In-aorta balloon counterpulsation system based on extracorporeal membrane oxygenation and control method

Abstract

The invention discloses an in-aorta balloon counterpulsation system based on extracorporeal membrane oxygenation and a control method. The in-aorta balloon counterpulsation system comprises a main controller, an electrocardiograph monitor, a first air channel catheter, a supporting air bag, a second air channel catheter and a control air bag. The main controller is respectively communicated with the supporting air bag and the control air bag through the first air path catheter and the second air path catheter, and is used for respectively carrying out inflation or deflation control on the supporting air bag and the control air bag by utilizing monitoring information of the electrocardiograph monitor. In clinic, the air bag is controlled to open and close a connecting channel between a blood supply pipeline outlet of the extracorporeal membrane oxygenation system and the aorta abdominalis of a patient, and is effectively matched with the ECMO blood supply process, so that the situation of hedging of ECMO reverse blood flow and cardiac ejection is effectively avoided, the left ventricular post-load is reduced, the rapid and stable recovery of cardiac functions is ensured, and the treatment effect is improved. The device has the advantages of low cost and high equipment utilization rate, and is particularly suitable for patients with heart failure and sudden cardiac arrest.

Description

Technical Field

[0001] The present invention relates to an extracorporeal life support system for medical use, and in particular to an intra-aortic balloon counterpulsation system and a control method based on extracorporeal membrane oxygenation for patients with heart failure, belonging to the field of medical equipment. Background Art

[0002] At present, the mortality rate of cardiovascular diseases ranks first among the disease mortality rates of Chinese residents. Among them, heart failure is the main cause of death. Thanks to the development of science and technology, extracorporeal life support (ECLS) plays an important role in the treatment of patients with circulatory failure. The most widely used ones include extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP).

[0003] ECMO combined with IABP is mainly used in patients with heart failure, especially those after cardiac surgery and cardiac arrest. Among them, the existing IABP system mainly includes a main controller, an ECG monitor, an airway catheter and a support airbag. The main controller cooperates with the ECMO system according to the monitoring of the ECG monitor. As the patient's left ventricle relaxes, it controls the inflation of the support airbag, and as the patient's left ventricle contracts, it controls the deflation of the support airbag, thereby completing the relaxation control of the patient's descending aorta by the support airbag, and coordinating the relaxation and contraction process of the left ventricle. The combined application of IABP and ECMO complements the advantages of the two, fully plays the role of supporting the patient's blood circulation and respiratory function, provides stable pulsatile blood flow, relieves the patient's heart load, reduces the burden on the patient's lungs, reduces the left ventricular afterload increased by the use of ECMO alone, increases coronary blood flow, reduces myocardial oxygen consumption, and allows the patient's heart to get a fuller rest, which is more conducive to the recovery of heart function.

[0004] Although ECMO combined with IABP has many advantages, the inventors have also found some shortcomings in clinical applications, including: although IABP can reduce the left ventricular afterload to a certain extent, the rapid deflation of the support balloon during left ventricular contraction causes the ECMO reverse blood flow to collide with the heart's ejection, increasing the left ventricular afterload. For patients with severe heart failure, reverse blood flow can lead to limited aortic valve opening, left ventricular dilation, and blood congestion at the aortic root in the left ventricle, and may even form thrombi, aggravating the patient's condition.

[0005] Therefore, the main problem that the present invention aims to solve is to improve the existing intra-aortic balloon counterpulsation system and control method to improve the coordination process with the extracorporeal membrane oxygenation system and left ventricular diastole and contraction, and reduce the left ventricular afterload. Summary of the invention

[0006] In view of the above-mentioned situation and deficiencies, the present invention aims to provide a method for improving the structure and control of the intra-aortic balloon counterpulsation system to achieve perfect coordination with the extracorporeal membrane oxygenation system, avoid the occurrence of reverse blood flow in ECMO and the collision of cardiac ejection, thereby reducing the left ventricular afterload and ensuring rapid recovery of cardiac function.

[0007] The present invention is achieved through the following technical solutions: The intra-aortic balloon counterpulsation system based on extracorporeal membrane oxygenation includes a main controller, an electrocardiogram monitor connected to the main controller by signal, and a support airbag connected to the main controller through a first airway catheter, and the support airbag is arranged in the patient's descending aorta. It also includes a control airbag, which is connected to the main controller through a second airway catheter, and the control airbag is arranged in the abdominal aorta and corresponds to the blood supply line outlet of the patient's extracorporeal membrane oxygenation system. The main controller controls the inflation or deflation of the control airbag through the monitoring information of the electrocardiogram monitor.

[0008] The control airbag is cylindrical.

[0009] The control method of the intra-aortic balloon counterpulsation system based on extracorporeal membrane oxygenation specifically includes: When the patient's left ventricle is in the early diastole and begins to relax, the main controller controls the first airway catheter and the second airway catheter to be opened to the outside respectively according to the monitoring information of the electrocardiogram monitor, the support airbag and the control airbag are in a deflated state, the patient's abdominal aorta remains unobstructed, and the blood supply line of the extracorporeal membrane oxygenation system supplies blood to the descending aorta; when the patient's left ventricle is in the middle and late diastole, the main controller controls the first airway catheter and the second airway catheter to be connected respectively according to the monitoring information of the electrocardiogram monitor, the support airbag and the control airbag are in an inflated state, and the patient's abdominal aorta is closed; when the patient's left ventricle begins to contract to the late systole, the main controller controls the first airway catheter to be opened to the outside according to the monitoring information of the electrocardiogram monitor, the support airbag is in a deflated state, the patient's descending aorta remains unobstructed, the control airbag continues to remain inflated, and the blood supply line outlet of the extracorporeal membrane oxygenation system remains closed to the abdominal aorta.

[0010] The beneficial effects of the intra-aortic balloon counterpulsation system and control method based on extracorporeal membrane oxygenation of the present invention include: 1. The control balloon is used to open and close the connection channel between the blood supply outlet of the extracorporeal membrane oxygenation system and the patient's abdominal aorta, effectively avoiding the occurrence of reverse blood flow of ECMO and the collision of cardiac ejection, reducing the afterload of the left ventricle, and ensuring the rapid and stable recovery of cardiac function; 2. Make full use of the main controller and ECG monitor of the existing IABP system to control product costs to the maximum extent and improve the utilization rate of existing equipment; 3. Through more refined control methods, the inflation or deflation status of the support bag and the control bag are coordinated with each other, and coordinated and accurately cooperated with the ECMO system, further ensuring stable pulsatile blood flow and reducing the cardiopulmonary burden on patients; 4. Especially suitable for patients with heart failure and cardiac arrest. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings required for use in the description of the embodiments will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without creative work.

[0012] Figure 1 This is a schematic diagram of the usage structure of the intra-aortic balloon counterpulsation system based on extracorporeal membrane oxygenation described in the present invention. DETAILED DESCRIPTION

[0013] The technical solutions in the embodiments of the present invention will be described clearly and completely below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments are only a part of the embodiments of the present invention, rather than all of the embodiments. The components of the embodiments of the present invention described and shown in the drawings here can be arranged and designed in various different configurations. It should be noted that the embodiments of the present invention and the features in the embodiments can also be combined with each other without conflict.

[0014] It should be noted that similar reference numerals and letters represent similar items in the following drawings, so once an item is defined in one drawing, it does not need to be further defined and explained in subsequent drawings. In the description of the present invention, the terms "first", "second", "third", and "fourth" are only used to distinguish the description and cannot be understood as just or implying relative importance.

[0015] The following is combined with Figure 1 The intra-aortic balloon counterpulsation system based on extracorporeal membrane oxygenation of the present invention is further described in detail: The intra-aortic balloon counterpulsation system based on extracorporeal membrane oxygenation described in the present invention includes a main controller 5, an electrocardiogram monitor 6, a first airway catheter 1, a support airbag 3, a second airway catheter 2 and a control airbag 4. Among them, the main controller 5 is connected to the electrocardiogram monitor 6 signal, and controls the first airway catheter 1 and the second airway catheter 2 to be opened or connected to the outside according to the monitoring information of the electrocardiogram monitor 6, so as to realize the inflation or deflation control of the support airbag 3 and the control airbag 4. In this example, the support airbag 3 is in the shape of a long strip, and the control airbag 4 is in the shape of a cylinder. The specifications of the support airbag 3 and the control airbag 4 can be selected according to the height and weight of the patient. Of course, in order to ensure the normal operation of the system, the main controller 5 also needs to be connected to the external pressure gas 7, and realize the pressure control of the support airbag 3 and the control airbag 4 by inflation and deflation.

[0016] During specific clinical use, the main controller 5 and the ECG monitor 6 are located outside the patient's body, and the ECG monitor 6 is connected to the patient's body through electrodes. The support balloon 3 is arranged in the patient's descending aorta. The control balloon 4 is arranged in the patient's abdominal aorta, and the control balloon 4 corresponds to the blood supply line outlet 8 of the patient's extracorporeal membrane oxygenation system. The long strip support balloon 3 can adjust and change the spatial state of the patient's descending aorta to the maximum extent, and form positive and negative pressure conversion in the patient's descending aorta through the inflation and deflation process, which is beneficial to the patient's cardiac discharge and coronary blood supply. The cylindrical control balloon 4 is used to control the connection state between the patient's abdominal aorta and the blood supply line outlet 8 of the extracorporeal membrane oxygenation system to avoid the collision of ECMO reverse blood flow and cardiac ejection.

[0017] The following is combined with Figure 1 The control method of the intra-aortic balloon counterpulsation system based on extracorporeal membrane oxygenation of the present invention is further described in detail: The control method of the intra-aortic balloon counterpulsation system based on extracorporeal membrane oxygenation of the present invention mainly includes three parts: Part 1: When the left ventricle of the patient is in the early diastole and begins to diastole, the main controller 5 controls the first airway catheter 1 and the second airway catheter 2 to be opened to the outside respectively according to the monitoring information of the electrocardiogram monitor 6. At this time, the support balloon 3 and the control balloon 4 are in the deflated state, the channel in the patient's abdominal aorta remains unobstructed, and the blood supply line of the extracorporeal membrane oxygenation system supplies blood to the patient's descending aorta from bottom to top normally.

[0018] Part 2. When the patient's left ventricle is in the middle and end of diastole, the main controller 5 controls the first airway catheter 1 and the second airway catheter 2 to be connected to the external pressure gas 7 respectively according to the monitoring information of the electrocardiogram monitor 6, the support airbag 3 and the control airbag 4 are inflated, and the patient's abdominal aorta remains in a temporarily closed state.

[0019] Part 3: When the patient's left ventricle begins to contract to the end of the systolic period, the main controller 5 controls the first airway catheter 1 to open to the outside according to the monitoring information of the electrocardiogram monitor 6, and the support balloon 3 is in a deflated state, and the patient's descending aorta remains unobstructed. The control balloon 4 is always in an inflated state, and the blood supply outlet 8 of the extracorporeal membrane oxygenation system is temporarily closed with the abdominal aorta, avoiding the collision between the reverse blood flow of ECMO and the cardiac ejection.

[0020] The above control process is carried out continuously with the monitoring of the ECG monitor 6, which not only effectively supports the patient's blood circulation and respiratory function, but also fully avoids the impact of ECMO reverse blood flow and cardiac ejection, reduces the left ventricular afterload, is more conducive to coronary blood supply, and promotes heart function recovery.

[0021] The above description is only a preferred embodiment of the present invention and an explanation of the technical principles used. It is not intended to limit the scope of the invention claimed for protection, but only represents the preferred embodiment of the present invention. Those skilled in the art should understand that the scope of the invention involved in the present invention is not limited to the technical solution formed by a specific combination of the above-mentioned technical features, but should also cover other technical solutions formed by any combination of the above-mentioned technical features or their equivalent features without departing from the inventive concept. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without making creative work belong to the scope of protection of the present invention.

Claims

1. An intra-aortic balloon counterpulsation system based on extracorporeal membrane oxygenation, comprising a main controller, an electrocardiogram monitor connected to the main controller by signal, and a support airbag connected to the main controller through a first airway catheter, wherein the support airbag is arranged in the descending aorta of the patient, and characterized in that: It also includes a control airbag, which is connected to the main controller through a second airway catheter. The control airbag is arranged in the abdominal aorta and corresponds to the blood supply line outlet of the patient's extracorporeal membrane oxygenation system; the main controller controls the inflation or deflation of the control airbag through the monitoring information of the electrocardiogram monitor.

2. The intra-aortic balloon counterpulsation system based on extracorporeal membrane oxygenation according to claim 1, characterized in that: The control airbag is cylindrical.

3. The control method of the intra-aortic balloon counterpulsation system based on extracorporeal membrane oxygenation according to any one of claims 1-2, characterized in that: Specifically include: When the patient's left ventricle is in the early diastole and begins to diastole, the main controller controls the first airway catheter and the second airway catheter to be opened to the outside respectively according to the monitoring information of the electrocardiogram monitor, the support airbag and the control airbag are in a deflated state, the patient's abdominal aorta remains unobstructed, and the blood supply line of the extracorporeal membrane oxygenation system supplies blood to the descending aorta; When the patient's left ventricle is in the middle or end of diastole, the main controller controls the first airway catheter and the second airway catheter to be connected respectively according to the monitoring information of the electrocardiogram monitor, the support airbag and the control airbag are inflated, and the patient's abdominal aorta is closed; When the patient's left ventricle begins to contract to the end of the systolic phase, the main controller controls the first airway catheter to open to the outside according to the monitoring information of the ECG monitor, the support bag is in a deflated state, the patient's descending aorta remains unobstructed, the control bag continues to remain inflated, and the blood supply line outlet of the extracorporeal membrane oxygenation system and the abdominal aorta remain closed.

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