Ventilator-Initiated Prompt Regarding Detection Of Inadequate Flow During Ventilation

• US 20120216809A1
• Filed: 02/27/2011
• Published: 08/30/2012
• Est. Priority Date: 02/27/2011
• Status: Abandoned Application

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Milne, Gary, Hensley, Kirk, Doyle, Peter R., Kimm, Gardner
• Application Number:
  US13/035,974
• Publication Number:
  US 20120216809A1
• Time in Patent Office: Days
• US Class Current: 128/204.18
• CPC Class Codes: A61B 5/0803 Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• 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 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 2205/13 with means for the detection of operative contact with patient, e.g. lip sensor
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/505 Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• CPC Class Codes: A61M 2205/581 by audible feedback
• CPC Class Codes: A61M 2205/583 by visual feedback
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation

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 inadequate flow during ventilation. According to embodiments, a ventilator may be configured to monitor and evaluate diverse ventilatory parameters to detect inadequate flow and may issue notifications and recommendations suitable for a patient to the clinician when inadequate flow is implicated. The suitable notifications and recommendations may further be provided in a hierarchical format.

Claims

1. A ventilator-implemented method for detecting inadequate flow 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;

determining that an inadequate flow is implicated upon detecting that the processed ventilatory parameter data breaches a received at least one predetermined threshold at a predetermined frequency; and

issuing a smart prompt when the inadequate flow is implicated.

2. The method of claim 1, wherein the processed ventilatory parameter data comprises:

a mean airway pressure for a PIM breath calculated between a beginning of inspiration and a point where a predetermined amount of tidal volume has been delivered in the PIM breath, and

wherein the step of determining that the inadequate flow is implicated comprises;

receiving a predetermined threshold for the mean airway pressure, the predetermined threshold for the mean airway pressure comprising;

a mean airway pressure threshold of less than a set PEEP;

determining the set PEEP;

determining the mean airway pressure; and

determining that the mean airway pressure is less than the set PEEP.

3. The method of claim 2, wherein the processed ventilatory parameter data comprises a disconnect alarm, and

wherein the step of determining that the inadequate flow is implicated further comprises:

determining that the disconnect alarm has not been executed.

4. The method of claim 2, wherein the processed ventilatory parameter data comprises a an expiratory time (T_E) for the PIM breath,

wherein the step of determining that the inadequate flow is implicated comprises:

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

an expiratory time (T_E) threshold of greater than a predetermined amount of time;

determining the expiratory time (T_E); and

determining that the expiratory time (T_E) is greater than the predetermined amount of time.

5. The method of claim 1, wherein the processed ventilatory parameter data comprises:

an airway pressure for a PIM breath calculated at a point where a predetermined portion of an inspiration time has expired during the PIM breath, and

wherein the step of determining that the inadequate flow is implicated comprises;

receiving a predetermined threshold for the airway pressure, the predetermined threshold for the airway pressure comprising;

an airway pressure threshold of less than a set PEEP;

determining the set PEEP;

determining the airway pressure; and

determining that the airway pressure is less than the set PEEP.

6. The method of claim 5, wherein the processed ventilatory parameter data comprises a ventilation tubing system connection status, and

wherein the step of determining that the inadequate flow is implicated further comprises:

determining that a ventilation tubing system has not been disconnected from at least one of a ventilator and the patient.

7. The method of claim 5, wherein the processed ventilatory parameter data comprises a an expiratory time (T_E) for the PIM breath,

wherein the step of determining that the inadequate flow is implicated comprises:

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

an expiratory time (T_E) threshold of greater than a predetermined amount of time;

determining the expiratory time (T_E); and

determining that the expiratory time (T_E) is greater than the predetermined amount of time.

8. The method of claim 5, further comprising:

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

determining an appropriate recommendation message for the issued smart prompt based at least in part on evaluating the one or more ventilatory settings.

9. The method of claim 5, wherein the one or more ventilatory settings include at least one of breath type, peak flow, tidal volume, and flow pattern.

10. A ventilatory system for issuing a smart prompt when inadequate flow 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 an inadequate flow is implicated for a patient;

determining an appropriate notification message;

determining an appropriate recommendation message; and

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

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

determining processed ventilatory parameter data that implicated the inadequate flow, and

wherein the step of determining the appropriate notification message is based at least in part on the processed ventilatory parameter data that implicated the inadequate flow.

12. The ventilatory system of claim 10, wherein the appropriate notification message comprises an alert that the inadequate flow is implicated and information regarding the processed ventilatory parameter data that implicated the inadequate flow.

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:

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

wherein the step of determining the appropriate recommendation message is 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 is a volume-control (VC) breath type.

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 breath type.

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

a recommendation to switch to a PC or VC+ breath type;

a recommendation to switch to a spontaneous breath type for one breath to measure an amount of flow desired by the patient;

a recommendation to increase a peak flow rate if a flow pattern is set to a square flow pattern;

a recommendation to increase the peak flow rate if the flow pattern is set to a decelerating ramp flow pattern; and

a recommendation to change the flow pattern from the decelerating ramp flow pattern to the square flow pattern.

18. The ventilatory system of claim 16, wherein the secondary recommendation message comprises:

a recommendation to switch to a spontaneous breath type; and

a recommendation to switch to a PC or VC+ breath type.

19. The ventilatory system of claim 10, wherein the step of determining the appropriate recommendation message comprises:

switching to a spontaneous breath type for a single spontaneous breath;

detecting an amount of flow desired by the patient based on the single spontaneous breath; and

identifying that the appropriate recommendation message should include a setting change that will provide the patient with the amount of flow desired by the patient.

20. The ventilatory system of claim 10, wherein the step of determining the appropriate recommendation message comprises:

switching to a spontaneous breath type for a single spontaneous breath;

determining a P_m level of the patient based on the single spontaneous breath;

determining an amount of flow desired by the patient based on the P_m level and an equation of motion; and

identifying that the appropriate recommendation message should include a setting change that will provide the patient with the amount of flow desired by the patient.

21. A graphical user interface for displaying one or more 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 prompt element for communicating information regarding a detected condition, wherein the detected condition is an inadequate flow during ventilation of a patient.

22. The graphical user interface of claim 21, wherein the at least one prompt element further comprises at least one of a notification message and one or more recommendation messages, wherein the notification message comprises one or more alerts associated with a detected implication and cause of the inadequate flow, and wherein the one or more recommendation messages comprise one or more recommendations for mitigating the inadequate flow.

23. The graphical user interface of claim 22, wherein the one or more recommendations during a volume-control (VC) breath type comprise one or more of:

consider switching to a PC or VC+ breath type;

consider switching to a spontaneous breath type for one breath to measure an amount of flow desired by the patient;

consider switching to a proportional assist (PA) breath type, a pressure-support (PS) breath type, or a volume-support (VS) breath type;

consider increasing a peak flow rate if a flow pattern is set to a square flow pattern;

consider increasing the peak flow rate if the flow pattern is set to a decelerating ramp flow pattern; and

consider changing the flow pattern from the decelerating ramp flow pattern to the square flow pattern.

24. A ventilatory system for issuing a smart prompt when inadequate flow 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 step of processing the collected ventilatory parameter data comprises deriving ventilatory parameter data from the collected ventilatory parameter data;

means for analyzing the processed ventilatory parameter data;

means for determining that an inadequate flow is implicated upon detecting that the processed ventilatory parameter data breaches a received at least one predetermined threshold at a predetermined frequency; and

means for issuing a smart prompt when the inadequate flow is implicated.