# US 11,304,878 B2 · Nutritional support feeding efficiency

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- Number: US 11,304,878 B2
- Document ID: US11304878B2
- Status: Granted
- Kind: B2
- Application number: 17/334,864
- Filed: 2021-05-31
- Published: 2021-09-16
- Granted: 2022-04-19
- Earliest claimed: 2019-03-04
- Assignees: ART MEDICAL Ltd.
- Applicants: ART MEDICAL Ltd.
- Inventors: Liron Elia; Gavriel J. Iddan
- Web page: https://patentgrep.com/patent/US11304878B2

## CPC

- A61J 15/0076: {Feeding pumps (A61M1/00, A61M5/142, A61M25/1018 take precedence)}
- A61J 15/0084: {for sensing parameters related to the patient}
- A61M 5/14232: {Roller pumps}
- A61M 5/16836: {by sensing tissue properties at the infusion site, e.g. for detecting infiltration}
- A61M 5/1684: {by detecting the amount of infusate remaining, e.g. signalling end of infusion}
- A61M 5/16854: {by monitoring line pressure}
- A61M 2005/14208: {with a programmable infusion control system, characterised by the infusion program}
- A61M 2005/1726: {the body parameters being measured at, or proximate to, the infusion site}
- A61M 2205/3334: Measuring or controlling the flow rate
- A61M 2205/502: User interfaces, e.g. screens or keyboards
- A61M 2205/581: by audible feedback
- A61J: CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}

## Abstract

There is provided a method comprising: computing a target nutritional goal to reach at an end of a time interval based on a real time energy expenditure of a patient, wherein the target nutritional goal comprises a volume to be delivered (VTBD) by the end of the time interval corresponding to a target amount of energy expenditure of the patient over the time interval, computing a target feeding profile defining a target feeding rate for enteral feeding of the patient for reaching the VTBD by the end of the time interval, continuously monitoring the real time energy expenditure, adapting the target nutritional goal and corresponding VTBD to compute a maximum VTBD to reach at the end of the time interval according to the monitoring, and dynamically adapting the target feeding rate and the corresponding target feeding profile for a remaining portion of the time interval for reaching the maximum VTBD.

## Claims

### Claim 1

A system for automated enteral feeding of a subject, comprising:
at least one hardware processor executing a code for:
measuring, over a portion of a time interval, a resting energy expenditure (REE) of the subject based on CO2 production rate and/or O2 consumption rate estimates of the subject made by measurements of at least one sensor;
computing a target nutritional goal to reach at an end of the time interval, wherein the target nutritional goal comprises a volume to be delivered (VTBD) by the end of the time interval that matches to a target amount of energy expenditure of the subject over the time interval computed by extrapolating the REE from the portion to the time interval;
computing a target feeding profile defining a target feeding delivery rate that is up to a defined maximal feeding delivery rate for enteral feeding of the subject by an automated enteral feeding device for reaching the VTBD by the end of the time interval;
continuously monitoring the real time energy expenditure of the subject over the time interval based on continuous measurements of the REE measurements computed from CO2 production rate and/or O2 consumption rate estimates of the subject made by measurements of the at least one sensor;
dynamically adapting the target nutritional goal and corresponding VTBD to compute a maximum VTBD (max VTBD) to reach at the end of the time interval according to dynamic adaptations of the monitored real time energy expenditure of the subject;
dynamically sending a control signal to the automated enteral feeding device that automatically delivers feedings to the subject for adapting the target feeding delivery rate and the corresponding target feeding profile for a remaining portion of the time interval for reaching the max VTBD by the end of the time interval,
wherein the target feeding profile matches to changes of the REE and does not exceed the defined maximal feeding delivery rate.

### Claim 2 (depends on 1)

The system of claim 1, further comprising code for:
selecting an optimal feeding formulation from a plurality of in-stock pre-prepared clinical feeding formulations,
wherein the target feeding profile is computed according to the optimal feeding formulation.

### Claim 3 (depends on 2)

The system of claim 2, further comprising code for:
computing an optimal protein nutritional goal to reach at the end of the time interval;
computing a protein deficit between the optimal protein nutritional goal and the optimal feeding formulation; and
generating instructions for adding an amount of protein corresponding to the protein deficit to the optimal feeding formulation.

### Claim 4 (depends on 3)

The system of claim 3, wherein the optimal protein nutritional goal is selected based on a medical state of the subject.

### Claim 5 (depends on 2)

The system of claim 2, wherein the optimal feeding formulation is selected to provide 100% or near 100% within a tolerance range of the target nutritional goal.

### Claim 6 (depends on 2)

The system of claim 2, wherein the plurality of in-stock pre-prepared clinical feeding formulations are filtered to exclude formulations unsuitable for the subject according to a medical state of the subject.

### Claim 7 (depends on 6)

The system of claim 6, wherein excluded formulations are selected from a group consisting of: low fiber content, high fiber content, include nourishments unsuitable for diabetics, and include nourishments unsuitable for cardiovascular disease.

### Claim 8 (depends on 1)

The system of claim 1, further comprising code for:
obtaining an amount of hidden calories carried by medications prescribed for the subject for administration by the end of the time interval;
adjusting the target feeding profile to take into account the amount of hidden calories.

### Claim 9 (depends on 1)

The system of claim 1, wherein the target nutritional goal comprises a preceding nutritional goal and the time interval comprises a preceding time interval, and further comprising computing a next target nutritional goal for a next time interval adding to a next target time nutritional goal to reach at an end of a next time interval, an amount equal to the preceding feeding deficit between the preceding nutritional goal and total feedings delivered over the preceding time interval.

### Claim 10

A system for automated enteral feeding of a subject, comprising:
at least one hardware processor executing a code for:
computing a target feeding profile denoting a target enteral feeding of the subject by an automated enteral feeding device for reaching a target nutritional goal at the end of a time interval;
defining a baseline feeding profile of a subject by matching to the target feeding profile, wherein the subject is automatically fed by the automated enteral feeding device according to the baseline feeding profile for reaching the target nutritional goal;
pausing or slowing down the enteral feeding by the automated enteral feeding device for at least one pause time interval;
wherein a feeding deficit is formed between the target feeding profile and the baseline feeding profile during each pause time interval, the feeding deficit denoting a deficit to reach the target nutritional goal at the end of the time interval; and
adjusting the baseline feeding profile to a higher feeding delivery rate that is higher than a feeding delivery rate of the corresponding target feeding profile to compensate the feeding deficit for reaching the target nutritional goal at the end of the time interval.

### Claim 11 (depends on 10)

The system of claim 10, further comprising code for:
measuring, over a portion of the time interval, a resting energy expenditure (REE) of the subject based on CO2 production rate and/or O2 consumption rate estimates of the subject made by measurements of at least one sensor;
computing the target nutritional goal to reach at an end of the time interval, the target nutritional goal matching to a target amount of energy expenditure of the subject over the time interval computed by extrapolating the REE from the portion to the time interval.

### Claim 12 (depends on 10)

The system of claim 10, further comprising code for:
detecting when the feeding deficit between the target feeding profile and the baseline feeding profile has been eliminated, when a gap indicating a difference the baseline feeding profile indicating total accumulated feedings actually administered to the patient matches the target feeding profile indicating total accumulated desired feeding; and
reducing the baseline feeding profile to match the target feeding profile.

### Claim 13 (depends on 10)

The system of claim 10, wherein a maximum feeding delivery rate defied by the baseline feeding profile is set according to a basal metabolic rate of the subject.

### Claim 14 (depends on 10)

The system of claim 10, further comprising code for:
selecting an optimal feeding formulation from a plurality of in-stock pre-prepared clinical feeding formulations,
wherein the target feeding profile is computed according to the optimal feeding formulation.

### Claim 15 (depends on 14)

The system of claim 14, further comprising code for:
computing an optimal protein nutritional goal to reach at the end of the time interval;
computing a protein deficit between the optimal protein nutritional goal and the optimal feeding formulation; and
generating instructions for adding an amount of protein corresponding to the protein deficit to the optimal feeding formulation.

### Claim 16 (depends on 15)

The system of claim 15, wherein the optimal protein nutritional goal is selected based on a medical state of the subject.

### Claim 17 (depends on 14)

The system of claim 14, wherein the optimal feeding formulation is selected to provide 100% or near 100% within a tolerance range of the target nutritional goal.

### Claim 18 (depends on 14)

The system of claim 14, wherein the plurality of in-stock pre-prepared clinical feeding formulations are filtered to exclude formulations unsuitable for the subject according to a medical state of the subject.

### Claim 19 (depends on 10)

The system of claim 10, wherein excluded formulations are selected from a group consisting of: low fiber content, high fiber content, include nourishments unsuitable for diabetics, and include nourishments unsuitable for cardiovascular disease.

### Claim 20 (depends on 10)

The system of claim 10, further comprising code for:
obtaining an amount of hidden calories carried by medications prescribed for the subject for administration by the end of the time interval;
adjusting the target feeding profile to take into account the amount of hidden calories.