Method and apparatus for providing variable positive airway pressure

• US 6,752,151 B2
• Filed: 09/20/2001
• Issued: 06/22/2004
• Est. Priority Date: 09/25/2000
• Status: Expired due to Term

• Current Assignee: RIC INVESTMENTS LLC (Koninklijke Philips N.V.)
• Original Assignee: Respironics Incorporated (Koninklijke Philips N.V.)
• Inventors: Hill, Peter D.
• Primary Examiner(s): Dawson, Glenn K.
• Assistant Examiner(s): Erezo, Darwin P.
• Application Number:
  US09/957,057
• Publication Number:
  US 20020088465A1
• Time in Patent Office: 1,006 Days
• Field of Search: 128/204.18, 128/204.21, 128/204.23, 128/205.23
• US Class Current: 128/204.18
• 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 16/204 used for inhalation control
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2205/35 Communication

Abstract

A method and apparatus for treating a breathing disorder and, more particularly, a method and apparatus for providing a pressurized air flow to an airway of a patient to treat congestive heart failure in combination with Cheyne-Stokes respiration and/or sleep apnea or other breathing disorders. A positive airway pressure ventilator is utilized in combination with an algorithm that adjusts IPAP and EPAP in order to counter a Cheyne-Stokes breathing pattern. Cheyne-Stokes respiration is detected by monitoring a peak flow of the patient.

Claims

1. A system for delivering a flow of breathing gas to an airway of a patient, the system comprising:

a gas flow generating system that generates a flow of breathing gas;

a patient circuit coupled to the gas flow generating system and adapted to communicate the flow of breathing gas to an airway of a patient;

a flow sensor associated with the gas flow generating system or the patient circuit and adapted to measure the flow of breathing gas within the patient circuit and to transmit a flow signal indicative thereof;

CSR monitoring means, receiving the flow signal from the flow sensor, for (1) determining peak flows Q_{peak(current)} therefrom, and for determining whether such a patient'"'"'s respiratory activity is indicative of Cheyne-Stokes respiration based on the peak flow Q_{peak(current)}; and

controlling means for controlling the gas flow generating system so as to cause the breathing gas to be delivered at a sufficient pressure during at least a portion of a breathing cycle to threat Cheyne-Stokes respiration based on an output of the CSR monitoring means.

2. The system of claim 1, wherein the gas flow generating system includes:

a pressure generator adapted to generate the flow of breathing gas; and

a pressure control valve associated with the pressure generator or the patient circuit to control a pressure of the flow of breathing gas delivered to a patient by the patient circuit.

3. The system of claim 1, wherein the CSR monitoring means sets a value for a target peak flow Q_peak(target) based on whether such a patient'"'"'s respiratory activity is indicative of Cheyne-Stokes respiration, and wherein the controlling means compares the inspiratory peak flow Q_{peak(current)} to the target peak flow Q_peak(target), and causes the gas flow generating system to adjust an inspiratory positive airway pressure (IPAP) based on the comparison between the inspiratory peak flow Q_{peak(current)} and target peak flow Q_peak(target).

4. The system of claim 3, wherein the controlling means detects I/E transitions between an inspiratory phase and an expiratory phase of a respiratory cycle, and causes the gas flow generating system to deliver a machine breath responsive to a failure to detect an a patient initiated between within a predetermined period of time.

5. The system of claim 3, wherein the CSR monitoring means monitors the efficacy of the delivering of pressurized breathing gas in the treatment of central apnea and Cheyne-Stokes respiration.

6. The system of claim 5, wherein the CSR monitoring means adjusts the value of the target peak flow Q_peak(target), an expiratory positive airway pressure, or both, responsive to a determination that the delivering of pressurized breathing gas in the treatment is not effectively treating Cheyne-Stokes respiration.

7. The system of claim 1, wherein the CSR monitoring means determines magnitudes and times of inspiratory peaks flows and comparing these to a Cheyne-Stokes respiration pattern.

8. A method for delivering pressurized breathing gas to an airway of a patient, the method comprising the steps of:

delivering a flow of gas to the airway of the patient from a source of breathing gas via a patient circuit;

sensing a parameter indicative of a flow of gas within the patient circuit and outputting a flow signal;

determining peak flows Q_{peak(current)} in the flow of gas from the flow signal;

monitoring whether such a patient'"'"'s respiratory activity is indicative of Cheyne-Stokes respiration based on the peak flows Q_{peak(current)}; and

controlling the delivery of gas so as to cause the breathing gas to be delivered at a sufficient pressure during at least a portion of a breathing cycle to treat Cheyne-Stokes respiration based on the detected peak flows and a result of the monitoring step.

9. The method of claim 8, wherein delivering a flow of gas includes generating a flow of breathing gas via a pressure generator and controlling a pressure of the flow of gas via (1) a pressure control valve associated with the pressure generator or the patient circuit, (2) controlling an operating speed of the pressure generator, or (3) a combination of both (1) and (2).

10. The method of claim 8, wherein monitoring whether such a patient'"'"'s respiratory activity is indicative of Cheyne-Stokes respiration includes determining a target peak flow Q_peak(target), and wherein controlling the delivery of gas includes comparing the inspiratory peak flow Q_{peak(current)} to the target peak flow Q_peak(target), and adjusting an inspiratory positive airway pressure (IPAP) based on the comparison between the inspiratory peak flow Q_{peak(current)} and target peak flow Q_peak(target).

11. The method of claim 10, further comprising:

detecting I/E transitions between an inspiratory phase and an expiratory phase of a respiratory cycle; and

delivering a machine generated breath to a patient responsive to a failure to detect an a patient initiated between within a predetermined period of time.

12. The method of claim 10, wherein monitoring whether such a patient'"'"'s respiratory activity is indicative of Cheyne-Stokes respiration includes monitoring the efficacy of the delivering of pressurized breathing gas in the treatment of central apnea and Cheyne-Stokes respiration.

13. The method of claim 12, wherein monitoring whether such a patient'"'"'s respirtory activity is indicative of Cheyne-Stokes respiration includes adjusting the target peak flow Q_peak(target), an expiratory positive airway pressure, or both, responsive to a determination the delivering of pressurized breathing gas in the treatment is not effectively treating Cheyne-Stokes respiration.

14. The method of claim 8, wherein monitoring whether such a patient'"'"'s respiratory activity is indicative of Cheyne-Stokes respiration includes determining magnitudes and times of inspiratory peaks flows and comparing these to a Cheyne-Stokes respiration pattern.