CN119280656B - Self-adaptive control method and device - Google Patents
Self-adaptive control method and deviceInfo
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- CN119280656B CN119280656B CN202411566768.5A CN202411566768A CN119280656B CN 119280656 B CN119280656 B CN 119280656B CN 202411566768 A CN202411566768 A CN 202411566768A CN 119280656 B CN119280656 B CN 119280656B
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- pumping
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Abstract
The application provides a self-adaptive control method and device, the method comprises the steps of obtaining a plurality of pumping flows when a ventricular assist device runs at a first rotating speed in a first period, recording a first time length and a second time length, wherein the first time length is the time length of an adjacent first pumping flow interval, the second time length is the time length from the first pumping flow to the pumping flow smaller than a first flow threshold value in the first time length, the first pumping flow is the peak value of the pumping flow of the ventricular assist device, and if the first rotating speed is regulated according to a target ratio, the target ratio is the ratio of the second time length to the first time length. According to the application, the cardiac cycle of the user and the low flow value of the ventricular assist device can be respectively determined according to the first time length and the second time length, and the rotating speed of the ventricular assist device is adaptively adjusted according to the ratio of the second time length to the first time length, so that the pumping flow of the ventricular assist device can meet the requirement of the user in real time, the occurrence of abnormality of the ventricular assist device is reduced, and the safety of the user is improved.
Description
Technical Field
The application relates to the technical field of medical equipment, in particular to a self-adaptive control method and device.
Background
The ventricular assist device is an effective means for treating heart failure patients, and is an artificial mechanical device for leading fluid out of a venous system or a heart and directly into an arterial system, and partially or completely replacing a ventricle to do work.
The ventricular assist device is configured to pump blood from the left ventricle to the aorta or from the right ventricle to the pulmonary artery by a motor disposed within the housing assembly driving the impeller in a levitating rotation. At present, the rotation speed of the ventricular assist device generally runs constantly at a set rotation speed, but because the requirements of users for output are different in different states, the pumping flow rate of the ventricular assist device may not match with the current requirements of the users for conditions, and the heart of the patient is damaged by the abnormality caused by the mismatch, so that the conditions of the patient are aggravated.
Disclosure of Invention
The embodiment of the application provides a self-adaptive control method and device, which can be used for self-adaptively adjusting the rotating speed, so that the pumping flow of a ventricular assist device can meet the condition requirements of users in real time.
In a first aspect, an embodiment of the present application provides an adaptive control method applied to a ventricular assist device, the method including:
Acquiring a plurality of pumping flows of the ventricular assist device during a first cycle at a first rotational speed;
Recording a first duration and a second duration, wherein the first duration is a duration of an adjacent first pumping flow interval, the second duration is a duration from the first pumping flow to the pumping flow less than a first flow threshold in the first duration, and the first pumping flow is a peak value of the pumping flow of the ventricular assist device;
And adjusting the first rotating speed according to a target ratio, wherein the target ratio is the ratio of the second duration to the first duration.
In a second aspect, an embodiment of the present application provides a control device for a ventricular assist device, where the control device includes one or more processors configured to:
Acquiring a plurality of pumping flows of the ventricular assist device during a first cycle at a first rotational speed;
Recording a first duration and a second duration, wherein the first duration is a duration of an adjacent first pumping flow interval, the second duration is a duration from the first pumping flow to the pumping flow less than a first flow threshold in the first duration, and the first pumping flow is a peak value of the pumping flow of the ventricular assist device;
And adjusting the first rotating speed according to a target ratio, wherein the target ratio is the ratio of the second duration to the first duration.
In a third aspect, embodiments of the present application provide a ventricular assist device comprising:
A housing;
An impeller disposed within the housing;
A control unit for controlling the rotation of the impeller, the control unit being adapted to perform some or all of the steps described in the method of the first aspect above.
In a fourth aspect, embodiments of the present application provide a medical device comprising a processor, a memory, a communication interface, and one or more programs stored in the memory and configured to be executed by the processor, the programs comprising instructions for performing part or all of the steps described in the method of the first aspect above.
In a fifth aspect, embodiments of the present application provide a computer-readable storage medium storing a computer program for electronic data exchange, wherein the computer program causes a computer to execute some or all of the steps described in the method of the first aspect.
In a sixth aspect, embodiments of the present application provide a computer program product, wherein the computer program product comprises a non-transitory computer readable storage medium storing a computer program, the computer program being operable to cause a computer to perform some or all of the steps described in the method according to the first aspect of the embodiments of the present application. The computer program product may be a software installation package.
The technical scheme includes that a plurality of pumping flows of a ventricular assist device are obtained when the ventricular assist device operates at a first rotating speed in a first period, a first duration and a second duration are recorded, the first duration is the duration of an adjacent first pumping flow interval, the second duration is the duration from the first pumping flow in the first duration to the pumping flow smaller than a first flow threshold, the first pumping flow is the peak value of the pumping flow of the ventricular assist device, and if the first rotating speed is regulated according to a target ratio, the target ratio is the ratio of the second duration to the first duration. According to the application, the cardiac cycle of the user and the low flow value of the ventricular assist device can be respectively determined according to the first time length and the second time length, and the rotating speed of the ventricular assist device is adaptively adjusted according to the ratio of the second time length to the first time length, so that the pumping flow of the ventricular assist device can meet the requirement of the user in real time, the occurrence of abnormality of the ventricular assist device is reduced, and the safety of the user is improved.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings that are needed in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present application, and other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
FIG. 1 is a schematic diagram of a ventricular assist device according to an embodiment of the present application;
FIG. 2 is a schematic illustration of a ventricular assist device according to an embodiment of the present application in a normal position of a patient's heart;
fig. 3 is a schematic flow chart of an adaptive control method according to an embodiment of the present application;
fig. 4 is a schematic structural diagram of a medical device according to an embodiment of the present application.
Detailed Description
For better understanding of the technical solutions of the present application by those skilled in the art, the technical solutions of the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present application, and it is apparent that the described embodiments are only some embodiments of the present application, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the description of the embodiments of the application without making any inventive effort, are intended to fall within the scope of the application.
The terms first, second and the like in the description and in the claims and in the above-described figures are used for distinguishing between different objects and not necessarily for describing a sequential or chronological order. Furthermore, the terms "comprise" and "have," as well as any variations thereof, are intended to cover a non-exclusive inclusion. For example, a process, method, software, article, or apparatus that comprises a list of steps or elements is not limited to only those listed steps or elements but may include other steps or elements not listed or inherent to such process, method, article, or apparatus.
Reference herein to "an embodiment" means that a particular feature, structure, or characteristic described in connection with the embodiment may be included in at least one embodiment of the application. The appearances of such phrases in various places in the specification are not necessarily all referring to the same embodiment, nor are separate or alternative embodiments mutually exclusive of other embodiments. Those of skill in the art will explicitly and implicitly appreciate that the embodiments described herein may be combined with other embodiments.
The medical device and pump according to the application may be a ventricular assist device (Ventricular ASSIST DEVICES, VAD), such as an implantable ventricular assist device, an interventional ventricular assist device, etc., and the ventricular assist device may comprise at least one blood pump, wherein the blood pump may be a centrifugal pump, an axial flow pump, a magnetic levitation pump, etc.
The term "current" in the present application refers to the current driving the motor or the electric machine, which is associated with the power of the motor or the electric machine, with the supply voltage unchanged. "rotational speed" refers to the rotational speed of a motor or electric machine, which is related to the rotational speed of the rotor or impeller of the ventricular assist device, and may be defined as a rotational speed per minute. "flow," "fluid flow," "pumping flow" refers to the volume of fluid delivered by a ventricular assist device per unit of time, which can be estimated and measured in liters per minute.
The term "proximal" or "proximal" in the present application refers to an end or side closer to the operator, and "distal" or "distal" refers to an end or side farther from the operator.
Referring to fig. 1-2, fig. 1 is a schematic diagram of a ventricular assist device 100 according to an embodiment of the application, and fig. 2 is a schematic diagram of a ventricular assist device 100 according to an embodiment of the application in a normal position of a heart 120 of a user. Ventricular assist device 100 may operate within a left heart, a right heart, outside a heart, partially outside a vascular system, or in any other suitable location in the vascular system of a user. The present application is illustrated by way of example with respect to placement of a ventricular assist device 100 in the left heart.
The ventricular assist device 100 may be percutaneously inserted through the femoral artery 122 into the aorta 124 and through the aorta 124 into the left ventricle 128. For example, the ventricular assist device may be percutaneously inserted into the aorta 124 via the axillary artery 123 and passed through the aorta 124 into the left ventricle. In other embodiments, the ventricular assist device 100 may also be inserted directly into the aorta 124 and through the aorta 124 into the left ventricle 128. During operational operation, ventricular assist device 100 pumps blood in left ventricle 128 into aorta 124.
The ventricular assist device 100 includes a cannula 10. The cannula 10 has a proximal end and a distal end, the distal end of the cannula 10 having a fluid inlet 101, the proximal end of the cannula 10 having a fluid outlet 102, blood flowing in from the fluid inlet 101 and out from the fluid outlet 102 via the cannula 10.
Ventricular assist device 100 includes an impeller (not shown). The impeller is at least partially located at the proximal end of the cannula 10, such as at the fluid outlet 102 of the cannula 10, such that the impeller is driven in rotation to pump blood from the left ventricle 128 to the aorta 124 when the ventricular assist device 100 is in operation.
Ventricular assist device 100 may include a motor (not shown) that may be disposed inside ventricular assist device 100 or may be disposed outside ventricular assist device 100. The embodiment of the present application is described by taking the example that the motor is disposed inside the ventricular assist device 100, for example, the motor is disposed in the motor housing 201, the distal end of the motor housing 201 is connected to the proximal end of the sleeve 10, and the motor drives the driving shaft to rotate, thereby driving the impeller to rotate, so as to realize the blood pumping function of the ventricular assist device 100.
Ventricular assist device 100 includes a catheter 30, a distal end of catheter 30 being connected to a proximal end of motor housing 201, and a drive cable extending through catheter 30. By way of example, catheter 30 may house electrical leads that connect ventricular assist device 100 to an external controller. Illustratively, the ventricular assist device 100 further includes a distal member 110, such as a pigtail, extending distally from the distal end of the cannula 10.
Ventricular assist device 100 also includes a control unit that may be used to perform any of the embodiments, aspects, and methods of the present application. The control unit may be provided inside the ventricular assist device 100 or may be provided outside the ventricular assist device 100. The control unit is used for detecting relevant parameters of the ventricular assist device 100 and a user, and controlling the operation of the ventricular assist device 100, for example, the control unit supplies current to the motor through one or more wires and detects the current through a current detection circuit (such as a phase current detection circuit), estimates the current pumping flow according to the received current, controls the rotation speed of the ventricular assist device 100 according to the received command, and further detects whether abnormal events such as pumping, reverse flow and the like exist according to the pumping speed flow and the rotation speed.
The ventricular assist device 100 is positioned such that the cannula 10 extends across the aortic valve 126 of the user, the distal end of the cannula 10 being located in the left ventricle 128 of the user, and the proximal end of the cannula 10 being located in the aorta 124 of the user.
In connection with the above description, the present application is described below from the viewpoint of a method example.
Referring to fig. 3, fig. 3 is a schematic flow chart of an adaptive control method according to an embodiment of the application, which is applied to the ventricular assist device shown in fig. 1 and fig. 2. As shown in fig. 3, the method includes the following steps.
S310, acquiring a plurality of pumping flows of the ventricular assist device in a first period at a first rotation speed.
During operation of the ventricular assist device 100 in the user, the pumping flow through the ventricular assist device 100 is dependent on the resistance of the ventricular assist device 100 to perform work to pump blood from the left ventricle 128 to the aorta 124. The amount of work done by ventricular assist device 100 may be quantified as the amount of current that needs to be provided to the motor, i.e., the motor current corresponds to the amount of current delivered to the motor of ventricular assist device 100 when ventricular assist device 100 is operating in a user. The load of the motor may vary during different phases of the cardiac cycle of the user's heart. When the pressure differential in the user's heart changes, the motor current will also change to keep the rotor speed constant. For example, as the flow rate of blood into the aorta 124 increases (e.g., during systole), the current required by the motor will increase. The change in motor current can therefore help characterize cardiac performance. That is, during operation of ventricular assist device 100, ventricular assist device 100 has a current-flow characteristic, wherein the greater the current, the more ventricular assist device 100 performs, i.e., the greater the pumping flow of ventricular assist device 100.
The current of ventricular assist device 100 may be measured by a phase current detection circuit provided or by any other suitable means, such as a current sensor. The current-flow characteristic curve may be stored in the control unit in advance, and before the ventricular assist device 100 leaves the factory, it may be placed in a test system to test the relationship curve of the pumping flow of the ventricular assist device 100 with the current change at different rotational speeds, respectively, so as to store the current-flow characteristic curve in the control unit. The control unit may store the detected current in real time.
Specifically, when the ventricular assist device 100 is operated at the first rotational speed, the control unit obtains a current curve in the first period, estimates a flow curve corresponding to the current curve using a pre-stored current-flow characteristic curve, and the plurality of pumping flows may be pumping flows collected from the flow curve at sampling intervals. The first period is greater than a normal human cardiac cycle. The first period may be, for example, m times the cardiac period, m may take on values of 10, 20, 30, etc
S320, recording a first duration and a second duration, wherein the first duration is a duration of an adjacent first pumping flow interval, the second duration is a duration from the first pumping flow to the pumping flow smaller than a first flow threshold in the first duration, and the first pumping flow is a peak value of the pumping flow of the ventricular assist device.
Wherein, during ventricular systole, the aortic valve 126 or pulmonary valve is opened, blood in the ventricle is pumped to the aorta 124 or pulmonary artery, the blood volume in the ventricle gradually decreases and the blood volume in the ventricle also gradually decreases, during ventricular diastole, the mitral valve or tricuspid valve is opened, blood in the atrium flows to the ventricle, the blood volume in the ventricle gradually increases and the ventricular pressure also gradually increases. Thus, during systole, blood in the ventricle is pumped to the aorta 124 or the pulmonary artery, the pumping rate of the ventricular assist device 100 gradually decreases to a minimum value, and during diastole, the volume of blood flowing from the atrium to the ventricle, in the ventricle, gradually increases, and the pumping rate of the ventricular assist device 100 gradually increases to a maximum value. I.e. the fluctuation of the pumping flow of the ventricular assist device 100 is synchronized with the cardiac cycle of the user, so that the change in the pumping flow through the ventricular assist device 100 reflects the current heart state of the user.
Wherein the cardiac cycle of the user may be determined by adjacent peaks or adjacent valleys of the pumping flow of the ventricular assist device 100, i.e. by the duration of the interval between adjacent first pumping flows of the ventricular assist device 100. During ventricular systole, the pumping rate of ventricular assist device 100 will be at a minimum, and the control unit may determine the duration of low pumping rate of ventricular assist device 100 based on the second duration, while the systolic and diastolic phases of the user's cardiac cycle are fixed, i.e., the trend and time of change in pumping rate of ventricular assist device 100 is fixed during one cardiac cycle. When the second duration exceeds the preset duration, then the current pumping flow of ventricular assist device 100 may be considered unsynchronized with the user's cardiac cycle. The control unit may thus determine the cardiac cycle of the user by a first time period and determine by a second time period whether the current pumping flow of the ventricular assist device 100 is synchronized with the cardiac cycle of the user, and thus by adjusting the rotational speed of the ventricular assist device 100 when not synchronized.
S330, adjusting the first rotating speed according to a target ratio, wherein the target ratio is a ratio of the second duration to the first duration.
In the present application, the ratio of the second time period to the first time period may determine the duty cycle of the low pumping flow throughout the cardiac cycle, determine whether the ventricular assist device 100 is operating abnormally based on the magnitude of the target ratio, and then address the abnormal condition by adjusting the first rotational speed.
Optionally, the adjusting the first rotation speed according to the target ratio includes sequentially increasing the first rotation speed until the first rotation speed is increased by n rotation speed steps or a difference between a first average flow and a second average flow is greater than a second flow threshold, wherein the first average flow is an average value of the pumping flows in the first period, the second average flow is an average value of the pumping flows in the second period, the first period is earlier than the second period, and n is a positive integer, and sequentially decreasing the first rotation speed until the first rotation speed is decreased by n rotation speed steps or a difference between the second average flow and the first average flow is greater than the second flow threshold if the target ratio is smaller than the second target value.
The fluctuation of the ventricular assist device 100 pumping flow is synchronized with the cardiac cycle so that the duration of the ventricular assist device 100 pumping flow less than the first flow threshold is within a fixed range during one cardiac cycle. When the target ratio of the second duration to the first duration is greater than the first target value, the ventricular assist device 100 is at the low pumping flow for too long, which indicates that the left ventricular pressure of the current user is too low or the aortic pressure is too high, and the rotational speed of the ventricular assist device 100 is too low, which may cause a reflux problem or an insufficient unloading problem, so that the control unit may control to increase the rotational speed of the ventricular assist device 100 to reduce or solve the reflux problem or the insufficient unloading problem of the ventricular assist device 100. When the target ratio of the second duration to the first duration is less than the second target value, the ventricular assist device 100 is at the low pumping flow rate for too short a time, which indicates that the left ventricular pressure of the current user is too high or the aortic pressure is too low, and the rotational speed of the ventricular assist device 100 is too high, which may cause an unloading excessive problem or a pumping problem, so the control unit may control to decrease the rotational speed of the ventricular assist device 100 to reduce or solve the unloading excessive problem or the pumping problem of the ventricular assist device 100.
The control unit may automatically control the sequential increase of the rotational speed of the ventricular assist device 100 when it is determined that there is regurgitation, or insufficient unloading, of the current ventricular assist device 100 according to the target ratio. The control unit increases the first rotational speed by a rotational speed step Deltav, runs the duration of the first period, calculates a target ratio in the period, and continues to increase the rotational speed step Deltav until the rotational speed step Deltav is increased n times or the average value of the pumping flow in the period is increased by a second flow threshold value compared with the average value of the pumping flow in the previous period if the target ratio is still larger than the first target value. That is, when a regurgitation problem or insufficient unloading is detected, the control unit automatically controls the rotational speed step of the increment Δv until the number of increases n is reached, or the ventricular assist device 100 does not have a regurgitation problem or insufficient unloading, or the pumping flow rate of the ventricular assist device 100 is increased.
The control unit may automatically control the sequential reduction of the rotational speed of the ventricular assist device 100 upon determining that there is an unloading excess or suction of the current ventricular assist device 100 based on the target ratio. The control unit firstly reduces the first rotating speed by a rotating speed step Deltav, runs the duration of the first period, calculates the target ratio in the period, and continuously reduces the rotating speed step Deltav if the target ratio is still smaller than the second target value until the rotating speed step Deltav is reduced by n times, or the average value of the pumping flow in the period is reduced by a second flow threshold value compared with the average value of the pumping flow in the previous period. I.e. when an unloading overdose problem or a pumping problem is detected, the control unit automatically controls the rotational speed step of the decrease Δv until an increase n is reached, or no unloading overdose problem or pumping problem is present in the ventricular assist device 100, or the pumping flow of the ventricular assist device 100 is reduced.
Wherein the first target value, the second target value may be set according to the cardiac cycle of the user, e.g. the first target value is set to 0.23, 0.25, 0.28, etc., and the second target value is set to 0.1, 0.15, 0.18, etc. The first flow threshold is less than the second flow threshold. For example, the first flow threshold is set to 0 and the second flow threshold is set to 1LPM. For example, the first flow threshold is set to 0.3LPM and the second flow threshold is set to 1LPM. The rotational speed step Δv may be determined according to the magnitude of the first rotational speed and the allowable operation rotational speed range of the ventricular assist device 100, and the greater the first rotational speed and the closer the first rotational speed is to the nearest boundary value of the operation rotational speed range, the greater the rotational speed step Δv is, the operation rotational speed range is 23000RPM to 46000RPM, and if the first rotational speed is 40000RPM, if it is determined that the first rotational speed is too high and needs to be reduced, the rotational speed step Δv may be 4000RPM. If the first rotational speed is 25000RPM, if it is determined that the first rotational speed is too low to be increased at this time, it may be determined that the rotational speed step Δv is 4000RPM. If the first rotational speed is 35000RPM, if it is determined that the first rotational speed is too low to be increased at this time, the rotational speed step Deltav may be determined to be 1000RPM. Where n can be set to 3, 4, 5, 6, etc.
In the application, the control unit monitors whether the current ventricular assist device 100 operates abnormally through the fluctuation condition of the pumping flow of the ventricular assist device 100, and further immediately and automatically controls to increase the rotation speed of the ventricular assist device 100 when the ventricular assist device 100 operates abnormally, so that the damage caused by the abnormal operation of the ventricular assist device 100 is timely reduced or avoided, and the user safety is improved.
The method further comprises the steps of determining a second pumping flow rate and a target number, wherein the target number is the number of pumping flows smaller than the first flow rate threshold value in the first time period, the second pumping flow rate is the smallest pumping flow rate in the first time period, and if the second pumping flow rate is smaller than a third flow rate threshold value and the target number is larger than or equal to a first value, determining that reflux exists in the ventricular assist device and giving an alarm.
Blood reflux refers to a blood flow phenomenon that reverses the normal flow direction of blood, such as blood flowing into the left ventricle 128 into the aorta 124, and when a significant amount of blood flowing into the left ventricle 128 from the aorta 124 reverses, it is indicated that blood reflux is occurring. Blood flashback is the flow of blood from the aorta 124 through the ventricular assist device 100 to the left ventricle 128, where the pumping flow of the ventricular assist device 100 is low or even negative. Blood flashback is prone to occur when the pumping flow of the ventricular assist device 100 is not synchronized with the cardiac cycle, such as when the ventricular assist device 100 is rotating too low and left ventricular pressure is too high. Reflux can cause complications such as ventricular enlargement, blood loss and the like of a user, and the reflux time is too long, so that the health of the user can be seriously endangered.
Based on this, the control unit may also monitor in real time whether there is a reflux problem during operation of the ventricular assist device 100. The control unit divides the plurality of pumping flows into a plurality of cardiac cycles according to adjacent first pumping flows. The number of pumping flows in each cardiac cycle that are less than the first flow threshold and the minimum pumping flow in that cardiac cycle (the second pumping flow) are then recorded separately. If the second pumping flow rate is less than the third flow rate threshold and the target number is greater than or equal to the first value, then the current ventricular assist device 100 is considered to have a reflux phenomenon, and the control unit may alarm to timely notify the healthcare personnel to make a resolution as soon as possible. The third flow threshold may be set to 0.5LPM.
Further, to improve the accuracy of the monitoring and the sensitivity of the alarm, the control unit may continuously monitor the second pumping flow rate and the target number in the first period, and if the second pumping flow rate in the first period is continuously smaller than the third flow rate threshold and the target number is continuously greater than or equal to the first value, confirm that the current ventricular assist device 100 has a reflux phenomenon and alarm.
Wherein, when confirming that the ventricular assist device 100 has a regurgitation phenomenon and alarming, the control unit may reduce or solve the regurgitation problem by increasing the rotation speed. Specifically, the first rotational speed is increased by a rotational speed step Deltav and the duration of the first period is operated, then whether the reflux phenomenon exists is judged, and if the reflux phenomenon still exists, the rotational speed step Deltav is increased and the duration of the first period is operated. In this way, the second flow threshold is increased until there is no regurgitation of the ventricular assist device 100, or the first rotational speed increases more than n, or the average pumping flow of the ventricular assist device 100.
Further, if the average pumping flow rate increase amount of the ventricular assist device 100 exceeds the third flow rate threshold during the continuous increase of the first rotation speed, the control unit may control to stop the alarm and simultaneously decrease the rotation speed of the current ventricular assist device 100, and the decreased rotation speed step may be set to Δv as described above.
In a possible embodiment, the method further comprises the steps of obtaining a target characteristic curve, determining a first pressure difference corresponding to a first average flow rate at the first rotating speed according to the target characteristic curve, wherein the first average flow rate is an average value of the multiple pumping flows in the first period, the first pressure difference is a difference value between the pressure at the outlet and the pressure at the inlet of the ventricular assist device, and determining that the blood pressure of a target user is abnormal and alarming if the first pressure difference is smaller than a first pressure threshold or the first pressure difference is larger than a second pressure threshold, wherein the target user is a user implanted with the ventricular assist device.
During operation of ventricular assist device 100, problems may occur with either a user's ventricular pressure differential that is too low (e.g., left ventricular pressure that is too high or aortic pressure that is too low), or a user's ventricular pressure differential that is too high (e.g., left ventricular pressure that is too low or aortic pressure that is too high). Too high or too low a user's ventricle may cause the pumping flow of the ventricular assist device 100 to be mismatched with the left cardiac output demand, resulting in problems with excessive unloading, aspiration, overcharging, etc. of the left ventricle 128.
Based on this, the control unit can monitor the pressure difference of the left ventricle 128 in real time during the operation of the ventricular assist device 100, find the abnormality of the blood pressure of the user or the abnormality of the ventricular assist device 100 as soon as possible, and give an alarm to prompt the treatment as soon as possible, thereby improving the success rate of treatment.
The arterial pressure may be too high because of the high blood pressure due to the excessive vascular resistance, and the blood is trapped in the left ventricle 128 and cannot be pumped into the aorta 124. The user's left ventricle may be depressed because of too little blood volume in the left ventricle 128 due to too high a rotational speed of the ventricular assist device 100, or too little blood volume in the left ventricle 128 due to systemic hypovolemia or right heart failure. The user's arterial pressure may be too low or left ventricular pressure may be due to excessive blood volume in left ventricle 128 caused by too low a rotational speed of ventricular assist device 100.
In the present application, the ventricular assist device 100 may be placed in a test environment to measure the characteristic curve of its pumping flow rate versus ventricular pressure differential at different rotational speeds prior to shipment of the ventricular assist device 100. The pressure flow characteristic for each rotational speed is then stored in the control unit. When the ventricular assist device 100 is in operation, the current rotational speed and pumping flow rate of the ventricular assist device 100 are obtained, and then the pressure difference of the current left ventricle 128 is estimated according to the pressure flow characteristic curve, and whether the current user pressure difference is abnormal is determined according to the magnitude of the ventricular pressure difference.
Specifically, the control unit may monitor the pumping flow rate of the ventricular assist device 100 in real-time and calculate an average pumping flow rate over each first period. And then searching a first differential pressure corresponding to the current rotating speed from the target characteristic curve. Comparing the first pressure difference with the pressure difference between the main pulse pressure and the left ventricular pressure when the user is normal, and if the first pressure difference is larger than the pressure difference when the user is normal, namely if the first pressure difference is smaller than a first pressure threshold or larger than a second pressure threshold, considering that the current blood pressure of the user is abnormal. The user blood pressure abnormality may include a left ventricular pressure being too low or an arterial pressure being too high due to an excessive rotational speed of the ventricular assist device 100, and a left ventricular pressure being too high or an arterial pressure being too low due to an excessive rotational speed of the ventricular assist device 100.
The first pressure threshold is the difference between the lower limit value of the main pulse pressure and the upper limit value of the left ventricular pressure when the user is normal, and the second pressure threshold is the difference between the upper limit value of the main pulse pressure and the lower limit value of the left ventricular pressure when the user is normal. By way of example, the first pressure threshold is set at 35mmHg and the second pressure threshold is set at 80mmHg. When the first pressure difference is less than 35mmHg, the current user is considered to have too low blood pressure, and when the first pressure difference is less than 80mmHg, the current user is considered to have too high blood pressure.
Further, when the abnormal blood pressure of the user is monitored, the control unit can automatically adjust the rotation speed of the ventricular assist device 100 to solve the abnormal blood pressure of the user caused by mismatching between the rotation speed of the ventricular assist device 100 and the current user demand.
If the first pressure difference is smaller than the first pressure difference threshold, it indicates that the rotational speed of the ventricular assist device 100 is too low, such that the left ventricular pressure is too high or the arterial pressure is too low, and at this time, the blood volume in the left ventricle 128 is too high, and the rotational speed of the ventricular assist device 100 needs to be increased, and if the first pressure difference is larger than the second pressure difference threshold, it indicates that the rotational speed of the current ventricular assist device 100 is too high, such that the left ventricular pressure is too low or the arterial pressure is too high, at this time, the blood volume in the left ventricle 128 is too low, and at this time, the rotational speed of the ventricular assist device 100 needs to be increased. Accordingly, upon detecting that the first differential pressure is smaller than the first differential pressure threshold, the control unit controls the rotation speed of the ventricular assist device 100 to be sequentially increased by the rotation speed step Δv until the first differential pressure is larger than the first differential pressure threshold and smaller than the second differential pressure threshold, or the number of times of increasing the rotation speed step Δv exceeds n. Similarly, when it is detected that the first differential pressure is greater than the second differential pressure threshold, the control unit controls the rotation speed of the ventricular assist device 100 to be sequentially reduced by Δv until the first differential pressure is greater than the first differential pressure threshold and less than the second differential pressure threshold, or the number of times of reducing the rotation speed by Δv exceeds n.
In the embodiment of the application, the control unit can monitor the blood pressure of the user in real time without additional monitoring equipment or devices, and when the blood pressure of the user is abnormal, the problem of the abnormal blood pressure of the user is reduced or solved by automatically adjusting the rotating speed of the ventricular assist device 100, so that the harm caused by the abnormal blood pressure can be reduced or avoided, and the safety of the user is improved.
In a possible embodiment, after the ventricular assist device is started, the method further includes obtaining a target efficiency map and a third average flow, wherein the target efficiency map is a map between a pressure difference and a rotation speed when the ventricular assist device is at an optimal operation efficiency under the pressure difference, the third average flow is an average pumping flow of the ventricular assist device in a third period after the ventricular assist device is started, determining a second pressure difference corresponding to the third average flow according to a target characteristic curve, determining a target rotation speed corresponding to the second pressure difference according to the target efficiency map, and adjusting the rotation speed of the ventricular assist device to the target rotation speed.
In practical applications, the starting rotation speed of the ventricular assist device 100 is set by a doctor according to experience and user conditions, and may require multiple attempts and a long time to find a suitable operation rotation speed, and the operation rotation speed cannot be automatically adjusted or can be adjusted only according to a set rotation speed adjustment interval and adjustment frequency. The auxiliary ventricular assist device 100 may be operated in a low-efficiency region for a long period of time, the advantages of the auxiliary ventricular assist device 100 may not be fully exerted, and there may be a risk of blood damage or an increased risk of thrombosis.
Based on this, after the ventricular assist device 100 is started, the control unit may directly adjust the rotation speed of the ventricular assist device 100 to the rotation speed with optimal operation efficiency, so as to improve the operation efficiency of the ventricular assist device 100, reduce the duration of the regurgitation of the ventricular assist device 100, and reduce the harm of the regurgitation to the user.
According to the pressure flow characteristic curve of the ventricular assist device 100, the ventricular pressure difference corresponding to different pumping flows is different at different rotational speeds. The ventricular pressure differential is the pressure differential between the user's aortic pressure and the left ventricular pressure and may also be characterized as the pressure differential between the pressure at the outlet and the pressure at the inlet of the ventricular assist device 100. Before the ventricular assist device 100 leaves the factory, the ventricular assist device 100 can be placed in a testing system to respectively test the pressure difference when the ventricular assist device 100 operates at the optimal efficiency of each rotation speed according to the pressure flow characteristic curve of the ventricular assist device 100 at each rotation speed or the rotation speed level, and then an optimal efficiency mapping table of the pressure difference and the rotation speed is fitted.
After activation of ventricular assist device 100, the control unit may monitor the pumping flow of ventricular assist device 100 in real-time and calculate an average pumping flow of ventricular assist device 100 over a third period of time. Then, a second differential pressure corresponding to the current rotating speed is found out from the target characteristic curve, and then, the rotating speed with the optimal operating efficiency of the ventricular assist device 100 under the second differential pressure is determined according to the target efficiency mapping table, so that the rotating speed of the ventricular assist device 100 is directly regulated to the target rotating speed, the workload of medical care manual monitoring and regulation can be reduced, the efficiency is improved, and the ventricular assist device 100 is always kept to operate in an optimal efficiency interval.
Where the rotational speed at which the ventricular assist device 100 operates optimally refers to the rotational speed at which the ventricular assist device 100 is able to provide the same pumping flow rate or more with minimal power consumption.
The target rotation speed may be any value within a rotation speed range. For example, if the target rotational speed is 35000RPM, then the ventricular assist device 100 may be considered to achieve the target rotational speed when adjusted to a rotational speed that is within 35000 RPM+ -1000 RPM.
Further, the control unit may not control the ventricular assist device 100 to be adjusted to the target rotational speed when the corresponding second pressure difference is smaller than the hypotensive alert threshold or larger than the hypertensive alert threshold, i.e. when the second pressure difference is smaller than the first pressure threshold or larger than the second pressure threshold.
In a possible embodiment, the method further comprises obtaining a target heart rate, wherein the target heart rate is the frequency of occurrence of the first pumping flow rate of the ventricular assist device in a preset time, and if the target heart rate is smaller than a first heart rate threshold value or larger than a second heart rate threshold value, determining that the heart rate of the target user is abnormal and alarming.
In practical applications, heart failure of the user removes heart function and pump insufficiency, and there are many complications, such as arrhythmia, ventricular fibrillation, bradycardia or tachycardia, and other arrhythmia problems. Therefore, during the operation of the ventricular assist device 100, the control unit also needs to monitor the heart rhythm of the user in real time, so that the heart rhythm abnormality exists, and the heart rhythm abnormality can be timely alarmed, so as to prompt the user to seek medical intervention as soon as possible, or prompt the doctor to make diagnosis as soon as possible and take necessary treatment measures, so as to reduce various risks caused by the heart rhythm abnormality and improve the survival rate of the user.
Heart rate is the number of beats of the heart per minute. The length of the cardiac cycle is related to the heart rate, wherein the heart rate increases and the cardiac cycle shortens. During operation of the ventricular assist device 100, the control unit monitors the pumping rate of the ventricular assist device 100 in real time, records the number of occurrences of the first pumping rate (i.e., the target heart rate) in 1 minute, with the time interval adjacent to the first pumping rate as the cardiac cycle. The target heart rate is then compared to a normal heart rate range, and if the target heart rate is at or above a first heart rate threshold or above a second heart rate threshold, the current heart rate is considered abnormal.
For example, the first heart rate threshold may be set to 40 times/min and the second heart rate threshold may be set to 150 times/min. When the target heart rate is less than 40 times/min, the current target user is considered bradycardia, and the control unit can alarm to indicate the current bradycardia of the user. When the target heart rate is less than 150 times/min, the current target user is considered to be tachycardia, and the control unit can alarm to indicate the current user tachycardia.
For example, the control unit may also set the priority of the alarm, set the judging threshold value for bradycardia or tachycardia in a grading manner, and adopt different alarm grades. By way of example, a low priority bradycardia alert may be sent out at a target heart rate of less than 60 beats/min, a medium priority bradycardia alert may be sent out at a target heart rate of less than 50 beats/min, and a high priority bradycardia alert may be sent out at a target heart rate of less than 40 beats/min.
Optionally, the method further comprises the steps of obtaining a fourth pumping flow in the first duration, wherein the fourth pumping flow is a flow valley value pumped by the ventricular assist device, calculating a fourth average flow, which is an average value of the fourth pumping flow and the first pumping flow, calculating a target pulsation index according to the first pumping flow, the fourth pumping flow and the fourth average flow, and determining that the target user is abnormal in heart rhythm and alarms if the target pulsation is smaller than a pulsation threshold value.
In an embodiment of the present application, the control unit may also monitor the current ventricular fibrillation of the user based on the fluctuation of the pumping flow of the ventricular assist device 100. Specifically, the control unit monitors the pumping flow rate of the ventricular assist device 100 in real time, records a peak value Lmax (first pumping flow rate) of the pumping flow rate of the ventricular assist device 100, and a valley value Lmin (fourth pumping flow rate) of the pumping flow rate of the ventricular assist device 100 adjacent to the peak value Lmax, and calculates an average pumping flow rate Lave (second average flow rate) between the peak value Lmax and the valley value Lmin. Then calculate the fluctuation index of the ventricular assist device 100 pumping flow, which is pi= (Lmax-Lmin)/Lave. Since the ventricular assist device 100 pumping flow rate variation is synchronized with the user's cardiac cycle, the user's pulsatility index may be characterized by the flow rate fluctuation index of the ventricular assist device 100. If the calculated target pulse index PI is smaller than the pulse threshold value, it is determined that the target user currently has ventricular fibrillation, and the control unit can alarm the ventricular fibrillation.
Further, to reduce the risk of false alarm, the control unit may calculate the pulsation index PI in the first period, and if the pulsation index PI in the first period is continuously smaller than the pulsation threshold value, or 80% of the pulsation index PI in the first period is smaller than the pulsation threshold value, determine that the target user currently has ventricular fibrillation, and alarm the target user.
Optionally, the method further comprises the steps of calculating a target change coefficient, wherein the target change coefficient is the ratio of adjacent first pumping flow or the ratio of adjacent first duration, and if the target change coefficient is smaller than a second value or larger than a third value, determining that the target user is abnormal in heart rhythm and alarming.
In an embodiment of the present application, the control unit may also monitor whether an arrhythmia is present in the user based on fluctuations in the pumping flow of the ventricular assist device 100. Specifically, the control unit monitors the pumping flow rate of the ventricular assist device 100 in the first period in real time, and records each first pumping flow rate and the time corresponding to the first pumping flow rate in the first period. And then calculating the change coefficient of the pumping flow in the first period, namely calculating the ratio (K i＝Lmaxi/Lmaxi-1) of each adjacent first pumping flow or the ratio of the interval duration between the adjacent first pumping flows (K i＝ti/ti-1,ti is the interval duration between the adjacent first pumping flows), so as to obtain a plurality of target change coefficients. If the target change coefficients in the first period are smaller than the second value or larger than the third value, determining that the current target user is arrhythmia, and alarming the arrhythmia by the control unit.
Wherein the first value and the second value may be set according to a heart rhythm of the target user when the target user is normal. For example, the second value may be set to 0.8 and the first value may be set to 1.2.
In the embodiment of the present application, the control unit may calculate the abnormal flow fluctuation phenomenon according to the characteristic that the pump flow variation of the ventricular assist device 100 is consistent with the cardiac cycle, without any additional monitoring device or apparatus, and may continuously monitor the patient's cardiac rhythm in real time, determine the corresponding abnormal cardiac rhythm situation (such as tachycardia, ventricular fibrillation, premature beat, etc.), and send an alarm, prompt the user to intervene in early medical intervention, or prompt the doctor to make a diagnosis early and take necessary treatment measures, so as to reduce various risks caused by arrhythmia, and improve the survival rate of the user.
It can be seen that the application provides a self-adaptive control method, which is used for acquiring a plurality of pumping flows of a ventricular assist device in a first period at a first rotation speed, recording a first duration and a second duration, wherein the first duration is a duration of an adjacent first pumping flow interval, the second duration is a duration from the first pumping flow in the first duration to a pumping flow smaller than a first flow threshold, the first pumping flow is a peak value of the pumping flow of the ventricular assist device, and if the first rotation speed is regulated according to a target ratio, the target ratio is a ratio of the second duration to the first duration. According to the application, the cardiac cycle of the user and the low flow value of the ventricular assist device can be respectively determined according to the first time length and the second time length, and the rotating speed of the ventricular assist device is adaptively adjusted according to the ratio of the second time length to the first time length, so that the pumping flow of the ventricular assist device can meet the requirement of the user in real time, the occurrence of abnormality of the ventricular assist device is reduced, and the safety of the user is improved.
The foregoing description of the embodiments of the present application has been presented primarily in terms of a method-side implementation. It will be appreciated that the network device, in order to implement the above-described functions, includes corresponding hardware structures and/or software modules that perform the respective functions. Those of skill in the art will readily appreciate that the various illustrative elements and algorithm steps described in connection with the embodiments disclosed herein may be implemented as hardware or combinations of hardware and computer software. Whether a function is implemented as hardware or computer software driven hardware depends upon the particular application and design constraints imposed on the solution. Skilled artisans may implement the described functionality in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the present application.
The application provides a control device of a ventricular assist device, which comprises one or more processors, wherein the one or more processors are used for acquiring a plurality of pumping flows when the ventricular assist device operates at a first rotating speed in a first period, the first time is the time length of an adjacent first pumping flow interval, the second time length is the time length from the first pumping flow to the pumping flow smaller than a first flow threshold value in the first time length, the first pumping flow is the peak value of the pumping flow of the ventricular assist device, and the first rotating speed is adjusted according to a target ratio, wherein the target ratio is the ratio of the second time length to the first time length.
The present application also provides a ventricular assist device, including:
A housing;
An impeller disposed within the housing;
A control unit for controlling the rotation of the impeller, said control unit being used for some or all of the steps described in the method described above.
The application also provides, for example, a medical device comprising the control device or the ventricular assist device described above.
The control device of each scheme has the function of realizing the corresponding steps executed by the medical equipment in the method, and the function can be realized by hardware or can be realized by executing corresponding software by hardware.
In an embodiment of the present application, the control device may also be a chip or a system on chip (SoC), for example.
Referring to fig. 4, fig. 4 is a schematic structural diagram of a medical device according to an embodiment of the present application, the medical device includes one or more processors, one or more memories, one or more communication interfaces, and one or more programs, and the one or more programs are stored in the memories and configured to be executed by the one or more processors.
The program includes instructions for performing the steps of:
Acquiring a plurality of pumping flows of the ventricular assist device during a first cycle at a first rotational speed;
the first duration is a duration of an adjacent first pumping flow interval, the second duration is a duration from the first pumping flow to the pumping flow less than a first flow threshold in the first duration, and the first pumping flow is a peak value of the pumping flow of the ventricular assist device;
And adjusting the first rotating speed according to a target ratio, wherein the target ratio is the ratio of the second duration to the first duration.
All relevant contents of each scenario related to the above method embodiment may be cited to the functional description of the corresponding functional module, which is not described herein.
It should be appreciated that the memory described above may include read only memory and random access memory and provide instructions and data to the processor. A portion of the memory may also include non-volatile random access memory. For example, the memory may also store information of the device type.
In an embodiment of the present application, the processor of the above apparatus may be a central processing unit (Central Processing Unit, CPU), which may also be other general purpose processors, digital Signal Processors (DSP), application Specific Integrated Circuits (ASIC), field Programmable Gate Arrays (FPGA) or other programmable logic devices, discrete gate or transistor logic devices, discrete hardware components, or the like. A general purpose processor may be a microprocessor or the processor may be any conventional processor or the like.
It should be understood that references to "at least one" in embodiments of the present application mean one or more, and "a plurality" means two or more. "and/or" describes an association of associated objects, meaning that there may be three relationships, e.g., A and/or B, and that there may be A alone, while A and B are present, and B alone, where A, B may be singular or plural. The character "/" generally indicates that the context-dependent object is an "or" relationship. "at least one of" or the like means any combination of these items, including any combination of single item(s) or plural items(s). For example, at least one (a, b, or c) of a, b, c, a-b, a-c, b-c, or a-b-c may be represented, wherein a, b, c may be single or plural.
And, unless specified to the contrary, references to "first," "second," etc. ordinal words of embodiments of the present application are used for distinguishing between multiple objects and are not used for limiting the order, timing, priority, or importance of the multiple objects. For example, the first information and the second information are only for distinguishing different information, and are not indicative of the difference in content, priority, transmission order, importance, or the like of the two information.
In implementation, the steps of the above method may be performed by integrated logic circuits of hardware in a processor or by instructions in the form of software. The steps of the method disclosed in connection with the embodiments of the present application may be embodied directly in a hardware processor for execution, or in a combination of hardware and software elements in the processor for execution. The software elements may be located in a random access memory, flash memory, read-only memory, programmable read-only memory or electrically erasable programmable memory, registers, etc. as well known in the art. The storage medium is located in a memory, and the processor executes instructions in the memory to perform the steps of the method described above in conjunction with its hardware. To avoid repetition, a detailed description is not provided herein.
The embodiment of the present application also provides a computer storage medium storing a computer program for electronic data exchange, where the computer program causes a computer to execute some or all of the steps of any one of the methods described in the above method embodiments.
Embodiments of the present application also provide a computer program product comprising a non-transitory computer-readable storage medium storing a computer program operable to cause a computer to perform part or all of the steps of any one of the methods described in the method embodiments above. The computer program product may be a software installation package.
It should be noted that, for simplicity of description, the foregoing method embodiments are all described as a series of acts, but it should be understood by those skilled in the art that the present application is not limited by the order of acts described, as some steps may be performed in other orders or concurrently in accordance with the present application. Further, those skilled in the art will also appreciate that the embodiments described in the specification are all preferred embodiments, and that the acts and modules referred to are not necessarily required for the present application.
In the foregoing embodiments, the descriptions of the embodiments are emphasized, and for parts of one embodiment that are not described in detail, reference may be made to related descriptions of other embodiments.
In the several embodiments provided by the present application, it should be understood that the disclosed apparatus may be implemented in other manners. For example, the above-described apparatus embodiments are merely illustrative, and the division of elements, such as those described above, is merely a logical function division, and may be implemented in other manners, such as multiple elements or components may be combined or integrated into another system, or some features may be omitted, or not performed. Alternatively, the coupling or direct coupling or communication connection shown or discussed with each other may be an indirect coupling or communication connection via some interfaces, devices or units, or may be in electrical or other forms.
The units described above as separate components may or may not be physically separate, and components shown as units may or may not be physical units, may be located in one place, or may be distributed over a plurality of network units. Some or all of the units may be selected according to actual needs to achieve the purpose of the embodiment of the present application.
In addition, each functional unit in the embodiments of the present application may be integrated in one processing unit, or each unit may exist alone physically, or two or more units may be integrated in one unit. The integrated units may be implemented in hardware or in software functional units.
The integrated units described above, if implemented in the form of software functional units and sold or used as stand-alone products, may be stored in a computer readable memory. Based on such understanding, the technical solution of the present application may be embodied essentially or partly in the form of a software product or all or part of the technical solution, which is stored in a memory, and includes several instructions for causing a computer device (which may be a personal computer, a server, or TRP, etc.) to perform all or part of the steps of the method of the embodiments of the present application. The Memory includes a U disk, a Read-Only Memory (ROM), a random access Memory (RAM, random Access Memory), a removable hard disk, a magnetic disk, or an optical disk, etc. which can store the program codes.
Those of ordinary skill in the art will appreciate that all or a portion of the steps of the various methods of the above embodiments may be implemented by a program that instructs associated hardware, and the program may be stored in a computer readable memory, which may include a flash disk, a ROM, a RAM, a magnetic disk, an optical disk, etc.
The foregoing has outlined rather broadly the more detailed description of embodiments of the application, wherein the principles and embodiments of the application are explained in detail using specific examples, the above examples being provided solely to facilitate the understanding of the method and core concepts of the application; meanwhile, as those skilled in the art will have variations in the specific embodiments and application scope in accordance with the ideas of the present application, the present description should not be construed as limiting the present application in view of the above.
Claims (10)
1. A control unit of a ventricular assist device, the control unit comprising one or more processors configured to perform the steps of:
Acquiring a plurality of pumping flows of the ventricular assist device during a first cycle at a first rotational speed;
Recording a first duration and a second duration, wherein the first duration is a duration of an adjacent first pumping flow interval, the second duration is a duration from the first pumping flow to the pumping flow less than a first flow threshold in the first duration, and the first pumping flow is a peak value of the pumping flow of the ventricular assist device;
the first rotating speed is regulated according to a target ratio, wherein the target ratio is the ratio of the second duration to the first duration;
wherein said adjusting said first rotational speed according to a target ratio comprises:
If the target ratio is greater than a first target value, sequentially increasing the first rotating speed until the first rotating speed is increased by n times of rotating speed steps or a difference value between a first average flow and a second average flow is greater than a second flow threshold, wherein the first average flow is an average value of the pumping flow in the first period, the second average flow is an average value of the pumping flow in the second period, the first period is earlier than the second period, and n is a positive integer;
And if the target ratio is smaller than a second target value, sequentially reducing the first rotating speed until the first rotating speed is reduced by n rotating speed steps or the difference value between the second average flow and the first average flow is larger than the second flow threshold.
2. The control unit of claim 1, further configured to perform the steps of:
determining a second pumping flow rate and a target number, wherein the target number is the number of pumping flows smaller than the first flow rate threshold in the first time period, and the second pumping flow rate is the minimum pumping flow rate in the first time period;
And if the second pumping flow is smaller than a third flow threshold and the target number is larger than or equal to a first value, determining that reflux exists in the ventricular assist device and alarming.
3. The control unit of claim 1, further configured to perform the steps of:
Acquiring a target characteristic curve, wherein the target characteristic curve is a pressure flow characteristic curve of the ventricular assist device;
Determining a first pressure difference corresponding to a first average flow rate at the first rotating speed according to the target characteristic curve, wherein the first pressure difference is a difference value between the pressure at the outlet and the pressure at the inlet of the ventricular assist device;
and if the first pressure difference is smaller than a first pressure threshold value or the first pressure difference is larger than a second pressure threshold value, determining that the blood pressure of a target user is abnormal and alarming, wherein the target user is the user implanted with the ventricular assist device.
4. The control unit of claim 1, wherein after activation of the ventricular assist device, the control unit is further configured to perform the steps of:
Obtaining a target efficiency mapping table and a third average flow, wherein the target efficiency mapping table is a mapping table between a pressure difference and a rotating speed when the operation efficiency of the ventricular assist device is optimal under the pressure difference, and the third average flow is an average pumping flow of the ventricular assist device in a third time period after the ventricular assist device is started;
Determining a second pressure difference corresponding to the third average flow according to the target characteristic curve;
Determining a target rotating speed corresponding to the second differential pressure according to the target efficiency mapping table;
the rotational speed of the ventricular assist device is adjusted to the target rotational speed.
5. The control unit of claim 1, further configured to perform the steps of:
acquiring a target heart rate, wherein the target heart rate is the occurrence frequency of the first pumping flow in a preset time by the ventricular assist device;
and if the target heart rate is smaller than the first heart rate threshold or larger than the second heart rate threshold, determining that the target user heart rate is abnormal and alarming.
6. The control unit of claim 1, further configured to perform the steps of:
Acquiring a fourth pumping flow rate in the first duration, wherein the fourth pumping flow rate is a flow valley value pumped by the ventricular assist device;
Calculating a fourth average flow rate, which is an average value of the fourth pumping flow rate and the first pumping flow rate;
Calculating a target pulsatility index from the first pumping flow, the fourth pumping flow, and the fourth mean flow;
and if the target pulse is smaller than the pulse threshold value, determining that the target user is abnormal in heart rhythm and alarming.
7. The control unit of claim 1, further configured to perform the steps of:
Calculating a target change coefficient, wherein the target change coefficient is the ratio of adjacent first pumping flows or the ratio of adjacent first duration;
And if the target change coefficient is smaller than the second value or larger than the third value, determining that the target user is abnormal in heart rhythm and alarming.
8. A ventricular assist device, the ventricular assist device comprising:
A housing;
An impeller disposed within the housing;
a control unit for controlling the rotation of the impeller, the control unit comprising one or more processors for performing the steps of any of the preceding claims 1-7.
9. A medical device comprising a processor, a memory and a communication interface, the memory storing one or more programs, and the one or more programs being executed by the processor, the one or more programs comprising instructions for performing the steps of any of claims 1-7.
10. A computer readable storage medium storing a computer program for electronic data exchange, wherein the computer program causes a computer to perform the steps of any one of claims 1-7.
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| CN202411566768.5A CN119280656B (en) | 2024-11-05 | Self-adaptive control method and device |
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| CN202411566768.5A CN119280656B (en) | 2024-11-05 | Self-adaptive control method and device |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5888242A (en) * | 1996-11-01 | 1999-03-30 | Nimbus, Inc. | Speed control system for implanted blood pumps |
| CN111867674A (en) * | 2018-03-09 | 2020-10-30 | 美敦力公司 | Ventricular assist devices and cardiac electrical stimulation systems for therapy control |
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5888242A (en) * | 1996-11-01 | 1999-03-30 | Nimbus, Inc. | Speed control system for implanted blood pumps |
| CN111867674A (en) * | 2018-03-09 | 2020-10-30 | 美敦力公司 | Ventricular assist devices and cardiac electrical stimulation systems for therapy control |
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