| 研究生: |
周芷璇 chou-chih-hsuan |
|---|---|
| 論文名稱: |
具氧氣回授控制與智慧型呼吸器警報系統之設計與實現 Design and Implementation of Oxygen Control with Feedback and Intelligent Alarm System of Ventilation |
| 指導教授: |
徐國鎧
Kuo-Kai Shyu |
| 口試委員: | |
| 學位類別: |
碩士 Master |
| 系所名稱: |
資訊電機學院 - 電機工程學系 Department of Electrical Engineering |
| 論文出版年: | 2013 |
| 畢業學年度: | 101 |
| 語文別: | 中文 |
| 論文頁數: | 81 |
| 中文關鍵詞: | 呼吸器自動化 、氧氣回授控制 、智慧型警報 |
| 外文關鍵詞: | Ventilation Automation, Oxygen Feedback Control, Intelligent alarm system |
| 相關次數: | 點閱:9 下載:0 |
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本論文以人工呼吸器自動化為主軸,設計具有氧氣回授控制與智慧型呼吸器警報之系統。以呼吸器設計之原則:設定人工呼吸器方式與安全警報兩方面作研究探討。在設定人工呼吸方式部分,所提出的氧氣回授概念,是人工呼吸器自動化中較容易切入研究的一個架構,當病人氧氣需求增加時,由設計的氧氣回授架構,自動依病人需求,利用模糊控制理論,來達到最適切及即時性的氧氣濃度,將醫生的知識、經驗、方法與策略,交由模糊控制器來實現,使得醫學經驗法則容易被理解與接受,其優點是設計上較為簡單與便於應用。而在安全警報部分,本研究開發創新的智慧型警報系統,將呼吸器的生理參數,經綜合演算判斷來達到一較有效率且準確較高的呼吸器警報系統,以提供醫護人員有效的警示及即時處置管理,如病人呼吸器資料收集管理及抽痰、管路脫離或洩漏等各項條件的警示。 最後,本論文已經藉由實驗證實提出之氧氣回授控制與智慧型呼吸器警報判斷,具有其使用優勢與判斷意義在。
This study propose a novel method for mechanical ventilation automation. Based on design principles of ventilation: Setting breathing and security alarms. In the setting the breathing part of the proposed concept of oxygen feedback control, when the patient oxygen requirements increase, the design Oxygen feedback architecture according to patient needs,using fuzzy control theory to achieve the most appropriate and the oxygen concentration in real-time. The alarm system of mechanical ventilation is important to alert caregiver to perform specific procedure to keep patient away from injury and dangerous condition. However, conventional alarm signals are simply designed and need more sophisticated analysis by skilled caregiver to have proper response in short time period. We try to develop an intelligent alarm system to demonstrate more specific clinical problem and allow caregiver to handle the critical situation handy and timely . We set up the alert system to signify the change of lung condition while Pplateau increases. The result presents the suction alarm occurs when Ppeak increase, Rexp increase and Fexp decrease in the mechanical ventilation model after simulated sputum injection.
參考文獻
[1] Grossbach, I., “Troubleshooting ventilator and patient-related
problems--Part 2”. NCBI, Crit Care Nurse, Vol 6, No 5, pp. 64-79.
1986.
[2] Grossbach, I., “Troubleshooting ventilator- and patient-related
problems/Part 1”. NCBI, Crit Care Nurse, Vol 6, No 4, pp. 58-70.
1986.
[3] Grossbach, I., L. Chlan, and M.F. Tracy, “Overview of mechanical
ventilatory support and management of patient- and ventilator-related
responses”. AACN Crit Care Nurse, Vol 31, No. 3 pp. 30-44, June
2011.
[4] Edworthy, J. and E. Hellier, “Alarms and human behaviour:
implications for medical alarms”. BJA, Vol 97, No 1, pp. 12–17, May
2006.
[5] Imhoff, M. and S. Kuhls, “Alarm algorithms in critical care
monitoring”. IARS Anesth Analg, Vol 102, No 5, pp. 1525-37,
December 2006.
[6] Gorges, M., B.A. Markewitz, and D.R. Westenskow, “Improving alarm
performance in the medical intensive care unit using delays and
clinical context”, IARS Anesth Analg, Vol. 108, No. 5, pp 1546 –52,
May 2009.
[7] Myerson, K.R., A.H. Ilsley, and W.B. Runciman, “An evaluation of
ventilator monitoring alarms”. NCBI, Anaesth Intensive Care, Vol. 14,
No. 2, pp. 174-85, 1986
[8] Visaria R.K, and Westenskow DR. “Model-based detection of partially
obstructed endotracheal tube”. SCCM, Vol. 33, No. 1, 2005.
[9] R. S. Evant, K. V. Johnson, V. B. Flint, T. Kinder, C. R. Lyon, W.Hawley, D. K. Vawdrey, G. Thomsen, “Enhanced Notification of
Critical Ventilator Events” . JAMIA, Vol 12, No. 6 pp. 589–595.
November 2005.
[10] J. M. Arnal, M. Wysocki, D. Novotni, D. Demory, R. Lopez, S. Donati,
I. Granier, G. Corno, J. D. Gasselin. “Safety and efficacy of a fully
closed-loop control ventilation (IntelliVent-ASV® ) in sedated ICU
patients with acute respiratory failure: a prospective randomized
crossover study”.ESICM, Intensive Care Med, Vol 38, pp. 781–787.
March 2012.
[11] Beachey W. Respiratory care anatomy physiology., 2th Edition, Mosby
Elsevier.,2007.
[12] Kevin T. Patton, and Gary A. Thibodeau, Anatomy & Physiology., 3th
Edition,1996.
[13] Lynelle N.B. Management of the Mechanically Ventilated Patient., 2th
Edition, Mosby Elsevier., 2006.
[14] Giorgio A. and Braschi A. Measurements of respiratory mechanics
during mechanical ventilation., Hamilton Medical AG, Rhäzüns,
Switzerland. 1999.
[15] 吳清平,呼吸作功在呼吸機使用上的角色,中華民國呼吸照護簡訊,
1999 年4 月。
[16] 美國胸腔學院院士等編著,呼吸加強照護,二版,合記圖書出版社,
台北市,民國八十一年。
[17] 吳清平等,機械性呼吸的演進-人工智慧型呼吸器的進展,Twain
Crit. Care Med. 2003 年。
[18] 吳清平,人工呼吸器的脫離。Taiwan Crit. Care Med. 1999 年。
[19] 楊式興等,呼吸器監測與管理通報系統。台灣呼吸治療雜誌,2007
年。
[20] Cairo J. M. and Pilbeam. Respiratory Care Equipment., 8th Edition,
Mosby Elsevier., 2009.
[21] 柳福源,「人體血液循環量測系統之研製」,國立中央大學電機工程
學系,碩士論文,民國94 年。
[22] Pilbeam S. P. and Cairo J.M. Mechanical ventilation: physiological and
clinical applications., 4th Edition, Mosby Elsevier., 2006.
[23] Aviva Petrie and Caroline Sabin. Medical Statistics at a Glance., 3th
Edition, John Wiley & Sons Inc, 2009.
[24] W. H. Woodall, D. J. Spitzner, D. C. Montgomery and S. Gupta,
“Using control charts to monitor process and product quality profiles,”
Journal of Quality Technology, vol. 36, pp. 309-320, 2004.
[25] 張維華,SPC 統計製程管制,中衛發展中心,台北市,1995。
[26] Shah, S., K. Fung, S. Brim, and B. rubin, “An in-vitro evaluation of the
effectivenss of endotracheal suction catheter”. CHEST, Vol 128, No. 5
pp. 3699-3704. November 2005.
[27] Microchip, “PIC32MX5XX/6XX/7XX Family Data Sheet”.
DS61156G, 2011.
[28] Microchip, “PIC32”. DS61127D, 2011.
[29] L. A. Zadeh, “Fuzzy sets”, Information and Control, Vol. 8,
pp.338-353,1965.
[30] 王進德,類神經網路與模糊控制理論入門與應用,初版,全華科技
圖書,台北市,民國九十五年。
[31] 王文俊,認識Fuzzy,三版,全華科技圖書,台北市,民國九十四
年。
[32] E. H. Mamdani, “Applications of Fuzzy Algorithm for Control a
Simple Dynamic Plant”, Proc. IEEE, pp.1585-1588, 1974.