USE OF MULTIPLE BREATH TYPES

• US 20130074844A1
• Filed: 09/23/2011
• Published: 03/28/2013
• Est. Priority Date: 09/23/2011
• Status: Abandoned Application

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Kimm, Gardner, Doyle, Peter
• Application Number:
  US13/241,799
• Publication Number:
  US 20130074844A1
• Time in Patent Office: Days
• US Class Current: 128/204.23
• 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 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0033 electrical
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/505 Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• CPC Class Codes: A61M 2230/20 Blood composition characteristics
• CPC Class Codes: A61M 2230/202 partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/42 Rate
• CPC Class Codes: A61M 2230/43 Composition of exhalation
• CPC Class Codes: A61M 2230/46 Resistance or compliance of the lungs
• CPC Class Codes: A61M 2230/60 Muscle strain, i.e. measured on the user

Abstract

The present disclosure describes a mode of ventilation that makes an automatic determination of an appropriate mandatory breath type in response to one or more patient based criteria. Specifically, the ventilator during the delivery a mandatory breath type determines whether predetermined ventilatory criteria have been met. Based on the determination, the ventilator may deliver one of any number of mandatory breath types. Further, the present disclosure also combines the advantages of a hybrid mode of ventilation with this automatic determination of an appropriate mandatory breath type in response to one or more patient based criteria.

Claims

1. A method for operating a ventilator, the method comprising:

receiving a user selection of two or more mandatory breath types from a plurality of mandatory breath types;

monitoring one or more patient respiratory parameters during ventilation of a patient;

comparing at least one monitored patient respiratory parameter to at least one predetermined mandatory threshold; and

delivering a mandatory breath of a selected one of the two or more selected mandatory breath types to the patient based on results of the mandatory comparing operation.

2. The method of claim 1, wherein the ventilator is operating in an Adjusting Hybrid Mode.

3. The method of claim 2, further comprising delivering a spontaneous breath of a preselected spontaneous breath type when a patient effort is detected within a set time period.

4. The method of claim 2, further comprising:

receiving a user selection of two or more spontaneous breath types from a plurality of spontaneous breath types.

5. The method of claim 4, wherein the two or more selected spontaneous breath types comprise:

proportional assist (PA), pressure support (PS) and volume support (VS) breath types.

6. The method of claim 4, further comprising:

detecting a patient effort within a set time period;

comparing the one or more patient respiratory parameters to at least one predetermined spontaneous threshold; and

delivering a spontaneous breath of a selected one of the two or more selected spontaneous breath types to the patient based on results of the spontaneous comparing operation.

7. The method of claim 6, wherein the at least one predetermined spontaneous threshold is at least one of work of breathing, patient effort, carbon dioxide, inspiratory pressure, expiratory pressure, respiratory rate, inspiratory volume, expiratory volume, body weight, minute ventilation, lung/chest wall compliance, tidal volume, airway resistance, PaCO₂, SO₂, peak inspiratory pressure, and target pressure threshold.

8. The method of claim 1, wherein the one or more patient respiratory parameters comprise:

work of breathing, patient effort, carbon dioxide, inspiratory pressure, expiratory pressure, respiratory rate, inspiratory volume, expiratory volume, body weight, minute ventilation, lung/chest wall compliance, tidal volume, airway resistance, PaCO₂, SpO₂, peak inspiratory pressure, and target pressure.

9. The method of claim 1, wherein the two or more selected mandatory breath types comprise:

volume control (VC), pressure control (PC), and volume-targeted-pressure-control (VC+) breath types.

10. The method of claim 1, wherein the at least one predetermined mandatory threshold is at least one of work of breathing, patient effort, carbon dioxide, inspiratory pressure, expiratory pressure, respiratory rate, inspiratory volume, expiratory volume, body weight, minute ventilation, lung/chest wall compliance, tidal volume, airway resistance, PaCO₂, SpO₂, peak inspiratory pressure, and target pressure threshold.

11. The method of claim 1, wherein the one or more patient respiratory parameters are monitored during exhalation.

12. The method of claim 1, wherein the one or more patient respiratory parameters are monitored during inhalation and exhalation.

13. A ventilator system, comprising:

at least one processor; and

at least one memory, communicatively coupled to the at least one processor and containing instructions for a plurality of breath types and instructions for operating a ventilator in at least an adjusting mandatory mode that, when executed by the at least one processor, perform a method comprising;

monitoring one or more patient respiratory parameters during ventilation of a patient;

comparing at least one monitored patient respiratory parameter to at least one predetermined mandatory threshold;

selecting one of a preselected set of mandatory breath types based on results of the mandatory comparing operation; and

delivering a mandatory breath of the selected one of the preselected set of mandatory breath types to the patient.

14. The method of claim 13, wherein the one or more patient respiratory parameters are monitored during exhalation.

15. The method of claim 13, wherein the one or more patient respiratory parameters are monitored during inhalation and exhalation.

16. The method of claim 13, wherein the instructions for operating the ventilator include instructions for operating the ventilator in an Adjusting Hybrid Mode that, when executed by the at least one processor, further performs a method comprising:

detecting a patient effort within a set time period; and

delivering a spontaneous breath of a preselected spontaneous breath type to the patient.

17. The method of claim 13, wherein the instructions for operating the ventilator include instructions for operating the ventilator in an Adjusting Hybrid Mode that when executed by the at least one processor, further performs a method comprising:

detecting a patient effort within a set time period;

comparing the at least one monitored patient respiratory parameter to at least one predetermined spontaneous threshold;

selecting one of a preselected set of spontaneous breath types based on results of the spontaneous comparing operation; and

delivering a spontaneous breath of the selected one of the preselected set of spontaneous breath types to the patient.

18. The method of claim 17, wherein the preselected set of spontaneous breath types comprise:

proportional assist (PA) and volume support (VS) breath types.

19. The method of claim 17, wherein the at least one predetermined spontaneous threshold is at least one of work of breathing, patient effort, carbon dioxide, inspiratory pressure, expiratory pressure, respiratory rate, inspiratory volume, expiratory volume, body weight, minute ventilation, lung/chest wall compliance, tidal volume, airway resistance, PaCO₂, SpO₂, peak inspiratory pressure, and target pressure threshold.

20. The method of claim 13, wherein the one or more patient respiratory parameters comprise:

work of breathing, patient effort, carbon dioxide, inspiratory pressure, expiratory pressure, respiratory rate, inspiratory volume, expiratory volume, body weight, minute ventilation, lung/chest wall compliance, tidal volume, airway resistance, PaCO₂, SpO₂, peak inspiratory pressure, and target pressure.

21. The method of claim 13, wherein the preselected set of mandatory breath types comprise:

pressure control (PC), volume control (VC), and volume-targeted-pressure-control (VC+) breath types.

22. The method of claim 13, wherein the at least one predetermined mandatory threshold is at least one of work of breathing, patient effort, carbon dioxide, inspiratory pressure, expiratory pressure, respiratory rate, inspiratory volume, expiratory volume, body weight, minute ventilation, lung/chest wall compliance, tidal volume, airway resistance, PaCO₂, SpO₂, peak inspiratory pressure, and target pressure threshold.

23. A graphical user interface for a ventilator, the ventilator configured with a computer having a user interface including the graphical user interface for accepting commands, the graphical user interface comprising:

at least one window associated with the graphical user interface;

one or more elements within the at least one window, comprising at least one of;

a mode button allowing selection of one of a plurality of modes; and

a mandatory breath type selection element through which a plurality of mandatory breath types is selected to be delivered to a patient.

24. The graphical user interface of claim 23, wherein the one or more elements within the at least one window, further comprises at least one of:

a spontaneous breath type selection element through which a plurality of spontaneous breath types is selected to be delivered when the ventilator is delivering a breath in response to detection of a patient effort within a set time period.

25. The graphical user interface of claim 23, wherein a mode of the plurality of modes comprises at least one of an Adjusting Mandatory Mode, an Adjusting Spontaneous Mode, and an Adjusting Hybrid Mode.

26. The graphical user interface of claim 25, wherein the one or more elements within the at least one window, further comprises at least one of:

a setting window after the selection of the Adjusting Hybrid mode, the setting window allowing selection of at least one of a mandatory adjust setting, a spontaneous adjust setting, and a dual adjust setting.