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A new apparatus for measuring lung function using forced inspired oxygen gas sinewaves

一种使用强制吸入氧气正弦波测量肺功能的新装置

基本信息

批准号：
EP/E028950/1
负责人：
Clive Edward Winston Hahn
金额：
$ 27.61万
依托单位：
University of Oxford
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2007
资助国家：
英国
起止时间：
2007 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=EP%2FE028950%2F1
关键词：
new apparatus measuring lung function

项目摘要

Lung function tests are commonly performed on patients in specialised Pulmonary Function Laboratories or in Cardiopulmonary Units in hospitals worldwide. Various cardiopulmonary function tests are performed, usually in hospital outpatients, and these require the co-operation of the patient and a rapport between the clinician and patient. These patients can be suffering from a wide variety of lung disorders ranging from asthma to chronic obstructive pulmonary disease.In contrast, patients in hospital Intensive Care Units (ICUs) are dependent upon complex life support and monitoring equipment, such that they cannot be moved easily to the Pulmonary Function Laboratory. The commonest reason for admission to the ICU is the need for mechanical ventilatory support, usually what is popularly known as 'life-support'. Such patients are not able to participate in any form of lung function testing involving volitional manoeuvres, nor can these patients be easily transferred or disconnected from their ventilatory support. Critical illness, including severe sepsis and mechanical ventilation itself, can lead to severe lung abnormalities decreased effective lung volume and decreased efficiency of gas exchange between the lung and the blood.It is therefore ironic that those patients who would benefit most from lung function and cardiopulmonary tests, are the most difficult to be assessed by conventional means.Furthermore, they will most likely be dependent upon high oxygen concentrations in the inspired gases and will not tolerate brief periods of breathing lower inspired oxygen concentrations, as is required in some lung function tests. Moreover, ventilated patients will have a variety of ventilatory modes and this has an important influence on the ability to perform cardiorespiratory and lung function tests. For the above reasons, it is seldom possible to perform lung function tests on the ventilated patient in the ICU, except in certain centres of excellence or for detailed research purposes. A similar argument arises in the case of the anaesthetised patient in the operating theatre. It is not easily possible to measure lung function since the unconscious patient is unable to participate in volitional respiratory manoeuvres.A great need therefore exists for these measurements to be able to be made non-invasively, with relatively simple equipment and gases that are routinely available, and that is the purpose of this grant project work. Our research proposal is to develop (over a period of 24 months) a new apparatus using oxygen as the measurement gas, to measure lung volume (and ultimately also blood flow through the lung) in a way that does not require patient co-operation and does not interfere with his/her breathing pattern / whether the patient is breathing spontaneously or is being mechanically ventilated. A lap-top computer will control this apparatus, and the signals from gas analysis and gas flow sensors will be fed into a computer model of the human lung to determine at the bed side the patient's end-expired and dead-space lung volumes.This apparatus will be tested as part of the project work first on a mechanical bench lung model and then on spontaneously breathing volunteers in our laboratory. The apparatus and technique will then be transferred to the hospital ICU for routine daily use.

肺功能测试通常在世界各地专门的肺功能实验室或医院的心肺单元对患者进行。各种心肺功能测试通常在医院的门诊患者中进行，这些测试需要患者的合作以及临床医生和患者之间的融洽。这些病人可能患有从哮喘到慢性阻塞性肺疾病的各种肺部疾病。相比之下，医院深切治疗部(ICU)的病人依赖复杂的生命支持和监测设备，因此他们不容易被转移到肺功能实验室。住进ICU最常见的原因是需要机械呼吸支持，通常被称为“生命支持”。这些患者不能参加任何形式的肺功能测试，包括意志动作，这些患者也不能轻易转移或脱离他们的呼吸机支持。危重疾病，包括严重的脓毒症和机械通气本身，可能会导致严重的肺部异常，有效肺容量和肺与血液之间的气体交换效率降低。因此，具有讽刺意味的是，那些从肺功能和心肺测试中受益最大的患者最难通过常规方法进行评估。此外，他们很可能依赖吸入气体中的高氧气浓度，不能像一些肺功能测试所要求的那样，耐受短暂的低吸入氧浓度。此外，呼吸机患者会有多种呼吸模式，这对进行心肺功能测试的能力有重要影响。由于上述原因，除非在某些卓越中心或出于详细的研究目的，否则很少可能对ICU中的呼吸机患者进行肺功能测试。类似的论点也出现在手术室里被麻醉的病人身上。由于昏迷患者不能参与自愿的呼吸动作，因此很难测量肺功能。因此，非常需要能够以非侵入性的方式进行这些测量，并且使用相对简单的设备和常规可用的气体，这就是这项赠款项目工作的目的。我们的研究建议是(在24个月内)开发一种使用氧气作为测量气体的新仪器，以一种不需要患者合作、不干扰患者的呼吸模式/无论患者是自主呼吸还是机械通气的方式来测量肺容量(最终也测量通过肺的血液流量)。一台笔记本电脑将控制这台设备，气体分析和气体流量传感器的信号将被输入到人体肺的计算机模型中，以在床边确定患者末梢呼气和死腔的肺容量。作为项目工作的一部分，该设备将首先在机械台式肺模型上进行测试，然后在我们实验室的自发呼吸志愿者身上进行测试。然后，这些仪器和技术将被转移到医院ICU进行日常使用。