Administration of CPAP treatment pressure in presence of apnea

• US 9,526,855 B2
• Filed: 02/24/2014
• Issued: 12/27/2016
• Est. Priority Date: 11/07/1997
• Status: Expired due to Fees

• Current Assignee: ResMed Pty Ltd. (ResMed Incorporated)
• Original Assignee: Resmed Limited (ResMed Incorporated)
• Inventors: Berthon-Jones, Michael, Farrugia, Steven Paul
• Primary Examiner(s): Dixon, Annette
• Application Number:
  US14/187,919
• Publication Number:
  US 20140166014A1
• Time in Patent Office: 1,037 Days
• Field of Search: 128/200.24, 128/204.18, 128/204.21, 128/204.22, 128/204.23, 128/204.24, 128/204.25, 128/204.26, 128/204.28, 128/204.29, 128/205.11, 128/205.12, 128/205.19, 128/205.23, 128/205.24, 128/205.25
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61M 16/00 Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes stimulating the respiratory movement by mechanical, pneumatic or electrical means, iron lungs combined with gas breathing means A61H31/00
• 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 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/0875 Connecting tubes
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase

Abstract

CPAP treatment apparatus is disclosed having a controllable flow generator (34, 38, 40) operable to produce breathable gas at a treatment pressure elevated above atmosphere to a patient by a delivery tube (32) coupled to a mask (30) having connection with a patient'"'"'s airway. A sensor (44, 50, 56, 58) generates a signal representative of patient respiratory flow, that is provided to a controller (54, 62, 64). The controller (54, 62, 64) is operable to determine the occurrence of an apnea from a reduction in respiratory airflow below a threshold, and if an apnea has occurred, to determine the duration of the apnea and to cause the flow generator (34, 38) to increase the treatment pressure. In one preferred form the increase in pressure is zero if the treatment pressure before the apnea exceeds a pressure threshold. Below the pressure threshold the increase in pressure is an increasing of the duration of the apnea multiplied by the between the pressure threshold and the current function difference treatment pressure.

Claims

1. A control method for a processor in the administration of CPAP treatment pressure, comprising:

controlling a flow generator for supplying breathable gas to a patient'"'"'s airway at a first treatment pressure;

controlling a determination of a measure of airflow;

controlling a detection of a reduction in the measure of airflow indicative of the presence of an apnea;

controlling a detection of a flow limitation in the measure of airflow;

in response to the detected indication of the presence of an apnea, dynamically adjusting a delta pressure amount due to apnea based at least in part on a comparison between the first treatment pressure and a top roll-off pressure value;

in response to the detected flow limitation, dynamically adjusting a delta pressure amount due to flow limitation independently of the top roll-off pressure value; and

controlling the flow generator for supplying breathable gas to the patient'"'"'s airway at a second treatment pressure based on the delta pressure amount due to apnea and the delta pressure amount due to flow limitation.

2. The method of claim 1, wherein the delta pressure amount due to apnea is determined based at least in part on a monotonically decreasing function.

3. The method of claim 2, wherein the monotonically decreasing function is a function of the first treatment pressure.

4. The method of claim 1, wherein the delta pressure amount due to apnea is unchanged if the first treatment pressure is at or above the top roll-off pressure value.

5. The method of claim 4, wherein the top roll-off pressure value is 10 cmH₂O.

6. The method of claim 1, wherein the delta pressure amount due to apnea is determined based at least in part on a monotonically increasing function.

7. The method of claim 1, further comprising determining a duration of the indicated apnea based at least in part on the detected reduction in the measure of airflow, wherein the adjustment to the delta pressure amount due to apnea is determined based at least in part on a function of the duration.

8. The method of claim 7, wherein the function of the duration is a monotonically increasing function.

9. The method of claim 8, wherein the function of the duration is a linearly increasing function.

10. The method of claim 8, wherein the function of the duration is an exponentially increasing function.

11. The method of claim 7, wherein the adjustment to the delta pressure amount due to apnea is determined based at least in part on both a function of the duration and a function of the first treatment pressure.

12. A CPAP treatment apparatus, comprising:

a flow generator operable to supply breathable gas to a mask at a first mask pressure;

a tube coupled to the flow generator and adapted to deliver the breathable gas from the flow generator to the mask;

a controller coupled to the flow generator and configured to control the mask pressure; and

one or more sensors operable to provide a signal to the controller from which a measure of airflow is determined,

wherein the controller is operable to;

in response to a detected reduction in the measure of airflow that is indicative of an apnea, dynamically adjust a delta pressure amount due to apnea based at least in part on a comparison between the first mask pressure and a top roll-off pressure value;

in response to a detected flow limitation in the measure of airflow, dynamically adjust a delta pressure amount due to flow limitation independently of the top roll-off pressure value; and

control the mask pressure to a second mask pressure based on the delta pressure amount due to apnea and the delta pressure amount due to flow limitation.

13. The CPAP treatment apparatus of claim 12, wherein the delta pressure amount due to apnea is based at least in part on a function of the first mask pressure.

14. The CPAP treatment apparatus of claim 12, wherein the controller is operable to determine the duration of the apnea based at least in part on the determined measure of airflow.

15. The CPAP treatment apparatus of claim 12, wherein the one or more sensors comprises a pressure sensor and a flow sensor, and wherein the controller is operable to calculate a mask pressure level based on input signals from the pressure sensor and flow sensor.

16. The CPAP treatment apparatus of claim 15, wherein the one or more sensors are mounted at or near the flow generator.

17. The CPAP treatment apparatus of claim 15, wherein the controller is configured to perform a table lookup in order to calculate the mask pressure level based on the input signals from the pressure sensor and flow sensor.

18. The CPAP treatment apparatus of claim 15, wherein the controller is configured to compare the first mask pressure to the top roll-off pressure value and, if the first mask pressure is lower than the top roll-off pressure value, to adjust the delta pressure amount due to apnea.