RESPIRATION-RATE DEPENDENT RESPIRATORY ASSISTANCE

• US 20130284174A1
• Filed: 12/12/2011
• Published: 10/31/2013
• Est. Priority Date: 12/20/2010
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Inventors: Sibenaller, Sara Marie, Baloa Welzien, Leonardo Alberto, Laura Lapoint, Manuel
• Granted Patent: US 9,272,106 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 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/003 with a flowmeter
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2230/42 Rate

Abstract

Respiratory assistance is provided to a subject in the form of a pressurized flow of breathable gas. The pressure of the gas is eased during expiration and increased during inspiration. Changes in pressure are triggered and/or cycled based on the monitoring of tidal volume. Volume thresholds that cause triggering and/or cycling are adjusted based on an observed or measured breath rate.

Claims

1. A method for controlling respiratory assistance of a subject, the subject having an airway, the method comprising:

generating a pressurized flow of breathable gas for delivery to the airway of a subject at an inspiratory pressure level during a breath by the subject, wherein the breath has inspiratory volume during an inspiratory phase and expiratory volume during an expiratory phase;

determining a breathing rate of the subject;

adjusting a first volume threshold based on the determined breathing rate;

monitoring the inspiratory volume of the breath by the subject;

comparing the inspiratory volume to the first volume threshold to determine when the inspiratory volume of the breath breaches the first volume threshold; and

responsive to the inspiratory volume of the breath breaching the first volume threshold, temporarily decreasing the pressure of the pressurized flow of breathable gas from the inspiratory pressure level for expiration by the subject.

2. The method of claim 1, further comprising:

adjusting a second volume threshold based on the determined breathing rate;

monitoring the expiratory volume of the breath;

comparing the expiratory volume of the breath to the second volume threshold to determine when the expiratory volume of the breath breaches the second volume threshold; and

responsive to the expiratory volume of the breath breaching the second volume threshold, returning the pressure level of the pressurized flow of breathable gas to the inspiratory pressure level.

3. The method of claim 2, further comprising:

determining inspiration characteristics and expiration characteristics; and

detecting respiratory events based on the inspiration characteristics and expiration characteristics.

4. The method of claim 1, wherein adjustment of the first volume threshold is performed based on an equation that represents an inverse relationship between breathing rate and tidal volume for common breathing rates.

5. The method of claim 2, wherein the first volume threshold is not higher than the second volume threshold for common breathing rates.

6. A system for controlling respiratory assistance of a subject, the subject having an airway, the system comprising:

a pressure generator configured to generate a pressurized flow of breathable gas for delivery to the airway of the subject during breaths of the subject, wherein a breath has inspiratory volume during an inspiratory phase and expiratory volume during an expiratory phase; and

one or more processors configured to execute computer program modules, the computer program modules comprising;

a breathing rate module configured to determine a breathing rate of the subject,

an adjustment module configured to adjust a first volume threshold based on the determined breathing rate,

a monitoring module configured to monitor inspiratory volumes of individual breaths by the subject,

a comparison module configured to compare the inspiratory volumes of the individual breaths by the subject to the first volume threshold to determine when the inspiratory volumes of the individual breaths have breached the first volume threshold, and

a control module configured to control the pressure generator to adjust a pressure level of the pressurized flow of breathable gas, wherein the control module is further configured such that responsive to the inspiratory volume of a given breath breaching the first volume threshold the control module controls the pressure generator to temporarily decrease the pressure level of the pressurized flow of breathable gas for expiration by the subject.

7. The system of claim 6,

wherein the adjustment module is further configured to adjust a second volume threshold based on the determined breathing rate,

wherein the monitoring module is further configured to monitor expiratory volumes of individual breaths by the subject,

wherein the comparison module is further configured to compare the expiratory volumes of the individual breaths by the subject to the second volume threshold to determine when the expiratory volumes of the individual breaths have breached the second volume threshold, and

wherein the control module is further configured such that responsive to the expiratory volume of a given breath breaching the second volume threshold the control module controls the pressure generator to temporarily increase the pressure level of the pressurized flow of breathable gas for inspiration by the subject.

8. The system of claim 7, further comprising:

a characteristics module configured to determine inspiration characteristics and expiration characteristics; and

a detection module configured to detect respiratory events based on the inspiration characteristics and the expiration characteristics.

9. The system of claim 6, wherein the adjustment module is configured such that adjustment of the first volume threshold is performed based on an equation that represents the inverse relationship between breathing rate and tidal volume for common breathing rates.

10. The system of claim 6, further comprising a subject interface configured to deliver the pressurized flow of breathable gas to the airway of the subject, wherein the subject interface includes a conduit and a subject interface appliance, and wherein the conduit is configured to provide fluid communication between the subject interface appliance and the pressure generator.

11. A system configured to control volume based respiratory assistance of a subject, the subject having an airway, the system comprising:

means for generating a pressurized flow of breathable gas for delivery to the airway of a subject at an inspiratory pressure level during a breath by the subject, wherein the breath has inspiratory volume during an inspiratory phase and expiratory volume during an expiratory phase;

means for determining a breathing rate of the subject;

means for adjusting a first volume threshold based on the determined breathing rate;

means for monitoring the inspiratory volume of the breath by the subject;

means for comparing the inspiratory volume to the first volume threshold to determine when the inspiratory volume of the breath breaches the first volume threshold; and

means for temporarily decreasing the pressure level of the pressurized flow of breathable gas from the inspiratory pressure level for expiration by the subject, responsive to the inspiratory volume of the breath breaching the first volume threshold.

12. The system of claim 11,

wherein the means for adjusting a first volume threshold based on the determined breathing rate is further configured for adjusting a second volume threshold based on the determined breathing rate,

wherein the means for monitoring the inspiratory volume of the breath by the subject is further configured for monitoring the expiratory volume of the breath by the subject,

wherein the means for comparing the inspiratory volume of the breath by the subject to the first volume threshold is further configured for comparing the expiratory volume of the breath by the subject to the second volume threshold to determine when the expiratory volume of the breath breaches the second volume threshold, and

wherein the means for temporarily decreasing the pressure level of the pressurized flow of breathable gas is further configured for returning the pressure level of the pressurized flow of breathable gas to the inspiratory level, responsive to the expiratory volume of the breath breaching the second volume threshold.

13. The system of claim 12, further comprising:

means for determining inspiration characteristics and expiration characteristics; and

means for detecting respiratory events based on the inspiration characteristics and expiration characteristics

14. The system of claim 11, wherein the operation of the means for adjusting a first volume threshold based on the determined breathing rate includes is performed based on an equation that represents an inverse relationship between breathing rate and tidal volume for common breathing rates.

15. The system of claim 12, wherein the first volume threshold is not higher than the second volume threshold for common breathing rates.