Patient cardiopulmonary function monitoring system and method and computer readable storage medium

Abstract

The invention relates to the technical field of medical monitoring, in particular to a patient cardiopulmonary function monitoring system and method and a computer readable storage medium, the monitoring system comprises a breathing machine, a pulmonary membrane oxygenation device, a first monitoring module and a second monitoring module, and the breathing machine comprises a breathing circuit, a processing module and a display module; the pulmonary membrane oxygenation equipment comprises an oxygenator; the first monitoring module is used for monitoring carbon dioxide exhaling parameters in gas exhaled by a patient in real time; the second monitoring module is used for monitoring carbon dioxide discharge parameters in gas discharged by the oxygenator in real time. By means of real-time monitoring of exhaling parameters of carbon dioxide in gas exhaled by a patient and discharging parameters of carbon dioxide in gas discharged by an oxygenator, continuous monitoring of the change condition of the cardiac function and / or the lung function of the patient is achieved, oxygen consumption of the patient can be truly reflected, parameter adjustment of a breathing machine and lung membrane oxygenation equipment is facilitated, and the patient experience is improved. And guidance is provided for turning of the pulmonary membrane oxygenation equipment.

Description

Technical Field

[0001] The present application relates to the field of medical monitoring technology, and more specifically to a patient cardiopulmonary function monitoring system, a monitoring method, and a computer-readable storage medium. Background Art

[0002] Among existing medical equipment, ventilators are mainly used for respiratory rescue and respiratory therapy, and are used to provide ventilation assistance and respiratory support for adults, children and infants. The essence of ECMO is a modified artificial heart-lung machine, with the core parts being the oxygenator and blood pump. ECMO can draw blood from the human body's large veins out of the body for oxygenation, and then return it to the aorta or large veins, thereby partially or completely replacing the patient's cardiopulmonary function, which is equivalent to an "artificial lung" and "artificial heart" outside the patient's body. Because ECMO acts as an artificial lung and an artificial heart respectively, it can provide long-term cardiopulmonary support for patients with severe cardiopulmonary failure, buying precious time for the rescue of critical illnesses. In other words, the actual working process of ECMO plays a very important role in cardiopulmonary support.

[0003] ECMO devices operate in two modes: VA-ECMO and VV-ECMO. ECMO in VV mode primarily provides replacement support for lung function until the patient's lungs return to normal function. ECMO in VV mode uses a near-series pathway, with blood first passing through the ECMO for gas exchange before entering the lungs for further gas exchange (ventilator).

[0004] During the ECMO transfer process, it is necessary to assess and understand changes in the patient's respiratory function (pulmonary function) and / or cardiac function, and to promptly adjust the blood flow and airflow settings to meet the patient's oxygen supply and perfusion needs and promote the recovery of pulmonary and cardiac function. During the VV-ECMO transfer process, due to the action of ECMO, changes in the patient's arterial blood gas system cannot reflect changes in the patient's respiratory function. The conventional ARDS definition monitoring method (P / F ratio) is not correlated with changes in the patient's lung function. During the VA-ECMO transfer process, because venous blood is drawn out of the body and passes through a temperature-controlled water tank, conventional hemodynamic monitoring technology (thermodilution algorithm) will be affected and cannot accurately reflect the patient's cardiac output.

[0005] Currently, the conventional method for assessing a patient's oxygen consumption is to use pre-membrane venous blood gas parameters (SvO2, HGB) and post-membrane blood gas parameters (SaO2, HGB), as well as ECMO blood flow, and derive the oxygen content and oxygen delivery formulas. However, in venovenous ECMO, the pre-membrane SvO2 is higher than the actual SvO2 due to the influence of recirculation. In venovenous ECMO, because perfusion is provided by both the patient's own cardiopulmonary circulation (perfusing the upper body) and the ECMO circulation (perfusing the lower body), the pre-membrane drain SvO2 only represents the oxygen consumption of the lower body, while the perfusion of core organs such as the brain and heart is not considered. Therefore, the upper body oxygen consumption is greater than the lower body oxygen consumption, and the pre-membrane SvO2 is also higher. Therefore, oxygen consumption calculated based on pre-membrane blood gas monitoring parameters does not truly reflect the patient's oxygen consumption and may even mislead clinicians in their assessment of the patient's condition. Summary of the Invention

[0006] The present application provides a patient cardiopulmonary function monitoring system, a monitoring method and a computer-readable storage medium to solve the above-mentioned technical problems.

[0007] In a first aspect, the present application provides a patient cardiopulmonary function monitoring system, comprising:

[0008] A ventilator is used to provide ventilation support for a patient; the ventilator comprises a breathing circuit, a display module and a processing module;

[0009] A membrane oxygenation device, comprising an oxygenator;

[0010] a first monitoring module, which is disposed at the end of the breathing circuit and is used to monitor in real time the exhaled carbon dioxide parameter in the patient's exhaled gas, and an output end of the first monitoring module is connected to the ventilator;

[0011] a second monitoring module, which is disposed at the gas outlet of the oxygenator and is used to monitor the carbon dioxide emission parameters in the exhaust gas of the oxygenator in real time, and the output end of the second monitoring module is connected to the ventilator;

[0012] The processing module is configured to receive the carbon dioxide exhalation parameter and the carbon dioxide emission parameter, and convert the patient's carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter per unit time, and the oxygen consumption based on a preset algorithm;

[0013] The display module is used to display in real time at least one of a trend graph of the carbon dioxide exhalation parameter within the unit time, a trend graph of the carbon dioxide emission parameter within the unit time, the carbon dioxide exhalation parameter, the carbon dioxide exhalation parameter within the unit time, the carbon dioxide emission parameter within the unit time, the total carbon dioxide parameter and the oxygen consumption.

[0014] In some optional embodiments, the ventilator also includes a storage module, which is used to store monitoring data, and the monitoring data includes the carbon dioxide exhalation parameter, the carbon dioxide emission parameter, the carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter and the oxygen consumption.

[0015] In some optional embodiments, the display module is configured to display a trend graph of the carbon dioxide exhalation parameter per unit time, a trend graph of the carbon dioxide emission parameter per unit time, the carbon dioxide exhalation parameter, the carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter, and the oxygen consumption on the same screen;

[0016] The display module includes a first display area and a second display area, the first display area is used to display a trend graph of the carbon dioxide exhalation parameter per unit time and a trend graph of the carbon dioxide emission parameter per unit time on the same screen; the second display area is used to display the carbon dioxide exhalation parameter, the carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter and the oxygen consumption on the same screen.

[0017] In some optional embodiments, the ventilator further includes a cursor movement and positioning module, and the processing module is further configured to:

[0018] receiving a cursor movement operation of a user on the first display area and determining the position coordinates of the cursor;

[0019] Mapping the position coordinates of the cursor to a trend graph of the carbon dioxide exhalation parameter within the unit time and a trend graph of the carbon dioxide emission parameter within the unit time to determine a corresponding time point;

[0020] extracting the carbon dioxide exhalation parameter per unit time and the carbon dioxide emission parameter per unit time corresponding to the time point from the stored monitoring data;

[0021] The first display area displays the extracted carbon dioxide exhalation parameter within the unit time and the extracted carbon dioxide discharge parameter within the unit time.

[0022] In some optional embodiments, the processing module is further configured to:

[0023] When the extracted carbon dioxide exhalation parameters per unit time and the carbon dioxide emission parameters per unit time are displayed in the first display area, the real-time carbon dioxide exhalation parameters, the carbon dioxide exhalation parameters per unit time, the carbon dioxide emission parameters per unit time, the total carbon dioxide parameters and the oxygen consumption are simultaneously displayed in the second display area.

[0024] In some optional embodiments, the carbon dioxide exhalation parameter includes the carbon dioxide partial pressure in the patient's exhaled gas; and / or the carbon dioxide discharge parameter includes the carbon dioxide concentration in the oxygenator's exhaust gas.

[0025] In some optional embodiments, the membrane oxygenation device further includes a third monitoring module, which is used to monitor the air flow in the oxygenator, and the third monitoring module is connected to the ventilator.

[0026] According to the second aspect, the present application also provides a method for monitoring the cardiopulmonary function of a patient, the steps of which include:

[0027] Acquiring carbon dioxide exhalation parameters in the patient's exhaled gas using the first monitoring module, and acquiring carbon dioxide discharge parameters in the oxygenator's exhaust gas using the second monitoring module;

[0028] Processing the carbon dioxide exhalation parameter and the carbon dioxide emission parameter using a preset algorithm by a processing module to obtain the carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter per unit time, and the oxygen consumption;

[0029] A display module is used to display in real time at least one of a trend graph of the carbon dioxide exhalation parameter within the unit time, a trend graph of the carbon dioxide emission parameter within the unit time, the carbon dioxide exhalation parameter, the carbon dioxide exhalation parameter within the unit time, the carbon dioxide emission parameter within the unit time, the total carbon dioxide parameter, and the oxygen consumption.

[0030] In some optional embodiments, the processing of the carbon dioxide exhalation parameter and the carbon dioxide emission parameter by a processing module using a preset algorithm includes:

[0031] Summing the carbon dioxide partial pressures in all exhaled gases of the patient per unit time to calculate the carbon dioxide exhaled parameter per unit time;

[0032] The carbon dioxide emission parameter per unit time is calculated by multiplying the carbon dioxide concentration in the oxygenator exhaust gas by the gas flow rate in the oxygenator;

[0033] The carbon dioxide total parameter is calculated by summing the carbon dioxide exhalation parameter within the unit time and the carbon dioxide emission parameter within the unit time;

[0034] The oxygen consumption is calculated based on the total carbon dioxide parameter, and the calculation formula is as follows:

[0035] Oxygen consumption = total carbon dioxide parameter / 0.85.

[0036] According to a third aspect, the present application further provides a computer-readable storage medium storing a computer program, which, when executed by a processing module, implements the patient cardiopulmonary function monitoring method as described above in the claims.

[0037] According to the patient cardiopulmonary function monitoring system in this embodiment, it includes a ventilator, a membrane oxygenation device, a first monitoring module, and a second monitoring module. The ventilator has a processing module and a display module. It uses real-time monitoring of carbon dioxide exhalation parameters in the patient's exhaled gas and carbon dioxide emission parameters in the oxygenator's exhaust gas to continuously monitor changes in the patient's cardiac function and / or pulmonary function, and can truly reflect the patient's oxygen consumption. Medical staff can adjust the parameters of the ventilator and membrane oxygenation device based on the monitored data and displayed content, and also provide guidance for the conversion of the membrane oxygenation device, effectively avoiding overload of the patient's body and preventing the patient's cardiac function and pulmonary function from deteriorating. BRIEF DESCRIPTION OF THE DRAWINGS

[0038] Figure 1 A schematic diagram of the structure of a patient cardiopulmonary function monitoring system in use according to an embodiment;

[0039] Figure 2 A structural block diagram of a module of a patient cardiopulmonary function monitoring system in one embodiment;

[0040] Figure 3 A flowchart of the steps of a method for monitoring the cardiopulmonary function of a patient in an embodiment;

[0041] Figure 4 This is a diagram of an interface displayed in real time by a patient's cardiopulmonary function monitoring system in an embodiment;

[0042] Figure 5 This is an interface diagram of a patient cardiopulmonary function monitoring system after a cursor movement operation in an embodiment.

[0043] Wherein: 10, ventilator; 11, display module; 12, processing module; 13, display module; 131, first display area; 132, second display area; 14, storage module; 15, cursor movement and positioning module;

[0044] 20. Membrane oxygenation equipment; 21. Oxygenator; 22. Third monitoring module;

[0045] 30. First monitoring module;

[0046] 40. Second detection module. DETAILED DESCRIPTION

[0047] The present application is 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. For those skilled in the art, it is not necessary to describe these related operations in detail. They can fully understand the related operations based on the description in the specification and the general technical knowledge in the art.

[0048] In addition, the features, operations, or characteristics described in the specification may be combined in any appropriate manner to form various implementations, and the operational steps involved in each embodiment may be interchanged or adjusted in a manner that is obvious to those skilled in the art. Therefore, the specification and drawings are only for the purpose of clearly describing a particular embodiment and do not imply a required composition and / or sequence.

[0049] 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).

[0050] The ventilator 10 is mainly used for respiratory rescue and respiratory therapy, and is used to provide ventilation assistance and respiratory support for adults, children and infants. The ventilator 10 includes an air supply device and a breathing circuit, which are used to provide ventilation support for the patient.

[0051] The membrane oxygenation device 20 (ECMO), or extracorporeal membrane oxygenation (ECMO), is an advanced life support technology that is mainly used to temporarily replace the human heart and lung function to buy treatment time for patients with severe cardiopulmonary failure. Specifically, ECMO uses an extracorporeal circulation device to draw the patient's venous blood out of the body, pass it through an oxygenator 21 (replacing the lung function) for oxygen exchange and carbon dioxide removal, and then return the oxygenated blood to the patient's body through an artificial pump (replacing the heart's pumping function), thereby maintaining oxygen supply to vital organs throughout the body. ECMO equipment includes two working modes: VA-ECMO and VV-ECMO. ECMO in VV mode mainly provides alternative support for human lung function until the patient's lung function is normal. ECMO in VV mode is a nearly serial pathway, with blood first passing through ECMO for gas exchange before entering the lungs for gas exchange (ventilator 10).

[0052] During ECMO transfer, it is necessary to assess and understand changes in the patient's respiratory function (pulmonary function) and / or cardiac function, allowing for timely adjustments to blood flow and airflow settings to meet the patient's oxygen perfusion needs and promote recovery of pulmonary and cardiac function. Currently, conventional methods for assessing oxygen consumption are based on pre-membrane venous blood gas parameters (SvO2, HGB) and post-membrane blood gas parameters (SaO2, HGB), along with ECMO blood flow, using formulas to derive oxygen content and oxygen delivery. However, in venovenous ECMO, the pre-membrane SvO2 is higher than the actual SvO2 due to recirculation. In venovenous ECMO, because perfusion is provided by both the patient's own cardiopulmonary circulation (perfusing the upper body) and the ECMO circulation (perfusing the lower body), the pre-membrane SvO2 only represents the oxygen consumption of the lower body, while the perfusion of core organs such as the brain and heart is not considered. Consequently, upper body oxygen consumption is greater than lower body oxygen consumption, and the pre-membrane SvO2 is also higher. Therefore, the oxygen consumption calculated by the parameters of pre-membrane blood gas monitoring cannot truly reflect the patient's oxygen consumption and may even mislead clinicians in their judgment of the patient's condition.

[0053] The present application provides a patient cardiopulmonary function monitoring system, a monitoring method, and a computer-readable storage medium. The display module 11 of the monitoring system is used to display the data monitored during the monitoring process to guide medical personnel to adjust the parameters of the ventilator 10 and the membrane oxygenation device 20 in the monitoring system to achieve a smooth transition and avoid respiratory alkalosis in patients.

[0054] See also Figure 1 and Figure 2The patient's cardiopulmonary function monitoring system (hereinafter referred to as the "monitoring system") includes a ventilator 10, a membrane oxygenation device 20, a first monitoring module 30, and a second monitoring module.

[0055] The ventilator 10 is used to provide ventilation support for the patient; the ventilator 10 includes a breathing circuit, a display module 11 and a processing module 12. The breathing circuit includes an inspiratory branch and an expiratory branch. The inspiratory branch is used to deliver the mixed gas to the patient, and the expiratory branch is used to collect the gas exhaled by the patient. The first monitoring module 30 is arranged at the end of the breathing circuit and is used to monitor the carbon dioxide exhalation parameter in the patient's exhaled gas in real time. That is, the first monitoring module 30 is arranged on the expiratory branch, and the output end of the first monitoring module 30 is connected to the ventilator 10 for transmitting the monitored data to the processing module 12 in the ventilator 10 for processing.

[0056] The membrane oxygenation device 20 includes an oxygenator 21 having an inlet and an outlet. The inlet is used to receive blood from the patient via a drainage tube, and the outlet is used to return the blood, oxygenated and decarbonated by the oxygenator 21, to the patient via a return tube. A second monitoring module is disposed at the gas outlet of the oxygenator 21, i.e., on the outlet side of the oxygenator 21, and is used to monitor the carbon dioxide emission parameters of the gas discharged from the oxygenator 21 in real time. The output of the second monitoring module is connected to the ventilator 10, and is used to transmit the monitored data to the processing module 12 within the ventilator 10 for processing.

[0057] In some embodiments, the ventilator 10 is further provided with a first data interface and a second data interface. The first monitoring module 30 is connected to the first data interface via a transmission line for transmitting the monitored data to the processing module 12 within the ventilator 10 for processing. The second monitoring module is also connected to the second data interface via a transmission line for transmitting the monitored data to the processing module 12 within the ventilator 10 for processing.

[0058] Of course, in other embodiments, the first monitoring module 30 and the second monitoring module may transmit the monitored data to the ventilator 10 via a wireless transmission module.

[0059] The processing module 12 implements the various functions of the aforementioned monitoring method by running or executing computer programs and / or modules stored in the storage module 14 and accessing data stored in the storage module 14. The processing module 12 is configured to receive carbon dioxide exhalation parameters and carbon dioxide emission parameters and, based on a preset algorithm, convert the patient's carbon dioxide exhalation parameters per unit time, carbon dioxide emission parameters per unit time, total carbon dioxide parameters per unit time, and oxygen consumption. The display module 11 is configured to display in real time at least one of a trend graph of the carbon dioxide exhalation parameters per unit time, a trend graph of the carbon dioxide emission parameters per unit time, the carbon dioxide exhalation parameters, the carbon dioxide exhalation parameters per unit time, the carbon dioxide emission parameters per unit time, the total carbon dioxide parameters, and oxygen consumption, so that medical personnel can adjust certain parameters of the ventilator 10 and the membrane oxygenation device 20 by viewing the data displayed on the display module 11.

[0060] In some embodiments, the ventilator 10 also includes a storage module 14, which is used to store monitoring data. The monitoring data includes carbon dioxide exhalation parameters, carbon dioxide emission parameters, carbon dioxide exhalation parameters per unit time, carbon dioxide emission parameters per unit time, total carbon dioxide parameters and oxygen consumption, so that subsequent users can retrieve these monitoring data through operations for viewing, or export these monitoring data.

[0061] The storage module 14 may include a high-speed random access storage module 14, and may also include a non-volatile storage module 14, such as a hard disk, memory, a plug-in hard disk, a smart memory card (Smart Media Card, SMC), a secure digital (Secure Digital, SD) card, a flash card (Flash Card), at least multiple disk storage devices, flash memory devices, or other volatile solid-state storage devices.

[0062] The display module 11 includes a display screen that can display a user interface (GUI, the display screen may include a liquid crystal display (LCD), a thin film transistor LCD (TFT-LCD), an organic light emitting diode OLED), a touch display, a flexible touch display, a three-dimensional (3D) touch display, etc.

[0063] In some embodiments, the display module 11 is used to display a trend graph of a carbon dioxide exhalation parameter per unit time, a trend graph of a carbon dioxide emission parameter per unit time, a carbon dioxide exhalation parameter, a carbon dioxide exhalation parameter per unit time, a carbon dioxide emission parameter per unit time, a total carbon dioxide parameter, and oxygen consumption on the same screen;

[0064] The display module 11 includes a first display area 131 and a second display area 132. The first display area 131 is used to display a trend graph of the carbon dioxide exhalation parameter per unit time and a trend graph of the carbon dioxide emission parameter per unit time on the same screen; the second display area 132 is used to display the carbon dioxide exhalation parameter, the carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter and the oxygen consumption on the same screen.

[0065] In some embodiments, the ventilator 10 further includes a cursor movement and positioning module 15, and the processing module 12 is further configured to:

[0066] receiving a cursor movement operation by the user on the first display area 131 and determining the position coordinates of the cursor;

[0067] Mapping the cursor position coordinates to the trend graph of the carbon dioxide exhalation parameter per unit time and the trend graph of the carbon dioxide emission parameter per unit time to determine the corresponding time point;

[0068] Extracting the carbon dioxide exhalation parameter per unit time and the carbon dioxide emission parameter per unit time corresponding to the time point from the stored monitoring data;

[0069] The first display area 131 displays the extracted carbon dioxide exhalation parameter per unit time and the carbon dioxide discharge parameter per unit time.

[0070] Through the above operation, the carbon dioxide exhalation parameters and carbon dioxide emission parameters per unit time in any time period of the monitored historical time period can be viewed at any time, so that medical staff can judge whether the patient's lung function has recovered and died, and predict the possibility and timing of removing the membrane oxygenation device 20.

[0071] In some embodiments, the processing module 12 is further configured to simultaneously display the real-time exhaled carbon dioxide parameter, the exhaled carbon dioxide parameter, the exhaled carbon dioxide parameter, the total carbon dioxide parameter, and oxygen consumption in the second display area 132 while the first display area 131 displays the extracted exhaled carbon dioxide parameter and the exhaled carbon dioxide parameter per unit time. That is, when medical personnel use the cursor to view historical monitoring data, the second display area 132 continues to display the monitored data and the exhaled carbon dioxide parameter, the exhaled carbon dioxide parameter, the total carbon dioxide parameter, and oxygen consumption calculated based on the monitored data in real time.

[0072] In some embodiments, the exhaled carbon dioxide parameter includes the partial pressure of carbon dioxide in the patient's exhaled gas, i.e., the exhaled carbon dioxide parameter is the end-tidal carbon dioxide partial pressure (PETCO2). The exhaled carbon dioxide parameter per unit time (VCO2.Pt) can be obtained by summing all end-tidal carbon dioxide partial pressures (PETCO2) per unit time. And / or, the exhaust carbon dioxide parameter includes the carbon dioxide concentration in the gas discharged from the oxygenator 21. The gas circuit of the oxygenator 21 is a constant gas flow (set by the user), so the amount of carbon dioxide discharged by the oxygenator 21 can be calculated using the monitored carbon dioxide (CO2) concentration at the outlet of the oxygenator 21.

[0073] Since the end-tidal carbon dioxide partial pressure (PETCO2) is correlated with the changes in the patient's arterial blood PaCO2, the monitoring of the end-tidal carbon dioxide partial pressure (PETCO2) can guide the parameter settings of the ventilator 10. The normal value of PETCO2 is 30mmHg-35mmHg. When PETCO2>35mmHg, the respiratory rate and tidal volume in the ventilator 10 parameters can be adjusted to reduce PETCO2. When PETCO2<30mmHg, the respiratory rate and tidal volume settings of the ventilator 10 need to be lowered to maintain PETCO2 at 30mmHg-35mmHg. After the parameters of the ventilator 10 are set, the patient's real-time ventilation effect can be fed back to the clinician through PETCO2 monitoring, guiding the clinician to further improve the parameter adjustment of the ventilator 10 based on the mutual influence between the patient's pulmonary circulation and ECMO circulation, so as to avoid respiratory alkalosis in the patient.

[0074] In the VV-ECMO mode, recirculation is unavoidable. Furthermore, the amount of recirculation is related to the ECMO blood flow setting. Individual differences in recirculation also exist. Different blood flows, inferior vena cava sizes, and patient body types all contribute to factors that influence the recirculation volume. In clinical practice, blood flow and gas flow settings are adjusted to ensure optimal blood flow for oxygenation and blood-gas exchange. During the adjustment process, as the effective blood flow increases (ECMO blood flow minus recirculation blood flow), the amount of venous blood required to complete gas exchange through the patient's pulmonary circulation decreases, and the amount of CO2 exhaled by the patient also decreases. When recirculation causes a decrease in effective blood flow, the amount of CO2 exhaled by the patient gradually increases, while the CO2 discharge from the oxygenator 21 decreases. The ECMO blood flow corresponding to the point where the patient's exhaled CO2 is the lowest or the point where the oxygenator 21 discharges the most CO2 is the optimal blood flow for VV-ECMO. Simultaneously, changes in PETCO2 are observed to determine whether the ventilator 10 parameter settings are appropriate. Use this as a reference to guide the adjustment of the parameters of the ventilator 10 to maintain the patient's PETCO2 within the normal range and avoid respiratory alkalosis (PETCO2<30mmHg).

[0075] During the VV-ECMO transfer (weaning) process, as the patient's lung function improves, the gas exchange function of the pulmonary circulation improves, and the amount of CO2 discharged through the pulmonary circulation increases. Therefore, by continuously observing the changes in the patient's CO2 discharge, the progression of the patient's lung lesions can be judged. By checking the historical data and records of the ventilator 10 and observing the changing trend of the patient's exhaled carbon dioxide parameter Pt.CO2 per unit time, the VV-ECMO blood flow can be adjusted in time to enter the ECMO weaning assessment. As the ECMO blood flow and gas flow process gradually decreases, the load capacity of the patient's lung function is fully understood, and a smooth weaning is achieved. Specifically, the increase in the amount of CO2 exhaled by the patient reflects that the patient's lung function is improving. The VV-ECMO blood flow and ventilator 10 parameters can be adjusted to gradually increase the patient's lung work and maintain the stability of the total amount of CO2 discharged and PETCO2 to achieve safe weaning.

[0076] During the VA-ECMO transition, changes in cardiac function are directly reflected in changes in pulmonary blood flow. Changes in pulmonary blood flow are directly reflected in changes in the amount of CO2 exhaled by the patient. Increased pulmonary blood flow increases the amount of CO2 exhaled, while decreased pulmonary blood flow decreases the amount of CO2 exhaled. By continuously monitoring changes in the amount of CO2 exhaled, changes in the patient's cardiac function can be assessed.

[0077] The VA-ECMO blood flow setting affects right ventricular preload and left ventricular afterload. When managing VA-ECMO blood flow settings, a balance must be struck: the patient's heart can tolerate changes in preload and afterload, particularly increases in preload, and the right heart's tolerance to volume overload. While decreasing ECMO blood flow increases right ventricular preload, according to the Starling curve, if the increase in preload is within the right ventricular compensatory range, right cardiac output increases, pulmonary blood flow increases, and the patient's exhaled CO₂ increases. If ECMO blood flow decreases, right ventricular preload reaches the heart's tolerance limit, and right ventricular output and pulmonary blood flow plateau, and the patient's exhaled CO₂ also plateaus (i.e., does not increase). The ECMO blood flow corresponding to the inflection point where the exhaled CO₂ curve transitions from the rising segment to the plateau is the optimal blood flow at this time. By measuring the changing trend of the amount of CO2 at the patient's exhaled end, the optimal blood flow of VA-ECMO can be accurately determined in real time, without causing cardiac overload and deterioration of cardiac function.

[0078] By monitoring the CO2 discharge at the gas outlet of the oxygenator 21, the gas flow supply of the oxygenator 21 can be adjusted to maintain the partial pressure of carbon dioxide (PCO2) in the discharged gas after oxygenation within a normal range. PETCO2 monitoring on the patient side is used to assess whether the ventilator 10 settings are suitable for the patient's current condition. By adjusting the ventilator 10 parameters (including respiratory rate and tidal volume), PETCO2 is maintained at 30mmHg-35mmHg to prevent the patient from developing respiratory alkalosis, thereby reducing the risk of neurological complications. By monitoring these two data points, the patient's cardiac and pulmonary function changes can be continuously monitored to ensure stable breathing and a smooth transition from ECMO.

[0079] In some embodiments, the membrane oxygenation device 20 further includes a third monitoring module 22 for monitoring the airflow in the oxygenator 21. The third monitoring module 22 is connected to the ventilator 10. The third monitoring module 22 may be an airflow sensor. The processing module 12 on the ventilator 10 may calculate a carbon dioxide emission parameter per unit time (VCO2.ML) by multiplying the monitored airflow by the CO2 concentration, expressed in mL / min. The airflow monitoring may also serve as a basis for adjusting the airflow on the membrane oxygenation device 20.

[0080] In some embodiments, the first monitoring module 30 uses an infrared sensor to obtain carbon dioxide exhalation parameters. Specifically, this uses the principle that CO2 molecules have absorption characteristics for infrared light of a specific wavelength (approximately 4.26 μm), and the absorption intensity is proportional to the CO2 concentration. The sensor's light absorption value is processed by the processing module 12 to convert it into a carbon dioxide exhalation parameter (i.e., end-tidal carbon dioxide partial pressure). This processing process includes first converting the light absorption value into carbon dioxide concentration, and then multiplying it by the total fraction of the mixed gas (atmospheric pressure, such as 760 mmHg) to obtain the end-tidal carbon dioxide partial pressure (PETCO2). The second monitoring module uses an infrared sensor to obtain carbon dioxide emission parameters. The second monitoring module also converts its measured light absorption value into a carbon dioxide emission parameter (i.e., carbon dioxide concentration) through the processing module 12.

[0081] The present application also provides a method for monitoring the cardiopulmonary function of a patient, the steps of which include:

[0082] S100: using the first monitoring module 30 to obtain carbon dioxide exhalation parameters in the patient's exhaled gas, and using the second monitoring module to obtain carbon dioxide discharge parameters in the exhaust gas of the oxygenator 21;

[0083] S200: Processing the carbon dioxide exhalation parameter and the carbon dioxide emission parameter using a preset algorithm by the processing module 12 to obtain the carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter per unit time, and the oxygen consumption;

[0084] S300: Using the display module 11, display in real time at least one of a trend graph of a carbon dioxide exhalation parameter per unit time, a trend graph of a carbon dioxide emission parameter per unit time, a carbon dioxide exhalation parameter, a carbon dioxide exhalation parameter per unit time, a carbon dioxide emission parameter per unit time, a total carbon dioxide parameter, and oxygen consumption.

[0085] In some embodiments, processing the carbon dioxide exhalation parameters and the carbon dioxide emission parameters using a preset algorithm by the processing module 12 includes:

[0086] The carbon dioxide partial pressure in all the patient's exhaled gases per unit time is summed to calculate the carbon dioxide exhalation parameter per unit time. Specifically, the summation can be performed based on a curve drawn based on the carbon dioxide partial pressure and time, and the area of ​​the curve per unit time is obtained by integration, thereby obtaining the carbon dioxide exhalation parameter per unit time (VCO2.Pt), whose unit is mL / min.

[0087] The carbon dioxide emission parameter per unit time is calculated by multiplying the carbon dioxide concentration in the exhaust gas from the oxygenator 21 by the gas flow rate in the oxygenator 21, i.e., the carbon dioxide emission parameter per unit time (per minute, / min) = gas flow rate × carbon dioxide concentration (FCO2).

[0088] The total carbon dioxide parameter is calculated by summing the carbon dioxide exhalation parameter per unit time and the carbon dioxide emission parameter per unit time, that is, the total carbon dioxide parameter (VCO2.tot) = the carbon dioxide exhalation parameter per unit time (VCO2.Pt) + the carbon dioxide emission parameter per unit time (VCO2.ML), and the unit is mL / min.

[0089] Oxygen consumption (VO2) is calculated based on the total carbon dioxide parameter. The calculation formula is as follows:

[0090] Oxygen consumption (VO2) = total carbon dioxide parameter (VCO2.tot) / 0.85.

[0091] The present application also provides a computer-readable storage medium storing a computer program, which implements the above-mentioned patient cardiopulmonary function monitoring method when executed by the processing module 12.

[0092] The above specific examples are used to illustrate the present application, which is only used to help understand the present application and is not intended to limit the present application. For those skilled in the art of the present application, based on the concept of the present application, they can also make some simple deductions, modifications or substitutions.

Claims

1. A patient cardiopulmonary function monitoring system, characterized in that: include: A ventilator is used to provide ventilation support for a patient; the ventilator comprises a breathing circuit, a display module and a processing module; A membrane oxygenation device, comprising an oxygenator; a first monitoring module, which is disposed at the end of the breathing circuit and is used to monitor in real time the exhaled carbon dioxide parameter in the patient's exhaled gas, and an output end of the first monitoring module is connected to the ventilator; a second monitoring module, which is disposed at the gas outlet of the oxygenator and is used to monitor the carbon dioxide emission parameters in the exhaust gas of the oxygenator in real time, and the output end of the second monitoring module is connected to the ventilator; The processing module is configured to receive the carbon dioxide exhalation parameter and the carbon dioxide emission parameter, and convert the patient's carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter per unit time, and the oxygen consumption based on a preset algorithm; The display module is used to display in real time at least one of a trend graph of the carbon dioxide exhalation parameter within the unit time, a trend graph of the carbon dioxide emission parameter within the unit time, the carbon dioxide exhalation parameter, the carbon dioxide exhalation parameter within the unit time, the carbon dioxide emission parameter within the unit time, the total carbon dioxide parameter and the oxygen consumption.

2. The patient cardiopulmonary function monitoring system according to claim 1, characterized in that: The ventilator also includes a storage module, which is used to store monitoring data, including the carbon dioxide exhalation parameter, the carbon dioxide emission parameter, the carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter and the oxygen consumption.

3. The patient cardiopulmonary function monitoring system according to claim 2, characterized in that: The display module is used to display a trend graph of the carbon dioxide exhalation parameter within the unit time, a trend graph of the carbon dioxide emission parameter within the unit time, the carbon dioxide exhalation parameter, the carbon dioxide exhalation parameter within the unit time, the carbon dioxide emission parameter within the unit time, the total carbon dioxide parameter, and the oxygen consumption on the same screen; The display module includes a first display area and a second display area, the first display area is used to display a trend graph of the carbon dioxide exhalation parameter per unit time and a trend graph of the carbon dioxide emission parameter per unit time on the same screen; the second display area is used to display the carbon dioxide exhalation parameter, the carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter and the oxygen consumption on the same screen.

4. The patient cardiopulmonary function monitoring system according to claim 3, characterized in that: The ventilator further includes a cursor movement and positioning module, and the processing module is further configured to: receiving a cursor movement operation of a user on the first display area and determining the position coordinates of the cursor; Mapping the position coordinates of the cursor to a trend graph of the carbon dioxide exhalation parameter within the unit time and a trend graph of the carbon dioxide emission parameter within the unit time to determine a corresponding time point; extracting the carbon dioxide exhalation parameter per unit time and the carbon dioxide emission parameter per unit time corresponding to the time point from the stored monitoring data; The first display area displays the extracted carbon dioxide exhalation parameter within the unit time and the extracted carbon dioxide discharge parameter within the unit time.

5. The patient cardiopulmonary function monitoring system according to claim 4, characterized in that: The processing module is further configured to: When the extracted carbon dioxide exhalation parameters per unit time and the carbon dioxide emission parameters per unit time are displayed in the first display area, the real-time carbon dioxide exhalation parameters, the carbon dioxide exhalation parameters per unit time, the carbon dioxide emission parameters per unit time, the total carbon dioxide parameters and the oxygen consumption are simultaneously displayed in the second display area.

6. The patient cardiopulmonary function monitoring system according to claim 1, characterized in that: The carbon dioxide exhalation parameter comprises the partial pressure of carbon dioxide in the patient's exhaled gas; and / or the carbon dioxide discharge parameter comprises the concentration of carbon dioxide in the oxygenator's exhaled gas.

7. The patient cardiopulmonary function monitoring system according to claim 1, characterized in that: The membrane oxygenation device further includes a third monitoring module, which is used to monitor the air flow in the oxygenator, and the third monitoring module is connected to the ventilator.

8. A method for monitoring a patient's cardiopulmonary function, characterized in that: The steps include: Acquiring carbon dioxide exhalation parameters in the patient's exhaled gas using the first monitoring module, and acquiring carbon dioxide discharge parameters in the oxygenator's exhaust gas using the second monitoring module; Processing the carbon dioxide exhalation parameter and the carbon dioxide emission parameter using a preset algorithm by a processing module to obtain the carbon dioxide exhalation parameter per unit time, the carbon dioxide emission parameter per unit time, the total carbon dioxide parameter per unit time, and the oxygen consumption; A display module is used to display in real time at least one of a trend graph of the carbon dioxide exhalation parameter within the unit time, a trend graph of the carbon dioxide emission parameter within the unit time, the carbon dioxide exhalation parameter, the carbon dioxide exhalation parameter within the unit time, the carbon dioxide emission parameter within the unit time, the total carbon dioxide parameter, and the oxygen consumption.

9. The method for monitoring the patient's cardiopulmonary function according to claim 8, characterized in that: The processing of the carbon dioxide exhalation parameter and the carbon dioxide emission parameter by using a preset algorithm by a processing module includes: Summing the carbon dioxide partial pressures in all exhaled gases of the patient per unit time to calculate the carbon dioxide exhaled parameter per unit time; The carbon dioxide emission parameter per unit time is calculated by multiplying the carbon dioxide concentration in the oxygenator exhaust gas by the gas flow rate in the oxygenator; The carbon dioxide total parameter is calculated by summing the carbon dioxide exhalation parameter within the unit time and the carbon dioxide emission parameter within the unit time; The oxygen consumption is calculated based on the total carbon dioxide parameter, and the calculation formula is as follows: Oxygen consumption = total carbon dioxide parameter / 0.

85.

10. A computer-readable storage medium storing a computer program, characterized in that: When the computer program is executed by the processing module, the patient cardiopulmonary function monitoring method according to any one of claims 8 or 9 is implemented.

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