratory phase starting portion.

  The means for recognizing the expiration phase start unit in the present invention recognizes the time point when the absolute value of the respiratory signal sent from the respiratory phase detection unit exceeds the reference value from the inspiration phase side to the expiration phase side as the expiration phase start unit. For example, when the method of detecting the gas pressure in the cannula part is used as a respiratory phase detection means, the point in time when the pressure value exceeds 0 Pa from the minus side to the plus side is recognized as the expiratory phase start part. is there.

  In recognizing the expiration phase start portion, in order to avoid erroneous recognition due to noise, even if the respiratory signal exceeds the reference value from the inspiration phase side to the expiration phase side, it is not determined as the expiration phase start portion, and temporary expiration If the respiratory signal is recognized as a phase initiating portion and then the breath signal is on the expiration side beyond a predetermined expiration determination threshold value that is on the expiration phase side from the reference value, the true expiration Recognize as phase start.

  For example, when the method of detecting the gas pressure in the cannula part is used as the respiratory phase detection means, the time when the pressure value exceeds the positive value (for example, 3 Pa) continues for 50 ms or more, and is recognized once The temporary expiratory phase start part is recognized as a true expiratory phase start part.

  At this time, before recognizing it as a true expiratory phase start part, that is, in a state of recognizing it as a temporary expiratory phase start part, a predetermined noise judgment threshold that the respiratory signal is on the inspiratory phase side from the reference value or the reference value If the time on the inspiratory phase side continues for a predetermined noise judgment time or longer, the temporary expiratory phase start portion that has been recognized once is discarded as noise, and then the respiratory signal is set to the reference value from the inspiratory phase side to the expiratory phase side. Re-recognize the time when it exceeds the provisional expiratory phase start.

  For example, when the method of detecting the gas pressure in the cannula portion is used as the respiratory phase detection means, if the time during which the pressure value falls below 0 Pa continues for 150 ms or longer, the temporary expiratory phase start portion that has been recognized once is detected as noise. Then, the time when the respiratory signal exceeds the reference value from the inspiratory phase side to the expiratory phase side is re-recognized as a temporary expiratory phase start unit.

  As a result, it is possible to avoid erroneously recognizing noise as the expiratory phase start unit. In avoidance, since the criterion for recognizing the expiration phase start part, that is, the criterion for recognizing the point when the respiratory signal exceeds the reference value from the inspiration phase side to the expiration phase side as the expiration phase start part is not strict. There is no delay in recognizing the phase start.

  The means for recognizing the inspiratory phase start part and the expiratory phase start part in the present invention is determined in advance after recognizing the inspiratory phase start part after recognizing the inspiratory phase start part and after recognizing the expiratory phase start part. It is characterized by not recognizing the next inspiratory phase start until the elapsed time elapses. In setting this time, it can be set to a certain time, for example, 200 msec. It is desirable to set it to 1/10 of the previous expiration phase. This expiration phase may be an average of several times.

  As mentioned above, since noise can be removed when recognizing the expiration phase start part, the period during which the inspiration phase is not recognized can be set correctly, and in the middle of the inspiration phase other than the inspiration phase start part, It is also possible to avoid erroneously recognizing noise as an inhalation phase start portion. In addition, since there is no delay in recognizing the expiration phase start part, a period in which the inspiration phase start part is not recognized can be set quickly, and the next inspiration phase start part is recognized following the change in the respiratory cycle. It becomes possible. In addition, since the recognition criteria for the inspiratory phase starting part are not strict, the inducing of the inspiratory phase starting part is not delayed.

  In this way, the midway part of the inspiratory phase other than the inspiratory phase starting part and noise are not mistakenly recognized as the inspiratory phase starting part, and the inspiration phase starting part is recognized by following the change in the user's respiratory cycle. It can be performed without error and quickly, and wasteful release of oxygen and user discomfort can be reduced.

  FIG. 1 shows an example of a preferred embodiment of the breathing gas supply device of the present invention. That is, oxygen emitted from the oxygen cylinder 1, which is a breathing gas generating means, passes through the container valve 2, the pressure reducing valve 3, the orifice type flow rate setting device 4, and the conduit means 6 provided with the automatic opening / closing valve 5, Released from the nasal cannula 7, which is an open-type supply means.

  Respiration pressure detection means 8 having a diaphragm type micro pressure fluctuation sensor provided at a branch from the conduit means 6 converts pressure fluctuations in respiration into capacitance fluctuations and transmits them to the control means 9.

  The control means 9 converts the respiratory phase data and opens the automatic opening / closing valve 5 at the time when the inspiration phase start is recognized, calculates the opening time of the automatic opening / closing valve 5 and, during the calculated time, After maintaining “open”, the automatic open / close valve 5 is closed.

  After that, until recognizing the expiration phase start part and until 1/10 of the previous expiration time has elapsed after recognizing the expiration phase start part, the next inspiration phase start part is not recognized, After such time, it will begin to attempt to recognize the next inspiratory phase start.

  FIG. 2 is a diagram illustrating an example of recognition of the inspiratory phase start unit and the expiratory phase start unit in the present invention. First, the inspiratory phase starting part a is recognized. Since the expiratory phase start part is not recognized at this time, the next inspiratory phase start part is not recognized, and therefore, the middle part of the inspiratory phase other than the inspiratory phase start part is erroneously recognized as the inspiratory phase start part. There is no.

  Next, the time point b when the respiratory signal exceeds the reference value from the inspiratory phase side to the expiratory phase side is recognized as a temporary expiratory phase start unit. At this time, the period during which the next inspiratory phase start part is not recognized is a period in which 1/10 of the previous expiratory phase period is added to the temporary expiratory phase start part b, that is, inspiration at time b in the figure. This is a period indicated as a period in which the phase start part is not recognized.

  Thereafter, the respiratory signal does not exceed the expiration determination threshold value and moves again to the inspiratory phase side, so the temporary expiration phase start part b is not regarded as a true expiration phase start part. Further, since the period in which the inspiratory phase starting portion is not recognized is entered, this portion is not recognized as the next inspiratory phase starting portion.

  After moving to the inspiratory phase side, the noise judgment threshold, in this example, the time that is on the inspiratory phase side from the same value as the reference value is equal to or longer than the noise judgment time. The point c moved from the phase side to the expiratory phase side is recognized again as a temporary expiratory phase start portion.

  At this time, the period during which the next inspiratory phase start part is not recognized is a period obtained by adding 1/10 of the previous expiratory phase period to the temporary expiratory phase start part c, that is, at the time point c in the figure. This is a period indicated as a period in which the inspiratory phase starting part is not recognized, and the provisional expiratory phase starting part is extended by the amount changed from b to c.

  After that, it moves to the intake phase side again, but since the period during which the intake phase start part is not recognized is extended, this part is not recognized as the next intake phase start part. In addition, since the time that is on the inspiratory phase side of the noise judgment threshold does not reach the noise judgment time this time, the tentatively recognized expiratory phase start part c is not discarded, so that the next movement to the expiratory phase side is performed again. d is not re-recognized as an expiratory-phase start part, and c remains recognized as a temporary expiratory-phase start part.

  Subsequently, the temporary expiration phase start unit c is recognized as a true expiration phase start unit at a time point e when the time on the expiration phase side of the expiration determination threshold becomes equal to or longer than the expiration determination time.

  The next inspiratory phase starting part is a period in which the inspiratory phase starting part is not recognized, i.e., a period in which no inspiratory phase starting part is recognized at the time point c in FIG. It is recognized as the time point f when moving to the intake phase side.

1. Oxygen cylinder 2. Container valve Pressure reducing valve 4. 4. Orifice type flow rate setting device Automatic on-off valve 6. Conduit means Nasal cannula 8. Respiratory phase detection means 9. Control means

Claims (2)

A breathing gas generating means; one end communicating with the generating means; the other end having an open-type supply means for the breathing gas; a predetermined phase, respiratory phase detecting means may detect, based on the pressure of the gas for the respiration in the open supply means, a control means for controlling the opening and closing of the automatic opening and closing valve means based on a detection result of said detecting means a breathing tuned gas supply apparatus equipped recognizes the expiratory phase start unit based on the control means exceeds the reference value is a pressure of the breathing gas in the inspiratory phase beginning and the open-type supply means A recognizing means, between the time when the recognizing means recognizes the inspiratory phase start portion and the time when the expiratory phase start portion is recognized and the time from when the expiratory phase start portion is recognized until a predetermined time elapses. It does not recognize the next inspiratory phase start. Respiratory tunable gas delivery system to. 2. The respiratory synchronization type according to claim 1, wherein the recognizing unit uses the pressure of the respiratory gas in the open type supply unit when the respiratory synchronization type gas supply device is opened to the atmosphere as the reference value. Gas supply device.

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