BREATHING ASSISTANCE SYSTEMS WITH LUNG RECRUITMENT MANEUVERS

• US 20090241957A1
• Filed: 03/23/2009
• Published: 10/01/2009
• Est. Priority Date: 03/27/2008
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Baker, Clark R. JR.
• Granted Patent: US 8,640,699 B2
• Time in Patent Office: Days
• US Class Current: 128/204.230
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• 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 16/12 by mixing different gases
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2205/505 Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• 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 2205/584 having a color code
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• 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 2230/46 Resistance or compliance of the lungs
• CPC Class Codes: A61M 2230/50 Temperature

Abstract

The disclosure provides a method for controlling the delivery of a breathing gas to a patient including automatic lung recruitment maneuvers. The method may include regulating the FiO₂ and the PEEP of the breathing gas delivered to the patient, determining a blood oxygenation level of the patient, automatically adjusting the FiO₂ of the breathing gas delivered to the patient based on at least the blood oxygenation level of the patient, and in response to determining that the FiO₂ of the breathing gas delivered to the patient exceeds a pre-determined value: automatically initiating a lung recruitment maneuver; and automatically increasing the PEEP of the breathing gas delivered to the patient.

Claims

1. A method for controlling the delivery of a breathing gas to a patient, the method including:

regulating the fractional inspired oxygen (FiO₂) and the positive end expiratory pressure (PEEP) of the breathing gas delivered to the patient;

determining a blood oxygenation level of the patient;

automatically adjusting the FiO₂ of the breathing gas delivered to the patient based on the blood oxygenation level of the patient; and

in response to determining that the FiO₂ of the breathing gas delivered to the patient exceeds a pre-determined value;

automatically initiating a lung recruitment maneuver; and

automatically increasing the PEEP of the breathing gas delivered to the patient subsequent to the completion of the lung recruitment maneuver.

2. The method of claim 1, wherein the blood oxygenation level is determined by measuring the saturation of peripheral oxygen (SpO₂) in the patient.

3. The method of claim 1, wherein the lung recruitment maneuver includes:

inflating the lungs of the patient at a relatively high pressure; and

maintaining the inflation of the lungs for a duration long enough to distend collapsed alveoli.

4. The method of claim 1, wherein the lung recruitment maneuver includes:

inflating the lungs of the patient at a relatively high pressure, the pressure preset by a user; and

maintaining the inflation of the lungs for a duration long enough to distend collapsed alveoli, the duration preset by a user.

5. The method of claim 1, wherein the lung recruitment maneuver includes:

inflating the lungs of the patient at a relatively high pressure, the pressure determined by a ventilation parameter; and

maintaining the inflation of the lungs for a duration long enough to distend collapsed alveoli, the duration determined by a ventilation parameter.

6. The method of claim 1, further comprising inhibiting the adjustment of the fractional inspired oxygen of the breathing gas delivered to the patient during the lung recruitment maneuver.

7. The method of claim 1, further comprising automatically adjusting the PEEP of the breathing gas delivered to the patient based on variations in the fractional inspired oxygen of the breathing gas delivered to the patient.

8. The method of claim 1, further comprising automatically adjusting the PEEP of the breathing gas delivered to the patient based on both:

variations in the FiO₂ of the breathing gas delivered to the patient; and

a ventilation parameter including one cardiovascular indicator of the patient.

9. The method of claim 1, further comprising:

regulating a third gas delivery parameter of the breathing gas delivered to the patient;

automatically adjusting the third gas delivery parameter of the breathing gas delivered to the patient based on the blood oxygenation level of the patient; and

adjusting the pre-determined value for automatic initiation of a lung recruitment maneuver based on the value of the third gas delivery parameter of the breathing gas delivered to the patient.

10. A breathing assistance system configured to deliver a breathing gas toward a patient, the system comprising:

a gas delivery control system configured to regulate the fractional inspired oxygen (FiO₂) and the positive end expiratory pressure (PEEP) of the breathing gas delivered to the patient;

a parameter module configured to determine a blood oxygenation level of the patient;

wherein the gas delivery control system automatically adjusts the FiO₂ of the breathing gas delivered to the patient based at least on the blood oxygenation level of the patient;

wherein the gas delivery control system automatically initiates a lung recruitment maneuver when the FiO₂ of the breathing gas exceeds a pre-determined value; and

wherein the gas delivery control system automatically increases the PEEP of the breathing gas delivered to the patient subsequent to performing the lung recruitment maneuver,

11. The system of claim 10, wherein the parameter module is configured to measure the saturation of peripheral oxygen (SpO₂) in the patient.

12. The system of claim 10, wherein the lung recruitment maneuver includes:

inflating the lungs of the patient at a relatively high pressure; and

maintaining the inflation of the lungs for a duration long enough to distend collapsed alveoli.

13. The system of claim 10, wherein the lung recruitment maneuver includes:

inflating the lungs of the patient at a relatively high pressure, the pressure preset by a user; and

maintaining the inflation of the lungs for a duration long enough to distend collapsed alveoli, the duration preset by a user.

14. The system of claim 10, wherein the lung recruitment maneuver includes:

inflating the lungs of the patient at a relatively high pressure, the pressure determined by a ventilation parameter; and

maintaining the inflation of the lungs for a duration long enough to distend collapsed alveoli, the duration determined by a ventilation parameter.

15. The system of claim 10, further comprising the gas delivery control system configured to inhibit the adjustment of the FiO₂ of the breathing gas delivered to the patient during the lung recruitment maneuver.

16. The system of claim 10, further comprising the gas delivery control system configured to automatically adjust the PEEP of the breathing gas delivered to the patient based on variations in the FiO₂ of the breathing gas delivered to the patient.

17. The system of claim 10, further comprising the gas delivery control system configured to automatically adjust the PEEP of the breathing gas delivered to the patient based on both:

variations in the FiO₂ of the breathing gas delivered to the patient; and

a ventilation parameter including one cardiovascular indicator of the patient.

18. The system of claim 10, further comprising:

the gas delivery control system configured to regulate a third parameter of the breathing gas delivered to the patient;

the gas delivery control system configured to automatically adjust the third parameter of the breathing gas delivered to the patient based on the blood oxygenation level of the patient; and

the gas delivery control system configured to adjust the pre-determined value for automatic initiation of a lung recruitment maneuver based on the value of the third gas parameter of the breathing gas delivered to the patient.

19. A computer-readable storage medium storing a set of instructions executable on a processor, the set of instructions comprising:

instructions for regulating the fractional inspired oxygen (FiO₂) and the positive end expiratory pressure (PEEP) of the breathing gas delivered to the patient;

instructions for determining a blood oxygenation level of the patient;

instructions for automatically adjusting the FiO₂ of the breathing gas delivered to the patient based on the blood oxygenation level of the patient; and

in response to determining that the FiO₂ of the breathing gas delivered to the patient exceeds a pre-determined value;

instructions for automatically initiating a lung recruitment maneuver; and

instructions for automatically increasing the PEEP of the breathing gas delivered to the patient subsequent to the completion of the lung recruitment maneuver.

20. A breathing assistance system, comprising:

means for regulating the fractional inspired oxygen (FiO₂) and the positive end expiratory pressure (PEEP) of the breathing gas delivered to the patient;

means for determining a blood oxygenation level of the patient;

means for automatically adjusting the FiO₂ of the breathing gas delivered to the patient based on the blood oxygenation level of the patient; and

in response to determining that the FiO₂ of the breathing gas delivered to the patient exceeds a pre-determined value;

means for automatically initiating a lung recruitment maneuver; and

means for automatically increasing the PEEP of the breathing gas delivered to the patient subsequent to the completion of the lung recruitment maneuver.