Ventilator-initiated prompt regarding detection of double triggering during ventilation

• US 8,757,153 B2
• Filed: 11/29/2010
• Issued: 06/24/2014
• Est. Priority Date: 11/29/2010
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Milne, Gary, Hensley, Kirk, Doyle, Peter R., Kimm, Gardner
• Primary Examiner(s): Yu, Justine
• Assistant Examiner(s): TSAI, MICHAEL JASPER
• Application Number:
  US12/955,422
• Publication Number:
  US 20120137249A1
• Time in Patent Office: 1,303 Days
• Field of Search: 12820421-20426, 128/204.18, 600/529, 600/538
• US Class Current: 128/204.23
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0057 Pumps therefor
• CPC Class Codes: A61M 16/0063 Compressors
• 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 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/0816 Joints or connectors
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 16/0875 Connecting tubes
• 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 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/505 Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• CPC Class Codes: A61M 2230/43 Composition of exhalation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

This disclosure describes systems and methods for monitoring and evaluating ventilatory parameters, analyzing those parameters and providing useful notifications and recommendations to clinicians. That is, modern ventilators monitor, evaluate, and graphically represent multiple ventilatory parameters. However, many clinicians may not easily recognize data patterns and correlations indicative of certain patient conditions, changes in patient condition, and/or effectiveness of ventilatory treatment. Further, clinicians may not readily determine appropriate ventilatory adjustments that may address certain patient conditions and/or the effectiveness of ventilatory treatment. Specifically, clinicians may not readily detect or recognize the presence of double triggering during ventilation. According to embodiments, a ventilator may be configured to monitor and evaluate diverse ventilatory parameters to detect double triggering and may issue notifications and recommendations suitable for a patient to the clinician when double triggering is implicated. The suitable notifications and recommendations may further be provided in a hierarchical format.

Claims

1. A ventilatory system for issuing a prompt when double triggering is implicated during ventilation of a patient, comprising:

at least one processor; and

at least one memory, communicatively coupled to the at least one processor and containing instructions that, are executed by the at least one processor, the instructions include;

detect that double triggering is implicated for a patient;

determine an appropriate notification;

determine an appropriate list of entries for mitigating the double triggering;

identify one or more ventilatory settings associated with a ventilatory treatment of the patient, wherein the one or more ventilatory settings are a ventilation breath type, wherein the ventilation breath type includes one or more of;

volume-targeted-pressure-control (VC+), pressure-support (PS), and volume-support (VS); and

issue the appropriate notification and the appropriate list of entries for mitigating the double triggering;

wherein the appropriate list of entries for mitigating the double triggering comprises a primary entry;

wherein if the ventilator identifies that the ventilation breath type is PS, the primary entry is a suggestion to decrease a set expiratory sensitivity (E_SENS);

wherein if the ventilator identifies that the ventilation breath type is VS, the primary entry is a suggestion to decrease the set expiratory sensitivity (E_SENS); and

wherein if the ventilator identifies that the ventilation breath type is VC+, the primary entry is a suggestion to increase set inspiration time (T_I).

2. The ventilatory system of claim 1, wherein the at least one memory containing instructions that, when executed by the at least one processor, perform the method further comprising:

identifying processed ventilatory parameter data that implicated double triggering; and

determining the appropriate notification based at least in part on the processed ventilatory parameter data that implicated double triggering.

3. The ventilatory system of claim 2, wherein the appropriate notification comprises an alert that double triggering is implicated and information regarding the processed ventilatory parameter data that implicated double triggering.

4. The ventilatory system of claim 1, wherein the appropriate list of entries comprises a secondary entry.

5. The ventilatory system of claim 4,

wherein if the ventilator identifies that the ventilation breath type is PS, the secondary entry is a suggestion to switch to a PA breath type;

if the ventilator identifies that the ventilation breath type is VS, the secondary entry is a suggestion to switch to the PA breath type; and

if the ventilator identifies that the ventilation breath type is VC+, the secondary entry is a suggestion to switch to the PA, the PS, or the VS breath type.

6. A graphical user interface for displaying one or more prompts corresponding to a detected condition, a ventilator configured with a computer having a user interface including the graphical user interface for accepting commands and for displaying information, the graphical user interface comprising:

at least one window; and

one or more elements within the at least one window comprising at least one prompt element for communicating information regarding a detected condition, wherein the detected condition is double triggering during ventilation of a patient, wherein the double triggering is detected when exhaled tidal volume associated with an expiratory period is less than 10% of a delivered tidal volume of a prior inspiratory period and no disconnect alarm is detected, and wherein the at least one prompt element further comprises;

a list of entries for mitigating the double triggering that is based at least in part on one or more ventilator settings, each entry identifying a switch in breath type, identifying an increase in a set inspiration time, or identifying a decrease a set expiratory sensitivity (E_SENS).

7. The graphical user interface of claim 6, wherein the at least one prompt element further comprises at least one of a notification message and one or more recommendation messages, wherein the notification comprises an alert associated with a detected implication and cause of double triggering.

8. The graphical user interface of claim 7, wherein the list of entries during a VC+ breath type comprises one or more of:

a suggestion to increase set time for inspiration (T_I); and

a suggestion to switch to one of the proportional assist (PA), a pressure-support (PS), and a volume-support (VS) breath type.

9. The graphical user interface of claim 7, wherein the list of entries during a PS breath type or a VS breath type comprises one or more of:

a suggestion to decrease a set expiratory sensitivity (E_SENS); and

a suggestion to switch to a proportional assist (PA) breath type.

10. A ventilatory system for issuing a prompt when double triggering is implicated during ventilation of a patient, comprising:

means for collecting data associated with ventilatory parameters;

means for processing the collected ventilatory parameter data, wherein the means for processing the collected ventilatory parameter data comprises means for deriving ventilatory parameter data from the collected ventilatory parameter data;

means for analyzing the processed ventilatory parameter data, wherein the means for analyzing the processed ventilatory parameter data comprises;

means for receiving at least one predetermined threshold associated with the processed ventilatory parameter data; and

means for detecting whether the processed ventilatory parameter data breaches the received at least one predetermined threshold at a predetermined frequency;

means for determining that double triggering is implicated upon detecting that the processed ventilatory data breaches the received at least one predetermined threshold at the predetermined frequency;

means for identifying one or more ventilatory settings associated with a ventilatory treatment of the patient, wherein the one or more ventilatory settings are a ventilation breath type, wherein the ventilation breath type includes one or more of;

volume-targeted-pressure-control (VC+), pressure-support (PS), and volume-support (VS); and

means for issuing a prompt when the double triggering is implicated, wherein the prompt includes an appropriate list of entries for mitigating the double triggering;

wherein the appropriate list of entries for mitigating the double triggering comprises a primary entry;

wherein if the means for identifying one or more ventilatory settings identifies that the ventilation breath type is PS, the primary entry is a suggestion to decrease a set expiratory sensitivity (E_SENS);

wherein if the means for identifying one or more ventilatory settings identifies that the ventilation breath type is VS, the primary entry is a suggestion to decrease the set expiratory sensitivity (E_SENS); and

wherein if the means for identifying one or more ventilatory settings identifies that the ventilation breath type is VC+, the primary entry is a suggestion to increase set inspiration time (T_I).

11. The ventilatory system of claim 10, wherein the appropriate list of entries for mitigating the double triggering comprises a secondary entry,

wherein if the means for identifying one or more ventilatory settings identifies that the ventilation breath type is PS, the secondary entry is a suggestion to switch to a PA breath type;

wherein if the means for identifying one or more ventilatory settings identifies that the ventilation breath type is VS, the secondary entry is a suggestion to switch to the PA breath type; and

wherein if the means for identifying one or more ventilatory settings identifies that the ventilation breath type is VC+, the secondary entry is a suggestion to switch to the PA, the PS, or the VS breath type.

12. The ventilatory system of claim 10, wherein the received at least one predetermined threshold is an exhaled tidal volume associated with an expiratory period that is less than 10% of the delivered tidal volume of the prior inspiratory period.