Methods and systems for adaptive base flow

• US 10,543,327 B2
• Filed: 05/12/2016
• Issued: 01/28/2020
• Est. Priority Date: 12/07/2011
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Jafari, Mehdi M., Masic, Milenko, Jimenez, Rhomere S., Aviano, Jeffrey K., McCoy, Edward R.
• Primary Examiner(s): Ho, Tan-Uyen T
• Assistant Examiner(s): Luarca, Margaret M
• Application Number:
  US15/152,694
• Publication Number:
  US 20160250427A1
• Time in Patent Office: 1,356 Days
• CPC Class Codes: A61M 16/00 Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes stimulating the respiratory movement by mechanical, pneumatic or electrical means, iron lungs combined with gas breathing means A61H31/00
• CPC Class Codes: A61M 16/0057 Pumps therefor
• CPC Class Codes: A61M 16/0063 Compressors
• 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 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 16/0875 Connecting tubes
• CPC Class Codes: A61M 2016/0015 inhalation detectors
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 in the expiratory circuit
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/505 Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• CPC Class Codes: A61M 2230/40 Respiratory characteristics

Abstract

This disclosure describes systems and methods for providing novel adaptive base flow scheduling during ventilation of a patient to optimize the accuracy of estimated exhaled tidal volume. Further, this disclosure describes systems and methods for providing novel adaptive inspiratory trigger threshold scheduling during the novel adaptive base flow scheduling.

Claims

1. A ventilator system for delivering breathing gases to a patient, the ventilator comprising at least one processor and at least one memory storing computer-executable instructions that, when executed by the at least one processor, cause the ventilator system to:

deliver an initial base flow during at least a first portion of exhalation;

set an inspiration trigger threshold to an initial inspiration trigger threshold;

increase base flow from the initial base flow toward a desired base flow during at least a second portion of exhalation;

decrease the inspiration trigger threshold from the initial inspiration trigger threshold toward a desired inspiration trigger threshold while increasing the base flow; and

increase a sensitivity to a patient initiated trigger during at least the second portion of exhalation while increasing the base flow and decreasing the inspiration trigger threshold.

2. The ventilator system of claim 1, wherein increasing the base flow includes increasing the base flow at a first exponential trajectory, and wherein decreasing the inspiration trigger threshold includes decreasing the inspiration trigger threshold at a second exponential trajectory.

3. The ventilator system of claim 1, wherein the initial base flow is zero.

4. The ventilator system of claim 1, wherein the second portion of exhalation begins upon occurrence of a condition, where the condition comprises at least one of:

determining that a minimum exhalation time has expired;

determining that exhalation flow is below a minimum exhalation flow;

determining that exhalation flow is below the minimum exhalation flow prior to expiration of a maximum exhalation time;

or

determining that the maximum exhalation time has expired.

5. The ventilator system of claim 1, the computer-executable instructions further causing the ventilator system to:

estimate a leak flow from a ventilation tubing system; and

adjust the initial base flow and the desired base flow to account for the estimated leak flow from the ventilation tubing system.

6. A ventilator, comprising:

a pressure generating system adapted to generate a flow of breathing gases;

a ventilation tubing system including a patient interface for connecting the pressure generating system to a patient;

a controller for controlling delivery of breathing gases to the patient, the controller operative to improve an accuracy of estimating an exhalation volume while ventilating a patient with the ventilator, the controller further operative to;

deliver a first base flow during at least a first portion of exhalation;

set an inspiration trigger threshold to a first inspiration trigger threshold;

increase base flow from the first base flow toward a second base flow during at least a second portion of exhalation;

decrease the inspiration trigger threshold from the first inspiration trigger threshold toward a second inspiration trigger threshold while increasing the base flow; and

increase a sensitivity to a patient-initiated trigger during at least the second portion of exhalation while increasing the base flow and decreasing the inspiration trigger threshold.

7. The ventilator of claim 6, wherein increasing the base flow includes increasing the base flow at a first exponential trajectory.

8. The ventilator of claim 6, wherein increasing the base flow is performed until at least one of a desired base flow is substantially reached or an inspiration trigger is detected.

9. The ventilator of claim 7, wherein decreasing the inspiration trigger threshold includes decreasing the inspiration trigger threshold at a second exponential trajectory.

10. The ventilator of claim 6, wherein decreasing the inspiration trigger threshold is performed until at least one of a desired inspiration trigger threshold is substantially reached or an inspiration trigger is detected.

11. The ventilator of claim 9, wherein a slope of the first exponential trajectory of the base flow and a slope of the second exponential trajectory of the inspiration trigger threshold are based on a time constant.

12. The ventilator of claim 7, wherein a slope of the first exponential trajectory of the base flow is based on a constant.

13. The ventilator of claim 6, wherein decreasing the inspiration trigger threshold includes decreasing the inspiration trigger threshold at an exponential trajectory until at least one of a desired inspiration trigger threshold is substantially reached or an inspiration trigger is detected.

14. The ventilator of claim 6, wherein the first base flow is zero.

15. The ventilator of claim 6, wherein the first inspiration trigger threshold is a change in flow of at least 6 LPM.

16. The ventilator of claim 6, wherein the second portion of exhalation begins upon an occurrence of a condition, wherein the condition comprises at least one of:

determining that a minimum exhalation time has expired;

determining that a monitored exhalation flow is below a minimum exhalation flow;

determining that the monitored exhalation flow is below the minimum exhalation flow prior to expiration of a maximum exhalation time;

or

determining that the maximum exhalation time has expired.

17. The ventilator of claim 6, the controller further operative to:

estimate a leak flow from the ventilation tubing system; and

adjust the first base flow and the second base flow to account for the estimated leak flow from the ventilation tubing system.

18. The ventilator of claim 6, wherein increasing the base flow and decreasing the inspiration trigger threshold are performed concurrently.

19. The ventilator of claim 6, wherein the inspiration trigger threshold is at least one of a change in a monitored exhalation flow or a change in a monitored exhalation pressure.

20. The ventilator of claim 6, the ventilator further operative to:

calculate an estimated exhaled tidal volume of the patient.