METHODS AND SYSTEMS FOR MONITORING A VENTILATED PATIENT WITH AN OXIMETER

• US 20130025597A1
• Filed: 07/29/2011
• Published: 01/31/2013
• Est. Priority Date: 07/29/2011
• Status: Abandoned Application

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Doyle, Peter, Jafari, Mehdi
• Application Number:
  US13/193,758
• Publication Number:
  US 20130025597A1
• Time in Patent Office: Days
• US Class Current: 128/204.23
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• 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 16/0063 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 16/0833 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 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/435 partial O2 pressure (P-O2)

Abstract

This disclosure describes systems and methods for monitoring the ventilation of a patient being ventilated by a medical ventilator. The disclosure describes a novel approach for triggering the delivery of a breath to account for cardiogenic artifacts. The disclosure further describes a novel approach for calculating exhaled spirometry to eliminate the effect of cardiogenic artifacts.

Claims

1. A method for monitoring the ventilation of a patient being ventilated by a medical ventilator system, the method comprising:

monitoring at least one respiratory parameter to determine at least one monitored respiratory parameter of a patient being ventilated by a medical ventilator system;

monitoring a pulse rate of the patient with a pulse rate monitoring device;

determining one or more potential cardiogenic artifacts in the at least one monitored respiratory parameter;

correlating the potential cardiogenic artifacts with the pulse rate of the patient to verify cardiogenic artifacts in the at least one monitored respiratory parameter; and

removing the verified cardiogenic artifacts from the at least one monitored respiratory parameter to provide at least one adjusted respiratory parameter.

2. The method of claim 1, further comprising:

determining exhaled spirometry based on the at least one adjusted respiratory parameters.

3. The method of claim 2, further comprising:

displaying at least one of the at least one adjusted respiratory parameter and the determined exhaled spirometry.

4. The method of claim 1, further comprising:

triggering a delivery of a breath based on the at least one adjusted respiratory parameter.

5. The method of claim 1, wherein the step of correlating the potential cardiogenic artifacts with the pulse rate comprises:

determining at least one of a beginning, an end, and an intermediate point of a pulsatile event in the pulse rate; and

calculating a delay in timing from at least one of the determined beginning, the determined intermediate point, and the determined end of the pulsatile event to a timing of the potential cardiogenic artifacts.

6. The method of claim 1, wherein the at least one respiratory parameter is one of flow and pressure.

7. The method of claim 1, wherein the pulse rate monitoring device is selected from a group of an oximeter and an ECG.

8. The method of claim 1, wherein at least one of an ideal body weight, a gender, a weight, and a height are utilized in combination with the pulse rate monitoring device to determine a pulse rate of the patient.

9. A method for triggering the ventilation of a patient being ventilated by a medical ventilator system, the method comprising:

monitoring at least one respiratory parameter to determine at least one monitored respiratory parameter of a patient being ventilated by a ventilator system;

determining that a triggering threshold has been breached for delivery of a breath based on the at least one monitored respiratory parameter;

monitoring a pulse rate of the patient with a pulse rate monitoring device;

determining one or more potential cardiogenic artifacts in the at least one monitored respiratory parameter;

correlating the potential cardiogenic artifacts with the pulse rate of the patient to verify cardiogenic artifacts in the at least one monitored respiratory parameter;

determining that the verified cardiogenic artifacts correlate with the step of determining that the triggering threshold has been breached; and

preventing the delivery of the breath based on the step of determining that the verified cardiogenic artifacts correlate with the step of determining that the triggering threshold has been breached.

10. The method of claim 9, wherein the at least one respiratory parameter is one of flow and pressure.

11. The method of claim 9, wherein the step of preventing the delivery of the breath comprises:

changing the triggering threshold.

12. The method of claim 9, wherein the triggering threshold is at least one of a flow threshold and a pressure threshold.

13. The method of claim 9, wherein the step of determining that the potential cardiogenic artifacts correlate with the pulse rate comprises:

determining at least one of a beginning, an end, and an intermediate point of a pulsatile event in the pulse rate; and

calculating a delay in timing from at least one of the determined beginning, the determined intermediate point, and the determined end of the pulsatile event to a timing of the potential cardiogenic artifacts.

14. The method of claim 13, wherein the step of preventing the delivery of the breath further comprises:

determining when to change the triggering threshold based on the delay and the pulse rate.

15. A medical ventilator system, comprising:

a pneumatic gas delivery system, the pneumatic gas delivery system adapted to control a flow of gas from a gas supply to a patient via a ventilator breathing circuit;

a pulse rate monitoring device, the pulse rate monitoring device monitors a pulse rate of the patient;

at least one sensor, the at least one sensor monitors at least one respiratory parameter to provide at least one monitored respiratory parameter;

a correlation module, the correlation module is adapted to identify one or more potential cardiogenic artifacts in the at least one monitored respiratory parameter, and to correlate the potential cardiogenic artifacts with the pulse rate of the patient to verify cardiogenic artifacts in the at least one monitored respiratory parameter; and

a processor in communication with the pneumatic gas delivery system, the pulse rate monitoring device, the at least one sensor, and the correlation module.

16. The medical ventilator system of claim 15, wherein the correlation module removes the verified cardiogenic artifacts from the at least one monitored respiratory parameter to provide at least one adjusted respiratory parameter.

17. The medical ventilator system of claim 16, further comprising:

a display in communication with the processor, the display displays at least one of the at least one monitored respiratory parameter and the at least one adjusted respiratory parameter.

18. The medical ventilator system of claim 16, wherein the correlation module determines exhaled spirometry based on the at least one adjusted respiratory parameter.

19. The medical ventilator system of claim 18, further comprising:

a display in communication with the processor, the display displays the determined exhaled spirometry.

20. The medical ventilator system of claim 16, further comprising:

a triggering module in communication with the processor, the triggering module is adapted to trigger a delivery of a breath to the patient based on the at least one adjusted respiratory parameter.

21. The medical ventilator system of claim 15, further comprising:

a triggering module in communication with the processor, the triggering module triggers a delivery of a breath to the patient based on the at least one monitored respiratory parameter exceeding a triggering threshold, wherein the triggering module is configured to adjust the triggering threshold to compensate for the verified cardiogenic artifacts in the at least one monitored respiratory parameter.

22. The medical ventilator system of claim 21, wherein the triggering module changes the triggering threshold periodically to compensate for the verified cardiogenic artifacts in the at least one monitored respiratory parameter based on a delay from the pulse rate to the verified cardiogenic artifact in the at least one monitored respiratory parameter.

23. A computer-readable medium having computer-executable instructions for performing a method for monitoring the ventilation of a patient being ventilated by a medical ventilator system, the method comprising:

repeatedly monitoring at least one respiratory parameter to determine at least one monitored respiratory parameter of a patient being ventilated by a medical ventilator system;

repeatedly monitoring a pulse rate of the patient with a pulse rate monitoring device;

repeatedly determining one or more potential cardiogenic artifacts in the at least one monitored respiratory parameter;

repeatedly correlating the potential cardiogenic artifacts with the pulse rate of the patient to verify cardiogenic artifacts in the at least one monitored respiratory parameter; and

repeatedly removing the verified cardiogenic artifacts from the at least one monitored respiratory parameter to provide at least one adjusted respiratory parameter.

24. A computer-readable medium having computer-executable instructions for performing a method for triggering the ventilation of a patient being ventilated by a medical ventilator system, the method comprising:

repeatedly monitoring at least one respiratory parameter to determine at least one monitored respiratory parameter of a patient being ventilated by a ventilator system;

repeatedly determining that a triggering threshold has been breached for delivery of a breath based on the at least one monitored respiratory parameter;

repeatedly monitoring a pulse rate of the patient with a pulse rate monitoring device;

repeatedly determining one or more potential cardiogenic artifacts in the at least one monitored respiratory parameter;

repeatedly correlating the potential cardiogenic artifacts with the pulse rate of the patient to verify cardiogenic artifacts in the at least one monitored respiratory parameter;

repeatedly determining that the verified cardiogenic artifacts correlate with the step of determining that the triggering threshold has been breached; and

repeatedly preventing the delivery of the breath based on the step of determining that the verified cardiogenic artifacts correlate with the step of determining that the triggering threshold has been breached.

25. A medical ventilator system, comprising:

means for monitoring at least one respiratory parameter to determine at least one monitored respiratory parameter of a patient being ventilated by a medical ventilator system;

means for monitoring a pulse rate of the patient with a pulse rate monitoring device;

means for determining one or more potential cardiogenic artifacts in the at least one monitored respiratory parameter;

means for correlating the potential cardiogenic artifacts with the pulse rate of the patient to verify cardiogenic artifacts in the at least one monitored respiratory parameter; and

means for removing the verified cardiogenic artifacts from the at least one monitored respiratory parameter to provide at least one adjusted respiratory parameter.

26. A medical ventilator system, comprising:

means for monitoring at least one respiratory parameter to determine at least one monitored respiratory parameter of a patient being ventilated by a ventilator system;

means for determining that a triggering threshold has been breached for delivery of a breath based on the at least one monitored respiratory parameter;

means for monitoring a pulse rate of the patient with a pulse rate monitoring device;

means for determining one or more potential cardiogenic artifacts in the at least one monitored respiratory parameter;

means for correlating the potential cardiogenic artifacts with the pulse rate of the patient to verify cardiogenic artifacts in the at least one monitored respiratory parameter;

means for determining that the verified cardiogenic artifacts correlate with the step of determining that the triggering threshold has been breached; and

means for preventing the delivery of the breath based on the step of determining that the verified cardiogenic artifacts correlate with the step of determining that the triggering threshold has been breached.