METHODS AND DEVICES FOR SENSING RESPIRATION AND CONTROLLING VENTILATOR FUNCTIONS

• US 20110259327A1
• Filed: 04/17/2009
• Published: 10/27/2011
• Est. Priority Date: 04/18/2008
• Status: Active Grant

• Current Assignee: Breathe Technologies, Inc. (Baxter International Inc.)
• Original Assignee: Breathe Technologies, Inc. (Baxter International Inc.)
• Inventors: Rossi, Stephen, Tran, Coung Q., Wondka, Anthony, Bryan, Robert F., McCall, Mark, Freitag, Lutz
• Granted Patent: US 8,770,193 B2
• Time in Patent Office: Days
• US Class Current: 128/203.14
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/0461 Nasoendotracheal tubes
• CPC Class Codes: A61M 16/0465 Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
• CPC Class Codes: A61M 16/0475 having openings in the tube
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/0666 Nasal cannulas or tubing devices for improving normal breathing through the nose A61F5/08; nose filters A62B23/06; outside holding devices A61M25/02
• CPC Class Codes: A61M 16/1015 using a gas flush valve, e.g. oxygen flush valve
• CPC Class Codes: A61M 16/1045 Devices for humidifying or heating the inspired gas by using recovered moisture or heat from the expired gas
• CPC Class Codes: A61M 16/1055 bacterial
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2202/025 Helium
• CPC Class Codes: A61M 2205/3368 Temperature
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/36 related to heating or cooling
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/70 with testing or calibration facilities
• CPC Class Codes: A61M 2230/005 : Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/50 : Temperature
• CPC Class Codes: A61M 2230/65 : Impedance, e.g. conductivity, capacity

Abstract

Improved methods and devices are described for sensing the respiration pattern of a patient and controlling ventilator functions, particularly for use in an open ventilation system. An apparatus for sensing respiration and synchronizing a ventilator to the respiration of a patient is described. The apparatus may include a plurality of thermal breath sensors. At least one of the plurality of thermal breath sensors may be a heated thermal breath sensor.

Claims

1. An apparatus for sensing respiration and synchronizing a ventilator to the respiration of a patient, the apparatus comprising:

a plurality of thermal breath sensors; and

wherein at least one of the plurality of thermal breath sensors is a heated thermal breath sensor.

2. The apparatus of claim 1, wherein the plurality of thermal breath sensors have attributes selected from the group consisting of:

(1) the plurality of thermal breath sensors are joined in a bridge circuit;

(2) the at least one heated thermal breath sensor is heated to maintain a desired baseline temperature compared to ambient temperature;

(3) the at least one heated thermal breath sensor is heated using a heat source decoupled from the at least one heated thermal breath sensor; and

(4) combinations thereof.

3. The apparatus of claim 1, wherein the plurality of thermal breath sensors have configurations selected from the group consisting of:

(1) one thermal breath sensor is a sensing sensor and a second thermal breath sensor is an ambient reference sensor;

(2) one thermal breath sensor is placed near the entrance to or in an airway, and a second thermal breath sensor is placed away from the airway as an ambient reference sensor;

(3) two thermal breath sensors are in communication with spontaneous airflow and are joined in bridge circuit, and a third thermal breath sensor is not in communication with the spontaneous airflow and is a reference sensor;

(4) at least one thermal breath sensor is positioned in a conduit that is in communication with spontaneous airflow, wherein the cross-section of the conduit and sensor signal are used to determine a volumetric flow rate;

(5) two thermal breath sensors are separated by a barrier to create a directionally biased signal response phase shift between the signals of the two thermal breath sensors, wherein the phase shift directionality is used to determine the direction of airflow and the phase of respiration; and

(6) combinations thereof.

4. The apparatus of claim 1, wherein a DC shift of a signal from at least one of the plurality of thermal breath sensors is controlled by (1) continually adjusting a source voltage or (2) auto-zeroing through a software feedback loop.

5. The apparatus of claim 1, wherein the plurality of thermal breath sensors are selected from the group consisting of:

thermistors;

polymer based thermally responsive materials;

thermally responsive materials shaped like a bead, strip or ring; and

combinations thereof.

6. The apparatus of claim 1, wherein a signal from the plurality of thermal breath sensors is correlated to flow, and the flow is correlated to depth of breathing, inspiratory effort, inspiratory and expiratory flow, inspiratory and expiratory volume, and patient respiratory status.

20. The apparatus of claims 1, 7 and 13, further comprising an intra-airway pressure sensing conduit, wherein at least one thermal breath sensor is used to determine spontaneous breathing airflow, and the intra-airway pressure sensing conduit is used to determine breathing pressure.

7. An apparatus for sensing respiration and synchronizing a ventilator to the respiration of a patient, the apparatus comprising:

at least three thermal breath sensors;

wherein a first thermal breath sensor measures temperature in an airway of the patient, a second thermal breath sensor measures temperature at or near the opening of an airway of the patient, and a third thermal breath sensor measures ambient temperature;

wherein signals from the first thermal breath sensor and the second thermal breath sensor are initially compared to a signal from the third thermal breath sensor to determine if inspired ambient air should be warmer or cooler than body temperature, and wherein the initial signal comparison defines an inspiratory phase and an expiratory phase associated with the signals from the first thermal breath sensor and the second thermal breath sensor; and

wherein the signals from the first thermal breath sensor and the second thermal breath sensor are subsequently compared to each other to compensate for drift and artifacts, and wherein the subsequent signal comparison is used to determine true patterns, phases and timing of the patient'"'"'s respiration.

8. The apparatus of claim 7, wherein the at least three thermal breath sensors have attributes selected from the group consisting of:

(1) the first thermal breath sensor and the second thermal breath sensor are joined in a bridge circuit;

(2) at least one of the first thermal breath sensor and the second thermal breath sensor are heated to maintain a desired baseline temperature compared to ambient temperature;

(3) at least one of the first thermal breath sensor and the second thermal breath sensor are heated using a heat source decoupled from the at least one of the first thermal breath sensor and the second thermal breath sensor; and

(4) combinations thereof.

9. The apparatus of claim 7, wherein the at least three thermal breath sensors have configurations selected from the group consisting of:

(1) the first thermal breath sensor and the second thermal breath sensor are in communication with spontaneous airflow and are joined in a bridge circuit, and the third thermal breath sensor is not in communication with spontaneous airflow and is a reference sensor;

(2) at least one of the at least three thermal breath sensors is positioned in a conduit that is in communication with spontaneous airflow, wherein the cross-section of the conduit and sensor signal are used to determine a volumetric flow rate;

(3) the first thermal breath sensor and the second thermal breath sensor are separated by a barrier to create a directionally biased signal response phase shift between the signals of the first thermal breath sensor and the second thermal breath sensor, wherein the phase shift directionality is used to determine the direction of airflow and the phase of respiration; and

(4) combinations thereof.

10. The apparatus of claim 7, wherein a DC shift of a signal of at least one of the at least three thermal breath sensors is controlled by (1) continually adjusting a source voltage or (2) auto-zeroing through a software feedback loop.

11. The apparatus of claim 7, wherein the at least three thermal breath sensors are selected from the group consisting of:

thermistors;

polymer based thermally responsive materials;

thermally responsive materials shaped like a bead, strip or ring; and

combinations thereof.

12. The apparatus of claim 7, wherein a signal from one or both of the first thermal breath sensor and the second thermal breath sensor is correlated to flow, and the flow is correlated to depth of breathing, inspiratory effort, inspiratory and expiratory flow, inspiratory and expiratory volume, and patient respiratory status.

13. An apparatus for sensing respiration and synchronizing a ventilator to the respiration of a patient, the apparatus comprising:

a ventilation tube to deliver gas to the patient;

wherein the ventilation tube further comprises a ventilation gas delivery channel to deliver gas to the patient; and

a breath sensing conduit in communication with an airway of the patient, wherein a thermal breath sensor is positioned in series with the breath sensing conduit.

14. The apparatus of claim 13, wherein the thermal breath sensor has attributes selected from the group consisting of:

(1) the thermal breath sensor is joined with a second sensor in a bridge circuit;

(2) the thermal breath sensor is heated to maintain a desired baseline temperature compared to ambient temperature;

(3) the thermal breath sensor is heated using a heat source decoupled from the thermal breath sensor; and

(4) combinations thereof.

15. The apparatus of claim 13, wherein the apparatus has configurations selected from the group consisting of:

(1) the apparatus includes a second sensor that is an ambient temperature reference sensor;

(2) the thermal breath sensor is placed near the entrance to an airway;

(3) the thermal breath sensor is placed in an airway;

(4) the thermal breath sensor is positioned in the sensing conduit near or in the patient'"'"'s airway; and

(5) combinations thereof.

16. The apparatus of claim 13, wherein a DC shift of a signal of the thermal breath sensor is controlled by (1) continually adjusting a source voltage or (2) auto-zeroing through a software feedback loop.

17. The apparatus of claim 13, wherein the thermal breath sensor is selected from the group consisting of:

thermistors;

polymer based thermally responsive materials;

thermally responsive materials shaped like a bead, strip or ring; and

combinations thereof.

18. The apparatus of claim 13, wherein a signal from the thermal breath sensor is correlated to flow, and the flow is correlated to depth of breathing, inspiratory effort, inspiratory and expiratory flow, inspiratory and expiratory volume, and patient respiratory status.

19. The apparatus of claim 13, wherein a signal from the thermal breath sensor is correlated to flow using the signal and a cross sectional area of the sensing conduit, and the flow is correlated to depth of breathing, inspiratory effort, inspiratory and expiratory flow, inspiratory and expiratory volume, and patient respiratory status.