Ventilator-Initiated Prompt Regarding Detection Of Double Triggering During Ventilation

• US 20120137249A1
• Filed: 11/29/2010
• Published: 05/31/2012
• Est. Priority Date: 11/29/2010
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Milne, Gary, Hensley, Kirk, Doyle, Peter R., Kimm, Gardner
• Granted Patent: US 8,757,153 B2
• Time in Patent Office: Days
• US Class Current: 715/808
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0057 Pumps therefor
• CPC Class Codes: A61M 16/0063 Compressors
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/0816 Joints or connectors
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 16/0875 Connecting tubes
• 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 2016/0036 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
• CPC Class Codes: A61M 2230/43 Composition of exhalation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

This disclosure describes systems and methods for monitoring and evaluating ventilatory parameters, analyzing those parameters and providing useful notifications and recommendations to clinicians. That is, modern ventilators monitor, evaluate, and graphically represent multiple ventilatory parameters. However, many clinicians may not easily recognize data patterns and correlations indicative of certain patient conditions, changes in patient condition, and/or effectiveness of ventilatory treatment. Further, clinicians may not readily determine appropriate ventilatory adjustments that may address certain patient conditions and/or the effectiveness of ventilatory treatment. Specifically, clinicians may not readily detect or recognize the presence of double triggering during ventilation. According to embodiments, a ventilator may be configured to monitor and evaluate diverse ventilatory parameters to detect double triggering and may issue notifications and recommendations suitable for a patient to the clinician when double triggering is implicated. The suitable notifications and recommendations may further be provided in a hierarchical format.

Claims

1. A ventilator-implemented method for detecting double triggering during ventilation of a patient, the method comprising:

collecting data associated with ventilatory parameters;

processing the collected ventilatory parameter data, wherein the step of processing the collected ventilatory parameter data comprises deriving ventilatory parameter data from the collected ventilatory parameter data;

analyzing the processed ventilatory parameter data, wherein the step of analyzing the processed ventilatory parameter data comprises;

receiving at least one predetermined threshold associated with the processed ventilatory parameter data; and

detecting whether the processed ventilatory parameter data breaches the received at least one predetermined threshold at a predetermined frequency;

determining that double triggering is implicated upon detecting that the processed ventilatory data breaches the received at least one predetermined threshold at the predetermined frequency; and

issuing a smart prompt when the double triggering is implicated.

2. The method of claim 1, wherein the processed ventilatory parameter data comprises exhaled tidal volume, and

wherein the step of analyzing of the exhaled tidal volume further comprises:

receiving a predetermined threshold for the exhaled tidal volume, the predetermined threshold comprising;

an exhaled tidal volume that is less than 10 percent of a delivered tidal volume;

determining the delivered tidal volume; and

determining that the exhaled tidal volume is less than 10 percent of the delivered tidal volume.

3. The method of claim 1, wherein the processed ventilatory parameter data comprises an expiratory time (T_E) for a patient-initiated mandatory breath.

4. The method of claim 3, wherein the step of analyzing the expiratory time (T_E) for the patient-initiated mandatory breath comprises:

receiving a predetermined threshold for the expiratory time (T_B), the predetermined threshold comprising;

an expiratory time (T_E) threshold of less than 240 ms;

determining an expiratory time (T_B) for the patient-initiated mandatory breath; and

determining that the expiratory time (T_B) is less than 240 ms.

5. The method of claim 3, wherein the step of analyzing the expiratory time (T_E) for the patient-initiated mandatory breath comprises:

receiving a predetermined threshold for the expiratory time (T_E), the predetermined threshold comprising;

an expiratory time (T_E) threshold of less than 210 ms;

determining an expiratory time (T_E) for the patient-initiated mandatory breath; and

determining that the expiratory time (T_E) is less than 210 ms.

6. The method of claim 3, wherein the step of analyzing the expiratory time (T_E) for the patient-initiated mandatory breath comprises:

receiving a predetermined threshold for the expiratory time (T_B), the predetermined threshold comprising;

an expiratory time (T_E) threshold of less than 190 ms;

determining an expiratory time (T_E) for the patient-initiated mandatory breath; and

determining that the expiratory time (T_E) is less than 190 ms.

7. The method of claim 1, wherein the processed ventilatory parameter data comprises a disconnect alarm, and

wherein the step of analyzing of the disconnect alarm comprises:

determining that the disconnect alarm has not been activated.

8. The method of claim 1, further comprising:

identifying one or more ventilatory settings associated with a ventilatory treatment of the patient;

determining an appropriate smart prompt based at least in part on evaluating the one or more ventilatory settings; and

wherein the issued smart prompt is the appropriate smart prompt.

9. The method of claim 8, wherein the one or more ventilatory settings are a ventilation breath type selected from a group of ventilation breath types of pressure-controlled (PC), volume-targeted-pressure-control (VC+), pressure-support (PS), and volume-support (VS).

10. A ventilatory system for issuing a smart prompt when double triggering is implicated during ventilation of a patient, comprising:

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;

detecting that double triggering is implicated for a patient;

determining an appropriate notification message;

determining an appropriate recommendation message; and

displaying at least one of the appropriate notification message and the appropriate recommendation message.

11. The ventilatory system of claim 10, further comprising:

identifying processed ventilatory parameter data that implicated double triggering; and

determining the appropriate notification message based at least in part on the processed ventilatory parameter data that implicated double triggering.

12. The ventilatory system of claim 11, wherein the appropriate notification message comprises an alert that double triggering is implicated and information regarding the processed ventilatory parameter data that implicated double triggering.

13. The ventilatory system of claim 10, wherein the appropriate recommendation message comprises a primary recommendation message and a secondary recommendation message.

14. The method of claim 10, further comprising:

identifying one or more ventilatory settings associated with a ventilatory treatment of the patient; and

determining the appropriate recommendation message based at least in part on evaluating the one or more ventilatory settings.

15. The method of claim 14, wherein the one or more ventilatory settings are a ventilation breath type selected from a group of ventilation breath types of pressure-controlled (PC), volume-targeted-pressure-control (VC+), pressure-support (PS), and volume-support (VS).

16. The ventilatory system of claim 15, wherein the appropriate recommendation message comprises a primary recommendation message and a secondary recommendation message based at least in part on the ventilation breath type.

17. The ventilatory system of claim 16, wherein the primary recommendation message comprises one of

a suggestion to decrease a set expiratory sensitivity (E_SENS) if the ventilation breath type is the pressure-support (PS);

a suggestion to decrease the set expiratory sensitivity (E_SENS) if the ventilation breath type is the volume-support (VS);

a suggestion to increase set inspiration time (T_I) if the ventilation breath type is the pressure-control (PC); and

a suggestion to increase set inspiration time (T_I) if the ventilation breath type is the volume-targeted-pressure-control (VC+).

18. The ventilatory system of claim 17, wherein the secondary recommendation message comprises one of:

a suggestion to switch to a proportional assist (PA) breath type if the ventilation breath type is the pressure-support (PS);

a suggestion to switch to the proportional assist (PA) breath type if the ventilation breath type is the volume-support (VS);

a suggestion to switch to the proportional assist (PA), the pressure-support (PS), or the volume-support (VS) breath type if the ventilation breath type is the pressure-control (PC); and

a suggestion to switch to the proportional assist (PA), the pressure-support (PS), or the volume-support (VS) breath type if the ventilation breath type is the volume-targeted-pressure-control (VC+).

19. A graphical user interface for displaying one or more smart prompts corresponding to a detected condition, a ventilator configured with a computer having a user interface including the graphical user interface for accepting commands and for displaying information, the graphical user interface comprising:

at least one window; and

one or more elements within the at least one window comprising at least one smart prompt element for communicating information regarding a detected condition, wherein the detected condition is double triggering during ventilation of a patient.

20. The graphical user interface of claim 19, wherein the at least one smart prompt element further comprises at least one of a notification message and one or more recommendation messages, wherein the notification message comprises an alert associated with a detected implication of double triggering, and wherein the one or more recommendation messages comprise one or more suggestions for mitigating double triggering.

21. The graphical user interface of claim 20, wherein the one or more recommendation messages comprise one or more of:

a suggestion to increase set time for inspiration (T_I);

a suggestion to decrease a set expiratory sensitivity (E_SENS);

a suggestion to switch to spontaneous breath type;

a suggestion to switch to a proportional assist (PA) breath type; and

a suggestion to switch to one of the proportional assist (PA), a pressure-support (PS), and a volume-support (VS) breath type.

22. A ventilatory system for issuing a smart prompt when double triggering is implicated during ventilation of a patient, comprising:

means for collecting data associated with ventilatory parameters;

means for processing the collected ventilatory parameter data, wherein the means for processing the collected ventilatory parameter data comprises means for deriving ventilatory parameter data from the collected ventilatory parameter data;

means for analyzing the processed ventilatory parameter data, wherein the means for analyzing the processed ventilatory parameter data comprises;

means for receiving at least one predetermined threshold associated with the processed ventilatory parameter data; and

means for detecting whether the processed ventilatory parameter data breaches the received at least one predetermined threshold at a predetermined frequency;

means for determining that double triggering is implicated upon detecting that the processed ventilatory data breaches the received at least one predetermined threshold at the predetermined frequency; and

means for issuing a smart prompt when the double triggering is implicated.