Method And System For Generating A Pressure Volume Loop Of A Low Flow Recruitment Maneuver

• US 20110023881A1
• Filed: 07/09/2010
• Published: 02/03/2011
• Est. Priority Date: 07/31/2009
• Status: Abandoned Application

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Thiessen, Ron
• Application Number:
  US12/833,706
• Publication Number:
  US 20110023881A1
• Time in Patent Office: Days
• US Class Current: 128/204.23
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0063 Compressors
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• 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 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/505 Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches

Abstract

This disclosure describes systems and methods for delivering one or more low flow recruitment maneuvers to a patient while on a ventilator. Embodiments described herein provide methods for delivering low flow recruitment maneuvers wherein either or both of the inspiratory and expiratory phases of the recruitment maneuver are maintained by the ventilator at a low flow. Embodiments described herein provide for single-breath recruitment maneuvers and multi-breath recruitment maneuvers at low flow. Embodiments described herein provide for graphical display of a pressure-volume loop (PV loop) for both single-breath and multi-breath recruitment maneuvers. Embodiments described herein also disclose an automated ventilator functionality whereby recruitment maneuvers settings and/or post-recruitment maneuver settings for resuming prescribed ventilation may be set via a graphical user interface. Other embodiments described herein enable a clinician to configure the ventilator to synchronize the end the recruitment maneuver with patient-triggered inspiration for post-recruitment maneuver ventilation.

Claims

1. A method for generating a pressure-volume loop (PV loop) for a single-breath, low flow recruitment maneuver, the method comprising:

monitoring pressure, volume, and flow while delivering air pressure from a baseline pressure to a target recruitment maneuver pressure at low flow;

storing pressure data versus volume data collected during delivery of air pressure from the baseline pressure to the target recruitment maneuver pressure;

upon determining that pressure is about equal to the target recruitment maneuver pressure, releasing air pressure;

monitoring pressure, volume, and flow while releasing air pressure from the target recruitment maneuver pressure to the baseline pressure at low flow;

upon determining that pressure is about equal to the baseline pressure, storing pressure data versus volume data collected during release of air pressure from the target recruitment maneuver pressure to the baseline pressure; and

displaying the stored pressure data versus volume data for the delivering air pressure and the stored pressure data versus volume data for the releasing air pressure to generate a PV loop for the single-breath, low flow recruitment maneuver.

2. The method of claim 1, wherein delivering air pressure at low flow further comprises:

delivering air pressure at a first inspiratory rate;

determining whether flow is less than a peak targeted flow, wherein when flow is not less than the peak targeted flow, delivering air pressure at a second inspiratory rate less than the first inspiratory rate; and

upon determining that the pressure is about equal to the target recruitment maneuver pressure, discontinuing delivering air pressure.

3. The method of claim 2, wherein the peak targeted flow is about 10 liters per minute (lpm).

4. The method of claim 1, wherein releasing air pressure at low flow further comprises:

releasing air pressure at a first expiratory rate;

determining whether flow is less than a peak targeted flow, wherein when flow is not less than the peak targeted flow, releasing air pressure at a second inspiratory rate less than the first inspiratory rate; and

upon determining that the pressure is about equal to the baseline pressure, discontinuing releasing air pressure.

5. The method of claim 1, wherein the peak targeted flow is about 10 liters per minute (lpm).

6. The method of claim 1, further comprising:

displaying the PV loop for the single-breath, low flow recruitment maneuver; and

displaying a PV loop generated during prescribed ventilation before delivery of the single-breath, low flow recruitment maneuver for comparison by a clinician.

7. The method of claim 1, further comprising:

storing a plurality of PV loops during ventilation of a patient; and

displaying each of the plurality of PV loops in succession.

8. The method of claim 1, further comprising calculating an optimal compliance for a patient based on the PV loop.

9. The method of claim 8, further comprising suggesting a minimum positive end expiratory pressure (PEEP) and a peak inspiratory pressure (PIP) based on the optimal compliance.

10. A method for generating a plurality of pressure-volume loops (PV loops) for a multi-breath, low flow recruitment maneuver, the method comprising:

monitoring pressure, volume, and flow while delivering pressure at low flow from a first baseline pressure to a peak inspiratory pressure during each of a first plurality of breaths of an ascending phase of a multi-breath recruitment maneuver;

monitoring pressure, volume, and flow while releasing pressure at low flow from the peak inspiratory pressure to the first baseline pressure during each of the first plurality of breaths of the ascending phase of the multi-breath recruitment maneuver;

storing pressure data versus volume data collected during delivery and release of pressure for each of the first plurality of breaths of the ascending phase of the multi-breath recruitment maneuver;

monitoring pressure, volume, and flow while delivering pressure at low flow from a second baseline pressure to the peak inspiratory pressure during each of a second plurality of breaths of the ascending phase of the multi-breath recruitment maneuver;

monitoring pressure, volume, and flow while releasing pressure at low flow from the peak inspiratory pressure to the second baseline pressure during each of the second plurality of breaths of the ascending phase of the multi-breath recruitment maneuver;

storing pressure data versus volume data collected during delivery and release of pressure for each of the second plurality of breaths of the ascending phase of the multi-breath recruitment maneuver; and

displaying the stored pressure data versus volume data for the first plurality of breaths and the stored pressure data versus volume data for the second plurality of breaths of the ascending phase of the multi-breath recruitment maneuver.

11. The method of claim 10, further comprising:

determining that the second baseline pressure is about equal to the baseline pressure plus a total change in positive end expiratory pressure (PEEP);

monitoring pressure, volume, and flow while delivering pressure at low flow from the first baseline pressure to the peak inspiratory pressure during each of a first plurality of breaths of a descending phase of the multi-breath recruitment maneuver;

monitoring pressure, volume, and flow while releasing pressure at low flow from the peak inspiratory pressure to the first baseline pressure during each of the first plurality of breaths of the descending phase of the multi-breath recruitment maneuver;

storing pressure data versus volume data collected during delivery and release of pressure for each of the first plurality of breaths of the descending phase of the multi-breath recruitment maneuver; and

displaying the stored pressure data versus volume data for the first plurality of breaths of the descending phase of the multi-breath recruitment maneuver.

12. The method of claim 10, wherein delivering pressure at low flow further comprises:

delivering pressure at a first inspiratory rate;

determining whether flow is less than a peak targeted flow, wherein when flow is not less than the peak targeted flow, delivering pressure at a second inspiratory rate less than the first inspiratory rate; and

upon determining that the pressure is about equal to the peak inspiratory pressure, discontinuing the delivering pressure.

13. The method of claim 12, wherein the peak targeted flow is about 10 liters per minute (lpm).

14. The method of claim 10, wherein releasing pressure at low flow further comprises:

releasing pressure at a first expiratory rate;

determining whether flow is less than a peak targeted flow, wherein when flow is not less than the peak targeted flow, releasing pressure at a second inspiratory rate less than the first inspiratory rate; and

upon determining that the pressure is about equal to the first baseline pressure, discontinuing the releasing pressure.

15. The method of claim 14, wherein the peak targeted flow is about 10 liters per minute (lpm).

16. The method of claim 10, further comprising:

displaying the plurality of PV loops for comparison by a clinician, wherein the clinician may visualize at least two or more of the plurality of PV loops concurrently.

17. The method of claim 10, further comprising:

storing the plurality of PV loops during ventilation of a patient; and

displaying each of the plurality of PV loops in succession.

18. The method of claim 10, further comprising calculating a dynamic compliance for a patient based on the plurality of PV loops.

19. The method of claim 18, further comprising suggesting a minimum positive end expiratory pressure (PEEP) and a peak inspiratory pressure (PIP) based on the dynamic compliance.

20. A ventilatory system for displaying a pressure-volume loop (PV loop) for a single-breath, low flow recruitment maneuver, comprising:

at least one display device;

at least one processor; and

at least one memory, communicatively coupled to the at least one processor and containing instructions that, when executed by the at least one processor, perform a method comprising;

monitoring pressure, volume, and flow while delivering pressure from a baseline pressure to a target recruitment maneuver pressure at low flow;

plotting pressure data versus volume data collected during delivery of pressure from the baseline pressure to the target recruitment maneuver pressure;

upon determining that pressure is about equal to the target recruitment maneuver pressure, releasing pressure at low flow;

monitoring pressure, volume, and flow while releasing pressure from the target recruitment maneuver pressure to the baseline pressure at low flow;

upon determining that pressure is about equal to the baseline pressure, plotting pressure data versus volume data collected during release of pressure from the target recruitment maneuver pressure to the baseline pressure; and

displaying on the display device the plotted pressure data versus volume data for the delivering pressure and the plotted pressure data versus volume data for the releasing pressure to generate a PV loop for the single-breath, low flow recruitment maneuver.