Apparatus and method for determining and displaying functional residual capacity data and related parameters of ventilated patients

• US 7,530,353 B2
• Filed: 02/21/2006
• Issued: 05/12/2009
• Est. Priority Date: 09/21/2005
• Status: Active Grant

• Current Assignee: General Electric Company
• Original Assignee: General Electric Company
• Inventors: Gosenheimer, Barbara M., Michell, Paul, Choncholas, Gary J.
• Primary Examiner(s): Douglas; Steven O
• Application Number:
  US11/358,855
• Publication Number:
  US 20070062529A1
• Time in Patent Office: 1,176 Days
• Field of Search: 128/204.18, 128/200.26, 128/204.22, 128/204.23, 128/200.15, 600/532, 600/529
• US Class Current: 128/204.18
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61M 11/00 Sprayers or atomisers specially adapted for therapeutic purposes in general B05B; aerosol containers B65D83/14
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0808 Condensation traps
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 16/085 Gas sampling
• CPC Class Codes: A61M 16/0858 Pressure sampling ports
• CPC Class Codes: A61M 16/1095 in the connecting tubes
• CPC Class Codes: A61M 16/12 by mixing different gases
• CPC Class Codes: A61M 16/16 Devices to humidify the respiration air A61M16/1045 takes precedence
• CPC Class Codes: A61M 16/204 used for inhalation control
• CPC Class Codes: A61M 16/205 used for exhalation control
• 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 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 in the expiratory circuit
• CPC Class Codes: A61M 2016/1025 the O2 concentration
• CPC Class Codes: A61M 2016/103 the CO2 concentration
• CPC Class Codes: A61M 2202/025 : Helium
• CPC Class Codes: A61M 2205/502 : User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/435 : partial O2 pressure (P-O2)

Abstract

A ventilator for ventilating a patient has means integrated therewith for carrying out a determination of the functional residual capacity of the patient using an inert gas wash in/wash out technique. To this end, the ventilator operates to alter the inert gas content of breathing gases provided to the patient. The amount of inert gas expired by the patient is obtained and used to determine functional residual capacity on a breath-by-breath basis. A graph of the functional residual capacities for a given number of breaths is produced. Thereafter, the inert gas levels in the breathing gases are returned to the original levels and further functional residual capacity determinations and a graph of same provided. The functional residual capacity information may also be provided in tabular form. A log of functional residual capacity determinations and ventilator settings or patient treatments affecting same may also be provided.

Claims

1. A ventilator for ventilating a patient and for carrying out a determination of the functional residual capacity of the patient, said ventilator being couplable to a breathing circuit having a gas monitor and delivering/receiving breathing gases to/from the patient, said ventilator comprising:

at least one gas flow control valve and controller for providing breathing gases containing oxygen and an inert gas to the breathing circuit for delivery to the patient; and

for causing the ventilator to alter the amount of oxygen in the breathing gases provided to the breathing circuit and patient;

a central processing unit incorporated in said ventilator for controlling said ventilator, said central processing unit employing the amount of inert gas expired by the patient obtained from measurements by the gas monitor following alteration of the amount of oxygen in the breathing gases to determine the functional residual capacity of the patient; and

a display coupled to said central processing unit for displaying information relating to the operation of the ventilator and the determined functional residual capacity.

2. The ventilator according to claim 1 wherein said central processing unit determines the functional residual capacity of the patient at the conclusion of each breath in a series of breaths.

3. The ventilator according to claim 2 wherein said display provides a graphic display of the functional residual capacity determined for each breath in a series of breaths as it is determined.

4. The ventilator according to claim 3 wherein said display provides a graph comprising a plot of functional residual capacity values and breath number.

5. The ventilator according to claim 2 wherein said display provides a table of breath numbers and functional residual capacity values.

6. The ventilator according to claim 1 wherein said display displays the determined functional residual capacity at the end of a series of breaths in tabular form.

7. The ventilator according to claim 1 wherein said at least one gas flow control valve and controller restores the amount of oxygen to an original level following the determination of functional residual capacity and wherein said control processing unit determines functional residual capacity when breathing gases of altered oxygen content are provided to the patient and thereafter determines functional residual capacity when breathing gases having the restored level of oxygen content are provided to the patient.

8. The ventilator according to claim 7 wherein said central processing unit determines the functional residual capacity of the patient at the conclusion of each breath of a series of breaths.

9. The ventilator according to claim 8 wherein said display provides a graphic display of the functional residual capacity sequentially determined for each breath of a series of breaths during the provision of breathing gases of altered oxygen content and during the provision of breathing gases having the restored level of oxygen content.

10. The ventilator according to claim 3 including a memory for storing earlier determinations of functional residual capacity and wherein said display graphically displays same, as a reference curve, with subsequent functional residual capacity determinations.

11. The ventilator according to claim 9 wherein said central processing unit determines functional residual capacity after each breath in a series of breaths and wherein said ventilator includes a memory for storing earlier determinations of functional residual capacity and wherein said display graphically displays same, as a reference curve, with subsequent functional residual capacity determinations.

12. The ventilator according to claim 7 wherein said display displays two values of functional residual capacity in tabular form if the difference in value for the two determinations of functional residual capacity is in excess of a predetermined amount.

13. The ventilator according to claim 1 wherein said display tabulates the functional residual capacity determination.

14. The ventilator according to claim 13 wherein said display tabulates the functional residual capacity determination with values of PEEPe and PEEPi.

15. The ventilator according to claim 2 wherein said display is further defined as providing a graphic display of the functional residual capacity determinations and wherein said graphic display has auto scaling.

16. The ventilator according to claim 1 wherein said display is further defined as tabulating the functional residual capacity determinations along with changes in ventilator settings and/or procedures that affect functional residual capacity, thereby to provide a functional residual capacity log.

17. The ventilator according to claim 1 wherein said display is further defined as displaying functional residual capacity determinations in conjunction with periodically obtained data of the operation of the ventilator and/or the ventilation of the patient.

18. The ventilator according to claim 17 wherein said display is further defined as displaying the information in tabular form.

19. The ventilator according to claim 17 wherein said display is further defined as displaying the information in graphic form.

20. The ventilator according to claim 1 wherein said at least one gas flow control valve and controller and said central processing unit terminate the provision of breathing gases with altered oxygen and the determination of functional residual capacity responsive to predetermined conditions or changes in the operation of the ventilator and/or predetermined conditions or changes in the treatment or ventilation of the patient.

21. The ventilator according to claim 1 further including control means for causing said at least one gas flow control valve and controller and said central processing unit to carry out their operation to determine functional residual capacity at periodic intervals.

22. The ventilator according to claim 21 wherein said control means is further defined as altering the periodic determination of functional residual capacity responsive to action by a clinician, to a predetermined event or circumstance, or to a change in ventilation setting.

23. The ventilator according to claim 21 wherein said display tabulates the functional residual capacity determinations.

24. The ventilator according to claim 23 wherein said display tabulates the functional residual capacity determination with PEEPe and PEEPi.

25. A ventilator according to claim 1 having means for generating and storing spirometry data of the breaths of a patient and means for generating spirometry data for a breath including a loop of lung pressure and tidal volume data and a dynostatic curve obtained from the loop, said display displaying the spirometry data.

26. A ventilator according to claim 25 wherein said display displays spirometry data for a plurality of breaths and the ventilator includes means for turning on/off the loops and/or curves of the spirometry data.

27. The ventilator according to claim 25 wherein said display has auto scaling.

28. A method for ventilating a patient with a ventilator and for carrying out a determination of the functional residual capacity of the patient, the ventilator being couplable to a breathing circuit having a gas monitor and delivering/receiving breathing gases to/from the patient, said method comprising the steps of:

(a) providing breathing gases containing oxygen and an inert gas to the breathing circuit for delivery to the patient;

(b) causing the ventilator to alter the amount of oxygen in the breathing gases provided to the breathing circuit and patient;

(c) obtaining the amount of inert gas expired by the patient from measurements by the gas monitor following alteration of the amount of oxygen in the breathing gases;

(d) determining the functional residual capacity of the patient based on the alteration in the amount of oxygen and the amount of expired inert gas using a central processing unit incorporated in the ventilator for controlling the ventilator; and

(e) displaying the determined functional residual capacity and information relating to the operation of the ventilator.

29. The method according to claim 28 wherein step (d) is further defined as determining the functional residual capacity of the patient at the conclusion of each breath of a series of breaths.

30. The method according to claim 29 wherein step (d) is further defined as determining the functional residual capacity over a predetermined number of breaths.

31. The method according to claim 29 wherein step (d) is further defined as terminating the determination of the functional residual capacity when the functional residual capacity measurement has become stable.

32. The method according to claim 31 further defined as including the step of measuring the composition of the breathing gases expired by the patient to determine when to terminate the determination of the functional residual capacity.

33. The method according to claim 29 wherein step (e) is further defined as providing a graphic display of the sequential functional residual capacity determinations for the breaths of a series of breaths.

34. The method according to claim 29 wherein step (e) is further defined as providing a graph comprising a plot of functional residual capacity and breath number.

35. The method according to claim 28 wherein step (e) is further defined as displaying the determined functional residual capacity at the end of a series of breaths in tabular form.

36. The method according to claim 28 wherein step (b) is further defined as causing the ventilator to provide one of an increase or decrease in the amount of oxygen in the breathing gases and thereafter restoring the amount of oxygen to an original level and wherein step (d) is further defined as determining functional residual capacity when breathing gases of increased or decreased oxygen content are provided to the patient and when breathing gases having the restored level of oxygen content are provided to the patient.

37. The method according to claim 29 wherein step (b) is further defined as causing the ventilator to provide one of an increase or decrease in the amount of oxygen in the breathing gases and thereafter restoring the amount of oxygen to an original level and wherein step (d) is further defined as determining functional residual capacity when breathing gases of increased or decreased oxygen content are provided to the patient and when breathing gases having the restored level of oxygen content are provided to the patient.

38. The method according to claim 33 including step (f) of storing earlier determinations of functional residual capacity and displaying same, as a reference curve, with subsequent functional residual capacity determinations.

39. The method according to claim 36 wherein step (e) is further defined as displaying two values of functional residual capacity in tabular form if the difference in values for the two determinations of functional residual capacity is in excess of a predetermined amount.

40. The method according to claim 28 wherein step (e) is further defined as tabulating the functional residual capacity determination.

41. The method according to claim 40 wherein step (e) is further defined as tabulating the functional residual capacity data with PEEPe and PEEPi.

42. The method according to claim 29 wherein step (e) is further defined as displaying the determined functional residual capacity as a graph having auto scaling.

43. The method according to claim 28 wherein step (e) is further defined as tabulating functional residual capacity determinations along with changes in ventilator settings and/or procedures that affect functional residual capacity, thereby to provide a functional residual capacity log.

44. The method according to claim 28 wherein step (e) is further defined as displaying functional residual capacity determination in conjunction with periodically obtained data of the operation of the ventilator and/or ventilation of the patient.

45. The method according to claim 44 wherein step (e) is further defined as displaying in tabular form.

46. The method according to claim 44 wherein step (e) is further defined as displaying in graphic form.

47. The method according to claim 28 wherein steps (b) and (d) are further defined as terminating the provision of breathing gases with altered oxygen and the determination of functional residual capacity responsive to predetermined conditions or changes in the operation of the ventilator and/or predetermined conditions or changes in the treatment or ventilation of the patient.

48. The method according to claim 28 further defined as repeating steps (b), (c), and (d) to determine functional residual capacity at periodic intervals.

49. The method according to claim 48 further defined as altering the periodic determination of functional residual capacity responsive to action by a clinician, to a predetermined event or circumstance, or to a change in ventilation setting.

50. The method according to claim 48 wherein step (e) is further defined as tabulating the functional residual capacity determinations.

51. The method according to claim 50 wherein step (e) is further defined as tabulating the functional residual capacity data with PEEPe and PEEPi.

52. A method for producing a display of functional residual capacity determinations and events affecting the functional residual capacity of a patient receiving mechanical ventilation, said method comprising the steps of:

determining the functional residual capacity of the patient at a sequence of points in time;

identifying the occurrence of selected events affecting the functional residual capacity of the patient including their nature and time of occurrence;

correlating the determinations of functional residual capacity and the event occurrences;

storing the determinations of functional residual capacity and event occurrences; and

displaying a chronological listing of functional residual capacity determinations and natures of functional residual capacity affecting events as a log.

53. The method of claim 52 wherein the selected events include actions relating to patient treatment and a change in ventilator setting.