Systems And Methods For Controlling An Amount Of Oxygen In Blood Of A Ventilator Patient

• US 20120090611A1
• Filed: 10/13/2010
• Published: 04/19/2012
• Est. Priority Date: 10/13/2010
• Status: Abandoned Application

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Graboi, Dan, Doyle, Peter, Masic, Milenko, Vandine, Joseph Douglas
• Application Number:
  US12/903,309
• Publication Number:
  US 20120090611A1
• Time in Patent Office: Days
• US Class Current: 128/204.23
• CPC Class Codes: A61M 16/1005 with O2 features or with parameter measurement
• 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 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/42 Rate

Abstract

This disclosure describes systems and methods for controlling blood oxygen saturation (SpO₂) or partial pressure of oxygen in arterial blood (PaO₂) of a patient being ventilated by a medical ventilator. The disclosure describes a novel approach of utilizing dynamic, real-time ventilator information in a closed-loop controller to determine the necessary FiO₂ and flow commands for the medical ventilator.

Claims

1. A method for controlling an amount of oxygen in blood in a patient being ventilated by a medical ventilator, the method comprising:

monitoring an amount of oxygen in blood in a patient during ventilation on the medical ventilator;

monitoring privileged ventilator information, the privileged ventilator information is flow rate, compliance of patient circuit, and minute volume; and

controlling at least one of a specific oxygen percentage in a gas mixture supplied by the ventilator to the patient and a gas flow rate of the gas mixture supplied by the ventilator to the patient during ventilation based on the monitored amount of oxygen in the blood in the patient and the monitored privileged ventilator information.

2. The method of claim 1, wherein the privileged ventilator further comprises ideal body weight.

3. The method of claim 2, further comprising estimating circulatory time and lung washout time based on the ideal body weight.

4. The method of claim 1, wherein the step of controlling the at least one of the specific oxygen percentage in the gas mixture supplied by the ventilator to the patient and the gas flow rate of the gas mixture supplied by the ventilator to the patient during ventilation, comprises:

controlling the specific oxygen percentage in the gas mixture supplied by the ventilator by adjusting a gain coefficient of a controller utilizing a PID method based on the monitored amount of oxygen in the blood in the patient and the privileged ventilator information.

5. The method of claim 1, wherein the step of controlling the at least one of the specific oxygen percentage in the gas mixture supplied by the ventilator to the patient and the gas flow rate of the gas mixture supplied by the ventilator to the patient during ventilation, comprises:

utilizing fuzzy logic to automate an adjustment of the specific oxygen percentage based on the monitored amount of oxygen in the blood in the patient and the privileged ventilator information.

6. The method of claim 1, further comprising:

determining that the amount of oxygen in the blood in the patient during ventilation on the medical ventilator is at least one of above a preset high threshold and below a preset low threshold;

wherein the step of controlling the at least one of the specific oxygen percentage in the gas mixture supplied by the ventilator to the patient and the gas flow rate of the gas mixture supplied by the ventilator to the patient during ventilation, comprises;

changing the specific oxygen percentage in the gas mixture in preset increments until the amount of oxygen in the blood in the patient is between the preset high threshold and the preset low threshold.

7. The method of claim 1, further comprising controlling the washout time for an inspiratory limb of a patient circuit.

8. The method of claim 1, further comprising implementing a fast washout cycle by increasing flow to an appropriate higher value while opening both inspiratory and expiratory valves.

9. The method of claim 8, wherein the fast washout cycle reduces washout time by at least 25%.

10. The method of claim 8, wherein the fast washout cycle reduces washout time by at least 75%.

11. The method of claim 1, wherein the monitored amount of oxygen in the blood is SpO₂.

12. The method of claim 1, wherein the monitored amount of oxygen in the blood is PaO₂.

13. A medical ventilator system comprising:

a processor;

a patient circuit;

an oximeter connected to a patient being ventilated by the medical ventilation system and controlled by the processor, the oximeter is adapted to monitor a blood oxygen saturation level of the patient during ventilation by the medical ventilator system; and

an SpO₂ controller in communication with the processor and the oximeter and adapted receive the monitored blood oxygen saturation level from the oximeter, adapted to receive privileged ventilator information from the processor, and adapted to control at least one of a specific oxygen percentage and a flow rate of a gas mixture supplied to the patient during ventilation by the medical ventilator system based on the monitored blood oxygen saturation level of the patient and the privileged ventilator information,

wherein the privileged ventilator information is flow rate, compliance of a patient circuit, minute volume, and ideal body weight.

14. The medical ventilator of claim 13, further comprising a flow valve controlled by the processor, the flow valve is adapted to regulate a flow rate, a pressure, a volume, and gas concentrations of the gas mixture from a gas supply to the patient being ventilated by the medical ventilator system via the patient circuit.

15. The medical ventilator of claim 13, further comprising at least one sensor in the patient circuit controlled by the processor and adapted to monitor at least one of a respiratory rate, a tidal volume, or a compliance of the patient circuit.

16. The medical ventilator of claim 13, further comprising an operator interface in communication with the processor, the operator interface is adapted to receive user inputs and commands.

17. A method for controlling an amount of oxygen in blood in a patient being ventilated by a medical ventilator, the method comprising:

monitoring an amount of oxygen in blood in a patient during ventilation on the medical ventilator;

monitoring privileged ventilator information, the privileged ventilator information is flow rate, compliance of patient circuit, and minute volume;

detecting apnea in the patient based on the monitored amount of oxygen in the blood in the patient and the monitored privileged ventilator information; and

sending a few small breaths through the ventilator circuit to stimulate breathing in the patient.

18. The method of claim 17, wherein the monitored amount of oxygen in the blood is SpO₂.

19. The method of claim 17, wherein the wherein the monitored amount of oxygen in the blood is PaO₂.

20. A medical ventilator system comprising:

a processor;

a patient circuit;

a blood gas monitor connected to a patient being ventilated by a medical ventilator system and controlled by the processor, the blood gas monitor is adapted to monitor a partial pressure of oxygen in the patient during ventilation by the medical ventilator system; and

a PaO₂ controller in communication with the processor and the blood gas monitor and adapted to receive the monitored partial pressure of oxygen in the patient from the blood gas monitor, adapted to receive privileged ventilator information from the processor, and adapted to control at least one of a specific oxygen percentage and a flow rate of a gas mixture supplied to the patient during ventilation by the medical ventilator system based on the monitored partial pressure of oxygen in the patient and the privileged ventilator information,

wherein the privileged ventilator information is flow rate, compliance of a patient circuit, minute volume, and ideal body weight.

21. A computer-readable medium having computer-executable instructions for performing a method for controlling an amount of oxygen in blood in a patient being ventilated by a medical ventilator, the method comprising:

repeatedly monitoring an amount of oxygen in blood in a patient during ventilation on a medical ventilator;

repeatedly monitoring privileged ventilator information, the ventilator privileged information comprises flow rate, compliance of a patient circuit, and minute volume;

determining that a change in at least one of an oxygen percentage or flow rate is necessary based on the monitored amount of oxygen in the blood in the patient and the monitored privileged ventilator information; and

adjusting at least one of the oxygen percentage in a gas mixture and the gas flow rate of the gas mixture supplied by the ventilator to the patient during ventilation based on the monitored amount of oxygen in the blood in the patient and the monitored privileged ventilator information.

22. A medical ventilator system, comprising:

means for repeatedly monitoring oxygen saturation level of blood in a patient during ventilation on the medical ventilator;

means for repeatedly monitoring privileged ventilator information, wherein the privileged ventilator information comprises flow rate, compliance of a patient circuit, minute volume, and ideal body weight;

means for determining if a change in at least one of an oxygen percentage or flow rate is necessary based on the monitored oxygen saturation level of the blood of the patient and the monitored privileged ventilator information; and

means for adjusting at least one of the oxygen percentage in a gas mixture and the gas flow rate of the gas mixture supplied by the ventilator to the patient during ventilation based on the monitored oxygen saturation level of the blood of the patient and the monitored privileged ventilator information.