SYSTEM FOR PROVIDING FLOW-TARGETED VENTILATION SYNCHRONIZED TO A PATIENT'S BREATHING CYCLE

• US 20080178880A1
• Filed: 01/26/2007
• Published: 07/31/2008
• Est. Priority Date: 01/26/2007
• Status: Active Grant

• Current Assignee: Fisher & Paykel Healthcare Limited
• Original Assignee: Cs Medical, Inc.
• Inventors: Diehl, Stephanie S., Christopher, Kent L.
• Granted Patent: US 8,020,558 B2
• Time in Patent Office: Days
• US Class Current: 128/204.23
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/0878 using temperature sensing means
• CPC Class Codes: A61B 5/097 Devices for facilitating collection of breath or for directing breath into or through measuring devices
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0066 Blowers or centrifugal pumps
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/0427 with removable and re-insertable liner tubes, e.g. for cleaning
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/0461 Nasoendotracheal tubes
• CPC Class Codes: A61M 16/0465 Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
• CPC Class Codes: A61M 16/0488 Mouthpieces; Means for guiding, securing or introducing the tubes guiding or introducing with laryngoscopes A61B1/267; holding devices on the body A61M25/02
• CPC Class Codes: A61M 16/0666 Nasal cannulas or tubing devices for improving normal breathing through the nose A61F5/08; nose filters A62B23/06; outside holding devices A61M25/02
• CPC Class Codes: A61M 16/0672 Nasal cannula assemblies for oxygen therapy
• CPC Class Codes: A61M 16/085 Gas sampling
• CPC Class Codes: A61M 16/0858 Pressure sampling ports
• CPC Class Codes: A61M 16/0875 Connecting tubes
• CPC Class Codes: A61M 16/10 Preparation of respiratory gases or vapours
• CPC Class Codes: A61M 16/101 using an oxygen concentrator
• CPC Class Codes: A61M 16/1095 : in the connecting tubes
• CPC Class Codes: A61M 16/12 : by mixing different gases
• CPC Class Codes: A61M 16/125 : Diluting primary gas with ambient air
• CPC Class Codes: A61M 16/161 : with means for measuring the humidity
• CPC Class Codes: A61M 16/204 : used for inhalation control
• CPC Class Codes: A61M 16/208 : Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• CPC Class Codes: A61M 16/209 : Relief valves
• 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 2016/0413 : with detectors of CO2 in exhaled gases
• CPC Class Codes: A61M 2016/1025 : the O2 concentration
• CPC Class Codes: A61M 2202/0208 : Oxygen
• CPC Class Codes: A61M 2202/025 : Helium
• CPC Class Codes: A61M 2202/0275 : Nitric oxide [NO]
• CPC Class Codes: A61M 2205/16 : with back-up system in case of failure
• CPC Class Codes: A61M 2205/18 : with alarm
• CPC Class Codes: A61M 2205/32 : with radio-opaque indicia
• CPC Class Codes: A61M 2205/3368 : Temperature
• CPC Class Codes: A61M 2205/502 : User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/70 : with testing or calibration facilities
• CPC Class Codes: A61M 2230/005 : Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/202 : partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
• CPC Class Codes: A61M 2230/205 : partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)
• CPC Class Codes: A62B 7/06 : with liquid oxygen or air; Cryogenic systems
• CPC Class Codes: A62B 7/08 : containing chemicals producing oxygen

Abstract

An open system provides breath-synchronized, flow-targeted ventilation to augment respiration by a self-breathing patient. A sensor detects a physical property of a patient'"'"'s respiratory cycle. A processor monitors the sensor and controls a gas source to deliver oxygen-containing gas through a tube extending into the patient'"'"'s airway with the flow rate varying over each respiratory cycle in a predetermined non-constant waveform synchronized with the respiratory cycle to augment the patient'"'"'s spontaneous respiration. Gas is delivered at a flow rate sufficient to significantly mitigate the airway pressure the patient must generate during spontaneous breathing and thereby reduce the patient'"'"'s work of breathing.

Claims

1. A method for delivering a flow of oxygen-containing gas to the airway of a spontaneously-breathing patient, said method comprising:

providing a tube to deliver a flow of oxygen-containing gas into a patient'"'"'s airway without interfering with a patient'"'"'s spontaneous respiration around the tube;

detecting a physical property of a patient'"'"'s respiratory cycle; and

supplying a flow of oxygen-containing gas varying over each inspiratory and expiratory phase of the respiratory cycle in a predetermined non-constant flow waveform synchronized with the respiratory cycle to augment the patient'"'"'s spontaneous respiration, said waveform including a positive flow beginning at the onset of the patient'"'"'s inspiratory phase at a flow rate sufficient to significantly mitigate the airway pressure the patient must generate during spontaneous breathing and thereby reduce the patient'"'"'s work of breathing, said waveform further including a positive flow during at least a portion of the patient'"'"'s expiratory phase at a flow rate sufficient to wash carbon dioxide from the patient'"'"'s airway.

2. The method of claim 1 wherein the patient'"'"'s respiratory cycle is detected by a pressure transducer.

3. The method of claim 1 wherein the patient'"'"'s respiratory cycle is detected by a flow sensor.

4. The method of claim 1 wherein the patient'"'"'s respiratory cycle is detected by a thermistor.

5. The method of claim 1 wherein the patient'"'"'s respiratory cycle is detected by a carbon dioxide sensor.

6. The method of claim 1 wherein the patient'"'"'s respiratory cycle is detected by a sensor on a portion of the tube within the patient'"'"'s airway.

7. The method of claim 1 wherein the patient'"'"'s respiratory cycle is detected through a sampling tube extending along a portion of the tube in a patient'"'"'s airway.

8. The method of claim 1 wherein the flow is interrupted for a portion of the patient'"'"'s respiratory cycle.

9. An apparatus for delivering a flow of oxygen-containing gas to the airway of a spontaneously-breathing patient, said apparatus comprising:

a tracheal tube delivering a flow of oxygen-containing gas into a patient'"'"'s airway without interfering with a patient'"'"'s spontaneous respiration around the tube;

a gas source delivering a variable flow of oxygen-containing gas through the tube;

a sensor detecting a physical property of a patient'"'"'s respiratory cycle; and

a processor monitoring the sensor and controlling the gas source to deliver a flow of oxygen-containing gas through the tube varying over each inspiratory and expiratory phase of the respiratory cycle in a predetermined non-constant flow waveform synchronized with the respiratory cycle to augment a patient'"'"'s spontaneous respiration, said waveform including a positive flow beginning at the onset of the patient'"'"'s inspiratory phase at a flow rate sufficient to significantly mitigate the airway pressure the patient must generate during spontaneous breathing and thereby reduce the patient'"'"'s work of breathing, said waveform further including a positive flow during at least a portion of the patient'"'"'s expiratory phase at a flow rate sufficient to wash carbon dioxide from the patient'"'"'s airway.

10. The apparatus of claim 9 wherein the sensor is attached to a portion of the tube in a patient'"'"'s airway.

11. The apparatus of claim 9 further comprising a sampling tube extending along a portion of the tube in a patient'"'"'s airway to the sensor.

12. The apparatus of claim 9 wherein the sensor comprises a pressure transducer.

13. The apparatus of claim 9 wherein the sensor comprises a flow sensor.

14. The apparatus of claim 9 wherein the sensor comprises a thermistor.

15. The apparatus of claim 9 wherein the sensor comprises a carbon dioxide sensor.

16. The apparatus of claim 9 wherein the tube comprises a transtracheal catheter.

17. The apparatus of claim 9 wherein the tube comprises a tracheostomy tube.

18. The apparatus of claim 9 further comprising a tracheostomy tube, and wherein the tracheal tube is inserted through the tracheostomy tube.

19. The apparatus of claim 9 wherein the processor interrupts the flow for a portion of the respiratory cycle.

20. The apparatus of claim 9 wherein the tube comprises an endotracheal catheter.

21. The apparatus of claim 9 wherein the tube comprises an endotracheal tube.

22. The apparatus of claim 9 wherein the tube comprises:

an endotracheal tube; and

an endotracheal catheter inserted through the endotracheal tube.