Vitals - Improve oxygen function to handle respiratory depression (#643)

**When merged this pull request will:** - Adds respiratory depression to the vitals loop - Adds pneumothorax's to the oxygen calculation to affect multiple areas ### IMPORTANT - [Development Guidelines](https://ace3.acemod.org/wiki/development/) are read, understood and applied. - Title of this PR uses our standard template `Component - Add|Fix|Improve|Change|Make|Remove {changes}`. --------- Co-authored-by: mazinskihenry <[email protected]>
KAT-Advanced-Medical · Jan 31, 2025 · bd700f4 · bd700f4
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Showing 5 changed files with 29 additions and 5 deletions.
diff --git a/addons/breathing/functions/fnc_checkBreathing.sqf b/addons/breathing/functions/fnc_checkBreathing.sqf
@@ -30,11 +30,17 @@ private _breathing_log = localize ACELSTRING(medical_treatment,Check_Pulse_Norma
 private _breath = "";
 private _breathRate = "RR: ";
 
-if ((_patient getVariable [QGVAR(pneumothorax), 0] > 0) || (_patient getVariable [QEGVAR(chemical,airPoisoning), false])) then {
+private _respiratoryDepth = _patient getVariable [QEGVAR(vitals,respiratoryDepth), 10];
+if (((10 > _respiratoryDepth) && (_respiratoryDepth >= 7)) || (_patient getVariable [QEGVAR(chemical,airPoisoning), false])) then {
     _breathing = LLSTRING(breathing_isShallow);
     _breathing_log = LLSTRING(breathing_shallow);
 };
 
+if (_respiratoryDepth < 7)  then {
+    _breathing = LLSTRING(breathing_isVeryShallow);
+    _breathing_log = LLSTRING(breathing_Veryshallow);
+};
+
 if (_ph < 7.2) then {
     _breath = LLSTRING(breath_mild);
 

diff --git a/addons/breathing/stringtable.xml b/addons/breathing/stringtable.xml
@@ -2505,6 +2505,12 @@
             <Japanese>呼吸速度: 正常</Japanese>
             <French>RR : Normal</French>
         </Key>
+        <Key ID="STR_KAT_Breathing_breathing_isVeryShallow">
+            <English>Patient's breathing is very shallow</English>
+        </Key>
+        <Key ID="STR_KAT_Breathing_breathing_Veryshallow">
+            <English>Very Shallow</English>
+        </Key>
         <Key ID="STR_KAT_Breathing_breathing_none">
             <English>Patient is not breathing</English>
             <Japanese>患者は呼吸していない</Japanese>

diff --git a/addons/main/script_macros.hpp b/addons/main/script_macros.hpp
@@ -280,6 +280,7 @@
 #define DEFAULT_PH 7.4
 #define DEFAULT_ETCO2 37
 #define DEFAULT_BLOOD_GAS [DEFAULT_PACO2, DEFAULT_PAO2, DEFAULT_O2SAT, DEFAULT_HCO3, DEFAULT_PH, DEFAULT_ETCO2]
+#define DEFAULT_RESPIRATORY_DEPTH       10
 
 #define DEFAULT_ANEROBIC_EXCHANGE 0.8
 #define DEFAULT_TEMPERATURE 37
@@ -302,6 +303,9 @@
 #define VAR_SURFACE_AREA                400
 #define GET_KAT_SURFACE_AREA(unit)      (VAR_SURFACE_AREA - (((unit getVariable [QEGVAR(breathing,pneumothorax), 0]) * 75)))
 
+#define VAR_RESPIRATORY_DEPTH           QEGVAR(vitals,respiratoryDepth)
+#define GET_KAT_RESPIRATORY_DEPTH(unit)      (unit getVariable [QEGVAR(vitals,respiratoryDepth), 10])
+
 #define VAR_BLOOD_GAS                  QEGVAR(circulation,bloodGas)
 #define VAR_BREATHING_RATE             QEGVAR(breathing,breathRate)
 

diff --git a/addons/vitals/functions/fnc_fullHealLocal.sqf b/addons/vitals/functions/fnc_fullHealLocal.sqf
@@ -18,6 +18,7 @@
 params ["_patient"];
 
 _patient setVariable [QGVAR(simpleMedical), false, true];
+_patient setVariable [QGVAR(respiratoryDepth), DEFAULT_RESPIRATORY_DEPTH, true];
 
 if (GVAR(enableSimpleMedical)) then {
     _patient setVariable [QGVAR(simpleMedical), true, true];

diff --git a/addons/vitals/functions/fnc_handleOxygenFunction.sqf b/addons/vitals/functions/fnc_handleOxygenFunction.sqf
@@ -31,8 +31,10 @@ params ["_unit", "_actualHeartRate", "_anerobicPressure", "_bloodGas", "_tempera
 #define PACO2_MAX_CHANGE 0.05
 #define PAO2_MAX_CHANGE 0.1
 #define DEFAULT_FIO2 0.21
+#define MINIMUM_DEPTH 0.2
 
 private _respiratoryRate = 0;
+private _respiratoryDepression = 0;
 private _demandVentilation = 0;
 private _actualVentilation = 0;
 private _previousCyclePaco2 = (_bloodGas select 0);
@@ -41,15 +43,20 @@ private _previousCyclePao2 = (_bloodGas select 1);
 if (IN_CRDC_ARRST(_unit)) then { 
     // When in arrest, there should be no effecive breaths but still a minimum O2 demand. Zero O2 demand would mean a dead patient. Actual ventilation is 1 to prevent issues in the gas tension functions
     _demandVentilation = MINIMUM_VENTILATION;
+    _respiratoryDepression = 1;
     _respiratoryRate = [0, 20] select (_unit getVariable [QEGVAR(breathing,BVMInUse), false]);
     _actualVentilation = 1;
 } else {
     // Ventilatory Demand comes from Heart Rate with increase demand from PaCO2 levels 
     _demandVentilation = ((((_actualHeartRate * HEART_RATE_CO2_MULTIPLIER) / _anerobicPressure) + ((_previousCyclePaco2 - DEFAULT_PACO2) * 200)) max MINIMUM_VENTILATION);
     private _tidalVolume = GET_KAT_SURFACE_AREA(_unit);
 
-    // Respiratory Rate is supressed by Opioids 
-    _respiratoryRate = [((_demandVentilation / _tidalVolume) - (_opioidDepression * 5)) min MAXIMUM_RR, 20] select (_unit getVariable [QEGVAR(breathing,BVMInUse), false]);
+    // Tidal Volume is modified by respiratory depth which can be supressed by opioids and pneumothroax
+    private _respiratoryDepth = [((DEFAULT_RESPIRATORY_DEPTH / 10) - (_opioidDepression / 1.5)), 10] select (_unit getVariable [QEGVAR(breathing,BVMInUse), false]);
+    private _tidalVolume = GET_KAT_SURFACE_AREA(_unit) * (_respiratoryDepth / 1);
+
+    // Respiratory Rate Calculation
+    _respiratoryRate = [((_demandVentilation / _tidalVolume)) min MAXIMUM_RR, 20] select (_unit getVariable [QEGVAR(breathing,BVMInUse), false]);
 
     // If respiratory rate is low due to PaCO2, it starts increasing faster to compensate
     if (_previousCyclePaco2 > 50) then { _respiratoryRate = (_respiratoryRate + ((_previousCyclePaco2 - 50) * 0.2)) min MAXIMUM_RR};
@@ -76,7 +83,7 @@ if (IN_CRDC_ARRST(_unit)) then {
     };
 } else {
     // Generated ETCO2 quadratic. Ensures ETCO2 moves with Respiratory Rate and is constantly below PaCO2 
-    _etco2 = ((_paco2 - 3) - ((-0.0416667 * (_respiratoryRate^2)) + (3.09167 * (_respiratoryRate)) - DEFAULT_ETCO2) max 5);
+    _etco2 = (((_paco2 - 3) - ((-0.0416667 * (_respiratoryRate^2)) + (3.09167 * (_respiratoryRate))) * (_respiratoryDepth)) - DEFAULT_ETCO2) max 5;
 };
 
 private _externalPh = 0;
@@ -123,5 +130,5 @@ private _o2Sat = ((_pao2 max 1)^2.7 / ((25 - (((_pH / DEFAULT_PH) - 1) * 150))^2
 
 _unit setVariable [VAR_BREATHING_RATE, (_respiratoryRate max 0), _syncValues];
 _unit setVariable [VAR_BLOOD_GAS, [_paco2, _pao2, _o2Sat, 24, _pH, _etco2], _syncValues];
-
+_unit setVariable [QGVAR(respiratoryDepth), (_respiratoryDepth max 0), _syncValues];
 _o2Sat * 100