RU2745261C1 - Complex for the centralized distribution of the pressure of the respiratory mixture for simultaneous and individual artificial ventilation of the lungs (avl) to a group of patients and an individual gas distribution unit providing an individual patient with individual avl with the help of the complex - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: group of inventions relates to a complex for centralized distribution of the pressure of the respiratory mixture for simultaneous artificial ventilation of the lungs (AVL) to a group of patients. The group of inventions is intended for a collective procedure of mechanical ventilation in a group of patients. It also relates to an individual gas distribution unit and a hardware and software center used in the complex. The complex uses a compressor, a system of sealed tubes, a system of air valves, a system for the formation of an air-respiratory mixture in its physical and chemical composition and physical characteristics. The complex consists of a pressure profile, which is a system of sealed tubes used unified for the entire group of patients and equipment for the formation and maintenance of positive and negative pressure in the ventilation system. The complex uses an individual gas distribution unit made with the ability to provide individual equipment for each patient for the implementation of an individual ventilation procedure. The complex includes the use of a hardware and software center and software for the implementation, management, and control of the functioning of the ventilation procedure. The complex uses compensating cylinders for accumulating high and low pressure. The accumulated pressure reserve of these cylinders is used to smooth out pressure drops in the pressure profile during the implementation of ventilation procedures as well as to quickly restore the pressure in the profile when it deviates from the norm as well as to temporarily maintain the pressure in the system during a short-term compressor shutdown. The pressure profile has a system of valves controlled by the program for controlling the ventilation procedure using the software of the complex and a system of emergency relief valves uncontrolled by the program. The pressure profile has a system of pressure sensors connected with the complex control system the readings of which are used by the system for the correct implementation of the ventilation procedure. An individual gas distribution unit determines the ventilation procedure on the basis of the functioning of its elements according to an individual program provided by a given control system through the functioning of its own valves, pressure sensors and additional equipment for forming a breathing mixture formulation. The individual gas distribution unit determines the ventilation procedure that is individual for each individual patient including individual time, speed, frequency and volume of inhalation or exhalation, the air-respiratory mixture in its physical and chemical composition and physical characteristics. The hardware and software center is a computerized system, which can be external or internal, with software installed on it. It combines all the elements of the ventilation system, controls the operation of all system mechanisms, collects information from all system sensors.

EFFECT: reduction in cost and simplification of manufacturing and transportation, implementation of individual ventilation programs for an almost unlimited number of patients.

15 cl, 3 dwg

Description

Engineering area:

The invention relates to medical equipment, in particular to complexes and systems for artificial ventilation of the lungs (IVL), groups of patients located in one or a nearby premises, in a hospital, and in mobile field hospitals.

The declared complex is designed to provide a high-quality ventilation procedure, to an unlimited number of patients, using relatively simple, small-sized, and cheap components.

A fundamentally new principle of gas distribution for mechanical ventilation is proposed. The declared complex consists of one, single, common for the entire complex, a system of two pipelines (pressure pipes, "pressure circuit"), and individual individual for each patient "gas distribution blocks".

The declared complex is of particular value for the emergency organization of mechanical ventilation for a large number of patients, for example, due to tragic emergencies, disasters, pandemics, with a sudden appearance of a large number of patients in need of mechanical ventilation.

A single pipeline system (pressure circuit), to create the required pressure, can be assembled at the hospitalization site from improvised, non-medical, widespread materials and equipment. Individual gas distribution units are light, small, low-cost, resistant to mechanical damage, so they (like the pressure circuit equipment) can be delivered to the emergency site, in large quantities, by parachute dropping from an aircraft.

Vehicle tier:

Currently, ventilators are widely used with their own mechanism for active injection and release of air, in the form of a compressor, bellows, piston, etc. Moreover, for each patient there is one, whole, separate ventilator, and therefore one, whole, separate air injection system ...

All solutions of ventilation systems used today are equally far from the declared concept of ventilation.

Problem:

A feature of disaster medicine is the fact that in a peaceful period, outside of an emergency, not many ventilators are needed, but during an emergency and / or a pandemic, the need for ventilators increases dramatically. Due to the high cost and large dimensions of a standard ventilator, with the principle of use: one ventilator, one patient, the existing ventilator concept is not able to cope with the tasks of emergency situations.

Recently (pandemics) have shown that there is a shortage of ventilators all over the world. Attempts to connect multiple patients to one ventilator are detrimental to patient health.

100% cross-contamination of patients through one device. One apparatus, one physicochemical setting, one cycle, all patients of different constitutions, different ages, different lung volumes, different diseases ... are forced to inhale in one cycle. The efficiency of the ventilator decreases in direct proportion to the increase in the number of connected ones.

The devices used are also extremely bulky and large in size, extremely heavy and unwieldy, extremely fragile for mechanical damage and expensive.

If there are no or few patients on mechanical ventilation, the devices simply have nowhere to store, because of their large dimensions and weight, they take up a lot of space. Due to their high cost, there are always few devices, and in the event of an emergency, they will always be lacking.

Due to its large size, mass, and fragility, it is simply impossible to quickly and safely transport devices from places where there is an excess of them to a place where their critical drawback is simply impossible.

Despite the fact that in some circumstances, in some institutions, doctors try to connect more than one patient to one ventilator (usually 2), This is extremely risky, according to many doctors it is dangerous and significantly reduces the efficiency of the device. This is done, as a rule, from hopelessness, and not from expediency, since one ventilator implements only one concept of the procedure, one mode of physical and mechanical parameters of the process, and one physicochemical quality of the air mixture.

First of all, the main purpose of using respiratory support is to maintain normal intrapulmonary gas exchange, and this goal is not achieved by “distributing ventilation” from one device to several patients. The biomechanical properties of the chest-lung system are different in all severe patients (and others are not ventilated!). As a result, no matter what ventilation mode you choose, it will be suitable at best for one of them, and after a while it will not suit him either. We emphasize that we are talking not only about volume control, when an improvement in compliance in one person risks ruining the other three, but also about pressure control: patients with different lungs need different values of PEEP, inspiratory pressure and plateau pressure. And even if you select a group of patients with approximately the same data (which in reality is impossible), after a few tens of minutes these needs will become completely different! Also, the extensibility of the breathing circuit, branched into several patients, is great, which will take up a large volume, from patients, for each millibar of applied pressure.

In addition, ventilation, in which the doctor is unable to control the parameters (for example, the tidal volume!) Of each patient, naturally jeopardizes in the legal sense: the legal formula is "urgent need", when violation of regulations is the only way to avoid serious consequences , in this case it is inappropriate, since the consequences of such actions are just grave and will turn out to be ...

Task:

1. To develop an innovative concept of ventilation, a set of equipment for the implementation of ventilation, software for ventilation management.

2. The declared complex must provide the mechanical ventilation procedure to an unlimited number of patients, while each patient receives mechanical ventilation with individual characteristics.

3. The declared complex should have a lower cost price

4. The declared complex should have smaller dimensions and weight

5. The declared complex should be simple and easy to transport, assemble, disassemble

6. The declared complex must be functionally resistant to mechanical shock and damage

7. The software must meet the requirements of the modern Internet of Things, including digital security.

Technical result: Innovative ventilation system:

- not expensive at cost;

- for the implementation of individual ventilation programs for an almost unlimited number of patients;

- easy to install and operate;

- lightweight and small-sized;

- easy and safe to carry, transported;

- Some elements of the system (pressure bureaus) can be assembled from non-medical, widespread materials, without harm to human quality and safety;

- In the period when there is no need for use during storage, they occupy a small volume;

- If it is necessary to deliver to the place of emergency, they can be easily and safely transported, including by air, up to being thrown to the place by parachute !.

Disclosure of the essence of a group of inventions:

"A complex for centralized distribution of the pressure of the breathing mixture for simultaneous and individual artificial ventilation of the lungs (IVL) for a group of patients, and an individual gas distribution unit for the implementation of an individual procedure for a patient with ventilation."

1. The declared complex of mechanical ventilation is designed to provide a high-quality ventilation procedure, to an unlimited number of patients, using relatively simple, small-sized, and cheap components.

The claimed version offers a fundamentally different principle and mechanism for air injection and bleeding.

The control system for all ventilation parameters is individual for each patient, can be set by the program or changed at any time in the online operator mode.

The declared complex is of particular value for the emergency organization of mechanical ventilation for a large number of patients, for example, due to tragic emergencies, disasters, pandemics, with a sudden appearance of a large number of patients in need of mechanical ventilation.

A single pipeline system (pressure circuit), to create the required pressure, can be assembled at the hospitalization site from improvised, non-medical, widespread materials and equipment. Individual gas distribution blocks are lightweight, small-sized, low-cost, resistant to mechanical damage, so they (like the pressure circuit equipment) can be delivered to the emergency site by parachuting from an aircraft.

The operation of the complex can be controlled and programmed via the Internet, including through devices.

A system of two parallel pipelines: in one pipe there is an increased pressure (above atmospheric) for pumping the lungs while inhaling, in the second pipe there is a reduced pressure (below atmospheric). For the entire complex, for the entire group of patients, one (single) pump pumps air into the inspiratory tube, it or the only second pump pumps air out of the exhalation tube. Pressure sensors monitor the pressure in the pipes. The system does not matter how many patients connect to it or disconnect from it. Pressure sensors on the pressure circuit automatically command the pump (s) to increase power (increasing pressure) or decrease power (decreasing pressure. Maintaining the pressure at the desired level in both pipes.

The gas distribution unit is individual for each person, it is he who contains valves and pressure sensors on the pipe side and on the patient's side. By opening the valve with the inspiratory tube, the system allows air from the inspiratory tube, under pressure, to enter the lungs. Both the pressure and the volume of the gas mixture for inhalation are programmed by the system and the program, individually for each patient.

After inhalation, or rather after reaching the pressure in the lungs of a certain predetermined parameter, the valve of the inhalation tube closes, and the valve of the exhalation tube opens. Since there is negative pressure in the exhalation tube, air from the lungs is drawn into the exhalation tube.

For natural exhalation (if necessary), the valve opens not into the exhalation tube, but into the environment (with atmospheric pressure) if the patient is not infectious, or into a closed container with atmospheric pressure if the patient is infectious.

For active exhalation by chest compression, motorized belts are used to tighten the chest and abdomen (diaphragm) as you exhale. The harness elements work in one piece with the mask valve elements.

Emergency valves that relieve excess pressure (positive or negative) in case of inadequate operation of the equipment. Emergency valve trips are recorded to identify problems and upgrade equipment and control programs.

Optionally, sensors are installed on the patient's respiratory muscles that read signals of the activity of the respiratory muscles, adjusting the ventilation work to the attempts (attempts) of the patient to breathe.

2. A fundamentally new principle of gas distribution for ventilation purposes has been proposed. The declared complex consists of:

2.1. - one, single, common for the whole complex, a system of two pipelines, hereinafter "pressure pipes", or "pressure circuit" (figure 1).

2.2. - separate, individual for each patient, mechanisms for distributing the pressure of the gas breathing mixture, hereinafter: "gas distribution block", or "gas distribution block" (figure 2).

2.3. - a software package consisting of computer equipment and software designed to monitor and control the operation of the declared ventilation complex.

3. The pressure loop (FIG. 1) is:

- a pair of sealed piping systems,

- one or two compressors,

- complex of compensatory gas chambers, cylinders (optional)

- pressure sensors,

- gas valves with electric drive,

- analog gas valves, emergency for relieving excess pressure, with a mechanical opening mechanism in automatic mode, not controlled by the program

- additional equipment for the formation of an air breathing mixture, or disinfection of the exhaled air (optional)

3.1. In a pressure loop, pressure is both positive and negative generated by the air compressor (s). If the cycle of movement of the air mixture is closed, when the same air is prepared for inhalation that was exhaled, then one compressor is sufficient (figure 1, element 1). If the expiratory air is discharged into the environment, and the inhalation air is taken from the environment, at least 2 compressors are required, the first compressor (el1) pumps air from the environment into the system, creating a positive pressure in the system, the second compressor (el2) pumps out air from the system, creating negative pressure in the system.

Figure 2 shows schematically a set of elements of the ventilator complex, with the ability to work with both one compressor and two.

In emergency cases, an emergency, a compressor may not be medical, but technical, provided that the pumped air is maintained in an unchanged state, in a quality that is safe for humans.

3.2. The pressure circuit piping system is designed to deliver to the patient, or rather to the patient's individual gas distribution unit, positive (through the inhalation tube) and negative (through the exhalation tube) pressure of the breathing gas mixture. The piping system must be sealed, inelastic, harmless to human health.

In a pair of the pressure circuit piping system, in one pipe (inhalation) (Fig. 1 el3), through the operation of the compressor (Fig. 1 el1), a pressure above atmospheric pressure is created to implement the inhalation of all patients, this pipe system is called the "inhalation pipe". In Fig. 1, the inspiratory tube and the inspiratory tube elements are filled with plus (+) symbols, which means division above atmospheric. The pressure in the inspiratory tube is constantly and evenly increased. The compressor does not determine the quality of inspiration in the ventilation procedure, the compressor sets the physical parameters of the overpressure in the inspiratory tube so that the gas distribution unit (el "block"), using the overpressure of the inspiratory tube, opening the valve between itself and the inspiratory tube (el 12.4), can initiate filling the patient's lungs with the breathing mixture, by means of a pressure equalization mechanism between the inspiratory tube and the patient's lungs.

In the second pipe (expiration) (Fig. 1 el 4), through the operation of compressor No. 1 (Fig. 1 el1, if the system is closed), or compressor No. 2 (Fig. 1 el2, if the system is not closed), a pressure is created below atmospheric pressure for the implementation of exhalations In all patients, this tube system is called the "expiratory tube".

In Fig. 1, the expiratory tube and the elements of the expiratory tube are filled with minus (-) symbols, which means division below atmospheric.

The pressure in the expiratory tube is constantly and evenly reduced. The compressor does not determine the quality of expiration in the ventilation procedure, the compressor sets the physical parameters of negative pressure in the expiratory tube so that the gas distribution unit (el “block”), using the negative pressure of the expiratory tube, opening the valve between itself and the expiratory tube (el 12.5), can initiate removal breathing gas from the patient's lungs, by means of a pressure equalization mechanism between the exhalation tube and the patient's lungs.

The pressure in the tubes creates a physical and mechanical condition for inhalation or exhalation, through equalizing the pressure in the communicating cavities, but does not determine the time, speed, intensity, frequency, and volume of inhalation or exhalation. The pressure in both pipes is set by the program and maintained automatically. The more patients are connected to the ventilator of the complex, the more actively the compressors will blurt out, constantly maintaining positive pressure in the inhalation tube and negative pressure in the exhalation tube.

Pipes and other elements of the pressure circuit are made and / or assembled from any materials resistant to pressure loads and harmless to human health. In emergency situations of emergency, not medical, but construction pipeline elements can be used for the circuit.

3.3. Both on the line of the inspiratory tube and on the line of the expiratory tube, there are compensatory tanks (hereinafter referred to as “compensatory balloons” (el 5, 6), balloon-shaped tanks capable of withstanding high pressure. They are designed to compensate for pressure drops in the system.

Expansion cylinders are designed for a high (low) pressure reserve, to compensate for pressure surges caused by:

- Compressors interruption, short-term compressor shutdown, or short-term increase in compressor capacity.

- Connecting or disconnecting patients to the ventilation system.

- Pressure drops associated with the synchronization of inspirations and expirations of a group of patients. When patients inhale and exhale at the same time, unwanted pressure surges occur in the system. These fluctuations are compensated not by changing the power of the compressor, but by changing the throughput of the valves between the compensating cylinders (el 5,6) and gas distribution blocks (el "block").

- Due to the fact that changes in pressure in the inspiratory and expiratory system can be short-term, unforeseen, abrupt, it is impractical and impossible to compensate for these pressure drops by changing the power of the compressor. This differential is compensated for by the pressure reserve in the compensator bladders, by slightly opening or closing the valves between the compensator bladders and the inspiratory / expiratory tube.

Thus, during joint inhalation, the system more opens the valve from the compensatory balloon of the inspiratory tube into the system, and less opens the valve from the compensatory balloon of the expiratory tube into the system. And with joint exhalation, the system removes the valve from the compensatory balloon of the inspiratory tube into the system less, and more opens the valve from the compensatory balloon of the expiratory tube into the system.

Since the need for such changes depends on the patient's condition, is very mobile and unpredictable in advance, it is impossible and not advisable to regulate by changing the power of a large compressor. Thanks to the software of the claimed complex, which, using pressure sensors (Fig. 1.el 13, Fig. 2, electrical 13.1, 13.2., 13.3, 13.4), controls the pressure in all parts of the system, which finely and accurately controls all the valves of the system, which analyzes the respiratory the activity of each individual patient, and can with a degree of probability predict respiratory activity in the future.

In the event that, due to a power outage, the compressors stop working, the reserves of positive and negative pressure stored in the compensating cylinders will allow the system to work for a while, without a compressor. At the same time, the air mixture is automatically saturated with oxygen, due to the same oxygen, the pressure in the inhalation tube is maintained. The frequency and volume of respiratory movements, at the same time, decreases.

In the absence of compensatory balloons, in an emergency, when it is critical to perform mechanical ventilation, the system can operate without compensatory balloons. The pressure is partly compensated by changes in the compressor power, partly by the actuation of emergency valves, which release excessive pressure, both in the part of the inspiratory tube (avoiding unacceptably high pressure) and in the part of the exhalation tube (avoiding unacceptably low pressure).

3.4. Equipment for preparation and processing of air breathing mixture, at the level of the pressure circuit:

3.4.1. To increase the oxygen concentration in the air mixture, at some interval of the inhalation tube, a mechanism for saturating the mixture with oxygen (El 7) is arranged. In figure 1, the saturation mechanism is arranged on the compensatory balloon of the inspiratory tube. If the air circuit is closed, more oxygen is needed. Since at the level of the pressure circuit, the gas mixture is prepared for all patients, the oxygen concentration is prepared to a minimum. Additional oxygen concentrations required for a particular patient are added to the system at the level of the individual valve timing unit (figure 2, el 19).

3.4.2. To moisten the air mixture, at some interval of the inhalation tube, a mechanism for saturating the mixture with water vapor is arranged (El 8). In figure 1, the mechanism for saturating the mixture with steam is arranged on the compensatory balloon of the inhalation tube. If the air cycle is closed, humidification is not required, since the air is sufficiently humid during exhalation, and even requires dehumidification. Since at the level of the pressure circuit, the gas mixture is prepared for all patients, the humidity level is prepared to a minimum. Additional moisture concentrations required for a particular patient are added to the system at the level of the individual valve block (figure 2, el. 20).

3.4.3. From the inspiratory pipe (el 3), the ready-made gas mixture, under the pressure of the inspiratory pipe, through the inlet (inlet) valve of the individual gas distribution unit (el 12.4), enters the gas distribution unit (el. "Block" (B)) and into the patient's lungs. At the stage of the gas distributor, the required, individual amount of oxygen, water vapor, drugs is added to the gas mixture.

Gas is exhaled from the lungs naturally (without using the negative pressure of the exhalation tube), or actively, by sucking air into the exhalation tube, in which the pressure is below atmospheric.

At the exit from the lungs, at the level of the gas distributor, there is a device for the removal of exhalation gases for analyzes (Fig. 2, el. 21). And also replaceable filters for cleaning the exhaled air from solid and liquid elements. From the lungs, or rather from the gas distributor block, air is sucked into the exhalation pipe through the gas distributor outlet valve (el 12.5). Through the exhalation tube, the exhaled gas goes into the compressor, or into the environment.

3.4.4. When moving along the exhalation pipe, if it is necessary to clean and disinfect the exhaled air, for example, in case of infectious pulmonary diseases, the air passes through the disinfection and disinfection unit, then the “purification unit” (el 9), optional.

3.4.5. After the cleaning unit, if a closed cycle of gas movement is used, carbon dioxide (el 10) is removed from the gas. In figure 1, the mechanism for removing carbon dioxide from the mixture is arranged on the compensatory balloon of the exhalation tube (optional).

If the gas cycle is not closed and the exhaled air is removed into the environment, there is no need to clean the exhaled air from carbon dioxide.

3.4.6. After the cleaning unit, if a closed cycle of gas movement is used, excess moisture (el 10) is removed from the gas. In figure 1, the mechanism for removing moisture from the mixture is arranged on the compensatory balloon of the exhalation tube (optional).

If the gas cycle is not closed and the exhaled air is removed into the environment, there is no need to clean the exhaled air from water.

3.4.7. With a certain frequency associated with the loading of the system, the air ducts and elements of the exhalation pipe are dismantled, disassembled, washed, disinfected, and assembled. A replaceable set of pipelines is provided for cleaning the system.

3.5. Valve systems of the declared ventilation complex in terms of the pressure circuit.

The valves are controlled and controlled by the program of the declared complex. The function of the valves: - to open, helping to equalize the pressure in the communicating cavities, or; - close, preventing pressure equalization in the communicating cavities. Valves are more often program controlled, but may not be controllable.

Below are descriptions of the valves in the order in which the breathing air moves from the compressor to the compressor.

3.5.1. a valve between the compressor and the inspiratory tube compensating cylinder (el 12.1). It operates according to the "nipple" system, analog, passes air only in one direction, from the compressor to the compensatory balloon of the inhalation pipe. If the compressor stops, prevents the pressure of the inspiratory tube expansion balloon from being vented through the compressor. The program is not controlled.

3.5.2. a valve between the compensating cylinder of the inspiratory tube and the inspiratory tube (el 12.2). We manage the program, it functions to maintain the pressure in the inspiratory tube at a certain level.

3.5.3. Inspiratory pipe emergency valve (el 12.3), in case of system failure and an unreasonable and inadequate increase in pressure in the inspiratory pipe, when the pressure reaches a certain value, the valve automatically releases air. The valve is automatic, mechanical, analog, not controlled by the program.

3.5.4. valve between the inspiratory tube and the individual gas distribution unit (el

12.4) "inlet valve of the gas distribution block". We manage the program, it functions in order to maintain the pressure in the gas distributor itself during inhalation, and therefore in the patient's lungs. For inhalation, the valve opens (with the gas distributor outlet valve closed), air from the increased pressure of the inhalation pipe fills the lung cavity, when inhalation is reached, the valve closes.

3.5.5. valve between the individual gas distribution unit and the exhalation pipe (el

12.5) "exhaust valve of the gas distribution block". We manage the program, it functions to maintain the pressure in the gas distributor itself during exhalation, and therefore in the patient's lungs. For active exhalation, the valve opens (when the inlet valve of the gas distributor is closed), air from the lung cavity is vented into the cavity of the exhalation tube, where the pressure is reduced, when exhalation is reached, the outlet valve closes. During passive exhalation, the outlet valve does not open, the lung cavity does not connect to the cavity of the exhalation tube, but the passive exhalation valve opens (Fig. 2 e 17), which connects the lung cavity to the environment.

3.5.6. in the cavity of the gas distribution block there are emergency valves (Fig. 2, el 12.11, 12.12), for bleeding and excessively high and excessively low pressure. In the event of a system failure and an unreasonable and inadequate increase or decrease in pressure in the gas distribution block, which is directly connected to the lungs, in order to prevent barometric pressure, when the pressure reaches a certain positive or negative critical value, the valves automatically open, bleeding air in the right direction. The valves are automatic, mechanical, analog, not controlled by the program.

3.5.6. Exhalation pipe emergency valve (el 12.6), in case of system failure and unreasonable and inadequate pressure decrease in the exhalation pipe, when the pressure reaches a certain value, the valve automatically releases air into the exhalation pipe. The valve is automatic, mechanical, analog, not controlled by the program.

3.5.7. a valve between the inspiratory tube and the compensatory balloon of the expiratory tube (el 12.7). We manage the program, it functions to maintain the pressure in the exhalation tube at a certain level.

3.5.8. a valve between the expansion tube of the expiratory tube and compressor No. 2 (pumping air from the expiratory tube into the surrounding atmosphere) (el 12.8).

In case the air cycle is closed and air is pumped by one compressor # 1. this valve is closed, compressor # 2 is not working. If the air cycle is not closed, this valve is open, compressor # 2 is working.

We manage the program at the open / closed level. It functions to maintain the pressure in the compensatory balloon of the expiratory tube at a certain level.

It operates according to the "nipple" system, analog, passes air only in one direction, from the compensatory balloon of the inhalation pipe to the compressor. In case the compressor stops, it does not allow the pressure of the expansion cylinder to escape through the compressor.

3.5.9. a valve between the compensatory balloon of the expiratory tube and compressor No. 1 (pumping air from the expiratory tube in a closed cycle) (el 12.9).

If the air cycle is not closed and the air is pumped by one compressor # 2. this valve is closed, compressor # 1 works only for pumping the inspiratory tube. If the air cycle is closed, this valve is open, compressor # 1 works both to pump the inhalation pipe and to pump out the exhalation pipe, compressor 2 does not work, valve 12.7. closed.

We manage the program, at the (open / closed) level. It functions to maintain the pressure in the compensatory balloon of the expiratory tube at a certain level.

It operates according to the "nipple" system, analog, passes air only in one direction, from the compensatory balloon of the inhalation pipe to the compressor. In case the compressor stops, it does not allow the pressure of the expansion cylinder to escape through the compressor.

3.5.10. air intake valve for compressor No. 1 (el 12.10). if the system works in a closed cycle, the valve is closed, it opens occasionally, if necessary, add pressure to the system. If the system operates in an open cycle, the valve is open, through which air is taken from the external environment.

3.5.11. The valves, optionally, can be in other places, for example, in the places of the pressure circuit leaving individual lines to the individual gas distribution unit, automatically closes in case of leakage in the individual circuit.

3.5.12. The emergency valves of the inhalation pipe (el 12.3) and the exhalation pipe (el 12.5) are designed to eliminate critical pressures in the pressure circuit, to protect against damage to equipment, including valves.

The emergency valves of the gas distribution unit (el 12.11, 12.12) are designed to eliminate critical pressures in the cavities of the gas distributor and in the lungs, to protect the lungs from barotrauma.

3.5.13. Figure 1 shows in a separate frame, a round hole with a crossed line is a hole with a valve, a round hole without a line is a hole without a valve.

3.6. Pressure sensors (el 13) of the declared IVL complex. Based on the readings of the pressure sensors in the cavities, the program decides whether to open or close the valves.

Pressure sensors are located:

- in the compensatory balloons of the inhalation and exhalation tubes

- in the tubes of inhalation and exhalation

- in an individual gas distribution block

a) The highest positive pressure in the compensatory balloon of the inspiratory tube.

b) Positive, but less, pressure in the inspiratory tube.

c) The positive pressure in the cavity of the gas distribution unit and in the lungs while inhaling is even less.

d) Slightly negative pressure in the cavity of the valve timing unit and in the lungs as you exhale.

e) Even more negative pressure in the exhalation tube

f) the maximum negative pressure in the compensatory balloon of the expiratory tube.

3.7. The volume / speed sensors (Fig. 2 el 15.1, 15.2) of gases are located in the individual gas distribution unit, record the speed and volume of the air flow during inhalation and exhalation.

3.8. If necessary, to heat the breathing air mixture for inhalation, heating elements (el 14) are used located on the inhalation pipe in front of the gas distribution unit, in the individual part of the pressure circuit.

4. Individual block of gas distribution (figure 2 (schematically)),

individual equipment, separate for each patient. Alternatively, it is a continuation of the intubation (endotracheal) tube (el 16) (mask). Connects the pressure circuit to the endotracheal ventilator tube (mask), and through it, to the patient's lungs. The distribution unit does not have its own pumps, bellows, pistons, compressors.

4.1. The gas distribution unit (among other things) has valves:

- "inlet valve of the gas distribution block", aka (inlet), (el 12.4), when opened, it triggers excessive pressure from the inhalation pipe (el 3) into the gas distribution unit (into the lungs), this is how the inhalation is realized. Managed by the program.

- and the "exhaust valve of the gas distribution block" (el 12.5), when opened, releases pressure (air) from the gas distribution (from the lungs), into the discharged space of the exhalation pipe (el 4), this is how exhalation is realized. Managed by the program.

On both sides of the inlet and outlet valves (el 12.4, 12.5) there are emergency valves designed to automatically release critical pressure, to protect equipment or lungs from barotrauma:

- in the cavity of the inhalation pipe, the emergency valve of the inhalation pipe (el 12.3), analog

- in the cavity of the expiratory tube, the emergency valve of the expiratory tube (el 12.6), analog

- in the cavity of the inhalation zone block, the emergency valve of the gas distribution block, inhalation zone (el 12.11), analog.

- in the cavity of the block of the exhalation zone, the emergency valve of the gas distribution block, the exhalation zone (el 12.12), analog.

When any emergency valves are triggered, a signal is sent to the system. The fact of triggering is recorded in memory, as well as the background and context. The program analyzes the act and the cause of the actuation, and adjusts the system in such a way as to avoid overloads.

By opening the valves, it either launches air into the lungs from the inhalation tube (with increased pressure), which corresponds to inhalation, or releases (bleeds) air from the lungs into the exhalation tube (with reduced pressure), which corresponds to exhalation. The function of the gas distributor is, at a certain moment, in a certain way, to open or close a certain valve.

To realize natural exhalation, when gas is pushed out of the lungs by the natural movement of the chest, in the exhalation cavity of the gas distribution unit, a natural exhalation valve (el 17), it removes gas into the environment or into a container that does not have negative pressure, in this case the compressors for exhalation do not are working, the exhaust valve to the exhalation tube is closed.

4.2. On both sides of the inlet and outlet valves (el 12.4, 12.5) there are pressure sensors (el 13), designed to read the pressure in the cavities by the control program of the complex.

- el 13.1 pressure sensor in the inspiratory tube

- email 13.2. pressure sensor in the gas distribution unit, in the inhalation zone

the difference in these pressures determines the peculiarities of the functioning of the intake valve.

- el 13.3 pressure sensor in the gas distribution unit, in the exhalation zone

- email 13.4. expiratory tube pressure sensor

the difference in these pressures determines the peculiarities of the functioning of the exhaust valve.

By means of pressure sensors and sensors of speed and volume, the program monitors and regulates the functioning of the ventilator.

4.3. sensors fixing the speed of movement and the volume of gas (el 15), record the speed at which the gas passes, and what volume of gas passes through. Along with pressure sensors, it affects the operation of valves, determines the functional parameters of inhalation and exhalation. Figure 2 shows a variant of an endotracheal tube (el 16) in which the flows of inhalation and exhalation are separated, therefore, they have separate elements for fixing the speed and volume, for the flow of inspiration (el 15.1), for the flow of exhalation (el 15.2). YOU are using a single-chamber setter tube with non-split streams, a single transducer is used, but capable of measuring streams in both directions.

4.4. Additional options for an inspiratory zone, a gas distribution unit, for preparing an air-respiratory mixture.

Since the proposed concept of ventilation implements an individual approach for each patient, and the individual element of the complex is an individual gas distribution block, it is in the gas distribution block that the individual characteristics of the ventilation procedure are formed, including the formulation of the air-respiratory mixture.

4.4.1. Elements (mechanisms) for the injection of medicinal substances into the gas mixture (el 18). The injection mechanism can be implemented in the form of pipelines, or in the form of capsules. Implementation, time, and injection volume are controlled automatically by the program, or by operator action through the program. Figure 2 shows 3 different capsules (or 3 different pipelines): 18a, 18b, 18c. It is assumed that each capsule contains a different substance.

4.4.2. the mechanism of adding (saturation) to the air-respiratory mixture of oxygen (el 19). In this case, that oxygen, which makes the given reception of the mixture individual, when some of the patients need more oxygen than others.

4.4.3. the mechanism of adding (saturation) to the air-respiratory mixture of water vapor (el 20). In this case, the humidity that makes the given reception of the mixture individual, when some of the patients need more humidity in the inhaled air than others.

4.5. Additional options for the exhalation zone, the gas distribution unit.

4.5.1. Exhaled air intake element for diagnostics (el 21). If diagnostics are required, for example, for the concentration of gases, toxic impurities, etc.

4.5.2. A filter for filtering out solid and liquid components of the exhaled air (el 22), to prevent contamination of the exhalation pipe, and to collect mucus and liquids for analysis.

4.6. each gas distribution unit is controlled from a single control center, but it can also have its own hardware and software element that controls the unit's equipment, executing the commands of the central console, and in the event of an interruption in communication with the control center, automatically takes over control of the equipment.

4.7. each gas distribution unit operates from the network, but also has its own built-in battery, which allows it to work for a while, when the central power supply is cut off, in the event of an interruption in communication with the control center, it automatically takes over the control of the equipment.

Each individual valve timing unit operates according to its own program set for a particular patient. The operation of each gas distributor is completely autonomous (individual), and in no way connected with the operation of other gas distributors.

5. Hardware-software complex and control panel (figure 3)

The operation of the entire complex, and the pressure circuit, and all gas distribution units separately, is controlled by the software installed on the hardware-software complex of the declared IVL complex.

5.1. The hardware and software complex is a computer system with special software (Fig. 3 e 31). This system is also a "stationary control panel"

The complex can operate both according to a predetermined program, and according to the commands set online by the operator of the complex (doctor). The complex can be monitored and controlled remotely.

The hardware and software complex is connected to all elements of the pressure circuit (Fig. 3, el. 31.1) and to all elements of the gas distribution units (el. 31.2) by a wired electronic network. With the help of pressure sensors connected to the program, the software complex reads the pressure parameters from the entire system. With the help of the valves connected to the program, the software complex regulates the pressure from the entire system.

A special program installed on the computer system, analyzing the preset parameters of ventilation, and data from pressure sensors, controls the operation of the system (compressor + valves) so that the actual physical parameters of ventilation correspond to the required parameters of the given ventilation procedure.

The software complex has elements of artificial intelligence that regulates the operation of the complex with maximum comfort and efficiency for each patient.

As an option, the patient is equipped with sensors on the respiratory muscles. The system detects a person's attempt to breathe independently, and automatically and instantly adjusts the ventilation rhythm to the breathing rhythm of the person himself.

5.2. By connecting the computer system of the stationary control panel to any other computer via the Internet (e-32) or intranet, a “remote control panel” (e-33) can be organized.

The interface and control system can be implemented both through a special application, which is pre-installed, or through a browser.

5.3. By connecting the computer system of the stationary control panel with a smartphone via the Internet (e-32) or bluetooth, a “mobile control panel” (e-34) can be organized.

The interface and control system can be implemented both through a special application, which is pre-installed, or through a browser.

5.4. According to another concept for the implementation of control, it is possible to control the ventilation procedure not centralized, from one control center (el 31), but an individual control panel (it is also the control panel of the unit) installed on each gas distribution unit (el 35).

In this case, in the gas distribution unit itself there is a computer filling, with its own processor, with its own program, with its own control and display elements (buttons, touch panel, touch screen). In this case, the unit's own computer element, using the software installed on it, controls this unit.

At the same time (if we consider the concept of ventilation without a single control unit), the pressure circuit has its own control unit, the task of which is to maintain a given pressure in the circuit (in the tubes of inhalation and exhalation) at a certain predetermined level, as well as to maintain the concentration of carbon dioxide, oxygen and humidity, at the proper level of minimum requirements.

The control systems for the pressure circuit and the gas distribution unit itself are in contact with each other for coordinated operation in order to correctly implement the ventilation procedure. The individual control system of the unit controls the readings of the pressure sensors in the circuit (el 31.3).

In the case of implementation and use of the “control panel of the unit”, the doctor can manipulate the control panel itself, mounted in the body of the unit itself, using buttons and a touch panel.

In addition, for convenience, the interface of the control panel of the unit (and the display interface and the control interface) can be projected, wired or wirelessly, onto a computer (el. 31.4) and / or a smartphone (el. 31.5), while the ventilation system is operated and the filling and software of the block itself, and not those devices through which the interfaces of the control panels are projected. The individual control system of the unit can also be connected to the Internet (el 31.6) to implement remote control ..

Brief description of the drawings of the group of inventions: "Complex for centralized distribution of the pressure of the respiratory mixture, for simultaneous and individual artificial ventilation of the lungs (IVL) to a group of patients, and a gas distribution unit, individual, for the implementation of the complex of an individual procedure for mechanical ventilation to the patient"

Figure 1 "pressure circuit" schematically

figure elements:

- 1. compressor 1 main - If the cycle of movement of the air mixture is closed, when the same air is prepared for inhalation that was exhaled, then its one compressor is enough;

- 2. Compressor 2, additional - If the expiratory air is discharged into the environment, and the air for inhalation is taken from the environment, the compressor 2 pumps out the air from the expiratory tube;

- 3. inspiratory tube, part of a positive pressure pressure circuit;

- 4. expiratory tube, part of the pressure circuit with negative pressure;

- 5. compensatory balloon (capacity) of the inspiratory tube;

- 6. compensatory balloon (capacity) of the exhalation tube;

- 7. mechanism for pumping oxygen into the inspiratory tube system;

- 8. a mechanism for injecting water vapor into the inhalation pipe system;

- 9. unit for cleaning, disinfection, sterilization of exhaled air;

- 10. mechanism for removing carbon dioxide from the exhalation tube system; -eleven. a mechanism for removing water vapor from the exhalation tube system;

- 12. valves;

- 12.1. a gas valve for the transition from compressor 1 to the compensating cylinder of the inhalation pipe;

- 12.2. gas transition valve from the compensatory balloon of the inhalation tube to the inhalation tube;

- 12.3. Inspiratory pipe emergency drain valve, analog, mechanical, automatic, not controlled by the control program;

- 12.4. inlet valve of the individual gas distributor block

- 12.5. exhaust valve of the individual gas distributor block

- 12.6. Exhalation pipe emergency inlet valve, analog, mechanical, automatic, not controlled by the control program;

- 12.7. gas valve for transition from the expiratory tube to the compensatory balloon of the expiratory tube;

- 12.8. a gas transition valve from the expansion tube of the expiratory tube to the compressor 2;

- 12.9. a gas valve for transition from the compensatory balloon of the exhalation pipe to the compressor 1;

- 12.10. a gas transition valve from the atmospheric air intake pipe to the compressor 1;

- 13. pressure sensors connected to the control system.

- 14. elements for heating the inhaled air.

- element "block" schematically the outer casing of an individual gas distribution block

- in a highlighted rectangle, a schematic representation of an opening with and without a valve.

- 16. endotracheal tube

Figure 2: "individual valve timing unit (schematically)

- 3. inspiratory tube, part of a positive pressure pressure circuit;

- 4. expiratory tube, part of the pressure circuit with negative pressure;

- 12.3. Inspiratory pipe emergency drain valve, analog, mechanical, automatic, not controlled by the control program;

- 12.4. inlet valve of the individual gas distributor block

- 12.5. exhaust valve of the individual gas distributor block

- 12.6. Exhalation pipe emergency inlet valve, analog, mechanical, automatic, not controlled by the control program;

- 12.11. emergency drain valve of the inhalation cavity of the distribution unit, analog, mechanical, automatic, not controlled by the control program;

- 12.12. emergency inlet valve of the exhalation cavity of the distribution unit, analog, mechanical, automatic, not controlled by the control program;

- 13.1. inspiratory tube pressure sensor

- 13.2. inspiratory cavity pressure sensor of distribution unit

- 13.3. expiratory cavity pressure sensor of distribution unit

- 13.4. expiratory tube pressure sensor

- 15.1 sensors for fixing the movement speed and volume of the gas flow of inspiration

- 15.2 sensors fixing the speed of movement and the volume of the expiratory flow gas

- 16 endotracheal tube

- 17 valve of natural exhalation

- 18 (a, b, c) pipelines or capsules for injecting inhaled medicinal substances.

- 19.mechanism for adding (saturation) oxygen to the air-respiratory mixture

- 20.the mechanism of adding (saturation) to the air-respiratory mixture of water vapor

- 21. Element of an intake of exhaled air for diagnostics (optional)

- 22. Filter for filtering out solid and liquid components of exhaled air (at the level of the exhalation chamber of the gas distribution unit and the exhalation tube)

Figure 3: Hardware-software complex and control panel

- 1. main compressor 1 - If the cycle of movement of the air mixture is closed, when the same air is prepared for inhalation that was exhaled, then its one compressor is enough;

- 3. inspiratory tube, part of a positive pressure pressure circuit;

- 4. expiratory tube, part of the pressure circuit with negative pressure;

- 5. compensatory balloon (capacity) of the inspiratory tube;

- 6. compensatory balloon (capacity) of the exhalation tube;

- 9. unit for cleaning, disinfection, sterilization of exhaled air;

- element "B" - individual gas distribution block

-31. computer system with special software.

- 31.1. wire connection of the hardware-software unified control of the complex to the pressure circuit

- 31.2. wire connection of the hardware-software unified control of the complex to the individual gas distribution unit

- 31.3. wire connection of hardware-software individual control of the gas distribution unit, to the pressure sensors of the pressure circuit

- 31.4. wired and / or wireless connection of hardware and software individual control of the gas distribution unit to a computer system;

- 31.5. wired and / or wireless connection of the hardware-software individual control of the gas distribution unit to the smartphone's ventilation control application;

- 31.6. wired and / or wireless connection of hardware and software individual control of the gas distribution unit to the Internet, and via the Internet to remote control panels, on computers and / or smartphones;

- 31.7. wired and / or wireless connection of the hardware-software unified control of the complex, and via the Internet to remote control panels, on computers and / or smartphones

Implementation of the group of inventions: "A complex for centralized distribution of the pressure of the respiratory mixture, for simultaneous and individual artificial ventilation of the lungs (IVL) to a group of patients, and a gas distribution unit, individual, for the implementation of a complex of an individual ventilation procedure for a patient."

The elements that make up the pressure circuit are known in the art, are not high-tech, easy to select and install.

Only an individual gas distribution unit, in particular a valve, and a hardware-software complex require a separate development. But this equipment is not high-tech, and is available to the state of the art.

Simplified assembly diagram:

- mounted pressure profile with compensating cylinders, gas valves, pressure sensors

- the pressure profile is connected to the compressor, the compressor control software is adjusted to maintain the set pressure in both arms of the pressure profile.

- according to the number of patients, individual valve timing units are connected to the pressure profile.

- all equipment is connected to a computerized hardware-software unit, configuration and control occurs through a computer

- each gas distribution unit is programmed according to the needs of each patient, by a central control unit, or an individual control unit.

Claims (15)

1. A complex for the centralized distribution of the pressure of the respiratory mixture for simultaneous artificial ventilation of the lungs (IVL) for a group of patients, designed for a collective procedure of mechanical ventilation for a group of patients, using a compressor, a system of sealed pipelines, a system of air valves, a system for forming an air-respiratory mixture in its physical - chemical composition and physical characteristics, while the complex contains a pressure profile, which is a system of sealed pipelines used unified for the entire group of patients and equipment for the formation and maintenance of positive and negative pressure in the ventilation system, the complex also uses an individual gas distribution unit, made with the ability providing individual equipment for each patient for the implementation of an individual ventilation procedure, the complex also includes the use of a hardware-software center and software for implementation , control, monitoring of the functioning of the ventilation procedure, characterized in that it uses compensatory balloons in its structure to accumulate increased and decreased pressure, and the accumulated pressure reserve of these balloons is used to smooth out pressure drops in the pressure profile during the implementation of ventilation procedures, as well as for prompt recovery pressure in the profile when it deviates from the norm, as well as to temporarily maintain the pressure in the system during a short-term shutdown of the compressor, while the pressure profile has a system of program-controlled valves for controlling the ventilation procedure using the software of the complex and a system of emergency overpressure relief valves uncontrolled by the program, at the same time, the pressure profile has a system of pressure sensors connected with the control system of the complex, the readings of which are used by the system for the correct implementation of the ventilation procedure. 2. The complex according to claim 1, characterized in that the pressure profile is the same for the entire group of patients, operating on one compressor in the case of a closed gas cycle and on two compressors in the case of an open gas cycle. 3. The complex according to claim 2, characterized in that the pressure profile consists of two parallel piping systems, in the first of which a constant positive pressure is maintained with the help of one compressor, and in the second of which a constant negative pressure is maintained with the help of one compressor. 4. The complex according to claim 3, characterized in that the pressure in the pressure profile systems creates only a physical and mechanical condition for inhalation or exhalation, but does not determine the time, speed, frequency, volume of inhalation or exhalation and the individual formulation of the air-respiratory mixture, and time, speed, frequency, volume of inhalation or exhalation and the individual formulation of the air-respiratory mixture is determined by the software of the complex, and is implemented by an individual gas distribution unit. 5. An individual gas distribution unit used in the complex according to claim 1, characterized in that the functioning of its elements according to an individual program by a given control system through the functioning of its own valves, pressure sensors and additional equipment for forming a breathing mixture formulation determines the ventilation procedure, which is individual for each individual patient, individual time, speed, frequency and volume of inhalation or exhalation, individual formulation of the air-respiratory mixture in its physical and chemical composition and physical characteristics. 6. An individual gas distribution unit according to claim 5, characterized in that for the implementation of inspirations and expirations, it uses the physical and mechanical conditions of high and low pressure of both pressure profile systems. 7. Individual gas distribution unit according to claim 6, characterized in that it is a continuation of the patient's endotracheal tube, mechanically and functionally connecting the endotracheal tube and the patient's lungs with a pressure profile. 8. An individual gas distribution unit according to claim 7, characterized in that it consists of two non-interconnected parallel cavities, through one of which gas is pumped into the lungs and an individual formulation of the air-breathing mixture is formed, and through the other, gas is pumped out of the lungs and air is taken exhalation for analyzes. 9. Individual gas distribution unit according to claim 8, characterized in that it has a system of program-controlled valves for controlling the ventilation procedure using the software of the complex and a system of uncontrolled emergency relief valves for overpressure in order to protect the patient's lungs from barotrauma. 10. An individual gas distribution unit according to claim 9, characterized in that it has a system of pressure, speed and volume sensors associated with the control system of the complex, the readings of which are used by the system for the correct implementation of the ventilation procedure. 11. An individual gas distribution unit according to claim 10, characterized in that the cavity associated with exhalation has a valve for natural exhalation, not initiated by negative pressure, of the pressure profile. 12. An individual gas distribution unit according to claim 11, characterized in that it is controlled by a control program from an internal, own, individual control center for the ventilation complex built into the unit body, and buttons, switches, regulators, a touch panel and a touch display are arranged on the unit body. 13. An individual gas distribution unit according to claim 12, characterized in that it is controlled from an external single control center, a single hardware and software control center for the ventilation complex. 14. Hardware and software center with software, used in the complex according to claim 1, characterized in that it is a computerized system, external or internal, with software installed on it, combines all the elements of the ventilation system, controls the operation of all mechanisms system, collects information from all sensors in the system. 15. Hardware and software center with software according to claim 14, characterized in that it allows the doctor to program the operation of the system in automatic and autonomous mode, and allows the doctor to monitor and control the system online, and allows the doctor to monitor and control the system remotely via a computer or smartphone connected to the system via the Internet.

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