System and method for automated titration of continuous positive airway pressure using an obstruction index

• US 9,713,688 B2
• Filed: 12/24/2008
• Issued: 07/25/2017
• Est. Priority Date: 06/04/2004
• Status: Active Grant

• Current Assignee: New York University
• Original Assignee: New York University
• Inventors: Ayappa, Indu A., Norman, Robert G., Rapoport, David M.
• Primary Examiner(s): PATEL, TARLA R
• Application Number:
  US12/343,972
• Publication Number:
  US 20090139523A1
• Time in Patent Office: 3,135 Days
• Field of Search: 12820418, 12820421, 12820422, 12820423, 12820426, 12820523, 128848
• 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 16/0431 with a cross-sectional shape other than circular
• CPC Class Codes: A61M 16/10 Preparation of respiratory gases or vapours
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0027 pressure meter

Abstract

Described is a system including an air pressure supply arrangement, a sensor and a titration device. The air pressure supply arrangement provides air pressure to a patient'"'"'s airways. The sensor detects input data corresponding to a patient'"'"'s breathing patterns of a plurality of breaths. The titration device receives and analyzes the input data to determine existence of breathing disorder and corresponding characteristics. The titration device generates output data for adjusting the air pressure supplied to the patient as a function of an index of abnormal respiratory events included in the input data.

Claims

1. A system, comprising:

an air pressure supply arrangement providing air pressure to a patient'"'"'s airways;

a sensor detecting input data corresponding to a patient'"'"'s breathing patterns of a plurality of breaths; and

a titration device receiving and analyzing the input data to determine existence of breathing disorder and corresponding characteristics, the titration device generating output data for adjusting the air pressure supplied to the patient as a function of an index of different abnormal respiratory events included in the input data, wherein the titration device performs the receiving and analyzing in a collection/analysis period during which no adjustment to the air pressure that is delivered to the patient'"'"'s airways is initiated by the titration device.

2. The system according to claim 1, wherein the abnormal respiratory events include at least one of an apnea, a hypopnea, an event of upper airway resistance, snoring and a flow limitation.

3. The system according to claim 1, wherein the output data is one of a predetermined pressure adjustment algorithm, a single value pressure and a varying pressure function.

4. The system according to claim 1, wherein the input data is obtained for at least one time period prior to generating the output data.

5. The system according to claim 1, wherein the index includes a sum of the abnormal respiratory events.

6. The system according to claim 5, wherein, when the sum for at least one time period surpasses a preset value, the titration device increases the pressure.

7. The system according to claim 6, wherein, when the sum for the at least one time period is less than the preset value, the titration device does one of (i) maintains the pressure and (ii) decreases the pressure.

8. The system according to claim 1, wherein the index includes at least one of (i) a sum of apneas and hypopneas, (ii) a number of flow limitations and (iii) and a time the patient is in a sustained flow limitation state.

9. The system according to claim 8, wherein the titration device adjusts the sum by a factor indicative of a time the patient is in a flow limitation state.

10. The system according to claim 9, wherein the factor is ⅓

.

11. The system according to claim 1, wherein the collection/analysis period lasts for a range of approximately 6 to 8 hours.

12. The system according to claim 1, wherein the collection/analysis period lasts for a range of 1 to 2 hours.

13. A method, comprising:

activating a titration device;

obtaining input data by the titration device from a sensor, the input data corresponding to a patient'"'"'s breathing patterns;

determining with the titration device an existence in the input data of one of a breathing disorder and an abnormal flow limitation and corresponding characteristics; and

generating using the titration device an output data as a function of an index of different abnormal respiratory events included in the input data, wherein the determining is performed in a collection/analysis period during which no adjustment to an air pressure that is delivered to the patient'"'"'s airway is initiated by the titration device.

14. The method according to claim 13, further comprising:

supplying the pressure to the patient'"'"'s airway.

15. The method according to claim 14, further comprising:

adjusting, after the collection/analysis period, the pressure supplied to the patient as a function of the output data.

16. The method according to claim 15, wherein the generating step includes the following substeps:

when the index of the breathing disorders is lower than a predefined value, generating the output data to decrease the pressure; and

when the index of the breathing disorders is greater than a predefined value generating the output data to increase the pressure.

17. The method according to claim 15, wherein the index includes a sum of the abnormal respiratory events in the at least one time period.

18. The method according to claim 17, wherein, when the sum for the at least one time period surpasses a preset value, increasing the pressure.

19. The method according to claim 17, wherein, when the sum for the at least one time period is less than the preset value, one of:

maintaining the pressure; and

decreasing the pressure.

20. The method according to claim 17, further comprising:

adjusting, by the titration device, the sum by a factor indicative of a time the patient is in a flow limitation state.

21. The method according to claim 13, wherein the abnormal respiratory events include at least one of an apnea, a hypopnea, an event of upper airway resistance, snoring and a flow limitation.

22. The method according to claim 13, wherein the output data is one of a predetermined pressure adjustment algorithm, a single value pressure and a varying pressure function.

23. The method according to claim 13, wherein the input data is obtained for at least one time period prior to generating the output data.

24. The method according to claim 13, wherein the index includes at least one of (i) a sum of apneas and hypopneas, (ii) a number of flow limitations and (iii) a time the patient is in a sustained flow limitation state.

25. A device, comprising:

a processor;

a memory;

a titration module obtaining input data from a sensor, the input data corresponding to a patient'"'"'s breathing patterns, the titration module determining an existence in the input data of one of a breathing disorder and an abnormal flow limitation and corresponding characteristics, the titration module generating an output data as a function of an index of different abnormal respiratory events included in the input data, wherein the titration module performs the determining in a collection/analysis period during which no adjustment to an air pressure that is delivered to a patient'"'"'s airways is initiated by the titration module.