Leak-compensated pressure regulated volume control ventilation

• US 8,973,577 B2
• Filed: 03/11/2013
• Issued: 03/10/2015
• Est. Priority Date: 03/20/2009
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Jafari, Mehdi M., Jimenez, Rhomere S., Upham, Gail F., Aviano, Jeffrey K.
• Primary Examiner(s): Anderson, Lynne
• Assistant Examiner(s): PHILIPS, BRADLEY H
• Application Number:
  US13/793,320
• Publication Number:
  US 20130186401A1
• Time in Patent Office: 729 Days
• Field of Search: 128/204.18, 128/204.21, 128/204.23, 128/200.24
• US Class Current: 128/204.21
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0057 Pumps therefor
• CPC Class Codes: A61M 16/0063 Compressors
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0666 Nasal cannulas or tubing devices for improving normal breathing through the nose A61F5/08; nose filters A62B23/06; outside holding devices A61M25/02
• CPC Class Codes: A61M 16/0875 Connecting tubes
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0033 electrical
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2230/46 Resistance or compliance of the lungs

Abstract

This disclosure describes systems and methods for compensating for leakage when during delivery of gas to a patient from a medical ventilator in a pressure regulated volume control (PRVC) ventilation mode. The technology described herein includes systems and methods that compensate the delivery of PRVC ventilation for leakage in the patient circuit by using leak-compensated lung flows as well as respiratory mechanics (lung compliance and lung resistance) estimated in a manner that compensates for elastic and inelastic leaks from the ventilation system.

Claims

1. A pressure support system comprising:

a pressure generating system adapted to generate a flow of breathing gas;

a ventilation tubing system including a patient interface device for connecting the pressure generating system to a patient;

one or more sensors operatively coupled to the pressure generating system or the ventilation tubing system, each sensor capable of generating an output indicative of a pressure or flow of the breathing gas in the ventilation tubing system;

a leak estimation module that identifies an elastic leakage in the ventilation tubing system as a first function of an output of at least one sensor and an inelastic leakage in the ventilation tubing system as a second function of an output of at least one sensor;

a delivered lung volume module that calculates a leak-compensated delivered lung volume for a first breath based on the leakage during the first breath and the flow of the breathing gas in the ventilation tubing system;

a respiratory mechanics calculation module that generates a leak-compensated lung compliance based on the leak-compensated delivered lung volume and at least one output indicative of a pressure of the breathing gas during the first breath; and

a pressure control module that causes the pressure generating system to deliver a second breath to the patient at a target pressure calculated based on the leak-compensated lung compliance and the leak-compensated delivered lung volume.

2. The system of claim 1 further comprising:

a memory storing a desired delivered lung volume provided by a user.

3. The system of claim 2 wherein the pressure regulated volume control module calculates the target pressure based on the desired delivered lung volume, the leak-compensated lung compliance and the leak-compensated delivered lung volume.

4. The system of claim 1 wherein the respiratory mechanics calculation module generates the leak-compensated lung compliance based on the leak-compensated delivered lung volume and a pressure difference.

5. The system of claim 4 wherein the pressure difference is a difference between an end inspiratory pressure of the first breath and an end expiratory pressure of the first breath.

6. The system of claim 1 wherein the delivered lung volume module calculates the leak-compensated delivered lung volume for a first breath based on the elastic and inelastic leakage during the first breath and the flow of the breathing gas in the ventilation tubing system.

7. A controller for a medical ventilator comprising:

a microprocessor;

a leak estimation module that identifies an instantaneous inelastic leakage in a ventilation tubing system as a first function of an output of at least one sensor; and

an instantaneous elastic leakage in the ventilation tubing system as a second function of an output of at least one sensor;

a module that calculates leak-compensated delivered lung volume and leak-compensated lung compliance based on the instantaneous elastic leakage and the instantaneous inelastic leakage of breathing gas from the ventilation tubing system; and

a pressure control module that provides pressure regulated volume control ventilation at a pressure determined based on the leak-compensated delivered lung volume and the leak-compensated lung compliance.

8. The controller of claim 7 further comprising:

a memory that stores an identification of a target volume of gas to be delivered during pressure regulated volume control ventilation; and

wherein the pressure control module provides pressure regulated volume control ventilation at a pressure determined based on the leak-compensated delivered lung volume, the leak-compensated lung compliance, and the target volume of gas.