Therapy control based on cardiopulmonary status

• US 8,221,327 B2
• Filed: 01/15/2010
• Issued: 07/17/2012
• Est. Priority Date: 09/18/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Lee, Kent, Stahmann, Jeffrey E., Hartley, Jesse W., Ni, Quan
• Primary Examiner(s): Marmor, II, Charles A
• Assistant Examiner(s): TOTH, KAREN E
• Application Number:
  US12/688,274
• Publication Number:
  US 20100174154A1
• Time in Patent Office: 914 Days
• Field of Search: 600/309, 600529-543
• US Class Current: 600/529
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/083 Measuring rate of metabolism by using breath test, e.g. measuring rate of oxygen consumption
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• 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 16/0051 with alarm devices
• 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 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2205/3523 using telemetric means
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

Methods and systems provide an approach to therapy control based on assessment of a patient'"'"'s cardiopulmonary status. Conditions sensed via sensors of an external respiratory therapy device are used to assess a patient'"'"'s cardiopulmonary status. The respiratory therapy device sensors may be utilized alone or in combination with other sensors to determine cardiopulmonary status of a patient. Therapy delivered to the patient is controlled based on the cardiopulmonary status assessment. For example, therapy delivered to the patient may be initiated, terminated, and/or modified based on the assessed cardiopulmonary status of the patient. Cardiopulmonary status assessment, therapy control, or both, are performed by an implantable device.

Claims

1. A method, comprising:

sensing a first set of one or more physiological parameters using one or more first sensors of a first medical unit configured to operate outside a patient'"'"'s body;

sensing a second set of one or more physiological parameters using one or more second sensors of a second medical unit configured for operation inside the patient'"'"'s body;

identifying, based on one or both of the first set of physiological parameters and the second set of physiological parameters, a cardiopulmonary disorder affecting a patient as a breathing rhythm disorder or identifying, based on one or both of the first set of physiological parameters and the second set of physiological parameters, the cardiopulmonary disorder affecting the patient as a non-rhythm breathing disorder, wherein identifying the cardiopulmonary disorder as a non-rhythm breathing disorder comprises discriminating between chronic bronchitis, asthma, emphysema, pulmonary edema and at least one other pulmonary vascular disorder; and

controlling a therapy delivered to the patient based on the identified cardiopulmonary disorder, wherein at least one of identifying and controlling are performed using circuitry.

2. The method of claim 1, wherein the at least one other pulmonary vascular disorder comprises pulmonary hypertension.

3. The method of claim 1, wherein identifying the non-rhythm breathing disorder comprises identifying an obstructive pulmonary disease or a restrictive pulmonary disease.

4. The method of claim 1, wherein identifying the non-rhythm breathing disorder comprises identifying an infectious pulmonary disease or a non-infectious pulmonary disease.

5. The method of claim 1, wherein identifying the breathing rhythm disorder comprises discriminating between apnea and at least one other breathing rhythm disorder.

6. The method of claim 5, wherein the at least one other breathing rhythm disorder comprises one or more of hypopnea, Cheyne-Stokes respiration, and periodic breathing.

7. The method of claim 1, wherein identifying the cardiopulmonary disorder comprises learning to recognize a presence of the cardiopulmonary disorder based on a history of the physiological parameters.

8. The method of claim 1, wherein identifying the non-rhythm breathing disorder includes identifying a pleural disorder.

9. The method of claim 8, wherein identifying the pleural disorder comprises discriminating between pleural effusion, pneumothorax, and hemothorax.

10. The method of claim 1, wherein controlling the therapy comprises controlling the first medical unit to deliver the therapy.

11. The method of claim 1, wherein controlling the therapy comprises controlling the second medical unit to deliver the therapy.

12. A medical system, comprising:

one or more first sensors of a first medical unit, the first medical unit configured for operation outside a patient'"'"'s body, the one or more first sensors configured to sense a first set of one or more physiological parameters;

one or more second sensors of a second medical unit configured for operation inside a patient'"'"'s body, the one or more second sensors configured to sense a second set of one or more physiological parameters;

a cardiopulmonary status processor configured to

identify, based on one or both of the first set of physiological parameters and the second set of physiological parameters, a cardiopulmonary disorder affecting a patient as a breathing rhythm disorder,

identify, based on one or both of the first set of physiological parameters and the second set of physiological parameters, a cardiopulmonary disorder affecting the patient as a non-rhythm breathing disorder,

wherein the cardiopulmonary status processor is configured to discriminate between chronic bronchitis, asthma, emphysema, pulmonary edema and at least one other pulmonary vascular disorder to identify the non-rhythm breathing disorder; and

a therapy controller configured to control a therapy delivered to the patient based on the identified cardiopulmonary disorder.

13. The medical system of claim 12, wherein the first medical unit comprises an external respiratory therapy device.

14. The medical system of claim 12, wherein the second medical unit comprises an implantable monitoring device.

15. The medical system of claim 12, wherein the second medical unit comprises an implantable therapy device.

16. The medical system of claim 12, wherein the cardiopulmonary status processor is configured to learn to recognize a presence of the cardiopulmonary disorder based on a history of the physiological parameters.

17. The medical system of claim 12, wherein the cardiopulmonary status processor is configured to identify the cardiopulmonary disorder as a pleural disorder.

18. The medical system of claim 17, wherein the cardiopulmonary status processor is configured to discriminate between pleural effusion, pneumothorax, and hemothorax to identify the pleural disorder.