Oxygen administration method for heart failure patients with sleep-disordered breathing

心力衰竭睡眠呼吸障碍患者的供氧方法

基本信息

批准号：
16360211
负责人：
ARAKI Mituhiko
金额：
$ 6.91万
依托单位：
Matsue National College of Technology (2006)Kyoto University (2004-2005)
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2004
资助国家：
日本
起止时间：
2004 至 2006
项目状态：
已结题

项目摘要

Sleep apnea syndrome (SAS) is a sleep-disordered breathing that causes hypoxemia during sleep. The effect of SAS on patients with heart failure attracts increasing attention. As a treatment for the sleep-disordered breathing, continuous positive airway pressure (CPAP) treatment is widely used and effective even for heart failure patients. However it cannot prevent the decrease of oxygen saturation satisfactorily, because the oxygen is administrated with a constant flow rate. In this research, a control system of oxygen administration is designed in order to improve the oxygen saturation under the CPCA treatment.First the dynamics of the oxygen saturation was studied based on clinical data and it was clarified that the 3 hours per day CPAP causes decrease of the artery pressure as well as of the heart rate meaningfully. As a result it was deduced that to keep the oxygen saturation should above 90 percent is vital. Second, based on the above study, a model of the oxygen dynamics was constructed as a second order state equation. It was assured that the model appropriately describe s the phenomena provided that the oxygen saturation drops caused by the heart failure do not occur very frequently. It was found that the individual difference of the model parameters (gain and time constant) is within 3 times. This model revealed that the heart rate has little effect on the oxygen saturation, against the previously claimed view. Lastly, a control system using the state predictive method was designed, and shown, by simulation, to be able to keep the oxygen saturation above 90 percent assuming that long term non-breathing does not happen.

睡眠呼吸暂停综合征（SAS）是一种睡眠呼吸的呼吸，会在睡眠期间引起低氧血症。 SAS对心力衰竭患者的影响会引起越来越多的注意力。作为对睡眠呼吸的治疗方法，连续阳性气道压力（CPAP）治疗也被广泛使用且有效，即使对心力衰竭患者也是有效的。但是，它无法令人满意地阻止氧饱和度的减少，因为氧气以恒定的流速管理。在这项研究中，为了改善CPCA处理下的氧气饱和度，设计了氧气施用的控制系统。首先根据临床数据研究了氧饱和度的动力学，并澄清说，每天的3小时CPAP导致动脉压力的降低以及心脏速度的有意义。结果，可以推断出保持氧饱和度应该超过90％至关重要。其次，基于上述研究，将氧动力学的模型构建为二阶状态方程。可以确保该模型适当地描述了这种现象，规定由心力衰竭引起的氧饱和度降低并不是很频繁。发现模型参数的个体差异（增益和时间常数）在3次之内。该模型表明，心率对氧饱和度几乎没有影响，与先前声称的观点相比。最后，设计了使用状态预测方法的控制系统，并通过仿真显示，可以将氧饱和度保持在90％以上，假设没有发生长期非呼吸。