Background
When the high-flow respiratory support device works, a user sets a desired flow and oxygen concentration, and then the high-flow respiratory support device provides a constant flow to deliver the air-oxygen mixed gas to a user end at the set flow value. And at the user end, a nasal oxygen tube is adopted to receive the gas transmitted by the equipment.
At present, most high-flow respiratory support devices do not detect the respiratory state of a user because the device end has difficulty in detecting obvious flow fluctuation because the high-flow respiratory support device aims at flow constant regulation.
However, without knowing the user's breathing state, it is not possible to estimate the user's basic physiological parameters, such as breathing rate, tidal volume, minute ventilation, etc. Therefore, whether the user is in the best state currently cannot be accurately known, if some users have low flow, the tidal volume is low due to airway narrowing, so that blood oxygen reduction occurs, and at the moment, if the value can be accurately monitored, the flow can be pertinently adjusted instead of increasing the oxygen concentration.
Traditionally, chinese patent (patent No. 201910857958.5) discloses a method of identifying a respiratory state, comprising: acquiring a respiratory signal; dividing the respiration signal into a plurality of intercepted signals; calculating the ratio of the total energy of a first preset frequency range to the total energy of a second preset frequency range in each intercepted signal, and recording the ratio of the total energy of the first preset frequency range to the total energy of the second preset frequency range as a total energy ratio; and comparing the total energy ratio in each intercepted signal with a first preset threshold value. The respiratory signal in the patent is a chest respiratory signal, namely a waveform signal curve, a large amount of calculation is needed to obtain the total energy value of the intercepted signal by intercepting the signal on the waveform signal curve, the requirement on hardware of respiratory support equipment is high, the equipment cost is increased inevitably, and meanwhile, the total energy value calculated in the patent cannot be used for calculating basic physiological parameters such as tidal volume, minute ventilation volume and the like.
Therefore, a method for identifying respiratory states with low computational and hardware requirements on the device is needed, and the physiological parameters of the user, such as tidal volume, minute ventilation and the like, can be estimated based on the method.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provides a method for identifying a respiratory state and application thereof, which can not only obtain the respiratory state of a user and have low requirement on hardware of a respiratory support device, but also estimate basic physiological parameters of the user such as tidal volume, minute ventilation volume and the like based on the method so as to make better adjustment.
In order to achieve the above object, the present invention provides a method of recognizing a respiratory state, comprising the steps of:
s1: detecting that the rotating speed of a real-time motor starts to reduce when the respiratory support equipment is in a load state, recording the time of the rotating speed of the motor starting to reduce as inspiration starting time TiStart, identifying that a user is in an inspiration phase until the rotating speed of the real-time motor starts to increase, recording the time of the rotating speed of the motor starting to increase as inspiration starting time TeStart, identifying that the user is in an expiration phase until the rotating speed of the real-time motor starts to decrease, circulating in sequence, and recording the starting time of each inspiration and each expiration as TiStart (n) and TeStart (n);
s2: obtaining the inspiration time and the expiration time of the nth breathing cycle of the user, namely:
the inspiration time is as follows: ti (t) tistart (t);
expiration time: te (n) ═ TiStart (n +1) -testart (n).
As a further improvement of the above solution, the method for identifying a respiratory state further includes step S3: the method comprises the following steps of obtaining a flow value of the respiratory support equipment and a corresponding motor rotating speed value of the respiratory support equipment in an idle state, and obtaining a relational expression between the flow and the motor rotating speed through fitting, namely: f ═ F (R), where R denotes motor speed and F denotes flow; setting the flow value of the respiratory support equipment to be F0, and obtaining the rotating speed R0 of the motor at the set flow F0 according to F ═ F (R);
as a further improvement of the above solution, in step S3, the respiratory support apparatus is in an unloaded state, that is, a state in which the respiratory support apparatus is not used by the user and the respiratory support apparatus is normally operated; the flow is measured by a flow sensor, the rotating speed of the motor is measured by a speed measuring sensor, the flow sensor and the speed measuring sensor respectively measure a group of flow values and corresponding rotating speed values, and then the group of flow values and the corresponding rotating speed values are fitted to obtain a relation formula F (F) (R) of the flow and the rotating speed of the motor.
As a further improvement of the above, in step S1, the respiratory support apparatus is in a loaded state, i.e., a state in which the user uses the respiratory support apparatus; in this state, detecting that the real-time motor rotating speed starts to decrease, and identifying that the user is in an inspiration phase, wherein the flow of the breathing support equipment is larger than a set flow F0, and the real-time motor rotating speed is larger than a rotating speed R0; and detecting that the rotating speed of the motor starts to rise, and identifying that the user is in an expiration stage, wherein the flow of the breathing support equipment is smaller than a set flow value F0, and the real-time rotating speed of the motor is smaller than the rotating speed R0.
As a further improvement of the above, in step S1, the start times tistart (n) and testart (n) of each inhalation and each exhalation of the user are stored in the storage device of the respiratory support apparatus.
As a further improvement of the above solution, in step S2, the calculation of the inspiration time and expiration time of the nth respiration cycle of the user is completed in the processor of the respiratory support apparatus, and the storage device is electrically connected with the processor.
The invention also provides a respiratory frequency monitoring method, which comprises the following steps:
obtained according to the above-mentioned method for recognizing respiratory state
Inspiration time period Ti (n) -TeStart (n) -TiStart (n) and
expiration time te (n) ═ TiStart (n +1) -testart (n);
estimating a respiratory rate of a user
The invention also provides a tidal volume monitoring method, which comprises the following steps:
s1: obtaining a relational expression F ═ F (R) of flow and motor rotating speed of the respiratory support equipment in an idle state based on a method for identifying a respiratory state, and obtaining theoretical flow F under the corresponding motor rotating speedtheoryThen measuring the actual flow under the state that the respiratory support equipment is loaded under the corresponding motor rotating speedQuantity Freal;
S2: with actual flow F under the load of the respiratory support apparatusrealSubtracting the theoretical flow F of the respiratory support apparatus in the idle statetheoryObtaining an actual respiration waveform of a user;
s3: integrating the respiratory waveform obtained in the step S2 to obtain the tidal volume, wherein the specific calculation formula is
As a further improvement of the scheme, Vte is selected as a final tidal volume reference index.
The invention also provides a method for monitoring the minute ventilation, which comprises the following steps:
a tidal volume Vti or Vte obtained based on the method for estimating the tidal volume;
BMP (n) of the respiratory rate obtained based on the method for estimating the respiratory rate;
the minute ventilation MV is obtained, where MV ═ Vte (or Vti) × bpm (n).
Due to the adoption of the technical scheme, the invention has the beneficial effects that:
1. the method for identifying the respiratory state of the invention utilizes the characteristic of constant flow of the high-flow respiratory support equipment, and needs to continuously adjust the rotating speed of the turbine motor in order to keep the flow stable, in particular, when the flow is greater than a set value F0, the rotating speed of the turbine motor needs to be reduced, so that the flow is recovered to the set value; similarly, when the flow rate is less than the set value F0, the rotation speed of the turbine motor needs to be increased, so that the flow rate is restored to the set value; meanwhile, when the user uses the high-flow respiratory support equipment, the flow of the high-flow respiratory support equipment is increased by inhaling the air, and the flow is detected to be larger than a set value F0; the respiration state is identified by detecting the adjustment condition of the motor speed, specifically, when the respiration support device is in a load state, the real-time motor speed is detected to start to reduce, the time for the motor speed to start to reduce is recorded as inspiration start time TiStart, the user is identified in an inspiration phase until the real-time motor speed is detected to start to increase, the time for the motor speed to start to increase is recorded as inspiration start time TeStart, the user is in an expiration phase until the real-time motor speed is detected to start to reduce, the starting time of each inspiration and each expiration is recorded as TiStart (n) and TeStart (n) in turn, the inspiration time and the expiration time of the nth respiration cycle of the user are obtained, and the purpose of identifying the respiration state of the user is achieved, the invention identifies the respiratory state of the user by utilizing the relation between the flow and the rotating speed of the motor, has simple method, small calculated amount and low requirement on hardware of high-flow respiratory support equipment.
2. According to the method for identifying the respiratory state, the respiratory frequency can be calculated based on the inspiration time and the expiration time obtained by the method for identifying the respiratory state, and the calculation is simple and convenient; meanwhile, the actual respiratory waveform of the user is obtained based on the difference between the flow of the respiratory support equipment without respiration and the theoretical flow, which is obtained by the method for identifying the respiratory state, and the tidal volume is obtained based on the actual respiratory waveform; and then the minute ventilation of the patient is obtained by combining the tidal volume and the respiratory frequency, so that the parameters of the respiratory state are the basis for estimating basic physiological parameters of the tidal volume, the minute ventilation and the like of the user, and after the effective parameters of the respiratory state are obtained, the basic physiological parameters of the user can be more easily obtained.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
The invention is further described below with reference to the following figures and specific embodiments:
example 1:
the invention provides a method for identifying a respiratory state, which comprises the following steps:
s1: the method comprises the following steps of obtaining a flow value of the respiratory support equipment and a corresponding motor rotating speed value of the respiratory support equipment in an idle state, and obtaining a relational expression between the flow and the motor rotating speed through fitting, namely: f ═ F (R), where R denotes motor speed and F denotes flow; setting the flow value of the respiratory support equipment to be F0, and obtaining the rotating speed R0 of the motor at the set flow F0 according to F ═ F (R);
s2: detecting that the rotating speed of a real-time motor starts to reduce when the respiratory support equipment is in a load state, recording the time of the rotating speed of the motor starting to reduce as inspiration starting time TiStart, identifying that a user is in an inspiration phase until the rotating speed of the real-time motor starts to increase, recording the time of the rotating speed of the motor starting to increase as inspiration starting time TeStart, identifying that the user is in an expiration phase until the rotating speed of the real-time motor starts to decrease, circulating in sequence, and recording the starting time of each inspiration and each expiration as TiStart (n) and TeStart (n);
s3: obtaining the inspiration time and the expiration time of the nth breathing cycle of the user, namely:
the inspiration time is as follows: ti (t) tistart (t);
expiration time: te (n) ═ TiStart (n +1) -testart (n).
The characteristic that the flow of the high-flow respiratory support equipment is constant is utilized, the rotating speed of the turbine motor needs to be continuously adjusted in order to keep the flow stable, and particularly, when the flow is larger than a set value F0, the rotating speed of the turbine motor needs to be reduced, so that the flow is recovered to the set value; similarly, when the flow rate is less than the set value F0, the rotation speed of the turbine motor needs to be increased, so that the flow rate is restored to the set value; meanwhile, when the user uses the high-flow respiratory support equipment, the flow of the high-flow respiratory support equipment is increased by inhaling the air, and the flow is detected to be larger than a set value F0; the respiration state is identified by detecting the regulation condition of the motor rotating speed, specifically, the respiration support equipment detects that the real-time motor rotating speed begins to reduce by a speed measuring sensor in a load state, the time for the motor rotating speed to reduce is recorded as inspiration starting time TiStart, the user is identified to be in an inspiration phase until the speed measuring sensor detects that the real-time motor rotating speed begins to increase, the time for the motor rotating speed to start to increase is recorded as inspiration starting time TeStart, the user is identified to be in an expiration phase until the speed measuring sensor detects that the real-time motor rotating speed begins to reduce, the circulation is sequentially recorded, the starting time of each inspiration and each expiration is recorded as TiStart (n) and TeStart (n), and the TiStart (n) and TeStart (n) are stored in a storage device of the respiration support equipment, the breathing state of the user is identified by utilizing the relation between the flow and the rotating speed of the motor, the method is simple, the calculated amount is small, and the requirement on hardware of high-flow breathing support equipment is low.
As a preferred embodiment, in step S1, the respiratory support apparatus is in an unloaded state, i.e. a state in which the respiratory support apparatus is not used by the user and the respiratory support apparatus is operating normally; the flow is measured by a flow sensor, the rotating speed of the motor is measured by a speed measuring sensor, the flow sensor and the speed measuring sensor respectively measure a group of flow values and corresponding rotating speed values, and then the group of flow values and the corresponding rotating speed values are fitted to obtain a relation formula F (F) (R) of the flow and the rotating speed of the motor.
As a preferred embodiment, in step S2, the respiratory support apparatus is in a loaded state, i.e. a state in which the user is using the respiratory support apparatus; in this state, detecting that the real-time motor rotating speed starts to decrease, and identifying that the user is in an inspiration phase, wherein the flow of the breathing support equipment is larger than a set flow F0, and the real-time motor rotating speed is larger than a rotating speed R0; and detecting that the rotating speed of the motor starts to rise, and identifying that the user is in an expiration stage, wherein the flow of the breathing support equipment is smaller than a set flow value F0, and the real-time rotating speed of the motor is smaller than the rotating speed R0.
As a preferred embodiment, in step S3, the calculation of the inspiration time and expiration time of the nth respiration cycle of the user is completed in a processor of the respiratory support apparatus, and the storage device is electrically connected to the processor.
It should be noted that, when the flow sensor of the high-flow respiratory support apparatus detects that the flow rate becomes larger or smaller and exceeds the allowable normal fluctuation range, the rotation speed of the motor is correspondingly adjusted to make the flow rate fall back to the range of F0 ± only.
Example 2:
in order to monitor the respiratory rate of the user to know whether the user is in the best state currently, the invention also provides a respiratory rate monitoring method, which comprises the following steps:
the inspiration time ti (n) ═ testart (n) — tistart (n) and obtained according to the above method of identifying the respiratory state
Expiration time te (n) ═ TiStart (n +1) -testart (n);
estimating a respiratory rate of a user
The breathing frequency of the user is estimated by obtaining the inspiration time and the expiration time of the user based on the method for recognizing the breathing state, and the method is simple and reliable.
Example 3:
in order to monitor the tidal volume of the user to know whether the user is in the best state currently, the invention also provides a tidal volume monitoring method, which comprises the following steps:
s1: obtaining a relation formula F ═ F (R) of flow and motor rotating speed of the respiratory support equipment in an idle state based on a method for identifying a respiratory state to obtain theoretical flow F under the corresponding motor rotating speedtheoryThen measuring the actual flow F under the condition that the respiratory support equipment is loaded under the corresponding motor rotating speedrealHere the theoretical flow rate FtheoryAnd the actual flow rate FrealIs a function curve relating to the corresponding motor speed;
s2: referring to fig. 1, the actual flow F under load of the respiratory support device is usedrealSubtracting the theoretical flow F of the respiratory support apparatus in the idle statetheoryObtaining an actual respiration waveform of a user;
s3: integrating the respiratory waveform obtained in the step S2 to obtain the tidal volume, wherein the specific calculation formula is
As a further improvement of the scheme, Vte is selected as a final tidal volume reference index.
Generally, the tidal volume of the breath of a normal adult is generally set to be 5-15ml/kg, the respiratory frequency is 15-20 times/minute, and when the tidal volume or the respiratory frequency of a user monitored by the respiratory support equipment exceed the normal value, relevant parameters such as the flow and the like are timely adjusted, so that discomfort of the user is avoided. For example, in clinical practice, when the tidal volume of some users is low, the tidal volume is low, and blood oxygen may be reduced due to airway stenosis, and at this time, if the tidal volume of the users can be accurately monitored, the flow can be adjusted in a targeted manner, rather than increasing the oxygen concentration.
Example 4:
the invention also provides a method for monitoring the minute ventilation, which comprises the following steps:
a tidal volume Vti or Vte obtained based on the method for estimating the tidal volume;
BMP (n) of the respiratory rate obtained based on the method for estimating the respiratory rate;
the minute ventilation MV is obtained, where MV ═ Vte (or Vti) × bpm (n).
The breathing frequency can be calculated based on the inspiration time and the expiration time obtained by the method for identifying the breathing state, and the calculation is simple and convenient; meanwhile, the actual respiratory waveform of the user is obtained based on the difference between the flow of the respiratory support equipment without respiration and the theoretical flow, which is obtained by the method for identifying the respiratory state, and the tidal volume is obtained based on the actual respiratory waveform; and the minute ventilation of the patient is obtained by combining the tidal volume and the respiratory frequency, so that the parameters of the respiratory state are the basis for estimating basic physiological parameters of the tidal volume, the minute ventilation and the like of the user, and after the effective parameters of the respiratory state are obtained, the basic physiological parameters of the user can be more easily obtained, so that the adjustment can be made according to the basic physiological parameters of the user, and the comfort level of the user is improved.
The foregoing is a detailed description of the invention, and specific examples are used herein to explain the principles and implementations of the invention, the above description being merely intended to facilitate an understanding of the principles and core concepts of the invention. It should be noted that, for those skilled in the art, it is possible to make various improvements and modifications to the present invention without departing from the principle of the present invention, and those improvements and modifications also fall within the scope of the claims of the present invention.