CN103830783A - Extracorporeal circulation perfusion policy making system - Google Patents

Abstract

Translated fromChinese

一种体外循环灌注决策系统，属于生物医学工程技术领域，主要包括决策模块和检测模块。决策模块根据检测模块采集和处理的数据，包括心功能指标和供氧指标以及外循环灌注系统的输出压力和血流量，计算得到灌注辅助指数。该灌注辅助指数代表体外灌注系统做功和患者心脏灌注做功的比值，灌注辅助指数值越高，体外灌注系统为患者提供的能量越高。决策模块根据采集模块采集的心功能指标和供氧指标进行判断，做出决策：如指标在正常范围内，则灌注辅助指数为推荐值，即参考决策值；如指标在正常范围外，则做出警告。医生或控制系统依据决策模块提出的参考决策值，选择执行。以参考决策值为基础调节体外灌注流量，可适应患者的生理需求，减少并发症。

An extracorporeal circulation perfusion decision-making system belongs to the technical field of biomedical engineering and mainly includes a decision-making module and a detection module. The decision-making module calculates the perfusion assistance index according to the data collected and processed by the detection module, including cardiac function indicators and oxygen supply indicators, as well as output pressure and blood flow of the external circulation perfusion system. The perfusion assistance index represents the ratio of the work done by the extracorporeal perfusion system to the perfusion work done by the patient's heart. The higher the perfusion assistance index value, the higher the energy provided by the extracorporeal perfusion system to the patient. The decision-making module judges and makes decisions based on the cardiac function indicators and oxygen supply indicators collected by the acquisition module: if the indicators are within the normal range, the perfusion assistance index is the recommended value, that is, the reference decision value; if the indicators are outside the normal range, then do Warning. The doctor or the control system chooses to execute according to the reference decision value proposed by the decision-making module. Adjusting the extracorporeal perfusion flow based on the reference decision value can adapt to the physiological needs of patients and reduce complications.

Description

A kind of extracorporeal circulation perfusion decision system

Technical field

The present invention relates to a kind of extracorporeal circulation perfusion decision system, belong to biomedical engineering field.

Background technology

Extracorporeal circulation filling system is supplementary means conventional in surgical operation.In the world, the arterial set of Ka Diou Jiade medical science company, system and method CN201080025371.5, adopting a kind of aspiration chamber to arrange whereby provides and leaves described aortal aspiration flow with absorption flow velocity.Can and optionally control described target perfusion flow velocity and described absorption flow velocity, but this flow-control is not taken into account patient's physiological parameter simultaneously.The extracorporeal circulation of medical fluid and the system CN200710093658.1 of perfusion in the monitoring cardiorespiratory bypass process of Lande Co., Ltd., the blood circulation loop of monitoring and control blood pump, but its monitoring parameter does not feed back to the control of perfusion blood pump.Domestic, a kind of extracorporeal circulation overall perfusion system CN201220067806.9 of the Fourth Military Medical University of P.L.A, does not realize according to physiological parameter control irrigation flow yet.

The irrigation flow of current external counterpulsation system is to rely on doctors experience control, and be not coupled patient's physiological parameter of irrigation flow changes and considers, and therefore has the danger of perfusion or hypoperfusion.

A kind of low perfusion measurement method of blood oxygen saturation CN103027690A based on self correlation modeling of the Central China University of Science and Technology, although designed a kind of method of measuring blood perfusion index, but this index has only reflected the pulsating nature of blood flow, cannot represent the ratio relation of external counterpulsation flow and patient self heart perfusion, cannot provide foundation for control agent outer filling flow.

In filling process, physiological parameter is as heart stroke, heart rate, and the flow of blood pressure etc. and external counterpulsation is relevant in real time, and these parameters can be rotated the changes in flow rate causing and change along with blood pump.In the decision-making of control blood pump, these parameters are also important influence factors.

Summary of the invention

In order, according to patient's physiological parameter control agent outer filling flow, to reduce complication, the invention provides a kind of extracorporeal circulation perfusion decision system, make groundwater increment maintain the scope that is applicable to patient's states.

To achieve these goals, the present invention has taked following technical scheme:

A kind of extracorporeal circulation perfusion decision system, system comprises detection module and decision-making module, described detection module circle collection patient's physiological data and the parameter of external counterpulsation system, patient's physiological data comprises heart stroke, heart rate, blood pressure, Svo2 and arterial oxygen saturation, the parameter of external counterpulsation system comprises output pressure and flow, and detection module is by heart stroke wherein, blood pressure, output pressure, flow fits to respectively the waveform of arterial pressure, the waveform of blood flow volume, the outlet pressure waveform of extracorporeal circulation perfusion blood pump, the waveform of the perfusion blood flow of extracorporeal circulation perfusion blood pump, out by above-mentioned data show and deliver to described decision-making module simultaneously, described decision-making module is according to formula

$\mathrm{PAI}\left(\mathrm{\ω}\right)=\frac{1}{T_c}{\∫}_0^{T_c}\left(\frac{P_p\left(t\right)F_p\left(t\right)}{P_{\mathrm{ap}}\left(t\right)F_{\mathrm{ap}}\left(t\right)}\right)\mathrm{dt}$

Obtain with reference to decision-making PAI, and show with reference to decision-making PAI, or export to external counterpulsation system simultaneously;

In formula, PAI(ω)---the acting relation of extracorporeal circulation perfusion and heart perfusion,

P_p(t)---the outlet pressure waveform of extracorporeal circulation perfusion blood pump,

F_p(t)---the waveform of the perfusion blood flow of extracorporeal circulation perfusion blood pump,

P_ap(t)---the waveform of arterial pressure,

F_ap(t)---the waveform of blood flow volume,

T_c---cardiac cycle, is obtained by heart rate;

Described Svo2 and arterial oxygen saturation are as differentiating PAI(ω) whether be the foundation with reference to decision-making PAI, if arterial oxygen saturation >90%, Svo2 maintains between 64～88%, PAI(ω) be recommendation, output is with reference to decision-making PAI.

Taking condition below as according to obtaining the described optimum with reference to decision-making PAI:

1) arterial oxygen saturation >90%, Svo2 maintains between 64～88%;

2) heart rate is near the value of calculating according to formula 118.1-(0.57 × age);

3) cardiac output is 4～7L/min, and meansigma methods is 4～6.5L/min;

4) blood pressure systolic pressure≤140mmHg (18.6kPa), diastolic pressure≤90mmHg (12kPa).

Beneficial effect of the present invention is: utilize extracorporeal circulation perfusion decision system to formulate perfusion decision-making according to patient's physiological parameter, and control agent outer filling flow based on this, adaptation patient's psychological need, reduces complication.

Brief description of the drawings

Fig. 1 is the structural representation of a kind of extracorporeal circulation perfusion of the present invention decision system.

Detailed description of the invention

Below in conjunction with accompanying drawing 1, concrete formation of the present invention is elaborated.

Extracorporeal circulation irrigation flow decision system comprises detection module and decision-making module, and structured flowchart as shown in Figure 1.Detection module gathers patient's physiological data and the parameter of external counterpulsation system, and data are passed to described decision-making module.Physiological data comprises Cardiac Function of Patients index, as heart stroke, heart rate, blood pressure and oxygen supply index (comprising Svo2 and arterial oxygen saturation).The parameter of external counterpulsation system comprises output pressure and flow.Decision-making module receives the data of detection module and calculates, and draws with reference to decision-making PAI.

Wherein, patient's heart stroke, heart rate, blood pressure, blood oxygen saturation can adopt conventional sense means to obtain, and as doppler flow quantity sensor detects heart stroke, two have wound pressure transducer to detect blood pressure, and electrocardioelectrode detects heart rate, and photoelectric sensor detects blood oxygen saturation.

Detection module adopts computer and multiple signals selected on-off circuit (as the multiple signals selected on-off circuit of chip CD4051 formation) to form, and multi-channel data acquisition module successively Jiang Ge road signals collecting arrives computer, and circle collection.Computer fitting goes out the waveform of arterial pressure and blood flow, and the waveform of extracorporeal circulation perfusion blood pump outlet pressure and flow.

Decision-making module can adopt simple single-chip microcomputer and peripheral circuit thereof to form.By coding, obtain with reference to decision-making PAI.Its principle is as follows:

For evaluating the acting relation of extracorporeal circulation perfusion and heart perfusion, introduce perfusion subsidiary index number PAI(ω), the distribution of work of doing between the two is described.Calculating PAI(ω has been installed in decision-making module) algorithm routine, by formula

$\mathrm{PAI}\left(\mathrm{\ω}\right)=\frac{1}{T_c}{\∫}_0^{T_c}\left(\frac{P_p\left(t\right)F_p\left(t\right)}{P_{\mathrm{ap}}\left(t\right)F_{\mathrm{ap}}\left(t\right)}\right)\mathrm{dt}$Obtain;

In formula, P_p(t)---the outlet pressure waveform of extracorporeal circulation perfusion blood pump,

F_p(t)---the waveform of the perfusion blood flow of extracorporeal circulation perfusion blood pump,

P_ap(t)---the waveform of arterial pressure,

F_ap(t)---the waveform of blood flow volume,

T_c---cardiac cycle.

Because the waveform of outlet pressure and blood flow is that extracorporeal circulation filling system produces, can regulate, obtained by described detection module, thereby PAI(ω) be a personalized decision factor changing with physiological parameter.PAI(ω) can assess cardiac and the acting relation of external counterpulsation system, the distribution of work of doing between the two is described, unit is " % ", its normal range is in 0%-100%.As PAI(ω) when <100%, external counterpulsation system is auxiliary in part.As PAI(ω)=100%, external counterpulsation system is in completely auxiliary.PAI(ω) value higher, external counterpulsation system for the energy that patient provides higher.

Decision-making module according to detection module gather physiological data as heart stroke, heart rate, blood pressure, blood oxygen saturation, computing reference decision-making, i.e. PAI(ω).When these physiological datas are during in normal value, PAI(ω) be with reference to decision value PAI, doctor or control system can regulate groundwater increment with reference to decision value PAI.If physiological data is not within normal range, decision-making module gives a warning.The normal value of the physiological parameter of decision-making module PAI reference is as follows: arterial oxygen saturation >90%, and Svo2 maintains between 64～88%; Normal palmic rate scope is divided at 60-100/, and on average 75/ point of left and right, heart rate normal value is calculated according to following formula: 118.1-(0.57 × age); Kinemic normal value is 4～7L/min, and meansigma methods is 4～6.5L/min; Blood pressure systolic pressure≤140mmHg (18.6kPa), diastolic pressure≤90mmHg (12kPa).

Claims (2)

Translated fromChinese

1.一种体外循环灌注决策系统，系统包括检测模块和决策模块,其特征在于：所述检测模块循环采集患者的生理数据和体外灌注系统的参数，患者的生理数据包括心排量、心率、血压、静脉血氧饱和度和动脉血氧饱和度，体外灌注系统的参数包括输出压力和流量，并且检测模块将其中的心排量、血压、输出压力、流量分别拟合成动脉压的波形、动脉血流量的波形、体外循环灌注血泵的出口压力波形、体外循环灌注血泵的灌注血流量的波形，同时将上述数据显示出来并送到所述决策模块；所述决策模块根据式1. An extracorporeal circulation perfusion decision-making system, the system includes a detection module and a decision-making module, characterized in that: the detection module cyclically collects the patient's physiological data and parameters of the extracorporeal perfusion system, and the patient's physiological data includes cardiac output, heart rate, Blood pressure, venous oxygen saturation and arterial oxygen saturation, the parameters of the extracorporeal perfusion system include output pressure and flow, and the detection module fits the cardiac output, blood pressure, output pressure, and flow into the waveform of arterial pressure, The waveform of the arterial blood flow, the outlet pressure waveform of the extracorporeal circulation perfusion blood pump, and the waveform of the perfusion blood flow of the extracorporeal circulation perfusion blood pump are displayed at the same time and sent to the decision-making module; the decision-making module is based on the formula$\mathrm{<span><span>PAI</span>PAI</span>}<span><span>(</span>(</span>\mathrm{<span><span>\&omega;</span>\&omega;</span>}<span><span>)</span>)</span><span><span>=</span>=</span>\frac{\mathrm{<span><span>1</span>1</span>}}{{\mathrm{<span><span>T</span>T</span>}}_{\mathrm{<span><span>c</span>c</span>}}}{<span><span>\&Integral;</span>\&Integral;</span>}_{\mathrm{<span><span>0</span>0</span>}}^{{\mathrm{<span><span>T</span>T</span>}}_{\mathrm{<span><span>c</span>c</span>}}}<span><span>(</span>(</span>\frac{{\mathrm{<span><span>P</span>P</span>}}_{\mathrm{<span><span>p</span>p</span>}}<span><span>(</span>(</span>\mathrm{<span><span>t</span>t</span>}<span><span>)</span>)</span>{\mathrm{<span><span>F</span>f</span>}}_{\mathrm{<span><span>p</span>p</span>}}<span><span>(</span>(</span>\mathrm{<span><span>t</span>t</span>}<span><span>)</span>)</span>}{{\mathrm{<span><span>P</span>P</span>}}_{\mathrm{<span><span>ap</span>ap</span>}}<span><span>(</span>(</span>\mathrm{<span><span>t</span>t</span>}<span><span>)</span>)</span>{\mathrm{<span><span>F</span>f</span>}}_{\mathrm{<span><span>ap</span>ap</span>}}<span><span>(</span>(</span>\mathrm{<span><span>t</span>t</span>}<span><span>)</span>)</span>}<span><span>)</span>)</span>\mathrm{<span><span>dt</span>dt</span>}$得到参考决策PAI，并将参考决策PAI显示出来，或者同时输出给体外灌注系统；Get the reference decision PAI, and display the reference decision PAI, or output it to the in vitro perfusion system at the same time;式中，PAI（ω）——体外循环灌注和心脏灌注的做功关系，In the formula, PAI (ω)—work relationship between extracorporeal circulation perfusion and cardiac perfusion,P_p(t)——体外循环灌注血泵的出口压力波形，P_p (t)——the outlet pressure waveform of extracorporeal circulation perfusion blood pump,Fp₍t)——体外循环灌注血泵的灌注血流量的波形，Fp₍ t )—the waveform of the perfusion blood flow of the extracorporeal circulation perfusion blood pump,P_ap(t)——动脉压的波形，P_ap (t) - waveform of arterial pressure,F_ap(t)——动脉血流量的波形，F_ap (t)—the waveform of arterial blood flow,T_c——心动周期，由心率得到；T_c ——cardiac cycle, obtained from heart rate;所述的静脉血氧饱和度和动脉血氧饱和度作为判别PAI（ω）是否为参考决策PAI的依据，如果动脉血氧饱和度>90％，静脉血氧饱和度维持在64～88％之间，PAI（ω）为推荐值，输出参考决策PAI。The venous blood oxygen saturation and arterial blood oxygen saturation are used as the basis for judging whether PAI (ω) is a reference decision-making PAI. If the arterial blood oxygen saturation is >90%, the venous blood oxygen saturation is maintained between 64% and 88%. , PAI (ω) is the recommended value, and the output refers to decision-making PAI.2.如权利要求1所述的一种体外循环灌注决策系统，其特征在于：所述参考决策PAI的依据为，2. A kind of extracorporeal circulation perfusion decision-making system as claimed in claim 1, characterized in that: the basis of the reference decision-making PAI is,1）动脉血氧饱和度>90％，静脉血氧饱和度维持在64～88％之间；1) Arterial oxygen saturation >90%, and venous oxygen saturation maintained between 64% and 88%;2）心率在根据公式118.1-(0.57×年龄）计算的值附近；2) The heart rate is near the value calculated according to the formula 118.1-(0.57×age);3）心输出量为4～7L/min，平均值为4～6.5L/min；3) The cardiac output is 4-7L/min, with an average of 4-6.5L/min;4）血压收缩压≤140mmHg(18.6kPa)，舒张压≤90mmHg(12kPa)。4) Blood pressure systolic pressure ≤ 140mmHg (18.6kPa), diastolic blood pressure ≤ 90mmHg (12kPa).

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