System for managing ventilator operation

• US 9,233,222 B2
• Filed: 06/27/2007
• Issued: 01/12/2016
• Est. Priority Date: 11/12/2003
• Status: Active Grant

• Current Assignee: Dragerwerk AG & Company KGaA (FPS Vermögensverwaltung GmbH)
• Original Assignee: Draeger Medical Systems Incorporated (FPS Vermögensverwaltung GmbH)
• Inventors: Elaz, Joseph, Scholz, Wolfgang, Cavallaro, Samuel, Butterbrodt, Jay, Ralfs, Frank
• Primary Examiner(s): Yu, Justine
• Assistant Examiner(s): Stuart, Colin W
• Application Number:
  US11/769,373
• Publication Number:
  US 20080000479A1
• Time in Patent Office: 3,121 Days
• Field of Search: 128/204.21, 128/204.23, 128/200.24, 128/204.18
• US Class Current: 1/1
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• 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 16/0066 Blowers or centrifugal pumps
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/10 Preparation of respiratory gases or vapours
• CPC Class Codes: A61M 16/1005 with O2 features or with parameter measurement
• CPC Class Codes: A61M 16/16 Devices to humidify the respiration air A61M16/1045 takes precedence
• CPC Class Codes: A61M 2205/33 Controlling, regulating or measuring
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 2205/3327 Measuring
• CPC Class Codes: A61M 2205/3561 local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/8206 battery-operated
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 2230/10 : Electroencephalographic signals
• CPC Class Codes: A61M 2230/205 : partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/30 : Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/42 : Rate
• CPC Class Codes: A61M 2230/60 : Muscle strain, i.e. measured on the user
• CPC Class Codes: G16H 20/17 : delivered via infusion or injection
• CPC Class Codes: G16H 30/20 : for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/63 : for local operation
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A method for managing patient ventilator operation includes receiving data representing one or more hemodynamic parameters. In response to the received data representing the one or more hemodynamic parameters, one or more commands are provided for adaptively altering ventilator operation.

Claims

1. A method for managing patient ventilator operation, comprising the activities of:

performing a ventilation maneuver using a patient treatment module;

receiving by a patient monitoring module data from at least one parameter sensor, said data representing at least one of arterial blood pressure, cardiac output, and ST segment level of a patient;

calculating a percent fall between first sensed data representing at least one of the arterial blood pressure and cardiac output and subsequent sensed data corresponding to the at least one of the arterial blood pressure and cardiac output using a central processor communicating and controlling the patient monitoring module and the patient treatment module;

comparing the percent fall to at least one of a selected first percentage threshold corresponding to arterial blood pressure and a selected second percentage threshold corresponding to cardiac output using the central processor;

in response to at least one of a fall in said arterial blood pressure exceeding the selected first percentage threshold and a fall in said cardiac output exceeding the selected second percentage threshold, analyzing ST segment level of the patient using the central processor;

in response to said ST segment level indicating no heart damage, using the central processor to adaptively alter at least one of the selected first percentage threshold and the selected second percentage threshold to a selected third percentage threshold that is greater than the selected first percentage threshold or a selected fourth percentage threshold that is greater than the selected second percentage threshold; and

in response to said ST segment level indicating possible heart damage, using the central processor to adaptively alter said ventilation maneuver.

2. The method of claim 1, wherein said adaptively altering said ventilation maneuver comprises at least one of (a) terminating the ventilation maneuver, (b) altering respiratory volume, and (c) altering respiratory pressure.

3. The method of claim 1, wherein said data representing at least one of arterial blood pressure, cardiac output, and ST segment level of a patient is averaged.

4. The method of claim 1, further comprising:

generating an alarm in response to the received data representing at least one of arterial blood pressure, cardiac output, and ST segment level of a patient.

5. The method of claim 1, wherein the ventilator maneuver is at least one of a recruitment maneuver and a low flow positive ventilation (PV) maneuver.

6. The method of claim 5, wherein the recruitment maneuver is selected from the group consisting of at least one of regular sighs, sustained inflations, successively increased positive end expiratory pressure (PEEP), and successively increased inspiratory pressure.

7. The method of claim 1, wherein said step of adaptively altering said ventilation maneuver comprises limiting the ventilation maneuver at a rate based on a degree of estimated heart damage as indicated by said ST segment level.

8. A method for managing patient ventilator operation comprising:

performing a ventilation maneuver using a patient treatment module;

receiving by a patient monitoring module data from at least one sensor representing arterial blood pressure;

receiving by the patient monitoring module data from said at least one sensor representing cardiac output;

calculating a percent fall between first sensed data representing at least one of the arterial blood pressure and the cardiac output and subsequent sensed data corresponding to the at least one of the arterial blood pressure and the cardiac output using a central processor communicating and controlling the patient monitoring module and the patient treatment module;

comparing the percent fall to at least one of a selected first percentage threshold corresponding to arterial blood pressure and a selected second percentage threshold corresponding to cardiac output using the central processor communicating and controlling the patient monitoring module and the patient treatment module;

in response to the at least one of a fall in said arterial blood pressure exceeding the selected first percentage threshold and a fall in said cardiac output exceeding the selected second percentage threshold, analyzing received ST segment level of a patient using the central processor;

in response to said ST segment level indicating no heart damage, using the central processor to adaptively alter at least one of the selected first percentage threshold and the selected second percentage threshold to a selected third percentage threshold that is greater than the selected first percentage threshold or a selected fourth percentage threshold that is greater than the selected second percentage threshold; and

in response to said ST segment level indicating possible heart damage, using the central processor to limit said ventilation maneuver at a rate based on a degree of estimated heart damage indicated by said ST segment level.

9. The method of claim 8, wherein at least one of the data representing the arterial blood pressure and the data representing the cardiac output is averaged.

10. The method of claim 8, further comprising:

generating an alarm in response to the received data representing at least one of arterial blood pressure and cardiac output.

11. The method of claim 8, wherein the ventilation maneuver is at least one of a recruitment maneuver and a low flow positive ventilation (PV) maneuver.

12. The method of claim 11, wherein the recruitment maneuver is selected from the group consisting of at least one of regular sighs, sustained inflations, successively increased positive end expiratory pressure (PEEP), and successively increased inspiratory pressure.

13. The method of claim 8, wherein said step of limiting the ventilation maneuver comprises switching to low flow expiration while continuing said ventilation maneuver.

14. A system for managing patient ventilator operation, comprising:

a patient monitoring module for receiving data from at least one sensor, said data representing at least one of arterial blood pressure, cardiac output, and ST segment level of a patient;

a patient treatment module for providing signals for adaptively altering a ventilation maneuver performed on the patient by a patient ventilator;

a central processor communicating and controlling the patient monitoring module and the patient treatment module, the central processor configured for

calculating a percent fall between first sensed data representing at least one of the arterial blood pressure and cardiac output and subsequent sensed data corresponding to the at least one of the arterial blood pressure and cardiac output;

comparing the percent fall to at least one of a selected first percentage threshold corresponding to arterial blood pressure and a selected second percentage threshold corresponding to cardiac output;

in response to at least one of a fall in said arterial blood pressure exceeding the selected first percentage threshold and a fall in said cardiac output exceeding the selected second percentage threshold, analyzing ST segment level data of the patient;

in response to ST segment level indicating no heart damage, adaptively altering at least one of the selected first percentage threshold and the selected second percentage threshold to a selected third percentage threshold that is greater than the selected first percentage threshold or a selected fourth percentage threshold that is greater than the selected second percentage threshold; and

in response to ST segment level indicating possible heart damage, adaptively altering said ventilation maneuver.

15. The system of claim 14, wherein adaptively altering said ventilation maneuver comprises at least one of (a) terminating the ventilation maneuver, (b) altering respiratory volume, and (c) altering respiratory pressure.

16. The system of claim 14, wherein said data representing at least one of arterial blood pressure, cardiac output, and ST segment level of the patient is averaged.

17. The system of claim 14,

wherein the central processor is further configured for generating an alarm in response to the received data representing at least one of arterial blood pressure, cardiac output and ST segment level of the patient.

18. The system of claim 14, wherein the ventilation maneuver is at least one of a recruitment maneuver and a low flow positive ventilation (PV) maneuver.

19. The system of claim 18, wherein the recruitment maneuver is selected from the group consisting of at least one of regular sighs, sustained inflations, successively increased positive end expiratory pressure (PEEP), and successively increased inspiratory pressure.

20. The system of claim 14, wherein adaptively altering said ventilation maneuver comprises limiting the ventilation maneuver at a rate based on a degree of estimated heart damage as indicated by said ST segment level.