Physiological information display device and physiological information display method

Abstract

A physiological information display apparatus includes: a heart rate acquisition unit configured to acquire a heart rate of a subject; a respiration rate acquisition unit configured to acquire a respiration rate of the subject; a hemodynamic calculation unit configured to calculate a hemodynamic parameter of the subject and a breath change of the hemodynamic parameter based on the plurality of hemodynamic parameters calculated within a predetermined period of time; and a display controller configured to output the breathing change to the display. The hemodynamic calculation unit is configured to calculate a heart rate of one breath. The display controller is configured to output a setting screen for setting a length of a predetermined period. The hemodynamic calculation unit is configured to acquire setting information, set a length of a predetermined period based on the acquired setting information, and calculate a breathing change within the set predetermined period.

Description

Technical Field

[0001] The invention relates to a physiological information display device and a physiological information display method. Background Art

[0002] In the prior art, when a subject is subjected to a treatment such as fluid administration, changes in parameters related to hemodynamics (hereinafter referred to as "hemodynamic parameters"), such as respiratory changes in the subject's stroke volume (hereinafter also referred to as "stroke volume variation (SVV)") or respiratory changes in pulse pressure (hereinafter also referred to as "pulse pressure variation (PPV)"), are used as useful parameters for examining the subject's state.

[0003] Specifically, when the intrathoracic pressure changes due to breathing, blood is pushed out, and the stroke volume or pulse pressure also changes. In a state where the total blood volume is small, the fluctuation of SVV or PPV is large, and therefore a large value of SVV or PPV indicates insufficient total blood volume. JP-A-2011-55961 discloses a method for reducing artifacts in an apparatus for analyzing SVV.

[0004] [Non-patent literature]

[0005] Non-patent literature 1: Daniel De Backer, Fabio Silvio Taccone, Roland Holstein, Fayssal Ibrahimi, Jean-Louis Vincent: Effect of respiratory rate on changes in stroke volume in mechanically ventilated patients, Anesthesiology, published in May 2009, Vol. 110, No. 5, pp. 1092-1097 Summary of the invention

[0006] [Technical issues]

[0007] In the device disclosed in JP-A-2011-55961, the SVV of one respiratory cycle is calculated. However, the heart rate of one respiratory cycle may be very low. In this case, the number of data pieces for calculating the stroke volume of SVV is insufficient, and a technology capable of more accurately monitoring the state of the subject is required.

[0008] The present disclosure provides a physiological information display device and a physiological information display method that can more accurately monitor the state of a subject.

[0009] [Solution to the problem]

[0010] The physiological information display device of the first aspect of the present disclosure comprises:

[0011] a heart rate acquisition unit, the heart rate acquisition unit being configured to acquire the heart rate of the subject;

[0012] a respiratory rate acquisition unit configured to acquire a respiratory rate of the subject;

[0013] A hemodynamic calculation unit, the hemodynamic calculation unit being configured to calculate:

[0014] hemodynamic parameters of the subject; and

[0015] respiratory changes in a hemodynamic parameter based on a plurality of said hemodynamic parameters calculated over a predetermined period of time; and

[0016] a display controller configured to output the breathing change to a display,

[0017] The hemodynamic calculation unit is further configured to calculate the heart rate of one breath using the heart rate and the respiratory rate, wherein the heart rate of one breath is the heart rate included in one respiratory cycle.

[0018] The display controller is further configured to output a setting screen for setting the length of the predetermined period to the display, the setting screen being configured to display the heart rate of the one breath, and

[0019] The hemodynamic calculation unit is configured to:

[0020] acquiring setting information indicating the contents set on the setting screen;

[0021] setting the length of the predetermined period based on the acquired setting information; and

[0022] The breathing variation within a set predetermined time period is calculated.

[0023] The physiological information display method of the second aspect of the present disclosure includes:

[0024] Obtain the subject's heart rate;

[0025] Obtain the subject's breathing rate;

[0026] Calculate the heart rate of one breath using the heart rate and the respiratory rate, the heart rate of one breath being the heart rate included in one respiratory cycle;

[0027] calculating hemodynamic parameters of the subject;

[0028] outputting a setting screen for setting the length of the predetermined period to a display, the setting screen being configured to display the heart rate for one breath;

[0029] setting the length of the predetermined period based on the content set on the setting screen;

[0030] Calculating respiratory changes in the hemodynamic parameters based on the plurality of hemodynamic parameters calculated within a set predetermined period of time; and

[0031] The breathing changes are output to the display.

[0032] [Beneficial effects of the present invention]

[0033] According to the present disclosure, the condition of a subject can be monitored more accurately. BRIEF DESCRIPTION OF THE DRAWINGS

[0034] [ Figure 1 ]

[0035] Figure 1 The configuration of a physiological information processing device according to one aspect of the present disclosure is shown.

[0036] [ Figure 2 ]

[0037] Figure 2 shows the use of Figure 1 An example of a measurement mode of a monitor of an example of a physiological information processing device is shown.

[0038] [ Figure 3 ]

[0039] Figure 3 Shows Figure 1 Configuration of the hemodynamic calculation unit.

[0040] [ Figure 4 ]

[0041] Figure 4 Shown in Figure 1 An example of a screen displayed on the monitor.

[0042] [ Figure 5 ]

[0043] Figure 5 It is used to illustrate the number of data used to calculate respiratory changes based on Figure 4 The diagram shown changes according to the number of cycles set on the setting screen.

[0044] [ Figure 6 ]

[0045] Figure 6 It is used to explain the operator to use Figure 3 The illustrated period setting unit is a diagram of a state in which the length of a predetermined period is manually changed.

[0046] [ Figure 7 ]

[0047] Figure 7 Is used to illustrate the Figure 3 The illustrated diagram is a diagram of a state in which the period setting unit automatically changes the length of a predetermined period.

[0048] [ Figure 8 ]

[0049] Figure 8 Is used to illustrate the Figure 3 The illustrated diagram is a diagram of a state in which the period setting unit automatically changes the length of a predetermined period.

[0050] [ Fig. 9 ]

[0051] Fig. 9 Is used to illustrate the Figure 3 The illustrated diagram is a diagram of a state in which the period setting unit automatically changes the length of a predetermined period.

[0052] [ Fig.10 ]

[0053] Fig.10 1 is a flowchart for explaining an overview of the operation performed by the physiological information processing apparatus according to an embodiment of the present disclosure when calculating and displaying respiratory changes in hemodynamic parameters.

[0054] [ Fig.11 ]

[0055] Fig.11 It is used to illustrate Figure 1 A flow chart showing the operation of the hemodynamic calculation unit in the case where it is operated in manual mode is shown.

[0056] [ Fig.12 ]

[0057] Fig.12 It is used to illustrate Figure 1 A flow chart showing the operation of the hemodynamic calculation unit in the case where it operates in automatic mode is shown. DETAILED DESCRIPTION

[0058] Exemplary embodiments of a physiological information display device and a physiological information display method according to the present disclosure will be described below with reference to the accompanying drawings.

[0059] <Configuration of Physiological Information Processing Device>

[0060] Figure 1 1 shows a configuration of a physiological information processing device (physiological information display device) M according to one aspect of the present disclosure. Figure 2 shows the use of Figure 1 An example of a measurement mode of the monitor M1 of the example of the physiological information processing device M is shown.

[0061] The physiological information processing device M may include: a display device 1, which is configured to perform calculations, display controls, etc. of hemodynamic parameters related to the hemodynamics of the subject; a blood pressure measuring device 2, which is configured to measure the systolic and diastolic pressures of the heart; a respiratory measuring device 4; a receiving unit 6; an ECG electrode 31; a photoplethysmography detection sensor 32; a measurement data transmitter 65 and a display 71.

[0062] The blood pressure measuring instrument 2 is designed and configured to measure the blood pressure of a subject by using a non-invasive blood pressure (NIBP) measurement method. The blood pressure measuring instrument 2 may include a cuff 21, an exhaust valve 22, a pressure pump 23, a pressure sensor 24, a cuff pressure detector 25, and an A / D converter 26. Specifically, Figure 2 As shown, the blood pressure measurement device 2 is configured to measure blood pressure with a cuff 21 attached to the upper arm of a subject.

[0063] The inside of the cuff 21 is configured to be opened or closed to the atmosphere by opening and closing the exhaust valve 22. The exhaust valve 22 is configured to be opened and closed based on a control signal output from the display instrument 1. The pressure pump 23 is configured to supply air to the cuff 21. The supply of air is controlled based on the control signal output from the display instrument 1.

[0064] The pressure sensor 24 is connected to the cuff 21. The sensor output of the pressure sensor 24 is detected by the cuff pressure detector 25. The sensor output from the cuff pressure detector 25 is converted into a digital signal by the A / D converter 26 and then input to the pulse pressure acquisition unit 11 of the display instrument 1.

[0065] like Figure 2 As shown, the ECG electrode 31 is attached to the chest of the subject and is configured to measure the time interval using the R wave generation time point in the electrocardiogram as a reference point. The ECG electrode 31 is electrically connected to the measurement data transmitter 65. The measurement data from the ECG electrode 31 is input to the measurement data transmitter 65 and then wirelessly transmitted from the measurement data transmitter 65 to the measurement data transmitter 65. Figure 1 The time interval detector 36 in the display device 1 is shown.

[0066] like Figure 2 As shown, the photoplethysmography detection sensor 32 is attached to the periphery of the subject, such as a finger, and is configured to measure, for example, a pulse wave. Based on the measurement data obtained from the ECG electrode 31 and the pulse wave obtained from the photoplethysmography detection sensor 32, a pulse wave propagation time (PWTT) is obtained. The photoplethysmography detection sensor 32 is electrically connected to the measurement data transmitter 65. The measurement data obtained by the photoplethysmography detection sensor 32 is input to the measurement data transmitter 65, and is wirelessly transmitted from the measurement data transmitter 65 to the measurement data transmitter 65. Figure 1 The pulse detector 33 in the display device 1 is shown.

[0067] The respirometer 4 is configured to continuously measure the respiration of the subject. The measurement data obtained by the measurement of the respirometer 4 is input to the respiration rate acquisition unit 41 of the display device 1.

[0068] The receiving unit 6 is configured to receive an input operation of the operator and is configured to generate a command signal corresponding to the input operation. The receiving unit 6 is, for example, a touch panel arranged to overlap with the display 71 described later, an operation button provided on the housing of the display device 1, or a mouse or keyboard connected to an input and output interface (e.g., a USB interface) not shown. The command signal generated by the receiving unit 6 is input to the display device 1.

[0069] <Display Instrument Configuration>

[0070] The display device 1 may include a pulse detector 33, an A / D converter 34, a time interval detector 36, a calculation unit 70, a display controller 72, and a receiving unit 74. The calculation unit 70 may include a pulse pressure acquisition unit 11, a heart rate acquisition unit 12, a pulse wave propagation time acquisition unit 13 (hereinafter referred to as a PWTT acquisition unit 13), a pulse wave propagation time respiratory variation acquisition unit 14 (hereinafter referred to as a PWTTRV acquisition unit 14), a pulse wave amplitude acquisition unit 15 (hereinafter referred to as a PWA acquisition unit 15), a pulse wave amplitude respiratory variation acquisition unit 16 (hereinafter referred to as a PWARV acquisition unit 16), a hemodynamic calculation unit 17, an inherent coefficient calculation unit 18, a memory 19, and a respiratory rate acquisition unit 41. The display device 1 may include one or more central processing units (CPUs), read-only memories (ROMs), random access memories (RAMs), hard disk drives (HDDs), and the like. The CPU may be used as the calculation unit 70, the display controller 72, the receiving unit 74, and the like.

[0071] The time interval detector 36 is configured to acquire an ECG waveform based on the measurement data received from the ECG electrode 31 via the measurement data transmitter 65. The time interval detector 36 is configured to convert the measurement data into a digital signal and to output the digital signal to the heart rate acquisition unit 12 and the PWTT acquisition unit 13 of the calculation unit 70.

[0072] The pulse detector 33 is configured to acquire a waveform of a peripheral photoplethysmogram based on the measurement data received from the photoplethysmography detection sensor 32 via the measurement data transmitter 65. Then, the pulse detector 33 is configured to output the measurement data to the A / D converter 34. The A / D converter 34 is configured to convert the measurement data into a digital signal, and is configured to output the digital signal to the PWTT acquisition unit 13 and the pulse wave amplitude acquisition unit 15 of the calculation unit 70.

[0073] The pulse pressure acquisition unit 11 is configured to measure the pulse pressure (PP) of the subject based on the blood pressure data obtained by the measurement of the blood pressure measuring instrument 2. For example, the pulse pressure PP is calculated from the difference between the systolic (maximum) blood pressure value and the diastolic (minimum) blood pressure value. The measured pulse pressure PP is input to the inherent coefficient calculation unit 18. The pulse pressure acquisition unit 11 is configured to store, for example, the pulse pressure PP and the current time point in association with each other in the memory 19.

[0074] The heart rate acquisition unit 12 is configured to calculate the number of heart beats (heart rate, HR) in one minute based on the reference point (R wave generation time point) measured by the time interval detector 36. The calculated heart rate HR is input to the hemodynamics calculation unit 17.

[0075] The PWTT acquisition unit 13 is configured to calculate the PWTT as the time elapsed from the appearance of the R wave in the electrocardiogram to the appearance of the SpO2 pulse wave based on the reference point (R wave generation time point) measured by the time interval detector 36 and based on the waveform in the periphery detected by the photoplethysmography detection sensor 32. The PWTT acquisition unit 13 is configured to output the calculated PWTT to the hemodynamics calculation unit 17 and the PWTTRV acquisition unit 14.

[0076] The respiratory rate acquisition unit 41 is configured to detect the respiratory cycle of the subject based on the respiratory data measured by the respiratory meter 4. For example, the respiratory meter 4 is a detector configured to detect the concentration of carbon dioxide in the exhaled air. The respiratory rate acquisition unit 41 is configured to specify at least one of the start time point and the end time point of the subject's respiration based on the detection result of the respiratory meter 4. The respiratory rate acquisition unit 41 is configured to detect the respiratory cycle of the subject based on the specified time point.

[0077] In addition, the respiratory rate acquisition unit 41 is configured to detect the respiratory rate (RR) of the subject per minute based on the respiratory data. Then, the respiratory rate acquisition unit 41 is configured to input the detected respiratory cycle and respiratory rate RR to the PWTTRV acquisition unit 14, the pulse wave amplitude respiratory change acquisition unit 16, and the hemodynamic calculation unit 17. For example, the respiratory rate acquisition unit 41 is configured to notify at least one of the start time point and the end time point of the respiratory cycle as a notification of the respiratory cycle.

[0078] Respirometer 4 is not limited to an instrument configured to detect the concentration of carbon dioxide in expired air, and may also be an instrument configured to measure the respiration of a subject by using impedance changes, an instrument configured to measure anesthetic gas output from an anesthesia device, or the like.

[0079] The physiological information processing device M may not include the respirometer 4. In this case, for example, the physiological information processing device M sets the length of one respiratory cycle to a fixed value such as 20 seconds, and is configured to determine at least one of a start time point and an end time point of the respiratory cycle.

[0080] The PWTTRV acquisition unit 14 is configured to measure respiratory variation of PWTT based on the PWTT calculated by the PWTT acquisition unit 13 and the respiratory cycle detected by the respiratory rate acquisition unit 41. Measurement data representing the measured respiratory variation of PWTT is input to the inherent coefficient calculation unit 18.

[0081] The pulse wave amplitude acquisition unit 15 is configured to measure the amplitude of the pulse wave from the peripheral waveform acquired by the pulse detector 33. The measured pulse wave amplitude is input to the pulse wave amplitude respiratory change acquisition unit 16.

[0082] The pulse wave amplitude respiratory variation acquisition unit 16 is configured to measure the respiratory variation of the pulse wave amplitude (pulse amplitude variation, PAV) based on the pulse wave amplitude measured by the pulse wave amplitude acquisition unit 15 and the respiratory cycle detected by the respiratory rate acquisition unit 41. The measured pulse amplitude variation PAV is input to the natural coefficient calculation unit 18.

[0083] The inherent coefficient calculation unit 18 is configured to calculate a coefficient inherent to the subject based on the pulse pressure PP measured by the pulse pressure acquisition unit 11, based on the respiratory variation of PWTT measured by the PWTTRV acquisition unit 14, and based on the pulse amplitude variation PAV measured by the pulse wave amplitude respiratory variation acquisition unit 16. The calculated coefficient is, for example, a coefficient K, α, or β to be described later, and is input to the hemodynamics calculation unit 17.

[0084] <Configuration of Hemodynamic Calculation Unit>

[0085] (Calculation of respiratory changes in hemodynamic parameters)

[0086] Figure 3 Shows Figure 1 The configuration of the hemodynamic calculation unit 17. Figure 3 As shown, the hemodynamic calculation unit 17 may include a parameter calculation unit 81 , a HR / RR calculation unit 82 , a time period setting unit 83 and a change rate calculation unit 84 .

[0087] The parameter calculation unit 81 is configured to calculate the hemodynamic parameters of the subject based on the heart rate HR calculated by the heart rate acquisition unit 12, based on the PWTT measured by the PWTT acquisition unit 13, and based on the coefficients K, α, and β calculated by the inherent coefficient calculation unit 18. The parameter calculation unit 81 is configured to calculate, for example, the flow rate (stroke volume, SV) of blood flowing into the aorta during contraction of the heart as a hemodynamic parameter.

[0088] There is a correlation between stroke volume SV and PWTT as shown in Equation 1. In Equation 1, K, α, and β are subject-specific coefficients.

[0089] SV=K*(α*PWTT+β)…(Equation 1)

[0090] The parameter calculation unit 81 is configured to substitute the coefficients K, α, and β calculated by the inherent coefficient calculation unit 18 into Equation 1. The parameter calculation unit 81 is configured to substitute, for example, the PWTT received from the PWTT acquisition unit 13 into the PWTT in Equation 1. Therefore, the parameter calculation unit 81 is able to calculate the stroke volume SV. Hereinafter, the stroke volume SV calculated by the parameter calculation unit 81 is referred to as "stroke volume esSV".

[0091] For example, the parameter calculation unit 81 is configured to periodically calculate the stroke volume esSV, to associate the calculated stroke volume esSV with the calculation time point of the stroke volume esSV, and to calculate the stroke volume esSV at a certain time. Figure 1 The memory 19 shown stores the calculated stroke volume esSV and the calculation time point.

[0092] For example, when receiving an input of a newly detected respiratory cycle from the respiratory rate acquisition unit 41, the change rate calculation unit 84 is configured to calculate the respiratory change of the hemodynamic parameter within a predetermined period based on the respiratory cycle. The predetermined period is the length of one or more recent respiratory cycles.

[0093] Here, it is assumed that the predetermined period is the latest respiratory cycle detected by the respiratory rate acquisition unit 41. In this case, the change rate calculation unit 84 is configured to read a plurality of stroke volumes esSV calculated in the latest respiratory cycle from the plurality of stroke volumes esSV stored in the memory 19.

[0094] Then, the change rate calculation unit 84 is configured to specify a maximum value esSVmax in the read stroke volume esSV, and to specify a minimum value esSVmin in the read stroke volume esSV. Then, the change rate calculation unit 84 is configured to calculate a respiratory change (i.e., a stroke volume change, SVV) of the stroke volume esSV by using the maximum value esSVmax and the minimum value esSVmin, as shown in the following equation 2. The change rate calculation unit 84 is configured to store the calculated respiratory change SVV in the memory 19.

[0095] SVV=2*(esSVmax-esSVmin) / (esSVmax+esSVmin)…(Equation 2)

[0096] As the respiratory change of the hemodynamic parameter within a predetermined period, the change rate calculation unit 84 can calculate Figure 1 The pulse pressure acquisition unit 11 shown measures the respiratory change of the pulse pressure PP (ie, the pulse pressure variation, PPV) instead of the stroke volume variation SVV.

[0097] For example, the change rate calculation unit 84 is configured to read a plurality of pulse pressures PP measured in a most recent respiratory cycle from the plurality of pulse pressures PP stored in the memory 19 upon receiving an input of a newly detected respiratory cycle from the respiratory rate acquisition unit 41 .

[0098] Then, the change rate calculation unit 84 is configured to specify the maximum value PPmax of the read pulse pressure PP, and to specify the minimum value PPmin of the read pulse pressure PP. The change rate calculation unit 84 is configured to calculate the pulse pressure variation PPV by using the maximum value PPax and the minimum value PPmin, as shown in the following equation 3. The change rate calculation unit 84 is configured to store the calculated respiratory variation PPV in the memory 19.

[0099] PPV = 2*(PPmax-PPmin) / (PPmax+PPmin)…(Equation 3)

[0100] (Display of breathing changes)

[0101] The display controller 72 is configured to output the hemodynamic parameters and the respiratory changes of the hemodynamic parameters calculated by the change rate calculation unit 84 to the display 71 such as a monitor. Therefore, a screen including a screen configured to display the hemodynamic parameters and the respiratory changes of the hemodynamic parameters is displayed on the display 71.

[0102] Figure 4 Shown in Figure 1 An example of a screen displayed on the display 71. Figure 4As shown, the screen displayed on the display 71 displays the subject's latest heart rate HR, blood pressure value, non-invasively estimated continuous cardiac output esCCO, stroke volume esSV, etc. As will be described later, the screen may include an area R for making settings related to hemodynamic parameters. For example, when the operator selects a menu button (not shown) displayed on the screen, the area R is displayed.

[0103] For example, the display controller 72 is configured to periodically refer to the memory 19 and is configured to control so that the latest hemodynamic parameters are displayed on the screen. Figure 4 In the illustrated example, a value of "3.73" of the noninvasively estimated continuous cardiac output esCCO and a value of "47" of the stroke volume esSV are displayed as examples of the latest hemodynamic parameters.

[0104] For example, the display controller 72 is configured to periodically refer to the memory 19 and is configured to control so that the latest respiratory changes of the hemodynamic parameters are displayed on the screen. Figure 4 In the illustrated example, as indicated by arrow A, the value "3.1" of the respiratory variation SVV shows an example of the respiratory variation as the latest hemodynamic parameter.

[0105] (Setting of preset time period)

[0106] Here, if the predetermined period is the most recent respiratory cycle, the heart rate in the predetermined period may be small. In this case, there is a problem that the number of data pieces used to calculate the hemodynamic parameters of respiratory changes (hereinafter referred to as "the number of data pieces used") is insufficient.

[0107] Specifically, non-patent document 1 discloses that the value (HR / RR) obtained by dividing the heart rate HR by the respiratory rate RR is greater than 3.6 as a condition for detecting respiratory changes in hemodynamic parameters. The value of HR / RR corresponds to the heart rate contained in one respiratory cycle. Hereinafter, HR / RR is also referred to as "heart rate for one breath". Generally, in healthy adults, the heart rate HR is about 80, the respiratory rate RR is about 12, and the HR / RR as the heart rate for one breath is about 6.7.

[0108] When HR / RR, which is the heart rate of one breath, is less than 3.6 due to a low heart rate HR or a high respiratory rate RR, the number of data items of the hemodynamic parameter calculated in one respiratory cycle, that is, the number of data items used, is insufficient. Figure 3 The hemodynamic calculation unit 17 shown is capable of varying the length of the predetermined period used to calculate the respiratory variation SVV and PPV.

[0109] (a) Display of the setting screen

[0110] like Figure 4 As shown, the region R may include a plurality of tabs Tb. The plurality of tabs Tb may include, for example, a tab Tb1 for selecting a display related to hemodynamic parameters and a tab Tb2 for selecting a display of a setting screen for a predetermined period. For example, letters "esCCO" are assigned to the tab Tb1. For example, letters "esSVV setting" are assigned to the tab Tb2. Figure 4 Shows the operator in Figure 1 The screen shown is displayed when an input operation of selecting the tab Tb1 and further selecting the tab Tb2 is performed on the receiving unit 6.

[0111] When the input operation as described above is performed, the receiving unit 6 outputs a command signal indicating the content of the input operation to the receiving unit 74 of the display device 1. When receiving the command signal output from the receiving unit 6, the receiving unit 74 outputs the command signal to the display controller 72. After receiving the command signal output from the receiving unit 74, the display controller 72 controls so that the following information is displayed in the area R: Figure 4 The setting screen is shown.

[0112] The setting screen may include: a selection button B11 for selecting manual change of the length of the predetermined period; a selection button B12 for selecting automatic change of the length of the predetermined period; a window W1 for displaying the number of breathing cycles (hereinafter also referred to as "number of cycles") included in the predetermined period; a window W2 for displaying the value of the heart rate HR / RR of one breath; a selection button B21 for selecting to increase the number of cycles; and a selection button B22 for selecting to decrease the number of cycles.

[0113] For example, Figure 3 The HR / RR calculation unit 82 shown is configured to periodically calculate the heart rate HR / RR of one breath by using the heart rate HR calculated by the heart rate acquisition unit 12 and the respiratory rate RR detected by the respiratory rate acquisition unit 41. Then, the HR / RR calculation unit 82 is configured to store the calculated heart rate HR / RR of one breath in the memory 19. The display controller 72 is configured to perform control to display the most recent heart rate HR / RR of one breath stored in the memory 19 in the window W2.

[0114] The operator can select one of the selection buttons B11 and B12. In a state where the operator selects neither the selection button B11 nor the selection button B12, the selection button B11 is automatically selected. That is, in such a state, the hemodynamic calculation unit 17 is configured to operate in a manual mode described later, and does not change the length of the predetermined period without receiving an operation by the operator.

[0115] The operator can select the selection button B21 and the selection button B22. For example, suppose the operator performs an operation to select the selection button B21. In this case, Figure 1 The receiving unit 6 shown outputs a command signal (setting information) indicating the operation content to the receiving unit 74. Upon receiving the command signal output from the receiving unit 6, the receiving unit 74 outputs the command signal to the display controller 72 and the calculation unit 70. After receiving the command signal output from the receiving unit 74, the display controller 72 increases the number displayed in the window W1 by 1.

[0116] In the calculation unit 70, Figure 3 The period setting unit 83 shown is configured to set the length of the predetermined period based on the respiratory cycle detected by the respiratory rate acquisition unit 41 and the number of cycles set on the setting screen. More specifically, in the case where the period setting unit 83 receives an instruction signal indicating that the selection button B21 is selected from the receiving unit 74, the period setting unit 83 resets the length of the predetermined period by adding 1 to the number of cycles based on the instruction signal, so that the period corresponding to the increased number of cycles becomes the predetermined period. Then, the period setting unit 83 is configured to notify the change rate calculation unit 84 of the reset predetermined period.

[0117] For example, it is assumed that the operator performs an operation to select the selection button B22 with respect to the receiving unit 6. In this case, the receiving unit 6 outputs an instruction signal indicating the operation content to the receiving unit 74. Upon receiving the instruction signal output from the receiving unit 6, the receiving unit 74 outputs the instruction signal to the display controller 72 and the calculation unit 70. After receiving the instruction signal output from the receiving unit 74, the display controller 72 decrements the number displayed in the window W1 by 1.

[0118] In the case where the period setting unit 83 of the calculation unit 70 receives the instruction signal indicating that the selection button B22 is selected from the receiving unit 74, the period setting unit 84 resets the length of the predetermined period by reducing the number of cycles by 1 based on the instruction signal so that the period corresponding to the reduced number of cycles becomes the predetermined period. Then, the period setting unit 83 is configured to notify the change rate calculation unit 84 of the reset predetermined period.

[0119] Based on the predetermined period notified from the period setting unit 83 , the change rate calculation unit 84 is configured to calculate the respiratory changes SVV and PPV of the hemodynamic parameters using the plurality of hemodynamic parameters calculated in the predetermined period.

[0120] Figure 5 The number of data used to calculate respiratory variation SVV and PPV is shown in Figure 4 The diagram shown in the setting screen changes according to the number of cycles set. Figure 5In the figure, curve G1 shows the Figure 1 The respiratory waveform of the measurement data obtained by the measurement of the respiratory meter 4 shown in FIG. Figure 1 1 and 2. The ECG waveform of the measurement data obtained by the ECG electrode 31 shown in FIG.

[0121] In the state where the respiratory waveform shown in the curve G1 and the ECG waveform shown in the curve G2 are obtained, when the number of cycles included in the predetermined period is "1", the heart rate included in the predetermined period is "3". When the number of cycles included in the predetermined period is "2", the heart rate included in the predetermined period is "5". As described above, as the number of cycles increases, the heart rate increases and the number of pieces of data used for calculating the respiratory variation SVV and PPV increases.

[0122] (b) Manual mode

[0123] Figure 6 It is shown by Figure 3 The illustrated diagram is a state in which the operator manually performs a change in the length of the predetermined period to be performed by the period setting unit 83. Here, a case in which the stroke volume variation SVV is calculated and displayed as a respiratory variation of the hemodynamic parameter will be described.

[0124] exist Figure 6 In, with Figure 4 Likewise or similarly, a setting screen is displayed in the region R. It is also assumed that the selection button B11 is selected on the setting screen. In this case, the hemodynamics calculation unit 17 operates in the manual mode.

[0125] like Figure 6 As shown, it is assumed that "1" is displayed in window W1 and "1.8" is displayed in window W2. In the following description, the threshold value of the heart rate HR / RR for one breath is set to "3.6". In this case, the heart rate HR / RR for one breath is "1.8" and is less than the threshold value.

[0126] When the heart rate HR / RR of one breath is less than the threshold value, the display controller 72 is configured to control so that the operator can easily recognize that the heart rate HR / RR of one breath is less than the threshold value. For example, the display controller 72 is configured to display the edge of the window W2 in red on the screen.

[0127] In the case where the respiratory rate acquisition unit 41 newly receives a notification of a respiratory cycle, the change rate calculation unit 84 is configured to read a plurality of stroke volumes esSV calculated in the most recent respiratory cycle. As described above, in the case where the heart rate HR / RR of one breath is less than the threshold, the number of used data read by the change rate calculation unit 84 is also less than the threshold. In this case, the change rate calculation unit 84 does not calculate the respiratory change SVV, and stores an error value indicating an error in the memory 19, for example.

[0128] The display controller 72 is configured to read the error value as the respiratory variation of the latest hemodynamic parameter stored in the memory 19. Then, for example, Figure 6 As shown by arrow A in FIG. 1 , the display controller 72 is configured to perform control so that “---” indicating that the respiratory change SVV of the hemodynamic parameter cannot be calculated is displayed on the screen.

[0129] Assume that the operator performs an operation of selecting the selection button B21 in this state. In this case, the number displayed in the window W1 changes from "1" to "2". The period setting unit 83 increases the cycle number from "1" to "2", and sets the predetermined period by using "2" as the increased cycle number. Then, the period setting unit 83 notifies the set predetermined period to the change rate calculation unit 84.

[0130] Upon receiving notification of a predetermined period from the period setting unit 83, the change rate calculation unit 84 is configured to read a plurality of stroke volumes esSV calculated within the predetermined period. In the case where the number of data pieces of the read stroke volume esSV, i.e., the number of data pieces used is equal to or greater than a threshold value, the change rate calculation unit 84 calculates the respiratory variation SVV by using the plurality of stroke volumes esSV. Therefore, the stroke volume variation SVV is displayed on the screen.

[0131] When the number of used data is still less than the threshold, the change rate calculation unit 84 determines that the respiratory variation SVV cannot be calculated, and stores, for example, an error value in the memory 19. In this case, the screen continues to display that the respiratory variation SVV cannot be calculated.

[0132] (c) Automatic mode

[0133] Figures 7 to 9 is used to show that Figure 3 The illustrated diagram is a diagram of a state in which the period setting unit 83 automatically changes the length of a predetermined period. Figures 7 to 9 The screen displayed when the operator selects the selection button B12 on the setting screen is shown.

[0134] When the input operation is performed as described above, Figure 1The illustrated acceptance unit 6 is configured to output an instruction signal indicating the content of the input operation to the reception unit 74 of the display instrument 1. Upon receiving the instruction signal output from the acceptance unit 6, the reception unit 74 outputs the instruction signal to the calculation unit 70.

[0135] The hemodynamic calculation unit 17 of the calculation unit 70 is configured to operate in the above-mentioned manual mode until receiving a command signal indicating that the selection button B12 is selected. On the other hand, in the case of receiving a command signal, the hemodynamic calculation unit 17 is configured to operate in the automatic mode.

[0136] More specifically, the period setting unit 83 is configured to increase the number of cycles to increase the predetermined period until the number of used data pieces is equal to or greater than the threshold. Figure 7 As shown in FIG. 1 , it is assumed that the heart rate HR / RR of one breath displayed in window W2 is "1.8". In this case, Figure 6 The situation shown is the same or similar, and the change rate calculation unit 84 notifies the period setting unit 83 that the number of used data pieces is less than the threshold value.

[0137] Upon receiving a notification that the number of used data pieces is less than a threshold value, the period setting unit 83 is configured to increase the number of cycles by one to reset the predetermined period, and is configured to notify the reset predetermined period to the change rate calculation unit 84 and the display controller 72. The period setting unit 83 is configured to notify the display controller 72 of the increased number of cycles.

[0138] After receiving the notification of the cycle number from the period setting unit 83, the display controller 72 is configured to control so that the notified cycle number is displayed in the window W1. Specifically, the display controller 72 is configured to Figure 7 The "1" displayed in window W1 in the Figure 8 The control of "2" is shown.

[0139] Upon receiving notification of the predetermined period from the period setting unit 83, the change rate calculation unit 84 is configured to read a plurality of stroke volumes esSV calculated within the notified predetermined period, and is configured to attempt to calculate the respiratory variation SVV.

[0140] Here, it is assumed that the number of used data included in the two breathing cycles read by the change rate calculation unit 84 is still less than the threshold. Figure 8 As shown by arrow A in FIG. 8 , the display indicating that the respiratory variation SVV cannot be calculated continues on the screen. The variation rate calculation unit 84 notifies the time period setting unit 83 again that the number of data used is less than the threshold value.

[0141] When receiving the notification that the number of used data is less than the threshold again, the period setting unit 83 adds 1 to the cycle number to reset the predetermined period, and notifies the reset predetermined period to the change rate calculation unit 84 and the display controller 72. The period setting unit 83 is configured to notify the display controller 72 of the increased cycle number.

[0142] After receiving the notification of the number of cycles from the period setting unit 83, the display controller 72 sets Figure 8 The "2" displayed in window W1 in the Fig. 9 Control of "3" shown.

[0143] After receiving the notification of the predetermined period from the period setting unit 83, the change rate calculation unit 84 is configured to read the plurality of stroke volumes esSV calculated within the notified predetermined period, and is configured to attempt to calculate the respiratory change SVV. Here, it is assumed that the number of used data pieces included in the three respiratory cycles read by the change rate calculation unit 84 is equal to or greater than the threshold value, and the respiratory change SVV is calculated. In this case, as Fig. 9 As shown by arrow A in FIG. 1 , the value of the respiratory variation SVV is, for example, “3.1” displayed on the screen. In this case, for example, the red color of the edge of the window W2 disappears.

[0144] <Operation Flow>

[0145] (Overview of overall operation)

[0146] Fig.10 1 is a flowchart for illustrating an outline of the operation performed by the physiological information processing device M according to the embodiment of the present disclosure when calculating and displaying respiratory changes in hemodynamic parameters. Here, a case where the stroke volume variation SVV is calculated and displayed as the respiratory changes in the hemodynamic parameters will be described.

[0147] Reference Fig.10 First, when the operator activates the physiological information processing device M, each acquisition unit in the calculation unit 70 performs measurement, etc. Specifically, the heart rate acquisition unit 12 is configured to calculate the heart rate HR (step 11), and the respiratory rate acquisition unit 41 is configured to detect the respiratory cycle and the respiratory rate RR (step 12).

[0148] Next, the HR / RR calculation unit 82 in the hemodynamic calculation unit 17 is configured to calculate the heart rate HR / RR for one breath using the heart rate HR calculated in step 11 and the respiratory rate RR detected in step 12. Then, the HR / RR calculation unit 82 is configured to store the calculated heart rate HR / RR for one breath in the memory 19 (step 13).

[0149] Next, the parameter calculation unit 81 in the hemodynamic calculation unit 17 is configured to calculate the stroke volume esSV based on the heart rate HR etc. calculated in step 11 etc., and is configured to store the calculated stroke volume esSV in the memory 19 (step 14).

[0150] Next, it is assumed that, for example, after selecting a menu button included in the screen and displaying the region R, the operator also performs an operation of selecting the tab Tb2 to select display of the setting screen in the region R. In this case, the display controller 72 is configured to perform control so that Figure 4 The setting screen shown is displayed on the display 71 (step 15).

[0151] Next, the hemodynamic calculation unit 17 is configured to check whether a command signal indicating that the operator has performed an operation to select the selection button B12 is received (step 16). If a command signal indicating the operation content is not received ("No" in step 16), the hemodynamic calculation unit 17 is configured to operate in the manual mode (step 17).

[0152] On the other hand, in the case of receiving the instruction signal indicating that the operator has selected the selection button B12 (“Yes” in step 16 ), the hemodynamic calculation unit 17 is configured to operate in the automatic mode (step 18 ).

[0153] (Operational procedures in manual mode)

[0154] Fig.11 is used to show Figure 1 FIG. 1 is a flow chart showing the operation of the hemodynamic calculation unit 17 in a case where the hemodynamic calculation unit 17 operates in the manual mode.

[0155] Reference Fig.11 First, upon newly receiving a notification of a respiratory cycle detected by the respiratory rate acquisition unit 41, the change rate calculation unit 84 is configured to read a plurality of stroke volumes esSV calculated within a predetermined period based on the notified respiratory cycle. The predetermined period corresponds to the most recent respiratory cycle (step 21).

[0156] Next, the change rate calculation unit 84 is configured to check whether the number of read stroke volume esSV, that is, the number of used data pieces is equal to or greater than a threshold value to determine whether the respiratory change SVV can be calculated (step 22).

[0157] When the number of pieces of data used is equal to or greater than the threshold value, the change rate calculation unit 84 determines that the respiratory change SVV can be calculated ("Yes" in step 22), and calculates the respiratory change SVV. Then, the display controller 72 is configured to perform control to display the respiratory change SVV calculated by the change rate calculation unit 84 on the screen (step 23).

[0158] On the other hand, when the number of pieces of data used is less than the threshold value, the change rate calculation unit 84 is configured to determine that the respiratory change SVV cannot be calculated ("No" in step 22), and is configured to output an error value as the respiratory change SVV. Then, the display controller 72 is configured to control, for example, to display "---" indicating that the respiratory change of the hemodynamic parameter cannot be calculated on the screen (step 24).

[0159] Next, the time period setting unit 83 is configured to check whether a command signal indicating that the operator has performed an operation of selecting the selection button B21 or the selection button B22 is received (step 25). In the case where a command signal indicating the operation content is not received ("No" in step 25), the time period setting unit 83 does not change the predetermined time period, and performs the operations in step 21 and subsequent steps again.

[0160] On the other hand, in the case where the instruction signal indicating that the operator performs an operation of selecting the selection button B21 or the selection button B22 is received ("Yes" in step 25), the period setting unit 83 is configured to change the number of cycles, which is the number of respiratory cycles included in the predetermined period, based on the instruction signal, and is configured to reset the predetermined period (step 26). Then, the stroke volume esSV calculated in the predetermined period after the reset is read (step 21), and the operations in step 22 and subsequent steps are performed again.

[0161] (Operation flow in automatic mode)

[0162] Fig.12 is used to show Figure 1 FIG. 1 is a flow chart showing the operation of the hemodynamic calculation unit 17 in the case where the hemodynamic calculation unit 17 operates in the automatic mode.

[0163] Because from Fig.12 The operations from step 31 to step 33 shown in Fig.11 The operations of step 21 to step 23 shown in FIG. 3 are the same or similar, so the detailed description thereof will not be repeated here. In the case where the respiratory variation SVV is calculated and displayed (step 33), the operations in step 31 and subsequent steps are performed again.

[0164] In step 32, when the number of pieces of data used is less than the threshold value, the change rate calculation unit 84 determines that the respiratory change SVV cannot be calculated ("No" in step 32). In this case, the change rate calculation unit 84 notifies the time period setting unit 83 that the number of pieces of data used is less than the threshold value (step 34).

[0165] Next, after receiving the notification of the above content from the change rate calculation unit 84, the period setting unit 83 increases the number of cycles by 1 and resets the predetermined period (step 35). Then, the stroke volume esSV calculated in the predetermined period after the reset is read (step 31), and the operations in step 32 and subsequent steps are performed again.

[0166] When operating in either manual mode or automatic mode, for example, when a predetermined period of time has passed since the time when the cycle number increased, the hemodynamic calculation unit 17 returns the cycle number to "1". This prevents the cycle number from continuing to increase. The upper limit of the cycle number is, for example, "8".

[0167] As described above, in the physiological information processing device M according to one aspect of the present disclosure, the heart rate acquisition unit 12 is configured to acquire the heart rate HR of the subject. The respiratory rate acquisition unit 41 is configured to acquire the respiratory rate RR of the subject. The hemodynamic calculation unit 17 is configured to calculate the hemodynamic parameters of the subject, and is configured to calculate the respiratory changes SVV and PPV of the hemodynamic parameters based on a plurality of hemodynamic parameters calculated in a predetermined period. The display controller 72 is configured to output the calculated respiratory changes SVV and PPV to the display 71. The hemodynamic calculation unit 17 is also configured to use the heart rate HR and the respiratory rate RR to calculate the heart rate HR / RR of one breath, which is the heart rate included in one respiratory cycle. The display controller 72 is also configured to output a setting screen for setting the length of the predetermined period to the display 71, the setting screen including a screen configured to display the heart rate HR / RR of one breath. Then, the hemodynamic calculation unit 17 is configured to acquire setting information indicating the contents set on the setting screen, to set the length of the predetermined period based on the acquired setting information, and to calculate the respiratory variation SVV and PPV in the predetermined period after the setting.

[0168] Through such a configuration, for example, the operator can determine the number of data items used to calculate the hemodynamic parameters of respiratory variation SVV and PPV, that is, whether the number of data items of the hemodynamic parameters calculated within the predetermined period is sufficient by checking the heart rate HR / RR of one breath displayed on the display 71. In the case where it is determined that the number of data items is insufficient, the operator can set the predetermined period to be longer on the setting screen to increase the number of data items. As a result, the respiratory variation SVV and PPV of the hemodynamic parameters can be calculated using a sufficient amount of data, so that the state of the subject can be monitored more accurately.

[0169] In the physiological information processing device M according to another aspect of the present disclosure, the length of the predetermined period is the length of one or more respiratory cycles. The display controller 72 is configured to cause the display to display a setting screen in which the number of respiratory cycles included in the predetermined period is configured to be set. The hemodynamic calculation unit 17 is configured to set the length of the predetermined period based on the respiratory cycle and based on the number of respiratory cycles set on the setting screen, and the respiratory cycle is detected based on at least one of the start time point and the end time point of the subject's breathing. As described above, by being able to set the configuration of the number of respiratory cycles on the setting screen, the operator can easily change the length of the predetermined period.

[0170] In the physiological information processing device M according to another aspect of the present disclosure, the respiratory rate acquisition unit 41 is also configured to determine at least one of the start time point and the end time point of the subject's breathing based on the detection results from the respirometer 4, which detects the concentration of carbon dioxide in the subject's exhaled breath.

[0171] Generally, many cardiac output measuring instruments have the function of measuring the stroke volume variation SVV, and are specifically used to measure cardiac output and related parameters. In these instruments, the function of measuring the respiratory cycle is not provided, but the respiratory cycle is set to a fixed value. In contrast, in the physiological information processing device M according to the subject matter of the present disclosure, through the above configuration, the respiratory cycle can be determined more accurately, so that the respiratory variation SVV and PPV of the hemodynamic parameters can be calculated more accurately.

[0172] In the physiological information processing device M according to another aspect of the present disclosure, the display controller 72 is further configured to cause the display to display a setting screen in which the automatic change of the length of the predetermined period is configured to be set. In the case where the automatic change of the length of the predetermined period is set on the setting screen and the number of pieces of data used for the hemodynamic parameter calculated in the predetermined period is less than a threshold value, the hemodynamic calculation unit 17 is configured to set the predetermined period to be long. As described above, by configuring the length of the predetermined period to be automatically changed according to the number of pieces of data used for the hemodynamic parameter calculated within the predetermined period, the operator's time and labor can be reduced.

[0173] In the physiological information processing device M according to another aspect of the present disclosure, when the length of a predetermined period is automatically changed, the hemodynamic calculation unit 17 increases the number of respiratory cycles included in the predetermined period until the number of data items used becomes equal to or greater than a threshold value, and sets the length of the predetermined period based on the respiratory cycle and the number of respiratory cycles included in the predetermined period, and the respiratory cycle is detected based on at least one of the start time point and the end time point of the subject's breathing.

[0174] As described above, by configuring the number of respiratory cycles included in a predetermined period to be increased when the number of data items of the hemodynamic parameters calculated within the predetermined period is less than a threshold value, and ending the increase in the number of respiratory cycles included in the predetermined period when the number of data items is equal to or greater than the threshold value, the number of data items of the respiratory changes SVV and PPV used to calculate the hemodynamic parameters can be set to an appropriate number.

[0175] In the physiological information processing device M according to another aspect of the present disclosure, when the number of data pieces of the hemodynamic parameter calculated in a predetermined period is less than a threshold value, the hemodynamic calculation unit 17 does not calculate the respiratory variation SVV and PPV. With such a configuration, since it is possible to avoid calculating and displaying the respiratory variation SVV and PPV with low accuracy, the operator can monitor the physiological information of the subject more accurately.

[0176] Although the embodiments of the present disclosure have been described above, the technical scope of the present application should not be construed as being limited to the description of the embodiments. The embodiments are merely examples, and those skilled in the art should understand that various modifications can be made to the embodiments within the scope of the present invention described in the claims. The technical scope of the present application should be determined based on the scope of the invention described in the claims and their equivalents.

[0177] This application claims priority from Japanese Patent Application No. 2022-127788 filed on August 10, 2022, the entire contents of which are incorporated herein by reference.

[0178] [Industrial Applicability]

[0179] According to the disclosed subject matter, it is possible to provide a physiological information display device and a physiological information display method capable of more accurately monitoring the state of a subject.

Claims

1. A physiological information display device, comprising: a heart rate acquisition unit, the heart rate acquisition unit being configured to acquire the heart rate of the subject; a respiratory rate acquisition unit configured to acquire a respiratory rate of the subject; A hemodynamic calculation unit, the hemodynamic calculation unit being configured to calculate: hemodynamic parameters of the subject; and a respiratory variation of a hemodynamic parameter, the respiratory variation of the hemodynamic parameter being based on a plurality of said hemodynamic parameters calculated over a predetermined period of time; as well as a display controller configured to output the respiratory change to a display, wherein the hemodynamic calculation unit is further configured to calculate the heart rate of one breath using the heart rate and the respiratory rate, the heart rate of one breath being the heart rate included in one respiratory cycle, The display controller is further configured to output a setting screen for setting the length of the predetermined period to the display, the setting screen being configured to display the heart rate of the one breath, and The hemodynamic calculation unit is configured to: acquiring setting information indicating the contents set on the setting screen; setting the length of the predetermined period based on the acquired setting information; and The breathing variation within the set predetermined time period is calculated.

2. The physiological information display device according to claim 1, in, The length of the predetermined time period is the length of one or more breathing cycles, The display controller is configured to cause the display to display the setting screen in which the number of respiratory cycles included in the predetermined period is configured to be settable, and The hemodynamic calculation unit is configured to set the length of the predetermined period based on a respiratory cycle and the number of the respiratory cycles, wherein the respiratory cycle is detected based on at least one of a start time point and an end time point of the subject's breathing, and the number of the respiratory cycles is set on the setting screen.

3. The physiological information display device according to claim 2, in, The respiratory rate acquisition unit is further configured to determine at least one of a start time point and an end time point of the subject's breathing based on a detection result from a detector, wherein the detector is configured to detect a concentration of carbon dioxide in the subject's exhaled breath.

4. The physiological information display device according to claim 1 or 2, in, The display controller is further configured to cause the display to display the setting screen in which the automatic change of the length of the predetermined period is configured to be settable, and When the automatic change of the length of the predetermined period is set in the setting screen and the number of data items of the hemodynamic parameter calculated in the predetermined period is less than a threshold, the hemodynamic calculation unit is configured to set the predetermined period to be long.

5. The physiological information display device according to claim 4, in, The length of the predetermined period is the length of one or more respiratory cycles, and In case the hemodynamic calculation unit performs an automatic change of the length of the predetermined period, the hemodynamic calculation unit is configured to: Increasing the number of the breathing cycles included in the predetermined period until the number of data pieces becomes equal to or greater than the threshold; as well as The length of the predetermined period is set based on a respiratory cycle detected based on at least one of a start time point and an end time point of respiration of the subject and the number of the respiratory cycles, the respiratory cycle being included in the predetermined period.

6. The physiological information display device according to claim 1 or 2, in, The hemodynamic calculation unit is configured not to calculate the respiratory change when the number of data items of the hemodynamic parameter calculated within the predetermined period is less than a threshold value.

7. A physiological information display method, comprising: Obtain the subject's heart rate; Obtain the subject's breathing rate; Calculate the heart rate of one breath using the heart rate and the respiratory rate, the heart rate of one breath being the heart rate included in one respiratory cycle; calculating hemodynamic parameters of the subject; outputting a setting screen for setting the length of the predetermined period to a display, the setting screen being configured to display the heart rate of the one breath; setting the length of the predetermined period based on the content set on the setting screen; Calculating respiratory changes of the hemodynamic parameters based on the plurality of hemodynamic parameters calculated within the predetermined time period; as well as The breathing changes are output to the display.

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