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US 6,257,234 B1Granted
Apparatus and method for determining respiratory mechanics of a patient and for controlling a ventilator based thereon
AssigneeRespironics, Inc.
InventorJianguo Sun
Life of this patent
Estimating the term…
Abstract
A ventilation system is controlled by detecting the resistance and elastance of the patient's respiratory system and adjusting the flow supplied by the ventilator accordingly. In one embodiment, the resistance is detected by controlling the ventilator to superimpose at least one forced single oscillation on the flow and observing the reaction of the respiratory system. In another embodiment, the elastance is detected by controlling the ventilator to supply a pressure which has the effect of temporarily occluding the respiratory system, waiting until the respiratory system has reached equilibrium, and observing the resulting state of the respiratory system. The detection techniques of these two embodiments can be used together.
Claims33
A ventilator system comprising:
- (a) ventilation means for delivering a therapeutic pressure to the respiratory system of a patient;
- (b) respiratory mechanics monitoring means for detecting a resistance of the respiratory system of the patient and for outputting the detected resistance, wherein the respiratory mechanics monitoring means comprises:
- (i) forced single oscillation means, in communication with the ventilation means, for controlling the ventilation means to superimpose at least one single pressure oscillation upon the therapeutic pressure during an inspiratory phase of the therapeutic pressure to obtain a forced single oscillation superimposed therapeutic pressure that is delivered to the patient, the single pressure oscillation having a maximum at time t1 and a minimum at time t2, and
- (ii) patient response monitoring means for monitoring a response by the patient to the forced single oscillation superimposed on the therapeutic pressure to determine the resistance in accordance with the response;
- and
- (c) adapter means, receiving the detected resistance output by the respiratory mechanics monitoring means, for controlling the ventilation means to adjust the therapeutic pressure in accordance with the detected resistance.
3 more elements
A ventilator system comprising:
- (a) ventilation means for delivering a therapeutic pressure to the respiratory system of a patient;
- (b) respiratory mechanics monitoring means for detecting an elastance of the respiratory system of the patient and for outputting the detected elastance, wherein the respiratory mechanics monitoring means comprises:
- (i) a pneumatic occlusion means, in communication with the ventilation means, for controlling the ventilation means to superimpose at least one occluding pressure upon the therapeutic pressure during an occluding time period within an expiratory phase of the therapeutic pressure to obtain a temporarily occluded therapeutic pressure that is delivered to the patient, the occluding pressure being such that during the occluding time period, patient air flow is substantially zero, and
- (ii) patient response monitoring means for monitoring a response by the patient to the temporarily occluded therapeutic pressure at a time associated with the occluding time period to determine the elastance;
- and
- (c) adapter means, receiving the detected elastance output by the respiratory mechanics monitoring means, for controlling the ventilation means to adjust the therapeutic pressure in accordance with the detected elastance.
3 more elements
A ventilator system comprising:
- (a) ventilation means for delivering a therapeutic pressure to the respiratory system of a patient;
- (b) respiratory mechanics monitoring means for detecting at least one of a resistance and an elastance of the respiratory system of the patient and for outputting the detected resistance and elastance, wherein the respiratory mechanics monitoring means comprises:
- (i) forced single oscillation means, in communication with the ventilation means, for controlling the ventilation means to superimpose at least one single pressure oscillation upon the therapeutic pressure during an inspiratory phase of the therapeutic pressure to obtain a forced single oscillation superimposed therapeutic pressure which is delivered to the patient, the at least one single pressure oscillation having a maximum at time t1 and a minimum at time t2,
- (ii) first patient response monitoring means for monitoring a response by the patient to the forced single oscillation superimposed therapeutic pressure to determine the resistance in accordance with the response,
- (iii) occlusion means, in communication with the ventilation means, for controlling the ventilation means to superimpose at least one occluding pressure upon the therapeutic pressure during an occluding time period within an expiratory phase of the therapeutic pressure to obtain a temporarily occluded therapeutic pressure which is delivered to the patient, the occluding pressure being such that during the occluding time period, patient air flow is substantially zero, and
- (iv) second patient response monitoring means for monitoring a response by the patient to the temporarily occluded therapeutic pressure during the occluding time period to determine the elastance;
- and
- (c) adapter means, receiving the detected resistance and elastance output by the respiratory mechanics monitoring means, for controlling the ventilation means to adjust the therapeutic pressure in accordance with the detected resistance and elastance.
5 more elements
A method for adaptively assisting a function of a respiratory system of a patient, the method comprising:
- (a) controlling a ventilator to deliver a therapeutic pressure to the respiratory system of the patient;
- (b) controlling the ventilator to superimpose at least one single pressure oscillation upon the therapeutic pressure during an inspiratory phase of the therapeutic pressure to obtain a forced single oscillation superimposed therapeutic pressure which is delivered to the patient, the at least one single pressure oscillation having a maximum at time t1 and a minimum at time t2;
- (c) monitoring a response by the patient to the forced single oscillation superimposed therapeutic pressure to determine a resistance of the respiratory system of the patient in accordance with the response;
- and
- (d) controlling the ventilator to adjust the therapeutic pressure in accordance with the resistance determined in step (c).
2 more elements
A method for adaptively assisting a function of a respiratory system of a patient, the method comprising:
- (a) controlling a ventilator to deliver a therapeutic pressure to the respiratory system of the patient;
- (b) controlling the ventilator to superimpose at least one occluding pressure upon the therapeutic pressure during an occluding time period within an expiratory phase of the therapeutic pressure to obtain a temporarily occluded therapeutic pressure which is delivered to the patient, the occluding pressure being such that during the occluding time period, patient air flow is substantially zero;
- and
- (c) monitoring a response by the patient to the temporarily occluded therapeutic pressure during the occluding time period to determine an elastance of the respiratory system of the patient;
- and
- (d) controlling the ventilator to adjust the therapeutic pressure in accordance with the elastance determined in step (c).
3 more elements
A method for adaptively assisting a function of a respiratory system of a patient, the method comprising:
- (a) controlling a ventilator to deliver a therapeutic pressure to the respiratory system of the patient;
- (b) controlling the ventilator to superimpose at least one single pressure oscillation upon the therapeutic pressure during an inspiratory phase of the therapeutic pressure to obtain a forced single oscillation superimposed therapeutic pressure which is delivered to the patient, the at least one single pressure oscillation having a maximum at time t1 and a minimum at time t2;
- (c) monitoring a response by the patient to the forced single oscillation superimposed therapeutic pressure to determine a resistance of a respiratory system of the patient in accordance with the response;
- (d) controlling the ventilator to superimpose at least one occluding pressure upon the therapeutic pressure during an occluding time period within an expiratory phase of the therapeutic pressure to obtain a temporarily occluded therapeutic pressure which is delivered to the patient, the occluding pressure being such that during the occluding time period, patient air flow is substantially zero;
- and
- (e) monitoring a response by the patient to the temporarily occluded therapeutic pressure during the occluding time period to determine an elastance of a respiratory system of the patient;
- and
- (f) controlling the ventilator to adjust the therapeutic pressure in accordance with the resistance determined in step (c) and the elastance determined in step (e).
5 more elements
A system for detecting a resistance of a respiratory system of a patient, the detecting system comprising:
- forced single oscillation means, in communication with a ventilation means for delivering a therapeutic pressure to the patient, for controlling the ventilation means to superimpose at least one single pressure oscillation upon the therapeutic pressure during an inspiratory phase of the therapeutic pressure to obtain a forced single oscillation superimposed therapeutic pressure which is delivered to the patient, the at least one single pressure oscillation having a maximum at time t1 and a minimum at time t2;
- and
- patient response monitoring means for monitoring a response by the patient to the forced single oscillation superimposed therapeutic pressure to determine the resistance in accordance with the response.
A system for detecting an elastance of a respiratory system of a patient, the detecting system comprising:
- occlusion means, in communication with ventilation means for delivering a therapeutic pressure to a patient, for controlling the ventilation means to superimpose at least one occluding pressure upon the therapeutic pressure during an occluding time period within an expiratory phase of the therapeutic pressure to obtain a temporarily occluded therapeutic pressure which is delivered to the patient, the occluding pressure being such that during the occluding time period, patient air flow is substantially zero;
- and
- patient response monitoring means for monitoring a response by the patient to the temporarily occluded therapeutic pressure during the occluding time period to determine the elastance.
A method for detecting a resistance of a respiratory system of a patient, the method comprising:
- (a) controlling a ventilator to deliver a therapeutic pressure to the respiratory system of the patient;
- (b) controlling a ventilator to superimpose at least one single pressure oscillation upon the therapeutic pressure during an inspiratory phase of the therapeutic pressure to obtain a forced single oscillation superimposed therapeutic pressure which is delivered to the patient, the at least one single pressure oscillation having a maximum at time t1 and a minimum at time t2;
- and
- (c) monitoring a response by the patient to the forced single oscillation superimposed therapeutic pressure to determine a resistance in accordance with the response.
1 more element
A method for detecting an elastance of a respiratory system of a patient, the method comprising:
- (a) controlling a ventilator to deliver a therapeutic pressure to the respiratory system of the patient;
- (b) controlling the ventilator to superimpose at least one occluding pressure upon the therapeutic pressure during an occluding time period within an expiratory phase of the therapeutic pressure to obtain a temporarily occluded therapeutic pressure which is delivered to the patient, the occluding pressure being such that during the occluding time period, patient air flow is substantially zero;
- and
- (c) monitoring responses by the patient to the temporarily occluded therapeutic pressure during the occluding time period to determine the elastance.
1 more element
Dependencies are inferred from the claim text.