Method and apparatus for rapid control of set inspired gas concentration in anesthesia delivery systems

• US 6,216,690 B1
• Filed: 10/13/1998
• Issued: 04/17/2001
• Est. Priority Date: 10/15/1997
• Status: Expired due to Term

• Current Assignee: Datex-Ohmeda Incorporated (GE Healthcare Technologies, Inc.)
• Original Assignee: Datex-Ohmeda Incorporated (GE Healthcare Technologies, Inc.)
• Inventors: Keitel, Todd A., Tham, Robert Q.
• Primary Examiner(s): Weiss, John G.
• Assistant Examiner(s): SRIVASTAVA, VIRENDRA KUMAR
• Application Number:
  US09/170,168
• Time in Patent Office: 917 Days
• Field of Search: 128/203.12, 128/204.21, 128/204.23, 128/204.18, 128/204.13, 128/203.25
• US Class Current: 128/203.12
• 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 16/104 specially adapted for anaesthetics A61M16/18 takes precedence
• CPC Class Codes: A61M 16/12 by mixing different gases
• CPC Class Codes: A61M 16/18 Vaporising devices for anaesthetic preparations
• CPC Class Codes: A61M 16/22 Carbon dioxide-absorbing devices ; Other means for removing carbon dioxidecartridges with absorbing substances for respiratory apparatus A62B19/00
• CPC Class Codes: A61M 2016/1025 the O2 concentration
• CPC Class Codes: A61M 2016/1035 the anaesthetic agent concentration

Abstract

A method and system for rapid control of set inspired gas concentration is disclosed for operating a medical anesthesia delivery system and for controlling the flow and concentration of gases and anesthesia vapor delivered to a patient. Control of the inspired gas and agent concentration is accomplished by operating in different control priority modes. In a flow priority control mode, the user may set, either directly or indirectly, the total fresh gas flow rate. The total fresh gas flow rate can then be slowly be varied by the control algorithm, while the vaporizer concentration is actively controlled to achieve the user set inspired gas concentration. The invention includes a process for switching from the flow priority control mode into a concentration priority mode for low flow rates. By throttling the flow, the patient will receive nearly an instantaneous change in the amount of agent and fresh gas without having the transport delay associated with a change in the agent concentration. Sensors are used to monitor agent concentration and minute volume, and a processor is programmed to estimate the concentration of the agent in the pipeline to select the control priority mode, and control the agent vaporizer and the fresh gas flow controller to selectively switch between control priority modes and operate extremely efficiently while in the concentration priority mode by changing the flow rate instead of the agent concentration.

Claims

1. An anesthetic agent delivery system for delivering a desired dose of anesthetic agent to a patient comprising:

an anesthetic agent supply having a controller for controlling the amount of anesthetic agent provided by the supply;

a gas supply for providing respiratory gas, said gas supply being in fluid communication with said anesthetic agent supply to receive the anesthetic agent from said anesthetic agent supply to form fresh gas, said gas supply having a gas flow controller for controlling the fresh gas flow rate;

a breathing circuit containing and recirculating breathing gas for the patient, said breathing circuit having a supply end and a patient end that is in communication with the patient, said breathing circuit being formed such that a gas volume displacement at the supply end will cause a rapid, corresponding volume displacement at the patient end, said supply end being in communication with the gas supply and the anesthetic agent supply to receive fresh gas into the breathing circuit, the breathing circuit providing a minute volume of breathing gas to the patient;

a sensor connected in the breathing circuit to provide a signal indicative of the anesthetic agent concentration delivered to the patient; and

a system control connected to the gas flow controller and anesthetic agent supply controller, said system control receiving the signal from said sensor for forming an anesthetic agent concentration error signal indicative of the difference between desired and delivered patient anesthetic agent concentrations, the system control having a plurality of control paths to control the anesthetic agent concentration delivered to the patient, said system control employing, when the fresh gas flow rate is less than or equal to the minute volume, a first control path comprising a feedforward control loop for said anesthetic agent supply for establishing the amount of anesthetic agent provided in the fresh gas by said anesthetic agent supply, and employing a second control path comprising a feedback control loop between said anesthetic agent concentration error signal and said gas flow controller to rapidly and incrementally change the fresh gas flow rate in a manner to rapidly minimize an error between desired and delivered patient anesthetic agent concentrations, said system control having switching means responsive to the fresh gas flow rate to switch from said first and second control paths to third and fourth control paths when the fresh gas flow rate exceeds the minute volume, said third control path comprising a feedforward control loop which is coupled to said gas flow controller for establishing the flow rate of the fresh gas, and said fourth control path comprising a closed, feedback control loop between the anesthetic agent concentration error signal and said anesthetic agent supply controller to vary the amount of anesthetic agent provided by said anesthetic agent supply in the fresh gas in a manner to minimize the error between desired and delivered patient anesthetic agent concentrations.

2. The system of claim 1 wherein said switching means carries out the switching using weighted signal gains for said control paths.

3. The system of claim 1 wherein said feedback control loops contain a proportional-integral-derivative controller.

4. The system of claim 2 wherein said feedback control loops contain a proportional-integral-derivative controller.

5. The system of claim 1 further including means for establishing a magnitude for the concentration of anesthetic agent in the fresh gas received into the breathing circuit;

means for establishing a magnitude for the concentration of anesthetic agent in the recirculating breathing gas in the breathing circuit; and

means for changing the fresh gas flow rate in accordance with the established magnitudes to minimize the error between desired and delivered anesthetic agent concentrations.

6. The system of claim 5 wherein at least one of said magnitude establishing means is further defined as means for estimating the magnitude of the concentration of anesthetic agent.

7. The system of claim 6 wherein said means for establishing a magnitude for the concentration of anesthetic gas in the fresh gas further comprises means providing an indication of a fresh gas mixing characterization that is determined, a priori, based on the configuration of the anesthesia delivery system, and a fresh gas transport delay estimator to predict delay characteristics in the transport of the fresh gas to the breathing circuit.

8. The system of claim 6 wherein said means for establishing a magnitude for the concentration of anesthetic agent in the recirculating breathing gases further comprises a recirculating agent concentration estimator to estimate the amount of anesthetic agent recirculated in the breathing circuit.

9. The system of claim 1 wherein said switching means is flirter defined as switching to said third and fourth control loops when the fresh gas flow rate is about 4 L/Min or above.

10. The system of claim 9 wherein said switching means is further defined as switching back from said third and fourth control paths to said first and second control paths when the fresh gas flow rate decreases to about 3 L/Min or less.

11. The system of claim 1 further comprising a user interface connected to said system control to provide a user desired patient anesthetic agent concentration value.

12. The system of claim 1 wherein said user interface is further defined as providing a user desired minimum fresh gas flow rate value to cause said gas flow controller to provide a desired minimum fresh gas flow rate to the breathing circuit.

13. A method for delivering a desired dose of anesthetic agent to a patient comprising the steps of:

providing a controllable flow of respiratory gas;

providing a controllable amount of anesthetic agent;

mixing the respiratory gas and anesthetic agent to form fresh gas, the flow rate of which and the amount of anesthetic agent contained therein are controllable;

supplying a minute volume of breathing gas to the patient with a breathing circuit containing and recirculating the breathing gas, said breathing circuit being formed such that a gas volume displacement at a supply end will cause rapid, corresponding gas volume displacement at a patient end that is in communication with the patient;

supplying the fresh gas into the breathing circuit at the supply end;

sensing the anesthetic agent concentration delivered to the patient by the breathing circuit and providing an aesthetic agent concentration error signal indicative of the difference between desired and delivered patient anesthetic concentrations;

when the flow rate of the fresh gas into the breathing circuit is less than or equal to the minute volume, establishing the amount of anesthetic agent provided in the fresh gas and controlling the fresh gas flow rate responsive to the error signal to rapidly and incrementally change the fresh gas flow rate in a manner to rapidly minimize an error between desired and delivered patient concentrations; and

when the flow rate of the fresh gas to the breathing circuit exceeds the minute volume, establishing the flow rate for the fresh gas and controlling the amount of anesthetic agent contained in the fresh gas responsive to the error signal in a manner to minimize an error between desired and delivered patient anesthetic agent concentrations.

14. The method of claim 13 further including the step of providing weighted signal gains to select control paths having desired characteristics that establish and control the amount anesthetic agent and fresh gas flow rate.

15. The method of claim 13 further including the step of carrying out proportional-integral-derivative control in closed, feedback control paths to control the amount of anesthetic agent and fresh gas flow rate.

16. The method of claim 14 further including the step of carrying out proportional-integral-derivative control in closed, feedback control paths to control the amount of anesthetic agent and fresh gas flow rate.

17. The method of claim 14 further defined as periodically ascertaining the fresh gas flow rate and updating the weighted signal gains provided to the control paths.

18. The method of claim 13 further including steps of establishing a magnitude for the concentration of anesthetic agent in the fresh gas received into the breathing circuit;

establishing a magnitude for the concentration of anesthetic agent in the recirculating breathing gas in the breathing circuit; and

changing the fresh gas flow rate in accordance with the established magnitudes to minimize the error between desired and delivered anesthetic agent concentrations.

19. The method of claim 18 wherein at least one of said magnitude establishing steps is further defined as estimating the magnitude of the concentration of anesthetic agent.

20. The method of claim 19 wherein the step of establishing the magnitude for the concentration of anesthetic gas in the fresh gas further comprises the step of providing an indication of a fresh gas mixing characterization that is determined, a priori, based on the configuration of the anesthesia delivery system, and the step of predicting delay characteristics in the transport of the fresh gas to the breathing circuit.

21. The method o f claim 19 wherein the step of establishing the magnitude for the concentration of anesthetic agent in the recirculating breathing gases further comprises estimating the amount of anesthetic agent recirculating in the breathing circuit.

22. The method of claim 13 wherein the method is further defined as switching from the operative mode described in the penultimate step to the operation mode described in the last step when the fresh gas flow rate is about 4 L/Min or above.

23. The method of claim 22 wherein the method is further defined as switching back from the mode of operation described in the last step to the mode of operation described in the penultimate step when the fresh gas flow rate decreases to about 3 L/Min or less.

24. The method of claim 13 further comprising the step of providing a user desired patient anesthetic agent concentration.

25. The method of claim 13 further comprising the steps of providing a user desired minimum fresh gas flow value rate and providing a desired minimum fresh gas flow rate to the breathing circuit.