Method for ventilation

• US 8,789,529 B2
• Filed: 07/28/2010
• Issued: 07/29/2014
• Est. Priority Date: 08/20/2009
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Vandine, Joseph D., Hyde, David, Sanborn, Warren G.
• Primary Examiner(s): Matter, Kristen
• Assistant Examiner(s): WARDAS, MARK A
• Application Number:
  US12/844,967
• Publication Number:
  US 20110041850A1
• Time in Patent Office: 1,462 Days
• Field of Search: 128/204.23, 128/204.18, 128/204.21, 128/204.26, 128/204.22, 600/529, 600/532, 600/533, 600/538
• US Class Current: 128/204.23
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• CPC Class Codes: A61M 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• CPC Class Codes: A61M 16/0051 with alarm devices
• 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 16/12 by mixing different gases
• CPC Class Codes: A61M 2016/0018 electrical
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/003 with a flowmeter
• CPC Class Codes: A61M 2016/0033 electrical
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2202/0266 Nitrogen (N)
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/42 Rate
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)

Abstract

The disclosure describes a method for automatically initiating ventilation, controlling ventilation, transitioning a ventilator to subject controlled ventilation, and weaning a subject from ventilation. The disclosure describes that the method for automatically initiating ventilation includes inputting a physical characteristic of the subject into a ventilator. The physical characteristic may be ideal body weight, height, or age. Based on the inputted physical characteristic, one or more ventilation parameters are calculated. The disclosure describes initiating ventilation based on the calculated parameters. During ventilation at least one physiological parameter of the subject is monitored. At least one ventilation parameter may be adjusted based on the monitoring of the physiological parameters and the inputted physical characteristic.

Claims

1. A method of automatically weaning a subject from a ventilator in volume support mode, comprising:

measuring at least one of end tidal exhaled carbon dioxide concentration (E_TCO₂), volume size of breath delivered to the subject (V_T) and breath frequency;

comparing at least one of measured E_TCO₂, V_T and breath frequency with predetermined E_TCO₂, V_T and breath frequency target ranges based on monitoring of subject parameters and an inputted ideal body weight (IBW) to determine if the subject is ready for weaning; and

if one or more of the measured E_TCO₂, V_T and breath frequency are within their respective target ranges for a predetermined period of time, determining that the subject is ready for weaning and then transitioning the ventilator from the volume support ventilation to pressure support ventilation to begin weaning.

2. The method of claim 1, wherein an initial pressure utilized in the pressure support ventilation is adjusted at a preset value below a target pressure utilized in said volume support ventilation.

3. The method of claim 2, further comprising reducing said initial pressure in a step wise manner over predetermined time intervals.

4. The method of claim 3, wherein said initial pressure is reduced by about 2 hPa over time intervals of about 15 minutes.

5. The method of claim 3, further comprising initiating a spontaneous breath trial.

6. The method of claim 5, wherein the subject maintains at least one physiological parameter at an acceptance criteria for a defined period of time during the spontaneous breath trial.

7. The method of claim 6, further comprising providing an alert that the subject can be withdrawn from mechanical ventilation.

8. The method of claim 5, further comprising adjusting ventilation parameters back to the volume support ventilation when the subject does not maintain at least one physiological parameter at an acceptable level for a defined period of time during the spontaneous breath trial.