Method and device for monitoring and improving patient-ventilator interaction

a technology of patient-ventilator interaction and monitoring method, which is applied in the direction of medical devices, valve details, operating means/releasing devices, etc., can solve the problems of ineffective effort, effort completely failing to trigger the ventilator, and often marked trigger delay, etc., to achieve the effect of reducing cycling off errors

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a technology of patient-ventilator interaction and monitoring method, which is applied in the direction of medical devices, valve details, operating means/releasing devices, etc., can solve the problems of ineffective effort, effort completely failing to trigger the ventilator, and often marked trigger delay, etc., to achieve the effect of reducing cycling off errors

US20060249148A1Inactive Publication Date: 2006-11-09YRT

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third embodiment

[0183] Certain internal signals need to be displayed to allow the user to adjust the input settings, while others provide the user with the results of monitoring. These signals can be displayed on a monitor 78 included in a freestanding device. Alternatively, if the device is incorporated inside the ventilator, the monitor of the ventilator can be used for this purpose. A third embodiment involves directing the device's outputs to an analog to digital converter and displaying the outputs on a separate computer.

[0184] The following output signals are necessary for adjusting the input settings:

[0185] a) The main signal itself 31.

[0186] b) The output of the integrator 48 in the Tonset circuit (32).

[0187] The use of these two signals for the sake of input adjustment is described below under OPERATION (below).

[0188] Additionally, the signals representing flow 9, pressure 15 and volume 79 may be displayed on the monitor for general monitoring purposes.

[0189] Signals representing the ...

embodiment 103

[0191] In another embodiment of the output processor 103 patient respiratory rate (or TTOT) is inputted to the processor, replacing the “Calculate Patient Rate” function 83. This input is then used to calculate the “Desirable TI”87 and “Flow at Desired TI”90. Patient respiratory rate may be determined by the user from inspection of chest movements or by observing the flow tracing on the monitor, or automatically using computational methods other than the ones described in the above embodiment 103.

Operation

[0192] When the device is built inside the ventilator, the pressure 15 and flow 9 signals are permanently connected to the device. For freestanding systems, the first step is to connect the flow meters and pressure ports to the inspiratory 2 and expiratory 3 lines close to the ventilator (FIG. 7). The device is turned on. Tracing of the Signal 31 appears on the screen (FIG. 10). Subsequent steps depend on what inputs are available on the device and user preference. For the most co...

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Abstract

Method and apparatus for non-invasively determining the time onset (Tonset) and end (Tend) of patient inspiratory efforts. A composite pressure signal is generated comprising the sum of an airway pressure signal, a gas flow pressure signal obtained by applying a gain factor (Kf) to a signal representing gas flow rate and a gas volume pressure signal obtained by applying a gain factor (Kv) to a signal representing volume of gas flow. Kf and Kv values are adjusted to result in a desired linear trajectory of composite pressure signal baseline in the latter part of the exhalation phase. The current composite pressure signal is compared with (i) selected earlier composite pressure signal values and / or (ii) value expected at current time based on extrapolation of composite pressure signal trajectory at specified earlier times and / or (iii) the current rate of change in the composite pressure signal with a selected earlier rates of change. The differences obtained by the comparison are compared with selected threshold values. Tonset is identified when at least one of the differences exceeds the threshold values.

Description

REFERENCE TO RELATED APPLICATION [0001] This application claims priority under 35 USC 119(e) from U.S. Provisional Patent Application No. 60 / 391,594 filed Jun. 27, 2002.FIELD OF INVENTION [0002] This invention relates to assisted mechanical ventilation. BACKGROUND TO THE INVENTION [0003] With assisted ventilation (e.g. assist volume cycled ventilation, pressure support ventilation and proportional assist ventilation) ventilator cycles are triggered by the patient and are intended to coincide with patient's inspiratory effort. In practice, however, the ventilator cycle never begins at the onset of patient's inspiratory effort (trigger delay) and the end of the ventilator's inflation phase only rarely coincides with the end of inspiratory effort (cycling-off errors). FIG. 1 provides an example. The bottom channel is transdiaphragmatic pressure (measured by esophageal and gastric catheters) and reflects true patient inspiratory effort. As may be seen, ventilator cycle was triggered sev...

Claims

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Application Information

Patent Timeline

09 Nov 2006

Publication

US20060249148A1

IPC: A61M16/00; A62B7/04; A62B7/00

CPC: A61M16/0051; A61M2016/0021; A61M2016/0042; A61M2016/0039; A61M2016/0027; A61M16/026; A61M2230/46

Inventors: YOUNES, MAGDY