Method for controlling a ventilator, and system therefor
First Claim
1. In a method for controlling a flow of breathing gas in a ventilator for assisted or controlled ventilation of a patient as a function of a tracheobronchial airway pressure of the patient, having one of a ventilator tube, a tracheal tube and a tracheostomy tube, which can be introduced into a trachea of the patient and can be subjected to the breathing gas and which has an inflatable cuff and at least one lumen that is continuous from a distal end of the ventilator tube to a proximal end of the ventilator tube, and wherein an airway pressure is detected, the improvement comprising:
- determining the tracheobronchial airway pressure by one of continuous and intermittent detection and evaluation of an intra-cuff pressure prevailing in the cuff of the tube inserted into the trachea, and controlling the flow of the breathing gas in the ventilator as a function of a detected intra-cuff pressure, determining a pressure difference (Δ
P) generated by the ventilator to overcome a flow resistance of the tube as a function of the pressure difference between the pressure at the proximal end of the tube and the tracheobronchial airway pressure at the distal end of the tube by measurement of the pressure at the proximal end of the tube and the intra-cuff pressure, and using a Δ
P to calculate a compensatory constant, and adapting dynamically the compensatory constant from one breathing stroke to another breathing stroke during respiration by the ventilator, to a respective current flow resistance of the tube.
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Accused Products
Abstract
A method for controlling breathing gas flow of a ventilator for assisted or controlled ventilation of a patient as a function of a tracheobronchial airway pressure of the patient. A ventilator tube, such as a tracheal tube or tracheostomy tube, can be introduced into a trachea of the patient and subjected to the breathing gas, and has an inflatable cuff and at least one lumen that is continuous from a distal end of the tube to a proximal end of the tube. An apparatus detects an airway pressure, in which the tracheobronchial airway pressure is ascertained by continuous or intermittent detection and evaluation of an intra-cuff pressure prevailing in the cuff of the tube inserted into the trachea. The breathing gas flow of the ventilator is controlled as a function of the intra-cuff pressure detected.
184 Citations
20 Claims
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1. In a method for controlling a flow of breathing gas in a ventilator for assisted or controlled ventilation of a patient as a function of a tracheobronchial airway pressure of the patient, having one of a ventilator tube, a tracheal tube and a tracheostomy tube, which can be introduced into a trachea of the patient and can be subjected to the breathing gas and which has an inflatable cuff and at least one lumen that is continuous from a distal end of the ventilator tube to a proximal end of the ventilator tube, and wherein an airway pressure is detected, the improvement comprising:
- determining the tracheobronchial airway pressure by one of continuous and intermittent detection and evaluation of an intra-cuff pressure prevailing in the cuff of the tube inserted into the trachea, and controlling the flow of the breathing gas in the ventilator as a function of a detected intra-cuff pressure, determining a pressure difference (Δ
P) generated by the ventilator to overcome a flow resistance of the tube as a function of the pressure difference between the pressure at the proximal end of the tube and the tracheobronchial airway pressure at the distal end of the tube by measurement of the pressure at the proximal end of the tube and the intra-cuff pressure, and using a Δ
P to calculate a compensatory constant, and adapting dynamically the compensatory constant from one breathing stroke to another breathing stroke during respiration by the ventilator, to a respective current flow resistance of the tube. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
- determining the tracheobronchial airway pressure by one of continuous and intermittent detection and evaluation of an intra-cuff pressure prevailing in the cuff of the tube inserted into the trachea, and controlling the flow of the breathing gas in the ventilator as a function of a detected intra-cuff pressure, determining a pressure difference (Δ
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18. In a method for controlling a flow of breathing gas in a ventilator for assisted or controlled ventilation of a patient as a function of a tracheobronchial airway pressure of the patient, having one of a ventilator tube, a tracheal tube and a tracheostomy tube, which can be introduced into a trachea of the patient and can be subjected to the breathing gas and which has an inflatable cuff and at least one lumen that is continuous from a distal end of the ventilator tube to a proximal end of the ventilator tube, and wherein an airway pressure is detected, the improvement comprising:
- determining the tracheobronchial airway pressure by one of continuous and intermittent detection and evaluation of an intra-cuff pressure prevailing in the cuff of the tube inserted into the trachea, and controlling the flow of the breathing gas in the ventilator as a function of a detected intra-cuff pressure, and during controlled respiration, using values obtained by measuring the intra-cuff pressure to control an upper pressure function of the upper pressure limit (Pmax) of the ventilator so that the ventilator on attaining a predetermined upper pressure one of switches off a delivery of the breathing gas and switches over to exhalation.
- View Dependent Claims (19)
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20. In a method for controlling a flow of breathing gas in a ventilator for assisted or controlled ventilation of a patient as a function of a tracheobronchial airway pressure of the patient, having one of a ventilator tube, a tracheal tube and a tracheostomy tube, which can be introduced into a trachea of the patient and can be subjected to the breathing gas and which has an inflatable cuff and at least one lumen that is continuous from a distal end of the ventilator tube to a proximal end of the ventilator tube, and wherein an airway pressure is detected, the improvement comprising:
- determining the tracheobronchial airway pressure by one of continuous and intermittent detection and evaluation of an intra-cuff pressure prevailing in the cuff of the tube inserted into the trachea, and controlling the flow of the breathing gas in the ventilator as a function of a detected intra-cuff pressure, measuring an esophageal balloon pressure in the balloon of the gastric probe introduced into the esophagus and transmitting second measured values from the balloon to one of the ventilator and a control device for the ventilator, and measuring values obtained by the esophageal balloon pressure and using the values to ascertain a respiratory work done by the patient, and from breathing strokes pressure-supported by the ventilator of respiratory cycles of fixed duration determining cyclical breathing work diagrams and displaying them on a monitor as one of loops and areas.
Specification