System and method for flow triggering of breath supported ventilation

• US 5,390,666 A
• Filed: 12/03/1993
• Issued: 02/21/1995
• Est. Priority Date: 05/11/1990
• Status: Expired due to Term

• Current Assignee: Puritan Bennett Corp. (Medtronic Plc)
• Original Assignee: Puritan Bennett Corp. (Medtronic Plc)
• Inventors: Sanborn, Warren G., Kimm, Gardner J., Gee, Glen N., Fennema, Paul J.
• Primary Examiner(s): Asher, Kimberly L.
• Application Number:
  US08/161,177
• Time in Patent Office: 445 Days
• Field of Search: 128/204.18, 128/204.21, 128/204.23, 128/204.26
• 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 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/1065 in the expiratory path
• CPC Class Codes: A61M 16/1075 by influencing the temperature A61M16/1045 takes precedence
• CPC Class Codes: A61M 16/12 by mixing different gases
• CPC Class Codes: A61M 16/204 used for inhalation control
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 in the expiratory circuit

Abstract

The method for flow triggering breath supported ventilation is accomplished by providing a system comprising a source of a predetermined, preinspiratory, constant flow of breathing gas and connecting such to a patient breathing attachment. One or more flow sensors measure the gas flow rate in a flow path communicating with the patient breathing attachment, determining when inhalation from the flow path has occurred. Breath support is generated in the delivered gas flow in response to inhalation by the patient, and the predetermined, preinspiratory, continuous flow of breathing gas is reestablished prior to the patient'"'"'s next inspiratory effort. In combination with various types of breath support, the flow triggering strategy of the invention offers significant improvements in providing breath support to patients having weakened respiratory capabilities.

Claims

1. A method of flow triggering of breath support ventilation to a patient supplied with a predetermined, preinspiratory, continuous flow of breathing gas from a ventilation system having a source of breathing gas, a patient breathing attachment, an exhalation valve, and a functionally open breathing gas flow path in fluid communication with said source of breathing gas, said ventilation flow path including flow sensor means for measuring flow rate of said breathing gas from said patient breathing attachment to said exhalation valve, the steps of the method comprising:

delivering said predetermined rate of flow of said breathing gas from said source to said patient breathing attachment;

measuring said flow rate of breathing gas from said source of breathing gas to said patient breathing attachment to determine a gas supply flow rate;

measuring said flow rate of breathing gas from said patient attachment to said exhalation valve to determine an exiting gas flow rate;

determining patient inspiratory effort in said flow path by comparing said gas supply flow rate with said exiting gas flow rate, and determining a flow rate change due to patient inhalation or exhalation, thereby indicating the patient'"'"'s breathing efforts;

generating breath support in said delivered flow of gas when said flow rate change exceeds a predetermined threshold value; and

restoring delivery of said breathing gas from said source to said patient breathing attachment at said preinspiratory, continuous rate of flow before a patient'"'"'s next inspiratory effort.

2. The method of claim 1, wherein said source of breathing gas comprises a plurality of different gas sources, and further comprises the step of mixing said plurality of different gases.

3. The method of claim 2, further comprising the step of controlling the mixing of said different gas sources according to a predetermined proportion of said different gases.

4. The method of claim 1, wherein said ventilation flow path includes an inhalation and exhalation flow path into and from said patient breathing attachment, and said inhalation flow path and said exhalation flow path form a wye junction communicating with the patient breathing attachment, and the step of determining the rate of gas flow in said flow path comprises measuring gas flow at the portion of the patient wye junction communicating with the patient breathing attachment.

5. The method of claim 1, wherein said ventilation flow path includes an exhalation flow path from said patient breathing attachment and an inhalation flow path to the patient breathing attachment, and the step of determining the rate of gas flow into and from said patient breathing attachment comprises performing measurements at least one position in the inhalation flow path and at least one position in the exhalation flow path.

6. The method of claim 1, wherein said flow path includes an exhalation flow path from said patient breathing attachment, and said measurement of said change in the rate of gas flow in said flow path is measured in at least one location in said exhalation flow path.

7. The method of claim 1, wherein said ventilation flow path includes a plurality of flow sensor means and a control means for measuring the change in the rate of gas flow, and said step of measuring said change in the rate of gas flow comprises measurement at least one of the sensor means.

8. A system of flow triggering breath support ventilation to a patient supplied with a predetermined, preinspiratory, continuous flow of breathing gas, comprising a ventilation system having a source of breathing gas, a patient breathing attachment, an exhalation valve, and a functionally open breathing gas flow path in fluid communication with said source of breathing gas, said patient breathing attachment and said exhalation valve, and flow sensor means for measuring flow rate of said breathing gas from said patient breathing attachment to said exhalation valve, the system further comprising:

means for delivering said breathing gas from said source to said patient breathing attachment at said predetermined, continuous rate of flow;

flow sensor means in said flow path for measuring flow rate of said breathing gas from said source of breathing gas to said patient breathing attachment to determine a gas supply flow rate, and for measuring flow rate of said breathing gas from said patient breathing attachment to said exhalation valve to determine an exiting gas flow rate;

means responsive to said flow sensor means for determining patient breathing efforts by comparing said gas supply flow rate with said exiting gas flow rate to determine a flow rate change due to patient inhalation or exhalation efforts,

means for generating breath support in said delivered flow of gas when said flow rate change exceeds a predetermined threshold value; and

means for restoring delivery of said breathing gas from said source to said patient breathing attachment at said preinspiratory, continuous rate of flow before a next patient'"'"'s inspiratory effort.

9. The system of claim 8, wherein said source of breathing gas comprises a plurality of different gas sources, and means for mixing said gas from said different gas sources.

10. The system of claim 8, further including means for controlling the proportions in said mixture of said gas from said different gas sources.

11. The system of claim 8, wherein said ventilation flow path includes an inhalation and exhalation flow path into and from said patient breathing attachment, and said source of inhalation and exhalation flow paths form a wye junction communicating with the patient breathing attachment, and wherein said flow sensor means for measuring the rate of gas flow into said patient breathing attachment is located at said wye junction.

12. The system of claim 11, wherein said flow sensor means is located in the ventilation flow path between said wye junction and said patient breathing attachment.

13. The system of claim 8, wherein said ventilation flow path includes an exhalation flow path from said patient breathing attachment, an inhalation flow path to said patient breathing attachment, and said flow sensor means for determining the change in the rate of gas flow into and from said patient breathing attachment comprises at least one flow sensor located in at least one location in said exhalation flow path and at least one other flow sensor in at least one other location in said inhalation flow path.

14. The system of claim 8, further comprising a plurality of flow sensor means and a control means for measuring the gas flow rate at least one of the flow sensor means.

15. The system of claim 8, further comprising means to determine the beginning of a patient'"'"'s exhalation cycle and means to reduce the flow rate for a predetermined period of time at the beginning of said exhalation cycle.