SETTING MANDATORY MECHANICAL VENTILATION PARAMETERS BASED ON PATIENT PHYSIOLOGY

• US 20080202525A1
• Filed: 02/28/2007
• Published: 08/28/2008
• Est. Priority Date: 02/23/2007
• Status: Abandoned Application

• Current Assignee: General Electric Company
• Original Assignee: General Electric Company
• Inventors: Acker, Jaron Matthew, Pinkert, John Raymond, Tham, Robert Quinyew, Mitton, Michael Paul, Choncholas, Gary James
• Application Number:
  US11/680,410
• Publication Number:
  US 20080202525A1
• Time in Patent Office: Days
• US Class Current: 128/204.22
• CPC Class Codes: A61M 16/0078 Breathing bags
• CPC Class Codes: A61M 16/01 specially adapted for anaesthetising A61M16/104, A61M16/18 take precedence
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/104 specially adapted for anaesthetics A61M16/18 takes precedence
• CPC Class Codes: A61M 16/22 Carbon dioxide-absorbing devices ; Other means for removing carbon dioxidecartridges with absorbing substances for respiratory apparatus A62B19/00
• 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 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2016/1025 the O2 concentration
• CPC Class Codes: A61M 2016/103 the CO2 concentration
• CPC Class Codes: A61M 2016/1035 the anaesthetic agent concentration
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2202/0225 Carbon oxides, e.g. Carbon dioxide
• CPC Class Codes: A61M 2202/0283 Nitrous oxide (N2O)
• CPC Class Codes: A61M 2205/18 with alarm
• 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 2230/06 Heartbeat rate only
• 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 2230/30 : Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/42 : Rate
• CPC Class Codes: A61M 2230/43 : Composition of exhalation
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/435 : partial O2 pressure (P-O2)
• CPC Class Codes: A61M 2230/437 : the anaesthetic agent concentration
• CPC Class Codes: A61M 2230/50 : Temperature

Abstract

A method of setting inspiratory time, expiratory time, and a subject'"'"'s breath size in controlled mechanical ventilation comprises: a) setting a subject'"'"'s expiratory time; b) setting the subject'"'"'s inspiratory time; and c) setting the subject'"'"'s breath size, all based on various criteria.

Claims

1. A method of setting inspiratory time, expiratory time, and a subject'"'"'s breath size in controlled mechanical ventilation, comprising:

a) setting a subject'"'"'s expiratory time based on at least one or more of the following;

1) said subject'"'"'s natural exhalation time;

2) when said subject'"'"'s natural exhalation flow ceases;

or

3) when said subject'"'"'s tidal volume is expired;

b) setting said subject'"'"'s inspiratory time based on at least one or more of the following;

1) varying said subject'"'"'s inspiratory times;

2) determining at least one or more of end tidal gas concentrations or gas volumes exhaled by said subject per breath or both associated with said inspiratory times;

3) establishing a stable condition of at least one or more of said gas concentrations or said gas volumes or both; and

4) determining an optimal inspiratory time based on a deviation from said stable condition; and

c) setting said subject'"'"'s breath size based on at least one or more of the following;

1) varying said subject'"'"'s tidal volumes for said inspiratory time and said expiratory time;

2) determining end tidal gas concentrations associated with said tidal volumes;

3) curve-fitting a relationship between said tidal volumes and said end tidal gas concentrations; and

4) determining a desired tidal volume for said subject based on a desired end tidal gas concentration and said relationship.

2. The method of claim 1, further comprising:

adding an expiratory pause to said expiratory time such that said tidal volume is set equal to or greater than said subject'"'"'s deadspace to achieve said subject'"'"'s desired end tidal gas concentration.

3. The method of claim 1, further comprising:

setting said subject'"'"'s fraction of inspired oxygen concentration based on a desired end tidal oxygen concentration.

4. The method of claim 1, further comprising:

setting said subject'"'"'s fraction of inspired oxygen concentration based on said subject'"'"'s desired arterial blood oxygen saturation level.

5. The method of claim 1, further comprising:

setting said subject'"'"'s vaporizer concentration based on said subject'"'"'s concentration of expired inhalation anesthetic agent.

6. A method of setting inspiratory time, expiratory time, and a subject'"'"'s breath size in controlled mechanical ventilation, comprising:

a) setting a subject'"'"'s expiratory time based on at least one or more of the following;

1) said subject'"'"'s natural exhalation time;

2) when said subject'"'"'s natural exhalation flow ceases;

or

3) when said subject'"'"'s tidal volume is expired;

b) setting said subject'"'"'s inspiratory time based on at least one or more of the following;

1) varying said subject'"'"'s inspiratory times;

2) determining at least one or more of end tidal gas concentrations or gas volumes exhaled by said subject per breath or both associated with said inspiratory times;

3) establishing a stable condition of at least one or more of said gas concentrations or said gas volumes or both; and

4) determining an optimal inspiratory time based on a deviation from said stable condition; and

c) setting said subject'"'"'s breath size based on at least one or more of the following;

1) varying said subject'"'"'s tidal volumes for said inspiratory time and said expiratory time;

2) determining end tidal gas concentrations associated with said tidal volumes;

3) curve-fitting a relationship between said tidal volumes and said end tidal gas concentrations;

4) displaying said relationship; and

5) determining a desired tidal volume for said subject based on a desired end tidal gas concentration and said display.

7. The method of claim 6, further comprising:

adding an expiratory pause to said expiratory time such that said tidal volume is set equal to or greater than said subject'"'"'s deadspace to achieve said subject'"'"'s desired end tidal gas concentration.

8. The method of claim 6, further comprising:

setting said subject'"'"'s fraction of inspired oxygen concentration based on a desired end tidal oxygen concentration.

9. The method of claim 6, further comprising:

setting said subject'"'"'s fraction of inspired oxygen concentration based on said subject'"'"'s desired arterial blood oxygen saturation level.

10. The method of claim 6, further comprising:

setting said subject'"'"'s vaporizer concentration based on said subject'"'"'s concentration of expired inhalation anesthetic agent.

11. A method of setting inspiratory time, expiratory time, and a subject'"'"'s breath size in controlled mechanical ventilation, comprising:

a) setting a subject'"'"'s expiratory time based on at least one or more of the following;

1) said subject'"'"'s natural exhalation time;

2) when said subject'"'"'s natural exhalation flow ceases;

or

3) when said subject'"'"'s tidal volume is expired;

b) setting said subject'"'"'s inspiratory time based on at least one or more of the following;

1) varying said subject'"'"'s inspiratory times;

2) determining at least one or more of end tidal gas concentrations or gas volumes exhaled by said subject per breath or both associated with said inspiratory times;

3) establishing a stable condition of at least one or more of said gas concentrations or said gas volumes or both; and

4) determining an optimal inspiratory time based on a deviation from said stable condition; and

c) setting said subject'"'"'s breath size based on at least one or more of the following;

1) varying said subject'"'"'s inspiratory pressures for said inspiratory time and said expiratory time;

2) determining end tidal gas concentrations associated with said inspiratory pressures;

3) curve-fitting a relationship between said inspiratory pressures and said end tidal gas concentrations; and

4) determining a desired inspiratory pressure for said subject based on a desired end tidal gas concentration and said relationship.

12. The method of claim 11, further comprising:

adding an expiratory pause to said expiratory time such that said tidal volume is set equal to or greater than said subject'"'"'s deadspace to achieve said subject'"'"'s desired end tidal gas concentration.

13. The method of claim 11, further comprising:

setting said subject'"'"'s fraction of inspired oxygen concentration based on a desired end tidal oxygen concentration.

14. The method of claim 11, further comprising:

setting said subject'"'"'s fraction of inspired oxygen concentration based on said subject'"'"'s desired arterial blood oxygen saturation level.

15. The method of claim 11, further comprising:

setting said subject'"'"'s vaporizer concentration based on said subject'"'"'s concentration of expired inhalation anesthetic agent.

16. A method of setting inspiratory time, expiratory time, and a subject'"'"'s breath size in controlled mechanical ventilation, comprising:

a) setting a subject'"'"'s expiratory time based on at least one or more of the following;

1) said subject'"'"'s natural exhalation time;

2) when said subject'"'"'s natural exhalation flow ceases;

or

3) when said subject'"'"'s tidal volume is expired;

b) setting said subject'"'"'s inspiratory time based on at least one or more of the following;

1) varying said subject'"'"'s inspiratory times;

2) determining at least one or more of end tidal gas concentrations or gas volumes exhaled by said subject per breath or both associated with said inspiratory times;

3) establishing a stable condition of at least one or more of said gas concentrations or said gas volumes or both; and

4) determining an optimal inspiratory time based on a deviation from said stable condition; and

c) setting said subject'"'"'s breath size based on at least one or more of the following;

1) varying said subject'"'"'s inspiratory pressures for said inspiratory time and said expiratory time;

2) determining end tidal gas concentrations associated with said inspiratory pressures;

3) curve-fitting a relationship between said inspiratory pressures and said end tidal gas concentrations;

4) displaying said relationship; and

5) determining a desired inspiratory pressure for said subject based on a desired end tidal gas concentration and said display.

17. The method of claim 16, further comprising:

adding an expiratory pause to said expiratory time such that said tidal volume is set equal to or greater than said subject'"'"'s deadspace to achieve said subject'"'"'s desired end tidal gas concentration.

18. The method of claim 16, further comprising:

setting said subject'"'"'s fraction of inspired oxygen concentration based on a desired end tidal oxygen concentration.

19. The method of claim 16, further comprising:

setting said subject'"'"'s fraction of inspired oxygen concentration based on said subject'"'"'s desired arterial blood oxygen saturation level.

20. The method of claim 16, further comprising:

setting said subject'"'"'s vaporizer concentration based on said subject'"'"'s concentration of expired inhalation anesthetic agent.