Methods and apparatus for monitoring and treating respiratory insufficiency

• US 10,525,219 B2
• Filed: 05/31/2013
• Issued: 01/07/2020
• Est. Priority Date: 06/26/2012
• Status: Active Grant

• Current Assignee: ResMed Sensor Technologies Limited (ResMed Incorporated)
• Original Assignee: ResMed Sensor Technologies Limited (ResMed Incorporated)
• Inventors: Schindhelm, Klaus Henry, Farrugia, Steven Paul
• Primary Examiner(s): Vasat, Peter S
• Application Number:
  US13/907,099
• Publication Number:
  US 20130340758A1
• Time in Patent Office: 2,412 Days
• Field of Search: None
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/0826 Detecting or evaluating apnoea events A61B5/4818 takes precedence
• CPC Class Codes: A61B 5/083 Measuring rate of metabolism by using breath test, e.g. measuring rate of oxygen consumption
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0066 Blowers or centrifugal pumps
• CPC Class Codes: A61M 16/0069 the speed thereof being controlled by respiratory parameters, e.g. by inhalation
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

An apparatus, such as a pressure support ventilator or respiratory monitor, provides operations for a patient, such as a patient with heart failure, Chronic Obstructive Pulmonary Disease or other respiratory insufficiency. In some embodiments, the apparatus may detect a respiratory condition, such as a decompensation event and/or exacerbation event, from respiratory parameters. A clinical alert message may be transmitted or displayed for a physician based on the results of query presented to the patient in response to an analysis of the one or more respiratory parameters. In some embodiments, the apparatus generates a potential relapse indicator that may provide a prediction of a risk of an oncoming clinical event such as for evaluating whether to release the patient from a hospital.

Claims

1. An apparatus for evaluating sensor signals representative of respiratory characteristics, the apparatus comprising:

at least one sensor adapted to measure at least one respiratory parameter of a user;

a display;

a controller, coupled to the at least one sensor and the display, the controller being configured to (i) evaluate the at least one respiratory parameter, (ii) generate a presentation of at least one query on the display based on the evaluation of the at least one respiratory parameter, the at least one query being configured to prompt for an input to the controller; and

(iii) generate an alert message based on a user response to the query that is input to the controller; and

a flow generator configured to generate a flow of breathable gas at a pressure above atmospheric pressure to a patient interface, and wherein the controller is configured to control the flow generator,

wherein the controller is further configured to modify a pressure control parameter of the flow generator based on the at least one query.

2. The apparatus of claim 1, wherein the controller comprises a memory including a data structure of questions, and each question of the data structure of questions is associated with a detectable condition of the at least one respiratory parameter.

3. The apparatus of claim 2, wherein a question of the data structure of questions addresses medication compliance.

4. The apparatus of claim 2, wherein a question of the data structure of questions addresses dietary compliance.

5. The apparatus of claim 2, wherein the controller is further configured to select a first question of the data structure of questions in response to a detected condition of the respiratory parameter, and based on an input response to the first question, continue to evaluate the at least one respiratory parameter in a subsequent monitoring session before generating a subsequent alert message.

6. The apparatus of claim 5, wherein the controller is further configured to generate the subsequent alert message following the subsequent monitoring session and the generation of the subsequent alert message is based on a user response to a second question of the data structure of questions presented by the controller.

7. The apparatus of claim 1, wherein the control parameter comprises a target ventilation.

8. The apparatus of claim 1 wherein the alert message comprises a warning presented on the display.

9. The apparatus of claim 1 further comprising a communications device, wherein the alert message comprises an electronic message transmitted from the communications device.

10. The apparatus of claim 1 wherein the evaluation of the at least one respiratory parameter comprises a detection of dyspnoea.

11. The apparatus of claim 1 wherein:

the controller is configured to (i) perform an evaluation of the at least one respiratory parameter during one or more monitoring sessions and (ii) generate for display a potential relapse indicator based on the performed evaluation of the at least one respiratory parameter, the potential relapse indicator representing a prediction of future relapse; and

(iii) display the potential relapse indicator on the display.

12. The apparatus of claim 11, wherein the performed evaluation of the at least one respiratory parameter comprises an evaluation of a detected respiratory rate.

13. The apparatus of claim 11, wherein the performed evaluation of the at least one respiratory parameter comprises an evaluation of sleep disordered breathing events.

14. The apparatus of claim 11, wherein the performed evaluation of the at least one respiratory parameter comprises an evaluation of a measure of ventilation.

15. The apparatus of claim 11 wherein the performed evaluation of the at least one respiratory parameter comprises an evaluation of a change in the at least one respiratory parameter over the one or more monitoring sessions.

16. The apparatus of claim 11 wherein the potential relapse indicator comprises a numerical value.

17. The apparatus of claim 11 wherein the potential relapse indicator comprises a calculated probability.

18. The apparatus of claim 17 wherein the generation of the potential relapse indicator comprises a comparison of changes in a plurality of respiratory parameters with a plurality of thresholds.

19. A method for an apparatus for evaluating sensor signals representative of respiratory characteristics, the method comprising:

evaluating at least one respiratory parameter of a user from a sensor signal with a controller;

generating with the controller a presentation of at least one query on a display based on the evaluation of the at least one respiratory parameter, the at least one query being configured to prompt for an input to the controller;

generating an alert message with the controller based on a user response to the query that is input to the controller;

generating, with the controller and a flow generator, a flow of breathable gas at a pressure above atmospheric pressure to a patient interface during the evaluating; and

modifying a pressure control parameter for the flow of breathable gas based on the at least one query.

20. The method of claim 19, further comprising accessing in a memory, a data structure of questions, each question associated with a detectable condition of the at least one respiratory parameter.

21. The method of claim 20, wherein a question addresses medication compliance.

22. The method of claim 20, wherein a question addresses dietary compliance.

23. The method of claim 20, further comprising selecting with the controller a first question in response to a detected condition of the respiratory parameter, and based on an input response to the first question, continuing to evaluate the at least one respiratory parameter in a subsequent monitoring session before generating a subsequent alert message.

24. The method of claim 23, wherein the controller generates the alert message following the subsequent monitoring session and the generation of the subsequent alert message is based on a user response to a second question presented by the controller on the display.

25. The method of claim 19, wherein the control parameter comprises a target ventilation.

26. The method of claim 19 further comprising presenting the alert message on the display.

27. The method of claim 19 further comprising transmitting, with a communications device, the alert message as an electronic message to another apparatus.

28. The method of claim 19 wherein the evaluating of the at least one respiratory parameter comprises detecting dyspnoea.

29. The method of claim 19 further comprising:

performing an evaluation with the controller of the at least one respiratory parameter during one or more monitoring sessions; and

generating with the controller a potential relapse indicator based on the performed evaluation of the at least one respiratory parameter, the potential relapse indicator representing a prediction of future relapse; and

displaying the potential relapse indicator on the display.

30. The method of claim 29, wherein the performed evaluation of the at least one respiratory parameter comprises an evaluation of a detected respiratory rate.

31. The method of claim 29, wherein the performed evaluation of the at least one respiratory parameter comprises an evaluation of sleep disordered breathing events.

32. The method of claim 29, wherein the performed evaluation of the at least one respiratory parameter comprises an evaluation of a measure of ventilation.

33. The method of claim 29 wherein the performed evaluation of the at least one respiratory parameter comprises an evaluation of a change in the at least one respiratory parameter over the one or more monitoring sessions.

34. The method of claim 29 wherein the potential relapse indicator comprises a numerical value.

35. The method of claim 34 wherein the potential relapse indicator comprises a calculated probability.

36. The method of claim 35 wherein the generating of the potential relapse indicator comprises a comparison of changes in a plurality of respiratory parameters with a plurality of thresholds.