METHOD AND SYSTEM FOR MONITORING PATIENT'S BREATHING ACTION RESPONSE TO CHANGES IN A VENTILATOR APPLIED BREATHING SUPPORT

• US 20080230065A1
• Filed: 03/20/2008
• Published: 09/25/2008
• Est. Priority Date: 03/22/2007
• Status: Active Grant

• Current Assignee: General Electric Company
• Original Assignee: General Electric Company
• Inventors: HEINONEN, Erkki Paavo
• Granted Patent: US 8,561,612 B2
• Time in Patent Office: Days
• US Class Current: 128/204.23
• 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 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 2016/1025 the O2 concentration
• CPC Class Codes: A61M 2016/103 the CO2 concentration
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/435 partial O2 pressure (P-O2)

Abstract

A method for monitoring patient'"'"'s breathing action response to changes in a ventilator applied breathing support, where a) a desired target range for a breathing gas indication of O2-consumption for the patient is first determined, after which b) the ventilator applied breathing support is changed, and c) the breathing gas indication of O2-consumption of said patient is measured and d) compared with the desired target range. At least the steps b)-d) are repeated to maintain the measured breathing gas indication of O2-consumption of said patient within the desired target range. A system for monitoring a patient'"'"'s breathing action is also provided.

Claims

1. A method for monitoring patient'"'"'s breathing action response to ventilator applied breathing support, the method comprising:

a) determining a desired target range for a breathing gas indication of O2-consumption for the patient;

b) changing the ventilator applied breathing support;

c) measuring the breathing gas indication of O2-consumption of said patient; and

d) comparing the measured breathing gas indication of O2-consumption of said patient with the desired target range.

2. A method according to claim 1, wherein the method further comprises:

e) using the comparison result and repeating steps b)-d) to maintain breathing gas indication of O2-consumption within said desired target range.

3. A method according to claim 1, wherein the method (140) is used for assessing a readiness of a patient to be weaned from a ventilator in a weaning process, whereupon in steps

a) determining a desired target range for a breathing gas indication of O2-consumption for the patient;

b) decreasing the ventilator applied breathing support;

c) measuring said breathing gas indication of O2-consumption of said patient; and

d) comparing the measured breathing gas indication of O2-consumption of said patient with the desired target range, whereupon

either

e) steps b) to d) are repeated in so far as the measured breathing gas indication of O2-consumption of said patient is within the desired target range determined in step a), and the ventilator applied support is needed,

or

f) the measured breathing gas indication of O2-consumption of said patient is outside the desired target range determined in step a), whereupon the ventilator applied breathing support is increased.

6. A method according to claim 3, wherein ventilator applied support is needed, if, when changing the ventilator applied breathing support, the breathing gas indication of O2-consumption of said patient reveals that the O2-consumption don'"'"'t remain in the determined desired target range.

7. A method according to claim 1, wherein a breathing gas indication of CO2-elimination (VCO2) of the patient is also determined.

8. A method according to claim 7, wherein said breathing gas indication of CO2-elimination of the patient is compared to the breathing gas indication of O2-consumption of said patient, and if said indications reveal O2-consumption growing faster than CO2-elimination when decreasing the breathing support for the patient, indicating that weaning of the patient from the ventilator is not possible and the breathing support is still needed.

9. A method according to claim 1, wherein said breathing gas indication of O2-consumption of the patient is a difference of inspired O2 and end-tidal O2-concentration.

10. A method according to claim 1, wherein said breathing gas indication of O2-consumption of the patient is measured from breathing gases of said patient by integrating the product of the breathing gas flow and gas concentration over time.

11. A method according to claim 7, wherein said breathing gas indication of CO2-elimination of the patient is measured as end-tidal CO2-concentration.

12. A method according to claim 7, wherein said breathing gas indication of CO2-elimination of the patient is measured from breathing gases of said patient by integrating the product of breathing gas flow and gas concentration over time.

13. A method according to claim 3, wherein the breathing gas indication of O2-consumption of the patient is a difference of inspired O2 and end-tidal O2-concentration and a breathing gas indication of CO2-elimination of the patient is measured as end-tidal CO2-concentration, whereupon a combination of high DO2 and high EtCO2 is used as a predictor of patient'"'"'s inability to maintain sufficient breathing and immediate increase of the support pressure is suggested.

4-5. -5. (canceled)

14. A system for monitoring patient'"'"'s breathing action response to ventilator applied breathing support, the system comprising a ventilator, controller and gas sensor, wherein the system is:

a) adapted to determine a desired target range for a breathing gas indication of O2-consumption for the patient;

b) adapted to change the ventilator applied breathing support;

c) adapted to measure the breathing gas indication of O2-consumption of said patient; and

d) adapted to compare the measured breathing gas indication of O2-consumption of said patient with the desired target range.

15. A system according to claim 14, wherein the system is further adapted

e) to use the comparison result and repeat steps b)-d) to maintain breathing gas indication of O2-consumption within said desired target range.

16. A system according to claim 14, wherein the system is adapted to be used for assessing a readiness of a patient to be weaned from a ventilator in a weaning process, whereupon the system is further

a) adapted to determine a desired target range for a breathing gas indication of O2-consumption for the patient,

b) adapted to decrease the ventilator applied breathing support,

c) adapted to measure said breathing gas indication of O2-consumption of said patient,

d) adapted to compare the measured breathing gas indication of O₂-consumption of said patient with the desired target range, whereupon either

e) adapted to repeat steps b) to d) in so far as the measured breathing gas indication of O2-consumption of said patient is within the desired target range determined in step a), and the ventilator applied support is needed, or

f) if the measured breathing gas indication of O2-consumption of said patient is outside the desired target range determined in step a), adapted to increase the ventilator applied breathing support.

17. A system according to claim 14, wherein the system is adapted to be used for adjusting the ventilator applied breathing support, whereupon the system is further

a) adapted to determine a desired target range for a breathing gas indication of O2-consumption for the patient,

b) adapted to change the ventilator applied breathing support,

c) adapted to measure the breathing gas indication of O2-consumption of said patient,

d) adapted to compare the measured breathing gas indication of O2-consumption of said patient with the desired target range,

e) adapted to repeat at least the steps b)-d) to maintain the breathing gas measured indication of O2-consumption of said patient within the desired target range.

18. A system according to claim 14, wherein a breathing support is a pressure support.

20. A system according to claim 14, wherein the system is also adapted to determine breathing gas indication of CO2-elimination of the patient.

21. A system according to claim 20, wherein the system is adapted to compare said breathing gas indication of CO2-elimination of the patient to breathing gas indication of O2-consumption of said patient, and if said indications reveal O2-consumption growing faster than CO2-elimination when decreasing the breathing support for the patient, the systems is adapted to suggest continuing the breathing support for the patient.

22. A system according to claim 20, wherein said breathing gas indication of O2-consumption of the patient is a difference of inspired O2 and end-tidal O2-concentration.

23. A system according to claim 20, wherein the system is adapted to measure said breathing gas indication of O2-consumption of the patient as an absolute value of O2-consumption.

24. A system according to claim 20, wherein the system is adapted to measure said breathing gas indication of O2-consumption of the patient from breathing gases of said patient by integrating the product of the breathing gas flow and gas concentration over time.

27. A system according to claim 16, wherein breathing gas indication of O2-consumption of the patient is a difference (DO2) of inspired O2 and end-tidal O2-concentration (EtO2) and the system is adapted to measure indication of CO2-elimination of the patient as end-tidal CO2-concentration (EtCO2), whereupon the system is adapted to use a combination of high DO2 and high EtCO2 as a predictor of patient'"'"'s inability to maintain sufficient breathing and suggest immediate increase of the support pressure based on said combination of high DO2 and high EtCO2.

19. (canceled)

25-26. -26. (canceled)

28-31. -31. (canceled)