System and method for treating lung disease using positive pressure airway support
First Claim
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1. A method of treating lung disease in a patient, comprising:
- determining, with a controller, a parameter indicative of the patient'"'"'s pulmonary mechanics, the parameter determination comprising;
(1) measuring, with one or more sensors, flow responses produced by two different parameter determination inspiratory positive airway pressure (IPAP) levels delivered to the patient during two successive breaths, subtracting the flow responses from one another, and performing a least squares error fit on flow data that results from the subtraction;
or(2) randomly varying a level of parameter determination pressure support delivered to the patient during the two successive breaths, determining a differential volume signal by subtracting volume responses measured during the two successive breaths from one another, and estimating a steady-state response of the differential volume signal;
generating, with a pressure support system, therapy positive pressure support for delivery to an airway of the patient, wherein a pressure level of the therapy positive pressure support during at least a portion of an inspiratory phase of the patient is determined based on the determined parameter,wherein the pressure level of the therapy positive pressure support during at least a portion of the inspiratory phase includes a peak pressure, anddetermining a second pressure level that is below the peak pressure of the therapy positive pressure support, the second pressure level being determined during an expiratory phase of the patient, the second pressure level determined based on the determined parameter.
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Abstract
A method of treating lung disease, such as asthma or COPD, is provided that includes determining a parameter indicative of a patient'"'"'s pulmonary mechanics (such as, without limitation, airway resistance or lung compliance), and delivering positive pressure support to the airway of the patient, wherein the pressure level (which may be constant or variable) of the positive pressure support during at least a portion of the inspiratory phase of the patient is determined based on the determined parameter.
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Citations
25 Claims
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1. A method of treating lung disease in a patient, comprising:
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determining, with a controller, a parameter indicative of the patient'"'"'s pulmonary mechanics, the parameter determination comprising; (1) measuring, with one or more sensors, flow responses produced by two different parameter determination inspiratory positive airway pressure (IPAP) levels delivered to the patient during two successive breaths, subtracting the flow responses from one another, and performing a least squares error fit on flow data that results from the subtraction;
or(2) randomly varying a level of parameter determination pressure support delivered to the patient during the two successive breaths, determining a differential volume signal by subtracting volume responses measured during the two successive breaths from one another, and estimating a steady-state response of the differential volume signal; generating, with a pressure support system, therapy positive pressure support for delivery to an airway of the patient, wherein a pressure level of the therapy positive pressure support during at least a portion of an inspiratory phase of the patient is determined based on the determined parameter, wherein the pressure level of the therapy positive pressure support during at least a portion of the inspiratory phase includes a peak pressure, and determining a second pressure level that is below the peak pressure of the therapy positive pressure support, the second pressure level being determined during an expiratory phase of the patient, the second pressure level determined based on the determined parameter. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A pressure support system for treating lung disease, comprising:
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a pressure generating system adapted to produce a flow of breathing gas; a patient circuit operatively coupled to the pressure generating system to deliver the flow of breathing gas to an airway of a patient; and a controller operatively coupled to the pressure generating system, the controller being adapted to; determine a parameter indicative of the patient'"'"'s pulmonary mechanics, the parameter determination comprising; (1) measuring, with one or more sensors, flow responses produced by two different parameter determination inspiratory positive airway pressure (IPAP) levels delivered to the patient during two successive breaths, subtracting the flow responses from one another, and performing a least squares error fit on flow data that results from the subtraction;
or(2) randomly varying a level of parameter determination pressure support delivered to the patient during the two successive breaths, determining a differential volume signal by subtracting volume responses measured during the two successive breaths from one another, and estimating a steady-state response of the differential volume signal; and control the pressure generating system to deliver the flow of breathing gas to the patient at a therapy pressure level during at least a portion of an inspiratory phase of the patient, wherein the therapy pressure level is determined based on the determined parameter, wherein the therapy pressure level of the flow of breathing gas during the portion of the inspiratory phase includes a peak pressure, and the controller is adapted to control the pressure generating system to deliver the flow of breathing gas to the patient at a second therapy pressure level that is below the peak pressure, the second therapy pressure level being determined during an expiratory phase of the patient, the second therapy pressure level determined based on the determined parameter. - View Dependent Claims (12, 13, 14, 15, 16, 17)
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18. A method of treating lung disease, comprising:
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(a) generating, with a pressure support system, a first bi-level positive pressure support for delivery to an airway of a patient at an IPAP/EPAP differential for a first number of respiratory cycles wherein the IPAP/EPAP differential is a pressure determined by subtracting an expiratory positive airway pressure (EPAP) from an inspiratory positive airway pressure (IPAP) for a given respiratory cycle, the IPAP/EPAP differential of the first bi-level positive pressure support being a baseline level based on a predetermined baseline IPAP level and a predetermined baseline EPAP level; (b) determining, with a controller, a parameter indicative of the patent'"'"'s pulmonary mechanics, the parameter determination comprising; (1) measuring, with one or more sensors, flow responses produced by two different parameter determination IPAP levels delivered to the patient during two successive breaths, subtracting the flow responses from one another, and performing a least squares error fit on flow data that results from the subtraction;
or(2) randomly varying a level of parameter determination IPAP/EPAP differential delivered to the patient during the two successive breaths, determining a differential volume signal by subtracting volume responses measured during the two successive breaths from one another, and estimating a steady-state response of the differential volume signal; (c) determining, with the controller, that the determined parameter is outside of a predetermined baseline range; (d) determining, with the controller, an increase of a predetermined magnitude in the baseline IPAP/EPAP differential to a current IPAP/EPAP differential, wherein the predetermined magnitude of the IPAP/EPAP differential is based on the determined parameter that is indicative of the patient'"'"'s pulmonary mechanics; (e) generating, with the pressure support system, a second bi-level positive pressure support for delivery to the airway of the patient at the then current IPAP/EPAP differential for a second number of respiratory cycles; (f) re-determining, with the controller, the parameter; and (g) repeating, with the controller and the pressure support system, (d), (e) and (f) one or more times until either it is determined that the then current re-determined parameter is within the baseline range or that the then current IPAP/EPAP differential is equal to a predetermined maximum differential. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25)
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Specification