Method and apparatus for determining instantaneous inspired volume of a subject during ventilatory assistance

• US 7,137,389 B2
• Filed: 03/15/2004
• Issued: 11/21/2006
• Est. Priority Date: 09/23/1996
• Status: Expired due to Fees

• Current Assignee: Resmed Limited (ResMed Incorporated)
• Original Assignee: Resmed Limited (ResMed Incorporated)
• Inventors: Berthon-Jones, Michael
• Primary Examiner(s): Lewis, Aaron J.
• Application Number:
  US10/801,259
• Publication Number:
  US 20040173212A1
• Time in Patent Office: 981 Days
• Field of Search: 128/200.24, 128/204.18, 128/204.21, 128/204.23, 700/50, 706/1, 706 7- 9
• US Class Current: 128/204.18
• CPC Class Codes: A61B 5/085 Measuring impedance of respiratory organs or lung elasticity
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• 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 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• 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 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/1055 bacterial
• CPC Class Codes: A61M 16/107 in the inspiratory path
• 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 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

The apparatus provides for the determination of the instantaneous phase in the respiratory cycle, subject'"'"'s average respiration rate and the provision of ventilatory assistance. A microprocessor (16) receives an airflow signal from a pressure transducer (18) coupled to a port (17) at a mask (11). The microprocessor (16) controls a servo (19), that in turn controls the fan motor (20) and thus the pressure of air delivered by the blower (10). The blower (10) is coupled to a subject'"'"'s mask (ii) by a conduit (12). The invention seeks to address the following goals: while the subject is awake and making substantial efforts the delivered assistance should be closely matched in phase with the subject'"'"'s efforts; the machine should automatically adjust the degree of assistance to maintain at least a specified minimum ventilation without relying on the integrity of the subject'"'"'s chemoreflexes; and it should continue to work correctly in the presence of large leaks.

Claims

1. A method for determining an instantaneous inspired volume of a subject during ventilatory assistance for use in a ventilator device comprising the steps of:

determining a measure of respiratory airflow of the patient;

calculating an index equal to the fuzzy extent to which a leak is changing based at least in part on the measure of respiratory airflow; and

calculating instantaneous inspired volume as a function of both the measure of respiratory airflow and said index.

2. The method of claim 1, in which said function is the time integral of the product of said index and the measure of respiratory airflow.

3. The method of claim 1 wherein said fuzzy extent to which a leak is changing is calculated as the fuzzy extent to which a measure of respiratory airflow is large for longer than expected.

4. The method of claim 1 wherein said fuzzy extent to which a leak is changing is a function of the fuzzy extent to which the leak has suddenly increased and the fuzzy extent to which the leak has suddenly decreased.

5. The method of claim 4 wherein the function is the fuzzy negation of a peak of a fuzzy union of said fuzzy extent to which the leak has suddenly increased and said fuzzy extent to which the leak has suddenly decreased.

6. The method of claim 4 wherein said fuzzy extent to which the leak has suddenly increased is the fuzzy intersection of the fuzzy extent to which a measure of respiratory airflow has been positive for longer than expected and the fuzzy extent to which a measure of respiratory airflow is large and positive.

7. The method of claim 1 wherein said fuzzy extent to which the leak has suddenly decreased is the fuzzy intersection of the fuzzy extent to which a measure of respiratory airflow has been negative for longer than expected and the fuzzy extent to which a measure of respiratory airflow is large and negative.

8. A method for determining the instantaneous inspired volume of a subject during ventilatory assistance for use in a ventilator device comprising the steps of:

determining a measure of airflow from the subject;

calculating an index equal to the fuzzy extent to which the impedance of a leak is changing based at least in part on the measure of airflow; and

calculating instantaneous inspired volume as a function of both the measure of airflow and said index.

9. The method of claim 8, in which said function is the time integral of the product of said index and the measure of airflow.

10. An apparatus for determining a calculation of instantaneous inspired volume of a subject comprising:

a means for determining, an estimate of the patient'"'"'s respiratory airflow; and

a means for calculating instantaneous inspired volume from said respiratory airflow;

wherein the means for calculating instantaneous inspired volume from said respiratory airflow includes coded machine control instructions to calculate said instantaneous inspired volume as a function of both the respiratory airflow and an index equal to the fuzzy extent to which a leak is changing.

11. The apparatus of claim 10 wherein said fuzzy extent to which a leak is changing is calculated as the fuzzy extent to which the respiratory airflow is large for longer than expected.

12. The apparatus of claim 10 wherein said function is the time integral of the product of said index and said respiratory airflow.

13. An apparatus for determining a calculation of an instantaneous inspired volume of a subject during pressure support assistance comprising:

a mask;

a blower to supply pressurized air to said mask;

a servo-controller coupled to said blower;

a transducer to generate a flow signal representing at least in part respiratory airflow; and

a processor, coupled to said transducer and said servo-controller, with programmed instructions;

wherein the instructions calculate instantaneous inspired volume as a function of both a measure of respiratory airflow from the flow signal and an index equal to the fuzzy extent to which a leak is changing.

14. The apparatus of claim 13 wherein said fuzzy extent to which a leak is changing is calculated as the fuzzy extent to which the respiratory airflow is large for longer than expected.

15. The apparatus of claim 13 wherein said function is the time integral of the product of said index and said respiratory airflow.

16. The apparatus of claim 13 wherein said fuzzy extent to which a leak is changing is a function of the fuzzy extent to which the leak has suddenly increased and the fuzzy extent to which the leak has suddenly decreased.

17. An apparatus for determining a calculation of an instantaneous inspired volume of a subject during pressure support assistance comprising:

a mask;

a blower to supply pressurized air to said mask;

a servo-controller coupled to said blower;

a transducer to generate a flow signal; and

a processor, coupled to said transducer and said servo-controller,

wherein the processor is configured and adapted for calculating instantaneous inspired volume as a function of both data from the flow signal and an index equal to the fuzzy extent to which a leak is changing.

18. The apparatus of claim 17 wherein said fuzzy extent to which a leak is changing is calculated as the fuzzy extent to which data from the flow signal is large for longer than expected.

19. The apparatus of claim 17 wherein said function is the time integral of the product of said index and said data from the flow signal.

20. The apparatus of claim 17 wherein said fuzzy extent to which a leak is changing is a function of the fuzzy extent to which the leak has suddenly increased and the fuzzy extent to which the leak has suddenly decreased.