Carbon dioxide-sensing airway products and technique for using the same

• US 8,128,574 B2
• Filed: 09/25/2006
• Issued: 03/06/2012
• Est. Priority Date: 09/25/2006
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Baker, Clark R. Jr., Mecca, Roger, O'Neil, Michael P., Ostrowski, Rafael
• Primary Examiner(s): Mallari, Patricia
• Application Number:
  US11/526,844
• Publication Number:
  US 20080077034A1
• Time in Patent Office: 1,989 Days
• Field of Search: 600/532, 600/538, 128/200.24
• US Class Current: 600/529
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61M 16/0057 Pumps therefor
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0415 with access means to the stomach
• CPC Class Codes: A61M 16/042 with separate conduits for in-and expiration gas, e.g. for limited dead volume
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/0443 Special cuff-wall materials A61M16/0481, A61M16/0422 take precedence
• CPC Class Codes: A61M 16/0459 one cuff behind another
• CPC Class Codes: A61M 16/0475 having openings in the tube
• CPC Class Codes: A61M 16/0486 Multi-lumen tracheal tubes
• CPC Class Codes: A61M 16/08 Bellows; Connecting tubes having means for taking samples G01N1/22; Water traps; Patient circuits
• CPC Class Codes: A61M 2016/0413 with detectors of CO2 in exhaled gases
• CPC Class Codes: A61M 2016/103 the CO2 concentration
• CPC Class Codes: A61M 2230/40 Respiratory characteristics
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)

Abstract

An airway device is provided that may track the flow of respiratory gases through the device with sensing elements at a plurality of locations along the gas flow path of the device. Such a device may be useful for assessing a variety of clinical states, for adjusting patient ventilator settings, or for determining whether or not an airway device has been properly inserted into a patient airway.

Claims

1. A non-transitory computer readable medium with instructions embodied thereon for determining a change in a non-gas-exchanging physiologic volume in a ventilated patient comprising:

code for receiving signals from a first carbon dioxide sensor disposed at a first location on a patient breathing circuit and a second carbon dioxide sensor disposed at a second location on the patient breathing circuit;

code for determining a concentration of carbon dioxide gas over time at the first location;

code for determining a concentration of carbon dioxide gas over time at the second location;

code for determining a velocity of the carbon dioxide gas between the first location and the second location; and

code for determining a change in physiological dead space, wherein the change in physiological dead space is determined based on a volume of the breathing circuit between the first location and the second location, the concentration of carbon dioxide gas at the first location and the second location, and the velocity of the carbon dioxide gas between the first location and the second location.

2. The computer readable medium of claim 1, comprising code for determining from the change in the non-gas-exchanging physiologic volume that the patient has experienced a respiratory event.

3. The computer readable medium of claim 1, comprising code for determining from the change in the non-gas-exchanging physiologic volume that the patient has experienced a pulmonary embolism.

4. The computer readable medium of claim 1, comprising code for triggering an indicator if the change in the non-gas-exchanging physiologic volume is beyond a critical threshold.

5. The computer readable medium of claim 4, wherein the indicator comprises an alarm.

6. The computer readable medium of claim 4, wherein the indicator comprises instructions related to a treatment protocol.

7. The computer readable medium of claim 4, wherein the first location and the second location are on a tracheal tube.

8. A medical system adapted to determine a change in a non-gas-exchanging physiologic volume in a ventilated patient comprising:

a tracheal tube comprising a first carbon dioxide sensor disposed at a first location on the tracheal tube and a second carbon dioxide sensor disposed at a second location on the tracheal tube; and

a processor adapted to;

receive signals from the first carbon dioxide sensor and the second carbon dioxide sensor;

determine a concentration of carbon dioxide gas over time at the first location;

determine a concentration of carbon dioxide gas over time at the second location;

determine a velocity of the carbon dioxide gas between the first location and the second location; and

determine a change in physiological dead space, wherein the change in physiological dead space is determined based on a volume of the breathing circuit between the first location and the second location, the concentration of carbon dioxide gas at the first location and the second location, and the velocity of the carbon dioxide gas between the first location and the second location.

9. The medical system of claim 8, wherein the change in non-gas-exchanging physiologic volume comprises an increase in an estimated alveolar dead space.

10. The medical system of claim 9, wherein the estimated alveolar dead space is determined by a difference in an estimated physiologic dead space and an estimated anatomic dead space.

11. The medical system of claim 8, wherein the processor is configured to generate a capnogram on a display based at least in part on the concentration of carbon dioxide gas at the first location and the second location.

12. The medical system of claim 8, wherein determining the change in physiological dead space comprises determining a flow over time based on the velocity and a cross-sectional area of the tracheal tube.

13. The medical system of claim 12, wherein the volume is determined by integrating the flow over time.

14. The medical system of claim 8, wherein the system does not receive a signal from a flow sensor.

15. The medical system of claim 8, wherein the processor is adapted to determine from the change in the non-gas-exchanging physiologic volume that the patient has experienced a respiratory event.

16. The medical system of claim 8, wherein the processor is adapted to determine from the change in the non-gas-exchanging physiologic volume that the patient has experienced a pulmonary embolism.

17. The medical system of claim 8, wherein the processor is adapted to trigger an indicator if the change in the non-gas-exchanging physiologic volume is beyond a critical threshold.

18. The medical system of claim 17, wherein the indicator comprises an alarm.

19. The medical system of claim 18, wherein the alarm is an audio alarm or a visual alarm.

20. The medical system of claim 17, wherein the indicator comprises instructions related to a treatment protocol.