Ventilator control system using sensed inspiratory flow rate

• US 5,107,831 A
• Filed: 06/06/1991
• Issued: 04/28/1992
• Est. Priority Date: 06/19/1989
• Status: Expired due to Term

• Current Assignee: Bear Medical Systems Inc. (Becton, Dickinson & Co)
• Original Assignee: Bear Medical Systems Inc. (Becton, Dickinson & Co)
• Inventors: Halpern, Arieh S., Oltean, Ioan T.
• Primary Examiner(s): Burr, Edgar S.
• Assistant Examiner(s): ASHER, KIMBERLY L
• Application Number:
  US07/711,595
• Time in Patent Office: 327 Days
• Field of Search: 128/204.21, 128/204.23, 128/204.26, 128/716, 128/719, 128/723, 128/202.22
• US Class Current: 128/204.26
• 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 16/0051 with alarm devices
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit

Abstract

A ventilator control system is responsive to a flow rate signal from a flow rate sensor that senses the flow rate of gas to a ventilated patient. The ventilator control system provides an episode signal to a ventilator to actuate the ventilator to provide an assisted breath. The ventilator control system has an interactive control panel for providing an operator selectable duration signal scaled to define a selected time interval between breaths. An operator also selects a flow rate threshold signal scale to define the flow rate that must be exceeded to qualify a breath from a patient as a valid breath. Episode signal circuitry responds to the flow rate signal, the flow-rate threshold signal, and the duration signal to generate an episode signal in response to the flow rate signal failing to exceed the flow rate threshold signal within the selected time interval.

Claims

1. A method of controlling a time-cycled constant-flow, pressure-limited medical ventilator during the ventilation of a patient, wherein the ventilator has a selectable breath rate interval, the method comprising the steps of:

(a) sensing the inspiratory flow rate of the patient and generating a flow rate signal;

(b) selecting a flow rate threshold value;

(c) selecting an episode time interval;

(d) selecting a number of ventilator-delivered breaths;

(e) comparing the flow rate signal value to the selected flow rate threshold value during the selected episode time; and

(f) actuating the ventilator to deliver the selected number of ventilator-delivered breaths to the patient if the flow rate signal value remains below the selected flow rate threshold value throughout the duration of the selected episode time interval.

2. The method of claim 1, wherein the actuation step comprises the steps of:

(1) generating a breath indicative signal whenever the value of the flow rate signal equals or exceeds the selected flow rate threshold value;

(2) interrupting and restarting the selected episode time interval in response to the breath-indicative signal; and

(3) generating a ventilator actuation signal when the selected episode time interval elapses without interruption.

3. The method of claim 1, further comprising the step of:

selecting the interval between the ventilator-delivered breaths to be delivered by the ventilator during the actuation step when the selected number of ventilator-delivered breaths is more than one.

4. The method of claim 1, wherein the ventilator has an intermittent mandatory ventilation mode, and wherein the actuation step comprises actuating the ventilator to deliver only one breath when the ventilator is in the intermittent mandatory ventilation mode, regardless of the number of ventilator-delivered breaths selected in the step of selecting the number of ventilator-delivered breaths.

5. A respiratory ventilator system for controllably ventilating a patient, wherein the system includes a time-cycled, constant-flow, pressure-limited ventilator operable in a mandatory ventilation mode with a selectable breath rate interval, and in a CPAP mode, the ventilator having an inspiratory flow line, an expiratory flow line, and a patient connector for coupling the inspiratory and expiratory flow lines to a patient, wherein the improvement comprises:

flow rate sensing means, in the patient connector, for generating a flow rate signal indicative of the flow rate of gas inspired by the patient through the connector; and

a ventilator control device, receptive to the flow rate signal and operatively coupled to the ventilator, the ventilator control device comprising;

first control means for providing a selectable duration signal scaled to define a selected time interval;

second control means for providing a selectable flow rate threshold signal;

episode signal generation means, responsive to the flow rate signal, the duration signal, and the flow rate threshold signal, for generating an episode signal in response to the failure of the flow rate signal to attain the value of the flow rate threshold signal within the selected time interval; and

ventilator actuation means, responsive to the episode signal, for actuating the ventilator to deliver a breath to the patient each time the episode signal is generated, independently of the selected breath rate interval of the ventilator, when the selected time interval is shorter than the selected breath rate interval of the ventilator operated in the mandatory ventilation mode.

6. The ventilator system of claim 5, wherein the episode signal generation means comprises:

computer means, responsive to the flow rate signal and to the flow rate threshold signal, for providing a breath-indicative signal each time the flow rate signal amplitude exceeds the flow rate threshold signal amplitude.

7. The ventilator system of claim 5 wherein said episode signal generation means further comprises:

computer means, responsive to the flow rate signal, to the flow rate threshold signal, and to the duration signal, for providing a breath-indicative signal each time the flow rate signal amplitude exceeds the flow rate threshold signal within the selected time interval.

8. The ventilator system of claim 5 wherein said episode signal generation means further comprises:

flow rate signal amplifier means, responsive to the flow rate signal, for amplifying the flow rate signal to provide an amplified flow rate signal.

9. The ventilator control system of claim 8, wherein said episode signal generation means further comprises:

flow rate threshold signal amplifier means, responsive to the flow rate threshold signal, for amplifying the flow rate threshold signal to provide an amplified flow rate threshold signal.

10. The ventilator system of claim 5, further comprising flow rate indicator means, and wherein the episode signal generation means further comprises:

driver means, responsive to the flow rate signal, for actuating the flow rate indicator means.

11. The ventilator system of claim 5, further comprising:

indicator means, responsive to the flow rate signal and to the flow rate threshold signal, for simultaneously indicating the value of the flow rate signal and the flow rate threshold signal.

12. The ventilator control system of claim 5, wherein the episode signal generation means further comprises:

driver means, responsive to the flow rate signal and to the flow rate threshold signal, for providing a weighted flow rate signal and a weighted flow rate threshold signal; and

computer means, responsive to the weighted flow rate and weighted flow rate threshold signals, for providing a breath-indicative signal each have the weighted flow rate signal exceeds the weighted flow rate threshold signal.

13. The ventilator system of claim 5, further comprising:

third control means for generating a selectable ventilator breath signal indicative of a selected number of ventilator-delivered breaths;

wherein the ventilator actuation means is responsive to the episode signal and the ventilator breath signal for actuating the ventilator, when operated in the CPAP mode, to deliver the selected number of breaths to the patient each time the episode signal is generated.

14. The ventilator system of claim 13, wherein the third control means includes means for selectably varying the time interval between ventilator-delivered breaths if the selected number of ventilator-delivered breaths is at least two.

15. A respiratory ventilator system for controllably ventilating a patient, wherein the system includes a time-cycled, constant-flow, pressure-limited ventilator operable in a mandatory ventilation mode with a selectable breath rate interval, and in a CPAP mode, the ventilator having an inspiratory flow line, an expiratory flow line, and a patient connector for coupling the inspiratory and expiratory flow lines to a patient, wherein the improvement comprises:

first means for fluidly coupling the ventilator to a patient;

second means in the first means for sensing an inspiratory effort by the patient and generating a flow rate signal in response thereto; and

a ventilator control device, operatively coupled to the ventilator, the ventilator control device comprising;

third means for providing a threshold signal having a selectable value;

fourth means for providing a selectable episode time interval;

fifth means for providing a selectable number of ventilator-delivered breaths when the ventilator is operated in the CPAP mode;

sixth means responsive to the flow rate signal and the threshold signal, for generating an episode signal when the value of the flow rate signal remains below the selected threshold signal value for the duration of the selected episode time interval; and

seventh means for actuating the ventilator, when operated in the CPAP mode, to deliver the selected number of ventilator-delivered breaths in response to each episode signal.

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

eighth means, responsive to the flow rate signal and the threshold signal, for generating a breath-indicative signal whenever the the value of the flow rate signal equals or exceeds the value of the threshold signal; and

ninth means, responsive to the breath indicative signal, for restarting the episode time interval in response to the breath-indicative signal.

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

tenth means for providing a selectable episode count time span;

eleventh means, responsive to the episode signal, for counting the number of times that the episode signal has been generated within the selected episode count time span to provide an episode count; and

twelfth means, responsive to the eleventh means, for indicating the episode count.

18. The respiratory ventilator system of claim 15, wherein the ventilator actuation means is responsive to the episode signal for actuating the ventilator to deliver a breath to the patient each time the episode signal is generated independently of the selected breath rate interval of the ventilator, when the ventilator is operated in the mandatory ventilation mode, and when the selected episode time interval is shorter than the selected breath rate interval of the ventilator.