Method for compensating for non-metabolic changes in respiratory or blood gas profile parameters

• US 6,238,351 B1
• Filed: 09/09/1998
• Issued: 05/29/2001
• Est. Priority Date: 09/09/1998
• Status: Expired due to Term

• Current Assignee: RIC INVESTMENTS LLC (Respironics Incorporated)
• Original Assignee: NTC Technology, Inc. (Dixtal Medical, Inc.)
• Inventors: Orr, Joseph A., Jaffe, Michael B., Kuck, Kai, Haryadi, Dinesh G.
• Primary Examiner(s): O'Connor, Cary
• Assistant Examiner(s): ASTORINO, MICHAEL C
• Application Number:
  US09/150,136
• Time in Patent Office: 993 Days
• Field of Search: 600/500-504, 600/526, 600/528, 600/529-543, 128/204.12-204.23, 128/897-899, 128/200.24
• US Class Current: 600/532
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: G01N 33/49 Blood chemical methods for determining blood cell populations G01N33/5094; chemical analysis of blood groups or blood types G01N33/80
• CPC Class Codes: G01N 33/497 of gaseous biological material, e.g. breath

Abstract

A method of compensating for non-metabolic changes in respiratory or blood gas parameters including generating a compensatory signal based on the magnitude of the non-metabolic change and the amount of time elapsed since the onset of the non-metabolic change. The method of the present invention is useful for compensating for non-metabolic changes in non-invasive carbon dioxide elimination measurements and, particularly, when carbon dioxide elimination is employed to determine cardiac output on a non-invasive, continuous basis.

Claims

1. A method of compensating for non-metabolic changes in a respiratory profile parameter of a patient, comprising:

detecting an onset of a non-metabolic change;

generating a compensatory signal in response to the non-metabolic change; and

employing said compensatory signal in calculating the respiratory profile parameter.

2. The method of claim 1, wherein said detecting said onset comprises detecting a substantial change in a partial pressure of end-tidal carbon dioxide of the patient.

3. The method of claim 1, wherein said detecting said onset comprises detecting a substantial change in a respiratory rate of the patient.

4. The method of claim 1, wherein said detecting said onset comprises detecting a substantial change in a tidal volume of the patient.

5. The method of claim 1, wherein said detecting said onset comprises detecting a substantial change in carbon dioxide elimination of the patient.

6. The method of claim 1, wherein said generating said compensatory signal comprises considering an amount of time elapsed since said onset.

7. The method of claim 1, wherein said generating said compensatory signal comprises considering a magnitude of said non-metabolic change.

8. The method of claim 1, further comprising estimating a stable respiratory profile parameter of the patient.

9. The method of claim 8, wherein said employing said compensatory signal comprises calculating a difference between said stable respiratory profile parameter and said compensatory signal.

10. A method of compensating for non-metabolic changes in carbon dioxide elimination of a patient, comprising:

detecting a change in ventilation of the patient;

non-invasively determining the carbon dioxide elimination of the patient;

estimating an arterial-venous gradient of the patient;

generating a compensatory signal in response to said change in ventilation and a magnitude of a non-metabolic change in carbon dioxide elimination; and

calculating a cardiac output of the patient by modifying at least one of the carbon dioxide elimination and said arterial-venous gradient and dividing the carbon dioxide elimination by said arterial-venous gradient.

11. The method of claim 10, wherein said estimating said arterial-venous gradient comprises determining said arterial-venous gradient prior to said change in ventilation.

12. The method of claim 10, wherein said estimating said arterial-venous gradient comprises employing a model based at least in part on a type of said change in ventilation.

13. The method of claim 10, wherein said estimating said arterial-venous gradient comprises employing a model based at least on a condition of said patient.

14. The method of claim 10, further comprising continuously monitoring at least one blood gas parameter of the patient.

15. The method of claim 14, wherein said at least one blood gas parameter is selected from the group comprising carbon dioxide content of arterial blood, carbon dioxide content of venous blood, oxygen content of arterial blood, oxygen content of venous blood, oxygen content of end capillary blood, partial pressure of oxygen in venous blood, partial pressure of oxygen in arterial blood, oxygen saturation of venous blood, and oxygen saturation of arterial blood.

16. The method of claim 10, wherein said detecting said change in ventilation comprises detecting a substantial change in a partial pressure of end-tidal carbon dioxide.

17. The method of claim 10, wherein said detecting said change in ventilation comprises detecting a substantial change in said carbon dioxide elimination of the patient.

18. The method of claim 10, wherein said detecting comprises detecting a substantial change in a respiratory rate of the patient.

19. The method of claim 10, wherein said detecting comprises detecting a substantial change in a tidal volume of the patient.

20. The method of claim 10, wherein said estimating said arterial-venous gradient is effected by a cardiac output determination comprising Fick cardiac output re-breathing.

21. The method of claim 20, wherein said re-breathing comprises total re-breathing or partial re-breathing.

22. The method of claim 10, wherein said estimating said arterial-venous gradient is effected by a differential Fick technique comprising adjusting a respiratory rate, adjusting an inspiratory time, adjusting an expiratory time, adjusting a tidal volume, or adding carbon dioxide to respiration of the patient.

23. The method of claim 10, wherein said generating said compensatory signal comprises considering an amount of time elapsed since an onset of said change in ventilation.

24. The method of claim 23, wherein said generating said compensatory signal comprises employing a model based on said magnitude and said amount of time.

25. The method of claim 10, wherein, in said generating said compensatory signal, said magnitude is based on a change in a partial pressure of end tidal carbon dioxide of the patient.

26. The method of claim 10, wherein, in said generating said compensatory signal, said magnitude is based on a change in carbon dioxide elimination of the patient.