Medical equipment, ventilation equipment and ventilation regulation and control method

Abstract

The invention discloses ventilation equipment and a ventilation regulation and control method, and the method comprises the steps: 1a, obtaining the monitoring pressure and / or the airway flow rate of the ventilation equipment in the mechanical ventilation process of a patient; step 2a, determining parameter values of respiration driving parameters according to the monitored pressure and / or the airway flow rate, and changing the respiration driving parameters to be used for representing the respiration effort of the patient; step 3a, performing statistical analysis on the parameter value of the respiration driving parameter to determine a first target value; step 4a, comparing the first target value with a preset first range; and step 5a, according to a comparison result, adjusting and / or reminding to adjust a parameter value of a ventilation support parameter, wherein the ventilation support parameter is used for reflecting a set pressure or flow condition of the ventilation equipment. According to the medical equipment, the ventilation equipment and the ventilation regulation and control method, lung injury or diaphragm fatigue caused by over-strong spontaneous respiration can be reduced, so that a better ventilation effect is achieved.

Description

Medical equipment, ventilation equipment and ventilation control method Technical Field

[0001] The present invention relates to the field of medical technology, and in particular to a medical device, a ventilation device, and a ventilation control method. Background Art

[0002] Mechanical ventilation is one of the most important life-support measures for critically ill patients. It helps patients with respiratory failure maintain normal oxygenation and CO2 excretion. Currently, the main method of mechanical ventilation in clinical practice is positive pressure ventilation, which provides patients with a certain volume or pressure of ventilation support during inspiration and maintains a certain positive end-expiratory pressure during expiration to prevent alveolar collapse.

[0003] Clinical studies have shown that while positive pressure ventilation helps maintain gas exchange, it can also cause some damage to the patient's respiratory system. For example, positive pressure ventilation can lead to excessively high transpulmonary pressure, causing respiratory muscle-related lung injury and, in turn, increasing mortality in critically ill patients. Prolonged positive pressure ventilation can also cause disuse and atrophy of the diaphragm, which can prolong the patient's time on the ventilator and delay weaning.

[0004] Currently, clinical lung protection strategies, such as low tidal volume ventilation, limiting plateau pressure, and driving pressure, are only effective when the patient has no spontaneous breathing or weak spontaneous breathing. When a patient's spontaneous breathing is too strong, even if conditions such as low tidal volume and low driving pressure are met, the patient's transpulmonary pressure remains high, indicating a high risk of lung injury. Preventing lung injury and protecting the diaphragm during mechanical ventilation is one of the current issues that need to be addressed or improved.

[0005] Summary of the Invention

[0006] According to the first aspect, an embodiment provides a ventilation control method, comprising:

[0007] Obtain monitoring pressure and / or airway flow rate during mechanical ventilation of patients by ventilation equipment;

[0008] Determining a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, wherein the respiratory drive parameter is used to characterize the patient's respiratory effort, and the respiratory drive parameter includes respiratory muscle pressure, inspiratory work, or a flow index. The respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate. The inspiratory work is obtained by integrating the product of the respiratory muscle pressure and the airway flow rate over time. The flow index is used to characterize the speed of change of an inspiratory flow curve obtained from the airway flow rate during a descending process.

[0009] Performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value;

[0010] The first target value is compared with a preset first range, and the parameter value of the ventilation support parameter is adjusted and / or prompted to be adjusted according to the comparison result. The ventilation support parameter is used to reflect the pressure or flow condition set by the ventilation device.

[0011] According to the second aspect, an embodiment provides a ventilation control method, comprising:

[0012] Obtain monitoring pressure and / or airway flow rate during mechanical ventilation of patients by ventilation equipment;

[0013] Determining a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, the respiratory drive parameter being used to characterize the patient's respiratory effort, the respiratory drive parameter including respiratory muscle pressure, respiratory muscle pressure area, inspiratory work, or a flow index, wherein the respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate, the respiratory muscle pressure area is obtained based on an integral value of the respiratory muscle pressure over time, the inspiratory work is obtained based on an integral value of the product of the respiratory muscle pressure and the airway flow rate over time, and the flow index is used to characterize how quickly an inspiratory flow curve derived from the airway flow rate changes during a descending process;

[0014] Performing statistical analysis on the parameter values ​​of the respiratory drive parameters to determine a first target value;

[0015] The first target value is compared with a preset first range, and the medication affecting the respiratory effort is adjusted and / or prompted to be adjusted according to the comparison result.

[0016] According to the third aspect, an embodiment provides a ventilation control method, comprising:

[0017] Obtain monitoring pressure and / or airway flow rate during mechanical ventilation of patients by ventilation equipment;

[0018] Determining a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, wherein the respiratory drive parameter is used to characterize the patient's respiratory effort, and the respiratory drive parameter includes respiratory muscle pressure, respiratory muscle pressure area, inspiratory work, or a flow index, wherein the respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate, the respiratory muscle pressure area is obtained based on the integral value of the respiratory muscle pressure over time, the inspiratory work is obtained based on the integral value of the product of the respiratory muscle pressure and the airway flow rate over time, and the flow index is used to characterize the speed of change of an inspiratory flow curve obtained from the airway flow rate during a descending process;

[0019] Performing statistical analysis on parameter values ​​of the respiratory drive parameter within a set time period to determine a second target value, wherein the set time period includes N respiratory cycles, where N is an integer greater than or equal to 1;

[0020] Obtaining a reference value corresponding to the ventilation support parameter in the ventilation device according to the second target value and a preset proportional relationship between the second target value corresponding to the respiratory drive parameter and the parameter value corresponding to the ventilation support parameter;

[0021] The parameter value of the ventilation support parameter of the ventilation device in the target respiratory cycle is adjusted and / or prompted to be adjusted according to the reference value, and the target respiratory cycle is after the set time period.

[0022] According to a fourth aspect, an embodiment provides a ventilation device, comprising:

[0023] a ventilation device for generating gas in accordance with a set setting including at least ventilation support parameters;

[0024] a ventilation circuit, for connecting to a patient's respiratory system to deliver the gas to the patient;

[0025] The sensor assembly includes at least a pressure sensor and a flow sensor, wherein the pressure sensor is used to collect monitoring pressure during mechanical ventilation of the patient by the ventilation device, and the flow sensor is used to collect airway flow rate during mechanical ventilation of the patient by the ventilation device;

[0026] a processor, configured to be in signal connection with the ventilation device and the sensor assembly;

[0027] The processor is further configured to obtain a monitored pressure collected by the pressure sensor and / or an airway flow rate collected by the flow sensor during mechanical ventilation of the patient; and determine a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, wherein the respiratory drive parameter is used to characterize the patient's respiratory effort, and the respiratory drive parameter includes a respiratory muscle pressure, an inspiratory work, or a flow index, wherein the respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate, the inspiratory work is obtained based on the integral value of the product of the respiratory muscle pressure and the airway flow rate over time, and the flow index is used to characterize the speed of change of the inspiratory flow curve obtained from the airway flow rate during the descending process;

[0028] The processor is also used to determine a first target value based on the parameter value of the respiratory drive parameter; and compare the first target value with a pre-set first range, and adjust and / or remind to adjust the parameter value of the ventilation support parameter according to the comparison result, where the ventilation support parameter is used to reflect the pressure or flow condition set by the ventilation device.

[0029] According to a fifth aspect, an embodiment provides a ventilation device, comprising:

[0030] Aeration device for generating gas at a set pressure or flow rate;

[0031] a ventilation circuit, for connecting to a patient's respiratory system to deliver the gas to the patient;

[0032] The sensor assembly includes at least a pressure sensor and a flow sensor, wherein the pressure sensor is used to collect the monitoring pressure of the ventilation device during the mechanical ventilation of the patient, and the flow sensor is used to collect the airway flow rate during the mechanical ventilation of the patient by the ventilation device;

[0033] a processor, configured to be signal-connected to the ventilation device and the sensor assembly, and to be communicatively connected to an output pump;

[0034] The processor is further configured to obtain a monitored pressure and / or airway flow rate during mechanical ventilation of a patient by the ventilation device; and determine a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, wherein the respiratory drive parameter is used to characterize the patient's respiratory effort, and the respiratory drive parameter includes respiratory muscle pressure, respiratory muscle pressure area, inspiratory work, or a flow index, wherein the respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate, the respiratory muscle pressure area is obtained based on the integral value of the respiratory muscle pressure over time, the inspiratory work is obtained based on the integral value of the product of the respiratory muscle pressure and the airway flow rate over time, and the flow index is used to characterize the speed of change of an inspiratory flow curve obtained from the airway flow rate during a descending process;

[0035] The processor is used to determine a first target value based on the parameter value of the respiratory drive parameter; and compare the first target value with a preset first range, and control the output pump adjustment and / or remind to adjust the drug that affects the respiratory effort according to the comparison result.

[0036] According to a sixth aspect, an embodiment provides a ventilation device, comprising:

[0037] a ventilation device for generating gas in accordance with a set setting including at least ventilation support parameters;

[0038] a ventilation circuit, for connecting to a patient's respiratory system to deliver the gas to the patient;

[0039] The sensor assembly includes at least a pressure sensor and a flow sensor, wherein the pressure sensor is used to collect monitoring pressure during mechanical ventilation of the patient by the ventilation device, and the flow sensor is used to collect airway flow rate during mechanical ventilation of the patient by the ventilation device;

[0040] a processor, configured to be in signal connection with the ventilation device and the sensor assembly;

[0041] The processor is further configured to obtain a monitored pressure collected by the pressure sensor and / or an airway flow rate collected by the flow sensor during mechanical ventilation of the patient; and determine a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, wherein the respiratory drive parameter is used to characterize the patient's respiratory effort, and the respiratory drive parameter includes respiratory muscle pressure, respiratory muscle pressure area, inspiratory work, or a flow index, wherein the respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate, the respiratory muscle pressure area is obtained based on the integral value of the respiratory muscle pressure over time, the inspiratory work is obtained based on the integral value of the product of the respiratory muscle pressure and the airway flow rate over time, and the flow index is used to characterize the speed of change of the inspiratory flow curve obtained from the airway flow rate during the descending process;

[0042] The processor is configured to determine a second target value based on a parameter value of a respiratory drive parameter within a set time period, wherein the set time period includes N respiratory cycles, where N is an integer greater than or equal to 1;

[0043] The processor is used to obtain a reference value corresponding to the ventilation support parameter in the ventilation device based on the second target value and the proportional relationship between the second target value corresponding to the pre-set respiratory drive parameter and the parameter value corresponding to the ventilation support parameter, and adjust and / or remind to adjust the parameter value of the ventilation support parameter of the ventilation device in a target respiratory cycle according to the reference value, and the target respiratory cycle is after the set time length.

[0044] According to a seventh aspect, an embodiment provides a medical device, comprising:

[0045] Memory, used to store programs;

[0046] A processor is configured to implement the above method by executing the program stored in the memory.

[0047] According to an eighth aspect, an embodiment provides a computer-readable storage medium, comprising a program, wherein the program can be executed by a processor to implement the methods of the above aspects.

[0048] In the above embodiments, during the process of ventilating the patient, a parameter value of a respiratory drive parameter used to characterize the patient's respiratory effort is obtained based on the patient's monitored pressure and / or airway flow rate. In some embodiments, a first target value is obtained based on the parameter value of the respiratory drive parameter, and then the parameter value of the ventilation support parameter is adjusted and / or prompted to be adjusted based on the comparison result between the first target value and the first range. Alternatively, the drug that affects the respiratory effort is adjusted and / or prompted to be adjusted based on the comparison result between the first target value and the first range, thereby suppressing the patient's spontaneous breathing when the patient's respiratory effort is too strong to prevent diaphragm fatigue and lung damage, and improving the patient's respiratory drive when the patient's respiratory effort is too weak to prevent diaphragm disuse atrophy.

[0049] In addition, a second target value can be obtained based on the parameter values ​​of the respiratory drive parameters in one or several respiratory cycles before the target respiratory cycle, and the parameter values ​​of the ventilation support parameters in the target respiratory cycle can be proportionally adjusted based on the second target value to better adapt to the patient's spontaneous breathing in the target respiratory cycle. BRIEF DESCRIPTION OF THE DRAWINGS

[0050] FIG1 is a structural block diagram of a monitor according to an embodiment;

[0051] FIG2 is a block diagram of a ventilator according to an embodiment;

[0052] FIG3 is a block diagram of an anesthesia machine according to an embodiment;

[0053] FIG4 is a flow chart of a ventilation control method according to an embodiment;

[0054] FIG5 is a schematic diagram of waveforms of airway pressure, respiratory muscle pressure, airway flow rate, and ventilation volume according to an embodiment;

[0055] FIG6 is a waveform graph of airway pressure, esophageal pressure, and airway flow rate according to an embodiment;

[0056] FIG7 is a model diagram of a human respiratory system according to an embodiment;

[0057] FIG8 is a flow chart of a ventilation control method according to another embodiment;

[0058] FIG9 is a flow chart of a ventilation control method according to another embodiment. DETAILED DESCRIPTION

[0059] The present invention will be further described in detail below by means of specific embodiments in conjunction with the accompanying drawings. Similar elements in different embodiments are numbered with associated similar elements. In the following embodiments, many detailed descriptions are provided to enable the present application to be better understood. However, those skilled in the art will readily appreciate that some of the features may be omitted in different circumstances, or may be replaced by other elements, materials, or methods. In some cases, some operations related to the present application are not shown or described in the specification. This is to avoid the core portion of the present application being overwhelmed by excessive descriptions, and for those skilled in the art, it is not necessary to describe these related operations in detail. They will fully understand the related operations based on the description in the specification and the general technical knowledge in the art.

[0060] Furthermore, the features, operations, or characteristics described in this specification may be combined in any appropriate manner to form various embodiments. Furthermore, the steps or actions in the method description may be reordered or adjusted in a manner readily apparent to those skilled in the art. Therefore, the various sequences in the specification and drawings are provided solely for the purpose of describing a particular embodiment and are not intended to be mandatory, unless otherwise specified.

[0061] The serial numbers assigned to components herein, such as "first," "second," etc., are used solely to distinguish the objects being described and do not convey any sequential or technical meaning. References to "connection" and "coupling" herein, unless otherwise specified, include both direct and indirect connections (couplings).

[0062] The medical devices in this application are used in various occasions. For example, in some embodiments, the medical device of the present invention can be a monitor or a monitoring module, etc., in some embodiments, it can be a ventilation device, such as a ventilator and an anesthesia machine, etc., and in some embodiments, it can be other medical devices with computing and processing capabilities, which are explained below.

[0063] In some embodiments, the medical device may be a monitor.

[0064] Referring to Figure 1, in some embodiments, the medical device may have an independent housing, and the housing panel may include a sensor interface area, wherein the sensor interface area may integrate multiple sensor interfaces for connecting to various external physiological parameter sensor accessories 111. The housing panel may also include one or more of a small LCD display area, a display 30, an input interface circuit 122, and an alarm circuit 120 (such as an LED alarm area). The medical device has an external communication interface 119 and a power interface 116 for communicating with and drawing power from a host medical device such as a patient monitor, ventilator, or anesthesia machine. Airway pressure and airway flow rate are typically collected by sensors in the ventilator / anesthesia machine, so the medical device can obtain the patient's airway pressure and airway flow rate during ventilation by communicating with the ventilator / anesthesia machine. The medical device may be equipped with a carbon dioxide sensor or an electrical impedance sensor to collect carbon dioxide concentration or chest electrical impedance data during ventilation. Of course, the carbon dioxide sensor or electrical impedance sensor can also be installed in other devices (such as a ventilator), and the medical device can obtain carbon dioxide concentration or chest electrical impedance data through communication with other devices. The medical device can also support external parameter modules. By inserting the parameter modules, a plug-in monitor host can be formed. As part of the monitor, it can also be connected to the host via a cable. The external parameter module is an external accessory of the monitor. The internal circuit of the medical device is placed in the shell and can include a signal acquisition circuit 112 and a front-end signal processing circuit 113 corresponding to one or more physiological parameters. The signal acquisition circuit 112 can be selected from an electrocardiogram circuit, a respiratory circuit, a body temperature circuit, a blood oxygenation circuit, a non-invasive blood pressure circuit, and an invasive blood pressure circuit, etc. These signal acquisition circuits 112 are respectively electrically connected to corresponding sensor interfaces for electrically connecting to sensor accessories 111 corresponding to different physiological parameters. The output end is coupled to the front-end signal processing circuit 113. The communication port of the front-end signal processing circuit 113 is coupled to the processor 10. The processor 10 is electrically connected to the external communication interface 119 and the power interface 116. The sensor accessories 111 and signal acquisition circuit 112 corresponding to various physiological parameters can utilize conventional circuits. The front-end signal processing circuit 113 performs sampling and analog-to-digital conversion of the output signal of the signal acquisition circuit 112, and outputs control signals to control the measurement process of physiological signals. These parameters include, but are not limited to, electrocardiogram (ECG), respiration, body temperature, blood oxygen, non-invasive blood pressure, and invasive blood pressure parameters. The front-end signal processing circuit 113 can be implemented using a single-chip microcomputer or other semiconductor device. The front-end signal processing circuit 113 can be powered by an isolated power supply. The sampled data undergoes simple processing and packaging, and is then sent to the processor 10 via an isolated communication interface. For example, the front-end signal processing circuit 113 can be coupled to the processor 10 via an isolated power supply interface 114 and a communication interface 115.The front-end signal processing circuit 113 is powered by an isolated power supply because it is a DC / DC power supply isolated by a transformer, isolating the patient from the power supply equipment. Its main purposes are: 1. Isolating the patient by floating the applied circuitry through the isolation transformer, minimizing patient leakage current; and 2. Preventing voltage or energy from affecting intermediate circuit boards and components such as the main control board during defibrillation or electrosurgical operation (as ensured by creepage distance and electrical clearance). Of course, the front-end signal processing circuit 113 can also be directly connected to the processor 10 via a cable. The processor 10 is used to complete the calculation of physiological parameters and send the calculation results and waveforms of the parameters to a host (such as a host with a display 30, a PC, a central station, etc.) through the external communication interface 119; the processor 10 can be directly connected to the external communication interface 119 via a cable for communication, and directly connected to the power interface 116 via a cable for power supply; the medical device can also include a power supply and battery management circuit 117, which draws power from the host through the power interface 116 and supplies it to the processor 10 after processing, such as rectification and filtering; the power supply and battery management circuit 117 can also monitor, manage and protect the power obtained from the host through the power interface 116. The external communication interface 119 can be one or a combination of Ethernet, Token Ring, Token Bus, and a local area network interface consisting of the fiber-optic distributed data interface (FDDI) as the backbone of these three networks. It can also be one or a combination of wireless interfaces such as infrared, Bluetooth, WiFi, WMTS communication, or one or a combination of wired data connection interfaces such as RS232 and USB. The external communication interface 119 can also be one or a combination of wireless data transmission interfaces and wired data transmission interfaces. The host can be any computer device such as the host of the monitor, a computer, etc., and by installing the corresponding software, it can form a monitoring device. The host can also be a communication device, such as a mobile phone. The medical device sends data to a mobile phone that supports Bluetooth communication via the Bluetooth interface to achieve remote data transmission. After the processor 10 completes the calculation of the physiological parameters, it can also determine whether the physiological parameters are abnormal. If abnormal, an alarm can be issued through the alarm circuit 120.

[0065] The above are some descriptions of the medical device being a monitor.

[0066] In some embodiments, the medical device is a ventilator, which is an artificial mechanical ventilation device used to assist or control the patient's spontaneous breathing movement to achieve the function of gas exchange in the lungs, reduce the body's consumption, and facilitate the recovery of respiratory function. Please refer to Figure 2, which shows an invasive ventilator, which includes a ventilation device, a ventilation circuit, a processor 10, a memory 20, a display 30, and a sensor assembly. The ventilation device is used to generate gas according to the set ventilation support parameters, thereby ventilating the patient at a certain pressure or flow rate to provide respiratory support, wherein the ventilation support parameters include but are not limited to support pressure, inspiratory pressure, tidal volume, minute ventilation, etc. The ventilation device at least includes a respiratory assistance device. The ventilation circuit is used to connect to the patient's respiratory system to deliver gas to the patient. The ventilation circuit includes a respiratory interface 211, a gas source interface 212, and a respiratory circuit. The sensor assembly includes at least a pressure sensor 40 and a flow sensor 50.

[0067] The breathing circuit selectively connects the gas source interface 212 to the patient's respiratory system. In some embodiments, such as invasive ventilators, the breathing circuit includes an expiratory branch 213a and an inspiratory branch 213b. The expiratory branch 213a is connected between the breathing interface 211 and the exhaust port 213c and is used to direct the patient's exhaled air to the exhaust port 213c. The exhaust port 213c can be connected to the external environment or to a dedicated gas recovery device. In some embodiments, such as non-invasive ventilators, the breathing circuit includes the inspiratory branch 213b but does not require the expiratory branch 213a. The gas source interface 212 is used to connect to a gas source (not shown in the figure), which is used to provide gas, which can generally be oxygen and air. In some embodiments, the gas source can be a compressed gas cylinder or a central gas supply source, and the gas is supplied to the ventilator through the gas source interface 212. The types of gas supplied include oxygen and air. The gas source interface 212 can include conventional components such as a pressure gauge, a pressure regulator, a flow meter, a pressure reducing valve, and an air-oxygen ratio control protection device, which are used to control the flow of various gases (such as oxygen and air). Of course, for an electric ventilator, the gas source can also be a turbine, which outputs gas to the gas source interface 212 through the turbine. The inhalation branch 213b is connected between the respiratory interface 211 and the gas source interface 212 to provide oxygen or air to the patient. For example, the gas input from the gas source interface 212 enters the inhalation branch 213b and then enters the patient's lungs through the respiratory interface 211. The respiratory interface 211 is used to connect the patient to the breathing circuit. In addition to directing gas transmitted by the inspiratory branch 213b to the patient, it can also direct the patient's exhaled gas through the expiratory branch 213a to the exhaust port 213c for invasive ventilators, and directly exhaust the patient's exhaled gas for non-invasive ventilators. Depending on the situation, the respiratory interface 211 can be a nasal cannula or a mask worn over the nose and mouth. The respiratory assistance device is connected to the gas source interface 212 and the breathing circuit to control the delivery of gas provided by the external gas source to the patient through the breathing circuit. In invasive ventilator embodiments, the respiratory assistance device may include an exhalation controller 214a and an inhalation controller 214b, while in non-invasive ventilator embodiments, the respiratory assistance device may include an inhalation controller 214b. The exhalation controller 214a is located on the exhalation branch 213a and is used to connect or close the exhalation branch 213a according to control commands, or to control the flow rate or pressure of the patient's exhaled gas. In a specific implementation, the exhalation controller 214a may include one or more devices capable of controlling flow or pressure, such as an exhalation valve, a one-way valve, a flow controller, or a PEEP valve. The inhalation controller 214b is disposed on the inhalation branch 213b and is used to open or close the inhalation branch 213b according to control instructions, or to control the flow rate or pressure of the output gas. In a specific implementation, the inhalation controller 214b may include one or more devices capable of controlling flow or pressure, such as an exhalation valve, a one-way valve, or a flow controller.

[0068] The pressure sensor 40 is used to collect the monitoring pressure of the ventilator during the mechanical ventilation of the patient, where the monitoring pressure includes but is not limited to airway pressure, esophageal pressure, etc. The flow sensor 50 is used to collect the airway flow rate of the ventilator during the mechanical ventilation of the patient.

[0069] The memory 20 may be used to store data or programs, such as data collected by a sensor, data generated by the processor 10 through calculation, or image frames generated by the processor 10, which may be 2D or 3D images. Alternatively, the memory 20 may store a graphical user interface, one or more default image display settings, or programming instructions for the processor 10. The memory 20 may be a tangible and non-transitory computer-readable medium, such as a flash memory, RAM, ROM, EEPROM, or the like.

[0070] The processor 10 is used to execute instructions or programs to control the respiratory assistance device, the gas source interface 212 and / or various control valves and sensor components in the respiratory circuit, or to process the received data to generate the required calculation or judgment results, or to generate visual data or graphics, and output the visual data or graphics to the display 30 for display.

[0071] The above is some description of the medical device being a ventilator. It should be noted that FIG2 above is only an example of a ventilator, and it is not intended to limit the ventilator to have only such a structure.

[0072] In some embodiments, the medical device may also be an anesthesia machine, which is mainly used to provide anesthetic gas, deliver the anesthetic gas to the patient's respiratory system through a ventilator, and control the amount of anesthetic gas inhaled. Please refer to the anesthesia machine shown in Figure 3, which includes a ventilation device, a ventilation circuit, a processor 10, a memory 20, a display 30 and a sensor assembly. The ventilation device is used to generate gas according to a set pressure or flow to ventilate the patient to provide respiratory support. The ventilation device includes at least a respiratory assistance device 320. The ventilation circuit is used to connect to the patient's respiratory system to deliver gas to the patient. The ventilation circuit includes: a respiratory interface 311, a gas source interface 312 and a respiratory circuit. The sensor assembly includes at least a pressure sensor 40 and a flow sensor 50.

[0073] The gas source interface 312 is used to be connected to a gas source (not shown), and the gas source is used to provide gas. The gas can generally be oxygen, nitrous oxide (laughing gas) or air. In some embodiments, the gas source can be a compressed gas cylinder or a central gas supply source, and the gas supply is oxygen, laughing gas N2O, air, etc. for the anesthesia machine through the gas source interface 312. The gas supply types include oxygen, laughing gas N2O, air, etc. The gas source interface 312 can include conventional components such as a pressure gauge, a pressure regulator, a flow meter, a pressure reducing valve, and an N2O-O2 ratio control protection device, which are respectively used to control the flow of various gases (such as oxygen, laughing gas, and air). The gas input by the gas source interface 312 enters the breathing circuit and forms a mixed gas with the original gas in the breathing circuit.

[0074] The breathing assistance device 320 is used to provide power for the patient's non-spontaneous breathing and maintain airway patency. In some embodiments, the breathing assistance device 320 is connected to the gas source interface 312 and the breathing circuit to control the gas provided by the external gas source to be delivered to the patient through the breathing circuit. In some specific embodiments, the breathing assistance device 320 mixes the fresh gas input from the gas source interface 312, the gas exhaled by the patient in the breathing circuit, and the anesthetic drug output from the anesthetic output device 330, and outputs the mixture to the breathing interface 311 through the inspiratory branch 340b to drive the patient to inhale, and receives the gas exhaled by the patient through the expiratory branch 340a. In a specific embodiment, the breathing assistance device 320 generally includes a machine-controlled ventilation module, and the airflow duct of the machine-controlled ventilation module is connected to the breathing circuit. During the anesthesia maintenance stage during surgery or when the patient has not recovered spontaneous breathing, the machine-controlled ventilation module is used to provide the patient with breathing power.

[0075] The anesthetic output device 330 is used to provide anesthetic drugs. Generally, the anesthetic drugs are mixed into the fresh air introduced by the gas source interface 312 in the form of gas and are delivered to the breathing circuit together. In a specific embodiment, the anesthetic output device 330 is implemented by an anesthetic vaporizer. The anesthetic is usually in liquid form and is stored in the anesthetic vaporizer. Optionally, the anesthetic vaporizer may include a heating device for heating the anesthetic to volatilize it and generate anesthetic vapor. The anesthetic output device 330 is connected to the pipeline of the gas source interface 312. The anesthetic vapor and the fresh air introduced by the gas source interface 312 are mixed and then delivered to the breathing circuit together.

[0076] In some embodiments, the breathing circuit may include an inspiratory branch 340b, an expiratory branch 340a, and a soda lime tank 340c. The inspiratory branch 340b and the expiratory branch 340a are connected to form a closed circuit, and the soda lime tank 340c is arranged on the pipeline of the expiratory branch 340a. The mixed gas of fresh air introduced by the gas source interface 312 is input through the inlet of the inspiratory branch 340b and provided to the patient through the breathing interface 311 arranged at the outlet of the inspiratory branch 340b. The breathing interface 311 can be a mask, a nasal cannula, or an endotracheal cannula. In a preferred embodiment, a one-way valve is provided on the inspiratory branch 340b, which opens during the inspiratory phase and closes during the expiratory phase. The expiratory branch 340a is also provided with a one-way valve, which closes during the inspiratory phase and opens during the expiratory phase. The inlet of the exhalation branch 340a is connected to the breathing interface 311. When the patient exhales, the exhaled gas enters the soda lime tank 340c through the exhalation branch 340a. The carbon dioxide in the exhaled gas is filtered out by the substance in the soda lime tank 340c. The gas after the carbon dioxide is filtered out is recirculated into the inhalation branch 340b.

[0077] The pressure sensor 40 is used to collect the monitoring pressure of the anesthesia machine during the mechanical ventilation of the patient, where the monitoring pressure includes but is not limited to airway pressure, esophageal pressure, etc. The flow sensor 50 is used to collect the airway flow rate of the anesthesia machine during the mechanical ventilation of the patient.

[0078] The memory 20 may be used to store data or programs, such as data collected by sensors, data generated by the processor 10 through calculations, or image frames generated by the processor 10, which may be 2D or 3D images. Alternatively, the memory 20 may store a graphical user interface, one or more default image display settings, or programming instructions for the processor 10. The memory 20 may be a tangible and non-transitory computer-readable medium, such as a flash memory, RAM, ROM, EEPROM, or the like.

[0079] The processor 10 is used to execute instructions or programs to control the respiratory assistance device, the gas source interface 212 and / or various control valves and sensor components in the respiratory circuit, or to process the received data to generate the required calculation or judgment results, or to generate visual data or graphics, and output the visual data or graphics to the display 30 for display.

[0080] The above is some description of the medical device as an anesthesia machine. It should be noted that Figure 3 above is only an example of an anesthesia machine, and it is not intended to limit the anesthesia machine to only have such a structure.

[0081] The following uses a ventilation device as an example of medical equipment to illustrate ventilation control methods in some embodiments of the present invention with reference to FIG4 .

[0082] Step 1a: Obtain monitoring pressure and / or airway flow rate of the ventilation device during mechanical ventilation of the patient.

[0083] In this embodiment, the monitored pressure includes but is not limited to airway pressure, esophageal pressure, etc. The pressure sensor 40 can be placed inside the machine (for example, set on the machine board), and the pressure it measures is determined by the different positions of the sampling tube to determine what kind of pressure is collected. For example, the sampling tube is connected to the air supply port or the air outlet end of the ventilator, or the airway pressure is measured on the pipeline / mask. For example, the esophageal pressure is measured by placing a pressure measuring tube in the esophagus. The flow sensor 50 can also be set at a location connected to the patient's airway, such as at a respiratory interface or a respiratory circuit. When the ventilation device ventilates the patient, the flow sensor 50 collects the airway flow rate of the ventilation, that is, the airway flow rate is collected, and the airway flow rate is known according to the inner diameter of the pipe, and the ventilation volume is known according to the time.

[0084] Step 2a: Determine a value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate. The value of the respiratory drive parameter can represent the strength of the patient's respiratory effort. A larger value of the respiratory drive parameter indicates a stronger respiratory effort, while a smaller value of the respiratory drive parameter indicates a weaker respiratory effort.

[0085] In some embodiments, the respiratory drive parameter is the respiratory muscle pressure Pmus. Several methods for calculating the respiratory muscle pressure Pmus are first described below.

[0086] In some embodiments, when the monitored pressure is the patient's airway pressure, the respiratory muscle pressure can be calculated based on a preset respiratory mechanics equation, as well as the airway pressure and airway flow rate. The human respiratory system can be simplified as a first-order RC model, and the respiratory mechanics equation can be established based on the first-order RC model:

[0087] Paw-Pmus=Flow*R+Volume*E+PEEPtot;

[0088] Where: R represents the viscous resistance of the respiratory system, and E is the elastic resistance of the respiratory system (which can also be represented by the compliance C of the respiratory system). R and E are usually constants.

[0089] Pmus represents respiratory muscle pressure; Paw represents airway pressure, which can be directly measured by pressure sensor 40 during mechanical ventilation; Flow represents airway flow velocity, which can be measured by flow sensor 50; Volume represents ventilation volume, which is the integral of airway flow velocity.

[0090] PEEPtot stands for total positive end-expiratory pressure. It is typically composed of two components: exogenous PEEPe and intrinsic PEEPi. Exogenous PEEPe, as the name suggests, is the positive pressure in the patient's airway at the end of expiration caused by external factors. It is typically generated by the ventilator when the patient is ventilating. The user can adjust the level of exogenous PEEPe by adjusting the ventilator settings. Intrinsic PEEPi, on the other hand, is the positive pressure in the patient's airway at the end of expiration caused by internal factors, such as the patient's lung condition. The sum of exogenous PEEPe and intrinsic PEEPi ultimately forms the total PEEPtot. In other words, PEEPtot is equal to the sum of exogenous PEEPe (exogenous PEEP, i.e., PEEP monitored by airway pressure) and intrinsic PEEPi (intrinsic PEEP).

[0091] Figure 5 shows some variables in the respiratory mechanics equations. These variables can be solved to obtain respiratory muscle pressure. Specifically, PEEPtot, Pmus, R, and E are unknown quantities in the respiratory mechanics equations, while the others are known quantities. During the patient's inhalation, Pmus changes over time. By measuring a series of Paw, Flow, and Volume, we can derive multiple equations:

[0092] Paw(1)-Pmus(1)=Flow(1)*R+Volume(1)*E+PEEPtot;

[0093] Paw(2)-Pmus(2)=Flow(2)*R+Volume(2)*E+PEEPtot;

[0094] …

[0095] Paw(n)-Pmus(n)=Flow(n)*R+Volume(n)*E+PEEPtot;

[0096] In other words, the processor 10 substitutes multiple sets of airway pressure Paw, airway flow rate Flow and ventilation volume Volume at different times as known quantities into the preset respiratory mechanics equation, and obtains a set of equations with unknown quantities being the pressure Pmus generated by the respiratory muscles and the total positive end-expiratory pressure PEEPtot. Taking n sets of Paw, Flow and Volume data as an example, n equations can be obtained, but there are n+3 unknowns. Therefore, in order to make the set of equations solvable, the present invention creatively simplifies Pmus, for example, simplifies Pmus into a known function (curve) according to the physiological characteristics of spontaneous breathing. In other words, in the respiratory mechanics equation, the respiratory muscle pressure is an unknown quantity that has a preset functional relationship with time. Although it is an unknown quantity, it also has its own rules (a preset functional relationship with time). The preset functional relationship may include: a combination of one or more of an exponential function, a trigonometric function, a piecewise function and a polynomial function. According to the physiological characteristics of spontaneous breathing, as shown in Figure 5, the absolute value of Pmus has a changing trend: from small to large, and then from large to small. Therefore, we can select an exponential function to simulate the section from small to large, and then select another exponential function to simulate the section from large to small. Of course, these two exponential functions actually constitute a piecewise function. We can also select a linear function to simulate the section from small to large, and then select another linear function to simulate the section from large to small. Similarly, these two linear functions actually constitute a piecewise function. We can also select trigonometric functions, multi-order polynomial functions, etc. to simulate. The number of unknowns will be different depending on the specific function relationship selected. Such as sine function (such as sin(b0+b1t)), cosine function, quadratic polynomial function (such as a1t+a2t 2 ) to simulate Pmus. This embodiment takes a parabola (quadratic polynomial function) to simplify Pmus as an example, and the above equations can be simplified to:

[0097] Y=[Paw(1),Paw(2),…,Paw(n)] T

[0098] F=[Flow(1),Flow(2),…,Flow(n)] T

[0099] V=[Volume(1),Volume(2),…,Volume(n)] T

[0100] Let: X = [F, V, 1, t, t 2 ],A=[R,E,PEEPtot,a1,a2] T ,

[0101] The above equations can be expressed using the matrix Y = X * A. Solving the above equations, i.e., performing a matrix solver, yields the respiratory muscle pressure Pmus. Specifically, the number of sampling points during inspiration (the number of data sets for Paw, Flow, and Volume) is generally much greater than 5. Therefore, this equation system is overdetermined. That is, the number n satisfies the need to solve n + 3 overdetermined equations. If R and E are known, then the need to solve n + 1 overdetermined equations is satisfied. The optimal solution to the overdetermined equation system can be found by the following process:

[0102] Y=X*A, then X T *Y=X T *X*A, where X T *X is a 5*5 matrix, which can be inverted, so the solution is:

[0103] A=(X T *X) -1 X T *Y;

[0104] After matrix solution, Pmus can be obtained.

[0105] Furthermore, to improve the accuracy and effectiveness of the solution, one or more constraints may be added during the solution of the system of equations, including but not limited to: setting the respiratory muscle pressure Pmus at both the start and end of inspiration to 0; setting the intrinsic positive end-expiratory pressure PEEPi to be greater than or equal to 0; setting the respiratory muscle pressure Pmus to 0 for patients without spontaneous breathing; and limiting the viscous resistance R and elastic resistance E of the respiratory system to within a preset reasonable range, which can be set based on actual conditions, clinical experience, etc. One or more of these constraints can be selected as constraints when solving the system of equations, thereby more accurately and reliably determining the respiratory muscle pressure Pmus.

[0106] In some embodiments, when the monitored pressure is the patient's esophageal pressure, the patient's chest wall compliance, Ccw, is calculated based on the esophageal pressure and airway flow rate. Chest wall compliance, Ccw, is calculated as ΔV / dPES, where ΔV represents the change in lung volume, which can be reflected by airway flow rate, and dPES refers to the change in esophageal pressure as volume changes. As shown in FIG6 , this includes the waveform change of esophageal pressure. After obtaining chest wall compliance, respiratory muscle pressure is calculated based on airway flow rate, esophageal pressure, and chest wall compliance according to a human respiratory system model. FIG7 is a schematic diagram of a human respiratory system model, where Paw represents airway pressure, Flow represents airway flow rate, R represents the viscous resistance of the respiratory system, PL represents intrapulmonary pressure, CL represents lung compliance, Ccw represents chest wall compliance, Pes represents esophageal pressure, which is used clinically to approximate intrathoracic pressure, and PEEPtot represents total positive end-expiratory pressure. According to the respiratory system model, the respiratory muscle pressure can be calculated through the esophageal pressure and chest wall compliance, specifically: Pmus = Pes-Volume / Ccw.

[0107] In some embodiments, when the monitored pressure is the patient's esophageal pressure and intragastric pressure, the patient's transdiaphragmatic pressure is calculated based on the esophageal pressure and intragastric pressure, and the transdiaphragmatic pressure is used as the respiratory muscle pressure, where transdiaphragmatic pressure = pleural pressure - intra-abdominal pressure. The transdiaphragmatic pressure can be obtained by approximately replacing the pleural pressure with the esophageal pressure and approximately replacing the intra-abdominal pressure with the intragastric pressure.

[0108] In some embodiments, when the monitored pressure is the patient's esophageal pressure, the esophageal pressure can also be directly used as the respiratory muscle pressure.

[0109] In some embodiments, the respiratory drive parameter is inspiratory work, which is calculated based on the time integral of the product of respiratory muscle pressure and airway flow rate. After calculating the respiratory muscle pressure using the method described in any of the above embodiments, the time integral of the product of respiratory muscle pressure and airway flow rate is calculated to obtain the inspiratory work.

[0110] In some embodiments, the respiratory drive parameter is a respiratory muscle pressure area. The respiratory muscle pressure area is obtained according to the integral value of the respiratory muscle pressure over time. After the respiratory muscle pressure is calculated by the method in any of the above embodiments, the integral value of the respiratory muscle pressure over time is calculated to obtain the respiratory muscle pressure area. In Figure 5, the area surrounded by the curve of the respiratory muscle pressure and the time axis in each respiratory cycle is the respiratory muscle pressure area corresponding to this respiratory cycle.

[0111] In some embodiments, the respiratory drive parameter is a flow index. The flow index is used to characterize the speed of change of the inspiratory flow curve obtained from the airway flow velocity during the downward process. Specifically, the flow index corresponding to a respiratory cycle can be calculated according to the following formula:

[0112] F=a+bΔt c ;

[0113] Where F represents the airway flow velocity during the inspiratory phase of the respiratory cycle, a represents the peak airway flow velocity during the inspiratory phase of the respiratory cycle, b represents the flow rate reduction rate corresponding to a selected duration Δt during the inspiratory phase of the respiratory cycle, and c represents the flow index. For example, the selected duration can be the time from the peak to one-quarter of the peak airway flow velocity during the inspiratory phase. As can be seen from this formula, a flow index can be obtained after determining the selected duration. In this embodiment, only one selected duration is used for each respiratory cycle, so each respiratory cycle corresponds to a flow index.

[0114] In some embodiments, after obtaining the parameter value of the respiratory drive parameter, the parameter value of the respiratory drive parameter can also be displayed. For example, when the medical device is a monitor, the parameter value of the respiratory drive parameter can be displayed together with the parameter value of the patient's physiological parameter on the display 30 of the monitor. When the medical device is a ventilator or an anesthesia machine, the parameter value of the respiratory drive parameter can be displayed together with the ventilation support parameter on the display 30 of the ventilator or anesthesia machine.

[0115] Step 3a: Perform statistical analysis on the parameter values ​​of the respiratory drive parameters to determine a first target value.

[0116] It is described above that the respiratory drive parameters include respiratory muscle pressure, inspiratory work, respiratory muscle pressure area or flow index.

[0117] In some embodiments, if the respiratory drive parameter is respiratory muscle pressure, the respiratory muscle pressure within a first set time period is obtained, and the associated value of any one of the maximum value, average value, and median value of the respiratory muscle pressure within the first set time period is used as the first target value. In some embodiments, the associated value refers to the maximum value, average value, or median value of the respiratory muscle pressure itself. For example, the maximum value of the respiratory muscle pressure within the first set time period is used as the first target value, or the average value of the respiratory muscle pressure within the first set time period is used as the first target value. In other embodiments, the associated value refers to a value obtained by performing a certain calculation based on the maximum value, average value, or median value of the respiratory muscle pressure. For example, after obtaining the maximum value of the respiratory muscle pressure, a preset correction coefficient is used to correct the maximum value to obtain the first target value. For another example, after obtaining the maximum value of the respiratory muscle pressure, a preset value is added or subtracted to obtain the first target value. In some embodiments, the first set time period is the duration of at least one respiratory cycle. As can be seen from Figure 5, respiratory muscle pressure is a variable that can be calculated in real time as it changes over time.

[0118] In some embodiments, if the respiratory drive parameter is inspiratory work, the first target value is determined based on the inspiratory work integrated over a second set time period. In some embodiments, the second set time period is the duration of at least one respiratory cycle. In other embodiments, N inspiratory works corresponding to N respiratory cycles can also be obtained, where N is an integer greater than or equal to 1, and each respiratory cycle corresponds to one inspiratory work. Then, a correlation value of any one of the maximum value, average value, and median value of the N inspiratory works is used as the first target value. In some embodiments, the correlation value refers to the maximum value, average value, or median value of the N inspiratory works themselves. For example, the maximum value of the N inspiratory works is used as the first target value. In other embodiments, the correlation value refers to a value obtained by performing a certain calculation based on the maximum value, average value, or median value of the N inspiratory works. For example, after obtaining the average value of the N inspiratory works, the average value is corrected using a preset correction coefficient to obtain the first target value. For another example, after obtaining the average value of the N inspiratory works, a preset value is added to or subtracted from it to obtain the first target value.

[0119] In some embodiments, if the respiratory drive parameter is the respiratory muscle pressure area, the first target value is determined based on the respiratory muscle pressure area obtained by integrating within the third set duration. In some embodiments, the third set duration is the duration of at least one respiratory cycle. In other embodiments, N respiratory muscle pressure areas corresponding to N respiratory cycles can also be obtained, wherein N is an integer greater than or equal to 1, and each respiratory cycle corresponds to a respiratory muscle pressure area. For example, in Figure 5, N is 2, and there are two respiratory muscle pressure areas. The associated value of any one of the maximum value, average value and median value of the N respiratory muscle pressure areas is then used as the first target value. In some embodiments, the associated value refers to the maximum value, average value or median value itself of the N respiratory muscle pressure areas. For example, the maximum value among the N respiratory muscle pressure areas is used as the first target value. In other embodiments, the associated value refers to a value obtained by performing certain calculations based on the maximum value, average value or median value of N respiratory muscle pressure areas. For example, after obtaining the average value of N respiratory muscle pressure areas, the average value is corrected using a preset correction coefficient to obtain a first target value. For another example, after obtaining the average value of N respiratory muscle pressure areas, the preset value is added or subtracted to obtain the first target value.

[0120] In some embodiments, if the respiratory drive parameter is a flow index, N flow indices corresponding to N respiratory cycles are calculated, where N is an integer greater than or equal to 1. Then, the correlation value of any one of the maximum value, average value, and median value of the N flow indices is used as the first target value. In some embodiments, the correlation value refers to the maximum value, average value, or median value itself of the N flow indices. For example, the maximum value of the N flow indices is used as the first target value. In other embodiments, the correlation value refers to a value obtained by performing a certain calculation based on the maximum value, average value, or median value of the N flow indices. For example, after obtaining the average value of the N flow indices, the average value is corrected using a preset correction coefficient to obtain the first target value. For another example, after obtaining the average value of the N flow indices, a preset value is added or subtracted to obtain the first target value.

[0121] Step 4a: Compare the first target value with a preset first range.

[0122] Step 5a: adjusting and / or prompting to adjust the parameter value of the ventilation support parameter according to the comparison result.

[0123] The respiratory drive parameter can characterize the patient's respiratory effort, and the first target value obtained by the parameter value of the respiratory drive parameter can more accurately reflect the strength of the patient's spontaneous breathing.

[0124] If the first target value is greater than the upper limit value of the first range, it means that the current patient's spontaneous breathing is too strong, so the parameter value of the ventilation support parameter is increased and / or reminded to be increased to reduce the intensity of the patient's spontaneous breathing and prevent diaphragm fatigue. Here, the method of increasing the parameter value of the ventilation support parameter can be that the ventilation device changes the parameter value of the ventilation support parameter according to a preset rule. In some embodiments, the parameter value of the ventilation support parameter can be increased with the first adjustment step corresponding to the ventilation support parameter. For example, if the ventilation support parameter is the support pressure, a preset pressure value is increased on the basis of the current support pressure. For another example, if the ventilation support parameter is the tidal volume, a preset tidal volume is increased on the basis of the current tidal volume. The reminder to increase the parameter value of the ventilation support parameter can display a reminder message on the display 30, or remind the user to increase the parameter value of the ventilation support parameter by sound, light, etc.

[0125] If the first target value is less than the lower limit of the first range, it means that the current patient's spontaneous breathing is very weak, so the parameter value of the ventilation support parameter is reduced and / or reminded to be reduced to improve the patient's respiratory drive and prevent diaphragmatic disuse atrophy. In some embodiments, reducing the parameter value of the ventilation support parameter is similar to increasing the parameter value of the ventilation support parameter, and the parameter value of the ventilation support parameter is also reduced by the second adjustment step corresponding to the ventilation support parameter. The first adjustment step and the second adjustment step may be the same or different. In summary, after obtaining the first target value, the first target value is compared with the first range. If the first target value is within the first range, it means that the patient's spontaneous breathing is within the appropriate range. If the first target value is not within the first range, it is determined whether to reduce or increase the ventilation support parameter based on whether the first target value is lower than or higher than the first range, and the adjustment process is a step-by-step adjustment.

[0126] In some embodiments, during the process of adjusting and / or reminding to adjust the parameter value of the ventilation support parameter, the parameter value of the ventilation support parameter can also be compared with the preset support parameter range in real time or periodically. When the parameter value of the ventilation support parameter reaches the boundary value of the support parameter range, the adjustment and / or reminder to adjust the parameter value of the ventilation support parameter is stopped. The support parameter range can be set by the user based on clinical experience to avoid excessive or excessively small ventilation support parameters causing harm to the patient's body. For example, if the first target value is greater than the upper limit value of the first range, the parameter value of the ventilation support parameter begins to increase. When the parameter value of the ventilation support parameter reaches the upper limit value of the support parameter range, the parameter value of the ventilation support parameter is no longer increased, making the adjustment of the ventilation support parameter safer.

[0127] The currently implemented PAV (Proportional Assist Ventilation) mode is based on the collected real-time parameter value representing the respiratory effort and the ventilation pressure at the next moment determined according to a preset ratio, and the ventilation equipment is controlled according to the determined ventilation pressure at the next moment; specifically, within a respiratory cycle, the greater the parameter value of the respiratory effort at the i-th moment, the greater the support pressure provided by the ventilator at the i+1 moment. Compared with the existing PAV mode, the embodiment described in Figure 4 above, on the one hand: the first range is set by the user, and when the user does not adjust the first range, the first target value obtained through statistical analysis is compared with the currently set first range. In this way, the user can set the first range by operating in the medical device, while the PAV mode does not require pre-setting the first range; on the other hand: the PAV mode directly performs proportional adjustment by collecting the parameter value of the respiratory effort in real time, while the present embodiment performs the comparison step only after the first target value is obtained through statistical analysis of the parameter value of the respiratory drive parameter. Since the ventilation pressure adjusted by the real-time proportional adjustment method has large fluctuations, it affects the stable regulation of the patient. The present embodiment does not adopt real-time regulation of the ventilation support parameters, which reduces the calculation complexity while achieving stable regulation of the patient.

[0128] In some embodiments, the processor 10 is further connected to a delivery pump. The delivery pump is used to deliver selected medications into the patient's body. The ventilation device can send control instructions to control the delivery pump's operation, such as controlling the delivery pump to deliver medications to the patient or controlling the medication infusion rate. As shown in FIG8 , after step 4a, the following steps may also be included:

[0129] Step 5b: Control the output pump to adjust and / or remind to adjust the drug that affects the respiratory effort according to the comparison result.

[0130] Specifically, if the first target value is greater than the upper limit of the first scope, then when the ventilation device is communicatively connected with the output pump, the ventilation device can directly control the output pump to increase the medicine that affects respiratory effort, such as muscle relaxants, sedatives, etc. In some embodiments, increasing medicine can have two meanings, the first is that the original patient did not use the medicine that affects respiratory effort, then starts to output the medicine that affects respiratory effort to the patient, and another meaning is that the patient is currently using the medicine that affects respiratory effort, then increases the usage amount and / or the number of times of use of the medicine. In addition to increasing medicine, if the first target value is greater than the upper limit of the first scope, the ventilation device can also remind to increase the medicine that affects respiratory effort, such as, display corresponding reminder information on display 30, or send corresponding reminder information to the output pump. It is understandable that no matter whether the ventilation device is communicatively connected with the output pump, the reminder of increasing medicine can be issued.

[0131] In some embodiments, when adding and / or reminding to add a medication, a first difference between a first target value and an upper limit of a first range is obtained, first medication data is determined based on the first difference, and the medication is added and / or reminded to add the medication based on the first medication data. In some embodiments, the first medication data includes a first medication dose of the medication, and if the first medication dose is greater than the medication dose before adjustment, then adding and / or reminding to add the medication based on the first medication data means administering the medication at the first medication dose and / or reminding to administer the medication at the first medication dose. In some embodiments, the first medication data includes a first medication frequency of a preset medication dose, and if the first medication frequency is greater than the medication frequency of the preset medication dose before adjustment, then adding and / or reminding to add the medication based on the first medication data means administering the medication at the first medication frequency and / or reminding to administer the medication at the first medication frequency while maintaining the preset medication dose. As can be seen from the above description, increasing medication can be achieved by at least one of increasing the medication dose and increasing the medication frequency. In some embodiments, the larger the first difference, the larger the first medication dose and / or the larger the first medication frequency.

[0132] If the first target value is less than the lower limit of the first range, then when the ventilation device is communicatively connected to the output pump, the ventilation device can directly control the output pump to reduce the amount of medication that affects respiratory effort. In some embodiments, reducing medication can have two meanings: the first meaning is that the patient is previously using a medication that affects respiratory effort, and the output pump is controlled to no longer deliver the medication; the second meaning is that the patient is currently using a medication that affects respiratory effort, and the amount and / or frequency of medication use is reduced. In addition to reducing medication, if the first target value is less than the lower limit of the first range, the ventilation device can also prompt the user to reduce the amount of medication that affects respiratory effort, for example, by displaying a corresponding reminder on the display 30. It is understood that the reminder to reduce medication can be issued regardless of whether the ventilation device is communicatively connected to the output pump.

[0133] In some embodiments, when reducing and / or reminding to reduce a medication that affects respiratory effort, a second difference between the first target value and the lower limit of the first range is obtained, second medication data is determined based on the second difference, and the medication is reduced and / or reminded to reduce based on the second medication data. In some embodiments, the second medication data includes a second medication dose, and the second medication dose is less than the medication dose before adjustment. In this case, reducing and / or reminding to reduce the medication based on the second medication data means administering the medication at the second medication dose and / or reminding to administer the medication at the second medication dose. In some embodiments, the second medication data includes a second medication frequency for a preset medication dose, and the second medication frequency is less than the medication frequency for the preset medication dose before adjustment. In this case, reducing and / or reminding to reduce the medication based on the second medication data means administering the medication at the second medication frequency and / or reminding to administer the medication at the second medication frequency while maintaining the preset medication dose. As can be seen from the above description, medication reduction can be achieved by at least one of reducing the medication dose and reducing the medication frequency. In some embodiments, the larger the second difference, the smaller the second medication dose and / or the fewer the second medication frequency.

[0134] In some embodiments, as shown in FIG9 , another ventilation control method is provided, which, after step 2a, includes:

[0135] Step 3c: Performing statistical analysis on the parameter values ​​of the respiratory drive parameter within a set duration to determine a second target value, wherein the set duration includes N respiratory cycles, where N is an integer greater than or equal to 1. In other words, in this embodiment, the second target value is determined based on the parameter values ​​of the respiratory drive parameter within at least one respiratory cycle.

[0136] Specifically, respiratory drive parameters include respiratory muscle pressure, respiratory muscle pressure area, inspiratory work, or flow index.

[0137] In some embodiments, if the respiratory drive parameter is the respiratory muscle pressure, the respiratory muscle pressure within the set time is obtained, and the associated value of any one of the maximum value, average value and median value of the respiratory muscle pressure within the set time is used as the second target value. In some embodiments, the associated value refers to the maximum value, average value or median value of the respiratory muscle pressure itself. For example, the maximum value of the respiratory muscle pressure within the set time is used as the second target value, or the average value of the respiratory muscle pressure within the set time is used as the second target value. In other embodiments, the associated value refers to a value obtained by performing a certain calculation based on the maximum value, average value or median value of the respiratory muscle pressure. For example, after obtaining the maximum value of the respiratory muscle pressure, a preset correction coefficient is used to correct the maximum value to obtain the second target value. For another example, after obtaining the maximum value of the respiratory muscle pressure, a preset value is added or subtracted to it to obtain the second target value.

[0138] In some embodiments, if the respiratory drive parameter is inspiratory work, the second target value is determined based on the inspiratory work integrated within the set duration. In other embodiments, N inspiratory works corresponding to the N respiratory cycles included in the set duration can also be obtained, wherein each respiratory cycle corresponds to one inspiratory work, and then the correlation value of any one of the maximum value, average value, and median value of the N inspiratory works is used as the second target value. In some embodiments, the correlation value refers to the maximum value, average value, or median value of the N inspiratory works themselves. For example, the maximum value of the N inspiratory works is used as the second target value. In other embodiments, the correlation value refers to a value obtained by performing a certain calculation based on the maximum value, average value, or median value of the N inspiratory works. For example, after obtaining the average value of the N inspiratory works, the average value is corrected using a preset correction coefficient to obtain the second target value. For example, after obtaining the average value of the N inspiratory works, a preset value is added or subtracted to obtain the second target value.

[0139] In some embodiments, if the respiratory drive parameter is a respiratory muscle pressure area, the second target value is determined based on the respiratory muscle pressure area obtained by integrating the pressure areas within the set duration. In other embodiments, N respiratory muscle pressure areas corresponding to the N respiratory cycles included in the set duration can also be obtained, wherein each respiratory cycle corresponds to a respiratory muscle pressure area. For example, in Figure 5, N is 2, and there are two respiratory muscle pressure areas. Then, the associated value of any one of the maximum value, average value, and median value of the N respiratory muscle pressure areas is used as the second target value. In some embodiments, the associated value refers to the maximum value, average value, or median value of the N respiratory muscle pressure areas. For example, the maximum value among the N respiratory muscle pressure areas is used as the second target value. In other embodiments, the associated value refers to a value obtained by performing a certain calculation based on the maximum value, average value, or median value of the N respiratory muscle pressure areas. For example, after obtaining the average value of the N respiratory muscle pressure areas, a preset correction coefficient is used to correct the average value to obtain the second target value. For another example, after obtaining the average value of the N respiratory muscle pressure areas, a preset value is added or subtracted to obtain the second target value.

[0140] In some embodiments, if the respiratory drive parameter is a flow index, N flow indices corresponding to the N respiratory cycles included in the set duration are calculated, and then the associated value of any one of the maximum value, average value, and median value of the N flow indices is used as the second target value. In some embodiments, the associated value refers to the maximum value, average value, or median value itself of the N flow indices. For example, the maximum value of the N flow indices is used as the second target value. In other embodiments, the associated value refers to a value obtained by performing a certain calculation based on the maximum value, average value, or median value of the N flow indices. For example, after obtaining the average value of the N flow indices, the average value is corrected using a preset correction coefficient to obtain the second target value. For example, after obtaining the average value of the N flow indices, the preset value is added or subtracted to obtain the second target value.

[0141] Step 4c: Obtain a reference value corresponding to the ventilation support parameter in the ventilation device based on the second target value, wherein the second target value and the parameter value corresponding to the ventilation support parameter have a preset proportional relationship. It is understood that the proportional relationships between the parameter values ​​of different types of ventilation support parameters and the second target value may be the same or different. For example, when the ventilation support parameter is support pressure, the proportional relationship may be x, and when the ventilation support parameter is tidal volume, the proportional relationship may be y.

[0142] Step 5c, adjusting and / or reminding to adjust the parameter value of the ventilation support parameter of the ventilation device in the target respiratory cycle according to the reference value. Wherein, the target respiratory cycle is after the set duration. That is to say, the ventilation control method shown in Figure 9 is to determine a second target value by the parameter value of the respiratory drive parameter in one or several respiratory cycles before the target respiratory cycle, and then proportionally adjust the parameter value of the ventilation support parameter in the target respiratory cycle according to the second target value, so that the parameter value of the ventilation support parameter in the target respiratory cycle is in a preset ratio with the obtained second target value.

[0143] Existing PAV modes use real-time acquired values ​​representing respiratory effort and a preset ratio to determine the ventilation pressure at the next moment, and then control the ventilation device based on the determined ventilation pressure at the next moment. Specifically, within a respiratory cycle, the greater the respiratory effort parameter value at moment i, the greater the support pressure provided by the ventilator at moment i+1. Compared to existing PAV modes, the embodiment described in FIG9 , on the one hand, has the following advantages: the preset proportional relationship is the ratio between a second target value obtained through statistical analysis of the respiratory drive parameter value and the ventilation support parameter, while the PAV mode uses the ratio between the respiratory muscle pressure parameter value and the ventilation pressure, without statistical analysis. On the other hand, the PAV mode directly adjusts the proportional relationship based on real-time acquired respiratory effort parameter values, while the present embodiment performs statistical analysis based on the respiratory drive parameter value and only determines the reference value corresponding to the ventilation support parameter after obtaining the second target value. Because the ventilation pressure adjusted using real-time proportional adjustment is subject to significant fluctuations, this affects stable ventilation control for the patient. The present embodiment does not employ real-time control of the ventilation support parameter, reducing computational complexity while still achieving stable ventilation control for the patient.

[0144] In the above embodiments, the target value is determined by the parameter value of the respiratory drive parameter, and the parameter value of the ventilation support parameter is adjusted and / or prompted to be adjusted according to the target value, or the drug that affects the respiratory effort is adjusted and / or prompted to be adjusted according to the target value, thereby preventing diaphragm fatigue and diaphragm disuse atrophy.

[0145] Those skilled in the art will appreciate that all or part of the functions of the various methods in the above embodiments can be implemented by hardware or by computer program. When all or part of the functions in the above embodiments are implemented by computer program, the program can be stored in a computer-readable storage medium, and the storage medium can include: read-only memory, random access memory, disk, optical disk, hard disk, etc., and the program is executed by a computer to implement the above functions. For example, the program is stored in the memory of the device, and when the program in the memory is executed by the processor, all or part of the above functions can be implemented. In addition, when all or part of the functions in the above embodiments are implemented by computer program, the program can also be stored in a storage medium such as a server, another computer, disk, optical disk, flash disk or mobile hard disk, and saved in the memory of the local device by downloading or copying, or the system of the local device is updated. When the program in the memory is executed by the processor, all or part of the functions in the above embodiments can be implemented.

[0146] The above specific examples are used to illustrate the present invention, which are only used to help understand the present invention and are not intended to limit the present invention. For those skilled in the art, according to the concept of the present invention, the above specific embodiments can be modified.

Claims

1. A ventilation control method, characterized in that: include: Obtain monitoring pressure and / or airway flow rate during mechanical ventilation of patients by ventilation equipment; Determining a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, wherein the respiratory drive parameter is used to characterize the patient's respiratory effort, and the respiratory drive parameter includes respiratory muscle pressure, inspiratory work, or a flow index. The respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate. The inspiratory work is obtained by integrating the product of the respiratory muscle pressure and the airway flow rate over time. The flow index is used to characterize the speed of change of an inspiratory flow curve obtained from the airway flow rate during a descending process. Performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value; The first target value is compared with a preset first range, and the parameter value of the ventilation support parameter is adjusted and / or prompted to be adjusted according to the comparison result. The ventilation support parameter is used to reflect the pressure or flow condition set by the ventilation device.

2. The method according to claim 1, wherein If the respiratory drive parameter is the respiratory muscle pressure, performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value includes: The respiratory muscle pressure within a first set time period is obtained, and a correlation value of any one of the maximum value, average value, and median value of the respiratory muscle pressure within the first set time period is used as the first target value.

3. The method according to claim 2, wherein The first set duration is the duration of at least one respiratory cycle.

4. The method according to claim 1, wherein If the respiratory drive parameter is the inspiratory work, performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value includes: The inhalation work integrated within the second set time period is used as the first target value.

5. The method according to claim 4, wherein The second set duration is the duration of at least one respiratory cycle.

6. The method according to claim 1, wherein If the respiratory drive parameter is the inspiratory work, performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value includes: Obtaining N inhalation works corresponding to N respiratory cycles, where each respiratory cycle corresponds to one inhalation work; and using a correlation value of any one of the maximum value, the average value, and the median value of the N inhalation works as the first target value; Wherein N is an integer greater than or equal to 1.

7. The method according to claim 1, wherein If the respiratory drive parameter is the flow index, performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value includes: Calculate N flow indices corresponding to N respiratory cycles, one flow index for each respiratory cycle; and use the associated value of any one of the maximum value, average value, and median value of the N flow indices as the first target value, where N is an integer greater than or equal to 1.

8. The method according to any one of claims 1 to 7, wherein: The adjusting and / or prompting to adjust the parameter value of the ventilation support parameter according to the comparison result includes: If the first target value is greater than the upper limit value of the first range, increase and / or remind to increase the parameter value of the ventilation support parameter; and / or, if the first target value is less than the lower limit value of the first range, decrease and / or remind to decrease the parameter value of the ventilation support parameter.

9. The method according to claim 8, wherein The increasing and / or prompting to increase the parameter value of the ventilation support parameter includes: increasing the parameter value of the ventilation support parameter by a first adjustment step corresponding to the ventilation support parameter, and / or prompting the patient to increase the parameter value of the ventilation support parameter by the first adjustment step corresponding to the ventilation support parameter; The reducing and / or prompting to reduce the parameter value of the ventilation support parameter includes: Decreasing the parameter value of the ventilation support parameter with the second adjustment step size corresponding to the ventilation support parameter, and / or prompting to decrease the parameter value of the ventilation support parameter with the second adjustment step size corresponding to the ventilation support parameter.

10. The method according to any one of claims 1 to 9, wherein Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the respiratory muscle pressure and the monitored pressure is the patient's airway pressure, the respiratory muscle pressure is calculated according to a preset respiratory mechanics equation, the airway pressure, and the airway flow rate; or When the respiratory drive parameter is the inspiratory work and the monitored pressure is the patient's airway pressure, the respiratory muscle pressure is calculated according to a preset respiratory mechanics equation, as well as the airway pressure and the airway flow rate; and the integral value of the product of the respiratory muscle pressure and the airway flow rate over time is used as the inspiratory work.

11. The method according to claim 10, characterized in that The step of calculating the respiratory muscle pressure according to a preset respiratory mechanics equation, the airway pressure, and the airway flow rate comprises: Substituting multiple sets of airway pressure, airway flow rate and ventilation volume at different times into the preset respiratory mechanics equation to obtain a set of equations for respiratory muscle pressure and total positive end-expiratory pressure; Solving the equation group to calculate the respiratory muscle pressure; Wherein, the preset respiratory mechanics equation is: Paw-Pmus=Flow*R+Volume*E+PEEPtot; Wherein, Paw represents airway pressure, Pmus represents respiratory muscle pressure, Flow represents airway flow rate, Volume represents ventilation volume, and the ventilation volume is obtained based on the integral value of the airway flow rate over time. R represents the viscous resistance of the respiratory system, E represents the elastic resistance of the respiratory system, and PEEPtot represents the total positive end-expiratory pressure.

12. The method according to any one of claims 1 to 9, wherein: Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the respiratory muscle pressure and the monitored pressure is the esophageal pressure of the patient, the chest wall compliance of the patient is calculated based on the esophageal pressure and the airway flow rate; the respiratory muscle pressure is calculated based on the airway flow rate, the esophageal pressure and the chest wall compliance according to a human respiratory system model; or When the respiratory drive parameter is the inspiratory work and the monitored pressure is the patient's esophageal pressure, the patient's chest wall compliance is calculated based on the esophageal pressure and the airway flow rate; the respiratory muscle pressure is calculated based on the airway flow rate, the esophageal pressure and the chest wall compliance according to the human respiratory system model; and the integral value of the product of the respiratory muscle pressure and the airway flow rate over time is used as the inspiratory work.

13. The method according to any one of claims 1 to 9, wherein: Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the respiratory muscle pressure and the monitored pressure is the esophageal pressure and the intragastric pressure of the patient, the transdiaphragmatic pressure of the patient is calculated based on the esophageal pressure and the intragastric pressure, and the transdiaphragmatic pressure is used as the respiratory muscle pressure; or When the respiratory drive parameter is the inspiratory work and the monitored pressure is the esophageal pressure and intragastric pressure of the patient, the patient's transdiaphragmatic pressure is calculated based on the esophageal pressure and intragastric pressure, and the transdiaphragmatic pressure is used as the respiratory muscle pressure; and the integral value of the product of the respiratory muscle pressure and the airway flow rate over time is used as the inspiratory work.

14. The method according to any one of claims 1 to 9, wherein: Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the flow index, the flow index corresponding to one respiratory cycle is calculated according to the following formula: F=a+bΔt c ; Wherein, F represents the airway flow velocity during the inspiratory phase of the respiratory cycle, a represents the peak value of the airway flow velocity during the inspiratory phase of the respiratory cycle, b represents the flow reduction rate corresponding to the selected duration Δt during the inspiratory phase of the respiratory cycle, and c represents the flow index.

15. The method according to any one of claims 1 to 14, wherein: The ventilation support parameter includes at least one of support pressure, inspiratory pressure, tidal volume, and minute ventilation.

16. A ventilation control method, characterized in that: include: Obtain monitoring pressure and / or airway flow rate during mechanical ventilation of patients by ventilation equipment; Determining a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, the respiratory drive parameter being used to characterize the patient's respiratory effort, the respiratory drive parameter including respiratory muscle pressure, respiratory muscle pressure area, inspiratory work, or a flow index, wherein the respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate, the respiratory muscle pressure area is obtained based on an integral value of the respiratory muscle pressure over time, the inspiratory work is obtained based on an integral value of the product of the respiratory muscle pressure and the airway flow rate over time, and the flow index is used to characterize how quickly an inspiratory flow curve derived from the airway flow rate changes during a descending process; Performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value; The first target value is compared with a preset first range, and the medication affecting the respiratory effort is adjusted and / or prompted to be adjusted according to the comparison result.

17. The method according to claim 16, wherein If the respiratory drive parameter is the respiratory muscle pressure, performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value includes: The respiratory muscle pressure within a first set time period is obtained, and a correlation value of any one of the maximum value, average value, and median value of the respiratory muscle pressure within the first set time period is used as the first target value.

18. The method according to claim 17, wherein The first set duration is the duration of at least one respiratory cycle.

19. The method according to claim 16, characterized in that , If the respiratory drive parameter is a respiratory muscle pressure area, performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value includes: The respiratory muscle pressure area obtained by integrating within the third set time period is used as the first target value.

20. The method according to claim 19, wherein The third set duration is the duration of at least one breathing cycle.

21. The method according to claim 16, characterized in that , If the respiratory drive parameter is a respiratory muscle pressure area, performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value includes: Obtaining N respiratory muscle pressure areas corresponding to N respiratory cycles, where each respiratory cycle corresponds to one respiratory muscle pressure area; and using a correlation value of any one of the maximum value, average value, and median value of the N respiratory muscle pressure areas as the first target value; Wherein N is an integer greater than or equal to 1.

22. The method of claim 16, wherein: If the respiratory drive parameter is the inspiratory work, performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value includes: The inhalation work integrated within the second set time period is used as the first target value.

23. The method according to claim 22, wherein The second set duration is the duration of at least one respiratory cycle.

24. The method of claim 16, wherein: If the respiratory drive parameter is the inspiratory work, performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value includes: Obtaining N inhalation works corresponding to N respiratory cycles, where each respiratory cycle corresponds to one inhalation work; and using a correlation value of any one of the maximum value, the average value, and the median value of the N inhalation works as the first target value; Wherein N is an integer greater than or equal to 1.

25. The method of claim 16, wherein: If the respiratory drive parameter is the flow index, performing statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value includes: Calculate N flow indices corresponding to N respiratory cycles, one flow index for each respiratory cycle; and use the associated value of any one of the maximum value, average value, and median value of the N flow indices as the first target value, where N is an integer greater than or equal to 1.

26. The method according to claim 16, characterized in that The adjusting and / or reminding to adjust the drug affecting the respiratory effort according to the comparison result includes: If the first target value is greater than the upper limit value of the first range, increase and / or remind to increase the drug that affects breathing effort; and / or, if the first target value is less than the lower limit value of the first range, reduce and / or remind to reduce the drug that affects breathing effort.

27. The method according to claim 26, characterized in that The increasing and / or reminding to increase the medication affecting respiratory effort includes: obtaining a first difference between the first target value and an upper limit of the first range, determining first medication data according to the first difference, and increasing and / or reminding to increase the medication affecting respiratory effort based on the first medication data; The first administration data includes the first administration of the drug affecting respiratory effort. the first administration amount is greater than the administration amount before adjustment; the first administration number is greater than the number of administrations with the preset dose before adjustment.

28. The method according to claim 26, characterized in that , Medications that reduce and / or remind you to reduce respiratory effort include: Obtaining a second difference between the first target value and the lower limit of the first range, determining second medication data according to the second difference, and reducing and / or reminding to reduce the medication according to the second medication data; wherein, The second administration data includes a second administration amount of the drug and / or a second administration number of a preset dose; the second administration amount is less than the administration amount before adjustment; the second administration number is less than the administration number of the preset dose before adjustment.

29. The method according to any one of claims 16 to 24 or 26 to 28, wherein: Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the respiratory muscle pressure and the monitored pressure is the patient's airway pressure, the respiratory muscle pressure is calculated according to a preset respiratory mechanics equation, the airway pressure, and the airway flow rate; or When the respiratory drive parameter is the respiratory muscle pressure area and the monitored pressure is the patient's airway pressure, the respiratory muscle pressure is calculated according to a preset respiratory mechanics equation, the airway pressure, and the airway flow rate; and the integral value of the respiratory muscle pressure over time is used as the respiratory muscle pressure area, or, When the respiratory drive parameter is the inspiratory work and the monitored pressure is the patient's airway pressure, the respiratory muscle pressure is calculated according to a preset respiratory mechanics equation, as well as the airway pressure and the airway flow rate; and the integral value of the product of the respiratory muscle pressure and the airway flow rate over time is used as the inspiratory work.

30. The method according to claim 29, wherein The step of calculating the respiratory muscle pressure according to a preset respiratory mechanics equation, the airway pressure, and the airway flow rate comprises: Substituting multiple sets of airway pressure, airway flow rate and ventilation volume at different times into the preset respiratory mechanics equations to obtain a set of equations for the pressure generated by the respiratory muscles and the total positive end-expiratory pressure; Solving the equation group to calculate the respiratory muscle pressure; Wherein, the preset respiratory mechanics equation is: Paw-Pmus=Flow*R+Volume*E+PEEPtot; Among them, Paw represents airway pressure, Pmus represents respiratory muscle pressure, and Flow represents airway flow. Speed, Volume represents the ventilation volume, and the ventilation volume is obtained according to the integral value of the airway flow rate over time. R is the viscous resistance of the respiratory system, E is the elastic resistance of the respiratory system, and PEEPtot is the total positive end-expiratory pressure.

31. The method according to any one of claims 16 to 24 or 26 to 28, wherein: Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the respiratory muscle pressure and the monitored pressure is the esophageal pressure of the patient, the chest wall compliance of the patient is calculated based on the esophageal pressure and the airway flow rate; the respiratory muscle pressure is calculated based on the airway flow rate, the esophageal pressure and the chest wall compliance according to a human respiratory system model; or When the respiratory drive parameter is the respiratory muscle pressure area and the monitored pressure is the esophageal pressure of the patient, the chest wall compliance of the patient is calculated based on the esophageal pressure and the airway flow rate; the respiratory muscle pressure is calculated based on the airway flow rate, the esophageal pressure and the chest wall compliance according to a human respiratory system model; and the integral value of the respiratory muscle pressure over time is used as the respiratory muscle pressure area; or, When the respiratory drive parameter is the inspiratory work and the monitored pressure is the patient's esophageal pressure, the patient's chest wall compliance is calculated based on the esophageal pressure and the airway flow rate; the respiratory muscle pressure is calculated based on the airway flow rate, the esophageal pressure and the chest wall compliance according to the human respiratory system model; and the integral value of the product of the respiratory muscle pressure and the airway flow rate over time is used as the inspiratory work.

32. The method according to any one of claims 16 to 24 or 26 to 28, wherein: Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the respiratory muscle pressure and the monitored pressure is the esophageal pressure and the intragastric pressure of the patient, the patient's transdiaphragmatic pressure is calculated based on the esophageal pressure and the intragastric pressure, and the transdiaphragmatic pressure is used as the respiratory muscle pressure; or When the respiratory drive parameter is the respiratory muscle pressure area and the monitored pressure is the esophageal pressure and the intragastric pressure of the patient, the patient's transdiaphragmatic pressure is calculated based on the esophageal pressure and the intragastric pressure, and the transdiaphragmatic pressure is used as the respiratory muscle pressure; and the integral value of the respiratory muscle pressure over time is used as the respiratory muscle pressure area; or When the respiratory drive parameter is the inspiratory work and the monitored pressure is the patient's esophageal pressure and intragastric pressure, the patient's transdiaphragmatic pressure is calculated based on the esophageal pressure and intragastric pressure, and the transdiaphragmatic pressure is used as the respiratory muscle pressure; and the integral value of the product of the respiratory muscle pressure and the airway flow rate over time is used as the inspiratory work.

33. The method according to any one of claims 16, 25-28, wherein: Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the flow index, the flow index corresponding to one respiratory cycle is calculated according to the following formula: F=a+bΔt c ; Wherein, F represents the airway flow velocity during the inspiratory phase of the respiratory cycle, a represents the peak value of the airway flow velocity during the inspiratory phase of the respiratory cycle, b represents the flow reduction rate corresponding to the selected duration Δt during the inspiratory phase of the respiratory cycle, and c represents the flow index.

34. A ventilation control method, characterized in that: include: Obtain monitoring pressure and / or airway flow rate during mechanical ventilation of patients by ventilation equipment; Determining a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, wherein the respiratory drive parameter is used to characterize the patient's respiratory effort, and the respiratory drive parameter includes respiratory muscle pressure, respiratory muscle pressure area, inspiratory work, or a flow index, wherein the respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate, the respiratory muscle pressure area is obtained based on the integral value of the respiratory muscle pressure over time, the inspiratory work is obtained based on the integral value of the product of the respiratory muscle pressure and the airway flow rate over time, and the flow index is used to characterize the speed of change of an inspiratory flow curve obtained from the airway flow rate during a descending process; Performing statistical analysis on parameter values ​​of the respiratory drive parameter within a set time period to determine a second target value, wherein the set time period includes N respiratory cycles, where N is an integer greater than or equal to 1; Obtaining a reference value corresponding to the ventilation support parameter in the ventilation device according to the second target value and a preset proportional relationship between a target value corresponding to the respiratory drive parameter and a parameter value corresponding to the ventilation support parameter; The parameter value of the ventilation support parameter of the ventilation device in the target respiratory cycle is adjusted and / or prompted to be adjusted according to the reference value, and the target respiratory cycle is after the set time period.

35. The method of claim 34, wherein: If the respiratory drive parameter is the respiratory muscle pressure, performing statistical analysis on the parameter value of the respiratory drive parameter within the set time period to determine the second target value includes: The respiratory muscle pressure within the set time period is obtained, and a correlation value of any one of the maximum value, average value, and median value of the respiratory muscle pressure within the set time period is used as the second target value.

36. The method of claim 34, wherein , If the respiratory drive parameter is a respiratory muscle pressure area, performing statistical analysis on the parameter value of the respiratory drive parameter within a set time period to determine a second target value includes: The respiratory muscle pressure area obtained by integrating the pressure within the set time period is used as a second target value; or, Obtain N respiratory muscle pressure areas corresponding to the N respiratory cycles included in the set duration, where each respiratory cycle corresponds to one respiratory muscle pressure area; and use the associated value of any one of the maximum value, average value and median value of the N respiratory muscle pressure areas as the second target value.

37. The method of claim 34, wherein: If the respiratory drive parameter is the inspiratory work, performing statistical analysis on the parameter value of the respiratory drive parameter within the set time period to determine the second target value includes: taking the inhalation work obtained by integrating the inhalation work within the set time as the second target value; or, Obtain N inhalation works corresponding to the N breathing cycles included in the set duration, where each breathing cycle corresponds to one inhalation work; and use the associated value of any one of the maximum value, average value, and median value of the N inhalation works as the second target value.

38. The method of claim 34, wherein: If the respiratory drive parameter is the flow index, performing statistical analysis on the parameter value of the respiratory drive parameter within the set time period to determine the second target value includes: Calculate N flow indices corresponding to the N respiratory cycles included in the set duration, where each respiratory cycle corresponds to a flow index; and use the associated value of any one of the maximum value, average value, and median value of the N flow indices as the second target value.

39. The method according to any one of claims 34 to 37, wherein: Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the respiratory muscle pressure and the monitored pressure is the patient's airway pressure, the respiratory muscle pressure is calculated according to a preset respiratory mechanics equation, the airway pressure, and the airway flow rate; or When the respiratory drive parameter is the respiratory muscle pressure area and the monitored pressure is the patient's airway pressure, the respiratory muscle pressure is calculated according to a preset respiratory mechanics equation, the airway pressure, and the airway flow rate; and the integral value of the respiratory muscle pressure over time is used as the respiratory muscle pressure area; or, When the respiratory drive parameter is the inspiratory work and the monitored pressure is the patient's airway pressure, the respiratory muscle pressure is calculated according to a preset respiratory mechanics equation, as well as the airway pressure and the airway flow rate; and the integral value of the product of the respiratory muscle pressure and the airway flow rate over time is used as the inspiratory work.

40. The method of claim 39, wherein The step of calculating the respiratory muscle pressure according to a preset respiratory mechanics equation, the airway pressure, and the airway flow rate comprises: Substituting multiple sets of airway pressure, airway flow rate and ventilation volume at different times into the preset respiratory mechanics equations to obtain a set of equations for the pressure generated by the respiratory muscles and the total positive end-expiratory pressure; Solving the equation group to calculate the respiratory muscle pressure; Wherein, the respiratory mechanics equation includes: Paw-Pmus=Flow*R+Volume*E+PEEPtot; Wherein, Paw represents airway pressure, Pmus represents respiratory muscle pressure, Flow represents airway flow rate, Volume represents ventilation volume, and the ventilation volume is obtained based on the integral value of the airway flow rate over time. R represents the viscous resistance of the respiratory system, E represents the elastic resistance of the respiratory system, and PEEPtot represents the total positive end-expiratory pressure.

41. The method according to any one of claims 34 to 37, wherein: Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the respiratory muscle pressure and the monitored pressure is the esophageal pressure of the patient, the chest wall compliance of the patient is calculated based on the esophageal pressure and the airway flow rate; the respiratory muscle pressure is calculated based on the airway flow rate, the esophageal pressure and the chest wall compliance according to a human respiratory system model; or When the respiratory drive parameter is the respiratory muscle pressure area and the monitored pressure is the esophageal pressure of the patient, the chest wall compliance of the patient is calculated based on the esophageal pressure and the airway flow rate; the respiratory muscle pressure is calculated based on the airway flow rate, the esophageal pressure and the chest wall compliance according to a human respiratory system model; and the integral value of the respiratory muscle pressure over time is used as the respiratory muscle pressure area; or, When the respiratory drive parameter is the inspiratory work and the monitored pressure is the patient's esophageal pressure, the patient's chest wall compliance is calculated based on the esophageal pressure and the airway flow rate; the respiratory muscle pressure is calculated based on the airway flow rate, the esophageal pressure and the chest wall compliance according to the human respiratory system model; and the integral value of the product of the respiratory muscle pressure and the airway flow rate over time is used as the inspiratory work.

42. The method according to any one of claims 34 to 37, wherein: Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: In the case where the respiratory drive parameter is the respiratory muscle pressure and the monitored pressure is the esophageal pressure and the intragastric pressure of the patient, the patient's esophageal pressure and the intragastric pressure are calculated based on the esophageal pressure and the intragastric pressure. the transdiaphragmatic pressure of the patient, taking the transdiaphragmatic pressure as the respiratory muscle pressure; or When the respiratory drive parameter is the respiratory muscle pressure area and the monitored pressure is the esophageal pressure and the intragastric pressure of the patient, the patient's transdiaphragmatic pressure is calculated based on the esophageal pressure and the intragastric pressure, and the transdiaphragmatic pressure is used as the respiratory muscle pressure; and the integral value of the respiratory muscle pressure over time is used as the respiratory muscle pressure area; or When the respiratory drive parameter is the inspiratory work and the monitored pressure is the patient's esophageal pressure and intragastric pressure, the patient's transdiaphragmatic pressure is calculated based on the esophageal pressure and intragastric pressure, and the transdiaphragmatic pressure is used as the respiratory muscle pressure; and the integral value of the product of the respiratory muscle pressure and the airway flow rate over time is used as the inspiratory work.

43. The method according to claim 34 or 38, wherein Determining the parameter value of the respiratory drive parameter according to the monitored pressure and / or airway flow rate includes: When the respiratory drive parameter is the flow index, the flow index corresponding to one respiratory cycle is calculated according to the following formula: F=a+bΔt c ; Wherein, F represents the airway flow velocity during the inspiratory phase of the respiratory cycle, a represents the peak value of the airway flow velocity during the inspiratory phase of the respiratory cycle, b represents the flow reduction rate corresponding to the selected duration Δt during the inspiratory phase of the respiratory cycle, and c represents the flow index.

44. The method according to any one of claims 34 to 43, wherein: The ventilation support parameter includes at least one of support pressure, inspiratory pressure, tidal volume, and minute ventilation.

45. A ventilation device, characterized in that include: a ventilation device for generating gas in accordance with a set setting including at least ventilation support parameters; a ventilation circuit, for connecting to a patient's respiratory system to deliver the gas to the patient; The sensor assembly includes at least a pressure sensor and a flow sensor, wherein the pressure sensor is used to collect monitoring pressure during mechanical ventilation of the patient by the ventilation device, and the flow sensor is used to collect airway flow rate during mechanical ventilation of the patient by the ventilation device; a processor, configured to be in signal connection with the ventilation device and the sensor assembly; The processor is further configured to obtain a monitored pressure collected by the pressure sensor and / or an airway flow rate collected by the flow sensor during mechanical ventilation of the patient; and determine a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, wherein the respiratory drive parameter is used to characterize the patient's respiratory effort, and the respiratory drive parameter includes respiratory muscle pressure, inspiratory work, or a flow index, wherein the respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate, the inspiratory work is obtained based on the integral value of the product of the respiratory muscle pressure and the airway flow rate over time, and the flow index is used to characterize the speed of change of the inspiratory flow curve obtained from the airway flow rate during the descending process; The processor is further configured to perform statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value; The first target value is compared with a preset first range, and the parameter value of the ventilation support parameter is adjusted and / or prompted to be adjusted according to the comparison result. The ventilation support parameter is used to reflect the pressure or flow condition set by the ventilation device.

46. ​​A ventilation device, characterized in that ,include: Aeration device for generating gas at a set pressure or flow rate; a ventilation circuit, for connecting to a patient's respiratory system to deliver the gas to the patient; The sensor assembly includes at least a pressure sensor and a flow sensor, wherein the pressure sensor is used to collect the monitoring pressure of the ventilation device during the mechanical ventilation of the patient, and the flow sensor is used to collect the airway flow rate during the mechanical ventilation of the patient by the ventilation device; a processor, configured to be signal-connected to the ventilation device and the sensor assembly, and to be communicatively connected to an output pump; The processor is further configured to obtain a monitored pressure and / or airway flow rate during mechanical ventilation of a patient by the ventilation device; and determine a parameter value of a respiratory drive parameter based on the monitored pressure and / or airway flow rate, wherein the respiratory drive parameter is used to characterize the patient's respiratory effort, and the respiratory drive parameter includes respiratory muscle pressure, respiratory muscle pressure area, inspiratory work, or a flow index, wherein the respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate, the respiratory muscle pressure area is obtained based on the integral value of the respiratory muscle pressure over time, the inspiratory work is obtained based on the integral value of the product of the respiratory muscle pressure and the airway flow rate over time, and the flow index is used to characterize the speed of change of an inspiratory flow curve obtained from the airway flow rate during a descending process; The processor is configured to perform statistical analysis on the parameter value of the respiratory drive parameter to determine a first target value; The first target value is compared with a preset first range, and the output pump is controlled to adjust and / or a reminder is given to adjust a drug that affects breathing effort according to the comparison result.

47. A ventilation device, characterized in that include: a ventilation device for generating gas in accordance with a set setting including at least ventilation support parameters; a ventilation circuit, for connecting to a patient's respiratory system to deliver the gas to the patient; The sensor assembly includes at least a pressure sensor and a flow sensor, wherein the pressure sensor is used to collect monitoring pressure during mechanical ventilation of the patient by the ventilation device, and the flow sensor is used to collect airway flow rate during mechanical ventilation of the patient by the ventilation device; a processor, configured to be in signal connection with the ventilation device and the sensor assembly; The processor is also used to obtain the monitoring pressure collected by the pressure sensor and / or the airway flow rate collected by the flow sensor during the patient's mechanical ventilation; and according to the Monitoring pressure and / or airway flow rate to determine a parameter value of a respiratory drive parameter used to characterize the patient's respiratory effort. The respiratory drive parameter includes respiratory muscle pressure, respiratory muscle pressure area, inspiratory work, or a flow index. The respiratory muscle pressure is calculated based on the monitored pressure and / or airway flow rate. The respiratory muscle pressure area is obtained based on the integral of the respiratory muscle pressure over time. The inspiratory work is obtained based on the integral of the product of the respiratory muscle pressure and the airway flow rate over time. The flow index is used to characterize the rate of change of an inspiratory flow curve obtained from the airway flow rate during a descending process. The processor is configured to perform statistical analysis on the parameter value of the respiratory drive parameter to determine a second target value, wherein the set duration includes N respiratory cycles, where N is an integer greater than or equal to 1; The processor is used to obtain a reference value corresponding to the ventilation support parameter in the ventilation device based on the second target value and the proportional relationship between the pre-set target value corresponding to the respiratory drive parameter and the parameter value corresponding to the ventilation support parameter, and adjust and / or remind to adjust the parameter value of the ventilation support parameter of the ventilation device in the target respiratory cycle according to the reference value, and the target respiratory cycle is after the set time length.

48. A medical device, characterized in that include: Memory, used to store programs; A processor, configured to implement the method according to any one of claims 1 to 44 by executing the program stored in the memory.

49. A computer-readable storage medium, characterized in that The method comprises a program which can be executed by a processor to implement the method according to any one of claims 1 to 44.

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