DO NOT MERGE: additional ventilation modes

.pre-commit-config.yaml

@@ -33,6 +33,7 @@ repos:
   rev: v2.5.0
   hooks:
   - id: check-yaml
+    exclude: ^software/.clang-format
   - id: end-of-file-fixer
     exclude: ^gui/app/third_party|^pcb/
   - id: trailing-whitespace

software/.clang-format

@@ -168,4 +168,8 @@ StatementMacros:
 TabWidth:        8
 UseCRLF:         false
 UseTab:          Never
+---
+Language: Proto
+BasedOnStyle:  Google
+ColumnLimit:     100
 ...

software/common/generated_libs/network_protocol/network_protocol.pb.h

@@ -18,7 +18,16 @@ typedef enum _VentMode {
     VentMode_OFF = 0,
     VentMode_PRESSURE_CONTROL = 1,
     VentMode_PRESSURE_ASSIST = 2,
-    VentMode_HIGH_FLOW_NASAL_CANNULA = 3
+    VentMode_HIGH_FLOW_NASAL_CANNULA = 3,
+    VentMode_VOLUME_CONTROL = 4,
+    VentMode_CPAP = 5,
+    VentMode_VOLUME_ASSIST = 6,
+    VentMode_PRESSURE_SUPPORT = 7,
+    VentMode_PC_SIMV = 8,
+    VentMode_VC_SIMV = 9,
+    VentMode_BIPAP = 10,
+    VentMode_PRESSURE_REG_VC = 11,
+    VentMode_SPONTANEOUS_BREATHS = 12,
 } VentMode;
 
 /* Struct definitions */
@@ -42,6 +51,10 @@ typedef struct _VentParams {
     uint32_t inspiratory_trigger_cm_h2o;
     uint32_t expiratory_trigger_ml_per_min;
     float fio2;
+    float viv_ml;
+    float flow_l_per_min;
+    uint32_t psupp_cm_h2o;
+    uint32_t pstep_cm_h2o;
 } VentParams;
 
 typedef struct _ControllerStatus {
@@ -60,18 +73,18 @@ typedef struct _GuiStatus {
 
 /* Helper constants for enums */
 #define _VentMode_MIN VentMode_OFF
-#define _VentMode_MAX VentMode_HIGH_FLOW_NASAL_CANNULA
-#define _VentMode_ARRAYSIZE ((VentMode)(VentMode_HIGH_FLOW_NASAL_CANNULA+1))
+#define _VentMode_MAX VentMode_SPONTANEOUS_BREATHS
+#define _VentMode_ARRAYSIZE ((VentMode)(VentMode_SPONTANEOUS_BREATHS+1))
 
 
 /* Initializer values for message structs */
 #define GuiStatus_init_default                   {0, VentParams_init_default}
 #define ControllerStatus_init_default            {0, VentParams_init_default, SensorsProto_init_default, 0, 0}
-#define VentParams_init_default                  {_VentMode_MIN, 0, 0, 0, 0, 0, 0, 0}
+#define VentParams_init_default                  {_VentMode_MIN, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0}
 #define SensorsProto_init_default                {0, 0, 0, 0, 0, 0, 0, 0}
 #define GuiStatus_init_zero                      {0, VentParams_init_zero}
 #define ControllerStatus_init_zero               {0, VentParams_init_zero, SensorsProto_init_zero, 0, 0}
-#define VentParams_init_zero                     {_VentMode_MIN, 0, 0, 0, 0, 0, 0, 0}
+#define VentParams_init_zero                     {_VentMode_MIN, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0}
 #define SensorsProto_init_zero                   {0, 0, 0, 0, 0, 0, 0, 0}
 
 /* Field tags (for use in manual encoding/decoding) */
@@ -91,6 +104,10 @@ typedef struct _GuiStatus {
 #define VentParams_inspiratory_trigger_cm_h2o_tag 8
 #define VentParams_expiratory_trigger_ml_per_min_tag 9
 #define VentParams_fio2_tag                      10
+#define VentParams_viv_ml_tag                    11
+#define VentParams_flow_l_per_min_tag            12
+#define VentParams_psupp_cm_h2o_tag              13
+#define VentParams_pstep_cm_h2o_tag              14
 #define ControllerStatus_uptime_ms_tag           1
 #define ControllerStatus_active_params_tag       2
 #define ControllerStatus_sensor_readings_tag     3
@@ -126,7 +143,11 @@ X(a, STATIC,   REQUIRED, UINT32,   pip_cm_h2o,        5) \
 X(a, STATIC,   REQUIRED, FLOAT,    inspiratory_expiratory_ratio,   6) \
 X(a, STATIC,   REQUIRED, UINT32,   inspiratory_trigger_cm_h2o,   8) \
 X(a, STATIC,   REQUIRED, UINT32,   expiratory_trigger_ml_per_min,   9) \
-X(a, STATIC,   REQUIRED, FLOAT,    fio2,             10)
+X(a, STATIC,   REQUIRED, FLOAT,    fio2,              10) \
+X(a, STATIC,   REQUIRED, FLOAT,    viv_ml,            11) \
+X(a, STATIC,   REQUIRED, FLOAT,    flow_l_per_min,    12) \
+X(a, STATIC,   REQUIRED, UINT32,    psupp_cm_h2o,     13) \
+X(a, STATIC,   REQUIRED, UINT32,    pstep_cm_h2o,     14)
 #define VentParams_CALLBACK NULL
 #define VentParams_DEFAULT NULL
 
@@ -154,9 +175,9 @@ extern const pb_msgdesc_t SensorsProto_msg;
 #define SensorsProto_fields &SensorsProto_msg
 
 /* Maximum encoded size of messages (where known) */
-#define GuiStatus_size                           55
-#define ControllerStatus_size                    108
-#define VentParams_size                          42
+#define GuiStatus_size                           71
+#define ControllerStatus_size                    124
+#define VentParams_size                          58
 #define SensorsProto_size                        45
 
 #ifdef __cplusplus

software/common/generated_libs/network_protocol/network_protocol.proto

@@ -88,8 +88,7 @@ message GuiStatus {
   // params.
   required VentParams desired_params = 2;
 
-  // TODO: Include some sort of code version, e.g. git sha that the gui was
-  // built from?
+  // TODO: Include some sort of code version, e.g. git sha that the gui was built from?
 }
 
 // Periodically sent from the controller to the GUI.
@@ -110,8 +109,7 @@ message ControllerStatus {
   // Value in range [0, 1] indicating how fast we're spinning the fan.
   required float fan_power = 6;
 
-  // TODO: Include some sort of code version, e.g. git sha that the controller
-  // was built from?
+  // TODO: Include some sort of code version, e.g. git sha that the controller built from?
 }
 
 // Values set by the ventilator operator.
@@ -121,18 +119,21 @@ message VentParams {
   // For more info on these terms, see
   // https://github.com/RespiraWorks/Ventilator/wiki/Ventilator-Glossary
 
-  required uint32 peep_cm_h2o = 3; // PEEP - positive end-expiratory pressure
-  required uint32 breaths_per_min = 4; // RR - respiratory rate
-  required uint32 pip_cm_h2o = 5;      // PIP - peak inspiratory pressure
-  required float inspiratory_expiratory_ratio = 6; // I:E
-
-  required uint32 inspiratory_trigger_cm_h2o = 8; // P-trigger
+  required uint32 peep_cm_h2o = 3;                  // PEEP - positive end-expiratory pressure
+  required uint32 breaths_per_min = 4;              // RR - respiratory rate
+  required uint32 pip_cm_h2o = 5;                   // PIP - peak inspiratory pressure
+  required float inspiratory_expiratory_ratio = 6;  // I:E
+  required uint32 inspiratory_trigger_cm_h2o = 8;   // P-trigger
 
   // TODO(jlebar): Is ml/min the correct unit for this?
-  required uint32 expiratory_trigger_ml_per_min = 9; // V-trigger
+  required uint32 expiratory_trigger_ml_per_min = 9;  // V-trigger
 
   // A value between 0..1. Technically only values in [0.21, 1] are allowed.
   required float fio2 = 10;
+  required float viv_ml = 11;
+  required float flow_l_per_min = 12;
+  required uint32 psupp_cm_h2o = 13;
+  required uint32 pstep_cm_h2o = 14;
 }
 
 // See
@@ -164,8 +165,17 @@ enum VentMode {
   //   P-trigger - inspiratory_trigger_cm_h2o
   PRESSURE_ASSIST = 2;
 
-  // TODO: Implement me!
+  // TODO: Document these!
   HIGH_FLOW_NASAL_CANNULA = 3;
+  VOLUME_CONTROL = 4;
+  CPAP = 5;
+  VOLUME_ASSIST = 6;
+  PRESSURE_SUPPORT = 7;
+  PC_SIMV = 8;
+  VC_SIMV = 9;
+  BIPAP = 10;
+  PRESSURE_REG_VC = 11;
+  SPONTANEOUS_BREATHS = 12;
 }
 
 // Sensor readings.

software/controller/lib/core/breath_detection.cpp

@@ -12,19 +12,23 @@ limitations under the License.
 
 #include "breath_detection.h"
 
+/// \TODO: this is only here for loop period for default trigger values. Get rid of this
 #include <algorithm>
 
 #include "controller.h"
 
 using DebugFloat = Debug::Variable::Float;
 
-// Note tat since BreathDetection is instantiated for each breath, these debugvars are static and
+// Note that since BreathDetection is instantiated for each breath, these debugvars are static and
 // apply to any and all breath detection instances, to make them permanent and therefore traceable.
 // This is fine because there can only ever be a single breath detection instance at any given time.
 
 /// \TODO This should be configurable from the GUI.
-static DebugFloat dbg_flow_trigger{"bd_flow_trigger", Debug::Variable::Access::ReadWrite, 200,
-                                   "mL/s", "Breath detection flow trigger"};
+static DebugFloat inhale_trigger{"bd_inhale_trigger", Debug::Variable::Access::ReadWrite, 200,
+                                 "mL/s", "Breath detection inhale trigger"};
+
+static DebugFloat exhale_trigger("bd_exhale_trigger", Debug::Variable::Access::ReadWrite, 300,
+                                 "mL/s", "Breath detection exhale trigger");
 
 // fast_alpha_ and slow_alpha_ were tuned for a control loop that runs at a particular frequency.
 // In theory if the control loop gets slower, the alpha terms should get bigger, placing more weight
@@ -48,13 +52,8 @@ BreathDetection::BreathDetection() {
   dbg_slow_flow_avg.set(0);
 };
 
-bool BreathDetection::PatientInspiring(const BreathDetectionInputs &inputs, bool at_dwell) {
-  if (inputs.net_flow < ml_per_sec(0)) {
-    return false;
-  }
-
-  // Once flow is non-negative, start calculating two
-  // exponentially-weighted averages of net flow: slow_flow_avg_ and fast_flow_avg_.
+void BreathDetection::update_averages(const BreathDetectionInputs &inputs) {
+  // Calculate two exponentially-weighted averages of net flow: slow_flow_avg_ and fast_flow_avg_.
   //
   // The slow one has a smaller alpha term, so updates slower than the fast one.
   // You can think of the slow average as estimating "flow at dwell" and
@@ -69,6 +68,26 @@ bool BreathDetection::PatientInspiring(const BreathDetectionInputs &inputs, bool
 
   dbg_slow_flow_avg.set(slow_flow_avg_.ml_per_sec());
   dbg_fast_flow_avg.set(fast_flow_avg_.ml_per_sec());
+}
+
+bool BreathDetection::PatientInhaling(const BreathDetectionInputs &inputs, bool at_dwell) {
+  // Calculate averages only once flow is non-negative
+  if (inputs.net_flow < ml_per_sec(0)) {
+    return false;
+  }
+
+  update_averages(inputs);
+
+  return at_dwell && fast_flow_avg_ - slow_flow_avg_ > ml_per_sec(inhale_trigger.get());
+}
+
+bool BreathDetection::PatientExhaling(const BreathDetectionInputs &inputs, bool at_dwell) {
+  // Calculate averages only once flow is non-negative
+  if (inputs.net_flow < ml_per_sec(0)) {
+    return false;
+  }
+
+  update_averages(inputs);
 
-  return at_dwell && fast_flow_avg_ - slow_flow_avg_ > ml_per_sec(dbg_flow_trigger.get());
+  return slow_flow_avg_ > fast_flow_avg_ + ml_per_sec(exhale_trigger.get());
 }

software/controller/lib/core/breath_detection.h

@@ -33,7 +33,11 @@ class BreathDetection {
   // - net_flow, to allow inspire detection
   // - at_dwell, telling BreathDetection that the dwell plateau has been reached
   // TODO: automatically detect dwell plateau from flow
-  bool PatientInspiring(const BreathDetectionInputs &inputs, bool at_dwell);
+  bool PatientInhaling(const BreathDetectionInputs &inputs, bool at_dwell);
+  bool PatientExhaling(const BreathDetectionInputs &inputs, bool at_dwell);
+
+ protected:
+  void update_averages(const BreathDetectionInputs &inputs);
 
  private:
   // During breath we maintain two exponentially-weighted averages of flow, one