OXYGENATION-VENTILATION METHODS AND SYSTEMS

• US 20150034082A1
• Filed: 08/05/2013
• Published: 02/05/2015
• Est. Priority Date: 08/05/2013
• Status: Abandoned Application

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Kimm, Gardner, Jafari, Mehdi, Sanborn, Warren
• Application Number:
  US13/958,769
• Publication Number:
  US 20150034082A1
• Time in Patent Office: Days
• US Class Current: 128/202.16
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61M 1/1698 Blood oxygenators with or without heat-exchangers intracorporal A61M1/1678; manufacturing of membranes therefor B01D67/00; semi-permeable membranes for separation processes characterised by their properties B01D69/00; semi-permeable membranes characterised by their material B01D71/00
• CPC Class Codes: A61M 16/0051 with alarm devices
• 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 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 2016/103 the CO2 concentration
• CPC Class Codes: A61M 2205/05 combined with other kinds of therapy
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3553 remote, e.g. between patient's home and doctor's office
• CPC Class Codes: A61M 2205/3561 local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/3592 : using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/505 : Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• CPC Class Codes: A61M 2230/04 : Heartbeat characteristics, e.g. ECG, blood pressure modulation
• 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 2230/208 : pH-value
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)

Abstract

The systems and methods include providing oxygenation-ventilation of a patient being monitored or treated with a medical system. The novel systems and methods may be configured to be able to simultaneously treat and/or monitor a patient with both a ventilator and an ECGE system. The novel systems and methods may monitor the patient and/or manage the treatment of a patient with a ventilator-ECGE system.

Claims

1. A method for managing treatment of a patient connected to a ventilator-extracorporeal membrane gas-exchanger system, the method comprising:

delivering breathing gas to a patient with a ventilator system based on one or more ventilator settings;

monitoring ventilator sensors with the ventilator system;

removing carbon dioxide from and adding a gas mixture to a bloodstream of the patient to oxygenate the bloodstream of the patient with an extracorporeal membrane gas-exchanger (ECGE) system based on one or more ECGE settings;

monitoring ECGE sensors with the ECGE system;

communicating information between the ventilator system and the ECGE system;

comparing sensor output from the ventilator sensors to a first threshold;

comparing the sensor output from the ECGE sensors to a second threshold;

adjusting at least one of the one or more ventilator settings and the one or more ECGE settings based on the comparing of the sensor output to the first threshold and the comparing of the sensor output to the second threshold.

2. The method of claim 1, wherein the first threshold is the same as the second threshold.

3. The method of claim 1, wherein the first threshold and the second threshold are received from operator input via the ventilator system;

4. The method of claim 1, wherein the first threshold is at least one of a E_TCO₂ level, a VCO₂ level, minute ventilation, tidal volume, peak inspiratory pressure, and a SpO₂ level and wherein the second threshold is at least one of a P_aCO₂ level, a pH level, blood flow level and a P_aO₂ level.

5. The method of claim 1, wherein the one or more ventilator settings is at least one of minute ventilation, peak inspiratory pressure, tidal volume, respiratory rate, Positive End Expiratory Pressure (PEEP), and FiO₂ and wherein the one or more ECGE settings are a sweep gas flow rate, FiO₂ of sweep gas, and blood flow.

6. The method of claim 1, wherein the adjusting step is performed by a controller on the ventilator system.

7. The method of claim 1, further comprising displaying the sensor output generated by the ventilator sensors and the ECGE sensors together on a ventilator display.

8. The method of claim 1, wherein the comparing step and the adjusting step further include one of:

determining that the sensor output from the ventilator sensors breached the first threshold and the sensor output from the ECGE sensors breached the second threshold by the comparing step and adjusting the one or more ECGE settings by the adjusting step;

determining that the sensor output from the ventilator sensors breached the first threshold and the sensor output for the ECGE sensors breached the second threshold by the comparing step and adjusting the one or more ECGE settings and adjusting the one or more ventilator settings by the adjusting step;

determining that the sensor output from the ventilator sensors breached the first threshold and the sensor output for the ECGE sensors breached the second threshold by the comparing step and adjusting the one or more ventilator settings by the adjusting step;

determining that the sensor output from the ventilator sensors breached the first threshold by the comparing step and adjusting the one or more ventilator settings by the adjusting step;

determining that the sensor output from the ventilator sensors breached the first threshold by the comparing step and adjusting the one or more ECGE settings by the adjusting step;

determining that the sensor output from the ventilator sensors breached the first threshold by the comparing step and adjusting the one or more ECGE settings and the one or more of ventilator settings by the adjusting step;

determining that the sensor output from the ECGE sensors breached the first threshold by the comparing step and adjusting the one or more ventilator settings by the adjusting step;

determining that the sensor output from the ECGE sensors breached the first threshold by the comparing step and adjusting the one or more ECGE settings by the adjusting step;

determining that the sensor output from the ECGE sensors breached the first threshold by the comparing step and adjusting the one or more ECGE settings and the one or more ventilator settings by the adjusting step; and

determining that the sensor output from the ventilator sensors did not breach the first threshold for a predetermined period and that the sensor output from the ECGE sensors did not breached the second threshold for the predetermined period by the comparing step and adjusting the one or more ECGE settings to reduce patient reliance on the ECGE system.

9. The method of claim 1, wherein the one or more ventilator settings are adjusted to increase patient reliance on the ventilator system and the one or more ECGE settings are adjusted to decrease patient reliance on the ECGE system.

10. The method of claim 1, wherein the one or more ventilator settings are adjusted to decrease patient reliance on the ventilator system and the one or more ECGE settings are adjusted to increase patient reliance on the ECGE system.

11. A ventilator-ECGE system for issuing a notification, 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 cause a controller to issue a notification, the controller including;

a manage module that detects improper treatment of a patient based on sensor output from a ventilator sensor and from an ECGE sensor, wherein the improper treatment includes detecting at least one of improper oxygenation and improper ventilation;

a notification module that determines an appropriate message based on the improper treatment and determines an appropriate entry based on the improper treatment; and

a display module that issues at least one of the appropriate message and the appropriate entry.

12. The ventilator-ECGE system of claim 11, wherein the manage module determines the sensor output that implicated the improper treatment and communicates the sensor output that implicated the improper treatment to the notification module, and

wherein the notification module determines the appropriate message based at least in part on the sensor output that implicated the improper treatment, and

wherein the appropriate message comprises an alert that improper treatment is implicated and information regarding the sensor output that implicated improper treatment.

13. The ventilator-ECGE system of claim 11, wherein the appropriate message comprises a primary message and a secondary message and is based at least in part on the sensor output that that implicated the improper treatment.

14. The ventilator-ECGE system of claim 11, wherein the appropriate message comprises one of the following entries:

increase a sweep flow rate based on at least one of the following sensor outputs;

P_aCO₂, pH, E_TCO₂, and VCO₂;

decrease the sweep flow rate based on at least one of the following sensor outputs;

P_aCO₂, pH, E_TCO₂, and VCO₂;

increase a FiO₂ of a sweep gas based on at least one of the following sensor outputs;

P_aO₂, blood flow, and SpO₂;

decrease the FiO₂ of the sweep gas based on at least one of the following sensor outputs;

P_aO₂, blood flow, and SpO₂;

increase a blood flow through an ECGE system based on at least one of the following sensor outputs;

P_aO₂, blood flow, and SpO₂;

decrease the blood flow through the ECGE system based on at least one of the following sensor outputs;

P_aO₂, blood flow, and SpO₂;

increase the FiO₂ based on at least one of the following sensor outputs;

P_aO₂, blood flow, and SpO₂;

decrease the FiO₂ based on at least one of the following sensor outputs;

P_aO₂, blood flow, and SpO₂;

increase a PEEP based on at least one of the following sensor outputs;

P_aO₂, blood flow, and SpO₂;

decrease the PEEP based on at least one of the following sensor outputs;

P_aO₂, blood flow, and SpO₂;

increase a peak inspiration pressure based on at least one of the following sensor outputs;

P_aCO₂, pH, E_TCO₂, and VCO₂

decrease the peak inspiration pressure based on at least one of the following sensor outputs;

P_aCO₂, pH, E_TCO₂, and VCO₂;

increase a tidal volume based on at least one of the following sensor outputs;

P_aCO₂, pH, E_TCO₂, and VCO₂;

decrease the tidal volume based on at least one of the following sensor outputs;

P_aCO₂, pH, E_TCO₂, and VCO₂;

increase a respiratory rate based on at least one of the following sensor outputs;

P_aCO₂, pH, E_TCO₂, and VCO₂;

decrease the respiratory rate based on at least one of the following sensor outputs;

P_aCO₂, pH, E_TCO₂, and VCO₂;

increase minute ventilation based on at least one of the following sensor outputs;

P_aCO₂, pH, E_TCO₂, and VCO₂; and

decrease the minute ventilation based on at least one of the following sensor outputs;

P_aCO₂, pH, E_TCO₂, and VCO₂.

15. A ventilator-ECGE system, comprising:

a ventilator system including a pressure generating system, the pressure generating system adapted to deliver breathing gas to a patient based on ventilator settings;

an ECGE system that removes carbon dioxide from a patient'"'"'s bloodstream and provides a gas mixture to the patient'"'"'s bloodstream to oxygenate the patient'"'"'s bloodstream based on ECGE settings;

an operator interface for receiving operator input;

a plurality of sensors operatively coupled to at least one of the pressure generating system, the patient, a patient circuit, and the patient'"'"'s bloodstream wherein the plurality of sensors monitor a plurality of parameters to generate sensor output;

a controller that receives the operator input and commands the pressure generating system and the ECGE system based on the operator input; and

a display module, the display module displays the generated sensor output.

16. The ventilator-ECGE system of claim 15, further comprising:

a compare module that compares the generated sensor output to at least one threshold; and

a manage module that manages treatment of the patient by adjusting at least one of the ventilator settings and the ECGE settings based on information received from the compare module, wherein the treatment of the patient include at least one of oxygenation and ventilation of the patient.

17. The ventilator-ECGE system of claim 15, further comprising:

a compare module that compares the generated sensor output to at least one threshold; and

a notification module that issues a notification based on information received from the compare module,

wherein the display module displays the notification.

18. The ventilator-ECGE system of claim 17, wherein the notification is a recommendation entry.

19. The ventilator-ECGE system of claim 18, wherein the recommendation entry is selectable.

20. The ventilator-ECGE system of claim 15, wherein the controller and the display module are part of the ventilator system.