Methods and Systems for Volume-Targeted Minimum Pressure-Control Ventilation

• US 20120272960A1
• Filed: 04/29/2011
• Published: 11/01/2012
• Est. Priority Date: 04/29/2011
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Milne, Gary
• Granted Patent: US 8,776,792 B2
• Time in Patent Office: Days
• US Class Current: 128/204.23
• CPC Class Codes: A61M 16/00 Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes stimulating the respiratory movement by mechanical, pneumatic or electrical means, iron lungs combined with gas breathing means A61H31/00
• 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 16/12 by mixing different gases
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• 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

Abstract

This disclosure describes systems and methods for providing a volume-targeted minimum pressure-control breath type during ventilation of a patient. The disclosure describes a novel breath type that allows an operator to input a tidal volume and receive some of the benefits of utilizing an airway pressure release ventilation (APRV) breath type in combination with some of the benefits of utilizing a volume-targeted-pressure-control (VC+) breath type.

Claims

1. A method for ventilating a patient with a ventilator comprising:

receiving a tidal volume and a PEEP;

receiving a minimum inspiration pressure;

receiving at least two of an inspiration time, an exhalation time, an I;

E ratio, and a respiratory rate;

calculating a calculated pressure based on measurements taken from a previous inspiration indicative of tidal volume delivered to the patient;

comparing the calculated pressure to the received minimum inspiration pressure;

delivering a delivered inspiration pressure during a next inhalation to the patient, the delivered inspiration pressure determined based on the step of comparing the calculated pressure to the received minimum inspiration pressure; and

delivering, after the next inhalation, the received PEEP.

2. The method of claim 1, wherein the step of comparing the calculated pressure to the received minimum inspiration pressure includes determining that the calculated pressure is less than the received minimum inspiration pressure, and

wherein the step of delivering the inspiration pressure during inhalation to the patient includes delivering the received minimum inspiration pressure during inhalation to the patient.

3. The method of claim 1, wherein the step of comparing the calculated pressure to the received minimum inspiration pressure includes determining that the calculated pressure is more than the received minimum inspiration pressure, and

wherein the step of delivering the inspiration pressure during inhalation to the patient includes delivering the calculated pressure during inhalation to the patient.

4. The method of claim 1, wherein the I:

E ratio is greater than 4;

1.

5. The method of claim 1, further comprising receiving at least one of a rise time and a FiO₂.

6. The method of claim 1, further comprising:

delivering a spontaneous breath in response to a patient initiated trigger during inspiration and expiration above the delivered inspiration pressure and the delivered PEEP.

7. The method of claim 6, further comprising receiving a pressure support setting that is applied to the delivered spontaneous breath.

8. The method of claim 6, further comprising tracking the delivered spontaneous breath.

9. The method of claim 1, further comprising:

receiving an inspiration pressure maximum; and

comparing the inspiration pressure maximum to the calculated pressure.

10. The method of claim 9, wherein the step of comparing the calculated pressure to the maximum inspiration pressure includes determining that the calculated pressure is less than the maximum inspiration pressure, and

wherein the step of delivering the inspiration pressure during inhalation to the patient includes delivering the calculated pressure during inhalation to the patient.

11. The method of claim 9, further comprising:

wherein the step of comparing the calculated pressure to the maximum inspiration pressure includes determining that the calculated pressure is more than the maximum inspiration pressure, and

wherein the step of delivering the inspiration pressure during inhalation to the patient includes delivering the maximum inspiration pressure during inhalation to the patient.

12. The method of claim 9, wherein the maximum inspiration pressure is calculated based on the minimum inspiration pressure.

13. The method of claim 9, further comprising:

receiving the minimum inspiration pressure from a default minimum inspiration pressure setting in the ventilator; and

receiving the maximum inspiration pressure from a default maximum inspiration setting in the ventilator.

14. The method of claim 1, further comprising:

receiving the received minimum inspiration pressure from a default minimum inspiration pressure setting in the ventilator.

15. The method of claim 1, further comprising:

receiving the received PEEP from a default PEEP setting in the ventilator.

16. The method of claim 1, further comprising:

executing an alarm when the received tidal volume is not delivered to the patient; and

executing an alarm when the inspired volume of the patient is above a predetermined threshold.

17. A ventilator system comprising:

a pressure generating system adapted to generate a flow of breathing gas;

a ventilation tubing system including a patient interface for connecting the pressure generating system to a patient;

one or more sensors operatively coupled to at least one of the pressure generating system, the patient, and the ventilation tubing system, wherein at least one sensor is capable of generating an output indicative of an inspiration flow; and

a VCI module that calculates an inspiration pressure based on a received tidal volume from the output indicative of the inspiration flow and causes the pressure generating system to deliver at least one of a calculated pressure or a received minimum pressure to the patient during inhalation.

18. A computer-readable medium having computer-executable instructions for performing a method of ventilating a patient with a ventilator, the method comprising:

repeatedly receiving a tidal volume and a PEEP;

repeatedly receiving a minimum inspiration pressure;

repeatedly receiving at least two of an inspiration time, an exhalation time, an I;

E ratio, and a respiratory rate;

repeatedly calculating a calculated pressure based on measurements taken from a previous inspiration indicative of tidal volume delivered to the patient;

repeatedly comparing the calculated pressure to the received minimum inspiration pressure;

repeatedly delivering a delivered inspiration pressure during a next inhalation to the patient, the delivered inspiration pressure determined based on the step of comparing the calculated pressure to the received minimum inspiration pressure; and

repeatedly delivering, after the next inhalation, the received PEEP.

19. A ventilator system, comprising:

means for receiving a tidal volume and a PEEP;

means for receiving a minimum inspiration pressure;

means for receiving at least two of an inspiration time, an exhalation time, an I;

E ratio, and a respiratory rate;

means for calculating a calculated pressure based on measurements taken from a previous inspiration indicative of tidal volume delivered to the patient;

means for comparing the calculated pressure to the received minimum inspiration pressure;

means for delivering a delivered inspiration pressure during a next inhalation to the patient, the delivered inspiration pressure determined based on the step of comparing the calculated pressure to the received minimum inspiration pressure; and

means for delivering, after the next inhalation, the received PEEP.