Ventilator Aerosol Delivery

• US 20080257337A1
• Filed: 04/10/2008
• Published: 10/23/2008
• Est. Priority Date: 04/19/2007
• Status: Active Grant

• Current Assignee: Respironics Respiratory Drug Delivery (UK) Ltd. (Koninklijke Philips N.V.)
• Original Assignee: Respironics Respiratory Drug Delivery (UK) Ltd. (Koninklijke Philips N.V.)
• Inventors: Prince, Ivan R., Denyer, Jonathan S. H.
• Granted Patent: US 8,371,299 B2
• Time in Patent Office: Days
• US Class Current: 128/200.14
• CPC Class Codes: A61M 11/005 using ultrasonics spraying or atomising liquids using ultrasonic vibrations in general B05B17/06
• CPC Class Codes: A61M 16/14 by mixing different fluids, one of them being in a liquid phase
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2205/581 by audible feedback
• CPC Class Codes: A61M 2205/582 by tactile feedback
• CPC Class Codes: A61M 2205/583 by visual feedback
• 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 2230/42 Rate
• CPC Class Codes: A61M 2230/46 Resistance or compliance of the lungs

Abstract

A method for delivering a medicament to a mechanically ventilated patient receiving a flow of breathing gas comprises delivering a respiratory maneuver to such a patient, monitoring the physiological effects of the respiratory maneuver on such patient, automatically establishing an optimized respiratory maneuver in response to the monitored physiological effects, and delivering the optimized respiratory maneuver to such a patient. A system for delivering an aerosolized medicament to a ventilated patient is also provided.

Claims

1. A method for delivering a medicament to a mechanically ventilated patient receiving a flow of breathing gas, the method comprising:

(A) delivering a respiratory maneuver to such a patient;

(B) monitoring the physiological effects of the respiratory maneuver on such patient;

(C) automatically establishing an optimized respiratory maneuver in response to the monitored physiological effects; and

(D) delivering the optimized respiratory maneuver to such a patient.

2. The method of claim 1, wherein delivering a respiratory maneuver to such a patient comprises:

(i) altering a normal tidal volume and a normal flow rate associated with flow of gas during a first predetermined period,

(ii) activating a drug delivery device structured to aerosolize the medicament during a second predetermined period, wherein the second predetermined period has a duration that is less than a duration of the first predetermined period, and

(iii) delivering the aerosolized medicament to such patient via the flow of gas.

3. The method of claim 2, wherein altering the normal tidal volume comprises increasing the normal tidal volume.

4. The method of claim 2, wherein altering the normal flow rate comprises decreasing the normal flow rate.

5. The method of claim 2, wherein altering the normal tidal volume, altering the normal flow rate, and activating the drug delivery device occur substantially simultaneously.

6. The method of claim 1, wherein automatically establishing an optimized respiratory maneuver comprises at least one of:

selecting an optimized tidal volume associated with the flow of gas;

selecting an optimized flow rate associated with the flow of gas;

selecting an optimized duration for the first predetermined period; and

selecting an optimized duration for the second predetermined period.

7. The method of claim 1, wherein monitoring the physiological effects of the respiratory maneuver on such patient comprises receiving signals associated with at least one of lung compliance, airway resistance, circuit pressure, respiratory rate, minute volume, partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide in arterial blood, and percentage of oxygen saturation in arterial blood.

8. The method of claim 1 further comprising, generating an indication to such a patient prior to the delivery of the respiratory maneuver and the optimized respiratory maneuver.

9. The method of claim 1 wherein delivering a respiratory maneuver comprises delivering a tidal volume between 0-4000 milliliters at a flow rate between 0-99 liters per minute, at an inhalation time between 0-10 seconds.

10. The method of claim 1 wherein delivering a respiratory maneuver comprises delivering a tidal volume between 100-1000 milliliters at a flow rate between 10-50 liters per minute, at an inhalation time between 0.5 and 5 seconds.

11. A method for coordinating delivery of a flow of gas and delivery of a medicament to a mechanically ventilated patient, the method comprising:

generating the flow of gas with a flow generator;

determining a number of first operational parameters associated with the flow generator;

establishing a respiratory maneuver, wherein the respiratory maneuver includes a number of second operational parameters associated with the flow generator and a number of operational parameters associated with a medicament delivery device;

delivering the respiratory maneuver to such patient, wherein the number of second operational parameters associated with the flow generator and the number of operational parameters associated with the medicament delivery device are implemented in a coordinated fashion;

monitoring such patient'"'"'s physiological reaction to the respiratory maneuver; and

automatically establishing an optimized respiratory maneuver responsive to such patient'"'"'s physiological reaction.

12. The method of claim 11 wherein delivering a respiratory maneuver to such a patient comprises:

(i) altering a normal tidal volume and a normal flow rate associated with flow of gas during a first predetermined period,

(ii) activating a drug delivery device structured to aerosolize the medicament during a second predetermined period, wherein the second predetermined period has a duration that is less than a duration of the first predetermined period, and

(iii) delivering the aerosolized medicament to such patient via the flow of gas.

13. The method of claim 12, wherein altering the normal tidal volume comprises increasing the normal tidal volume.

14. The method of claim 12, wherein altering the normal flow rate comprises decreasing the normal flow rate.

15. The method of claim 12, wherein altering the normal tidal volume, altering the normal flow rate, and activating the drug delivery device occur substantially simultaneously.

16. The method of claim 11, wherein automatically establishing an optimized respiratory maneuver comprises at least one of:

selecting an optimized tidal volume associated with the flow of gas;

selecting an optimized flow rate associated with the flow of gas;

selecting an optimized duration for the first predetermined period; and

selecting an optimized duration for the second predetermined period.

17. The method of claim 11, wherein monitoring the physiological effects of the respiratory maneuver on such patient comprises receiving signals associated with at least one of lung compliance, airway resistance, circuit pressure, respiratory rate, minute volume, partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide in arterial blood, and percentage of oxygen saturation in arterial blood.

18. The method of claim 11 further comprising, generating an indication to such a patient prior to the delivery of the respiratory maneuver and the optimized respiratory maneuver.

19. The method of claim 11 wherein delivering a respiratory maneuver comprises delivering a tidal volume between 0-4000 milliliters at a flow rate between 0-99 liters per minute, at an inhalation time between 0-10 seconds.

20. The method of claim 11 wherein delivering a respiratory maneuver comprises delivering a tidal volume between 100-1000 milliliters at a flow rate between 10-50 liters per minute, at an inhalation time between 0.5 and 5 seconds.

21. A system for delivering an aerosolized medicament to a ventilated patient, comprising:

a ventilator structured to produce a flow of breathing gas;

a nebulizer structured to aerosolize a medicament;

a monitoring device structured to generate an output signal associated with a response of such a patient to receipt of the aerosolized medicament; and

a controller operatively coupled with the ventilator, nebulizer, and monitoring device, wherein the controller is adapted to;

coordinate operation of the ventilator and the nebulizer to produce a respiratory maneuver, and

responsive to the output signal from the monitoring device, automatically establish ventilator settings and nebulizer settings to optimize delivery of the aerosolized medicament to such patient.