Determination of patency of airway

• US 6,029,665 A
• Filed: 10/14/1997
• Issued: 02/29/2000
• Est. Priority Date: 11/05/1993
• Status: Expired due to Term

• Current Assignee: Resmed Limited (ResMed Incorporated)
• Original Assignee: Resmed Limited (ResMed Incorporated)
• Inventors: Berthon-Jones, Michael
• Primary Examiner(s): Weiss, John G.
• Assistant Examiner(s): WEISS JR, JOSEPH
• Application Number:
  US08/950,322
• Time in Patent Office: 868 Days
• Field of Search: 128/204.18, 128/204.21, 128/204.23, 128/204.24, 128/205.13, 128/205.18, 128/205.24, 128/205.25, 600/529, 600/533, 607/42
• US Class Current: 128/204.23
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: A61F 5/56 Devices for preventing snoring by influencing the respiratory system by gas treatment A61M16/00
• CPC Class Codes: A61M 16/0006 with means for creating vibrations in patients' airways
• CPC Class Codes: A61M 16/0069 the speed thereof being controlled by respiratory parameters, e.g. by inhalation
• 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 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/60 Muscle strain, i.e. measured on the user
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

Methods and apparatus for determining the occurrence of an apnea, patency and/or partial obstruction of the airway are disclosed. Respiratory air flow from a patient is measured to give an air flow signal. The determination of an apnea is performed by calculating the variance of the air flow signal over a moving time window and comparing the variance with a threshold value. One determination of partial obstruction of the airway is performed by detecting the inspiratory part of the air flow signal, scaling it to unity duration and area and calculating an index value of the amplitude of the scaled signal over a mid-portion. Alternatively, the index value is a measure of the flatness of the air flow signal over the mid-portion. One determination of patency of the airway is performed by applying an oscillatory pressure waveform of known frequency to a patient'"'"'s airway, calculating the magnitude of the component of the air flow signal at the known frequency induced by the oscillatory pressure waveform and comparing the calculated magnitude with a threshold value. Alternatively, the air flow signal is analysed to detect the presence of a component due to cardiogenic activity.

Claims

1. The method for determining patency of the airway of a patient, the method comprising the steps of:

measuring respiratory air flow from the patient; and

analyzing said measured air flow to detect the presence of cardiogenic air flow, and if said cardiogenic air flow is present then the airway is declared patent.

2. The method as claimed in claim 1, wherein said measured air flow is expressed as an air flow signal.

3. The method as claimed in claim 2, wherein the respiratory air flow is high pass filtered to reject components due to respiration.

4. The method as claimed in claim 3, wherein said analyzing step detects the presence of a periodic component.

5. The method as claimed in claim 4, wherein said analyzing step further includes performing a Fourier transformation on said air flow signal.

6. The method as claimed in claim 1, comprising the further step of detecting the patient'"'"'s cardiac rate, and whereby the analyzing step includes detecting a component of said air flow at the cardiac rate.

7. Apparatus for determining patency of the airway of a patient, the apparatus comprising:

means for measuring respiratory air flow from patient to derive an air flow signal; and

processor means for analyzing said air flow signal to detect presence of any cardiogenic air flow, and if present, then declaring the airway patent.

8. The apparatus as claimed in claim 7, wherein said processor high pass filters said air flow signal to reject components due to respiration, and further analyzes the filtered signal for the presence of a periodic component corresponding to the cardiogenic air flow.

9. The apparatus as claimed in claim 8, wherein said processor performs said analysis on the basis of conducting a Fourier transformation of the filtered air flow signal.

10. The apparatus as claimed in claim 9, further comprising means for measuring patient cardiac rate to derive a cardiac rate signal, and wherein said processor also receives said cardiac rate signal and compares the rate with the transformed air flow signal to identify cardiogenic air flow.

11. An apparatus for the provision of constant level, bi-level or autosetting continuous positive airway pressure (CPAP) treatment, the apparatus comprising:

a turbine controllable to provide a supply of breathable gas at desired pressures elevated above atmospheric pressure;

a conduit receiving said breathable gas;

a mask coupled with the conduit to provide said breathable gas to the entrance to the patient'"'"'s airway;

means for applying an oscillatory pressure waveform of known frequency to the patient'"'"'s airway;

transducer means for measuring respiratory air flow from the patient to derive an air flow signal; and

processor means for determining that the airway is patent if there is a component of said air flow at said known frequency induced by said oscillatory pressure waveform, and for causing the turbine to produce a desire pressure of breathable gas in response thereto, wherein said processor high pass filters said air flow signal to reject components due to respiration, and further analyzes the filtered signal for the presence of a periodic component corresponding to the cardiogenic air flow.

12. The apparatus as claimed in claim 11, wherein said processor performs said analysis on the basis of conducting a Fourier transformation of the filtered air flow signal.

13. The apparatus as claimed in claim 12, further comprising means for measuring patient cardiac rate to derive a cardiac rate signal, and said processor also receives said cardiac rate signal and compares the rate with the transformed air flow signal to identify cardiogenic air flow.