Methods and apparatus for stroke patient treatment

• US 7,942,823 B2
• Filed: 01/25/2006
• Issued: 05/17/2011
• Est. Priority Date: 12/11/2000
• Status: Active Grant

• Current Assignee: ResMed Pty Ltd. (ResMed Incorporated)
• Original Assignee: Resmed Limited (ResMed Incorporated)
• Inventors: Ujhazy, Anthony John, Hansford, Alison Mary, Wright, Jonathan Caldwell
• Primary Examiner(s): Marmor, II; Charles A
• Assistant Examiner(s): Natnithithadha; Navin
• Application Number:
  US11/339,908
• Publication Number:
  US 20060135878A1
• Time in Patent Office: 1,938 Days
• Field of Search: 600529-543, 600/484, 128/204.18, 128/204.21, 128/204.23
• US Class Current: 600/538
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/1455 using optical sensors, e.g. spectral photometrical oximeters
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61M 16/0066 Blowers or centrifugal pumps
• 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 16/085 Gas sampling
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/63 Motion, e.g. physical activity

Abstract

Methods and apparatus for assessing the condition of and treating patients for stroke during the delivery of continuous positive airway pressure (CPAP) are disclosed. By determining central and obstructive apnea occurrences or the percentile of pressure delivered to the patient from patient airflow, stroke indicators may be calculated and analyzed to provide information on the type of stroke a patient has suffered and the degree of a patient'"'"'s neuro-recovery. The apparatus may be programmed with a particular protocol intended to identify between alternative forms of CPAP treatment appropriate for the patient based upon an assessment of the patient'"'"'s condition. The device can select and recommend between the various treatment forms, identify billing reimbursement codes and generate data to track patient response to stroke treatments.

Claims

1. A method for evaluating the condition of a patient after stroke comprising the steps of:

delivering breathable gas at a pressure above atmospheric to a patient after stroke;

measuring the airflow of said patient; and

determining, using a computer, a stroke indicator from said airflow, said stroke indicator representing information about the patient'"'"'s stroke condition.

2. The method of claim 1 wherein said determining step includes analyzing said airflow to determine an occurrence of central apnea and said stroke indicator is calculated as a function of said occurrence of central apnea.

3. The method of claim 2 wherein said determining step includes analyzing said airflow to determine an occurrence of obstructive apnea and said stroke indicator is calculated as a function of said occurrence of obstructive apnea.

4. The method of claim 1 further comprising the step of evaluating changes in said stroke indicator to assess the efficacy of an administered drug.

5. The method of claim 4 wherein said step of evaluating said stroke indicator includes storing said stroke indicator in a database of patient information.

6. The method of claim 5 wherein said stroke indicator is a function of a number of occurrences of central apnea.

7. The method of claim 6 wherein said stroke indicator is a function of a number of occurrences of obstructive apnea.

8. A method for evaluating the condition of a patient after stroke in accordance with claim 1 further comprising the steps of:

determining the number of central and obstructive apneas which the patient has during a first time period; and

calculating a stroke indicator index from a comparison of the number of central and obstructive apneas which the patient has during the first time period, said stroke indicator representing information about the patient'"'"'s rehabilitation from stroke.

9. An apparatus for evaluating the condition of a patient after stroke comprising:

a source for delivering breathable gas at a pressure above atmospheric to a patient after stroke;

a sensor for measuring the airflow of said patient; and

means for determining a stroke indicator from said airflow, said stroke indicator representing information about the patient'"'"'s stroke condition.

10. An apparatus for evaluating the condition of a patient after stroke in accordance with claim 9 wherein said determining means analyzes said airflow to determine occurrences of central apneas and said stroke indicator is determined as a function of said occurrences of central apneas.

11. An apparatus for evaluating the condition of a patient after stroke in accordance with claim 10 wherein said determining means analyzes said airflow to determine occurrences of obstructive apneas and said stroke indicator is determined as a function of said occurrences of obstructive apneas.

12. An apparatus for evaluating the condition of a patient after stroke in accordance with claim 9 wherein said determining means further evaluates changes in said stroke indicator to assess the efficacy of an administered drug.

13. An apparatus for evaluating the condition of a patient after stroke in accordance with claim 12 wherein said determining means further stores the evaluated stroke indicator in a database of patient information.

14. An apparatus for evaluating the condition of a patient after stroke in accordance with claim 13 wherein said stroke indicator is evaluated as a function of a number of occurrences of central apneas.

15. An apparatus for evaluating the condition of a patient after stroke in accordance with claim 14 wherein said stroke indicator is evaluated as a function of a number of occurrences of obstructive apneas.

16. An apparatus for evaluating the condition of a patient after stroke in accordance with claim 9 further comprising

effort sensor means for measuring the respiratory effort of the patient;

and wherein said determining means monitors the airflow and effort sensor means to determine a number of central and obstructive apneas which the patient has during a first time period, and calculates said stroke indicator from a comparison of the number of central and obstructive apneas which the patient has during the first time period, said stroke indicator representing information about the patient'"'"'s recovery from stroke.

17. The apparatus for evaluating the condition of a patient after stroke in accordance with claim 16 wherein the effort sensor means is a respiratory band.