Method and apparatus for ECG gated ventilation

• US 5,188,098 A
• Filed: 11/04/1991
• Issued: 02/23/1993
• Est. Priority Date: 11/04/1991
• Status: Expired due to Term

• Current Assignee: Trustees Of The University Of Pennsylvania (University of Pennsylvania)
• Original Assignee: Trustees Of The University Of Pennsylvania (University of Pennsylvania)
• Inventors: Hoffman, Eric A., Hanson, C. William III
• Primary Examiner(s): Grieb, William H.
• Application Number:
  US07/787,635
• Time in Patent Office: 477 Days
• Field of Search: 128/204.23, 128/204.18, 128/204.21, 128/205.23
• 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 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation

Abstract

Method and apparatus for maximizing the volume of blood pumped by a heart and maximizing ventilation/perfusion matching in the lungs, wherein the lungs are ventilated by a respirator in response to a control signal, are shown to include a series of monitors for generating a heart signal such as an electrocardiogram, a lung air flow rate signal and a lung air pressure signal and a controller, connected to receive these signals and to the respirator. The controller monitors the signals and generates the control signal when the heart signal is representative of a desired in point in the pumping cycle of the heart and the other signals indicate desired flow rate and pressure in the lungs. In a preferred embodiment, the control signal is generated so as to maximize the augmentation of the pumping of the heart and to minimize the trapping of air in the lungs. Using the present invention, blood being pumped from the heart is assisted by the ventilation of the lungs. It is preferred for the controller to include a series of threshold detectors for detecting when the signals exceed threshold levels. It is especially preferred for the detector to detect a point during ventricular contraction. It is especially preferred for the apparatus to further include a delay mechanism, interposed between the respirator and the controller, for delaying the control signal.

Claims

1. Apparatus for maximizing the volume of blood pumped by a heart, wherein the lungs associated with said heart are ventilated by a respirator, wherein said respirator causes ventilation of said lungs in response to a control signal, said apparatus comprising:

a first monitor for generating a heart signal representative of the action of said heart;

a second monitor for generating a flow rate signal representative of the rate of flow of air into and out of said lungs;

a third monitor for generating a pressure signal representative of the air pressure in said lungs; and

a controller, connected to receive said heart signal, said flow rate signal, said pressure signal and to said respirator, for generating said control signal in response to said heart signal, said flow rate signal and said pressure signal, whereby blood being pumped from the heart is assisted by the ventilation of said lungs.

6. The apparatus of claim 1, wherein said controller comprises delay means for delaying the provision of said control signal to said respirator.

7. The apparatus of claim 6, wherein said delay means is operative in response to said flow rate signal and said pressure signal.

2. The apparatus of claim wherein said controller comprises a plurality of threshold detectors for detecting when said heart signal, said flow rate signal and said pressure signal exceed threshold levels.

3. The apparatus of claim 2, wherein said first monitor comprises an electro cardiogram signal generator, whereby said heart signal comprises an electrocardiogram signal.

4. The apparatus of claim 2, wherein said heart comprises a Ventricle and wherein said electrocardiogram signal is representative of the contraction of said ventricle, said threshold level representative of a point during said ventricular contraction, so that said detector detects a particular point during ventricular contraction.

5. The apparatus of claim 4, wherein each of said detectors comprises a comparator and a variable reference signal generator, whereby the comparator compares a monitor generated signal to a signal generated by the associated variable reference signal generator.

8. A system for maximizing the volume of blood pumped by a heart or optimizing ventilation/perfusion matching in the lungs, said system comprising:

a programmable respirator for ventilating lungs associated with said heart, wherein said respirator causes inspiration in response to a control signal,

a monitor for generating a heart signal representative of the action of said heart; and

a controller, connected to receive said heart signal and to said respirator, for monitoring said heart signal and for generating said control signal when said heart signal is representative of the diastolic phase of said heart, whereby blood being pumped from the heart is assisted by the inspiration pulses generated by said ventilator.

9. A method for maximizing the volume of blood pumped by the heart of a patient or optimizing ventilation/perfusion matching in the lungs of a patient, said method comprising the steps of:

ventilating said patient, wherein said ventilation is achieved in response to a control signal;

generating a heart signal representative of the action of said heart;

generating a flow rate signal representative of the flow rate of air into and out of said lungs;

generating a pressure signal representative of the air pressure in said lungs; and

generating said control signal in response to said heart signal, said flow rate signal and said pressure signal, whereby the pumping action of said heart is assisted by the ventilation of said lungs.

10. The method of claim 9, wherein said step of generating a control signal comprises the steps of monitoring said heart signal, said flow rate signal and said pressure signal and detecting when such signals exceed threshold levels.

11. The method of claim 10, wherein said step of generating a heart signal comprises the step of generating an electrocardiogram signal, whereby said heart signal comprises an electrocardiogram signal.

12. The method of claim 11, wherein said heart comprises a ventricle and wherein said step of generating an electrocardiogram signal comprises the step of generating a signal representative of the contraction of said ventricle, said threshold level representative of a point during said ventricular contraction, so that said step of monitoring comprises the step of detecting a particular point during ventricular contraction.

13. The method of claim 12, wherein said step of detecting a particular point during ventricular contraction comprises the steps of generating a variable reference signal and comparing said electrocardiogram signal to said variable reference signal.

14. The method of claim 10, further comprising the step of delaying said control signal.

15. The method of claim 14, wherein the step of delaying said control signal comprises the step of delaying said control signal until said heart is in the diastolic portion of its cycle.

16. A method for treating respiratory, cardiac or coextensive respiratory and cardiac failure, wherein heart and lungs are functioning abnormally, said method comprising the steps of:

providing a respirator for ventilating said lungs, wherein said respirator is operative in response to a control signal;

generating a heart signal representative of the action of said heart;

generating a flow rate signal representative of the flow rate of air into and out of said lungs;

generating a pressure signal representative of the air pressure in said lungs; and

generating said control signal in response to said heart signal, said flow rate signal and said pressure signal, whereby the pumping action of said heart is assisted by the ventilation of said lungs.