Systems and methods for drive pressure spontaneous ventilation

• US 10,668,239 B2
• Filed: 10/30/2018
• Issued: 06/02/2020
• Est. Priority Date: 11/14/2017
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Kimm, Gardner, Miller, Cynthia, Milne, Gary, Upham, Gail, Nakai, Richard, Doyle, Peter, Sanborn, Warren
• Primary Examiner(s): Dixon, Annette
• Application Number:
  US16/174,483
• Publication Number:
  US 20190143058A1
• Time in Patent Office: 581 Days
• CPC Class Codes: A61M 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 2016/0018 electrical
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0033 electrical
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3331 Pressure; Flow
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/42 Rate
• CPC Class Codes: A61M 2230/46 Resistance or compliance of the lungs
• CPC Class Codes: A61M 2230/60 Muscle strain, i.e. measured on the user
• CPC Class Codes: G06F 3/04847 Interaction techniques to control parameter settings, e.g. interaction with sliders or dials

Abstract

This disclosure describes systems and methods for providing drive pressure ventilation of a patient. The disclosure describes a novel breath type that provides a spontaneous breath type that allows for the calculation of drive pressure that does not require invasive monitoring, where drive pressure is the pressure applied to the lungs that causes them to inflate during mechanical ventilation.

Claims

1. A ventilator system for delivering drive pressure ventilation to a patient, the ventilator system comprising:

a pressure generating system that generates a flow of breathing gas;

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

one or more non-invasive sensors operatively coupled to at least one of the pressure generating system or the ventilation tubing system, wherein the one or more non-invasive sensors generate output indicative of at least one of flow, volume or pressure;

a controller that collects and analyzes the output to determine a condition, wherein the controller is configured to;

in response to the condition, temporarily switch the ventilator system from a spontaneous breath subtype into a proportional assist (PA) breath subtype for at least one breath;

estimate a respiratory system compliance of the patient during the PA breath subtype based on the output collected during the PA breath subtype;

after the at least one breath, switch the ventilator system from the PA breath subtype back to the spontaneous breath subtype;

after a return to the spontaneous breath subtype, calculate a drive pressure of the patient based on the respiratory system compliance and the output after the return, wherein the drive pressure is a pressure represented in cmH₂O that is applied within the patient'"'"'s lungs to cause inflation; and

a display for displaying the drive pressure.

2. The ventilator system of claim 1, wherein the controller is further configured to:

compare the drive pressure to a threshold to form a comparison;

determine that the drive pressure breaches the threshold based on the comparison; and

provide an alert.

3. The ventilator system of claim 2, wherein the controller is further configured to:

adjust a ventilation parameter for the ventilator system.

4. The ventilator system of claim 3, wherein the ventilation parameter is at least one of oxygen percentage, rise time, trigger sensitivity, peak flow rate, peak inspiratory pressure, tidal volume, PEEP, or a target setting.

5. The ventilator system of claim 1, wherein the controller is further configured to:

utilize a predetermined percent support setting for the PA breath subtype.

6. A non-transitory computer-readable medium having computer-executable instructions for performing a method of ventilating a patient with a ventilator, the method comprising:

ventilating the patient with the ventilator in a spontaneous breath subtype, wherein the spontaneous breath subtype does not include a proportional assist (PA) breath subtype;

monitoring respiratory data of the patient with at least one of a pressure sensor and a flow sensor operatively coupled to at least one of a patient circuit or a pressure generating system;

analyzing the respiratory data to detect a patient effort;

delivering inspiratory gas to the patient with the ventilator in response to a detected patient effort;

determining an occurrence of a condition by the ventilator based on information gathered by the ventilator;

in response to the condition, automatically and temporarily switching from the spontaneous breath subtype into the PA breath subtype for at least three breaths, wherein a percent support setting for the PA breath subtype is determined based on at least one of a target setting, a non-invasively monitored flow, a non-invasively monitored pressure, or a noninvasively monitor tidal volume during the spontaneous breath subtype from at least one of the pressure sensor and the flow sensor;

estimating a respiratory system compliance and a respiratory system resistance of the patient during the PA breath subtype based on the respiratory data;

calculating a drive pressure of the patient during the spontaneous breath subtype utilizing respiratory system compliance, the respiratory system resistance, and the respiratory data received during the spontaneous breath subtype, wherein the drive pressure is a pressure represented in cmH₂O that is applied within the patient'"'"'s lungs to cause inflation; and

performing an action based on the drive pressure.

7. The method of claim 6, wherein the action includes providing a drive pressure alert.

8. The method of claim 6, wherein the action includes providing a recommendation.