Method and system for processing data with a measuring device and an analyzing device

Abstract

The apparatus and method (100) for processing data (101, 102, 103) acquired by means of an imaging method enable an improved determination of the quality and quantity of ventilation of the lungs. By including a correction data record KDS determined during one or more inhalation phases, it is determined which effects are achieved by adapting the pressure level (PEEP A , PEEP B ) (81, 82) during artificial respiration, and the determined results are provided as an output signal (900).

Description

Technical Field

[0001] This invention relates to methods and systems for processing data from an analytical device and for acquiring or determining measurement data during artificial respiration of a patient. Measurement data can be acquired and provided by a measurement system suitable for acquiring physical measurement data in a measurement technique. The analytical device can preferably be configured as a system or apparatus for electrical impedance tomography (EIT), which provides data as image data or as a dataset of image data as EIT data. In addition to image data, EIT data may also include impedance values, impedance changes, and impedance time-varying processes. Devices for electrical impedance tomography (EIT) are known from the prior art. These devices are designed and configured to generate an image, multiple images, or a sequence of consecutive images from signals acquired by means of impedance measurements and data and data streams acquired therefrom. These images or image sequences reveal differences in the electrical conductivity of different body tissues, bones, skin, and body fluids and organs, which can then be used by a user to support the diagnosis of a disease or symptom.

[0002] Thus, for example, US 6,236,886 describes an apparatus with multiple electrodes, an electrical impedance tomography (EIT) imaging system for feeding current to at least two electrodes, and a method for determining the distribution of electrical conductivity in the body, such as bones, skin, and blood vessels, in a principle design having components for signal acquisition (electrodes), components for signal processing (amplifiers, A / D converters), current feeding devices (generators, voltage-to-current converters, current limiting devices), and components for control (µC). Further applications for identifying various forms of lung disease are possible with the aid of visualization.

[0003] US 2019 038 173 A describes a device for determining differential characteristic numbers of end-expiratory impedance values ​​from impedance tomography data of a region of the lung based on biological data. This device enables the evaluation of changes in overexpansion or collapse in a region of the lung using differential characteristic number assessment (WIN / LOSS).

[0004] As stated in US 5,807,251, in the clinical application of EIT, it is known to provide a set of electrodes arranged at specific intervals, for example, around the patient's chest, in a manner that allows for electrical contact with the skin, and to alternately apply current or voltage input signals between different or all pairs of possible pairs of electrodes arranged adjacent to each other. While an input signal is applied to one of the pairs of electrodes arranged adjacent to each other, current or voltage is measured between each pair of the remaining electrodes, and the obtained measurement data is processed in a known manner to obtain a representation of the resistivity distribution across a cross-section of the patient, around which the electrode rings are arranged, and displayed on a screen.

[0005] US 5,184,624 discloses an apparatus for measuring electrical impedance at a body using a plurality of electrodes, wherein current is fed into the body via electrode pairs and voltage potential is acquired at the body via the remaining electrode pairs. Here, two electrodes are sequentially selected from the plurality of electrodes as feed-in electrode pairs in a manner that surrounds the body, and multiple of the remaining electrodes are used as electrode pairs for acquiring voltage potential.

[0006] US 4,486,835 describes an apparatus for electrical impedance tomography (EIT) in which electrical signals are fed into a body at selected first electrode pairs and acquired at selected second electrode pairs in a predetermined order via a multiplexing device. These signals are then forwarded to a computing device coupled to the multiplexing device to determine the electrical properties of a large number of local regions of the body. Here, these local regions are arranged in a three-dimensional imaging mesh structure within the body, and the conductivity at these numerous local regions is continuously updated during iterative processes.

[0007] US 5,311,878 describes a method and apparatus for electrical impedance tomography (EIT) for real-time imaging. Impedance measurement signals are transmitted to a digital signal processing device by two selected adjacent electrodes arranged around the thoracic cavity, while a feed current is simultaneously fed into selected electrodes, and real-time images are generated by computer-based reconstruction.

[0008] EP 1 292 224 B2 describes a method and apparatus for representing data acquired by means of electrical impedance tomography. Different specific modes are described, such as relative mode, absolute mode, perfusion mode, time constant mode, and regional lung volume measurement mode. These different modes are used to distinguish different lung states.

[0009] US 9,713,689 B2 discloses a ventilator for automatically assessing a patient during positive end-expiratory pressure (PEEP) therapy. The ventilator enables the support of the patient's breathing and the delivery of therapy by measuring the patient's end-expiratory lung volume (EELV) at a first end-expiratory pressure and at a second end-expiratory pressure. Based on the calculation of the difference between the first and second end-expiratory lung volumes, indicators indicative of the patient's response to PEEP therapy are determined, including the patient's functional residual capacity (FRC). Summary of the Invention

[0010] The present invention is proposed as a task to describe a method and system for processing data, said data having been acquired during artificial respiration by means of a measuring and analyzing device, in order to determine the ventilation status (gas exchange) of the lungs.

[0011] This task, as well as other tasks, is addressed by a system for processing data acquired during artificial respiration via a ventilator using analytical devices suitable for determining lung condition and measurement data acquired using measurement devices suitable for acquiring physical measurement data in a measurement technique.

[0012] Another solution to the task can be derived by using the methods employed to process the data.

[0013] Advantageous embodiments of the invention are derived from other embodiments and are described in more detail in part with reference to the accompanying drawings.

[0014] The system according to the invention for processing data acquired or provided by means of measuring and analyzing devices can process the data such that the difference between data that can be assigned to a second condition and data that can be assigned to a first condition can be determined and can be provided by the control unit as an output signal by means of a data output unit indicating the difference. The effects on the condition of the organism's lungs due to the different levels in the exhalation phase during artificial respiration between the first and second conditions can be determined by including corrected data determined during one or more inhalation phases.

[0015] Some of the terms used in the scope of this patent application are explained in more detail below. Breathing pressure (Beatmungsdruck) for the inhalation (inspiratory) phase is referred to as inspiratory breathing pressure P. insp The respiratory pressure during the exhalation phase is called the expiratory respiratory pressure P. expThe respiratory pressure at the end of the exhalation phase is referred to as "Positive End Expiratory Pressure" (PEEP). In the context of this invention, a time segment within a time process can be understood as an observation period. The start and end of such an observation period are given by events characterized by breathing or artificial respiration. Examples of breathing-specific observation periods include a single respiratory cycle, multiple respiratory cycles, portions of a respiratory cycle such as inhalation (inspiration), inspiratory pause, exhalation (expiration), expiratory pause, and portions of one or more respiratory cycles, such as multiple inhalations and multiple exhalations. Other observation periods, particularly in the case of artificial respiration, can be segments of a specific pressure level, such as plateau pressure or PEEP pressure (PEEP), or segments of a specific characteristic corresponding to a form of artificial respiration (e.g., Bi-Level Positive Airway Pressure (BiPAP) or Continuous Positive Airway Pressure (CPAP).

[0016] In this context, for the purposes of this invention, EIT data can be understood as the following signals or data: -EIT raw data, i.e., measurement signals such as voltage or current acquired using EIT equipment via a set of electrodes or via electrode strips, are assigned to the electrodes or electrode groups or to the position of the electrodes or electrode groups at the electrode strips. -EIT image data refers to data or signals that determine and reproduce the local impedance, impedance differences, or impedance changes of a patient's lung region or lung and heart region from the raw EIT data using reconstruction algorithms. - Classified EIT data, i.e., EIT image data or signals that have been pre-sorted or pre-classified according to pre-given criteria.

[0017] The system according to the invention has - Measuring device -Analytical device -Data Input Unit -Control unit - Data output unit.

[0018] The measuring device is configured to acquire physical measurement data in a measurement technique. Specifically, the measuring device is configured to acquire pressure measurements of respiratory pressure or the time process of respiratory pressure in a measurement technique.

[0019] The analysis apparatus is preferably designed as an EIT system and includes an electrical impedance tomography (EIT) device, a data input unit for processing EIT data, and a display device. The EIT device includes an electrode assembly with numerous electrodes, operating electronics, a measurement acquisition and evaluation unit, and a data processing and calculation unit.

[0020] An electrode device is positioned in or around the patient's chest cavity. At least two electrodes of the electrode device are configured to receive alternating current or alternating voltage, and at least two electrodes of the electrode device are configured to acquire measurement signals. Operating electronics are configured to feed alternating current or alternating voltage into the electrodes. A measurement acquisition and evaluation unit is configured to acquire measurement signals at the electrodes. The operating electronics and the measurement acquisition and evaluation unit are designed to feed alternating current or alternating voltage into at least two electrodes of the electrode device and acquire measurement signals at at least two electrodes of the electrode device, such that in a continuous sequence, two additional electrodes are sequentially selected from the electrode device for feeding alternating current or alternating voltage, and measurement signals are acquired using at least two electrodes of the electrode device. A data processing and computation unit is configured to generate a dataset of signals from the measurement signals at at least one location within an observation time period using a reconstruction algorithm, and provides it to a data input unit.

[0021] Data processing and analysis can be divided into the following steps: -The first dataset that provides measurement data through the measuring device -A second dataset provided by the analysis device -A third dataset that provides data through an analysis device -Perform comparisons along with determining differences based on the second and third datasets. - Include correction data in the comparison to determine differences based on the first, second, and third datasets. - Generate an output signal, which serves as a result indication of the determined difference.

[0022] In the system according to the invention, these steps of data processing are implemented by the control unit and are repeated continuously.

[0023] The processed data is provided here as an output signal through the data output unit in a suitable manner, preferably for image representation and for further processing or evaluation.

[0024] Data sets can be provided using a data input unit, and output signals can be provided using a data output unit.

[0025] Data is processed by a control unit, which performs sorting, analysis, comparison, and selection. To this end, the control unit, for example in the form of an "embedded system," has elements for data processing, computation, and process control, such as microcontrollers (µC), microprocessors (µP), signal processors (DSPs), logic components (FPGAs, PLDs), storage components (ROMs, RAMs, SD-RAMs), and combinations thereof. These elements are designed together and adapted to each other, and are programmed to implement data processing.

[0026] The data input unit is configured to provide a dataset or to read data or datasets via an interface. The data input unit preferably includes interface elements such as amplifiers, A / D converters, components for overvoltage protection (ESD protection), logic elements, and other electronic components for receiving data and signals wired or wirelessly, as well as adapter elements such as code or protocol conversion elements for adapting signals and data for further processing in the control unit.

[0027] The data output unit is configured to generate and provide an output signal. The output signal is preferably a video signal (e.g., video output, component video, S-video, HDMI, VGA, DVI, RGB) designed to be displayed on a display unit wirelessly or wired (WLAN, Bluetooth, WiFi) connected to the output unit, or on the output unit itself, so as to represent at least one characteristic location and inject specific parameters in a graphical, numerical, or graphic manner during the observation period.

[0028] The system according to the invention is configured to process data acquired during artificial respiration via a breathing apparatus by means of an analytical device (30) suitable for determining the state of the lungs and measurement data acquired by means of a measuring device suitable for acquiring physical measurement data in a measurement technique.

[0029] Therefore, the system according to the invention includes a data input unit, a data output unit, and a control unit. The system is designed, by means of the data input unit, to acquire or receive data from a measuring device. The data from the measuring device can be assigned to a condition with a predetermined pressure level and can be provided as a first dataset of measurement data over the observation period during artificial respiration of an organism. The system is also designed, by means of the data input unit, to acquire or receive data from an analytical device. The data from the analytical device can be assigned to a first condition and can be provided as a second dataset of data over the observation period during artificial respiration of an organism.

[0030] The system is configured to provide control signals through the interaction of a control unit and a data output unit. The control unit can initiate a control signal at the breathing device to generate a predetermined pressure difference from the first positive end-expiratory pressure (PEEP) level using the control signal. A ) to the positive end-expiratory pressure (PEEP) level B ).

[0031] This system is designed to acquire or receive additional data from the analysis device via a data input unit. This additional data can be allocated to a second situation and, during the observation period of artificial respiration of the organism, can be provided as a third dataset of additional data.

[0032] The control unit is constructed and configured to perform data processing. The control unit is constructed to process a first dataset, a second dataset, and a third dataset. The difference (Unterschied) DZ between the data of the second condition and the data of the first condition can be determined by comparison. The control unit is constructed to include a correction data record (KDS) in the comparison to correct the difference DZ. Thus, the corrected difference DZ is obtained. K .

[0033] In an alternative design, the difference DZ between the signal of the second condition and the signal of the first condition can also be determined based on, for example, a current or voltage signal provided by an electrode device of an EIT system. This difference determined based on the signal also allows for the assessment of what effect the adaptation of end-expiratory pressure has resulted in. Based on the signal, it can be determined, for example, whether (e.g., when end-expiratory pressure is increased) the lungs or which areas of the lungs not only directly benefit from the volume increase caused by the pressure increase, and whether and in which areas of the lungs an increase in reopened lung areas (alveoli, lung cells) that were previously unavailable for gas exchange has been observed. The corrected data record (KDS) includes data elements of a second dataset indicating specific pressure conditions P1 and P2 at time points t1 and t2 within the observation period of respiratory pressure. The control unit is configured to be based on comparison, based on difference DZ, or based on corrected difference DZ. K To determine the output signal. The output signal can indicate the difference DZ and / or the corrected difference DZ. K The control unit is configured to provide output signals via a data output unit.

[0034] In a preferred embodiment of the system, the inspiratory breathing pressure P is indicated. inspThe data elements for the specific pressure conditions P1 and P2 at time points t1 and t2 on the rising edge are included in the first data element.

[0035] In a preferred embodiment of the system, the indicator is given at the expiratory respiratory pressure P. exp The data elements for specific pressure conditions P1 and P2 at time points t1 and t2 on the falling edge are included in the first dataset.

[0036] Preferably, specific pressure conditions P1 and P2 indicate the state of the lung volume change in an organism during artificial respiration, which can be determined by means of an analytical device, such that specific pressure conditions, for example, during the inhalation phase, or at the inspiratory breathing pressure P1, are used to indicate the state of the lung volume change during artificial respiration. insp The pressure level P1 during the rising edge of the respiratory tract corresponds to the change in lung volume. A similar concept can be applied to exhalation, where specific pressure conditions during the exhalation phase, such as the expiratory respiratory pressure Pex, are considered. p The pressure level P2 during the descent corresponds to the volume change in the lungs.

[0037] In a preferred embodiment of the system, the analytical apparatus is adapted and configured for imaging the lungs of an organism. In a particularly preferred embodiment of the analytical apparatus, lung imaging can be performed using a system such as an apparatus for electrical impedance tomography (EIT) or an EIT system. Lung imaging can also be performed using a system such as an apparatus for magnetic resonance tomography (MRI). Lung imaging can be performed using a system such as an apparatus for computed tomography (CT). Lung imaging can be performed using a system such as an apparatus for ultrasound imaging. Apparatus for electrical impedance tomography (EIT) has significant advantages over magnetic resonance tomography (MRI) and computed tomography (CT), primarily in the following aspects: •EIT has real-time functionality •EIT does not need to be coupled to EKG •EIT does not require contrast agents •EIT allows for trend representation and analysis.

[0038] Regarding sonographic devices used in cardiology, angiology, prenatal, or neonatal imaging, it should be noted that because the ultrasound probe connected to the contact gel is guided by the user, and the orientation of the ultrasound probe and the function of the contact gel must be observed continuously and visually by the user during the examination, the sonographic device is limited to temporary examinations in application. From this, the following advantages can be derived: •EIT does not require contact with the gel. •EIT does not require continuous functional monitoring by users.

[0039] Therefore, unlike other medical devices mentioned for imaging (X-ray equipment, computed tomography, magnetic resonance imaging, sonography equipment), electrical impedance tomography (EIT) is suitable for continuous and sustained imaging, especially of the lungs and both the lungs and heart, without causing any noteworthy physiological burden or discomfort to the patient.

[0040] In a preferred embodiment of the system, the analytical device is configured to be suitable for determining the volume of an organism's lungs. The device suitable for determining the volume of an organism's lungs can be constructed using a device for lung volume measurement, or by utilizing the measurement and analytical functions of a device used for artificial respiration of an organism, such as a monitoring ventilator, emergency ventilator, transport ventilator, neonatal ventilator, or anesthesia machine.

[0041] In a preferred embodiment of the system, a first condition can be assigned to a first predetermined pressure level P1. In this preferred embodiment, at the breathing device, a predetermined pressure difference is initiated by means of the control signal to raise the first positive end-expiratory pressure (PEEP) level by means of the predetermined pressure signal, as the predetermined pressure level P1 rises above the predetermined pressure level P1. A Adapt to the positive end-expiratory pressure (PEEP) level. B The first predetermined pressure level P1 is preferably at the inspiratory breathing pressure P. insp The rising edge period is determined by time point t1. In this preferred embodiment, the comparison is performed by the control unit subtracting the third dataset from the second dataset. In this preferred embodiment, the control unit is configured to determine the corrected difference DZ. K1 As a subtraction correction DZ K2 = (Z) y -Z1)-Z K1 Implement the correction.

[0042] In a further preferred embodiment, the first condition can be assigned to a second predetermined pressure level P2. In this further preferred embodiment, at the breathing device, a predetermined pressure difference is initiated by means of the control signal to reduce the first positive end-expiratory pressure (PEEP) level as a result of lowering the predetermined pressure level P2. A Adapt to the positive end-expiratory pressure (PEEP) level. C The second predetermined pressure level P2 is preferably at the expiratory breathing pressure P. exp The falling edge period is determined by time point t2. In this further preferred embodiment, the comparison is performed by the control unit as the subtraction of the third dataset from the second dataset. In this further preferred embodiment, the control unit is configured to determine the corrected difference DZ. K2 As an additive correction DZK2 =(Z y -Z2)+ Z K2 Implement the correction.

[0043] In a further preferred embodiment of the system, the control unit is configured to perform data acquisition at a predetermined pressure level P1 during artificial respiration in a first condition.

[0044] In a further preferred embodiment of the system, the control unit is configured to perform data acquisition at a predetermined pressure level P2 during artificial respiration in a second condition.

[0045] In a further preferred embodiment, the control unit is configured to, during the first condition, time-dependently adjust the inspiratory respiratory pressure P during artificial respiration. insp Inspiratory pressure P following the rising edge insp Data acquisition is performed on the platform at a predetermined pressure level P1.

[0046] In a further preferred embodiment, the control unit is configured to, during the second condition, time-dependently adjust the inspiratory pressure P during artificial respiration. insp Inspiratory pressure P following the rising edge insp Data acquisition is performed on the platform at a predetermined pressure level P2.

[0047] In a further preferred embodiment of the system, the measuring device is configured to perform pressure measurement. In a variation of this further preferred embodiment of the system, the measuring device may be a submodule of the breathing device or the analysis device, or the measuring device and the analysis device may form a common device.

[0048] In a further preferred embodiment of the system, the measuring device is configured to perform flow measurement and / or volume measurement. In a variation of this further preferred embodiment of the system, the measuring device may form a submodule of a breathing device or an analysis device, or the measuring device may form a common device with the analysis device.

[0049] In a further preferred embodiment of the system, the control unit is configured to perform data acquisition as the acquisition of impedance values ​​of a selected or representative region of the lung and / or as the acquisition of global impedance values ​​over a time process as a global impedance curve. The selected or representative region of the lung in the apparatus for electrical impedance tomography is a spatially defined area in a 2D or 3D representation of EIT data, and is often also referred to as a ROI (Region of Interest), and can be defined or determined, for example, based on EIT data, as a single impedance value or pixel, multiple impedance values ​​or pixels, or a group of impedance values ​​or pixels. The global impedance curve can be determined by the control unit from the EIT data based on a majority of all impedance values ​​or a majority of pixels, and all impedance values ​​or all pixels.

[0050] In a further preferred embodiment of the system, the control unit is configured to determine a representative reference value Z0 or a fourth dataset as a reference value for the normalized data record NDS by means of further data acquisition at a normalized state t0 prior to the first state during the time process. In this further preferred embodiment, the control unit is configured to perform normalization by means of the normalized data record NDS and / or the representative reference value Z0 during the data acquisition. This normalization to the reference value Z0 can be performed periodically by the control unit—preferably during artificial respiration at a time point t0 for the end-expiratory state, i.e., at the end of exhalation and before the start of the next subsequent inhalation. For this purpose, the control unit can preferably use individual impedance values, groups of impedance values, or a global impedance value, i.e., the value of the global impedance curve for the end-expiratory state at time point t0. It can be said that the subsequent acquisition of impedance values ​​or EIT data is zeroed out from this normalization. This zeroing can be performed by the analysis device, the EIT system, or the control unit before each breath or at the beginning of each breath after a certain number of breaths, for example, every 5 to 10 breaths at the beginning. This zeroing process during data acquisition in an EIT system, especially for the consistently defined states in the lungs, and particularly for the repeated and periodic zeroing of the end-expiratory state in the lungs (where exhaled air largely escapes completely from the lungs at the end of exhalation), yields a variety of advantages. Among these advantages, the following should be mentioned, for example: - Reduce the quality of electrode coupling and contact on the skin surface of organisms, especially the effect of variable electrode-to-skin contact resistance. - The electrode contact and changes in its contact resistance should be inspected periodically. - Changes in the position of electrodes in the thoracic cavity of an organism. - Identify defective electrodes, - Used to adjust electronic components to defined states, such as offset correction, signal amplification adaptation, and signal filtering possibilities. - The possibility of performing comparisons based on 2D or 3D representations of EIT data, selected regions of interest (ROIs) based on these representations, or global impedance curves given changes in the organism's lung rehabilitation.

[0051] In a further preferred embodiment of the system, the control unit is configured to perform data adaptation to balance the time difference between the first and second datasets, so as to synchronize the measuring and analyzing devices in time. (The last part, "by inspiratory breathing pressure P," appears to be unrelated and likely refers to a different implementation.) insp The slope of the rising edge determines that not only the sampling rate needs to be adapted to the slope of data acquisition, but also that there needs to be sufficient time synchronization between the data acquisition of the analysis and measurement devices. This is to ensure that the selected, and subsequently used, correction data records KDS containing the inspiratory breathing pressure P are used to correct previously determined differences. insp The corresponding positive end-expiratory pressure level PEEP A PEEP B PEEP C The predetermined pressure levels P1 and P2 are associated together. Synchronization is especially important in the system even when the analysis and measurement devices are connected via a network (LAN, WLAN). Time delays in the network can be compensated for by data synchronization, preferably by synchronizing the system time or timers (clocks) in the analysis and measurement devices within the system.

[0052] In a further preferred embodiment, the control unit is configured to operate during the second state at a time delay time T. Delay Data collection then begins. Application delay time T. Delay The following advantages are observed: Individual effects arising from pressure increases or decreases during artificial respiration due to the varying physiological and anatomical characteristics of different organisms, or delays in the inflow of respiratory air into different regions of the lungs, are not included in the collected data. Individual effects or delays such as regional ventilation delays (RVD) caused by flow effects, volume shifts in the airway or lungs, or intratidal redistribution of respiratory gases within the lungs, are observed in the delay time T. Delay That largely ended thereafter.

[0053] In a further preferred embodiment, the control unit is configured to, during the second condition, rise to the second positive end-expiratory pressure (PEEP) level. BAfter initiating the second state, data acquisition is performed at predetermined time intervals of 5 to 10 respiratory cycles. In a further preferred embodiment, the control unit is configured to perform data acquisition during the second state at a level reduced to the third positive end-expiratory pressure (PEEP) level. C After initiating the second condition, the data acquisition is performed at predetermined time intervals of 5 to 10 respiratory cycles.

[0054] In a further preferred embodiment, the control unit is configured to utilize the first state to inspirate respiratory pressure P during artificial respiration using the breathing device. insp The maneuver is initiated at a largely constant pressure level. This maneuver may, for example, include the duration of a single breath. For example, and preferably, a largely constant pressure level can be selected at predetermined pressure levels P1, P2.

[0055] In a further preferred embodiment, the control unit is configured to operate at the breathing apparatus at an inspiratory breathing pressure P during artificial respiration. insp Multiple discrete pressure levels along the rising edge initiate maneuvering. This results in a hierarchy of pressure levels, sometimes constant and segmentally constant, affecting the inspiratory and respiratory pressure P. insp The rising edge is graded. If inspiratory breathing pressure P is performed at time points t1 and t2, which are essentially in the middle of the time interval of this pressure level, the pressure level is graded. insp Pressure measurements are susceptible to errors caused by imperfect synchronization or asynchrony between analytical devices, especially EIT systems, as well as by suboptimal adaptation to the inspiratory breathing pressure P during data acquisition and processing. insp The potential error caused by the sampling rate and the slope of the rising edge is not very decisive. Not only the inspiratory pressure P... insp The rising edge of the pressure level is largely constant, and multiple discretely constructed pressure levels make it possible to give the inspiratory breathing pressure P when acquiring the dataset. insp A stable or temporarily stable state. Because the inspiratory respiratory pressure P insp The slope of the rising edge is not a problem at least temporarily, and thus has a small impact on the form or slope of the rising edge when acquiring and correcting data records (KDS). Therefore, in this way, the requirements for the sampling rate during data acquisition and the synchronization requirements for data acquisition of the analysis and measurement devices can be reduced.

[0056] In a further preferred embodiment of the system, the measuring device is configured as a module or as a component of a device for performing artificial respiration. In such an embodiment, the measuring technology components, such as sensors for pressure measurement, flow measurement, volume measurement, or volume balancing, and associated electronic equipment with signal processing, signal amplification (OP amplifier), signal filtering, signal conversion (A / D converter), and signal processing (µC, DSP, FPGA, A / D-μC) are arranged within the respiration device, so that it is not necessary to prepare additional sensor systems and / or electronic equipment in a separate measuring device to work with the analysis device. The device for performing artificial respiration can be configured, for example, as a monitoring ventilator, emergency ventilator, transport ventilator, neonatal ventilator, or anesthesia machine.

[0057] In a further preferred embodiment, the system having an analytical device, a measuring device, and a breathing device forms a common system for artificial respiration and monitoring of organisms. Besides spatial integration with each other, the common system also offers advantages in the design of coordinated measurement and signal acquisition and signal processing, regarding aspects such as sampling rate, signal filtering, time synchronization of datasets, and the possibility of coordinated and / or centralized control of the joint action of the components of the analytical device, measuring device, and breathing device. The aspects and advantages mentioned for embodiments having a measuring device as a module or component for artificial respiration are also applicable in the same and / or transferable manner to embodiments of the common system consisting of the analytical device, measuring device, and breathing device, and need not be specifically or repeatedly mentioned for the common system in this respect.

[0058] In a further preferred embodiment of the system, the control unit is configured as follows: -In the breathing apparatus -In the analysis device - Measuring device Components or sub-modules, Alternatively, the control unit may be constructed as a component or module of a common system. The control unit may be centrally located within the system or distributed or modularly arranged within the system, serving as a module or submodule of an analytical device, measuring device, or respiratory device. The control unit may be implemented using multiple control modules, for example, in a master / slave configuration within the system. The aspects and advantages mentioned in the implementation for the common system or in the implementation having a measuring device as a module or component for performing artificial respiration also apply in the same and / or transferable manner to this implementation for the control unit design, where no special or repeated mention is necessary for the common system.

[0059] In a further preferred embodiment of the system, particularly a common system, the control unit is configured to apply an inspiratory breathing pressure P at the breathing apparatus during artificial respiration. insp Multiple pressure levels initiate maneuvering actions.

[0060] In a further preferred embodiment, the control unit is configured to utilize the inspiratory breathing pressure P through the breathing device. insp and / or expiratory respiratory pressure P exp And / or end-expiratory pressure PEEP during artificial respiration, in the process or motor action of gradually or progressively reducing pressure to remove the organism from artificial respiration, by means of a control signal at the level of pressure reduction or at the time interval between pressure adaptation steps, based on the difference DZ or based on the corrected difference DZ. K DZ K1 DZ K2 Initiate, coordinate, or control the steps or levels of pressure reduction. The control unit can adjust the pressure reduction based on previously determined and continuously adjusted DZ levels during the removal process. K DZ K1 DZ K2 The design, implementation, and / or adaptation of withdrawal strategies—that is, withdrawal methods performed solely at the biological site—involve pressure adaptation initiated by the control unit via control signals based on the timing, time intervals, and form of the withdrawal, i.e., the order of magnitude of ΔP, primarily utilizing a decrease in the level of end-expiratory pressure (PEEP). Therefore, even based on the determined differences in DZ, DZ... K DZ K1 DZ K2 Returning to a previous state by utilizing an increase in end-expiratory pressure (PEEP) can be achieved by the control unit within the withdrawal range, as needed and in an adaptive control manner. Specifically, this includes corrected differential DZ. K DZ K1 DZ K2This provides the following advantages: The control unit can adapt the withdrawal process so that the reduction in the level of end-expiratory pressure (PEEP) performed for withdrawal does not result in a persistent loss of lung areas previously involved in gas exchange. Once, for example, one of the reductions in the level of PEEP performed in a specific lung region (ROI) has caused a loss of lung areas previously involved in gas exchange—that is, a so-called collapse, commonly referred to as "de-expiration"—the control unit can initiate a pressure increase above the current PEEP level to a previously given higher pressure level or to a pressure level between the current pressure level and the previously given higher pressure level. Alternatively or additionally, the control unit can also extend the duration set during withdrawal until the next pressure reduction. In this way, it is possible for the control unit to accompany, safeguard, and / or coordinate the withdrawal of the organism from artificial respiration via a ventilator using data analysis of the current lung condition based on data provided by means of electrical impedance tomography. Here, accompaniment may include providing the user with the results of the data analysis. Assurance here may include outputting prompts or warnings determined by data analysis. Coordination here may include controlling the breathing device with respect to the set value of the breathing pressure, especially the end-expiratory breathing pressure level.

[0061] In a further preferred embodiment, the control unit is configured to initiate an increase in the sampling rate at the measuring device and / or the analysis device during data acquisition at the start of the first condition. This increase is achieved by the control unit at the measuring device or analysis device, for example, at a predictable inspiratory breathing pressure P. insp During the rapid increase in time interval, especially when used to collect inspiratory respiratory pressure P insp The increased sampling rate, triggered by the rising edge value and shape, yields the following advantages: The improved time resolution of pressure measurements in the control unit simplifies the identification of predetermined pressure levels P1 or P2 within the first dataset or when acquiring pressure measurements included in the first dataset. A sufficiently high sampling rate, for example, yields the following advantages: It is not necessary to implement methods for controlling the inspiratory breathing pressure P... insp A method for interpolating or estimating between sampled values ​​on the rising edge.

[0062] In another preferred embodiment, the control unit is configured to initiate a maneuvering action by a predetermined slow increase in inspiratory pressure before the breathing apparatus is in the first state or during artificial respiration in the first state. This maneuvering action is also known as a so-called "slow inflation maneuvering action." The inspiratory pressure P is determined during the maneuvering action with a predetermined slow increase in inspiratory pressure having a reduced steepness compared to conventional pressure-controlled artificial respiration. inspThe rising edge variation process, i.e., the requirement for a higher sampling rate caused by pressure changes in each time segment (ΔP / Δt) during the duration of the maneuver, represents an alternative to increasing the sampling rate. Therefore, the control unit can, for example, initiate such a maneuver from time to time with a predetermined slow increase in inhalation pressure to provide a less intrusive state for determining reliable pressure measurements for predetermined pressure conditions P1, P2 during the data acquisition of the first dataset.

[0063] The above describes a solution to the system's task. The features, advantages, or alternative implementations mentioned in this context can also be applied to the claimed method and vice versa. The corresponding specific features of the system are formed in the method through corresponding functional features.

[0064] The method for processing data according to the present invention can be constructed as a sequence of steps, including - Receive data that can be assigned to conditions with predetermined pressure levels. - Provide measurement data as the first dataset - Receive EIT data in the first situation - Provide EIT data as a second dataset - Receive additional EIT data in the second scenario - Provide EIT data as a third dataset - Process the first, second, and third datasets so that, with the inclusion of the corrected data record KDS, the difference DZ between other EIT data in the second condition and the EIT data in the first condition can be determined by comparison. - Identify and provide an output signal indicating the difference and / or the corrected difference.

[0065] In a manner similar to that previously implemented and mentioned for the system according to the invention and the embodiments described herein, the steps of receiving data along with providing the dataset can be implemented, for example, by a data input unit, the data processing steps can be implemented, for example, by a control unit, and the provision of an output signal can be implemented, for example, by an output unit. Furthermore, the method can also be provided as a computer program or a computer program product, such that the scope of protection of this application also extends to computer program products and computer programs.

[0066] The described embodiments are specific design schemes of the system according to the invention, both individually and in combination with each other. While not all possible combinations of embodiments have been described in detail, the advantages derived from one or more combinations of embodiments are equally included with the inventive concept. Attached Figure Description

[0067] The invention will now be described in more detail with the aid of the following drawings and their accompanying figures, without limiting the general inventive concept. Wherein: Figure 1 A schematic diagram of functional elements for processing image data or EIT data is shown. Figure 2 A second schematic diagram of the functional elements is shown. Figure 3 A third schematic diagram showing the functional elements is provided. Figure 4 The fourth schematic diagram shows the functional elements. Figure 5 The fifth schematic diagram shows the functional elements. Figure 6 The sixth schematic diagram shows the functional elements. Figure 7 A schematic diagram shows components used for data processing of measurement data or datasets. Figure 8 A schematic diagram of a system for artificial respiration and monitoring of organisms is shown. Detailed Implementation

[0068] exist Figure 1-6 This describes the relationships and processes for providing and processing datasets 101, 102, 103, and 104 in systems 100, 200, 300, 400, 500, and 600, which are devices with functional elements. Figure 1-6 In the described process, the second state 32 is derived temporally after the first state 31. However, within the scope of this invention, the time allocation between the "first" and "second" states should also be included: during artificial respiration, the first state 31 can also be derived temporally after the second state 32. More precisely, different positive end-expiratory pressure (PEEP) levels are derived in states 31 and 32. A 81. PEEP B 81. PEEP C 83. In Figure 1-3 In the process, the pressure level is reduced from the positive end-expiratory pressure (PEEP) level in condition 31 over time. A 81 is increased to the positive end-expiratory level PEEP in condition 32. B 82.

[0069] exist Figure 4-6 In the process, the pressure level is reduced from the positive end-expiratory pressure (PEEP) level in condition 31 over time. B 82 drops to the positive end-expiratory PEEP level in condition 32 of the second situation. C 83. In Figure 1-6In this process, the control unit 70 utilizes and processes datasets, which are designed as a first dataset 101, a second dataset 102, a third dataset 103, and a fourth dataset 104. The first dataset 101 includes measurement data 4 continuously acquired during operation of the measuring device 40, the analyzing device 30, and the breathing device 2, particularly pressure measurements. The first dataset 101 specifically includes the pressure measurement value P141 acquired in the first condition 31. The second dataset 102 includes the global impedance curve Z acquired in the first condition 31. Global The impedance value of 75 is 74 or data or image data 3. The third dataset 103 includes the global impedance curve Z acquired in the second situation 32. Global Other impedance values ​​74 or data or image data 39. The fourth dataset 104 includes normalized data records NDS 330 with impedance values ​​Z0 or image data 3 acquired in normalized condition 33.

[0070] exist Figure 1 The diagram illustrates a system 100 having a device with functional elements for processing image data or EIT data 3.

[0071] System 100 includes a data input unit 50, a control unit 70, and a data output unit 90 as basic components. Figure 1Display devices (not shown together for obvious reasons) are depicted on the data output unit 90. For example, such a display device may include display elements, screens, or monitors for representing graphics, curve changes, charts, or images, or it may include numerical displays for reproducing digital values, as well as input and operation elements such as switches, buttons, knobs, or touch-sensitive displays (touchscreens) that combine input and representation functions. Such a display device may be connected to the data output unit 90 as an internal module or as an external device. The data output unit 90 enables, for example, the wireless or wired provision of data to a data network (LAN, WLAN, Ethernet) for exchanging measurement and control data (e.g., USB, RS232, RS485, FireWire, NMEA 0183, IrDA, Bluetooth, CAN, UMTS [SMS, MMS]) with various other external devices (anesthesia or ventilator, breathing apparatus, physiological monitor, personal computer, hospital management system) and provides audio / video data in various data formats (e.g., MPEG, JPEG, etc.) (e.g., video output, component video, S-video, HDMI, VGA, DVI, RGB) to connect to a display device (screen, monitor, tablet). The data output unit 90 is configured to provide control signals and / or output signals, for example, to represent values, images, graphs or curves, curve changes, time signal changes, or data records for display devices (screen, monitor, data visual display). In the sense of this invention, "providing" should be understood as providing signals or data in any form to other devices or parts of devices for transfer, output, representation, display, expression, transmission, or further processing. Control unit 70 performs a multitude of tasks within system 100, such as coordinating with data input unit 50 and data output unit 90. Control unit 70 is preferably constructed, for example, as a central computing unit (CPU, μP) or a device of various microcontrollers (µC). Control unit 70 includes other units constructed for further processing, storing, and preparing signals or data, such as storage components (RAM, ROM, A / D converter). Furthermore, various elements for providing voltage and energy supply belong to system 100, but these elements are within the system... Figure 1 Not shown together. The connections between the components and units of system 100 are described in [the diagram]. Figure 1The diagram only schematically illustrates, for example, important data connections, data input terminals, and data output terminals; however, supply lines are not shown for clarity, and not all connections between components and units are shown. These units can be constructed as individual elements of the control unit 70, but together in the sense of the invention, the control unit 70 can be divided into other sub-modules and can be programmed to provide and execute functions and tasks in the same manner or in the same or altered order of processing. Data storage, for example as a RAM memory component preferably arranged within the control unit 70, is provided and constructed for storing and organizing data or datasets 101, 102, 103, 104 for data processing, said data or datasets being designed, for example, as one-dimensional or multi-dimensional fields (arrays), data records or collections of data records, and results or intermediate results of data processing (calculation, sorting, allocation). During the operation of system 100, data input unit 50 reads measurement data 4 from measuring device 40. Figure 1 In this system, the measuring device 40 is exemplarily integrated into the system 100 as an external device or internal module. After being provided or read, the data input unit 50 prepares the measurement data 4 as a first dataset 101 for further processing by the control unit 70. As the measurement data 4 from the measuring device 40, pressure measurements 45 and optionally other sensor measurements, such as flow measurements 46 or volume measurements 47, are provided to the control unit 70 via the data input interface 50 as the first dataset 101. During operation of the system 100, the data input unit 50 reads image data 3 from the analysis device 30. Figure 1-6 In this system, the analytical apparatus is configured for performing electrical impedance tomography (EIT) to image and analyze the lungs of a living organism. Such a system is also referred to as EIT system 30. EIT system 30, through the use of electrode devices arranged or placed around the patient's upper body and the signal feed and acquisition process at the electrodes, enables the determination of the patient's lung impedance values, along with impedance changes and impedance variations. By means of image reconstruction, the impedance values ​​can be converted into global and regional ventilation status of the lungs and provided as EIT data 3 in the form of image data or impedance values. Data input unit 50 reads the EIT data 3 from EIT system 30 during operation. Figure 1In this system, the EIT system 30 is exemplarily integrated into the system 100 as an external device or internal module. After reading, the data input unit 50 prepares the EIT data 3 as a second dataset 102 for further processing by the control unit 70. In further operation of the system 100, the data input unit 50 reads other image data 39 from the EIT system 30 as EIT data 3 and prepares the other image data as a third dataset 103 for further processing by the control unit 70. During operation of the system 100, the control unit 70 performs the data processing described below. The pressure measurement value P141, which is a data element of the first dataset 101, represents the inspiratory breathing pressure P during artificial respiration in the first condition 31. insp The pressure at time point t1 on the rising edge of the pressure, where artificial respiration is performed at the positive end-expiratory pressure (PEEP) level. A The breathing device 2 performs the operation above 81. For the second condition 32, which follows the first condition in time, the control unit 70 stores the pressure measurement value P141 as a predetermined pressure difference ΔP 411. During the second condition 32, the positive end-expiratory pressure (PEEP) level is compared with the first positive end-expiratory pressure (PEEP) level. A The pressure difference (intermediate storage) increased by 81 compared to the positive end-expiratory pressure (PEEP) level by +ΔP 411. B 82. To this end, the control unit 70 uses a predetermined pressure difference +ΔP 411 in the control signal 72 to increase the positive end-expiratory pressure (PEEP) level at the breathing device 2 according to Formula 1. (PEEP) A ) + ΔP = (PEEP) B ) Formula 1.

[0072] Therefore, according to Figures 1 to 3 In the diagram, in the second state 32, the positive end-expiratory pressure (PEEP) level changes to a higher PEEP level compared to the first state 31. The control unit 70 generates a corresponding control signal 72 to initiate a change in the PEEP level to a second PEEP level at the start of the second state 32 in the breathing device 2. B An improvement of 82. For illustration, in Figure 1 The diagram illustrates the measuring device 40 during artificial respiration, showing time points t1 and t2. y Together with the corresponding pressure measurement values ​​P141 and P y 47. Pressure / Time Process. For further illustration, in... Figure 1 The diagram illustrates the EIT system 30 during artificial respiration, showing time points t1 and t2. y Together with the corresponding impedance values ​​Z174, Z y 77 and the impedance value Z as for the first condition 311,1 ...Z 1,m and the impedance value Z for the second condition 32 y,1 ...Z y,m Impedance / time process t in the design scheme of multidimensional data fields y Z174, Z y 77. Z Global 75. Additionally, the EIT data 3 and 39 for the two conditions 31 and 32 are schematically shown in the timing of the visualization 3001 of the lungs. Here, in this exemplary design drawn according to FIG1, the darker area components in the schematic image 3001 of the lungs in the lateral view correspond to areas with good ventilation, and the brighter area components corresponding to areas with less ventilation. In a practical design of the EIT system 30, the bright / dark design will mostly be, and can be, designed in reverse. The control unit 70 uses the impedance value Z174 of the first condition 31 and the impedance value Z of the second condition 32. y 77 or the second dataset 102 and the third dataset 103 are used to determine the difference between two conditions 31 and 32 by subtraction using comparison 700. DZ = Z y – Z1 Formula 2.

[0073] Furthermore, it is of interest to determine whether or which areas of the lungs directly benefit from (the increase in pressure) to the positive end-expiratory pressure (PEEP) level. B The increase in volume caused by 82, and whether it is related to the increase in reopened lung areas (alveoli, lung cells) in which areas of the lung were previously unavailable for gas exchange. This "reopening" of lung areas previously unavailable for gas exchange is called re-expansion (Rekrutierung) or also "recruitment". For this purpose, in the comparison, at the inspiratory expiratory pressure P insp The rising edge of the second positive end-expiratory pressure (PEEP) at time point t1 corresponds in amplitude or value to the level of positive end-expiratory pressure (PEEP). B )82 pressure status P141 during inspiration at the positive level of PEEP at the end of the first expiration A The data record is acquired on 81 or identified by analysis within the first dataset 101. Subsequently, it is identified by analysis within the second dataset 102 at time point t1. This identified data record of impedance value serves as a correction data record (KDS Z) for impedance value 74 or image data 3, belonging to pressure condition P1 and time point t1. K1 311 is included in comparison 700 for one type of normalization. To normalize the difference DZ 71, the control unit 70 applies the correction data record KDS Z according to the following formula 3.K1 311, in order to determine the so-called "gain" (WIN). WIN = DZK1 = (Z y - Z1) - Z K1 Formula 3.

[0074] The first corrected difference WIN or DZK1711 determined in this way can be provided as an output signal 900 indicating the difference 711 by means of data output unit 90. The output signal 900 can be represented by schematic visualization 3000. In this schematic visualization 3000, four representative regions I...IV (Regions of Interest: ROI) 73 are shown exemplarily; in this example, a small, dark area is visible in region II. This small, dark area II represents the lungs benefiting from the positive end-expiratory pressure (PEEP) level. A ) + ΔP = (PEEP) B The area that increases with increased ventilation. This means that in this area II, not only is there an increase in lung volume directly caused by the increase in pressure, but also a regional increase in the reopened lung areas (alveoli, alveoli) that were previously unusable for gas exchange. Comparison 700 makes this difference 71 available to the user so that, for example, it can be estimated how the increase in pressure, in addition to the increase in volume, also applies to the reopening of previously collapsed lung areas. It is thus possible to provide the user, both globally based on global impedance curves and regionally, qualitatively and quantitatively, for example, in the form of a gain / loss representation or a percentage description in a gain / loss statement (WIN / LOSS) for further diagnosis and treatment, directly with respect to the increase in the area component achieved by this treatment measure of increased pressure.

[0075] Figure 2 and Figure 3 Showing according to Figure 1 The extension, Figure 1 , 2 The same components in 3 Figure 1 , 2 The same reference numerals are used in figures 1 and 3. Figure 2 , 3 The design scheme is shown, wherein at the time point t0 of the normalized state 33, which is prior to the first state 31 and the second state 32, the impedance value Z0 or image data 3 is acquired by the EIT system 30 as normalized data record 330 and stored as the fourth dataset 104. The normalized state 33 is obtained before the start of inhalation or at the end of exhalation. The normalization in the normalized state 33 is... Figure 2 and3 This is implemented differently by the control unit 70. Figure 2 In system 200, the differences 71 determined by comparison 700 are normalized based on the fourth dataset 104. The second dataset 102 and the first dataset 103 are not directly included in the normalization process. Figure 2 This design scheme can be used as a basis Figure 1 This is a supplement to System 100. Figure 3 In system 300, the second dataset 102, the third dataset 103, and all other impedance values ​​74, 75, image data 3, 39 determined during data acquisition using EIT system 30 are normalized based on the fourth dataset 104 determined during normalization state 33. These normalizations are also indirectly included in the determination of difference 71, such that the output signal 900 indicates difference DZ 71 or the first corrected difference DZK1 in a form normalized according to normalization state 33.

[0076] Figures 4 to 6 Data processing is shown via control unit 70. Figures 1 to 3 The design scheme is used for system 400, 500 and 600. Figure 1 , 2 The same elements in 3, 4, 5, and 6 Figure 1 , 2 The same reference numerals are used in figures 3, 4, 5, and 6. For figures based on... Figures 4 to 6 The common feature of the described data processing flow is that, during the time of artificial respiration by the ventilator, the pressure level is initiated by the control unit 70 from the second end-expiratory pressure level PEEP. B 82 to the third end-expiratory pressure level PEEP c The decrease is 83. Regarding the control unit 70, data input unit 50, data output unit 90, visualization units 3001 and 3002, and the reading and provision of measurement data 4 as the first dataset 101 and EIT data 3 and 39 as the second dataset 102 and the third dataset 103, the following aspects are discussed: Figures 1 to 3 Designed in a manner comparable to that described in systems 100, 200, and 300. This is achieved through a control unit designed for... Figure 1-3 The first dataset 101 is acquired in the same manner as described above, in an uninterrupted, i.e., continuous, manner, such that the first dataset contains a large number of data elements indicating the changes in pressure measurements and respiratory pressure measurements during artificial respiration. The control unit 70 performs the data processing described below in a first state 31 and a second state 32 during operation of the system 400. For illustration, in Figure 4 China and Israel and targeting Figures 1 to 3The measuring device 40 is schematically shown in a comparable manner during the performance of artificial respiration, with time points t2 and t3. y Together with the corresponding pressure measurements P242, P y 47. Pressure / Time Process. For further illustration, in... Figure 4 China and Israel and targeting Figures 1 to 3 The impedance / time process t of the EIT system 30 during artificial respiration is schematically illustrated in a comparable manner, presented and described in the form of data fields (arrays). y Z276, Z y 77. Z Global 75. Additionally, the EIT data 3 and 39 for two conditions 31 and 32 are schematically shown in the time series of a lung visualization 3002. According to... Figure 4 During the operation of system 400, control unit 70 performs the data processing described below based on first dataset 101, second dataset 102, and third dataset 103. Figures 1 to 3 Different, in this Figure 4 In system 400, the functional procedures differ slightly from those in comparison 800. This is related to the positive end-expiratory pressure (PEEP) level. B Compared to condition 32, during condition 32, the positive end-expiratory pressure (PEEP) level was reduced by a pressure difference -ΔP 421 to the third positive end-expiratory pressure (PEEP) level. B 83. The control unit 70 uses a predetermined pressure difference -ΔP 421 in the control signal 72 to reduce the positive end-expiratory pressure (PEEP) level at the breathing device 2 according to Formula 4. (PEEP B ) - ΔP = (PEEP C ) Formula 4.

[0077] If already targeted Figure 1 As described, the control unit 70 uses the impedance value of the first condition 31 and the impedance value of the second condition 32, or the second dataset 102 and the third dataset 103, to determine the difference DZ 71 between the two conditions 31 and 32 by means of comparison and subtraction. DZ = Z y – Z2 Formula 5.

[0078] The pressure measurement value P242, which is a data element in the first dataset 101, represents the inspiratory pressure P at the rising edge time t2 during artificial respiration in the second condition 32. insp The pressure level, wherein the breathing device 2 is at a reduced end-expiratory pressure level PEEP. C Artificial respiration was performed on 83. According to... Figure 4In this design, it is also interesting to determine whether, or which areas of the lungs, are affected not only directly by the volume reduction caused by (pressure decrease), but also whether and in which areas of the lungs there is a reduction in previously available lung areas (alveoli, alveoli). This "closure" of previously available lung areas for gas exchange is also known as collapse (Derekrutierung) or "de-recruitment." For this purpose, in Comparison 800, the amplitude or value corresponds to the positive end-expiratory pressure (PEEP) level during the first condition 31. B The pressure condition P242 at time point t2 of the second condition 32 is identified by analysis within the first dataset 101. Subsequently, data records are identified by analysis within the third dataset 103 at time point t2. This identified data record of the impedance value serves as a correction data record (KDS Z) for the impedance value 77 or image data 39 belonging to the pressure condition P2 and time point t2. K2 321 is included in comparison 800 for one type of standardization. To normalize the difference DZ 71, the control unit 70 applies the correction data record KDS Z according to the following formula 5. K1 321, in order to determine the "loss". LOSS= DZK2= Z y – Z2 + Z K2 Formula 6.

[0079] The second corrected difference LOSS or DZK2721 determined in this way can be provided by means of data output unit 90 as an output signal 900 indicating difference 721. The output signal 900 can be represented by means of schematic visualization 3000. In this schematic visualization 3000, four representative regions I...IV (regions of interest: ROI) are shown exemplarily, in which, in this example, a small, dark area is visible in region II. This small, dark area II represents the region of lung ventilation that results from a decrease in the positive end-expiratory pressure level. This means that in region II, not only does a decrease in lung volume occur directly due to the pressure decrease -ΔP, but also a regional decrease in the amount of lung areas (alveoli, alveoli) that were previously still available for gas exchange occur.

[0080] Figure 5 and Figure 6 Showing according to Figure 4 An extension of. Figure 4 , 5 The same components as in 6 Figure 4 , 5 The same reference numerals are used in Figures 6 and 7. Figure 5 ,6 The design scheme is shown, in which, at time point t0, which is the time point of normalized state 33 preceding the first state 31 and the second state 32, the impedance value Z0 or image data 3 is acquired by the EIT system 30 as normalized data record 330 and stored as a fourth dataset 104. Normalized state 33 is derived in the state before the start of inhalation or at the end of exhalation. Normalization in normalized state 33 is performed by the control unit 70. Figure 5 , 6 It is executed differently in different ways. Figure 5 In system 500, the differences 71 determined by comparison 800 are normalized based on the fourth dataset 104. The second dataset 102 and the first dataset 103 are not directly included in the normalization. Figure 5 This design scheme can be used as a basis Figure 4 The system 400 is a supplement. Figure 6 In system 600, the second dataset 102, the third dataset 103, and all other impedance values ​​74, 75, image data 3, 39 determined during data acquisition using the EIT system 30 are normalized based on the fourth dataset 104 determined during normalization state 33. Thus, these normalizations are also indirectly included in the determination of difference 71, such that the output signal 900 indicates difference DZ 71 or the second corrected difference DZK2 in a form normalized according to normalization state 33. Correspondingly, other variations in the design of process 400 and other possibilities for using the output signal 900 are derived, as already discussed. Figure 1-3 As described. Utilizing according to Figures 1 to 6The described design may involve providing the user directly with information about the reduction or increase in the area component caused by pressure-increasing or decreasing treatment measures, either globally based on a global impedance curve or regionally, qualitatively and quantitatively, for example, in the form of a gain / loss representation or a percentage description in a gain / loss statement (WIN / LOSS) for further diagnosis and treatment. In typical designs of systems 100, 200, 300, 400, 500, and 600, a predetermined waiting duration can be considered by the control unit 70 after initiating the second condition 31, prior to data acquisition. Thus, in alternative design variations, the control unit may consider a predetermined waiting duration 35, for example, 5 to 10 respiratory cycles, before using impedance values ​​to compare 700 and 800 to determine differences 71, 711, and 721. In optional design schemes of systems 100, 200, 300, 400, 500, and 600, in addition to pressure measurements 41 and 45, the measuring device 40 can also provide flow measurement values ​​46 or volumes 49 and 45 to the data input unit 50. In this way, the control unit 70 can assign impedance values ​​74 and 75 to tidal volume and inspiratory or expiratory flow during artificial respiration. This may be advantageous for designs or extensions of electrical impedance tomography systems, where the determined impedance values ​​can not only be qualitatively determined and their relative changes visualized, but also the volumes and volume changes during artificial respiration can be prepared for quantitative observation. Especially when the measuring system 40 is designed as part of the breathing device 2, corresponding measurements or data regarding flow or volume are largely available. According to... Figure 1 , 2 In the optional design schemes of systems 100, 200, 300, 400, 500, and 600 (3, 5, 6), normalization can be performed before each respiratory cycle, for example, at the minimum of the global impedance curve before the start of inhalation, but it can also be performed less frequently, for example, every 5 to 10 respiratory cycles. Figures 1 to 6 In the alternative design schemes of systems 100, 200, 300, 400, 500, and 600—as previously indicated regarding the time relationship between the first and second conditions 31 and 32—the second positive end-expiratory pressure (PEEP) level is designed instead of pre-determining pressure measurements P141 or P242 during the first condition 31. B 82. (PEEP) C Alternatively, an alternative procedure can be designed, in which the second condition 32 is given before the first condition 31 in terms of time. This alternative procedure can again be based on and referenced from [the original text]. Figures 1 to 6 The diagram is used to illustrate this.

[0081] In the alternative process, here exemplarily for... Figure 1-3 The procedure described above determines the value of end-expiratory pressure (PEEP) within the first dataset 101 in the second situation 32. Subsequently, within the first dataset 101, during artificial respiration, the value of the first positive end-expiratory pressure (PEEP) level is determined in the first situation 31. A Above 81, the inspiratory respiratory pressure P insp The rising edge of the pressure measurement P141 is used to identify and determine the pressure measurement value. Time point t1 within the first dataset 101 is identified in a traceable manner using the pressure measurement value P141. Then, within the second dataset 103, data records of impedance values ​​at time point t1 are determined, corresponding to the second end-expiratory pressure level (PEEP) during artificial respiration. B 82.

[0082] exist Figures 1 to 6 In the alternative design schemes for systems 100, 200, 300, 400, 500, and 600, the identified impedance value data record can be used as correction data record KDS Z for pressure condition P1 and time point t1. K1 311 or Z K2 321 is included together in comparison 700 or comparison 800, as in the case of comparison 700 or comparison 800. Figure 1-3 Or as described in section 4-6. By using the output signal 900, the results of comparing 700 and 800 can be further used for gain / loss representation or gain and loss description (WIN / LOSS).

[0083] Figure 7 In one design, a schematic diagram of elements for processing measurement data or datasets is shown as a system 1000 having a measuring device 40, a control unit 70, a data output unit 90, a data input unit 50, and an analysis device, wherein according to Figure 1-6 The analysis device 30 is designed as a device 60 for determining and providing a first dataset 101 of pressure measurement value 45 and a fifth dataset 105 of flow measurement value 46 and volume measurement value 49. Figure 1 , 2 The same components in 1, 3, 4, 5, 6, and 7 Figure 1 , 2 The same reference numerals are used to denote numbers 1, 3, 4, 5, 6, and 7. The fifth dataset 105 can be assigned by the control unit 70 to the second dataset 102 and the third dataset 103 as needed, such as for... Figure 1 As described, that is, assigned to either the first condition 31 or the second condition 32. In this Figure 7In this context, device 60 and measuring device 40 are designed together as common devices 40 and 60. Data from the fifth dataset 105 are represented as volume 67 in visualization 3003 within the time series. PEEP at different end-expiratory pressure levels... A PEEP B PEEP C At inhalation pressure P on 81, 82, and 83 insp The rising edge of the curve shows pressure measurement values ​​P1, P2, and P1 at time points t1 and t2 during the time process. y 47. The inspiratory respiratory pressure P of P242 insp The condition. The pressure level of end-expiratory pressure (PEEP). A PEEP B PEEP C 81, 82, and 83 differ in pressure differences +ΔP 411 and -ΔP 421. Comparison 880, to determine the difference DV 71, together includes volume measurements from the fifth dataset 105 and pressure measurements from the first dataset 101 for the second condition, as well as condition-specific correction data records KDS 311 and 321. Correction data records KDS 311 and 321 include data corresponding to the inspiratory pressure P. insp The volume or volume measurement at time points t1 and t2 during the time process. Summarizing from the start of the inhalation phase until the inspiratory pressure P is reached. insp The pressure measurement value P141 at time point t1 and the inflow volume 64 are recorded as correction data. KDS 311 corresponds to this time point t1. This is summarized from the start of the inhalation phase until the inspiratory breathing pressure P is reached. insp The volume 67 flowing in at time point t2 of the pressure measurement value P242 is recorded as correction data KDS 321 corresponding to that time point t2. The difference DV 71 or the corrected difference DVK1711 or DVK2721 determined based on the correction data records KDS 311, 321 can be provided as an output signal 900 by means of the data output unit 90.

[0084] Figure 8 A common system 2000 for artificial respiration and monitoring of organisms is shown, comprising analytical devices 30 and 60, a measuring device 40, a control unit 70, a data output unit 90, a data input unit 50, and a breathing device 2. Figure 1 , 2 The same components in 3, 4, 5, 6, 7, and 8 Figure 1 , 2 The same reference numerals are used to denote numbers 101, 102, 103, 104, and 105 in the accompanying drawings. Data sets 101, 102, 103, 104, and 105 are processed by control unit 70 to match the data for… Figure 1-7The comparable forms described are derived. Difference 71, or corrected differences 711, 721, are determined and provided by the control unit based on datasets 101, 102, 103, 104, 105, as for... Figures 1 to 7 As described and illustrated, the control unit can be centrally located within the system or modularly distributed throughout the system 2000, serving as a module or submodule of the analysis devices 40, 60, measurement device 40, control unit 70, data output unit 90, data input unit 50, and breathing device 2, as well as as a central control unit. A master / slave configuration within the system 2000 is possible. The system 2000 can have a network (LAN, WLAN, Ethernet) or bus system (RS232, CAN bus, I...). 2 The network or bus system uses interfaces 20 (such as C-bus, SPI, USB, SCSI, IEEE488) to connect components 2, 30, 40, 50, 60, 70, and 90 for one-way or two-way data exchange within the system. The common system 2000 for artificial respiration and monitoring of organisms enables coordinated and controlled removal of the organism from artificial respiration (weaning). For this purpose, the control unit 70 can initiate, coordinate, or control the motorized actions for weaning via control signal 72. During weaning, the inspiratory pressure P is gradually or progressively adjusted via the breathing device 2 during artificial respiration. insp and / or expiratory respiratory pressure P exp Pressure reduction is achieved through and / or end-expiratory pressure (PEEP). Here, control unit 70 can initiate, coordinate, or control the pressure reduction steps or levels at the breathing apparatus based on determined differences 71, 711, 721, using control signals to adjust the pressure reduction level or the time interval between pressure reduction steps. Initiation enables control unit 70 to trigger or activate active elements, actuators such as artificial respiration drives (blowers, pistons, pumps), adjusting and switching elements, and metering elements, such as valves in breathing apparatus 2. Coordination enables control unit 70 to coordinate measurement acquisition, including sensors or actuators, data processing, and activation of adjusting and switching elements within system 2000. Control enables control unit 70 to perform open-loop control, such as adjusting or setting specific analog, digital, or logic states of adjusting and switching elements. Control enables control unit 70 to adjust or set specific analog, digital, or logic states of adjusting and switching elements in a closed-loop control system and to design specific types of regulating devices or regulators, such as those with specific characteristics (amplification K). P Adjust the time T again N Preset time (Vorhaltezeit) T VThe P controller, PI controller, and PID controller are used for regulation or closed-loop control (eine Regelung bzw. ein Regeln).

[0085] In order to implement the withdrawal method during artificial respiration, if the breathing device 2 includes analysis devices 30 and 60, measuring device 40, control unit 70, data output unit 90, and data input unit 50, and the system thus forms a common system 2000 and systems 100, 200, 300, 400, 500, and 600, then according to Figures 1 to 8 This could be very advantageous in the design scheme.

[0086] List of reference numerals 100, 200, 300 systems 400, 500, 600 systems 2. Breathing apparatus 3.39 Image Data 4. Measurement Data 20 Interfaces, Bus System, Data Bus, Network, Ethernet 30 EIT System 31 First Situation 32 Second Situation 33 Normalization status 35 Waiting duration 40 Measuring device 46 Flow measurement values 41 Pressure measurement value P1 45. Pressure sensor, pressure measurement value 411 Predetermined pressure difference + ΔP 421 Predetermined pressure difference - ΔP 50 Data Input Units 60 Volume measuring device 64. Volume measurement value V1 66. Volume measurement value V y 67. Volume measurement value V2 70 Control Unit 71 Differences between DZ and DV 711, 721 Corrected differences DZK, DVK 72 Control Signals 73. Region of Interest (ROI) 74 Impedance value Z1 75 Global impedance curve, Z Global 76 Impedance value Z2 77 Impedance value Z y 81 First PEEP A Level A 82 Second PEEP B Level B 82 Third PEEP C Level C 90 Data Output Unit 101 First Dataset 102 Second Dataset 103 Third Dataset 104 Fourth Dataset 105 Fifth Dataset Visualization of 3000, 3001, 3002, and 3003 311, 321 Correction Data Records (KDS) 330 Normalized Data Records (NDS), Representative Reference Value Z0 Comparison of 700, 800, and 880 900 Output Signal 1000 System 2000 Common System.

Claims

1. A device for administering artificial respiration via a breathing apparatus during respiration. - Data acquired using analytical devices suitable for determining lung condition and -A system that processes measurement data acquired using a measuring device suitable for acquiring physical measurement data in measurement technology. The system has -Data input unit, -Data output unit -Control unit The system, by means of the data input unit, is designed to acquire or receive measurement data that the measuring device can assign to conditions with predetermined pressure levels, so as to provide the measurement data as a first dataset over the time course of the observation period during artificial respiration of an organism. The system, by means of the data input unit, is designed to acquire or receive data that the analysis device can assign to a first condition, so as to provide the data as a second dataset over the time course of the observation period during artificial respiration of the organism. The system is configured to provide control signals through the combined action of a control unit and a data output unit. The control unit initiates an PEEP (Positive End-Expiratory Pressure) at the breathing device using the control signal at a predetermined pressure difference from the first positive end-expiratory pressure level. A PEEP level B On the adaptation, The system described herein is designed, by means of the data input unit, to acquire or receive additional data that the analysis device can assign to the second condition, so as to provide the additional data as a third dataset over a time course at at least one location during the observation period of artificial respiration of the organism. The control unit is configured to process the first dataset, the second dataset, and the third dataset in order to determine the difference DZ between other data in the second condition and data in the first condition by means of comparison. The control unit is configured to include a correction data record (KDS) in the comparison to correct for the difference (DZ). The corrected data record (KDS) includes data elements from the second dataset, which indicate specific pressure conditions P1 and P2 at time points t1 and t2 within the observation period. The control unit is configured to base its operation on the comparison, the difference DZ, or the corrected difference DZ. K To determine the output signal, the output signal indicating the difference DZ and / or the corrected difference DZ. K , The control unit is configured to provide the output signal by means of the data output unit.

2. The system of claim 1, wherein the second dataset includes data elements, the data elements indicating -At the inspiratory breathing pressure P insp On the rising edge and / or -At expiratory respiratory pressure P exp on the falling edge The specific pressure conditions P1 and P2 at time points t1 and t2.

3. The system according to claim 1 or claim 2, wherein the analytical device is adapted and configured for imaging the lungs of an organism.

4. The system of claim 3, wherein the analysis device is configured as follows: - A device or EIT system suitable for imaging the lungs of organisms using electrical impedance tomography. - A device suitable for imaging the lungs of a living organism using magnetic resonance tomography. - A device for computed tomography imaging suitable for imaging the lungs of organisms. - A device for performing ultrasound imaging, suitable for imaging the lungs of organisms.

5. The system according to any one of claims 1 to 2, wherein the analytical device is configured to be suitable for determining the volume of the lungs of an organism.

6. The system according to any one of claims 1 to 2, wherein the first condition can be assigned to a first predetermined pressure level P1. The first positive end-expiratory pressure (PEEP) is initiated at the breathing device by means of the control signal to increase the pressure difference at a predetermined pressure level P1 to a predetermined pressure level P1. A The predetermined pressure difference is adapted to the second positive end-expiratory pressure (PEEP) level. B superior, The comparison is performed by the control unit, which subtracts the third dataset from the second dataset. The control unit is configured to determine the second corrected difference DZ. K2 As a subtraction correction DZ K2 =(Z y – Z1) - Z K2 Perform the correction.

7. The system according to any one of claims 1 to 2, The second condition can be assigned to the second predetermined pressure level P2. Specifically, at the breathing device, a predetermined pressure difference is initiated by reducing the predetermined pressure level P2 at the predetermined pressure level P2 using the control signal to raise the first positive end-expiratory pressure level PEEP. A The predetermined pressure difference is adapted to the positive end-expiratory pressure (PEEP) level. C superior, The comparison is performed by the control unit as an addition of the third dataset and the second dataset. The control unit is configured to determine the second corrected difference DZ. K2 As an additive correction DZ K2 =(Z y – Z2) + Z K2 Perform the correction.

8. The system according to claim 6, The control unit is configured to perform data acquisition at the predetermined pressure level P1 during artificial respiration in the first condition.

9. The system according to claim 7, The control unit is configured to perform data acquisition at the predetermined pressure level P2 during artificial respiration in the second condition.

10. The system according to claim 6, The control unit is configured to, during the first condition, time-dependently adjust the inspiratory breathing pressure P. insp The inspiratory respiratory pressure P following the rising edge insp Data acquisition is performed on the platform at the predetermined pressure level P1.

11. The system according to claim 7, The control unit is configured to, during the second condition, time-dependently adjust the inspiratory pressure P. insp The inspiratory respiratory pressure P following the rising edge insp Data acquisition is performed on the platform at the predetermined pressure level P2.

12. The system according to any one of claims 1 to 2, wherein the measuring device is configured to perform... - Pressure measurement and / or - Flow measurement and / or - Volume measurement.

13. The system according to any one of claims 1 to 2, wherein the control unit is configured for Data acquisition is performed as the acquisition of impedance values ​​of selected or representative regions of the lung and / or as the acquisition of global impedance values ​​over a time process that serves as a global impedance curve.

14. The system according to any one of claims 1 to 2, wherein the control unit is configured for -A representative reference value Z0 is determined by further data acquisition during the time process prior to the first state in the normalized state t0, or by a fourth dataset serving as a reference value for the normalized data record NDS. - Normalization is performed during data acquisition using the normalized data record NDS and / or the representative reference value Z0.

15. The system according to any one of claims 1 to 2, The control unit is configured to perform data adaptation to balance the time difference between the first dataset and the second dataset, so as to synchronize the measuring device and the analyzing device in time.

16. The system according to any one of claims 1 to 2, wherein the control unit is configured to, during the second state, at a time delay time T Delay Then data collection began.

17. The system of claim 16, wherein the control unit is configured to, during the second condition, increase PEEP to the second positive end-expiratory pressure level. B After initiating the second condition, the data acquisition is performed at predetermined time intervals of 5 to 10 respiratory cycles.

18. The system of claim 16, wherein the control unit is configured to reduce PEEP to the second positive end-expiratory pressure level during the second condition. C After initiating the second condition, the data acquisition is performed at predetermined time intervals of 5 to 10 respiratory cycles.

19. The system according to any one of claims 1 to 2, wherein the control unit is configured to initiate a maneuver at a constant pressure level during artificial respiration using the first condition.

20. The system according to any one of claims 1 to 2, wherein the control unit is configured during artificial respiration to operate at the breathing apparatus at an inspiratory pressure P. insp Multiple discretely constructed pressure levels on the rising edge initiate maneuvering actions.

21. The system according to any one of claims 1 to 2, wherein the measuring device is configured as a module or as a component of a device for performing artificial respiration.

22. The system according to any one of claims 1 to 2, wherein the system having an analytical device, a measuring device and a breathing device constitutes a common system for artificial respiration and monitoring of organisms.

23. The system according to any one of claims 1 to 2, The control unit is configured as follows -In the breathing device -In the analytical device -The measuring device Components or sub-modules, or The control unit is configured as a component or module of a common system.

24. The system of claim 15, wherein the control unit is configured during artificial respiration to operate at the breathing apparatus at an inspiratory breathing pressure P. insp Multiple pressure levels initiate maneuvering actions.

25. The system of claim 15, wherein the control unit is configured to utilize the inspiratory breathing pressure P through the breathing device. insp and / or expiratory respiratory pressure P exp And / or end-expiratory pressure PEEP during artificial respiration, in the process or motor action of gradually or progressively reducing pressure to remove the organism from artificial respiration, by means of a control signal at the level of pressure reduction or at the time interval between pressure reduction steps, based on the difference DZ, the first corrected difference DZ. K1 The second corrected difference DZ K2 Initiate, coordinate, or control steps or levels of stress reduction.

26. The system of claim 15, wherein the control unit is configured to initiate a maneuver by a predetermined slow increase in inhalation pressure before the breathing apparatus is in the first state or during artificial respiration in the first state.

27. The system of claim 15, wherein the control unit is configured to initiate an increase in the sampling rate at the measuring device and / or the analysis device during data acquisition at the start of the first condition.

28. A method for processing data, comprising: - Receive measurement data from the measuring device that can be assigned to conditions with a predetermined pressure level. - The measurement data is provided as the first dataset. - Receive EIT data from the EIT system, which has already been detected in the first situation. - Provide the EIT data as a second dataset. - Receive other EIT data from the EIT system, which has already been detected in the second scenario. - Provide the EIT data as a third dataset. - Process the first dataset, the second dataset, and the third dataset to determine the difference DZ between other EIT data in the second condition and the EIT data in the first condition by means of comparison, including the correction data record KDS. - Provides an output signal indicating the difference DZ and / or the corrected difference DZ. K .

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