Determination of leak and respiratory airflow

• US 6,279,569 B1
• Filed: 03/14/2000
• Issued: 08/28/2001
• Est. Priority Date: 08/14/1996
• Status: Expired due to Term

• Current Assignee: Resmed Limited (ResMed Incorporated)
• Original Assignee: Resmed Limited (ResMed Incorporated)
• Inventors: Berthon-Jones, Michael
• Primary Examiner(s): Lewis, Aaron J.
• Assistant Examiner(s): MITCHELL, TEENA KAY
• Application Number:
  US09/525,042
• Time in Patent Office: 532 Days
• Field of Search: 128/204.18, 128/204.21, 128/204.23, 128/204.26, 128/205.23, 128/200.24, 128/203.12, 128/207.14
• US Class Current: 128/200.24
• CPC Class Codes: A61M 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• CPC Class Codes: A61M 16/0057 Pumps therefor
• CPC Class Codes: A61M 16/0069 the speed thereof being controlled by respiratory parameters, e.g. by inhalation
• 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 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0033 electrical
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2205/15 Detection of leaks

Abstract

Methods and apparatus for determining leak and respiratory airflow are disclosed. A pressure sensor (34) and a differential pressure sensor (32) have connection with a pneumotach (24) to derive instantaneous mask pressure and airflow respectively. A microcontroller (38) estimates a non-linear conductance of any leak path occurring at a mask (12) as being the low pass filtered instantaneous airflow divided by the low pass filtered square root of the instantaneous pressure. The instantaneous leak flow is then the conductance multiplied by the square root of the instantaneous pressure, and the respiratory airflow is calculated as being the instantaneous airflow minus the instantaneous leak flow. The time constants for the low pass filtering performed by the microcontroller (38) can be dynamically adjusted dependent upon sudden changes in the instantaneous leak flow.

Claims

1. A method for determining the instantaneous leak flow from a face mask comprising the steps of:

(a) determining pairs of values for pressure in the mask and airflow through the mask;

(b) calculating the conductance of a leak as a function of pairs of values for pressure and airflow that are determined over a time interval that exceeds a normal breath; and

(c) calculating the instantaneous leak flow as a function of the calculated leak conductance and an instantaneous determined value of mask pressure.

2. A method in accordance with claim 1 wherein said pairs of values are determined by taking direct measures of pressure and airflow.

3. A method in accordance with claim 1, accomplished by apparatus that includes an air delivery system, wherein said pairs of values are determined by taking direct measures of pressure and airflow in said air delivery system at a point remote from said face mask, and calculating said pairs of values in accordance with physical characteristics of said air delivery system and said direct measures.

4. A method in accordance with claim 1, 2 or 3 wherein said time interval varies as a function of the rate at which the calculated leak conductance changes.

5. A method in accordance with claims 1, 2 or 3 wherein said time interval varies inversely with the rate at which the calculated leak conductance changes.

6. Apparatus for determining the instantaneous leak flow from a patient mask during mechanical ventilation comprising transducer means located at or approximate to the mask to determine instantaneous values for the pressure in the mask and the airflow through the mask;

and processor means for calculating the conductance of the leak as a function of said pressure and airflow values determined over a time interval exceeding that of a normal breath, and for calculating the instantaneous leak flow as a function of the calculated leak conductance and the instantaneously determined value of mask pressure.

7. The apparatus of claim 6 wherein said transducer means determines said instantaneous values by taking direct measures of mask pressure and airflow.

8. The apparatus of claim 7 wherein said processor means varies said time interval over which pressure and airflow values are used to determine leak conductance in accordance with the rate at which the calculated leak conductance changes.

9. The apparatus of claim 7 wherein said processor means varies said time interval over which pressure and airflow values are used to determine leak conductance inversely with the rate at which the calculated leak conductance changes.

10. Apparatus for providing mechanical ventilation for a patient comprising a flow generator for the supply of pressurized breathable gas;

a gas delivery system having connection with the flow generator;

a mask having connection with the gas delivery system to supply said gas to the airway of said patient;

transducer means continuously taking measurements from which the pressure in the mask and the airflow through the mask can be determined;

processor means calculating the conductance of any mask leak as a function of said mask pressure and airflow values determined over a time interval exceeding that of a normal breath, and for calculating the instantaneous leak flow as a function of the calculated leak conductance and the determined value of mask pressure; and

control means to adjust said flow generator to control at least one of mask pressure and mask airflow on the basis of the mask airflow and calculated leak flow.

11. The apparatus of claim 10 wherein the transducer means takes direct measures of mask pressure and airflow.

12. The apparatus of claim 10 wherein said transducer means takes direct measures of pressure and airflow in said gas delivery system at a point remote from the mask, and said processor means calculates mask pressure and airflow values in accordance with physical characteristics of said gas delivery system and said direct measures.

13. The apparatus of claim 11 or claim 12 wherein said processor means varies said time interval over which pressure and airflow values are used to determine leak conductance in accordance with the rate at which the calculated leak conductance changes.

14. The apparatus of claim 11 or claim 12 wherein said processor means varies said time interval over which pressure and airflow values are used to determine leak conductance inversely with the rate at which the calculated leak conductance changes.

15. A method for determining the instantaneous leak flow from a patient mask comprising the steps of determining instantaneous values for pressure in the mask and airflow through the mask;

calculating the conductance of the leak as a function of the average values of the respective pressure and airflow instantaneous values wherein said average values are taken over a period exceeding a normal breath; and

calculating the instantaneous leak flow as a function of the calculated leak conductance and the instantaneously determined value of mask pressure.

16. The method of claim 15 wherein the time interval over which pressure and airflow values are used to determine leak conductance is varied in accordance with the rate at which the calculated leak conductance changes.

17. The method of claim 15 wherein the time interval over which pressure and airflow values are used to determine leak conductance is varied inversely with the rate at which the calculated leak conductance changes.

18. A method of providing breathable gas for a patient comprising the steps of supplying pressurized breathable gas via a mask to the airway of said patient;

continuously taking measurements from which the pressure in the mask and the airflow through the mask can be determined;

calculating the conductance of any mask leak as a function of said mask pressure and airflow values determined over a time interval exceeding that of a normal breath, and calculating the instantaneous leak flow as a function of the calculated leak conductance and the determined value of mask pressure; and

adjusting the supply of said breathable gas in accordance with the mask airflow and calculated leak flow.

19. The method of claim 18 wherein direct measures of pressure and airflow are taken.

20. The method of claim 18 wherein direct measures of pressure and airflow are taken at a point remote from the mask, and mask pressure and airflow values are calculated in accordance with said direct measures and physical characteristics of the air delivery system over which said breathable gas is supplied to the airway of the patient.

21. The method of claim 19 or claim 20 wherein the time interval over which pressure and airflow values are used to determine leak conductance is varied in accordance with the rate at which the calculated leak conductance changes.

22. The method of claim 19 or claim 20 wherein the time interval over which pressure and airflow values are used to determine leak conductance is varied inversely with the rate at which the calculated leak conductance changes.

23. Apparatus for determining the instantaneous leak flow from a patient mask comprising means for determining instantaneous values for the pressure in the mask and the airflow through the mask;

means for calculating the conductance of the leak as a function of the average values of the respective pressure and airflow instantaneous values taken over a time period of more than a normal breath; and

means for calculating the instantaneous leak flow as a function of the calculated leak conductance and an instantaneously determined value of pressure in the mask.

24. Apparatus in accordance with claim 23 wherein the time interval over which pressure and airflow values are used to determine leak conductance is varied in accordance with the rate at which the calculated leak conductance changes.

25. Apparatus for determining the instantaneous leak flow from a patient mask comprising means for determining instantaneous values for pressure in the mask and airflow through the mask;

means for calculating the conductance of the leak as a function of the average values of the respective pressure and airflow instantaneous values; and

means for calculating the instantaneous leak flow as a function of the calculated leak conductance and an instantaneously determined value of pressure in the mask, wherein the time interval over which pressure and airflow values are used to determine leak conductance is varied inversely with the rate at which the calculated leak conductance changes.

26. Apparatus for providing breathable gas to a patient comprising means for supplying pressurized breathable gas via a mask to the airway of said patient;

means for continuously taking measurements from which the pressure in the mask and the airflow through the mask can be determined;

means for calculating the conductance of any mask leak as a function of said mask pressure and airflow values determined over a time interval exceeding that of a normal breath, and for calculating the instantaneous leak flow as a function of the calculated leak conductance and the determined value of mask pressure; and

means for adjusting the supply of said breathable gas in accordance with the mask airflow and calculated leak flow.

27. Apparatus in accordance with claim 26 wherein direct measures of pressure and airflow are taken.

28. Apparatus in accordance with claim 26 wherein direct measures of pressure and airflow are taken at a point remote from the mask, and mask pressure and airflow values are calculated in accordance with said direct measures and physical characteristics of said gas supplying means.

29. Apparatus in accordance with claim 27 or claim 28 wherein the time interval over which pressure and airflow values are used to determine leak conductance is varied in accordance with the rate at which the calculated leak conductance changes.

30. Apparatus in accordance with claim 28 or claim 29 wherein the time interval over which pressure and airflow values are used to determine leak conductance is varied inversely with the rate at which the calculated leak conductance changes.

31. A method for determining an instantaneous leak flow from a patient mask during mechanical ventilation comprising the step of:

(a) continuously determining values for pressure in the mask and airflow through the mask wherein said values are determined by taking direct measures of pressure and airflow;

(b) calculating conductance of a leak as a function of the values for pressure and airflow determined over a time interval wherein said time interval exceeds that of a normal breath and varies inversely with the rate at which the calculated leak conductance changes; and

(c) calculating the instantaneous leak flow as a function of the calculated leak conductance and an instantaneous determined value of mask pressure.

32. A method for determining an instantaneous leak flow from a patient mask during mechanical ventilation from an air delivery system comprising the steps of:

(a) continuously determining values for pressure in the mask and airflow through the mask wherein said values are determined by taking direct measures of pressure and airflow at a point remote from the mask and calculating said values in accordance with physical characteristics of the air delivery system and the direct measures;

(b) calculating conductance of a leak as a function of the values for pressure and airflow determined over a time interval wherein said time interval exceeds that of a normal breath and varies inversely with the rate at which the calculated leak conductance changes; and

(c) calculating the instantaneous leak flow as a function of the calculated leak conductance and an instantaneous determined value of mask pressure,

wherein said mechanical ventilation is accomplished by forcing air to flow through the air delivery system.

33. A method for determining the instantaneous leak flow from a patient mask comprising the steps of determining instantaneous values for pressure in the mask and airflow through the mask;

calculating the conductance of the leak as a function of the average values of the respective pressure and airflow instantaneous values; and

calculating the instantaneous leak flow as a function of the calculated leak conductance and an instantaneously determined value of mask pressure, wherein the time interval over which pressure and airflow values are used to calculate leak conductance is varied inversely with the rate at which the calculated leak conductance changes.