Diagnosis and/or therapy using blood chemistry/expired gas parameter analysis

• US 7,970,470 B2
• Filed: 08/30/2004
• Issued: 06/28/2011
• Est. Priority Date: 09/18/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Hartley, Jesse W., Lee, Kent, Ni, Quan
• Primary Examiner(s): Patel; Niketa I
• Assistant Examiner(s): Lavert; Nicole F
• Application Number:
  US10/929,830
• Publication Number:
  US 20050065572A1
• Time in Patent Office: 2,493 Days
• Field of Search: 607 20- 22, 607/42, 600309-310, 600/345
• US Class Current: 607/22
• 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 16/0051 with alarm devices
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2230/202 partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/208 pH-value
• 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 2230/65 Impedance, e.g. conductivity, capacity
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood

Abstract

Methods and systems for diagnosing disorders, including, for example, disordered breathing, involve sensing one or more of a blood chemistry parameter and/or an expired gas parameter, such as expired respiratory gas concentration, blood gas concentration, and blood pH. Diagnosis of the disorder may be performed by a medical device, such as a respiratory therapy device or a cardiac therapy device, based on implantably detected blood gas/pH concentration/level or externally detected expired respiratory gas concentration. Cardiac and respiratory therapies for addressing the disorder may be adjusted based on the detected parameters.

Claims

1. A method of providing disordered breathing therapy for a patient whose respiration cycle includes inspiration and expiration intervals, comprising:

providing a patient-external respiratory therapy and a patient-internal cardiac therapy to a patient, the respiratory therapy being adapted to treat disordered breathing;

measuring an expired respiratory gas concentration of an expired respiratory gas sample acquired at the end of an expiration interval of the patient as determined by a timing element, the measured expired respiratory gas concentration representative of blood gas concentration;

determining one or more parameters influenced by disordered breathing, the one or more parameters comprising at least the expired respiratory gas concentration;

providing one or more parameter thresholds comprising at least an expired respiratory gas threshold; and

adjusting the respiratory therapy and the cardiac therapy based on the one or more parameters and the one or more parameter thresholds.

2. The method of claim 1, the one or more parameters further comprising blood pH measured by a sensor.

3. The method of claim 1, wherein determining the one or more parameters comprises determining the one or more parameters using one or more implantable sensors.

4. The method of claim 1, wherein determining the one or more parameters comprises determining the one or more parameters using one or more patient-external sensors.

5. The method of claim 1, wherein determining the one or more parameters comprises determining the one or more parameters using one or more implantable sensors and one or more patient-external sensors.

6. The method of claim 1, wherein adjusting the respiratory therapy comprises adjusting a positive airway pressure therapy.

7. The method of claim 1, wherein adjusting the cardiac therapy comprises adjusting a cardiac pacing therapy.

8. The method of claim 1, wherein determining the one or more parameters comprises determining one or both of expired oxygen concentration or carbon dioxide gas concentration.

9. The method of claim 1, wherein determining the one or more parameters comprises determining one or more of blood oxygen concentration, blood carbon dioxide concentration, or blood pH.

10. The method of claim 1, further comprising monitoring for a change in the one or more parameters.

11. The method of claim 10, wherein monitoring for the change in the one or more parameters comprises detecting a change in the one or more parameters indicative of hypoxemia.

12. The method of claim 10, wherein monitoring for the change in the one or more parameters comprises detecting a change in the one or more parameters indicative of apnea.

13. The method of claim 10, wherein monitoring for the change in the one or more parameters comprises detecting a change in the one or more parameters indicative of hypercapnea or hypocapnea.

14. The method of claim 1, wherein adjusting the respiratory therapy and the cardiac therapy comprises using the therapy controller of a patient-external system for adjusting one or both of the respiratory therapy and the cardiac therapy.

15. A method of providing disordered breathing therapy for a patient whose respiration cycle includes inspiration and expiration, comprising:

providing a patient-external respiratory therapy and a patient-internal cardiac therapy to a patient, the respiratory therapy being adapted to treat disordered breathing;

measuring an expired respiratory gas concentration of an expired respiratory gas sample acquired at the end of an expiration interval of the patient as determined by a timing element, the measured expired respiratory gas concentration representative of blood gas concentration;

determining one or more parameters influenced by disordered breathing, the one or more parameters comprising at least the expired respiratory gas concentration;

providing one or more parameter thresholds comprising at least an expired respiratory gas threshold; and

adjusting, using a therapy controller, the respiratory therapy and the cardiac therapy based on the one or more parameters and the one or more parameter thresholds.

16. The method of claim 15, wherein the one or more parameters further comprise blood gas concentration or blood pH.

17. The method of claim 15, wherein determining the one or more parameters comprises determining the one or more parameters using one or more implantable sensors.

18. The method of claim 15, wherein adjusting the respiratory therapy comprises adjusting a positive airway pressure therapy.

19. The method of claim 15, wherein adjusting the cardiac therapy comprises adjusting a cardiac pacing therapy.

20. The method of claim 15, wherein adjusting the respiratory therapy and the cardiac therapy comprises using the therapy controller of a patient-external system for adjusting one or both of the respiratory therapy and the cardiac therapy.

21. The method of claim 15, wherein determining the one or more parameters comprises determining one or more of expired oxygen concentration, carbon dioxide gas concentration, blood oxygen concentration, blood carbon dioxide concentration, and blood pH.

22. The method of claim 15, further comprising monitoring the one or more parameters and detecting a change in the one or more parameters indicative of at least one of hypoxemia, apnea, hypercapnea or hypocapnea.

23. A method of providing disordered breathing therapy for a patient whose breathing includes inspiration and expiration, comprising:

providing a patient-external respiratory therapy and a patient-internal cardiac therapy to a patient, the respiratory therapy being adapted to treat disordered breathing;

measuring an expired respiratory gas concentration of an expired respiratory gas sample acquired at the very end of the patient'"'"'s expiration just before inhalation starts as determined by a timing element, the measured expired respiratory gas concentration representative of blood gas concentration;

determining one or more parameters influenced by disordered breathing, the one or more parameters comprising at least the expired respiratory gas concentration;

providing one or more parameter thresholds comprising at least an expired respiratory gas threshold; and

adjusting, using a therapy controller disposed in an implantable housing, the respiratory therapy and the cardiac therapy based on the one or more parameters and the one or more parameter thresholds.

24. The method of claim 23, wherein the one or more parameters further comprise blood gas concentration or blood pH.

25. The method of claim 23, wherein determining the one or more parameters comprises determining the one or more parameters using one or more implantable sensors.

26. The method of claim 23, wherein adjusting the respiratory therapy comprises adjusting a positive airway pressure therapy.

27. The method of claim 23, wherein adjusting the cardiac therapy comprises adjusting a cardiac pacing therapy.

28. The method of claim 23, wherein adjusting the respiratory therapy and the cardiac therapy comprises using the therapy controller of a patient-external system for adjusting one or both of the respiratory therapy and the cardiac therapy.

29. The method of claim 23, wherein determining the one or more parameters comprises determining one or more of expired oxygen concentration, carbon dioxide gas concentration, blood oxygen concentration, blood carbon dioxide concentration, and blood pH.

30. The method of claim 23, further comprising monitoring the one or more parameters and detecting a change in the one or more parameters indicative of at least one of hypoxemia, apnea, hypercapnea or hypocapnea.