Ventilator Based On A Fluid Equivalent Of The "Digital To Analog Voltage" Concept

• US 20110023879A1
• Filed: 03/30/2009
• Published: 02/03/2011
• Est. Priority Date: 03/31/2008
• Status: Abandoned Application

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Kudaravalli, Ravikumar Venkata, Vandine, Joseph Douglas
• Application Number:
  US12/935,824
• Publication Number:
  US 20110023879A1
• Time in Patent Office: Days
• US Class Current: 128/204.21
• 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 16/12 by mixing different gases
• CPC Class Codes: A61M 16/125 Diluting primary gas with ambient air
• CPC Class Codes: A61M 16/204 used for inhalation control
• 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 2016/1025 the O2 concentration
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards

Abstract

The present invention is directed to a ventilator that, in one embodiment, uses one or more valve banks having precalibrated orifices to perform real time control of flow metering devices and, in a second embodiment, uses a choked flow orifice and upstream gas pressure regulator to generate a desired flow trajectory.

Claims

1. A method, comprising:

providing a ventilation system for receiving at least one input gas, the ventilation system comprising at least one valve bank to meter a flow of the at least one input gas and deliver an output gas to a patient, the at least one valve bank comprising a plurality of valves with each valve comprising a respective orifice;

receiving a set of ventilation parameters;

based on the set of ventilation parameters, determining, for each of a plurality of successive time intervals in an inspiration cycle, a respective plurality of operating states for selected valves in the at least one valve bank to provide the output gas, the output gas having at least one of a selected gas composition and flow trajectory;

when an inspiration cycle is initiated, implementing, for each successive time interval, the determined operating states for the selected valves in the at least one valve bank.

2. The method of claim 1, wherein the at least one input gas is received from at least one gas source and the at least one gas source comprises at least first and second gas sources, wherein the at least one valve bank comprises a first valve bank corresponding to the first gas source and a second valve bank corresponding to the second gas source, and wherein the first and second valve banks are positioned upstream of a mixing zone for the first and second gases.

3. The method of claim 1, wherein the at least one of a gas composition and flow trajectory is gas composition trajectory, wherein each of the valves in the at least one valve bank has binary operating states, and wherein, for a selected maximum flow rate Y, a smallest flow rate X for any valve in the at least one valve bank is provided by the equation:

X=Y/2^m,

where m is the number of valves in the at least one valve bank.

4. The method of claim 1, wherein the at least one input gas is received from at least one gas source and the at least one gas source comprises first and second gas sources, the first gas source comprising predominantly molecular oxygen and the second gas source comprising predominantly air, wherein the at least one valve bank comprises a first valve bank corresponding to the first gas source and a second valve bank corresponding to the second gas source, wherein, for a selected input gas pressure, a first valve in the first valve bank has a first flow rate, the first flow rate being lower than flow rates of other valves in the first valve bank, wherein, for the selected input gas pressure, a second valve in the second valve bank has a second flow rate, the second flow rate being lower than flow rates of other valves in the second valve bank, wherein, for the selected input gas pressure, the first and second flow rates are different, and wherein, for the selected input gas pressure, at least two valves in the first valve bank have differing flow rates and at least two valves in the second valve bank have differing flow rates.

5. The method of claim 3, wherein, in the at least one valve bank, at least one valve is open during a first time interval and closed during a second time interval, wherein, for a selected input gas pressure, a plurality of valves in the at least one valve bank have different flow rates, and wherein the different flow rates are multiples of X.

6. The method of claim 2, wherein the set of ventilation parameters comprise a plurality of target pressure for the output gas provided to the patient, an inspiratory time, a rise time, tidal volume, inspiratory flow rate, respiratory rate, ratio of inspiration to expiration time, and FiO2 and wherein a number of valves in the first valve bank is different from a number of valves in the second valve bank.

7. The method of claim 1, further comprising:

after the inspiration cycle is completed, comparing at least one of a target tidal volume and a target trajectory with at least one of an actual tidal volume and an actual trajectory provided to the patient in the implementing step to determine a deviation;

determining whether the deviation is significant; and

when the deviation is significant, applying a correction factor to at least one of the time intervals, wherein the correction factor is the target tidal volume divided by the actual tidal volume.

8. The method of claim 1, wherein, in the implementing step, the valves in the at least one valve bank are operated in a choked flow condition and wherein the ventilation system comprises at least one gas regulator to regulate an input gas pressure upstream of the at least one valve bank.

9. A ventilator, comprising:

at least one valve bank to meter a flow of at least one input gas and deliver an output gas for patient inhalation, the at least one valve bank comprising a plurality of valves with each valve comprising a respective orifice; and

a control module operable to determine, for each of a plurality of successive time intervals, a respective plurality of differing operating states for at least one of the valves in the at least one valve bank and, during an inspiration cycle, provide control signals to implement, for each successive time interval, the determined operating states for the at least one valve to provide the output gas.

10. The ventilator of claim 9, wherein the at least one input gas is received from at least one gas source and the at least one gas source comprises at least first and second gas sources, wherein the at least one valve bank comprises a first valve bank corresponding to the first gas source and a second valve bank corresponding to the second gas source, and wherein the first and second valve banks are positioned upstream of a mixing zone for the first and second gases.

11. The ventilator of claim 9, wherein the at least one valve bank provides a gas composition trajectory, wherein each of the valves in the at least one valve bank is a two-way solenoid valve, and wherein, for a selected maximum flow rate Y, a smallest flow rate X for any valve in the at least one valve bank is provided by the equation:

X=Y/2^m,

where m is the number of valves in the at least one valve bank, wherein, for a selected input gas pressure, a plurality of valves in the at least one valve bank have different flow rates, and wherein the different flow rates are multiples of X.

12. The ventilator of claim 10, wherein, for a selected input gas pressure, at least two valves in the first valve bank have differing flow rates and at least two valves in the second valve bank have differing flow rates, wherein a first valve in the first valve bank has a first flow rate, the first flow rate being lower than flow rates of other valves in the first valve bank, wherein a second valve in the second valve bank has a second flow rate, the second flow rate being lower than flow rates of other valves in the second valve bank, and wherein, for the selected input gas pressure, the first and second flow rates are different.

13. The ventilator of claim 9, wherein the valves in the at least one valve bank are operated in a choked flow condition and further comprising at least one gas regulator to regulate a gas pressure upstream of the at least one valve bank.

14. A method, comprising:

providing a ventilator to receive at least one input gas from at least one gas source and deliver an output gas for patient inhalation, the ventilator comprising at least one gas regulator to control a pressure of the at least one input gas and at least one valve positioned downstream of the gas regulator, wherein the at least one valve comprises an orifice and the output gas is derived from the at least one gas source; and

while maintaining the at least one valve at choked flow, varying the input gas pressure to provide differing output gas flow rates

15. The method of claim 14 wherein the different output gas flow rates are adapted for use with patients having differing lung conditions.

16. The method of claim 14, wherein the varying step comprises:

selecting a first flow rate of the output gas during an inspiratory cycle by a first patient;

during the inspiratory cycle by the first patient, maintaining, by the at least one gas regulator, a first input gas pressure, wherein, at the first input gas pressure, the orifice of the at least one valve operates at choked flow;

selecting a second flow rate of the output gas during an inspiratory cycle by a second patient, the first and second patients having differing lung capacities and the first and second flow rates being different; and

during the inspiratory cycle by the second patient, maintaining, by the at least one gas regulator, a second input gas pressure, wherein, at the second input gas pressure, the orifice of the at least one valve operates at choked flow.

17. The method of claim 16, wherein a ratio of the output gas pressure to the input gas pressure is 0.528 or less and wherein the first patient is an adult and the second patient is an infant.

18. The method of claim 16, wherein a peak flow for the first patient is at least about 75 SLPM and a peak flow for the second patient is no more than about 40 SLPM.

19. The method of claim 16, wherein the at least one gas source comprises at least first and second gas sources, wherein the at least one valve comprises a first valve bank corresponding to the first gas source and a second valve bank corresponding to the second gas source, wherein the first and second valve banks are positioned upstream of a mixing zone for the first and second gases, and further comprising:

receiving a set of ventilation parameters;

based on the set of ventilation parameters, determining, for each of a plurality of successive time intervals in an inspiration cycle, a respective plurality of operating states for each valve in each of the first and second valve banks to provide at least one of a selected gas composition and flow trajectory;

when an inspiration cycle is initiated, implementing, for each successive time interval, the determined operating states for each valve in each of the first and second valve banks.

20. A ventilator to provide an output gas for patient inhalation, the ventilator comprising:

at least one gas regulator to control a pressure of at least one input gas;

at least one valve positioned downstream of the gas regulator, wherein the at least one valve comprises an orifice and the output gas is derived from the at least one input gas; and

a control module operable to vary the input gas pressure to provide differing output gas flow rates for differing patients while maintaining the at least one valve at choked flow.

21. The ventilator of claim 20, wherein the differing patients have differing lung capacities and wherein the control module is adapted to perform the following operations:

select a first flow rate of the output gas during an inspiratory cycle by a first patient;

during the inspiratory cycle by the first patient, maintain, by the at least one gas regulator, a first input gas pressure, wherein, at the first input gas pressure, the orifice of the at least one valve operates at choked flow;

select a second flow rate of the output gas during an inspiratory cycle by a second patient, the first and second patients having differing lung capacities and the first and second flow rates being different; and

during the inspiratory cycle by the second patient, maintain, by the at least one gas regulator, a second input gas pressure, wherein, at the second input gas pressure, the orifice of the at least one valve operates at choked flow.

22. The ventilator of claim 21, wherein a ratio of the output gas pressure to the input gas pressure is 0.528 or less and wherein the first patient is an adult and the second patient is an infant.

23. The ventilator of claim 21, wherein a peak flow for the first patient is at least about 75 SLPM and a peak flow for the second patient is no more than about 40 SLPM.

24. The ventilator of claim 20, wherein the at least one valve is a plurality of valves, wherein the control module is further operable to determine, for each of a plurality of successive time intervals, a respective plurality of differing operating states for at least one of the valves and, during an inspiration cycle, provide control signals to implement, for each successive time interval, the determined operating states for the at least one valve.