Ventilator monitor system and method of using same

• US 7,210,478 B2
• Filed: 09/28/2004
• Issued: 05/01/2007
• Est. Priority Date: 06/30/1999
• Status: Expired due to Term

• Current Assignee: University of Florida Research Foundation, Incorporated (State University System of Florida)
• Original Assignee: University of Florida Research Foundation, Incorporated (State University System of Florida)
• Inventors: Euliano, Neil Russell II, Principe, Jose C., Banner, Michael J., Blanch, Paul B.
• Primary Examiner(s): Patel; Mital
• Application Number:
  US10/953,019
• Publication Number:
  US 20050098178A1
• Time in Patent Office: 945 Days
• Field of Search: 128/204.18, 128/204.21, 128/204.22, 128/204.23, 128/202.22, 128/205.23, 128/920, 128/923, 128/924, 128/925
• US Class Current: 128/204.23
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• 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: A61B 5/7267 involving training the classification device
• CPC Class Codes: A61M 16/0051 with alarm devices
• 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 16/12 by mixing different gases
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2205/3553 remote, e.g. between patient's home and doctor's office
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/30 Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/435 partial O2 pressure (P-O2)
• CPC Class Codes: A61M 2230/50 Temperature
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: Y10S 128/924 : using artificial intelligence
• CPC Class Codes: Y10S 128/925 : Neural network

Abstract

Embodiments of the present invention described and shown in the specification and drawings include a system and method for monitoring the ventilation support provided by a ventilator that is supplying a breathing gas to a patient via a breathing circuit that is in fluid communication with the lungs of the patient.

Claims

1. A method for monitoring ventilatory support for a patient having an airway, wherein said method comprises:

(1) providing a monitoring system comprising;

(a) at least one sensor adapted to monitor the patient, or to monitor a breathing circuit coupled to the airway of the patient, each sensor generating an output signal, and

(b) a processing subsystem adapted to receive the at least one of the output signals,

wherein the processing subsystem has a processor and a memory and is adapted to run under control of a program stored in the memory, wherein the processing subsystem evaluates at least one output signal to determine a desired setting for at least one ventilation parameter;

(2) receiving into the processing subsystem at least one of the output signals;

(3) implementing the processing subsystem to evaluate the at least one output signal to assess the ventilatory support provided to the patient; and

(4) recommending, without the need for clinician input, the desired setting for at least one ventilation parameter based on the evaluation of the at least one output signal by the processing subsystem.

2. The method of claim 1, further comprising providing a ventilator adapted to supply a gas to a patient via a breathing circuit in fluid communication with at least one lung of the patient, wherein the ventilator is operatively connected to the processing subsystem, and wherein the ventilator includes a plurality of ventilator setting controls, wherein each ventilator setting control controls a parameter relating to the supply of gas from the ventilator to the patient.

3. The method of claim 2, further comprising:

causing the ventilator to generate at least one ventilator setting signal indicative of the current level setting of at least one ventilator setting control for a ventilation parameter related to the supply of gas from the ventilator to the patient; and

providing the ventilator setting signal to the processing subsystem, wherein the processing subsystem evaluates the at least one output signal and the ventilator setting signal to determine the desired setting.

4. The method of claim 3, wherein the at least one ventilator setting signal includes at least one of the group consisting of:

a minute ventilation (V_E) signal;

a ventilator breathing frequency (f) signal;

a tidal volume (V_T) signal;

a breathing gas flow rate (V) signal;

a pressure limit signal;

a work of breathing (WOB) signal;

a pressure support ventilation (PSV) signal;

a positive end expiratory pressure (PEEP) signal;

a continuous positive airway pressure (CPAP) signal; and

a fractional inhaled oxygen concentration (FIO2) signal.

5. The method of claim 2, further comprising adjusting at least one of the plurality of ventilator setting controls based on the setting determined in the recommending step.

6. The method of claim 2, further comprising displaying whether said at least one desired setting is different from the ventilator setting control(s).

7. The method of claim 2, wherein the processing subsystem is adapted to determine whether the desired setting is different from the ventilator setting control(s).

8. The method of claim 1, wherein said output signals are selected from the group consisting of:

an exhaled carbon dioxide signal indicative of the exhaled carbon dioxide (ExCO2) level of the exhaled gas expired by the patient within the breathing circuit;

a flow rate signal indicative of the flow rate (V) of the inhaled/exhaled gas expired by the patient within the breathing circuit;

a pulse oximeter hemoglobin oxygen saturation (SpO2) signal indicative of the oxygen saturation level of the patient;

a pressure (P) signal indicative of the pressure of the breathing gas within the breathing circuit;

a blood pressure (BP) signal indicative of the blood pressure of the patient; and

a temperature (T) signal indicative of the core body temperature of the patient.

9. The method of claim 8, wherein the output signals also include at least one of the group consisting of:

an arterial blood gas PaO2 signal;

an arterial blood gas PaCO2 signal; and

an arterial blood gas pH signal.

10. The method of claim 1, further comprising:

selecting output signals for display; and

displaying the selected output signals in real time.

11. The method of claim 1, further comprising displaying the desired setting(s).

12. The method of claim 1, wherein the processing subsystem comprises a neural network, and wherein recommending the settings of the ventilator setting controls of the ventilator comprises applying at least a portion of the output signals and the ventilator setting signal(s) to the neural network of the processing subsystem to determine the desired setting(s) of the ventilator setting controls.

13. The method of claim 1, wherein the processing subsystem further comprises a feature extraction subsystem.

14. The method of claim 1, wherein the processing subsystem further comprises an intelligence subsystem.

15. The method of claim 14, wherein the processing subsystem comprises at least one-rule-based module.

16. The method of claim 1, wherein said at least one desired setting optimizes one of the following selected from the group consisting of:

patient ventilation, oxygenation, and breathing effort.

17. A monitoring system comprising:

at least one sensor adapted to monitor a patient, or to monitor a breathing circuit coupled to an airway of a patient, wherein each sensor generates an output signal; and

a processing subsystem adapted to receive at least one of the output signals, wherein the processing subsystem has a processor and a memory, the processor adapted to run under the control of a program stored in the memory, wherein the processing subsystem evaluates at least one output signal to determine the desired setting for at least one ventilation parameter.

18. The system of claim 17, further comprising a ventilator operatively coupled to the processing subsystem, wherein the ventilator is adapted to supply a gas to a patient via a breathing circuit in fluid communication with at least one lung of the patient, wherein the ventilator includes at least one ventilator setting control, and wherein each ventilator setting control controls a parameter relating to the supply of gas from the ventilator to the patient.

19. The system of claim 18, wherein the ventilator is adapted to generate a ventilator setting signal indicative of a current setting of said at least one ventilator setting control, and wherein the processing subsystem evaluates the at least one output signal and the ventilator setting signal to determine the desired setting(s).

20. The system of claim 19, wherein said at least one ventilator setting signal comprises at least one of the group consisting of:

a minute ventilation (V_E) signal;

a ventilator breathing frequency (f) signal;

a tidal volume (V_T) signal;

a breathing gas flow rate (V) signal;

a pressure limit signal;

a work of breathing (WOB) signal;

a pressure support ventilation (PSV) signal;

a positive end expiratory pressure (PEEP) signal;

a continuous positive airway pressure (CPAP) signal; and

a fractional inhaled oxygen concentration (FIO2) signal.

21. The system of claim 18, further comprising an alarm for notifying an operator of the ventilator that the setting of at least one of the ventilator setting controls differs from the desired setting(s).

22. The system of claim 18, wherein the processing subsystem can select and adjust the setting of said ventilator setting control;

and wherein the level setting of said ventilator setting control is adjusted based on a result of the evaluation of the at least one output signal.

23. The system of claim 19, wherein the processing subsystem is adapted to determine whether the current setting of said at least one ventilator setting control is different from the desired setting.

24. The system of claim 18, further comprising a display, wherein the processing subsystem provides to the display whether said at least one desired setting is different from the ventilator setting control(s).

25. The system of claim 17, wherein said at least one ventilation parameter is selected from the group consisting of:

a flow rate (V) of the exhaled gas inspired/expired by the patient within the breathing circuit;

exhaled carbon dioxide (Ex CO2) level of the exhaled gas expired by the patient within the breathing circuit;

hemoglobin oxygen saturation (SPO2) level of the patient;

pressure (P) of the breathing gas within the breathing circuit;

blood pressure (BP) of the patient; and

core body temperature (T) of the patient.

26. The system of claim 25, wherein said at least one ventilation parameter also includes at least one of the group consisting of:

an arterial blood gas PaO2 level of the patient;

an arterial blood gas PaCO2 level of the patient; and

an arterial blood gas pH level of the patient.

27. The system of claim 17, wherein the processing subsystem further comprises a feature extraction subsystem.

28. The system of claim 17, wherein said at least one desired setting optimizes one of the following selected from the group consisting of:

patient ventilation, oxygenation, and breathing effort.

29. The system of claim 17, further comprising a display, wherein the processing subsystem provides to the display the desired setting(s).

30. The system of claim 17, wherein the processing subsystem further comprises an intelligence subsystem.

31. The system of claim 30, wherein:

the intelligence subsystem comprises at least one neural network.

32. The system of claim 31, wherein the intelligence subsystem comprises at least one rule-based module.

33. The system of claim 31, wherein the intelligence subsystem has means for training the neural network.