Auto-titration pressure support system and method of using same
First Claim
1. An auto-titration pressure support system comprising:
- a pressure generating system adapted to generate a flow of breathing gas at a selectable pressure level;
a patient circuit having a first end adapted to be coupled to the pressure generating system and a second end adapted to be coupled to an airway of a patient;
a monitoring system associated with the patient circuit or the pressure generating system and adapted to measure a parameter indicative of a pressure at a patient'"'"'s airway, a flow of gas in such a patient'"'"'s airway, or both and to output a pressure signal, a flow signal indicative thereof, respectively, or both; and
a controller coupled to the monitoring system and the pressure generating system, for controlling a pressure of the flow of breathing gas output by the pressure generating system based on the output of the monitoring system, wherein the controller is programmed to operate according to one control layer in a set of prioritized control layers, wherein each control layer in the set of prioritized control layers competes for control of the pressure generating system with the other control layers, and wherein each control layer implements a unique pressure control process for controlling the pressure of the flow of breathing gas output by the pressure generating system.
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Accused Products
Abstract
A pressure support system and method of treating disordered breathing that optimizes the pressure delivered to the patient to treat the disordered breathing while minimizing the delivered pressure for patient comfort. The controller in the pressure support system operates as a set of prioritized control layers, wherein each control layer competes for control of the pressure generating system to implement a unique pressure control process. The pressure support system also controls the pressure provided to the patient based on the variability of the monitored data and a trend analysis of this data, including an indication the skewness of the patient'"'"'s inspiratory waveform.
112 Citations
57 Claims
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1. An auto-titration pressure support system comprising:
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a pressure generating system adapted to generate a flow of breathing gas at a selectable pressure level;
a patient circuit having a first end adapted to be coupled to the pressure generating system and a second end adapted to be coupled to an airway of a patient;
a monitoring system associated with the patient circuit or the pressure generating system and adapted to measure a parameter indicative of a pressure at a patient'"'"'s airway, a flow of gas in such a patient'"'"'s airway, or both and to output a pressure signal, a flow signal indicative thereof, respectively, or both; and
a controller coupled to the monitoring system and the pressure generating system, for controlling a pressure of the flow of breathing gas output by the pressure generating system based on the output of the monitoring system, wherein the controller is programmed to operate according to one control layer in a set of prioritized control layers, wherein each control layer in the set of prioritized control layers competes for control of the pressure generating system with the other control layers, and wherein each control layer implements a unique pressure control process for controlling the pressure of the flow of breathing gas output by the pressure generating system. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method of providing pressure support to a patient, comprising:
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providing flow of breathing gas at a selectable pressure level to an airway of a patient;
monitoring a pressure, a flow, or both of the flow of breathing gas and outputting a pressure signal, a flow signal indicative thereof, respectively, or both;
selecting a control layer from a set of prioritized control layers based on the pressure signal, the flow signal, or both; and
controlling a pressure of the flow of breathing gas according to a pressure control technique unique to the selected pressure control layer. - View Dependent Claims (9, 10, 11)
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12. An auto-titration pressure support system comprising:
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a pressure generating system adapted to generate a flow of breathing gas at a selectable pressure level;
a patient circuit having a first end adapted to be coupled to the pressure generating system and a second end adapted to be coupled to an airway of a patient;
a monitoring system associated with the patient circuit or the pressure generating system and adapted to measure a parameter indicative of a flow of gas in such a patient'"'"'s airway and to output a flow signal indicative thereof; and
a controller coupled to the monitoring system and the pressure generating system, for controlling the pressure generating system based on the output of the monitoring system, wherein the controller performs a trend analysis on the output of the monitoring system. - View Dependent Claims (13, 14, 15, 16, 17, 18)
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19. A method or providing pressure support system to a patient, comprising:
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providing flow of breathing gas at a selectable pressure level to an airway of a patient;
monitoring a flow of the flow of breathing gas and outputting a flow signal indicative thereof;
performing a trend analysis on data determined from the flow signal; and
controlling a pressure of the flow of breathing gas based on the trend analysis. - View Dependent Claims (20, 21, 22, 23, 24, 25)
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26. An auto-titration pressure support system comprising:
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a pressure generating system adapted to generate a flow of breathing gas at a selectable pressure level;
a patient circuit having a first end adapted to be coupled to the pressure generating system and a second end adapted to be coupled to an airway of a patient;
a monitoring system associated with the patient circuit or the pressure generating system and adapted to measure a parameter indicative of a flow of gas in such a patient'"'"'s airway and to output a flow signal indicative thereof; and
a controller coupled to the monitoring system and the pressure generating system, for controlling the pressure generating system based on the output of the monitoring system, wherein the controller determines a breathing parameter from the flow signal, and wherein the controller analyzes a variability of the breathing parameter and controls the pressure generating system based on a result of the variability analysis. - View Dependent Claims (27, 28, 29)
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30. A method of providing pressure support to a patient, comprising:
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providing flow of breathing gas at a selectable pressure level to an airway of a patient;
monitoring a flow of the flow of breathing gas and outputting a flow signal indicative thereof, determining a breathing parameter from the flow signal;
analyzing a variability of the breathing parameter; and
controlling a pressure of the flow of breathing gas based on a result of the variability analysis. - View Dependent Claims (31, 32, 33)
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34. An auto-titration pressure support system comprising:
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a pressure generating system adapted to generate a flow of breathing gas at a selectable pressure level;
a patient circuit having a first end adapted to be coupled to the pressure generating system and a second end adapted to be coupled to an airway of a patient;
a monitoring system associated with the patient circuit or the pressure generating system and adapted to measure a parameter indicative of a pressure at a patient'"'"'s airway and a flow of gas in such a patient'"'"'s airway and to output a pressure signal and a flow signal indicative thereof; and
a controller coupled to the monitoring system and the pressure generating system, for controlling the pressure generating system based on the output of the monitoring system, wherein the controller monitors leakage of gas from the patient circuit based on the flow signal, the pressure signal, or both and reduces a pressure provided to a patient by the pressure generating system for a predetermined period of time responsive to a determination that a rate of the leakage of gas exceeds a predetermined threshold, and wherein the controller continues to deliver a therapeutic pressure support treatment to the patient by causing the pressure generating system to continue to deliver the flow of breathing gas a reduced level that is a level sufficient to provide a therapeutic treatment to such a patient.
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35. A method of providing pressure support to a patient, comprising:
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providing flow of breathing gas at a selectable pressure level to an airway of a patient via a patient circuit in fluid communication with an airway of a patient defining a closed system;
monitoring a pressure and a flow of the flow of breathing gas and outputting a pressure signal and a flow signal indicative thereof, respectively;
determining a rate of leakage of gas from the closed system based on the pressure signal, the flow signal, or both;
reducing the pressure of the flow of breathing for a predetermined period of time responsive to a determination that the rate of the leakage of gas exceeds a predetermined threshold; and
continuing to deliver the flow of breathing gas at a reduced level, wherein the reduced level is a level sufficient to provide a therapeutic treatment to such a patient.
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36. An auto-titration pressure support system comprising:
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a pressure generating system adapted to generate a flow of breathing gas at a selectable pressure level;
a patient circuit having a first end adapted to be coupled to the pressure generating system and a second end adapted to be coupled to an airway of a patient;
a monitoring system associated with the patient circuit or the pressure generating system and adapted to measure a parameter indicative of a flow of gas in such a patient'"'"'s airway and to output a flow signal indicative thereof; and
a controller coupled to the monitoring system and the pressure generating system, for controlling the pressure generating system based on the output of the monitoring system, wherein the controller determines a skewness of a patient'"'"'s inspiratory waveforms from the output of the flow sensor and controls the pressure generating system according to the skewness determination. - View Dependent Claims (37, 38, 39, 40, 41)
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42. A method or providing pressure support system to a patient, comprising:
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providing flow of breathing gas at a selectable pressure level to an airway of a patient;
monitoring a flow of the flow of breathing gas and outputting a flow signal indicative thereof;
determining a skewness of a patient'"'"'s inspiratory waveforms from the flow signal; and
controlling a pressure of the flow of breathing gas based on the skewness determination. - View Dependent Claims (43, 44, 45, 46, 47)
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48. An auto-titration pressure support system comprising:
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a pressure generating system adapted to generate a flow of breathing gas at a selectable pressure level;
a patient circuit having a first end adapted to be coupled to the pressure generating system and a second end adapted to be coupled to an airway of a patient;
a monitoring system associated with the patient circuit or the pressure generating system and adapted to measure a parameter indicative of a flow of gas in such a patient'"'"'s airway and to output a flow signal indicative thereof, and a controller coupled to the monitoring system and the pressure generating system, for controlling the pressure generating system based on the output of the monitoring system, wherein the controller is programmed determine whether the patient is experiencing a central apnea/hypopnea or an obstructive/restrictive apnea/hypopnea by monitoring one or more of the following;
(1) at least one shape parameter associated with the flow of gas during an apnea/hypopnea period, and (2) a characteristic of the flow of gas at the end of the apnea/hypopnea period indicative of an increase in respiratory effort. - View Dependent Claims (49, 50, 51)
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52. A method or providing pressure support system to a patient, comprising:
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providing flow of breathing gas at a selectable pressure level to an airway of a patient;
monitoring a flow of the flow of breathing gas and outputting a flow signal indicative thereof; and
determining whether the patient is experiencing a central apnea/hypopnea or an obstructive/restrictive apnea/hypopnea by monitoring one or more of the following;
(1) at least one shape parameter associated with the flow of gas during an apnea/hypopnea period, and (2) a characteristic of the flow of gas at the end of the apnea/hypopnea period indicative of an increase in respiratory effort; and
controlling a pressure of the flow of breathing gas based on the skewness determination. - View Dependent Claims (53, 54, 55)
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56. An auto-titration pressure support system comprising:
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a pressure generating system adapted to generate a flow of breathing gas at a selectable pressure level;
a patient circuit having a first end adapted to be coupled to the pressure generating system and a second end adapted to be coupled to an airway of a patient;
a monitoring system associated with the patient circuit or the pressure generating system and adapted to measure a parameter indicative of a pressure at a patient'"'"'s airway, a flow of gas in such a patient'"'"'s airway, or both and to output a pressure signal, a flow signal indicative thereof, respectively, or both; and
a controller coupled to the monitoring system and the pressure generating system, for controlling the pressure generating system based on the output of the monitoring system, wherein the controller is programmed to;
(1) determine whether the patient is experiencing an apnea/hypopnea based on the pressure signal or the flow signal, (2) set a pressure treatment limit based on a pressure at a time an apnea/hypopnea is detected, (3) cause the pressure generating system to increase a pressure of the flow of breathing gas delivered to a patient responsive to a current pressure being below the pressure treatment limit, and (4) cause the pressure generating system to decrease a pressure of the flow of breathing gas delivered to a patient responsive to a current pressure being at or above the pressure treatment limit.
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57. A method of providing pressure support to a patient, comprising:
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providing flow of breathing gas at a selectable pressure level to an airway of a patient;
monitoring a pressure, a flow, or both of the flow of breathing gas and outputting a pressure signal, a flow signal indicative thereof, respectively, or both;
determine whether the patient is experiencing an apnea/hypopnea based on the pressure signal, the flow signal, or both;
setting a pressure treatment limit based on a pressure at a time an apnea/hypopnea is detected;
increasing a pressure of the flow of breathing gas delivered to a patient responsive to a current pressure being below the pressure treatment limit; and
decreasing a pressure of the flow of breathing gas delivered to a patient responsive to a current pressure being at or above the pressure treatment limit.
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Specification