SYSTEM AND METHOD FOR TREATING LUNG DISEASE USING POSITIVE PRESSURE AIRWAY SUPPORT

• US 20110232643A1
• Filed: 11/21/2009
• Published: 09/29/2011
• Est. Priority Date: 12/19/2008
• Status: Active Grant

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Inventors: Coldren, Richard J., Mechlenburg, Douglas
• Granted Patent: US 9,901,692 B2
• Time in Patent Office: Days
• US Class Current: 128/204.23
• CPC Class Codes: A61B 5/085 Measuring impedance of respiratory organs or lung elasticity
• CPC Class Codes: A61M 11/00 Sprayers or atomisers specially adapted for therapeutic purposes in general B05B; aerosol containers B65D83/14
• CPC Class Codes: A61M 15/00 Inhalators drug delivery in endotracheal tubes A61M16/04
• CPC Class Codes: A61M 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• CPC Class Codes: A61M 16/0006 with means for creating vibrations in patients' airways
• CPC Class Codes: A61M 16/0069 the speed thereof being controlled by respiratory parameters, e.g. by inhalation
• CPC Class Codes: A61M 16/021 operated by electrical means A61M16/202 – A61M16/205 take precedence
• CPC Class Codes: A61M 16/022 Control means therefor
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• 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 16/202 electrically actuated
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/003 with a flowmeter
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2230/46 Resistance or compliance of the lungs

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.

Claims

1. A method of treating lung disease, comprising:

determining a parameter indicative of a patient'"'"'s pulmonary mechanics; and

delivering positive pressure support to an airway of the patient, wherein a pressure level of the positive pressure support during at least a portion of the inspiratory phase of the patient is determined based on the determined parameter.

2. The method according to claim 1, wherein the pressure level of the positive pressure support during at least a portion of the inspiratory phase includes a peak pressure, and wherein a second pressure level of the positive pressure support during at least a portion of an expiratory phase of the patient is below the peak pressure.

3. The method according to claim 2, wherein the second pressure level is also determined based on the determined parameter.

4. The method according to claim 1, wherein the delivering positive pressure support to an airway of the patient comprises delivering bi-level positive pressure support to an airway of the patient, the bi-level positive pressure support having an inspiratory positive airway pressure (IPAP) level and an expiratory positive airway pressure (EPAP) level, wherein the IPAP level and the EPAP level are determined based on the determined parameter.

5. The method according to claim 1, wherein the determining step is performed prior to the delivering step.

6. The method according to claim 1, wherein the determining step is performed during the delivering step.

7. The method according to claim 1, wherein the lung disease is asthma.

8. The method according to claim 1, wherein the lung disease is COPD.

9. The method according to claim 1, wherein the parameter is upper airway resistance.

10. The method according to claim 1, wherein the parameter is lung compliance.

11. The method according to claim 1, wherein the delivering is performed by a pressure support system and wherein the determining a parameter indicative of a patient'"'"'s pulmonary mechanics comprises determining the parameter in a device external to the pressure support system and providing the parameter to the pressure support system.

12. The method according to claim 1, wherein the delivering is performed by a pressure support system and wherein the determining a parameter indicative of a patient'"'"'s pulmonary mechanics comprises determining the parameter external to the pressure support system and manually inputting the parameter into the pressure support system.

13. A pressure support system for treating lung disease, comprising:

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 and to control the pressure generating system to deliver the flow of breathing gas to the patient at a pressure level during at least a portion of an inspiratory phase of the patient, wherein the pressure level is determined based on the determined parameter.

14. The system according to claim 13, wherein the pressure level of the positive pressure support during at least a portion of the inspiratory phase includes a peak pressure, and wherein the controller is adapted to control the pressure generating system to deliver the flow of breathing gas to the patient at a second pressure level during at least a portion of an expiratory phase of the patient that is below the peak pressure.

15. The system according to claim 14, wherein the second pressure level is also determined based on the determined parameter.

16. The system according to claim 13, wherein the controller is adapted to control the pressure generating system to deliver the flow of breathing gas to the patient at an inspiratory positive airway pressure (IPAP) level during the at least a portion of an inspiratory phase of the patient and deliver the flow of breathing gas to the patient at an expiratory positive airway pressure (EPAP) level during at least a portion of an expiratory phase of the patient, wherein the IPAP level and the EPAP level are determined based on the determined parameter.

17. The system according to claim 13, wherein the controller is adapted to determine the parameter prior to the controlling of the pressure generating system.

18. The system according to claim 13, wherein the controller is adapted to determine the parameter during the controlling of the pressure generating system.

19. The system according to claim 13, wherein the parameter is upper airway resistance.

20. The system according to claim 13, wherein the parameter is lung compliance.

21. The system according to claim 13, wherein the lung disease is asthma.

22. The system according to claim 13, wherein the lung disease is COPD.

23. The system according to claim 13, further comprising one or more sensors operatively coupled to the controller, the one or more sensors being adapted to measure one or more characteristics associated with the flow of breathing gas and to generate one or more signals indicative thereof, wherein the controller is adapted to determine the parameter using the one or more signals.

24. A method of treating lung disease, comprising:

(a) delivering a first bi-level positive pressure support at an IPAP/EPAP differential for a first number of respiratory cycles, 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 a parameter indicative of the patent'"'"'s pulmonary mechanics;

(c) determining that the determined parameter is outside of a predetermined baseline range;

(d) increasing the IPAP/EPAP differential to a current IPAP/EPAP differential;

(e) delivering a second bi-level positive pressure support at the then current IPAP/EPAP differential for a second number of respiratory cycles;

(f) re-determining the parameter; and

(g) repeating (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.

25. The method according to claim 24, wherein if it is determined in (g) that the then current IPAP/EPAP differential is equal to the predetermined maximum differential, the method further comprises notifying the patient to begin using asthma medication and continuing to provide the second bi-level positive pressure support at the then current IPAP/EPAP differential.

26. The method according to claim 24, wherein if it is determined in (g) that the then current IPAP/EPAP differential is equal to the predetermined maximum differential, the method further comprises automatically providing asthma medication to the patient while continuing to provide the second bi-level positive pressure support at the then current IPAP/EPAP differential.

27. The method according to claim 24, wherein if it is determined in (g) that the then current re-determined parameter is within the baseline range, the method further comprises:

(h) decreasing the then current IPAP/EPAP differential to a decreased level;

(i) delivering a third bi-level positive pressure support at the decreased level for a third number of respiratory cycles;

(j) re-determining the parameter; and

(k) repeating (h), (i) and (j) one or more times until either it is determined that the then current re-determined parameter is outside the baseline range or that the then current decreased level is equal to the baseline level.

28. The method according to claim 27, wherein if it is determined in (k) that the then current re-determined parameter is outside of the baseline range, the method repeats (d), (e), (f) and (g).

29. The method according to claim 27, wherein if it is determined in (k) that then current re-determined parameter is not outside the baseline range and the then current decreased level is equal to the baseline level, the method further comprises continuing to provide the third bi-level positive pressure support at the baseline level.

30. The method according to claim 24, wherein the lung disease is asthma.

31. The method according to claim 24, wherein the lung disease is COPD.