FIELD: medical equipment.
SUBSTANCE: group of inventions relates to medical equipment, namely to six variants of an apparatus (1) for artificial ventilation and three variants of the method for operating the apparatus (1) for artificial ventilation. In the first variant, the apparatus (1) for artificial ventilation of a patient comprises a fluid supply unit (2) and a fluid discharge unit (3), suitable for supplying a fluid medium (4) to the airway (5), i.e. into a part of the lung or into the lung, of the patient and for discharging the fluid medium (4) from the airway (5), respectively. The apparatus additionally comprises a control apparatus (6) configured to adjust, during the process of artificial ventilation of the airway (5), the pressure profile P (7) in cm of H2O in the airway (5) and the volume profile V (8) in ml of the fluid medium (4) supplied to the airway (5) and discharged from the airway (5), in accordance with V=fZP(P) and V=fAP(P) or in accordance with P=fZV(V) and P=fAV(V). The process of artificial ventilation is executed within the pressure interval (9) and within the volume interval (10). The process of artificial ventilation is adjustable by means of the control apparatus (6) so that a) the ratio of the absolute value of change of the first volume (12) present at the pressure P0(11) when the fluid medium (4) is supplied, i.e. dfAP/d(P) (P0), and the absolute value of change of the second volume (13) present at the same pressure P0 (11) when the fluid medium (4) is discharged, i.e. dfZP/d(P) (P0), above at least 60% of the pressure interval (9), or b) the ratio of the absolute value of change of the first pressure (15) present at the volume V0 (14) when the fluid medium (4) is supplied, i.e. dfAV/d(V) (V0), and the absolute value of change of the second pressure (16) present at the same volume V0 (14) when the fluid medium (4) is discharged, i.e. dfZV/d(V) (V0), above at least 60% of the volume interval (10), has a value of at least 0.5 and no greater than 2.0. In the second variant, the apparatus (1) for artificial ventilation comprises a visualisation apparatus (17) and is suitable for determining the profile of at least one volume-pressure curve in the volume-pressure diagram; wherein the curve has a first section (18) of the curve, V=fZP(P) or P=fZV(V), and a second section (19) of the curve, V=fAP(P) or P=fAV(V), wherein the first section (18) of the curve constitutes the profile of the supplied volume V (8) and pressure P (7) when the fluid medium (4) is supplied to at least one airway, and the second section (19) of the curve constitutes the profile of the discharged volume V (8) and pressure P (7) when the fluid medium (4) is discharged from at least one airway (5); wherein the process of artificial ventilation is executed within the pressure interval (9) and within the volume interval (10); wherein the control apparatus (6) is suitable for determining the area (20), wherein said area (20) in the volume-pressure diagram is defined by the first section (18) of the curve and the second section (19) of the curve of one process of artificial ventilation; wherein at least one of the following parameters can be visually discernibly displayed by means of an visualisation apparatus (17): a) a measure for the size of the area (20), or b) a measure for changing the area (20) during a combination of processes of artificial ventilation, or c) a measure for the ratio of the area (20) to the critical area (21) defined for a given patient, or d) a measure for changing the ratio of the area (20) to the critical area (21) defined for a given patient during a combination of processes of artificial ventilation. In the third variant of the apparatus (1) for artificial ventilation, by means of using the control apparatus (6), the process of artificial ventilation is adjustable so that when the fluid medium (4) is supplied and when the fluid (4) is discharged, the volumetric flow rate F(t) (26) in l/min varies by a maximum of 50% relative to the average volumetric flow rate FD (42) during the process of artificial ventilation for at least 80% of the duration of the process of artificial ventilation. In the fourth variant, the apparatus (1) for artificial ventilation comprises a visualisation apparatus (17) and is suitable for determining and adjusting the volumetric flow rate F(t) (26) in l/min of the fluid medium (4). The process of artificial ventilation is executed within the pressure interval (9) and within the volume interval (10). The control apparatus (6), assuming a resistance R (27) of the airway (5) of the patient, is suitable for determining the power loss PW(t) (28) in W of the airway in accordance with PW(t) = R1*(F(t))3+R2*(F(t))2, wherein R1=R in Pa/(m3/s)2 and R2=R in Pa/(m3/s); wherein at least one of the following parameters can be visually discernibly displayed by means of the visualisation apparatus (17): a) power loss PW(t) (28), or b) energy loss E (29) in J, namely, an integral PW(t)dt, i.e. ∫ PW(t)dt within a time interval, or c) a measure for the ratio of the power loss PW(t) (28) to the critical power loss (30) defined for a given patient, or d) a measure for the ratio of the energy loss E (29) to the critical energy loss (31) defined for a given patient. In the fifth variant of the apparatus (1) for artificial ventilation, by means of using the control apparatus (6), the process of artificial ventilation is adjustable so that when the fluid medium (4) is supplied and when the fluid medium (4) is discharged, squared velocity (s(t))2 (32) of the pressure profile P (7) in cm of H2O and the volume V (8) in ml, i.e. (s(t))2=(dP/dt)2+(dV/dt)2, varies by a maximum of 300% relative to the average squared velocity sD2 (43) during the process of artificial ventilation for at least 80% of the duration of the process of artificial ventilation. In the sixth variant, the apparatus (1) for artificial ventilation comprises a visualisation apparatus (13), and the control apparatus (6) is suitable for determining the squared velocity (s(t))2 (32) of the pressure profile P (7) in cm of H2O and the volume V (8) in ml when the fluid medium (4) is supplied and when the fluid medium (4) is discharged, i.e. (s(t))2=(dP/dt)2+(dV/dt)2, wherein at least one of the following parameters is displayed by means of the visualisation apparatus (17): a) the squared velocity s(t), i.e. (s(t))2, or b) the integral (s(t))2dt, i.e. ∫ (s(t))2dt, within a time interval, or c) a measure for the ratio of the squared velocity (s(t))2 (32) to the critical squared velocity (33) defined for a given patient, or d) a measure for the ratio of the integral (s(t))2dt to the critical value of this variable (34) defined for a given patient. In the first variant, the method for controlling the apparatus (1) for artificial ventilation includes stage a) of executing the process of artificial ventilation, wherein the process of artificial ventilation is executed within the pressure interval (9) and within the volume interval (10). The method also includes stage b) of determining or adjusting the profile of the volume-pressure curve on a volume-pressure diagram by means of a control apparatus (6) during the process of artificial ventilation. The curve has a first section (18) of the curve V=fZP(P) or P=fZV(V) and a second section (19) of the curve V=fAP(P) or P=fAV(V). The first section (18) of the curve represents the profile of the supplied volume V (8) and the pressure P (7) when the fluid medium (4) is supplied to the airway (5), and the second section (19) of the curve represents the profile of the discharged volume V (8) and pressure P (7) when the fluid medium (4) is discharged from the airway (5). By using the control apparatus (6), the process of artificial ventilation is adjusted so that (1) above at least 60% of the pressure interval (9), the ratio of the absolute value of a first inclination (23) of the first section (18) of the curve at the pressure P0 (11), i.e. dfAP/d(P) (P0), and the absolute value of a second inclination (24) of the second section (19) of the curve, i.e. dfAP/d(P) (P0), at the same pressure P0 (11) has a value of at least 0.5 and no greater than 2.0, or (2) above at least 60% of the volume interval (10), the ratio of the absolute value of the first inclination (23) of the first section (18) of the curve at the volume V0 (14), i.e. dfAV/d(V) (V0), and the absolute value of the second inclination (24) of the second section (19) of the curve, i.e. dfAV/d(V) (V0), at the same volume V0 (14), has a value of at least 0.5 and no greater than 2.0. In the second variant of the method, at stage b) of determining or adjusting the pressure profile P (7) in the airway (5) and the volume profile V (8) of the fluid medium (4) by means of using the control apparatus (6), the process of artificial ventilation is adjusted so that when the fluid medium (4) is supplied and when the fluid medium is discharged the volumetric flow rate F(t) (26) in l/min varies by a maximum of 50% relative to the average volumetric flow rate FD (42) during the process of artificial ventilation for at least 80% of the duration of the process of artificial ventilation. In the third variant of the method, when the fluid medium (4) is discharged, the squared velocity (s(t))2 (32) of the pressure profile P (7) in cm of H2O and the volume V (8) in ml, i.e. (s(t))2=(dP/dt)2+(dV/dt)2, varies by a maximum of 300% relative to the average squared velocity sD2 (43) during the process of artificial ventilation for at least 80% of the duration of the process of artificial ventilation.
EFFECT: technical result is a proposal of an improved apparatus for artificial ventilation and an improved method for artificial ventilation.
24 cl, 8 dwg
