Method for determining a parameter related to spontaneous breathing efforts by a subject, and breathing-assist apparatus operating in accordance with the method

• US 6,240,920 B1
• Filed: 04/07/1999
• Issued: 06/05/2001
• Est. Priority Date: 04/23/1998
• Status: Expired due to Term

• Current Assignee: Maquet Critical Care AB (Getinge AB)
• Original Assignee: Siemens-Elema AB (Siemens AG)
• Inventors: Ström, Christer
• Primary Examiner(s): Lewis, Aaron J.
• Assistant Examiner(s): MITCHELL, TEENA KAY
• Application Number:
  US09/287,315
• Time in Patent Office: 790 Days
• Field of Search: 128/204.18, 128/204-1-2, 128/204.26, 128/205.24, 128/200.24
• 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 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 in the expiratory circuit

Abstract

In a method and apparatus for determining at least one parameter related to a patient'"'"'s spontaneous attempts at inspiration and/or the patient'"'"'s respiratory effort in attempts at spontaneous inspiration, a pressure gradient is determined in relation to a known apparatus pressure and time, the pressure gradient being generated by the patient at inspiration, a residual positive pressure in the patient'"'"'s lungs is determined and an output signal is generated. The output signal can represent determined parameters as well as other related calculated results. The pressure gradient can be extrapolated against residual positive pressure, and both a delay for respiratory assistance and true inspiratory effort can be determined.

Claims

1. A method for determining at least one parameter related to at least one of spontaneous attempts at inspiration by a patient connected to a breathing tube of a breathing apparatus and respiratory effort in spontaneous attempts at inspiration by a patient connected to a breathing tube of a breathing apparatus, comprising the steps of:

determining a pressure gradient relating a known apparatus pressure and time, said pressure gradient being generated by a patient connected to a breathing tube of a breathing apparatus upon inspiration;

determining a residual positive pressure in the lungs of a patient connected to a breathing tube of a breathing apparatus; and

generating a signal dependent on said pressure gradient and said residual positive pressure.

2. A method as claimed in claim 1 wherein the step of determining a pressure gradient comprises determining said pressure gradient by extrapolation using said residual positive pressure, to obtain an extrapolated pressure gradient.

3. A method as claimed in claim 2 wherein said extrapolated pressure gradient has two intersections with said apparatus pressure, separated by a time delay, and comprising the additional steps of identifying said time delay and wherein the step of generating a signal includes generating a signal containing information regarding said time delay.

4. A method as claimed in claim 3 wherein said extrapolated pressure gradient and a curve representing said residual positive pressure enclose an area, and wherein said method includes the step of identifying said area, and wherein the step of generating a signal comprises generating a signal containing information regarding said area.

5. A method as claimed in claim 1 comprising the additional step of displaying a representation of said signal on a display.

6. A method for determining at least one parameter related to at least one of spontaneous attempts at inspiration by a patient connected to a breathing tube of a breathing apparatus and respiratory effort in spontaneous attempts at inspiration by a patient connected to a breathing tube of a breathing apparatus, comprising the steps of:

determining an expiratory curve for a patient connected to a breathing tube of a breathing apparatus for at least one breathing cycle; and

extracting signal components relating to an attempt at inspiration by a patient connected to a breathing tube of a breathing apparatus from said expiratory curve.

7. A method as claimed in claim 6 comprising the additional steps of:

identifying an anticipated start of inspiration in a next attempt at inspiration by a patient connected to a breathing tube of a breathing apparatus after said one breathing cycle and, at said anticipated time, determining a pressure gradient relating a known apparatus pressure and time, said pressure gradient being generated by a patient connected to a breathing tube of a breathing apparatus upon inspiration, determining a residual positive pressure in the lungs of a patient connected to a breathing tube of a breathing apparatus, and generating a signal dependent on said pressure gradient and said residual positive pressure.

8. A method as claimed in claim 7 wherein the step of determining a pressure gradient comprises determining said pressure gradient by extrapolation using said residual positive pressure, to obtain an extrapolated pressure gradient.

9. A method as claimed in claim 8 wherein said extrapolated pressure gradient has two intersections with said apparatus pressure, separated by a time delay, and comprising the additional steps of identifying said time delay and wherein the step of generating a signal includes generating a signal containing information regarding said time delay.

10. A method as claimed in claim 8 wherein said extrapolated pressure gradient and a curve representing said residual positive pressure enclose an area, and wherein said method includes the step of identifying said area, and wherein the step of generating a signal comprises generating a signal containing information regarding said area.

11. A method as claimed in claim 7 comprising the additional step of displaying a representation of said signal on a display.

12. A breathing apparatus comprising:

a breathing tube adapted for connection to a patient, said patient at least occasionally breathing spontaneously;

a gas flow generator operably connected to said breathing tube for generating a gas flow of inspiratory gas therein for supply to a patient;

a first pressure meter operably connected to said breathing tube for identifying an inspiratory gas pressure;

a first flow meter operably connected to said breathing tube for identifying an inspiratory gas flow of;

a second pressure meter operably connected to said breathing tube for identifying a pressure of expiratory gas from a patient;

a second flow meter operably connected to said breathing tube for identifying a flow of said expiratory gas;

a control unit operably connected to each of said first and second pressure meters and each of said first and second flow meters for detecting inspiration attempts by a patient and operably connected to said gas flow generator for controlling said flow of inspiratory gas dependent on detection of said attempts at inspiration; and

said control unit determining a pressure gradient in relation to a known apparatus pressure and time, said pressure gradient being generated by a patient at inspiration, and said control unit determining a residual positive pressure in the lungs of a patient, and said control unit generating a control signal for controlling said gas flow generator dependent on said pressure gradient and said residual positive pressure.

13. A breathing apparatus as claimed in claim 12 wherein said control unit obtains a value in said signal dependent on said pressure gradient and said residual positive pressure and compare said value with a predetermined value range and wherein said control unit controls said gas flow generator to generate an end expiratory apparatus pressure, consisting of a predetermined percentage of said residual positive pressure, if said value deviates from said value range.

14. A breathing apparatus as claimed in claim 12 wherein said control unit identifies a value in said signal dependent on said pressure gradient and said residual positive pressure and compare said value to a predetermined value range, and wherein said control unit calculates a change in at least one respiratory assistance parameter selected from the group consisting of inspiration duration, expiration duration, breathing gas flow, and title volume, if said value deviates from said value range.

15. A breathing apparatus comprising:

a breathing tube adapted for connection to a patient, said patient at least occasionally breathing spontaneously;

a gas flow generator operably connected to said breathing tube for generating a gas flow of inspiratory gas therein for supply to a patient;

a first pressure meter operably connected to said breathing tube for identifying an inspiratory gas pressure;

a first flow meter operably connected to said breathing tube for identifying an inspiratory gas flow;

a second pressure meter operably connected to said breathing tube for identifying a pressure of expiratory gas from a patient;

a second flow meter operably connected to said breathing tube for identifying a flow of expiratory gas from a patient;

a control unit connected to each of said first and second pressure meters and each of said first and second flow meters for detecting inspiration attempts by a patient and connected to said gas flow generator for controlling said flow of breathing gas dependent on detection of said attempts at inspiration; and

said control unit determining an expiratory curve for one breathing cycle of a patient and extracting signal components from said expiratory curve related to an attempt at inspiration by a patient, and said control unit identifying an anticipated time of a next attempt at inspiration by a patient and, at said anticipated time, determining a pressure gradient in relation to a known apparatus pressure and time, said pressure gradient being generated by a patient at inspiration, and said control unit determining a residual positive pressure in the lungs of a patient, and said control unit generating a control signal for controlling said gas flow generator dependent on said pressure gradient and said residual positive pressure.