Methods and systems for adaptive base flow and leak compensation

• US 9,498,589 B2
• Filed: 12/31/2011
• Issued: 11/22/2016
• Est. Priority Date: 12/31/2011
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Jafari, Mehdi M., Masic, Milenko, Jimenez, Rhomere S., Aviano, Jeffrey K., McCoy, Edward R.
• Primary Examiner(s): Yu, Justine
• Assistant Examiner(s): Han, Mark K
• Application Number:
  US13/341,957
• Publication Number:
  US 20130167842A1
• Time in Patent Office: 1,788 Days
• Field of Search: 12820212-20314, 128/204.18, 12820421-20423, 128/204.26, 128/205.11, 12820523-20524, 128/898
• US Class Current: 1/1
• CPC Class Codes: A61M 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• 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 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 16/0875 Connecting tubes
• CPC Class Codes: A61M 2016/0018 electrical
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0033 electrical
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 in the expiratory circuit
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: A61M 2205/505 Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• CPC Class Codes: A61M 2205/583 by visual feedback
• CPC Class Codes: A61M 2230/40 Respiratory characteristics

Abstract

This disclosure describes systems and methods for providing adaptive base flow scheduling during ventilation of a patient to optimize patient-machine synchrony and accuracy of estimated exhaled as well as inhaled tidal volumes. Further, this disclosure describes systems and methods for providing adaptive inspiratory trigger threshold scheduling during the adaptive base flow scheduling. Further still, this disclosure describes systems and methods for determining an estimated leak flow and adjusting the adaptive base flow scheduling and the adaptive inspiratory trigger threshold scheduling based on the estimated leak flow. Moreover, this disclosure describes systems and methods for determining a change in the estimated leak flow and adjusting the adaptive base flow scheduling and the adaptive inspiratory trigger threshold scheduling based on the change in the estimated leak flow.

Claims

1. A method for improving an accuracy of estimating an exhalation volume while ventilating a patient with a ventilator, the ventilator comprising at least one processor and at least one memory, the method comprising:

delivering a base flow to a patient during exhalation, wherein the base flow includes an estimated leak flow;

determining, by the ventilator, an initial base flow to improve the accuracy of estimating the exhalation volume;

determining, by the ventilator, an initial inspiratory trigger threshold to prevent false triggering while base flow is changing;

delivering the initial base flow during at least a first portion of the exhalation while setting an inspiratory trigger threshold to the initial inspiratory trigger threshold;

changing the base flow from the initial base flow toward a desired base flow during at least a second portion of exhalation;

decreasing the inspiratory trigger threshold from the initial inspiratory trigger threshold toward a desired inspiratory trigger threshold while performing the step of changing the base flow;

determining a change in the estimated leak flow; and

progressively adjusting the base flow in a set time period during at least the second portion of exhalation to compensate for the determined change in the estimated leak flow while adjusting the inspiratory trigger threshold in the set time period.

2. The method of claim 1, wherein the step of progressively adjusting the base flow includes progressively adjusting the base flow according to an exponential trajectory.

3. The method of claim 2, wherein a slope of the exponential trajectory of the base flow is based on a time constant selected by the ventilator.

4. The method of claim 2, wherein the step of decreasing the inspiratory trigger threshold includes decreasing the inspiratory trigger threshold according to an exponential trajectory.

5. The method of claim 4, wherein a slope of the exponential trajectory of the inspiratory trigger threshold is based on a time constant selected by the ventilator.

6. The method of claim 4, wherein a slope of the exponential trajectory of the base flow is based on a first time constant and a slope of the exponential trajectory of the inspiratory trigger threshold is based on a second time constant.

7. The method of claim 6, wherein the first time constant and the second time constant are the same.

8. The method of claim 1, wherein the set time period is less than or substantially equal to 200 ms.

9. The method of claim 1, wherein the determined change in the estimated leak flow is an increase in the estimated leak flow, and wherein the step of progressively adjusting the base flow includes increasing the inspiratory trigger threshold as a function of the determined increase in the estimated leak flow.

10. The method of claim 1, wherein the initial base flow is zero.

11. The method of claim 1, wherein the step of changing the base flow includes increasing the base flow according to an exponential trajectory, and

wherein the step of decreasing the inspiratory trigger threshold includes decreasing the inspiratory trigger threshold according to an exponential trajectory.

12. The method of claim 11, wherein a slope of the exponential trajectory of the base flow is based on a time constant and a slope of the exponential trajectory of the inspiratory trigger threshold is based on the time constant.

13. The method of claim 1, wherein the second portion of exhalation begins based on an occurrence of a condition.

14. The method of claim 1, wherein adjusting the inspiratory trigger threshold for the set time period is performed concurrently with the progressively adjusting of the base flow in the set time period to compensate for the determined change in the estimated leak flow.

15. The method of claim 1, wherein the inspiratory trigger threshold is based on at least one of an exhalation flow and an exhalation pressure.

16. The method of claim 1, further comprising:

calculating an estimated exhaled tidal volume of the patient.

17. The method of claim 1, further comprising:

displaying at least one of;

a minimum exhalation flow, a minimum exhalation time, a maximum exhalation time, the desired base flow, the desired inspiratory trigger threshold, the inspiratory trigger threshold, the base flow, the exhalation flow, the estimated leak flow, the determined change in the estimated leak flow, the set period of time, and an exhalation pressure.

18. A computer-readable medium having computer-executable instructions that when executed by a processor cause a ventilator to:

deliver a base flow to a patient during exhalation, wherein the base flow includes an estimated leak flow;

determine, by the ventilator, an initial base flow to improve an accuracy of estimating an exhalation volume;

determine, by the ventilator, an initial inspiratory trigger threshold to prevent false triggering while base flow is changing;

deliver the initial base flow during at least a first portion of the exhalation while setting an inspiratory trigger threshold to the initial inspiratory trigger threshold;

change the base flow from the initial base flow toward a desired base flow during at least a second portion of exhalation;

decrease the inspiratory trigger threshold from the initial inspiratory trigger threshold toward a desired inspiratory trigger threshold while performing the step of changing the base flow;

determine a change in the estimated leak flow; and

progressively adjust the base flow in a set time period during at least the second portion of exhalation to compensate for the determined change in the estimated leak flow while adjusting the inspiratory trigger threshold in the set time period.

19. The computer-readable medium of claim 18, wherein progressively adjusting the base flow includes progressively adjusting the base flow according to an exponential trajectory.

20. The computer-readable medium of claim 19, wherein a slope of the exponential trajectory of the base flow is based on a time constant selected by the ventilator.

21. The computer-readable medium of claim 19, wherein decreasing the inspiratory trigger threshold includes decreasing the inspiratory trigger threshold according to an exponential trajectory.

22. The computer-readable medium of claim 21, wherein a slope of the exponential trajectory of the inspiratory trigger threshold is based on a time constant selected by the ventilator.

23. The computer-readable medium of claim 21, wherein a slope of the exponential trajectory of the base flow is based on a first time constant and a slope of the exponential trajectory of the inspiratory trigger threshold is based on a second time constant.

24. The computer-readable medium of claim 23, wherein the first time constant and the second time constant are the same.

25. The computer-readable medium of claim 18, wherein the set time period is less than or substantially equal to 200 ms.