Method and apparatus for providing variable positive airway pressure

• US 20020088465A1
• Filed: 09/20/2001
• Published: 07/11/2002
• Est. Priority Date: 09/25/2000
• Status: Active Grant

• Current Assignee: RIC INVESTMENTS LLC (Respironics Incorporated)
• Original Assignee: RIC INVESTMENTS LLC (Respironics Incorporated)
• Inventors: Hill, Peter D.
• Granted Patent: US 6,752,151 B2
• Time in Patent Office: Days
• US Class Current: 128/204.23
• CPC Class Codes: A61M 16/0069 the speed thereof being controlled by respiratory parameters, e.g. by inhalation
• 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 16/204 used for inhalation control
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2205/35 Communication

Abstract

A method and apparatus for treating a breathing disorder and, more particularly, a method and apparatus for providing a pressurized air flow to an airway of a patient to treat congestive heart failure in combination with Cheyne-Stokes respiration and/or sleep apnea or other breathing disorders. A positive airway pressure ventilator is utilized in combination with an algorithm that adjusts IPAP and EPAP in order to counter a Cheyne-Stokes breathing pattern. Cheyne-Stokes respiration is detected by monitoring a peak flow of the patient.

Claims

1. A system for delivering a flow of breathing gas to an airway of a patient, the apparatus comprising:

a gas flow generating system that generates a flow of breathing gas;

a patient circuit coupled to the gas flow generating system and adapted to communicate the flow of breathing gas to an airway of a patient;

a flow sensor associated with the gas flow generating system or the patient circuit and adapted to measure the flow of breathing gas within the patient circuit and to transmit a flow signal indicative thereof; and

controlling means, receiving the flow signal from the flow sensor, for (1) determining peak flows Q_{peak(current)} therefrom and for (2) controlling the gas flow generating system so as to cause the breathing gas to be delivered at a sufficient pressure during at least a portion of a breathing cycle to threat Cheyne-Stokes respiration based on the detected peak flows.

2. The apparatus of claim 1, wherein the pressure generating system includes:

a pressure generator adapted to generate a flow of breathing gas; and

a pressure control valve associated with the pressure generator or the patient circuit to control a pressure of the flow of breathing gas delivered to a patient by the patient circuit.

3. The apparatus of claim 1, wherein the controlling means compares the inspiratory peak flow Q_{peak(current)} to a target peak flow Q_peak(target), and causes the pressure generating system to adjust an inspiratory positive airway pressure (IPAP) based on the comparison between the inspiratory peak flow Q_{peak(current)} and target peak flow Q_peak(target).

4. The apparatus of claim 3, wherein the controlling means detects I/E transitions between an inspiratory phase and an expiratory phase of a respiratory cycle, and causes the pressure generating system to deliver a machine breath responsive to a failure to detect an a patient initiated between within a predetermined period of time.

5. The apparatus of claim 3, further comprising means for monitoring the efficacy of the delivering of pressurized breathing gas in the treatment of central apnea and Cheyne-Stokes respiration.

6. The apparatus of claim 5, wherein the controlling means includes means for adjusting the target peak flow Q_peak(target), an expiratory positive airway pressure, or both, responsive to a determination the delivering of pressurized breathing gas in the treatment is not effectively treating Cheyne-Stokes respiration.

7. The apparatus of claim 3, further comprising means for detecting Cheyne-Stokes respiration.

8. The apparatus of claim 7, wherein the controlling means includes means for adjusting the target peak flow Q_peak(target), an expiratory positive airway pressure, or both, responsive to a determination a patient is experiencing Cheyne-Stokes respiration.

9. The apparatus of claim 7, wherein the means for detecting Cheyne-Stokes respiration comprises means for determining magnitudes and times of inspiratory peaks flows and comparing these to a Cheyne-Stokes respiration pattern.

18. The method of claim 7, wherein detecting Cheyne-Stokes respiration includes determining magnitudes and times of inspiratory peaks flows and comparing these to a Cheyne-Stokes respiration pattern.

10. A method for delivering pressurized breathing gas to an airway of a patient, the method comprising the steps of:

delivering a flow of gas to the airway of the patient from a source of breathing gas via a patient circuit;

sensing a parameter indicative of a flow of gas within the patient circuit and outputting a flow signal;

determining peak flows Q_{peak(current)} in the flow of gas; and

controlling the delivery of gas so as to cause the breathing gas to be delivered at a sufficient pressure during at least a portion of a breathing cycle to treat Cheyne-Stokes respiration based on the detected peak flows.

11. The method of claim 10, wherein delivering a flow of gas includes generating a flow of breathing gas via a pressure generator and controlling a pressure of the flow of gas via (1) a pressure control valve associated with the pressure generator or the patient circuit, (2) controlling an operating speed of the pressure generator, or (3) a combination of both (1) and (2).

12. The method of claim 10, wherein controlling the delivery of gas includes comparing the inspiratory peak flow Q_{peak(current)} to a target peak flow Q_peak(target), and adjusting an inspiratory positive airway pressure (IPAP) based on the comparison between the inspiratory peak flow Q_{peak(current)} and target peak flow Q_peak(target).

13. The method of claim 12, further comprising:

detecting I/E transitions between an inspiratory phase and an expiratory phase of a respiratory cycle; and

delivering a machine generated breath to a patient responsive to a failure to detect an a patient initiated between within a predetermined period of time.

14. The method of claim 12, further comprising monitoring the efficacy of the delivering of pressurized breathing gas in the treatment of central apnea and Cheyne-Stokes respiration.

15. The method of claim 14, further comprising adjusting the target peak flow Q_peak(target), an expiratory positive airway pressure, or both, responsive to a determination the delivering of pressurized breathing gas in the treatment is not effectively treating Cheyne-Stokes respiration.

16. The method of claim 12, further comprising detecting Cheyne-Stokes respiration.

17. The method of claim 16, further comprising adjusting the target peak flow Q_peak(target), an expiratory positive airway pressure, or both, responsive to a determination a patient is experiencing Cheyne-Stokes respiration.