# US 12,465,331 B2 · Methods and systems for ventilation management using lung ultrasound

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- Number: US 12,465,331 B2
- Document ID: US12465331B2
- Status: Granted
- Kind: B2
- Application number: 18/571,811
- Filed: 2022-06-21
- Published: 2024-08-29
- Granted: 2025-11-11
- Earliest claimed: 2021-06-23
- Assignees: Koninklijke Philips N.V.
- Applicants: Koninklijke Philips N.V.
- Inventors: Jochen Kruecker; Seyedali Sadeghi; Shyam Bharat; Claudia Errico; Samer Bou Jawde; Roberto Buizza; Balasundar Iyyavu Raju; Sven Peter Prevrhal
- Web page: https://patentgrep.com/patent/US12465331B2

## CPC

- A61B 8/5223: {for extracting a diagnostic or physiological parameter from medical diagnostic data (for algorithms to analyse biomedical images G06T7/0012)}
- A61B 8/08: Clinical applications (A61B8/02, A61B8/04, A61B8/06 take precedence)
- A61B 8/463: {characterised by displaying multiple images or images and diagnostic data on one display}
- 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}
- G16H 50/30: for calculating health indices; for individual health risk assessment
- A61M 16/0066: {Blowers or centrifugal pumps}
- A61M 16/06: Respiratory or anaesthetic masks
- A61M 2205/3693: by mechanical waves, e.g. ultrasonic
- A61M 2205/502: User interfaces, e.g. screens or keyboards
- A61M 2210/1039: Lungs
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- 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)}
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

A lung injury monitoring system (200) configured to monitor a patient's lungs during ventilation, comprising: an ultrasound device (280) configured to obtain an ultrasound image of the patient's lungs during ventilation of the patient; a processor (220) configured to: (i) receive the obtained ultrasound image; (ii) determine a ventilation phase of the ventilator; (iii) analyze the received ultrasound image; and (iv) determine a risk score for a potential ventilator-associated lung injury (VALI); and a user interface (240) configured to display the determined risk score for the potential VALI.

## Claims

### Claim 1

A lung injury monitoring system configured to monitor a patient's lungs during ventilation, comprising:
an ultrasound device configured to obtain an ultrasound image of the patient's lungs during ventilation of the patient;
a processor configured to: (i) receive the obtained ultrasound image; (ii) determine a ventilation phase of the ventilator; (iii) analyze the received ultrasound image; and (iv) determine a risk score for a potential ventilator-associated lung injury (VALI); and
a user interface configured to display the risk score of the potential VALI.

### Claim 2 (depends on 1)

The system of claim 1, wherein analyzing comprises:
labeling the received ultrasound image as an inspiratory or expiratory image based on the determined ventilation phase of the ventilator;
determining a number of B-lines in the labeled received ultrasound image, wherein the determined number of B-lines in the labeled received ultrasound image comprises a maximum and/or average number of B-lines;
receiving an updated ultrasound image in the other of an inspiratory or expiratory ventilation phase of the ventilator, and labeling the updated ultrasound image as the other of the inspiratory and expiratory ventilation phase of the ventilator;
determining a number of B-lines in the updated ultrasound image, wherein the determined number of B-lines in the updated ultrasound image comprises a maximum and/or average number of B-lines; and
comparing the number of determined B-lines in the labeled received ultrasound image to the number of determined B-lines in the updated ultrasound image to identify a ratio of maximum and/or average number of B-lines in an inspiratory ventilation stage relative to an expiratory ventilation stage, wherein the ratio is a metric indicative of VALI.

### Claim 3 (depends on 2)

The system of claim 2, wherein the identified ratio is indicative of a potential VALI if the identified ratio is above a predetermined threshold, and wherein the identified ratio is indicative of a healthy lung if the identified ratio is below a predetermined threshold.

### Claim 4 (depends on 1)

The system of claim 1, wherein analyzing comprises:
determining, from the determined ventilation phase of the ventilator, that full expiration of the patient's lungs has been reached;
identifying a pleural line in a received ultrasound image after full expiration of the patient's lungs has been reached;
identifying, if a pleural line is identified, a parietal pleura (Rp) and a visceral pleura (Rv) in the received ultrasound image;
receiving, from the ultrasound device, an updated ultrasound image;
identifying a pleural line in the updated ultrasound image and identifying a parietal pleura (Rp) and a visceral pleura (Rv) in the updated ultrasound image;
determining, by comparing the parietal pleura and visceral pleura in the received ultrasound image and updated ultrasound image, a parietal displacement vector (dp) and a visceral displacement vector (dv);
determining a relative displacement (di) by subtracting dp from dv;
calculating, from di, a metric indicative of VALI.

### Claim 5 (depends on 4)

The system of claim 4, wherein calculating comprises determining a quantitative lung sliding parameter such as amplitude, velocity, or phase lag of displacement.

### Claim 6 (depends on 1)

The system of claim 1, wherein the VALI is atelectotrauma and/or overdistension.

### Claim 7 (depends on 1)

The system of claim 1, wherein the user interface is further configured to display one or more of monitoring or demographic information about the patient.

### Claim 8

A method for monitoring a patient's lungs during ventilation using a lung injury monitoring system, comprising:
receiving, from an ultrasound device of the lung injury monitoring system, an ultrasound image of the patient's lungs during ventilation of the patient by a ventilator of the lung injury monitoring system;
determine, by a processor of the lung injury monitoring system, a ventilation phase of the ventilator;
analyze, using the processor of the lung injury monitoring system, the received ultrasound image; and
determine, based on the analysis, a risk score for a potential ventilator-associated lung injury (VALI).

### Claim 9 (depends on 8)

The method of claim 8, wherein analyzing the received ultrasound image comprises:
labeling the received ultrasound image as an inspiratory or expiratory image based on the determined ventilation phase of the ventilator;
determining a number of B-lines in the labeled received ultrasound image, wherein the determined number of B-lines in the labeled received ultrasound image comprises a maximum and/or average number of B-lines;
receiving an updated ultrasound image in the other of an inspiratory or expiratory ventilation phase of the ventilator, and labeling the updated ultrasound image as the other of the inspiratory and expiratory ventilation phase of the ventilator;
determining a number of B-lines in the updated ultrasound image, wherein the determined number of B-lines in the updated ultrasound image comprises a maximum and/or average number of B-lines; and
comparing the number of determined B-lines in the labeled received ultrasound image to the number of determined B-lines in the updated ultrasound image to identify a ratio of maximum and/or average number of B-lines in an inspiratory ventilation stage relative to an expiratory ventilation stage, wherein the ratio is a metric indicative of VALI.

### Claim 10 (depends on 9)

The method of claim 9, wherein the identified ratio is indicative of a potential VALI if the identified ratio is above a predetermined threshold, and wherein the identified ratio is indicative of a healthy lung if the identified ratio is below a predetermined threshold.

### Claim 11 (depends on 8)

The method of claim 8, wherein analyzing the received ultrasound image comprises:
determining, from the determined ventilation phase of the ventilator, that full expiration of the patient's lungs has been reached;
identifying a pleural line in a received ultrasound image after full expiration of the patient's lungs has been reached;
identifying, if a pleural line is identified, a parietal pleura (Rp) and a visceral pleura (Rv) in the received ultrasound image;
receiving, from the ultrasound device, an updated ultrasound image;
identifying a pleural line in the updated ultrasound image and identifying a parietal pleura (Rp) and a visceral pleura (Rv) in the updated ultrasound image;
determining, by comparing the parietal pleura and visceral pleura in the received ultrasound image and updated ultrasound image, a parietal displacement vector (dp) and a visceral displacement vector (dv);
determining a relative displacement (di) by subtracting dp from dv;
calculating, from di, a metric indicative of VALI.

### Claim 12 (depends on 11)

The method of claim 11, wherein calculating comprises determining a quantitative lung sliding parameter such as amplitude, velocity, or phase lag of displacement.

### Claim 13 (depends on 8)

The method of claim 8, wherein the VALI is atelectotrauma and/or overdistension.

### Claim 14 (depends on 8)

The method of claim 8, further comprising displaying, via a user interface of the lung injury monitoring system, the risk score of the potential VALI.

### Claim 15 (depends on 14)

The method of claim 14, further comprising displaying via a user interface of the lung injury monitoring system, one or more of monitoring or demographic information about the patient.