METHOD AND SYSTEMS FOR EXECUTING NASAL HIGH FLOW THERAPY WITH SETTINGS DETERMINED FROM FLOW OUTPUTS DURING A PREVIOUS VENTILATION MODE

• US 20190344032A1
• Filed: 05/14/2018
• Published: 11/14/2019
• Est. Priority Date: 05/14/2018
• Status: Active Grant

• Current Assignee: General Electric Company
• Original Assignee: General Electric Company
• Inventors: McCormick, Timothy Patrick, Hanrahan, James
• Granted Patent: US 11,298,484 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 2562/0247 Pressure sensors
• CPC Class Codes: A61B 5/083 Measuring rate of metabolism by using breath test, e.g. measuring rate of oxygen consumption
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61M 16/0057 Pumps therefor
• CPC Class Codes: A61M 16/0096 High frequency jet ventilation
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• 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 16/0672 Nasal cannula assemblies for oxygen therapy
• CPC Class Codes: A61M 16/125 Diluting primary gas with ambient air
• 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 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2016/1025 the O2 concentration
• CPC Class Codes: A61M 2016/103 the CO2 concentration
• CPC Class Codes: A61M 2202/0007 introduced into the body
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2210/0618 Nose
• CPC Class Codes: A61M 2230/40 : Respiratory characteristics
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/435 : partial O2 pressure (P-O2)
• CPC Class Codes: A61M 2240/00 : Specially adapted for neonatal use

Abstract

Various methods and systems are provided for performing nasal high flow therapy. In one example, a method for respiratory support includes: delivering an air and oxygen mixture for nasal high flow therapy to a patient at a flow setting, the flow setting determined based on a peak inspiratory flow obtained during a previous, spontaneous breathing mode during mechanical ventilation of the patient. The flow setting may be a flow rate of a heated and humidified mixture of air and oxygen delivered via a high flow nasal cannula.

Claims

1. A method for respiratory support, comprising:

delivering an air and oxygen mixture for nasal high flow therapy to a patient at a flow setting, the flow setting determined based on a peak inspiratory flow obtained during a previous, spontaneous breathing mode during mechanical ventilation of the patient.

2. The method of claim 1, wherein the delivering the air and oxygen mixture for nasal high flow therapy at the flow setting occurs immediately following the spontaneous breathing mode, without additional flow modes occurring between the spontaneous breathing mode and the nasal high flow therapy.

3. The method of claim 1, wherein the delivering the air and oxygen mixture for nasal high flow therapy at the flow setting occurs immediately following an intermediate breathing mode which occurs immediately following the spontaneous breathing mode, where the intermediate breathing mode includes one of a continuous positive airway pressure mode and a nasal continuous positive airway pressure mode.

4. The method of claim 1, wherein the flow setting is an initial flow rate of the air and oxygen mixture flowing to the patient from a nasal high flow therapy system.

5. The method of claim 4, further comprising adjusting the initial flow rate based on one or more of patient weight and patient comfort.

6. The method of claim 1, wherein the delivering the air and oxygen mixture for nasal high flow therapy includes delivering the air and oxygen mixture to the patient via a high flow nasal cannula.

7. The method of claim 1, further comprising, via a controller, automatically obtaining the peak inspiratory flow from a waveform output produced during the spontaneous breathing mode during mechanical ventilation of the patient, automatically determining the flow setting based on the automatically obtained peak inspiratory flow, and, upon transitioning from mechanical ventilation to nasal high flow therapy, delivering the air and oxygen mixture for nasal high flow therapy to the patient at the automatically determined flow setting.

8. The method of claim 7, wherein the controller is in electronic communication with each of a mechanical ventilator and a nasal high flow therapy system.

9. The method of claim 1, further comprising automatically obtaining the peak inspiratory flow from a waveform output produced during the spontaneous breathing mode during mechanical ventilation of the patient, in response to spontaneous breathing of the patient, during the spontaneous breathing mode, for a threshold duration below a threshold positive end expiratory pressure.

10. The method of claim 9, wherein automatically obtaining the peak inspiratory flow from the waveform output includes averaging the peak inspiratory flow of the waveform output over a predetermined period of time during the spontaneous breathing mode.

11. A method for respiratory support, comprising:

while operating a respiratory support device, attached to a patient, in a spontaneous breathing mode during mechanical ventilation of the patient, displaying a breathing waveform of the patient and obtaining a peak inspiratory flow from the breathing waveform; and

following the spontaneous breathing mode and after stopping mechanical ventilation of the patient, delivering an air and oxygen mixture via a nasal high flow therapy system to the patient at a flow rate that is determined based on the peak inspiratory flow.

12. The method of claim 11, further comprising automatically determining the flow rate via a controller in electronic communication with a controller of the respiratory support device and a flow meter of the nasal high flow therapy system.

13. The method of claim 12, wherein automatically determining the flow rate includes trending the breathing waveform over a predetermined period of time, during the spontaneous breathing mode, and averaging peak inspiratory flow measurements for each breath cycle of the trended breathing waveform over the predetermined period of time to obtain an average peak inspiratory flow.

14. The method of claim 13, further comprising setting the flow rate for nasal high flow therapy at a level that is a function of the average peak inspiratory flow.

15. The method of claim 13, further comprising starting the predetermined period of time for trending the breathing waveform only after positive end expiratory pressure is below a threshold level.

16. The method of claim 11, wherein the spontaneous breathing mode is a spontaneous breathing trial and further comprising determining the flow rate for nasal high flow therapy based on the peak inspiratory flow in response to conclusion of the spontaneous breathing trial and a request to wean the patient from mechanical ventilation.

17. A system, comprising:

a mechanical ventilator adapted to provide respiratory support to a patient; and

a control system with one or more controllers with computer readable instructions stored on non-transitory memory that when executed during operation of the mechanical ventilator, cause the one or more controllers to;

execute a spontaneous breathing mode in response to a request for the spontaneous breathing mode;

during executing of the spontaneous breathing mode, acquire flow data from a plurality of breath cycles; and

determine a nasal high flow therapy flow setting based on a peak inspiratory flow of the acquired flow data.

18. The system of claim 17, further comprising a user interface with a display and wherein the computer readable instructions further cause the one or more controllers to display a flow waveform of the acquired flow data and the determined nasal high flow therapy via the display.

19. The system of claim 17, further comprising a nasal high flow therapy system including a high flow cannula adapted to deliver an air and oxygen mixture to the patient and wherein the one or more controllers include computer readable instructions that when executed during operation of the nasal high flow therapy system, cause the one or more controllers to deliver the air and oxygen mixture for nasal high flow therapy to the patient, via the high flow cannula, at the determined nasal high flow therapy setting.

20. The system of claim 19, wherein the nasal high flow therapy system includes a humidifier and heated circuit coupled with the high flow cannula and wherein the air and oxygen mixture delivered to the patient is a heated and humidified air and oxygen mixture.