Methods and systems for monitoring resistance and work of breathing for ventilator-dependent patients
AssigneesConvergent Engineering, Inc., University of Florida Research Foundation, Inc.
InventorsMichael J. BANNER, Neil Russel EULIANO, Andrea GABRIELLI, Nawar Nazar Yousif AL-RAWAS
Life of this patent
Estimating the term…
Abstract
Methods for non-invasively and accurately estimating and monitoring resistance and work of breathing parameters from airway pressure and flow sensors attached to the ventilator-dependent patient using an adaptive mathematical model are provided. These methods are based on calculations using multiple parameters derived from the above-mentioned sensors. The resistance and work of breathing parameters are important for: assessing patient status and diagnosis, appropriately selecting treatment, assessing efficacy of treatment, and properly adjusting ventilatory support.
Claims32
A method for estimating real-time airway resistance, endotracheal tube resistance and total resistance of a patient comprising:
- (a) non-invasively measuring pressure and flow data from a breathing circuit of an intubated patient;
- (b) using the pressure and flow data from step (a), determining endotracheal pressure without an end-inspiratory pause and/or an end-expiratory pause;
- and
- (c) using the endotracheal pressure determined from step (b), calculating estimated real-time airway resistance (RAW), endotracheal tube resistance (RETT), and total resistance (RTOT) values.
A method for estimating in real-time physiologic work of breathing, imposed work of breathing and total work of breathing comprising:
- (a) non-invasively measuring pressure and flow data from a breathing circuit of an intubated patient;
- (b) using the pressure and flow data from step (a), determining endotracheal pressure without an end-inspiratory pause and/or an end-expiratory pause;
- and
- (c) using the endotracheal pressure determined from step (b), calculating estimated real-time total work of breathing (WOBTOT/min), imposed work of breathing (WOBI/min), and physiologic work of breathing (WOBp/min) values.
A method of providing ventilator support to a patient, wherein breathing gas from a ventilator is supplied to and from the patient via a ventilator flow conduit having a patient breathing attachment in fluid communication with the patient, wherein the conduit and the breathing attachment include sensors, and wherein the ventilator has a display and at least one setting control for controlling the breathing gas supplied to and from the patient, the method comprising:
- (a) sensing the pressure of the breathing gas within the ventilator conduit and generating a pressure signal representative of that pressure;
- (b) measuring the flow rate of the breathing gas within the ventilator conduit and generating a flow signal representative of that flow rate;
- (c) measuring the pressure at the breathing attachment and generating an intra-tracheal pressure signal representative of that pressure;
- (d) processing the pressure, flow and intra-tracheal pressure signal to determine RTOT, RAW and/or RETT;
- (e) monitoring RTOT, RAW and/or RETT;
- and
- (f) determining whether monitored RAW and/or RETT is outside of a predetermined RAW and/or RETT range or value.
A method of providing ventilator support to a patient, wherein breathing gas from a ventilator is supplied to and from the patient via a ventilator flow conduit having a patient breathing attachment in fluid communication with the patient, wherein the conduit and the breathing attachment include sensors, and wherein the ventilator has a display and at least one setting control for controlling the breathing gas supplied to and from the patient, the method comprising:
- (a) sensing the pressure of the breathing gas within the ventilator conduit and generating a pressure signal representative of that pressure;
- (b) measuring the flow rate of the breathing gas within the ventilator conduit and generating a flow signal representative of that flow rate;
- (c) measuring the pressure at the breathing attachment and generating an intra-tracheal pressure signal representative of that pressure;
- (d) processing the pressure, flow and intra-tracheal pressure signal to determine WOBTOT, WOBP and/or WOBI;
- (e) monitoring WOBTOT, WOBP and/or WOBI;
- (f) determining whether monitored WOBTOT is outside of a predetermined WOBTOT range;
- and
- (g) if the monitored WOBTOT is outside of the predetermined WOBTOT range, determining whether the monitored WOBP and/or WOBI is outside of a predetermined WOBP and/or WOBI range or value.
A method of determining whether bronchodilator treatment is to be administered to a patient on ventilator support, wherein breathing gas from a ventilator is supplied to and from the patient via a ventilator flow conduit having a patient breathing attachment in fluid communication with the patient, wherein the conduit and the breathing attachment include sensors, and wherein the ventilator has a display and at least one setting control for controlling the breathing gas supplied to and from the patient, the method comprising:
- (a) sensing the pressure of the breathing gas within the ventilator conduit and generating a pressure signal representative of that pressure;
- (b) measuring the flow rate of the breathing gas within the ventilator conduit and generating a flow signal representative of that flow rate;
- (c) measuring the pressure at the breathing attachment and generating an intra-tracheal pressure signal representative of that pressure;
- (d) processing the pressure, flow and intra-tracheal pressure signal to determine RAW;
- (e) monitoring RAW;
- (f) determining whether the monitored RAW is outside of a predetermined RAW range;
- and
- (g) determining whether bronchodilator therapy is to be administered based upon monitored RAW that is outside of the predetermined RAW range.
A method of determining whether an endotracheal tube of an intubated patient on ventilator support is obstructed, wherein breathing gas from a ventilator is supplied to and from the patient via a ventilator flow conduit having a patient breathing attachment in fluid communication with the patient, wherein the conduit and the breathing attachment include sensors, and wherein the ventilator has a display and at least one setting control for controlling the breathing gas supplied to and from the patient, the method comprising:
- (a) sensing the pressure of the breathing gas within the ventilator conduit and generating a pressure signal representative of that pressure;
- (b) measuring the flow rate of the breathing gas within the ventilator conduit and generating a flow signal representative of that flow rate;
- (c) measuring the pressure at the breathing attachment and generating an intra-tracheal pressure signal representative of that pressure;
- (d) processing the pressure, flow and intra-tracheal pressure signal to determine RETT;
- (e) monitoring RETT;
- (f) determining whether the monitored RETT is outside of a predetermined RETT range;
- and
- (g) determining whether the endotracheal tube is obstructed based upon monitored RETT that is outside of the predetermined RETT range.
A method of automatically providing bronchodilator treatment to a patient on ventilator support, wherein breathing gas from a ventilator is supplied to and from the patient via a ventilator flow conduit having a patient breathing attachment in fluid communication with the patient, wherein the conduit and the breathing attachment include sensors, and wherein a bronchodilator delivery system is in fluid communication with the ventilator flow conduit, the method comprising:
- (a) sensing the pressure of the breathing gas within the ventilator conduit and generating a pressure signal representative of that pressure;
- (b) measuring the flow rate of the breathing gas within the ventilator conduit and generating a flow signal representative of that flow rate;
- (c) measuring the pressure at the breathing attachment and generating an intra-tracheal pressure signal representative of that pressure;
- (d) processing the pressure, flow and intra-tracheal pressure signal to determine RAW and/or RETT;
- (e) monitoring RAW and/or RETT;
- (f) determining whether the monitored RAW and/or RETT is outside of a predetermined RAW and/or RETT range;
- and
- (g) providing bronchodilator therapy via the bronchodilator system when it is determined that monitored RAW and/or RETT is outside of the predetermined RAW and/or RETT range.
A method of determining efficacy of a bronchodilator treatment that has been administered to a patient on ventilator support, wherein breathing gas from a ventilator is supplied to and from the patient via a ventilator flow conduit having a patient breathing attachment in fluid communication with the patient, wherein the conduit and the breathing attachment include sensors, and wherein the ventilator has a display and at least one setting control for controlling the breathing gas supplied to and from the patient, the method comprising:
- (a) administering a bronchodilator treatment to a patient on ventilator support;
- (b) sensing the pressure of the breathing gas within the ventilator conduit and generating a pressure signal representative of that pressure;
- (c) measuring the flow rate of the breathing gas within the ventilator conduit and generating a flow signal representative of that flow rate;
- (d) measuring the pressure at the breathing attachment and generating an intra-tracheal pressure signal representative of that pressure;
- (e) processing the pressure, flow and intra-tracheal pressure signal to determine RAW;
- (f) monitoring RAW;
- (g) determining whether the monitored RAW is within a predetermined RAW range;
- and
- (h) determining whether the bronchodilator treatment that is administered is efficacious based upon monitored RAW.
Dependencies are inferred from the claim text.