Acoustic analysis of respiratory therapy systems

Abstract

The method and apparatus are configured to administer respiratory therapy to a patient and / or respiratory Obtain information about the respiratory therapy system. This respiratory therapy system uses an air circuit to support the patient's breathing. The system includes a flow generator configured to supply pressurized air to the interface. Yes, it is possible. The sound signal representing the sound in the air circuit can be processed, and cepstrum data can be obtained. It generates a time-series delay estimate based on the acoustic signature of the cepstrum data. This is possible. Each acoustic signature reflects sound along the air circuit from the patient interface. It can represent morphisms. It can analyze fluctuations in time-series delayed estimations. It can generate one or more output indicators based on variability. One or more output indicators are affected This may relate to the status of individuals and / or systems.

Description

Technical Field

[0001] [Cross - Reference to Related Applications] This application claims the benefit of U.S. Provisional Application No. 62 / 908,364, filed on September 30, 2019, and Australian Provisional Application No. 2019903799, filed on October 9, 2019, and each disclosure is hereby incorporated by reference in its entirety to form a part of this specification.

[0002] This technology relates to one or more of the detection, diagnosis, treatment, prevention, and improvement of respiratory - related diseases. This technology also relates to medical devices or apparatuses and their use.

Background Art

[0003] [2.2.1 The Human Respiratory System and Its Diseases] The respiratory system of the body facilitates gas exchange. The nose and mouth form the entrance to the patient's airway.

[0004] The airway contains a series of tubes that branch out in a way that becomes narrower, shorter, and more numerous as they penetrate deeper into the lungs. The main function of the lungs is gas exchange, which moves oxygen from inhaled air into venous blood and carbon dioxide in the opposite direction. The trachea divides into the right and left main bronchi, which further divide ultimately into terminal bronchioles. The bronchi supplement the conducting airway and are not involved in gas exchange. The airway further differentiates and connects to respiratory bronchioles, which ultimately connect to alveoli. The alveolar region of the lungs is where gas exchange occurs and is referred to as the respiratory zone. "Respiratory Physiology" by John B. West ​​​​​​​​​​​ See Lippincott Williams & Wilkins, 9th edition, published 2012.

[0005] A wide range of respiratory diseases exist. Specific diseases are specific to certain conditions. The elephant's condition is characterized by, for example, apnea, hypopnea, and hyperpnea.

[0006] Obstructive sleep apnea (OSA) is a condition in which the upper airway is obstructed during sleep. This is a respiratory disease characterized by events such as obstruction or obstruction. This occurs when the upper airway is smaller than normal. This is related to the fact that normal muscle tone is lost in the areas of the tongue, soft palate, and posterior wall of the oropharynx during sleep. This occurs as a result of a combination of factors. Due to this symptom, the affected patient experiences a period of apnea. Normally, breathing stops for 30 to 120 seconds, and in some cases, 200 to 300 times per night. This often causes excessive daytime sleepiness and can lead to cardiovascular disease. This syndrome can cause brain damage (SE). This syndrome is especially common in overweight middle-aged men. Although it is a disorder that can be diagnosed, those affected may not be aware of the problem. See issues 944 and 310 (Sullivan).

[0007] A wide range of treatments have been used to treat or improve these symptoms. Healthy individuals may also utilize such treatments to prevent the onset of respiratory illnesses. However, these have numerous drawbacks.

[0008] [2.2.2 Treatment] Continuous Positive Airway Pressure (CPAP) therapy, high flow therapy High flow therapy (HFT), non-invasive ventilation (NIV) ), using various treatments such as invasive ventilation (IV), the above respiratory treatments We have performed treatment for one or more organ diseases.

[0009] [2.2.3 Treatment System] These treatments can be provided by respiratory therapy systems or devices. Such systems and devices can also be used to diagnose symptoms without performing any treatment. It is possible.

[0010] Respiratory therapy systems include respiratory therapy devices (RT (Respiratory Therapy) devices), It shall include an air circuit, humidifier, patient interface, and data management. It is possible.

[0011] [2.2.3.1 Patient Interface] Using a patient interface, for example, the flow of air at the entrance to the airway. By providing this, an interface may be established between the wearer and the breathing equipment. Airflow is from the mask to the nose and / or mouth, from the tube to the mouth, or through the tracheostomy of the patient's trachea. It can be delivered via a tube. Depending on the treatment applied, the patient interface For example, it forms a seal with the area of ​​the patient's face, for example, against ambient pressure of approximately 10 cmH Use a positive pressure of 2O or similar, and apply the gas at a pressure that is sufficiently varied from the ambient pressure to make the treatment effective. It can facilitate delivery. In other forms of treatment, such as oxygen delivery, the patient The interface facilitates airway delivery by supplying gas at a positive pressure of approximately 10 cmH2O. It may not be necessary to have sufficient sealing.

[0012] [2.2.3.2 Respiratory Therapy (RT) Devices] Respiratory therapy (RT) devices such as respiratory pressure therapy (RPT) devices are used to generate an airflow delivered to the airway inlet, etc., to perform one or more of the above-mentioned multiple treatments. The air flow can be pressurized. Examples of RPT devices include CPAP devices and ventilators. In some cases, the respiratory therapy (RT) device can be a high-flow therapy (HFT) device that provides high-flow respiratory therapy.

[0013] Air pressure generators are known in a wide range of applications such as industrial-scale ventilation systems. However, air pressure generators for medical purposes have specific requirements that are not satisfied by more general air pressure generators, such as requirements for the reliability, size, and weight of medical devices.

[0014] Examples of RPT devices include the S9 Sleep Therapy System manufactured by ResMed Limited, the ResMed Stellar (registered trademark) series of Adult and Paediatric Ventilators, and the ResMed Astral (registered trademark) 150 ventilator.

[0015] [2.2.3.3 Air Circuit] The air circuit is constructed and arranged as a conduit or tube that allows air to flow back and forth between two components of a respiratory therapy system, such as an RT In some cases, the air circuit is divided into branches between inhalation and exhalation. It may be divided into two. In other cases, a single branch air circuit may be used for both inhalation and exhalation. ru.

[0016] [2.2.3.4 Humidifier] Delivering airflow without humidification can lead to airway dryness. RT device and patient Using a humidifier along with the interface minimizes dryness of the nasal mucosa and improves the patient's airway. It produces humidifying gases that increase comfort. In addition, in colder climates, the patient interface Warm air is more comfortable than cold air in the facial area inside and around the unit.

[0017] [2.2.3.5 Ventilation Technology] In some forms of respiratory therapy systems, venting is used to flush out the carbon dioxide from exhaled air. It may contain (air). By ventilation, for example, the patient interface of the plenum chamber It is possible to create a flow of air from the internal space to, for example, the outside of the surrounding patient interface. Cut.

[0018] [2.2.3.6 Sensing and Data Management] Patients, caregivers, clinicians, insurance companies, or technicians may use respiratory therapy, or these may be used in the treatment of patients. We wish to collect data regarding the individual components used or whether they relate to the entire treatment system. This may also occur. One or more patients involved may be responsible for the collection and use of treatment-related data. There are numerous situations in which providing respiratory therapy to patients could be beneficial. .

[0019] [2.2.4 Identification of Components] As mentioned above, respiratory therapy systems typically consist of an RPT device, a humidifier, an air circuit, and It is equipped with a patient interface. Various different forms of patient interfaces are available, for example, a nasal pillow. , nasal cannula, nasal mask, nose and mouth (mouth and nose) mask, or full face mask, etc. It can be used with RPT devices. Furthermore, different types of devices can be used in air circuits, etc. A different type (length, diameter) conduit can be used. To improve the control of the treatment being performed, pressure, leak flow rate, and flow rate in the patient interface are controlled. It can sometimes be advantageous to estimate treatment parameters such as airflow. In systems that use estimation, knowledge of the type of component is used for the patient. This knowledge can improve the accuracy of parameter estimation and, consequently, the effectiveness of treatment. To obtain this, some RPT devices use, for example, brand, form, model, etc. A menu that allows the patient to select the type of system component, including the patient interface. It is equipped with a new system. Once the type of component is selected for the patient, the RPT device will Select the appropriate operating parameters for the flow generator that best coordinate with the selected components. This allows for more accurate monitoring of treatment parameters during treatment. However, the patient did not accurately enter the type of component, or did not enter it at all, RPT You may be leaving the device in an error state, or you may be ignorant about the types of components being used. stomach.

[0020] Some components of the respiratory therapy system are replaced more frequently than others for effective treatment. It needs to be replaced. For example, the silicone seal-forming portion. A patient interface equipped with ) will check for any patient every few months (for example, every three months). They may be replaced by the users, while RT devices should be replaced every few years (for example, every 3 years). Components that are replaced or updated relatively frequently (such as patient interfaces) may be replaced or updated. So, when it's time to replace a component, the patient or caregiver needs to do so reliably and accurately at low cost. The challenge of being informed is faced regularly. During replacement, one or more settings of the treatment system (for example) If the RT device's software settings are configured, the system will ensure that the new components are fully utilized. It may need to be modified to suit the patient. Therefore, optimizing treatment and the patient For both reasons, and to keep caregivers informed about when to change the respiratory therapy system, The ability to automatically identify the components of a system is crucial.

[0021] In the past, arrays of solutions were used in the respiratory therapy field for component identification. Or have been presented. For example, data on environmental conditions, patient information, and component data. Sensors / transducers (tr) are used in many forms to collect information on identification, treatment operation conditions, etc. Ansducer (i.e., sensor or transducer) has been used and presented. However, many RT devices are flow sensors, pressure sensors, humidity sensors, temperature sensors, etc. It comprises one or more sensors. The signals generated by such sensors are analyzed to call Identifying specific components within the inhalation therapy system, generating treatment-related data such as patient interfaces, etc. It is possible.

[0022] However, sensors / transducers usually require a complete set of additional components. These can hinder its compatibility in many forms. For example, by the sensor / transducer The collected data is then stored and / or analyzed (i.e., stored or analyzed or For both of these, for example, communication from the sensor to the memory and / or processor is not required. This must be done. This, along with the aforementioned sensors, urges medical device manufacturers to... The cost of calculation, testing, and / or manufacturing may increase further, and / or the patient This can also increase the cost and complexity of the process.

[0023] Furthermore, expensive electrical and / or Integrating mechanical characteristics can sometimes hinder the provision of the most cost-effective treatment. This leads to increased waste, which is potentially unsustainable from an environmental perspective.

[0024] Furthermore, many solutions have been presented regarding sensors and / or transducers. (Solution) The sensor is placed away from the data storage and / or analysis location. This often increases complexity and / or implementation costs, which is a limitation. It is possible. For example, if the patient interface is equipped with sensors, the electrical signals to the RT device may be affected. This requires specific connections, which can further increase complexity and / or implementation costs.

[0025] Furthermore, RT device designers face numerous options, including competition and even within the same manufacturer. Even if they are created at different times, they offer different solutions compared to other devices on the market. It often reaches the . As a result, the related electrical connector provided is specific to RT. It may only be connectable to a vise. This may unintentionally result in incompatibility. This could be inconvenient for certain subsegments of consumers, and / or affect consumer choices. This can sometimes narrow down the range of choices.

[0026] [2.2.5 Composition of exhaled gases] The composition of a patient's exhaled gas is a useful indicator of their health status. In particular, Capnography sensors are used, for example, during anesthesia and intensive care, or For the longer duration of COPD progression, exhaled carbon dioxide is used for therapeutic and monitoring purposes. It is configured to measure the fractional concentration of carbon.

[0027] Cardiac output is an important hemodynamic parameter of a patient. It is a meter. It is used by doctors, clinicians, technicians, caregivers, etc. for treatment and / or it can define the patient's response to medical treatment or intervention. Cardiac output is simple This refers to the amount of blood pumped by the heart per unit of time. This is called heart rate (HR). HR is the product of heart rate (HR) and stroke volume (SV). The number of heartbeats per unit time (bpm) is the number of heartbeats per unit time. SV is the number of pumps drawn from the ventricles per heartbeat. This is the amount of blood pumped up. Cardiac output is usually provided in units of liters per minute (L / min). ).

[0028] The Fick method is an approach used to determine cardiac output. It contains oxygen (O2), carbon dioxide (CO2), and para-aminohippuric acid (PAH). This includes the measurement of nohippuric. Typically, the Fick method is used to calculate carbon dioxide exchange. This includes monitoring oxygen consumption in a confined space. However, cardiac output It can be estimated using the modified Fick method. This assumes that oxygen consumption and carbon dioxide production have a known relationship (such as a linear relationship), Related to carbon oxide production.

[0029] Capnography sensors are expensive and difficult to integrate into respiratory therapy systems. Even in that case, the high latency makes it unsuitable for real-time CO2 monitoring. (Latency: waiting time) may also be present. Therefore, the respiratory system has its own air circuit. It is desirable to have a low-cost method for estimating the CO2 concentration inside, in real time. It is even more desirable that it be close to the original and capable of supporting such estimations. [Overview of the Initiative] [Problems that the invention aims to solve]

[0030] This technology offers advantages in terms of comfort, cost-effectiveness, efficacy, ease of use, and patient engagement. A product having one or more of the following: nt, and improvements in manufacturability, for the diagnosis, improvement, treatment, or This relates to providing medical devices used in prevention. [Means for solving the problem]

[0031] A first aspect of this technology relates to a device used for the diagnosis, improvement, treatment, or prevention of respiratory diseases. Related.

[0032] Other aspects of this technology relate to methods used for the diagnosis, improvement, treatment, or prevention of respiratory diseases. To be connected.

[0033] This technology, through acoustic analysis, particularly analyzes acoustic reflection signatures (signatures) at different time scales. By analyzing the temporal variation of the delay of the characteristic e, we can learn about the respiratory therapy system. This may involve improving on known devices for obtaining useful information. For example, breathing By delay variations in the frequency band, it may be possible to provide measurements of exhaled carbon dioxide concentration, and consequently It may be used for diagnostic and therapeutic purposes, such as estimating a patient's cardiac output.

[0034] Some implementations of this technology involve a respiratory therapy system configured to administer respiratory therapy to a patient. The system can affect the patient and / or the system (i.e., the patient or the system or both). This includes one or more processor methods for generating an indication of the status of (the method). The respiratory therapy system generates a supply of pressurized air to the patient interface along the air circuit. A flow generator configured in this manner may be provided. The sound signal representing the sound in the air circuit from the crossphone is processed, and the cepstrum day This may include obtaining the data. This method involves the acoustics of cepstrum data. Based on the signature (acoustic signature), it generates a time-series estimate of the delay. This may include the following: Each acoustic signature is from the patient interface to the air circuit. This method can represent sound reflections along this time series. This may include analyzing one or more output indicators based on the variability. This may include generating one or more output indicators for the patient and / or system. Regarding status.

[0035] In some implementations, generating time series involves cepstrum data. This may include separating the acoustic signature from the RAM. To generate a time series, This can include estimating the acoustic signature delay for time-series delay estimations. Generating a time series involves repeatedly separating and estimating data. This can be done. The analysis involves filtering the time-series delayed estimates to determine the respiratory rate. This may include passing frequencies within a certain frequency band. The analysis will be time-series. This further includes converting the resulting delayed estimate into an indicator of the carbon dioxide concentration in the air circuit. It is possible to use one or more output indicators, such as the patient's end-tidal carbon dioxide concentration (EtCO2). This method may include an indication of EtCO2. This may further include adjusting the parameters of the treatment system.

[0036] In some implementations, one or more output metrics may include an estimate of the patient's cardiac output. Yes, it is possible. This method involves applying a revised Fick technique function and time-series delay estimation. The system measures the change in the EtCO2 reading generated and uses that to estimate cardiac output. This method can be included in the following. This method estimates the patient's cardiac output by repeatedly performing analyses. This method may further include generating multiple estimates of the patient's cardiac output. This method may further include determining the trend in the determination. This can further include taking action based on trends in a given situation. Taking a signal includes generating output communication and / or output to a display. This can be done. The analysis allows for the determination of one or more environmental parameters of the respiratory therapy system. Furthermore, the determination of carbon dioxide concentration includes correcting for one or more environmental parameters. It is possible to do so. One or more environmental parameters include air temperature, ambient pressure, and ambient acidity. This may include carbon dioxide concentration, background noise, or a combination thereof. It is possible. Background noise can be different from the sound sensor that generated the sound signal. It can be generated by a sound sensor.

[0037] In some implementations, the analysis involves estimating the time-series delay from the respiratory rate cycle. Remove wavenumber bandwidth fluctuations to estimate non-respiratory-related delays in the time series. This may include obtaining a delay estimate. One or more output indicators include the air circuit and / or it may include indications of exchange conditions for components of the patient interface. This means that the time-series non-respiratory delay estimate is taken from the time-series length value of the air circuit. This can further include mapping to multiple treatment sessions. This further includes determining whether the increase in the length of the air circuit exceeds a threshold over time. Yes, it is possible. The analysis will reveal the variability in the length of the air circuit over a single respiratory therapy session. This may further include determining (variability). This process involves determining respiration from the sound signal. This may include removing background noise from the treatment system environment.

[0038] In some implementations, one or more output indicators were used to (a) adjust the therapeutic output of the therapeutic device. Control signals for controlling the system, and / or (b) output to output communication or display. It can also include more.

[0039] Some implementations of this technology involve a respiratory therapy system configured to administer respiratory therapy to a patient. The system provides a device for generating indicators of the patient and / or system status. The respiratory therapy system includes a supply of pressurized air to the patient interface along an air circuit. It may include a flow generator configured to generate air circuits. It may be equipped with a sensor configured to generate an audio signal representing the sound inside. The device may include a controller that has one or more processors and memory. It is possible. One or more processors can perform tasks using program instructions stored in memory. to configure to perform one or more of the embodiments of the methods described herein. This is possible. In some implementations, this device is further equipped with a blower. The controller can be configured to control the operation of the blower.

[0040] Some implementations of this technology involve a respiratory therapy system configured to administer respiratory therapy to a patient. The system provides a device for generating indicators of the patient and / or system status. The respiratory therapy system includes a supply of pressurized air to the patient interface along an air circuit. It may include a flow generator configured to generate air circuits. It may be equipped with a sensor configured to generate an audio signal representing the sound inside. The device may include a controller that represents sound in the air circuit. It is possible to configure this to process audio signals and obtain cepstrum data. Laura generates time-series delay estimates based on acoustic signatures in cepstrum data. It can be configured to do so. Each acoustic signature is empty from the patient interface. It can represent sound reflection along the air circuit. This controller is used for time-series delay estimation. It can be configured to analyze fluctuations. This controller analyzes fluctuations. It can be configured to generate one or more output metrics, and one or more output metrics are, Regarding the status of patients and / or systems.

[0041] In several implementations, this device reduces background noise in the respiratory therapy system environment. It can further include a second sensor configured to generate an audio signal representing 'z'. This controller generates to represent background noise in the respiratory therapy system environment. Using the generated sound signal, the sound signal is generated to represent sound in an air circuit, breathing It can be further configured to remove background noise from the treatment system environment. The controller generates a time series from the cepstrum data. The Hibiki signature can be configured to be separated. This controller generates a time series To achieve this, the system is configured to estimate the acoustic signature delay for time-series delay estimations. This controller can perform separation and estimation to generate a time series. It can be configured to return a value.

[0042] In some implementations, the controllers have been time-series delayed to analyze the fluctuations. The delay estimation is filtered and configured to allow frequencies to pass through within the frequency band of the respiratory rate. The controller can analyze the fluctuations by performing time-series delayed estimations. It can be configured to convert the concentration of carbon dioxide in the air circuit into an index. The output indicator may also include the patient's end-tidal carbon dioxide concentration (EtCO2) reading. This controller adjusts the parameters of the respiratory therapy system based on the EtCO2 reading. It can be further configured to adjust. One or more output indicators are the patient's cardiac output. It may also include estimation of . The controller applies a revised fix technique function and By measuring the change in the EtCO2 reading generated by time-series delayed estimation, cardiac output is estimated. It can be configured to generate a fixed value. The controller performs analysis. This process may be repeated to generate multiple estimates of the patient's cardiac output. The system can be configured to determine trends in multiple estimates of a patient's cardiac output. The controller then takes action based on the trends of the multiple estimations that have been determined. Further configuration is possible. Actions include output communication and / or output to display. It may include generating forces. The controller analyzes the fluctuations using time series. By removing the respiratory rate frequency band fluctuations from the delayed estimation, the time-series non-respiratory related delays are reduced. It can be configured to obtain a delay estimate. One or more output indicators are air circuits and / or The indication of the exchange conditions for the components of the patient interface may be included.

[0043] In some implementations, the controller analyzes the variability using time-series non-respiratory relationships. The delay estimation of the sequence is configured to map to the time-series length values ​​of the air circuit. This is possible. The controller analyzes the variability across multiple treatment sessions. It can be configured to determine whether the increase in the length of the air circuit exceeds a threshold. Laura analyzed the variability by measuring the length of the air circuit over a single respiratory therapy session. It can be configured to determine the variability of (a) treatment. Control signals for controlling the adjustment of the device's therapeutic output, and / or (b) output communication or It can also include output to a display.

[0044] Some implementations of this technology involve generating sound signals that represent sounds in the air circuit of a respiratory therapy system. The respiratory therapy system includes a device that can be equipped with means to do so, and the respiratory therapy system can provide air from the outlet. A flow configured to produce a supply of pressurized air to the patient interface along the circuit. It can be equipped with a generator. This device processes sound signals representing sound in an air circuit. The apparatus can be further equipped with means for obtaining cepstrum data. The system further comprises means for generating time-series delay estimates based on acoustic signatures within the data. The acoustic signature can be obtained, and each is from the patient interface along the air circuit. This represents sound reflection. The device is equipped with means for analyzing the fluctuations in time-series delay estimation. Yes, it is possible. The device may include means for generating one or more output indicators based on variations. It is possible to have one or more output indicators relating to the patient and / or system status.

[0045] Some embodiments of the present invention include a respiratory therapy system configured to administer respiratory therapy to a patient. To generate status indicators for patient interfaces associated with the stem The respiratory therapy system includes one or more processor methods, and the patient enters the air circuit along the airway. It is possible to provide a flow generator configured to supply pressurized air to the tough surface. This method processes the sound signal representing sound in an air circuit to obtain cepstrum data. This method allows you to obtain acoustic signatures from cepstrum data. It may further include separation, where the acoustic signature is the patient interface. This represents the reflection of sound along the air circuit. This method is an internal delay of the acoustic signature. This may further include estimating the delay, and the internal delay is separated by the mask tube. Between the two parts of the acoustic signature representing the reflection from each component of the patient interface This can be a delay. This method involves processing, separating, and estimating. This can include repeatedly generating an estimate of the internal delay in a time series. The method may include analyzing the estimation of internal delays over time. Based on the analysis, this may include generating one or more output metrics, and one or more output The force indicator relates to the status of the patient interface.

[0046] In some implementations, the analysis filters the estimation of internal delays over time. This may involve ringing and passing frequencies within the frequency band of the respiratory rate. The process involves analyzing the estimated internal delay of the filtered time series, and then masking the lag. This may further include generating an index of the carbon dioxide concentration in the oil and analyzing it. This involves removing fluctuations in the frequency band of respiratory rate from the estimation of internal delays in this time series, and then... This may include obtaining a series of estimates of non-respiratory related internal delays. The analysis is time The estimation of non-respiratory related internal delays in a time series is based on the time-series length of the mask tube. It can be further equipped to map to. Analyzing numerous treatment sessions This further includes determining whether the increase in the length of the mask tube exceeds a threshold over a certain period. It is possible to analyze the mask tube over a single respiratory therapy session. This may further include determining the variability of the length.

[0047] Some implementations of this technology involve a respiratory therapy system configured to administer respiratory therapy to a patient. To generate status indicators for patient interfaces associated with the stem The device includes a respiratory therapy system that uses pressurized air along the air circuit to the patient interface. The device may include a flow generator configured to produce an air supply. It can be equipped with a sensor configured to generate an audio signal representing sound within the air circuit. This device may be equipped with a controller. This controller may be one or more It can be equipped with a processor and memory. One or more processors record memory The stored program instructions execute one or more of the methods described herein. It can be configured to do so.

[0048] Some implementations of this technology involve a respiratory therapy system configured to administer respiratory therapy to a patient. A device for generating status indications regarding the patient interface for the system. The respiratory therapy system includes supplying pressurized air to the patient interface along the air circuit. The device may include a flow generator configured to produce air. The system may include a sensor configured to generate an audio signal representing the sound within the circuit. This device may be equipped with a controller. This controller is connected to the air circuit. It is possible to configure the system to process sound signals representing sound in a given location and obtain cepstrum data. This controller is configured to separate acoustic signatures from cepstrum data. This acoustic signature allows for the transmission of sound along the air circuit from the patient interface. It can represent reflections. This controller estimates the internal delay of the acoustic signature. It can be configured in this way. This internal delay is the delay between the two parts of the acoustic signature and This is possible. Each part is a patient interface separated by a mask tube. It can represent reflection from the corresponding component. This controller processes and divides By repeatedly separating and estimating, we generate an estimated internal delay in a time series. It can be configured as follows. This controller analyzes the estimation of internal delays in a time series. This controller may be configured to output one or more signals based on the analysis. It can be configured to generate indicators, and one or more output indicators are available in the patient interface. Regarding status.

[0049] In some implementations, the controller analyzes the time series, which is then converted to a time series. The estimated internal delay is filtered, allowing frequencies to pass through within the respiratory rate frequency band. It can be configured in this way. The controller filters the time series to analyze it. By analyzing the estimated internal delay in the time series obtained, the carbon dioxide concentration in the mask tube was determined. It can be further configured to generate indicators. The controller analyzes the time series. Therefore, the frequency band variation of the respiratory rate is removed from the estimation of the internal delay in time series, It can be configured to obtain a series of non-respiratory related internal delay estimates. To analyze the time series, R estimates the non-respiratory related internal delay in the time series, and masks It can be further configured to map to the time-series length values ​​of the tube. The controller analyzes the time series across multiple treatment sessions, It can be further configured to determine whether the increase in the length of the tube exceeds a threshold. The controller analyzes the time series by monitoring the mask throughout a single respiratory therapy session. The system can be further configured to determine the variability of the tube's length.

[0050] Some implementations of this technology involve generating sound signals that represent sounds in the air circuit of a respiratory therapy system. The respiratory therapy system includes a device that can be equipped with means to do so, and the respiratory therapy system can provide air from the outlet. A flow configured to produce a supply of pressurized air to the patient interface along the circuit. It can be equipped with a generator. This device processes sound signals representing sound in an air circuit. The device can be further equipped with means for obtaining cepstrum data. From the patient interface, the acoustic signature representing sound reflection along the air circuit is separated. It can be further equipped with means to do so. This device estimates the internal delay of the acoustic signature. It can be equipped with a means to do so, and the internal delay is separated by the mask tube. Between the two parts of the acoustic signature, each representing a reflection from the corresponding component of the face. It can be delayed. This device processes, separates, and estimates. The system can be equipped with means for repeatedly performing the above steps to generate an estimate of the internal delay in the aforementioned time series. This device may be equipped with means for analyzing the estimation of internal delays in a time series. The device may include means for generating one or more output indicators based on analysis. It is possible to have one or more output indicators related to the status of the patient interface.

[0051] Some implementations of this technology include respiratory therapy systems for providing respiratory treatment to patients. This system includes a flow generator configured to produce a supply of pressurized air. This system can deliver pressurized air to the patient interface. This system can be equipped with an air circuit connected to a generator. The system includes a device that generates an indication of the patient's and / or system's status. This device may have one or more of the features described herein. It is possible.

[0052] Some implementations of this technology include respiratory therapy systems for providing respiratory treatment to patients. This system includes a flow generator configured to produce a supply of pressurized air. This system can deliver pressurized air to the patient interface. This system can be equipped with an air circuit connected to a generator. It can be equipped with a device for generating status indicators related to the unit, The chair has one or more of the features described herein.

[0053] The methods, systems, devices, and apparatus described herein are computers for a particular purpose. The functionality of processors in respiratory monitors and / or respiratory therapy devices can be improved. Furthermore, the described methods, systems, devices, and apparatus include, for example, sleep-disordered breathing. This will lead to improvements in the technical field of automated management, monitoring, and / or treatment of respiratory status. It can happen.

[0054] Naturally, some of these aspects can form secondary aspects of this technology. Furthermore, various secondary aspects and / or aspects can be combined in various ways. These can be used to construct further or secondary embodiments of the present technology.

[0055] Other features of this technology are included in the following detailed description, abstract, drawings, and claims. This will become clear when the information is considered. [Brief explanation of the drawing]

[0056] This technology is illustrated for illustrative purposes only and is not intended to be limiting, but rather to highlight the features of the attached drawings. Similar reference signs represent similar elements.

[0057] [Figure 1A] [4.1 Respiratory Therapy System] Figure 1A shows a system including patient 1000 fitted with patient interface 3000 in the form of a nasal pillow, receiving a supply of air at positive pressure from RPT device 4000. The air from RPT device 4000 is humidified by humidifier 5000 and passes through air circuit 4170 to patient 1000. Bed partner 1100 is also illustrated. The patient is sleeping in a supine position. [Figure 1B]Figure 1B shows a system including patient 1000 wearing a patient interface 3000 in the form of a nasal mask, receiving a supply of air at positive pressure from an RPT device 4000. The air from the RPT device is humidified by a humidifier 5000 and passes through an air circuit 4170 to patient 1000. [Figure 1C] Figure 1C shows a system including patient 1000 wearing a patient interface 3000 in the form of a full face mask, receiving a supply of air at positive pressure from an RPT device 4000. The air from the RPT device is humidified by a humidifier 5000 and passes through an air circuit 4170 to patient 1000. The patient is sleeping in a side-lying position. [Figure 2] [4.2 Respiratory and Facial Anatomy] Figure 2 shows an overall diagram of the human respiratory system, including the nasal cavity and oral cavity, pharynx, vocal cords, esophagus, trachea, bronchi, lungs, alveolar sacs, heart, and diaphragm. [Figure 3] [4.3 Patient Interface] Figure 3 shows an example of a nasal mask-type patient interface relating to one embodiment of this technology. [Figure 4A] [4.4 RPT Device] Figure 4A shows an exploded view of the respiratory pressure therapy (RPT) device 4000 as an example relating to one embodiment of the present technology. [Figure 4B] Figure 4B is a schematic diagram of the pneumatic path of an RPT device according to one embodiment of this technology. The upstream and downstream directions are shown. [Figure 5A] [4.5 Humidifier] Figure 5A shows an isometric view of a humidifier according to one embodiment of this technology. [Figure 5B] Figure 5B shows an isometric view of a humidifier according to one embodiment of this technology, and shows the humidifier storage unit 5110 removed from the humidifier storage unit dock 5130. [Figure 6][4.6 Respiratory Waveform] Figure 6 shows a typical respiratory waveform as a model for a human during sleep. The horizontal axis represents time, and the vertical axis represents respiratory flow rate. Although parameter values ​​vary, typical respiration can have the following approximate values: Tidal volume (Vt): 0.5 L, Inspiratory time (Ti): 1.6 seconds, Peak inspiratory flow rate (Qpeak): 0.4 L / s, Expiratory time (Te): 2.4 seconds, Peak expiratory flow rate (Qpeak): -0.5 L / s. The total duration of respiration (Ttot) is approximately 4 seconds. Humans typically breathe at a rate of approximately 15 breaths per minute (BPM) with a ventilation rate (Vent) of approximately 7.5 L / min. The normal duty cycle, the ratio of Ti to Ttot, is approximately 40%. [Figure 7] [4.7 Acoustic Analysis] Figure 7 is a schematic diagram of a respiratory therapy system according to an example of the present technology, which may include an acoustic analysis device, as will be described in more detail herein. [Figure 8] Figure 8 is a graph that includes an example of the impulse response function of the respiratory therapy system shown in Figure 7. [Figure 9] Figure 9 is a graph showing cepstrums for masks as various examples at different blower speeds in the respiratory therapy system of Figure 7. [Figure 10] Figure 10 is a schematic diagram of a respiratory therapy system according to one example of this technology. [Figure 11] Figure 11 is a flowchart illustrating a method for estimating the acoustic signature delay of the air circuit in the respiratory therapy system shown in Figure 7, which is an example of this technology. [Figure 12] Figure 12 includes two time series plotted on the same time axis: acoustic signature delay (trace at the top) and carbon dioxide concentration measured in the conduit of the respiratory therapy system in Figure 7 (trace at the bottom). [Figure 13] Figure 13 is a graph containing cepstrum related to a pillow mask including a mask tube in the respiratory therapy system shown in Figure 7. [Figure 14] Figure 14 is a schematic diagram of a respiratory therapy system according to an example of the present technology, which may include an acoustic analysis device, as will be described in more detail in this specification. [Figure 15] Figure 15 is a flowchart showing an example of a process for determining a patient's cardiac output according to one aspect of this technology. [Figure 16] Figure 16 is a diagram of the components of an acoustic analysis device, such as the one shown in Figure 7 or Figure 14, according to one embodiment of this technology. [Modes for carrying out the invention]

[0058] Before describing this technology in more detail, it should be noted that this technology is used in the specific implementations described herein. It must be understood that this is not limited to the example, and that it is subject to change. The terms used in this disclosure are intended to describe only the specific examples described herein. It must be understood that this is intended as a general rule and not as a limitation.

[0059] The following description relates to various embodiments that may share one or more common properties and / or features. Provided as follows: One or more features of any one embodiment may be found in one or more other embodiments. It must be understood that it can be combined with one or more of the following features. Any single feature or combination of features in any of the examples may lead to further development. You may construct a case study.

[0060] In this specification, "identification" of a component refers to the identification of the type of that component. Meaning. In this specification, “mask” means, for the sake of brevity, “patient interface.” Although it is used synonymously with "mask," there are also patient interfaces that are not generally referred to as "masks." To exist.

[0061] [5.1 Treatment] In one form, this technology involves a step that applies positive pressure to the airway entrance of 1000 patients. This includes methods for treating respiratory diseases that are equipped with [a specific feature / technology].

[0062] [5.2 Treatment System] In one form, this technology includes a system for treating respiratory diseases. Respiratory therapy The (RT) system includes an air circuit 4170 and a patient interface 3000. RPT device 400 to supply positive-pressure humidified air to patient 1000 via the pathway It may also be equipped with a 0 and a humidifier 5000.

[0063] [5.3 Patient Interface] One example of a non-invasive patient interface 3000 is shown in Figure 3. The following functional aspects are present, namely, the seal-formin structure. g structure)3100, plenum chamber 3200, positioning and Positioning and stabilizing structure 3300, vent 3 400, a form of connection port 3 for connection to the air circuit 4170 It includes 600 and a forehead support 3700. The functional aspects can be provided by one or more physical elements. In some forms... Thus, a single physical element can provide one or more functional modes. The sealing structure 3100 facilitates the supply of air to the airway with positive pressure, for the patient It is positioned to surround the entrance to the airway.

[0064] A patient interface 3000 according to one embodiment of this technology has at least 4c of surrounding area. mH2O, or at least 10 cmH2O, or at least 20 cmH2O, or less Both are constructed and arranged to supply air at a positive pressure of 25 cmH2O or similar. ru.

[0065] [5.3.1 Sealing formation structure] In one embodiment of this technology, the sealing formation structure 3100 is a target sealing formation surface region (target s It may provide a seal-forming surface region and further provide cushioning functionality. The sealing formation region is a region on the sealing formation structure 3100 where sealing can occur. The area where this occurs, i.e., the actual sealing surface, is, for example, where the patient interface is placed on the face. Tension in the positioning and stabilization of the location and structure, and the shape of the patient's face Depending on a wide range of factors, including, on a daily and patient-by-patient basis within a given treatment session It can change.

[0066] [5.3.2 Plenum Chamber] The plenum chamber 3200 is designed to accommodate an average human in the area where a seal is formed during use. It has an outer circumference shaped to complement the surface contour of the face. In this process, the peripheral edge of the plenum chamber 3200 is positioned in close proximity to the adjacent surfaces of the face. Actual contact with the surface is provided by the sealing forming structure 3100. 100 may extend around the entire circumference of the plenum chamber 3200 when in use. In that configuration, the plenum chamber 3200 and the sealing formation structure 3100 are made of a single material. It is formed from homogeneous pieces.

[0067] [5.3.3 Positioning and Stabilization Structures] The sealing formation structure 3100 of the patient interface 3000 of this technology is located in the position of the headgear, etc. The fixing and stabilizing structure 3300 allows the device to be held in the sealed position during use.

[0068] [5.3.4 Bent] In one embodiment, the patient interface 3000 can detect exhaled gases such as carbon dioxide. It is equipped with vent 3400, which is constructed and positioned to allow for rinsing.

[0069] In certain configurations, the vent 3400 is located inside the plenum chamber 3200 and extends to the periphery. It is configured to allow continuous vent flow, and the plenamchang The pressure inside the vent is positive relative to the surroundings. The vent 3400 has a ventilation flow rate (vent flo) when in use. The w rate maintains the therapeutic pressure within the plenum chamber while controlling the patient's exhaled carbon dioxide. It is configured to be large enough to reduce rebreathing. Vent 3 of this technology One form of 400 is a plurality of holes, for example, about 20 to about 80 holes, or about 40 to It has approximately 60 holes, or approximately 45 to 55 holes.

[0070] The vent 3400 can be placed inside the plenum chamber 3200. Alternatively, The 3400 is placed, for example, within a detachment structure such as a swivel.

[0071] [5.3.5 Connection Ports] The connection port 3600 connects the patient interface 3000 to the air circuit 4170. Let it.

[0072] In some implementations, the plenum chamber 3200 and the connection port 3600 are separated. There may be a flexible tube (not shown) of a certain length. In this specification, a tube is distinguished from a conduit or tube that forms an air circuit 4170. It is called a "mask tube".

[0073] [5.4 RPT Devices] A respiratory pressure therapy (RPT) device 4000 according to one aspect of this technology is shown in Figure 4A in an exploded view. It is shown as comprising one or more mechanical, pneumatic, and / or electrical components. The RPT device 4000 is configured to execute algorithm 4300. Delivery to the patient's airway, such as treating one or more of the respiratory symptoms described elsewhere in the book. It can be configured to generate an airflow. Acoustic technologies and methods described herein The RPT device 4000 is illustrated in general terms as an example, but such techniques The procedures and methods are performed within an HFT device, or by means of these, within other RT devices, or These methods allow for similar implementation.

[0074] In one embodiment, the RPT device 4000 contains at least 4 cmH2O, or at least Also 10 cmH2O, or at least 20 cmH2O, or at least 25 cmH2O While maintaining the pressure, it is possible to deliver airflow within the range of -20 L / min to +150 L / min. It will be built or configured to enable this.

[0075] The RPT device is formed in two parts, namely an upper part 4012 and a lower part 4014. It can have an external housing 4010. Furthermore, the external housing 4010 It may have one or more panels 4015. The RPT device 4000 is RP The chassis 4016 includes a T device 4000 that supports one or more internal components. The RPT device 4000 may be equipped with a handle 4018.

[0076] The pneumatic path of the RPT device 4000 consists of one or more air path eyes. TEM (air path item), for example, inlet air filter 4112, inlet muffler 4122, A pressure generator 4140 (e.g., blower 4142) capable of supplying air at positive pressure, outlet muff A 4124 and one or more transducers 4270 such as pressure sensors and flow sensors You can prepare for it.

[0077] One or more air path items are removable, referred to as pneumatic blocks 4020. It can be placed within a single structure. The pneumatic block 4020 is located in the external housing 401 It can be placed within 0. In one embodiment, the pneumatic block 4020 is located in the chassis 4 It is supported by 016 or formed as part of chassis 4016.

[0078] The RPT device 4000 includes a power supply 4210, one or more input devices 4220, and a central control. Controller 4230, treatment device controller 4240, pressure generator 4140, one or more The upper protection circuit 4250, memory 4260, transducer 4270, data communication interface It may have a face 4280 and one or more output devices 4290. Electrical section Product 4200 is to be mounted on a single printed circuit board assembly (PCBA) 4202. This is possible. In other forms, the RPT device 4000 has two or more PCBA4202s. You can prepare for it.

[0079] [5.4.1 Mechanical & Pneumatic Components of RPT Devices] The RPT device may include one or more of the following components within the integrated unit. In an alternative form, one or more of the following components are arranged as separate units. It can be placed there.

[0080] [5.4.1.1 Pressure Generator] In one embodiment of this technology, a downstream airflow (downstream a) is provided, such as a flow or supply of air with positive pressure. The pressure generator 4140 for generating IR flow is a controllable blower 4142. The fan can handle temperatures from approximately 4 cmH2O to 20 cmH2O, or in other forms up to approximately 30 cmH2O. It enables air supply at a positive pressure range, for example, at a rate of up to approximately 120 liters / minute. It is possible. The blower is described in any one of the following patents or patent applications. Even if this is the case, the entirety of these contents may be incorporated by reference into this specification. U.S. Patent No. 7,866,944, U.S. Patent No. 8,638,14, U.S. Patent No. 8, Patents No. 636,479, and PCT Patent Application Publication No. WO2013 / 020167.

[0081] The pressure generator 4140 is under the control of the treatment device controller 4240.

[0082] In other forms, the pressure generator 4140 is a piston-driven pump, a high-pressure source (for example, A pressure regulator or bellow can be connected to the pressurized air storage unit. Cut.

[0083] [5.4.1.2 Memory] According to one aspect of this technology, the RPT device 4000 has a memory 4260, for example, a non-volatile memory. It is equipped with a battery-powered memory. In some forms, the memory 4260 is a battery-powered star It can be equipped with tick RAM. In some forms, memory 4260 is It can be equipped with cellular RAM.

[0084] Memory 4260 can be placed on PCBA4202. Memory 4260 is It can be in the form of EEPROM or NAND flash.

[0085] As an addition or alternative, the RPT device 4000 is a removable memory 4260. For example, it can be equipped with a memory card that conforms to the Secure Digital (SD) standard.

[0086] In one embodiment of this technology, the memory 4260 contains one or more algorithms 4300, etc. Computer program instructions or processor control representing one or more methodologies described in the specification. It operates as a persistent, computer-readable storage medium that stores instructions.

[0087] [5.4.1.3 Data Communication System] In one embodiment of this technology, a data communication interface 4280 is provided, and a central control It is connected to roller 4230. The data communication interface 4280 is a remote external communication network. To enable connection to network 4282 and / or local external communication network 4284 Yes, it is possible. The remote external communication network 4282 can connect to the remote external device 4286. It is possible. The local external communication network 4284 connects to the local external device 4288. It can be made possible to connect.

[0088] In one configuration, the data communication interface 4280 is a central controller 4230 This is part of it. In other forms, the data communication interface 4280 is a central control It is separated from the Ra 4230 and may include an integrated circuit or processor.

[0089] In one form, the remote external communication network 4282 is the Internet (the Internet The data communication interface 4280 is wired communication (e.g., Ethernet). Registered trademark) or optical fiber) or wireless protocol (e.g., CDMA, GSM, LTE) You can use this to connect to the internet.

[0090] In one embodiment, the local external communication network 4284 is Bluetooth (registered trademark). It utilizes one or more communication standards, such as the Standard Infrared Protocol or Consumer Infrared Protocol.

[0091] In one embodiment, the remote external device 4286 is one or more computers, for example In one form, it is a cluster of networked computers. The Vice 4286 can be a virtual computer, not a physical computer. In any case, such remote external devices 4286 are appropriate resources for clinicians, etc. It is accessible to those who meet the required standards.

[0092] The local external device 4288 is a personal computer, smartphone, or tablet. It can be used as a mobile computing device such as a net device, or as a remote control. ru.

[0093] [5.4.2 RPT Device Algorithm] As described above, in some forms of this technology, the central controller 4230 is a memo. Computer programs stored on non-temporary computer-readable storage media such as Ri4260 It can be configured to implement one or more algorithms 4300 that are expressed as follows. The algorithm 4300 is generally grouped into groups called modules.

[0094] [5.5 Humidifier] [5.5.1 Overview of Humidifiers] In one embodiment of this technology, the RT system comprises an RPT device 4000 and an air circuit 417 A humidifier 5000 is installed between 0 (shown in Figure 4A) and the patient, and the absolute humidity of the air delivered to the patient is It changes the surrounding air. Typically, a humidifier 5000 is used to increase the absolute humidity. Prior to delivery to the patient's airway, the temperature of the airflow is raised (relative to the surrounding air). .

[0095] The humidifier 5000 (for example, shown in Figure 5A) includes a humidifier storage unit 5110 and a receiving unit for airflow. It can be equipped with a humidifier inlet 5002 and a humidifier outlet 5004 for delivering humidified airflow. In some forms, as shown in Figures 5A and 5B, the humidifier storage unit 51 The inlet and outlet of unit 10 shall be designated as humidifier inlet 5002 and humidifier outlet 5004, respectively. Yes, it is possible. Humidifier 5000 may also be equipped with humidifier base 5006 and humidifier storage unit. It can be adapted to accept 5110 and can be equipped with a heating element 5240. ru.

[0096] [5.5.2 Components of a Humidifier] [5.5.2.1 Water Storage Section] According to one arrangement, the humidifier 5000 has a certain capacity that is evaporated for humidifying the airflow. It includes a water reservoir 5110 configured to hold or retain a liquid (for example, water). That is also fine. The water reservoir 5110 lasts for at least the duration of a respiratory therapy session, such as during a night's sleep. It can be configured to hold a predetermined maximum amount of water to provide sufficient humidification. Normally, the storage unit 5110 contains several hundred milliliters of water, for example, 300 milliliters. It is configured to hold (ml), 325ml, 350ml, or 400ml of water. In other configurations, the humidifier 5000 receives water from an external water source, such as the building's water supply system. It can be configured to receive.

[0097] According to one embodiment, when airflow passes through the water storage section 5110, the RPT device 4000 It is configured to impart humidity to the airflow. In one embodiment, the water reservoir 5110 is configured to impart humidity to the airflow While in contact with a certain volume of water inside, it passes through the storage section 5110 and along a winding path. It can be configured to encourage doing so.

[0098] According to one embodiment, the storage section 5110 is, for example, shown in Figures 5A and 5B, horizontal It can be detached from the humidifier 5000 in that direction.

[0099] The storage unit 5110 operates at any degree of opening, and / or between its sub-components, etc. To prevent liquid from leaking out when the device is displaced and / or rotated in the direction of motion. It may also be configured to do so. The airflow humidified by the humidifier 5000 is normally pressurized. Therefore, the storage unit 5110 receives air pressure through leak and / or flow impedance. It can also be configured to prevent the force from being diminished.

[0100] [5.5.2.2 Conductive parts] According to one arrangement, the storage unit 5110 is heated from the heating element 5240 to the storage unit 5110. A conductive portion 5120 configured to efficiently transfer heat to a certain volume of liquid. It is equipped with. In one embodiment, the conductive portion 5120 can be arranged as a plate. However, other shapes may also be preferred. All or part of the conductive portion 5120 is aluminum. Miniature (for example, approximately 2mm thick, 1mm, 1.5mm, 2.5mm, or 3mm), It can also be made from other heat-conducting metals or heat-conducting materials such as plastics. Therefore, suitable heat transfer can also be achieved with less conductive materials due to a suitable geometry. can.

[0101] [5.5.2.3 Humidifier Storage Dock] In one embodiment, the humidifier 5000 is configured to receive the humidifier storage unit 5110. It may also be equipped with a humidifier storage dock 5130 (shown in Figure 5B). In the range, the humidifier storage dock 5130 is the storage unit within the humidifier storage dock 5130 Locking lever 5135 and other components configured to hold 5110 in place It can possess stopping characteristics.

[0102] [5.5.2.4 Water Level Indicator] The humidifier storage unit 5110 has a water level indicator (wa) as shown in Figures 5A and 5B. It may be equipped with a water level indicator (5150). In some forms, the water level indicator Caterer 5150, with respect to a certain volume of water in the humidifier storage unit 5110, patient 1000 or It can provide one or more indicators to users such as caregivers. Water level indicator 515 One or more indications provided by 0 include water at a maximum predetermined volume, any portion such as 25%, 50%, or 7 5%, etc., or indications of volumes such as 200 ml, 300 ml, or 400 ml may be included. It may be included.

[0103] [5.5.2.5 Humidifier Transducer] The humidifier 5000 can include one or more humidifier transducers (sensors) 5210 as an alternative or addition to the above-described transducer 4270. The humidifier transducer 5210 can include one or more of an air pressure sensor 5212, an air flow rate transducer (air flow rate transducer) 5214, a temperature sensor 5216, or a humidity sensor 5218. The humidifier transducer 5210 can generate one or more [[ID=​​​​​​​​​​​​​​​​​​​​​​​​​​​[5.7 Transducer] The RT system is any number of RT systems, its patients, and / or its environment. One or more transducers configured to measure one or more of the parameters It can be equipped with a (sensor) 4270. The transducer is a transducer To generate an output signal that represents one or more parameters configured to be measured. It can be configured.

[0107] The output signal may be an electrical signal, magnetic signal, mechanical signal, visual signal, optical signal, sound signal, or any other signal. This can be one or more of the other conventionally known signals.

[0108] The transducer can be integrated into other components of the RT system, as one example. In this arrangement, the transducer is located inside the RPT device. It is provided in [location]. The transducer is essentially a "standalone" component of the RT system. It can be made basic, and in one example arrangement, the transducer is an RPT device It is located outside of it.

[0109] Transducers include RPT devices, local external devices, or remote external devices. It can be configured to communicate its output signal to one or more components of the RT system. External transducers can be accessed, for example, on the patient interface or via a smartphone. It can be placed within an external computing device. The external transducer is For example, it may be positioned on or off a portion of the air circuit of the patient interface.

[0110] One or more transducers 4270 can be constructed and arranged to generate a signal representative of a flow rate, pressure, or temperature characteristic. The air can be a flow of air from the RT device to the patient, from the patient to the atmosphere, ambient air, or something else. The signal can represent the characteristics of the air flow at a particular point, such as the air flow rate in the air path between the RT device and the patient. In one form of the technology, one or more transducers 4270 are disposed within the air pressure path of the RT device, such as downstream of the humidifier 5000. In one aspect of the technology, one or more transducers 4270 comprise a pressure sensor disposed in fluid communication with the air pressure path of the RT device. An example of a suitable pressure sensor is a transducer of the HONEYWELL ASDX series. An alternative suitable pressure sensor is a transducer of the NPA series of GENERAL ELECTRIC. In one implementation, the pressure sensor is disposed within the air circuit 4170 adjacent to the outlet 5004 of the humidifier 5000. The pressure sensor (microphone) 4270 is configured to generate an acoustic signal representative of pressure variations within the air circuit 4170. The microphone 4270 can be directly exposed to the air flow within the air circuit 4170 or encapsulated behind a thin layer of a flexible membrane material to increase its sensitivity to sound. This membrane can function to protect the microphone 4270 from heat and / or humidity. The acoustic signal from the microphone 4270 is processed by an algorithm described below in this specification. In one form of the technology, one or more transducers 4270 are disposed within the air pressure path of the RT device, such as downstream of the humidifier 5000.

[0111] [5.7.1 Pressure Sensor] In one aspect of the technology, one or more transducers 4270 are disposed within the air pressure path of the RT device, such as downstream of the humidifier 5000. <000095...In one aspect of the technology, one or more transducers 4270 comprise a pressure sensor disposed in fluid communication with the air pressure path of the RT device. An example of a suitable pressure sensor is a transducer of the HONEYWELL ASDX series. An alternative suitable pressure sensor is a transducer of the NPA series of GENERAL ELECTRIC. In one implementation, the pressure sensor is disposed within the air circuit 4170 adjacent to the outlet 5004 of the humidifier 5000. 、HONEYWELL ASDXシリーズのトランスデューサである。代替の好適な圧力センサとして、 GENERAL ELECTRICのNPAシリーズのトランスデューサである。一つの実施において、圧 力センサは、加湿器5000の出口5004に隣接した空気回路4170内に配置される 。 W

[0112] 圧力センサ(マイクロフォン)4270は、空気回路4170内の圧力の変動を表す音 信号を生成するように構成される。マイクロフォン4270は、音に対する感度をより高 くするために、空気回路4170内の気流に直接露出することができ、又は、可撓性膜材 料の薄い層の後ろにカプセル化されてもよい。この膜は、マイクロフォン4270を熱及 び / 又は湿度から保護するように機能することができる。

[0113] マイクロフォン4270からの音信号は、本明細書において以下に説明するアルゴリズ To perform acoustic processing and analysis by one or more of the following methods, as an acoustic analysis device It can be received by the central controller 4230, which plays the role of [this]. Alternatively, The audio signal from the ICROphone 4270 is processed by the algorithm described below in this specification / To perform acoustic processing and analysis using one or more of the methods, other acoustic analysis equipment Therefore, it can be received.

[0114] [5.8 Acoustic analysis] According to one or more aspects of this technology, acoustic analysis is used for respiratory diseases or treatment of respiratory diseases. To determine one or more parameters related to the system, use the apparatus etc. described in this specification. It can be implemented more effectively.

[0115] Acoustic analysis related to this technology aims to reduce care costs, provide higher quality treatment, and improve treatment quality. Improved ease of use of the stem, reduced waste, and low-cost digitalization. It can offer one or more advantages that surpass conventional technologies, such as providing connectivity.

[0116] As will become clear in the context of the rest of this document, the term "acoustic" in this document is used. The terms "sound" or "noise" are usually used when these are heard. This refers to anything involving airborne vibrations, whether perceptible or not. In this document, the terms "acoustics," "sound," or "noise" are used unless otherwise specified. This is intended to include ultrasonic waves or airborne vibrations within the subsonic range.

[0117] Some implementations of the acoustic analysis techniques described herein involve cepstrum analysis. ) can be performed. Cepstrum can perform the forward Fourier transform of a signal. Even if you think of it as the inverse Fourier transform of the logarithm of the Fourier Transform Good. The operation is essentially an impulse response function (IRF). Furthermore, by converting the convolution of the input sound signal into an additional operation, the input sound signal is then analyzed. Therefore, to make it easier to consider or remove IRF data, This is the case. Regarding the techniques of cepstrum analysis, see the scientific journal title "Cepstrum: Treatment "The Cepstrum: A Guide to Processing" (Childers et al., Proceedings of IEEE) , Vol. 65, No. 10, October 1977) and Randall RB, Frequenc (Y Analysis), Copenhagen: Bruel & Kjaer, 344 pages (1977 revised edition, 198 It is described in detail in 7 years. Cepstrum for detecting air pathway characteristics in respiratory therapy systems Regarding the application of the analysis, see PCT Publication WO2010 / 091462, titled "Respiration" Acoustic Detection for Respiratory Treatment Apparatus This is described in detail in ) and by quoting its entirety, it forms part of this specification. It shall be considered as such.

[0118] Cepstrum analysis may be understood in terms of the properties of convolution. The convolution of f and g is This can be written as f*g. This operation involves two numbers after one has been reversed and shifted. It can also be an integral of the product of functions (f and g). Thus, this is a kind of product as follows: This is a minute conversion.

number

[0119] The symbol t is used above, but it does not necessarily have to represent the time domain. Therefore, in such a context, the convolution equation is the weighted average of the function f(τ) at instantaneous t. It can be written as follows, where the weighting is simply g(-τ) shifted by quantity t. Given, as t changes, the weighting function emphasizes different parts of the input function. .

[0120] For time-invariant linear acoustic systems such as air pathways in respiratory therapy systems. Therefore, mathematical models that can relate the output to the input shall be based on convolution. It is possible. Microphone 42 adapted to sense sound in the air circuit 4170 The sound signal generated by 70 is expressed as a function of time (t) in relation to the system impulse response. It can be considered as an input (sound) signal that has undergone "convolution" using an IRF (Intermediate Resonance Field). y(t) = S1(t) * h1(t) (2)

[0121] Here, y(t) is the output (sound) signal generated by microphone 4270. s1(t) is in the pressure generator 4140 of the respiratory therapy device 4000, or by means of This is an input signal representing the generated sound (for example, motor operation noise), and h1(t) is the sound source. If the system IRF is up to microphone 4270, then the system IRF h1 (t) may be considered as the system response to the unit impulse input. Respiratory therapy system In linear acoustic systems such as the air path of a system, the h1(t) of the system IRF is two From the reflection of unit impulses from any discontinuity point in the air path, such as the joints between components Yes.

[0122] The transformation of the Fourier transform of the sound signal y(t) into the frequency domain of equation (2) (for example, discrete Fourier transform ("DFT (discrete Fourier Transform)") or Fast Fourier transform (" Considering FFT (Fast Fourier Transform) and the Convolution Theorem By considering this, the following equation can be derived. Y(f) = S1(f)H1(f) (3)

[0123] Here, Y(f) is the Fourier transform (spectrum) of y(t), and S1(t) is s1(f). The Fourier transform of time, and H1(f) is the Fourier transform of h1(t). In other words, time Convolution in the domain is equivalent to multiplication in the frequency domain.

[0124] Logarithmic operations may be applied to equation (3) such that multiplication is converted to addition.

number

[0125] Subsequently, equation (4) is obtained using the inverse Fourier transform (IFT) (e.g., inverse DFT or inverse FFT). This allows us to convert it back to the time domain, which in turn results in it being complex-valued. This produces the inverse Fourier transform of the logarithm of the cepstrum spectrum Y(f).

number

[0126] The ax-coordinate (abscissa) τ is a real-valued variable known as quefrency. The unit is measured in seconds. Therefore, the effect of convolution in the time domain is spectral This results in the additive treatment of the logarithm of trams, and the territory of cepstrum or kefrensi. It remains in the region as is. In particular, the emitted cepstrum

number

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[0127] Through analysis of data from cepstrum analysis, including the investigation of data values ​​within the cefrenci region, We can provide information about RT systems. For example, cepst for the system. Compare the system's cepstrum data to historical or known baselines of the Cepstrum data. By using this comparison of differences, etc., automatic control can be implemented to vary the function or purpose. It is possible to recognize differences or similarities within a system that can be used for this purpose.

[0128] [5.8.1 Extraction of Acoustic Signatures] One implementation of this technology involves the acoustic signature of components such as masks in respiratory therapy systems. This includes devices, apparatus, and / or methods for extracting. Analysis of sound signals generated by sound sensors such as microphone 4270, which are positioned as shown. You may use this.

[0129] This technology includes noise and response from other systems, including but not limited to blower noise. This includes an analysis method that can separate reflections from an acoustic mask.

[0130] One example of a method for extracting the acoustic signature of a mask is at least, for example, 20kHz. At the desired sampling rate, such as Nike Straight, the microphone 4270... This involves sampling the output signal y(t) generated by the cepstrum.

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[0131] Figure 7 is a schematic diagram of an RT system 7000 according to one aspect of this technology. In this example embodiment, the conduit 7010 (having a length L) is connected to the speaker. The sound includes, or instead of, the noise of the blower (e.g., motor and / or impeller) in operation. RPT device 7040 (which may include a humidifier) ​​is used to produce only the following: It effectively acts as an acoustic waveguide for sound. In this embodiment, the input signal is sound generated by the RPT device / humidifier 7040. Yes (i.e., no sound is requested or used from the speaker). Input signal (e.g., input The slus enters the microphone 7050 positioned at one end of the conduit 7010, and the conduit 7 Proceed along 010 to mask 7020, and the features within the air pathway (including conduits and mask) Therefore, the signal is reflected back along the conduit 7010 and enters the microphone 7050 once more. Therefore, the system IRF (output signal generated by the input impulse) contains the input signal It includes both the condensate and the reflected component. A key feature of the RT System 7000 is that sound travels through the air. This is the time it takes to travel from one end to the other. Microphone 7050 is RPT The device / humidifier 7040 receives an input signal, and then after a while, the conduit 701 Filtered by 0, mask 7020 (and potentially other masks attached to the mask) In any system 7030, for example, when a mask 7020 is assisted to a patient The system receives input signals that have been reflected and filtered by the respiratory system. It appears within the IRF. This is related to the reflection from the mask end of conduit 7010 (reflection component). The components of the filtered system IRF reach the microphone after a relatively short delay. The components of the system IRF associated with the signal (input signal components) are delayed. This means that (in actual use, this short delay is because the microphone 7050 is the first to receive input) When responding to a signal, it can be ignored and approximated as zero time. The delay of the reflected component is: It is equal to 2L / c (where L is the length of the conduit and c is the speed of sound in the conduit).

[0132] System 7000 communicates with microphone 7050 via connection 7025. The system includes an analysis device 7015. For example, the acoustic analysis device receives a signal from a microphone. It can be equipped with an input interface. As will be explained in more detail below, acoustic resolution The analyzer 7015 measures the concentration of carbon dioxide in the conduit 7010, and then the patient's carbon dioxide concentration. One or more configured to implement a specific methodology for determining the cardiac output of an individual. It is equipped with a processor. Therefore, the acoustic analysis device 7015 implements these methodologies. Integrated chips, memory and / or other control instruction, data, or information storage media for the purpose of It is possible to prepare for this. For example, a programmed instruction that covers such detection methodologies would be sound Such instructions may be coded on the integrated chip in the memory of the sound analysis device 7015. This involves using a suitable persistent data storage medium and implementing it as software or firmware. It may be loaded, and further or alternatively.

[0133] Another characteristic of the RT System 7000 is that the air path experiences frequent losses, so the conduits are not sufficient. If the duration is long, the input signal component will be a negligible amount for the duration of the system IRF's reflection component. This means that it is attenuated by the reflection of the system IRF. In this case, the input signal component is attenuated by the reflection of the system IRF. It can be separated into parts. As an example, Figure 8 shows the input signal to the blower of the RPT device. Among the treatment systems that may be issued from 4142, such system IR An example of F is shown. Alternatively, the input signal is a speaker at the end of the device in the air path. The sound emitted from (regardless of whether or not the sound is generated by the RPT device / humidifier 7040) It can contain (a small amount). Figure 8 shows that the reflective component 8020 of the system IRF is equal to 2 L / c. It appears with a significant delay from the input signal component 8010 in the system IRF. It is showing.

[0134] The Cepstral system IRF associated with the aforementioned equations (2), (4), and (5) Mu

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[0135] This separation is performed when the input signal s1(t) is transient (e.g., impulse) or steady random This can be achieved if either of the following conditions is met. In either case, Cepstr Input signal components of the M

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[0136] Figure 9 shows a respiratory therapy system similar to the one in Figure 7, implemented with three different masks. The actual parts of the cepstrum are depicted as various examples from measurements, and the input signal is RP This is the sound generated by the T-device blower. Each mask in this example is one of the two different sounds from the blower. The following operating speeds were tested: 10krpm and 15krpm. In this example, Although these speeds were used, this methodology is particularly important because the resulting sound is obtained with a microphone. If detectable, this may be carried out at other fan speeds.

[0137] In Figure 9, the reflected component starts with a 12 millisecond (12 ms) Kefrensi sound, It can be clearly seen in a total of six cepstrums. In an example treatment system, A 2-meter conduit is used, and the speed of sound is 343 m / s, therefore this position is (2L It is predicted that / c). In Figure 9, the graph is masked from top to bottom in the following order. This shows cepstrum. • ResMed Ultra Mirage (registered trademark) at 10krpm • ResMed Ultra Mirage (registered trademark) at 15krpm • ResMed Mirage Quattro (registered trademark) for use at 10krpm • ResMed Mirage Quattro (registered trademark) at 15krpm • ResMed Swift II (registered trademark) at 10krpm • ResMed Swift II (registered trademark) at 15krpm

[0138] Figure 7 shows a system with a single microphone 7050 in one or more alternative implementations. The TEM7000 is shown, but it can have multiple microphones. Figure 14 shows This shows such a system 1400 according to an aspect of the present technology. System 1400 is Except for the differences described below, it is identical to the system 7000 in Figure 7. Therefore, Figure 14 The features are the same as those labeled in Figure 7, as explained with reference to Figure 7, and are specified. Unless otherwise specified, similar label numbers are used.

[0139] System 7000 includes a first microphone 1450 and a second microphone 146 The first microphone is equipped with 0, and both are similar to the microphone 7050. Microphone 1450 is isolated from the second microphone 1460 along the air circuit. In one implementation, the separation distance is L, which is the length of conduit 1410. System 140 0 is connected to the first microphone 1450 via connection 1425, and also via connection 1435. It is equipped with a second microphone 1460 and an acoustic analysis device 1415 in communication with it.

[0140] In one or more implementations, the second microphone 1460 provides additional range information (extra ra (sound information) (modeling of flight time from one or more sound sources), noise reduction, or It can provide higher precision in other functions and capabilities. In this configuration, the first microphone 1450 senses the sound inside the conduit 1410, and the second microphone The crossphone 1460 is located in the environment outside the conduit 1410 or RPT device / humidifier 1440. It detects (for example, background noise). In systems with two or more microphones, Signal processing is performed from the reflection of sound generated by the RPT device / humidifier 1440 to the patient By removing sound or other interference noise in the environment, the signal of system 1400 They can be arranged to increase the noise-to-noise ratio.

[0141] In other implementations, a second microphone 1460 is used to capture the sound inside the conduit 1410. It senses. The sound is generated by the RPT device / humidifier 1440 and goes down the conduit 1410. And so it proceeds. The sound goes from the RPT device / humidifier 1440 to the first microphone 1450. After that, it is necessary to move from the first microphone 1450 to the second microphone 1460. The time required depends on the speed of sound c within the conduit 1410.

[0142] Generally, the time at which the generated sound appears in the first microphone 1450, and the same sound The delay between the time when the signal appears in the second microphone 1460 is approximately L / c, where L is , the length of the conduit 1410 between the first and second microphones 1450 and 1460. , where c is the speed of sound in conduit 1410. In such implementation, the delay is approximately 2L / c. To distinguish it from a reflective-based system, it is called a "transmission-based system." It is referred to as "m)".

[0143] In the transmissive base system, the cepst of the signal generated by the first microphone 1450 is Lamb

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[0144] [5.8.1.1 Minimizing back reflections] One complex factor in extracting acoustic signatures is the device (RPT) of the conduit 7010. The device is subjected to "back reflection (bask-reflection)" of sound from its end. Conduit 7010 and conduit Acoustic interference between tube 7010 and the internal cavity of the RPT device / humidifier 7040 to which it is connected. As a result of the change in impedance, the sound reflected from mask 7020 into conduit 7010 After traveling back along the device of conduit 7010, these back reflections are reflected in the device. It originates from the edges. Such back reflections cause matting to the acoustic signature of the mask. It has a maddying effect. Therefore, in some implementations, back reflection is reduced. Alternatively, if it can be minimized, acoustic signature analysis can be performed more accurately. For example, the dimensions of the mask The law stipulates the distance between the acoustic sensor and any discontinuity in the cross-sectional area inside the flow generator and If the physical scales are similar, the reflection from the mask is relative to the response of the back reflection of the flow generator. The output signal may be convolved. In some cases, the back reflection is characterized and the components It is sometimes desirable to deconvolve these reflections. However, in some designs, it is desirable to minimize back reflection.

[0145] In one such implementation shown in Figure 10, the closest to the microphone 1050 The end of the conduit 1010 is equipped with a structure 1060 configured to reduce back reflection. Structure 1060 is an RPT device whose diameter gradually increases from the device end of the conduit 1010. An extension into the internal cavity of the chair / humidifier 1040, with a diameter equal to the diameter of the conduit 1010. It is illustrated as a single horn. The acoustic impedance of the acoustic waveguide is the waveguide's Because it relates to the diameter, the horn structure 1060 is connected to the conduit 1010 and the RPT device / humidifier 1 Gradually change the acoustic impedance between the 040 cavity and the surrounding area. This minimizes back reflection. The horn structure 1060 is a circle as shown in Figure 10. The profile can be conical, or the cross-section of the horn can be the bell of a brass instrument. It may be curved as shown. The effect of the horn structure 1060 is the sound of the system component 1020. The goal is to reduce the back reflection component in the Hibiki signature.

[0146] [5.8.1.2 Spectral Flattening] Cepstrum

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[0147] [5.8.2 Analysis of Acoustic Signature Delay] Output cepstrum

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[0148] Multiple output cepstrums

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[0149] The speed of sound in a gas mixture varies depending on the composition of the mixture. This is especially true in respiratory therapy systems. The speed of sound c in the conduit decreases as the concentration of carbon dioxide in the conduit increases.

[0150] For example, a 2-meter conduit is 2 meters (based on the speed of sound in the air at room temperature and indoor pressure). With a certain length, once the conduit is filled with a higher concentration of carbon dioxide, the effect of the conduit... The length of the sound changes as it appears. This is because the speed of sound in carbon dioxide gas is per second at 20°C. It is approximately 267 meters (m / s), and the speed of sound in the atmosphere is approximately 343 m / s at 20°C. Therefore, through cepstrum analysis or other signal processing techniques, the inside of the conduit When analyzing sound, this characteristic of sound can be used to estimate the carbon dioxide concentration inside the conduit. can.

[0151] Generally, the concentration of carbon dioxide in the conduits of a respiratory therapy system is highest at the end of exhalation. It fluctuates throughout the respiratory cycle, with the lowest point occurring at the end of inspiration. According to one estimate, 2 At 0°C, the speed of sound in the respiratory conduit changes throughout the respiratory cycle due to this change in CO2 concentration. It fluctuates by approximately 0.67%. This fluctuation is due to the periodic change in the acoustic signature delay in respiratory rate. It will be reflected as a movement. The length L of the conduit is in conjunction with the respiratory cycle (breathing rate). It is safer to assume that it does not fluctuate periodically. As a result, the time-series acoustic series Estimation of texture delay, and in particular the variability of that delay estimation, is related to the frequency band around the patient's respiratory rate. Related to the components from, information regarding the concentration of CO2 in the conduits of the respiratory therapy system is generated. It is likely that, selectively determining the CO2 concentration is possible (for example, device settings, usage). (Regardless of whether it is in use or not, based on the humidifier and its configuration, the type of conduit, whether or not it is heated, etc.) Correct one or more environmental parameters such as temperature, humidity, pressure, ambient CO2 concentration, and background noise. It can include doing.

[0152] Figure 11 shows the acoustic signature delay of the air path in a respiratory therapy system according to one embodiment of this technology. A flowchart of estimation method 11000. Method 11000 is step 11 It may start at 10, and the output signal y during the window described above with respect to equation (5) (t) Output cepstrum

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[0153] Step 1120 follows, where the reflected component (acoustic signature) is calculated in step 1110. It is separated from the cepstrum. In the next step 1130, the acoustic signature delay corresponds It is estimated and recorded along the window time.

[0154] Next, in step 1140, we check whether more acoustic signature delay can be obtained. If so ("Y"), then method 11000 proceeds to step 1160, step Returning to p1110, before calculating a new cepstrum from the next window, Wait until the next window. Otherwise ("N"), method 11000 is step 11 It ends at 50.

[0155] [5.8.2.1 Analysis of the frequency band of respiratory rate (e.g., CO2 concentration and / or cardiac output) )] The estimation of time-series acoustic signature delay is subject to fluctuations due to variations in CO2 concentration in the conduit. To extract the time series of increasing acoustic signature delay, band the frequency band of the respiratory rate. Path filtering is possible. The frequency band for a normal adult's resting respiratory rate is approximately The frequency range is 0.1Hz to 0.5Hz.

[0156] The bandpass-filtered delay time series is obtained by each delay estimation, such as a transmission-based system. By dividing the current length L of the air circuit, we can convert it into a time series of sound estimations based on the velocity c. This is possible. In reflection-based systems such as System 7000, the resulting estimation is, Then it can be multiplied by 2. Next, the estimated speed c of sound is nitrogen, oxygen, and C The properties of O2 can be used to estimate the CO2 concentration in an air circuit.

[0157] In one implementation, divided concentration p i The speed of sound in a gas mixture weighted by c i A simple model of the speed of sound c in a gas mixture can be used as a weighted sum. ru.

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[0158] Table 1 shows the speed of sound c in the pure forms of four major source gases in the atmosphere at room temperature. i of The estimation is based on the normal divided concentrations p in those atmospheres. i It includes these. [Table 1]

[0159] The fractional concentrations p1 and p2 of nitrogen and argon in the conduit are Assuming that they do not change throughout the intake cycle, the concentrations of oxygen and carbon dioxide in the air circuit are: Complementarily, it changes throughout the respiratory cycle. This is the fractional concentration of carbon dioxide at any given moment. If we denote this as p, then the fractional concentration of oxygen can be written as (1-(p1+p2)-p). It can also be done this way. Substituting these values ​​into equation (6), we get the measurement speed c of the sound in the air circuit. Therefore, an equation for the divided concentration p of CO2 can be derived.

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[0160] Using the values ​​in Table 1, equation (7) gives the measured speed of sound c as the division of CO2 in the air circuit. This can be simplified to the following equation, which relates to the concentration p.

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[0161] Therefore, the system uses the filtered time-series acoustic signature delay. Based on estimations, it is configured to generate one or more CO2 concentration readings, or their variations. It is also possible to filter by the respiration frequency. It plays a role in separating or encompassing the selected frequencies. Such generation determines the concentration indication. Based on possible indications and / or evaluations such as whether the threshold is satisfied (e.g., exceeded), to change or alter the displayed or communicated message and / or the treatment provided. It may include one or more output signals, including control signals (for example, pressure or flow).

[0162] For example, Figure 12 shows two time series that occurred at the same time, plotted on the same time axis. It includes. The upper trace 1200 bandpass filtering is applied to the respiratory rate frequency band. This is the estimated acoustic signature delay value in a time series. The lower trace 1250 is In the plenum chamber of the mask where the acoustic signature generated in Race 1200 is reflected This is a time-series of CO2 concentration measurements from a CO2 sensor for the same period. For example, in the trace 1200 of the acoustic signature delay, the peak at 1210, that is, Therefore, the measurement by exhalation is such that the moment when the sound delay increases or the moment when the speed is slowest is expected. The peak at the CO2 concentration, for example, matches 1260, which corresponds to C in the air. This can be seen as a result of the decrease in the speed of sound in air as the O2 concentration increases.

[0163] As an additional example, from the indication of fluctuations in CO2 concentration in the conduit over the respiratory cycle, other implementations Possible information can be extracted. For example, CO2 in the conduit at the end of exhalation. The fractional concentration (end-tidal CO2 concentration, or EtCO2), i.e., respiration The peak CO2 concentration throughout the cycle is used in the revised FIC technology for measuring the patient's cardiac output. It can be used in [1] the dead space of respiratory therapy systems. By adding step variations to the pace and measuring the effect on EtCO2, the patient's cardiac output is measured. This includes estimating the value of dead space in one implementation of the revised fix technique. Effective capacity may be replaced by changing the CPAP treatment pressure or HFT flow rate. For example, pressure Alternatively, if the flow rate is lower, by reducing the flow rate of flushing through the system vent, Increase the effective dead space. The resulting change in EtCO2 is estimated. This is converted into an estimate of the patient's cardiac output.

[0164] Figure 15 shows a process 1500 for determining a patient's cardiac output according to one embodiment of this technology. An example flowchart is shown. Process 1500 is an acoustic analysis device such as the acoustic analysis device 7015. As described below, the process 1500 is performed by the analysis device, as mentioned above. As described above, the central controller 4230 also implements it as part of algorithm 4300. It is permissible to proceed.

[0165] In step 1510, the acoustic analysis device is connected to at least one conduit connected to the patient. Two sound sensors are used to determine the sound measurement. The sound sensors are part of the 700 Respiratory Therapy System. Microphone 7050 can be used to detect various sounds inside the conduit, such as conduit 7010. Yes, it is possible. In one or more embodiments, prior to or simultaneously with step 1510. The sound source can generate sound within the conduit. The sound source is the RPT device / humidifier 7 040, etc., can be used as an element of a respiratory therapy system, in which case the conduit is under continuous positive air pressure. (CPAP) system or similar system, as part of the airway of a respiratory therapy system Yes. Alternatively, the conduit may be part of the airway of the respiratory treatment system, or the conduit may be part of the respiratory treatment system. In both cases, where the sound source is separated from the airway of the medical system, the sound source is a speaker. This is possible. The sound measurement should be the measurement of the sound inside the conduit generated by the sound source. This is possible. In one or more embodiments, at least one sound sensor is a microphone It may also be the case that the conduit is part of the airway of a respiratory therapy system to which a microphone is connected. It can be designated as a department.

[0166] In step 1520, the acoustic analysis device, based at least partially on sound measurements, Determine the carbon dioxide concentration inside the conduit. In one or more embodiments, determine the carbon dioxide concentration. Determining this involves calculating the Fourier transform of the data samples that represent the sound measurements. This can be done. In one or more embodiments, determining the carbon dioxide concentration is equivalent to measuring sound. This can further include calculating the logarithm of the Fourier transform of the data samples representing the values. In one or more embodiments, determining the carbon dioxide concentration is a way of representing the sound measurement. This further includes calculating the inverse Fourier transform of the logarithm of the Fourier transform of the sample. Yes, it is possible. In one or more embodiments, determining the carbon dioxide concentration is (a) measuring sound (b) Respiratory therapy Fourier transform of data samples representing baseline carbon dioxide concentration in the stem's air pathway. This further includes calculating the difference between the logarithm of the inverse Fourier transform and the logarithm of the result.

[0167] In one or more embodiments, the acoustic analysis device is one or more conduits or respiratory therapy systems. Configured to detect environmental parameters and / or other data entered into the system. These parameters can be determined by sensors, etc., that are installed. Environmental parameters include air temperature, ambient pressure, ambient carbon dioxide concentration, background noise, or This may include one or more of these combinations. Then, acoustic analysis equipment The system allows for the modification of one or more environmental parameters when determining carbon dioxide concentration. For example, temperature can affect the speed of sound in a conduit. Considering temperature is important for subsequent carbon dioxide To make the determination of carbon concentration more accurate, the effect of temperature on the speed of sound is taken into consideration.

[0168] In one or more embodiments, the acoustic analysis device determines the ambient carbon dioxide concentration and whether the conduit is affected. When not connected to a device, the baseline carbon dioxide concentration in the conduit can be determined. Under these circumstances, the concentration of carbon dioxide in the conduit will reflect the surrounding carbon dioxide concentration. As an alternative or addition, the acoustic analysis device uses carbon dioxide relative to the position of the acoustic analysis device. It is possible to query one or more external databases that contain information on elementary cardinality. Alternatively or additionally, the acoustic analysis device may indirectly sense the sound measurement rather than the conduit. It can be equipped with a carbon dioxide sensor that can directly sense the concentration of carbon dioxide inside. The acoustic analysis device evaluates the carbon dioxide concentration from the carbon dioxide sensor. By analyzing the sound measurement, it is possible to compare the determined carbon dioxide concentrations. ru.

[0169] In one or more embodiments, the sound sensor can detect background noise. For example, If so, the sound sensor can detect background noise prior to the patient being connected to the conduit. For example, if the conduit is part of the airway of a respiratory treatment system, at least one sound The sensor uses the respiratory therapy system to detect background noise before the patient starts. This is possible. Alternatively, if the sound measurement is based on a sound source in the conduit, at least one sound sensor Sa is either before or after the sound source generates sound, or both before and after the sound source generates sound. It can detect ambient noise.

[0170] In step 1530, the acoustic analysis device is at least partially based on the carbon dioxide concentration. Then, the patient's cardiac output is determined. Determining the patient's cardiac output is at least partially Based on the revised Fick method described above, and at least in part on carbon dioxide concentration It can be assumed that this is the case. The revised Fick method depends on equation (9).

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[0171] Here, CO is cardiac output, VCO2 is the carbon dioxide concentration in exhaled air, and CvCO2 is the carbon dioxide content in the veins, and CaCO2 is the carbon dioxide content in the arteries.

[0172] Assuming that cardiac output remains unchanged under normal (N) and rebreathing (R) conditions, Equation (9) results in the following:

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[0173] By subtracting the ratio of normal to rebreathing, the following differential Fick equation is obtained.

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[0174] Because carbon dioxide diffuses rapidly into the blood (i.e., 22 times faster than oxygen), CvC Since we can assume that O2 does not differ between normal conditions and rebreathing conditions, etc. The venous content disappears from the numerator of equation (11), leaving equation (12).

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[0175] The delta in CaCO2 is multiplied by the slope (S) of the carbon dioxide dissociation curve. This can be approximated by the delta at tCO2. This curve represents the carbon dioxide capacity (carbon dioxide content) This represents the relationship between (used in quantitative calculations) and the partial pressure of carbon dioxide. It can be considered linear between 15 and 70 mmHg of the partial pressure of carbon dioxide. As a result, equation (13) is obtained.

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[0176] Based on the above, the patient's cardiac output can be determined based on the carbon dioxide concentration in the patient's exhaled breath. Therefore, the patient breathes throughout the entire sleep session, such as throughout the night. The treatment system can be used. During use, within or separately from the respiratory treatment system The acoustic analysis device developed using this technology can determine the patient's cardiac output. It can be performed non-invasively and without interfering with the patient. However, the patient The individual or other user can gain a better understanding of the patient's cardiac output.

[0177] Process 1500 in Figure 15, once performed, determines the individual cardiac output of the patient. This can be done. Alternatively, one or more of the process steps of process 600 can be repeated. It is possible to determine both carbon dioxide concentration and cardiac output, depending on the patient's condition. To determine the individual cardiac output of each individual, this can be performed multiple times during a single session. As mentioned above, if the conduit is part of the respiratory therapy system, this session will be overnight. This can be during the period of time, or over several different nights, while using the respiratory therapy system. The acoustic analysis device can then determine the trend in cardiac output during the session. Based on the trend, one or more actions can be taken. For example, this trend can affect cardiac output. The amount may also worsen. In such cases, medical treatment should be sought. The person may be notified. Alternatively, this trend may also indicate an improvement in cardiac output. In such cases, medical treatment may be suspended or reduced.

[0178] Cardiac output for a single session or multiple sessions is determined by one or more thresholds, including age, It can be compared to population normative values ​​such as gender, heart health, and medication plan. The displayed or communicated message... Treatment based on sage and / or cardiac output and / or its assessment (e.g., pressure or flow) Change or alter the set point of the treatment device that creates the treatment device. Actions such as generating one or more output signals, including control signals, determine the cardiac output. It can be adjusted by comparing whether it satisfies a threshold (for example, exceeds it). The trend data is (a) based on one or more tasks in an acoustic analysis device, and is not accurate. (b) assistance of acoustic analysis equipment in determining cardiac output, and (b) deterioration in cardiac output ( To detect changes in patient data showing an improvement trend, the patient's normal baseline It can be used to detect lines. If a worsening trend is observed, the system This involves generating output that recommends a check-up by a healthcare professional. It is also possible to detect heart failure due to edema by a decrease in cardiac output. A decrease in cardiac output can indicate heart failure. Upon detection of a decrease in volume, the patient receives an output message generated based on the analysis, in accordance with medical advice. It can generate interest. Chronic Obstructive Pulmonary Disease (COPD) The worsening of (a type of disease) can also be predicted or detected using this approach. can.

[0179] In one or more embodiments, a pressure sensor, a flow sensor, a velocity sensor in a respiratory therapy system Signals from a sensor or other sensor indicate the rate and depth of breathing (when the rate increases, and This information can be analyzed regarding cardiac decompensation (which involves shallower breathing). Used in conjunction with heart rate and / or cardiac output to predict or detect decompensation. It is possible to combine cardiac output with other parameters of patients using a respiratory therapy system. This can be done. Such parameters include tidal volume and per minute This may include ventilation volume, etc.

[0180] A respiratory therapy system equipped with an integrated acoustic analysis device and cardiac output detection is a technology that Therefore, it is taken into consideration, but the methodology of the components of this device is multiple components within the system It can be shared across elements. For example, a measuring device can determine the delay of a conduit and The measurement process of transferring the data to another processing system can be simply performed. The system may then analyze the data to determine the carbon dioxide concentration, and then As mentioned above, in order to determine cardiac output, data is sent to other devices. Yes, it is possible. The third processing system measures, for example, for display to the patient or clinician or physician. One or more electronically written messages instructing the device to be returned to its designated device or another device. The cardiac output described in this specification may be shown by transmission or other means.

[0181] Other examples of EtCO2 use include the following: • Monitoring the progression of COPD • Titration ventilation parameters such as pressure support, volume delivery, and minute ventilation target. • Determining the correct placement of the endotracheal tube within the trachea.

[0182] [5.8.2.2 Frequency band analysis of additional respiratory rate (e.g., CO2 distribution)] Regarding the overall acoustic signature delay, estimation of the time-series internal delay of the acoustic signature, particularly By analyzing components from around the patient's respiratory rate and the frequency band including it, masked cells can be analyzed. Information about the CO2 concentration inside the tube is generated. More generally, the air path of the mask. Any type of mass, including a separate series of reflective components corresponding to different structures along the same line. By analyzing the respiratory rate frequency band variation in the structure of the acoustic signature of the mask, Information regarding the distribution of relative CO2 concentrations in various parts can be generated. This represents the acoustic signature delay indicating the concentration of CO2 in conduit 7010, and the CO in the pneumatic circuit. Combining the photographs of the distribution of 2 with an analysis of its evolution over time will lead to the establishment of a new system. Good. Actionable information can be extracted from this photograph. For example, R The relative increase in CO2 concentration directed toward the PT device / humidifier 7040 is due to system ventilation. This is because the exhaled CO2 is not being flushed out sufficiently, resulting in excessive rebreathing of CO2. This can lead to symptoms such as central sleep apnea, headache, or a feeling of blockage. Therefore, this system displays or based on the distribution of CO2 or changes in its distribution. The transmitted message and / or the treatment provided (e.g., vent area such as mask vent) One or more output signals containing control signals that change or alter (pressure, flow, or control adjustment) It can be configured to generate.

[0183] [5.8.2.3 Frequency band analysis of non-respiratory frequency (e.g., conduit length)] Time-series variations in acoustic signature delay that fall outside the frequency band of the respiratory rate are not related to respiration. Therefore, the time series of the bandpass filtered version of the delay is obtained from the original delay time series. By subtracting columns, etc., the frequency band fluctuations of respiratory rate are removed from the original delayed time series. This gives a time-series non-respiratory delay estimate. The main source of non-respiratory delay variation is, This is the variation in the length L of the conduit. Each delay value in the non-respiratory time series is c / 2 (reflex-based saturation). By multiplying the delay value by (for stems) or c (for permeation base systems), the length of the conduit can be calculated. It can be mapped to the value of L, where c is the speed of sound in the atmosphere (approximately 34 at 20°C). (3 m / s).

[0184] Variations in conduit length L detected in the time series of non-respiratory acoustic delays indicate the patient or respiratory treatment It can be interpreted as an indicator of the system's status. For example, as mentioned above, Tube resistance is one of the possible factors influencing changes in conduit length. Tube resistance affects the patient's sleep. Posture changes throughout the treatment session and therefore fluctuates. The variability in conduit length is related to the patient's activity or emotional restlessness during the treatment session. It can be understood as a demonstration. Such patient activity is systemic in many ways. It can be used or implemented in [location / place]. • As an indicator of treatment effectiveness • As an indicator of sleep state (sleep / wakefulness) • As an aid in the process of detecting apnea or hypopnea, apnea or hypopnea that matches the period of high activity Because respiration is less likely to represent true airway obstruction, it is often underestimated or ignored by treatment algorithms. It is possible.

[0185] Furthermore, the sustained drag force causes the conduit 7010 to lose its elasticity, resulting in the accumulation of tube drag. The measured values ​​can be used as an indicator of the lifespan of the conduit. For example, the length of the conduit The long-term increase can be interpreted as an indication that conduit 7010 is permanently elongating. Therefore, the respiratory therapy system does not change the length of the conduit over many treatment sessions. Dynamic statistical analysis revealed that the increase in duct length across many treatment sessions was a threshold. It is possible to determine or predict the timing when it exceeds or will exceed, and therefore Therefore, estimate or predict when the conduit is due for replacement, or will soon need replacement. This can be done. Based on such an evaluation, the system will indicate or propose an exchange. It can trigger the generation of more than one output message.

[0186] [5.8.3 Shape analysis of acoustic signatures (e.g., mask tube or headgear)] In a further embodiment of this technology, the form of the acoustic signature in a reflective base system The state can be analyzed by the system to detect specific characteristics of the mask. For example, The acoustic signature can then be analyzed by the system to detect the characteristics of the mask. The characteristics include the diameter of the mask, the constituent materials, the volume of the air cavity, the overall configuration, etc. It is possible.

[0187] One such characteristic of the mask is the length of the mask tube, which is the acoustic signature It can be detected from shape analysis of the cha. Acoustic signature of a mask with a mask tube The cable consists of two separate parts, namely the connection between the air circuit 4170 and the mask tube. This section corresponds to the sound reflection from the 3600 and the sound reflection from the main body of the 3000 mask. It includes a part delayed from the corresponding first part. The delay between the two parts is It is equal to twice the length of the mask tube divided by the speed of sound inside the mask tube.

[0188] Figure 13 shows the cyst mask 7020 with a mask tube attached to the respiratory therapy system 7000. This graph includes Cepstrum 1300. Cepstrum 130 corresponds to the acoustic signature. A portion of the 0 is shown as 1350. Part of the acoustic signature 1350, 1310, This addresses sound reflection from the connection port 3600 between the air circuit 4170 and the mask tube. The acoustic signature part 1320 corresponds to the sound reflection from the body of the pillow mask. The "internal delay" between parts 1310 and 1320, 1330, is c (sound inside the mask tube). It is equal to twice the length l of the mask tube divided by the speed (of the mask tube).

[0189] Another characteristic of the mask is the elasticity of the headgear. The headgear is a positioning and stabilizing structure. When used as 3300, the headgear extends. The effect of the extension is the sealing structure 31 This means that the pressure applied to the patient's face will be reduced. This reduction in pressure is This may manifest as a change in the acoustic signature corresponding to the sound reflection from the mask itself. Therefore, the respiratory therapy system performs analysis of that portion over many respiratory sessions. As a result, the mask needs to be replaced due to the stretching of the headgear, or this Therefore, the timing when it will be needed can be estimated or predicted. For example, the past tense of this part Detecting the displacement or other change in the shape of this part from its position or location is done by the exchange indicator. It can serve as the basis for this. Therefore, based on such an evaluation, The system can trigger the generation of one or more output messages that instruct or suggest an exchange. Cut.

[0190] [5.8.3.1 Frequency band analysis of non-respiratory frequency (e.g., mask tube length)] Regarding the overall acoustic signature delay, non-breathing related to the internal delay of the mask signature The variation is the band-pass filtered version of the internal delay from the original internal delay time series. By subtracting the time series, etc., the frequency band fluctuations of the respiratory rate are removed from the original internal delay time series. This may be obtained by the following: The non-respiratory-related fluctuations in the resulting time series of internal delays are It is then multiplied by c / 2 to obtain a time series of fluctuations corresponding to the length I of the mask tube. Therefore, as an addition to or alternative to the shape analysis described above, variations in the length of the mask tube are considered. It can be derived through filtering.

[0191] Tube drag is caused by variations in the length l of the mask tube and the length L of the air circuit. Furthermore, in implementation, a long-term increase in the length of the mask tube will cause the mask tube to be permanently stretched. This indicates that the respiratory therapy system will be maintained throughout many treatment sessions. By performing a statistical analysis of the variation in mask tube length, the current lifespan of the mask can be evaluated. It is also possible to increase the length of the mask tube over many treatment sessions. In order to determine or predict when a threshold has been exceeded, or when it will be exceeded in the future Statistical analysis reveals that the respiratory therapy system is affected by the mask pulling on the mask tube. Estimate or predict when replacement is needed or will be needed due to this. It can be measured.

[0192] In other implementations, the variability in mask tube length across treatment sessions is considered in the treatment set. It can be used as a substitute or indicator for the patient's activity or emotional distress during urination.

[0193] [5.8.4 Implementation of System Design as an Example] The signal processing analysis described in Figures 11 and 15, and the aforementioned delay detection and cepstrum analysis, are explained above. Or, additional methodologies described herein using Kefrensi-related analysis, etc., are considered above. As described above, the firmware, hardware, and / or software controls This can be implemented by a R or processor. Controllers like this estimate the CO2 concentration at one or more locations within the respiratory therapy system. This can be determined. CO2 concentration data and / or cardiac output from this revised fix technology. The data is then sent to further controllers, processors, systems, or computers. It can be relayed or used by a controller. This information can then be used. In the implementation of respiratory therapy using a respiratory therapy system, for the treatment or control of the RPT device This can be used to adjust other settings.

[0194] For example, the aforementioned technology can be used as part of the controller for respiratory therapy systems such as CPAP devices. It can be implemented.

[0195] Alternatively, the aforementioned technology involves the acoustic analysis device itself being equipped with a pressure generator (e.g., a flow generator). To prevent this from happening, the acoustic analysis device 7 shown in Figure 7 can be located outside the CPAP device. This can be done using acoustic analysis equipment such as 015. For example, such monitoring The apparatus may be implemented as shown in Figure 16. In this regard, Figure 16 is the technology Figure 7 shows the components of an acoustic analysis device 7015 according to one embodiment. In addition to performing the other functions described above, the 16 acoustic analysis devices 1600 determine the user's cardiac output. It comprises one or more components for the purpose of [doing something]. The function of these components is one or more components It can be combined in a basic manner, or implemented by other components with equivalent functionality. It's also possible.

[0196] One or more processors, such as the 1602 processor, are particularly useful for computer program code. Information such as data samples representing sound measurements from a sound transducer, as defined. The code then performs a set of operations. The code further processes such data and checks it within this specification. In addition to one or more of the methodologies discussed, the CO2 concentration reading and / or the user's cardiac output Other outputs, such as those related to the detection of the computer program, can be generated. The RAM code provides control instructions for the operation of the processor 1602, which performs specific functions. It is a set of instructions or suggestions. The code is, for example, the native code of processor 1602. It can be written in a computer programming language compiled into an instruction set. The code also uses a native instruction set (e.g., machine language) to write directly. This can be done. The operation of this set typically involves comparing information from two or more units. , shifting the position of the information of these units, and addition or multiplication or OR or exclusive OR This includes combining information from two or more units through logical operations such as XOR. It is possible to perform each of the set of operations that can be executed by processor 1602, one by one. The information, referred to as instructions such as the arithmetic code for the upper digits, is presented to the processor 1602. A series of operations, such as a series of arithmetic codes, are performed by the processor 1602. These are instructions, also called computer system instructions, or simply computer instructions. To build something that is worthy of recognition.

[0197] Memory 1604, along with other methodologies disclosed herein, determines the user's cardiac output. It stores information including the aforementioned processor control instructions, such as those mentioned above. Furthermore, this is a caps. Tram data, acoustic signature data, delay data, delay time series data (filtered Filtered and / or unfiltered data, CO2 concentration data, cardiac output data, etc. Further storage of generated or received data, such as serial data or output data. This is possible. Memory 1604 is random access memory (RAM) or any other dynamic It can be used as a storage device. In dynamic memory, the information stored internally is processed by the processor 1. It can be changed by 602. RAM is located in a certain place (for example, memory address The unit of information stored in ) is stored and retrieved independently of the information at nearby addresses. To allow this to happen. Memory 1604 is also used by the processor to store temporary values ​​during instruction execution. Used by S1602. Alternatively or additionally, memory 1604 remains unchanged. Read-only memory (ROM) or other memory linked to store static information, including instructions. It can be any static storage device.

[0198] In one or more embodiments, the memory 1604 performs measurement filtering and Fourier transform. , stored for audio signal processing and acoustic analysis such as logarithmic, position determination, degree determination, and difference determination. Processor control instructions may be included. In one or more embodiments, the methodology of this disclosure The processor control instructions and data for controlling the methodology described herein are as follows: The software used by the processor 1602, which is a specific-purpose processor related to either of the above, It can be included in memory 1604 of the software, etc.

[0199] In one or more embodiments, the acoustic analysis device 1600 monitors the output data. The system optionally includes a display 1606 such as an LCD panel or touchscreen. This is possible. The acoustic analysis device 1600 can input data, or otherwise, it can be described in this specification. To activate or operate the installed methodology, optionally, a keyboard, touch panel, control It can also be equipped with control interfaces 1608 such as buttons and a mouse. Acoustic analysis device 1600 is used to provide programming instructions, setting data, and sound to other devices such as the sound sensor 104. The data interface 1610, such as a bus for sending and receiving data, is also optional. This allows us to prepare for it.

[0200] Furthermore, in some embodiments, the information obtained from the delayed analysis is such information By communicating this information to the manufacturer, doctor, or clinician, the patient's troubleshoot can be improved. To be used to support the process, one or more servers or other systems are selectively used in other systems. It can be transmitted. For example, such data can be transmitted via Bluetooth (registered (Registered trademark) and / or WiFi (registered trademark) or other communication protocols (may be multiple) It can be transmitted via wired and / or wireless communication, such as wireless communication protocols including (ru).

[0201] Furthermore, in some embodiments, the information obtained from the delayed analysis is, for example, the mask Personal coaching or training related to specific masks, such as how to make adjustments. It can be used to trigger actions such as manually or automatically expanding the content. This can be done. Such materials can be displayed on the screen of a treatment device or on a mobile device that provides support. Through an application, or other means of communication such as email or SMS messages, It can communicate with the user. For example, in cases where the CO2 concentration is excessively high or low This can trigger recommendations to increase or decrease the treatment pressure or flow rate, or to change the type of mask.

[0202] In some embodiments, blower speeds faster than those shown above result in acoustic This may be done during the estimation of the texture delay. For example, depending on the conduit, noise may be reduced. Materials with the following properties are used. In such a system, the acoustic loss of the system is high. This can occur. When the loss detected by the measured signal increases (for example, amplitude), (The sound level decreases), and the decibel level of the sound source or noise source increases, which can overcome the effect of sound loss. This may also be achieved by increasing the speed of the blower during the test measurement process. Furthermore, other elements included in the air path can increase acoustic loss. These elements include Humidifiers, noise baffles, and valves may be included. Again, problems arising from such components The losses can also be overcome by increasing the noise source level or amplitude. The optimal sound level for the input signal can be approximately 20 dBA or higher.

[0203] The frequency range of microphone 4270 is the resolution of the geometry required for delay estimation. It can be selected according to the following. For resolving information about small dimensions, it is usually generated The sound signal will require high-frequency content. Normal air for respiratory therapy. The circuit exhibits tube resonance at fundamental frequencies below 100 Hz, but the fundamental frequency is above 10 kHz. In the spectrum as integer multiples of frequency, higher harmonics appeared. (Microphone 42) The frequency range of 70 is such that the period associated with the harmonic interval is the inverse Fourier variable of the logarithmic spectrum. The amplitude is sufficient to adequately detect the resonant harmonics present during the exchange. It may be selected so as to be the case. Therefore, in one implementation, microphone 4 The 270 is configured to detect frequencies up to a frequency upper limit of at least 10 kHz. That's good too.

[0204] As described above, in some embodiments, sound impulses or white noise are generated. It can use sound sources such as speakers. This does not generate much noise, very This may be particularly useful in respiratory therapy systems equipped with a quiet fan. For example, typically 6 kRP. When using the ResMed® RPT device at speeds of less than m / s, the fan operates very quietly. Under these conditions, only the sound of a fan is used as the sound source to generate the input signal. This may be insufficient for estimating acoustic signature delay. This can be overcome by including additional sound sources. This is because the mask is initially attached to the conduit. It may be activated during the measurement period, such as when it is being measured. The additional sound source may be a speaker. However, other sound generators may be used. For example, a simple sound generator can be selectively activated and It may be stopped (for example, mechanically attached and detached from the system's air path) It may be configured to vibrate in response to airflow from an RPT device such as a lead. This may play a role in selectively generating sound impulses. Furthermore, the drive valve of the RPT device may also serve as an additional sound source.

[0205] Furthermore, using sound sources such as speakers, the sound spectrum generated by the blower is... The gap can be filled. For example, by using a speaker, the fan noise and speaker sound can be filled. Designed to have a specific spectrum so that it creates a white spectrum by adding [something]. It is possible to generate a signal. This can improve the detection accuracy of the system and repair The perceived quality of sound experienced by users of therapeutic devices may be improved.

[0206] In some embodiments, autocorrelation (i.e., power specs) The inverse Fourier transform of Khtor can be performed instead of cepstrum analysis.

[0207] [5.9 Aspects of the Technology] The following paragraphs describe further embodiments of the technology described above.

[0208] Example 1 A method for determining cardiac output, Sound measurement is performed by at least one sound sensor located in the conduit of a respiratory treatment device connected to the user. Determining a constant value, Determining the carbon dioxide concentration in the conduit, at least in part, based on sound measurements. and, Determining the user's cardiac output based at least partially on carbon dioxide concentration. A method that includes this.

[0209] Example 2 The conduit is the airway of a respiratory treatment device, as described in Example 1.

[0210] Example 3 Determining carbon dioxide concentration involves Fourier transforming data samples representing sound measurements. The method according to Example 1, which includes calculating [the value].

[0211] Example 4 Determining carbon dioxide concentration involves Fourier transforming data samples representing sound measurements. The method according to Example 3, further comprising calculating the logarithm of [the specified value].

[0212] Example 5 Determining carbon dioxide concentration involves Fourier transforming data samples representing sound measurements. The method according to Example 4, further comprising calculating the inverse logarithmic transform of .

[0213] Example 6 Determining carbon dioxide concentration involves (a) using data samples representing sound measurements. (b) The inverse logarithmic transform of the Lier transform, and data representing the baseline carbon dioxide concentration in the conduit. This further includes calculating the difference between the inverse logarithmic transform of the Fourier transform from the sample and the sample itself. The method described in Example 5.

[0214] Example 7 This further includes generating sound using a sound source within a conduit. Determining sound measurements is based on at least one sound sensor that detects sound from a sound source. The method described in Example 1.

[0215] Example 8 The sound source is a flow generator in a respiratory treatment device, as described in Example 7.

[0216] Example 9 The sound source is a speaker inside the conduit, as described in Example 7.

[0217] Example 10 At least one sound sensor is a microphone, and the conduit is connected to the microphone. The method according to Example 1, which is the airway of a respiratory treatment device.

[0218] Example 11 Determining one or more environmental parameters of a respiratory treatment device, When determining carbon dioxide concentration, one or more environmental parameters should be considered. The method according to Example 1, further comprising:

[0219] Example 12 One or more environmental parameters include air temperature, ambient pressure, ambient carbon dioxide concentration, and background. The method according to Example 11, which includes noise, or a combination thereof.

[0220] Example 13 Background noise is detected by at least one sound sensor, as described in Example 12. Law.

[0221] Example 14 Background noise is a second sound that is different from at least one sound sensor that determines the sound measurement. The method according to Example 12, as detected by a sensor.

[0222] Example 15 At least one sound sensor comprises a first sound sensor and a second sound sensor, and the first sound The method according to Embodiment 1, wherein the sensor is located in a different conduit than the second sound sensor. .

[0223] Example 16 The sound measurement includes the time of flight between the first sound sensor and the second sound sensor, in Example 1. The method described in 5.

[0224] Example 17 Based at least partially on sound measurements from the first and second sound sensors, the sound The method according to Example 15, further comprising increasing the signal-to-noise ratio of the measured values.

[0225] Example 18 Determining the carbon dioxide concentration inside a conduit provides data that at least partially represents sound measurements. The method according to Example 1, based on a sample of cepstrum.

[0226] Example 19 Determining a user's cardiac output is at least partially based on carbon dioxide concentration, The method described in Example 1, which is based at least partially on the revised Fick method.

[0227] Example 20 Determining carbon dioxide concentration and determining cardiac output multiple times during a single session. Repeating the same thing, At least partially, carbon dioxide concentration, cardiac output, or a combination thereof during a session Based on being within the threshold range for a single session, carbon dioxide concentration, heart Evaluating cardiac output, or a combination thereof. The method according to Example 1, further comprising:

[0228] Example 21 The system determines carbon dioxide concentration and cardiac output multiple times during a single session. The act of repeating the act, To determine the trend in cardiac output for each session and The method according to Example 1, further comprising:

[0229] Example 22 This further includes determining the background carbon dioxide level relative to the location of the respiratory device, Determining a user's cardiac output is at least partially dependent on the background carbon dioxide level at that location. The method according to Example 1, based on Bell.

[0230] Example 23 Based on the trend, determine the deterioration of cardiac output, Based on the deterioration of cardiac output, determine the need for intervention. The method according to Example 22, further comprising:

[0231] Example 24 Determining the carbon dioxide concentration inside a conduit involves analyzing the standing waves and harmonics within the conduit. The method described in Example 1, based on the previous example.

[0232] Example 25 A respiratory treatment device having a conduit connected to the user, A system comprising at least one sensor configured to detect sound measurements within a conduit, Memory for storing machine-readable instructions, A control system including one or more processors configured to execute machine-readable instructions Mu and Equipped with machine-readable instructions, Determining the carbon dioxide concentration in the conduit based at least partially on sound measurements. , Determining the user's cardiac output based at least partially on carbon dioxide concentration. A system for determining cardiac output.

[0233] Example 26 The conduit is the airway of the respiratory treatment device, as described in Example 25.

[0234] Example 27 One or more processors execute machine-readable instructions to generate data samples representing sound measurements. It is configured to determine the carbon dioxide concentration based on calculating the Fourier transform from The system described in Example 25.

[0235] Example 28 One or more processors execute machine-readable instructions to generate data samples representing sound measurements. To determine the carbon dioxide concentration based on calculating the logarithm of the Fourier transform from The system described in Example 27 is configured as follows.

[0236] Example 29 One or more processors execute machine-readable instructions to generate data samples representing sound measurements. The carbon dioxide concentration is determined based on calculating the inverse logarithmic transform of the Fourier transform. The system described in Example 28 is configured as follows.

[0237] Example 30 One or more processors execute machine-readable instructions to (a) generate data representing sound measurements. (b) Inverse logarithmic transform of the Fourier transform from the sample, and (b) baseline carbon dioxide in the conduit. To calculate the difference between the inverse logarithmic transform of the Fourier transform from a data sample representing concentration, The system according to Example 29, configured to determine the carbon dioxide concentration based on the above.

[0238] Example 31 It is equipped with a sound source configured to generate sound within a conduit, One or more processors execute machine-readable instructions to detect sound from a sound source. The system described in Example 25 is configured to determine the sound measurement based on another sound sensor. The system.

[0239] Example 32 The sound source is a flow generator within a respiratory treatment device, as described in Example 31.

[0240] Example 33 The sound source is the system described in Example 31, which consists of a speaker inside a conduit.

[0241] Example 34 At least one sound sensor is a microphone, and the conduit is connected to the microphone. The system described in Example 25 is an airway for a respiratory treatment device.

[0242] Example 35 One or more processors are configured to execute machine-readable instructions. Determining one or more environmental parameters of a respiratory treatment device, When determining carbon dioxide concentration, one or more environmental parameters should be considered. The system described in Example 25 performs the following actions.

[0243] Example 36 One or more environmental parameters include air temperature, ambient pressure, ambient carbon dioxide concentration, and background. The system described in Example 35 includes noise, or a combination thereof.

[0244] Example 37 Background noise is detected by at least one sound sensor in the system described in Example 36. .

[0245] Example 38 Background noise is detected by at least one sound sensor configured to determine sound measurements. The system according to embodiment 36, which is detected by a second sound sensor different from the first.

[0246] Example 39 At least one sound sensor comprises a first sound sensor and a second sound sensor, and the first sound The sensor is located in a different conduit than the second sound sensor, as described in Example 25. Stem.

[0247] Example 40 The sound measurement includes the time of flight between the first sound sensor and the second sound sensor. The system described in Example 39.

[0248] Example 41 One or more processors execute machine-readable instructions to at least partially process the first sound sensor Based on the sound measurements from the first and second sound sensors, the signal-to-noise ratio of the sound measurements is increased. The system according to Example 39, configured as described above.

[0249] Example 42 One or more processors execute machine-readable instructions to at least partially measure sound. Based on the cepstrum of the data sample, the carbon dioxide concentration in the conduit is determined. The system described in Example 25, which is configured as follows.

[0250] Example 43 One or more processors execute machine-readable instructions to at least partially reduce carbon dioxide concentration. Based on the degree, the user's cardiac output is determined, at least partially based on the revised Fick method. The system according to Example 25, configured as described above.

[0251] Example 44 One or more processors are configured to execute machine-readable instructions. Machine-readable instructions are, The process involves determining carbon dioxide concentration and cardiac output multiple times during a single session. Repeating the same thing, At least partially, carbon dioxide concentration, cardiac output, or a combination thereof is a single set Based on the session being within the threshold range, the carbon dioxide concentration and cardiac output during that session are... Evaluating the quantity, or combinations thereof The system described in Example 25 performs the following actions.

[0252] Example 45 One or more processors are configured to execute machine-readable instructions. Machine-readable instructions are, Determining carbon dioxide concentration and determining cardiac output multiple times during the session. Repeating this, To determine the trend in cardiac output during the session and The system described in Example 25 performs the following actions.

[0253] Example 46 One or more processors are configured to execute machine-readable instructions. Determine the background carbon dioxide level relative to the location of the respiratory device. Determining a user's cardiac output is at least partially dependent on the background carbon dioxide at that location. The system described in Example 25, based on carbon dioxide levels.

[0254] Example 47 One or more processors are configured to execute machine-readable instructions. Machine-readable instructions are, Based on the trend, determine the deterioration of cardiac output, Based on the deterioration of cardiac output, determine the need for intervention. The system described in Example 46 performs the following actions.

[0255] Example 48 One or more processors are configured to execute machine-readable instructions, and machine-readable instructions are, The carbon dioxide concentration inside the conduit is determined by analyzing the standing waves and harmonics in the conduit. The method described in Example 25.

[0256] [5.10 Glossary] For the purpose of disclosing this technology, according to a certain form of this technology, one of the following definitions is used. The above can be applied. According to other forms of this technology, alternative definitions can be applied. can.

[0257] [5.10.1 General] Air: In a certain form of this technology, air may be understood to mean the atmosphere. According to other forms of technology, air can be made into some other breathable air, such as oxygen-enhanced air. It can also be interpreted as a combination of gases that can function well.

[0258] Ambient: According to a certain form of this technology, the term ambient means (i) respiratory therapy (ii) outside the stem or patient, and (ii) immediately surrounding the respiratory treatment system or patient. This is how it would be interpreted.

[0259] For example, the ambient humidity for a humidifier can be defined as the humidity of the air immediately surrounding the humidifier. For example, this could be the humidity in the room where the patient is sleeping. Such ambient humidity affects the patient The humidity may differ from the humidity outside the room where the person is sleeping.

[0260] Automatic Positive Airway Pressure (APAP) therapy: For example, SD Depending on whether or not there is anything suggestive of event B, the treatment between the maximum and minimum values ​​from respiration to respiration is performed. CPAP therapy with automatically adjustable treatment pressure.

[0261] Continuous Positive Airway Pressure (CPAP) Treatment: Treatment Pressure Respiratory pressure therapy in which the respiratory pressure remains nearly constant throughout the patient's respiratory cycle. In some forms, The pressure at the entrance to the airway is slightly higher during exhalation and slightly lower during inhalation. It will become more difficult. In some forms, pressure can, for example, affect a partial upper airway barrier (up The number of cases increased in response to the detection of something suggesting per wairway abstruction, and partially onwards. Changes between different respiratory cycles in patients, such as a decrease when there is no indication of an airway barrier. To move.

[0262] Flow rate: The volume (or mass) of air supplied per unit time. It can also refer to an instantaneous quantity. In some cases, referring to flow rate is scalar. This refers to quantities, that is, quantities that have only size. Also, in some cases Therefore, mentioning flow rate is related to vector quantities, that is, magnitude and direction. This refers to quantities that possess both properties. Flow rate may sometimes be assigned the symbol Q. The term "flow rate" is sometimes shortened to simply "flow" or "airflow." .

[0263] Leak: The word "leak" can be understood as an unintended flow of air. For example, a leak occurs as a result of incomplete sealing between the mask and the patient's face. In some cases, leakage to the surrounding area occurs at swivel joints (swivel elbows). Sometimes that happens.

[0264] Patient: A human being, regardless of whether or not they have respiratory symptoms.

[0265] Pressure: Force per unit area. Pressure is expressed as cmH2O, gf / cm². 2 , and hectopasca It can be expressed in units that cover a range including . 1 cmH2O is 1 g-f / cm 2 to Equally, approximately 0.98 hectopascals. In this specification, unless otherwise noted, pressure is It is given in units of cmH2O.

[0266] Respiratory pressure therapy (RPT): Usually, in response to atmospheric pressure, The procedure involves supplying air to the airway opening at the appropriate pressure.

[0267] Seal: A noun form referring to a structure ("a seal"), or a verb referring to an effect. It can take the verb form ("to seal"). The two elements are essentially separate. To enable "encapsulation" between them without requiring individual "encapsulation" elements, or to enable "encapsulation" They may be constructed and / or arranged to be effective.

[0268] [5.10.2 Patient Interface] Plenum chamber: The mask plenum chamber is large when used. A space of a certain volume containing air pressurized to a pressure exceeding atmospheric pressure, at least partially. It is understood to mean the part of the patient interface that has a surrounding wall. The shell is It may form part of the wall of the mask plenum chamber.

[0269] Shell: A shell is a curved, comparative material with bending, tensile, and compressive rigidity. This would be interpreted as meaning a very thin structure. For example, the curved structural wall of the mask is the shell This may also be the case. In some forms, the shell may have faceted surfaces. In some forms, the shell may be airtight. The structure can also be made non-airtight.

[0270] Vent (noun): Inside a mask or conduit to clinically effectively flush out exhaled air. A structure that allows airflow. For example, the design of a mask for clinically effective rinsing. Depending on the treatment pressure, the flow rate is approximately 10 liters per minute to approximately 100 liters per minute. It can include...

[0271] [5.11 Other Notes] Some of the disclosures in this patent document include copyrighted material. The copyright holders are As described in the patent files or records of the Japan Patent Office, either this patent document or this patent disclosure We do not object to reproduction by any other party, but otherwise we reserve all copyrights. ru.

[0272] Unless the context explicitly rejects it, and if a range of values ​​is provided, the lower limit is 10th of a unit. Up to 1, each value that intersects between the upper and lower limits of that range, and any other value within the range mentioned It must be understood that the mentioned or intervening values ​​are included within the scope of this technology. The upper and lower limits of the range in which eels are present may be independently included within the range of presence, This is also included within the scope of this technology and subject to any limitations specifically excluded within the scope mentioned. If the scope mentioned includes one or both of these limits, then these limits are included. The scope that excludes one or both of the limitations is also included in this technology.

[0273] Furthermore, where values ​​are referred to herein as being implemented as part of this technology In total, such values ​​may be approximate unless otherwise specified, and such values ​​may be used in actual techniques. You may use any suitable number of significant figures to the extent that the technical implementation allows or requires it. stomach.

[0274] Unless otherwise specified, all technical and scientific terms used herein are in accordance with the Art of the Arts. It has the same meaning as it is generally understood by someone with the usual skills in their field. Any methods and materials similar to or equivalent to those described herein may actually be used in this technology. It can also be used in technical testing, and a limited number of examples of methods and materials are provided herein. It is written inside.

[0275] When a particular material is identified as being used to construct a component, similar properties are considered. A clearly alternative material may be used as a substitute. Furthermore, the opposite is true. Unless otherwise specified, any and all components described herein are not to be used together or separately. It is understood that it is possible to manufacture it, and similarly, it may be manufactured.

[0276] As used in this specification and the appended claims, “one” or “a certain” Singular forms such as "a," "an," and "the" are used when the context clearly indicates negation. Unless otherwise specified, it should be noted that this also includes multiple equivalents of those.

[0277] The term "about" means approximately 30%, preferably approximately 20%, of the reference quantity. More preferably, a variable amount of about 10% is used herein. Limit the number. The reason for using the word "approximately" is simply that the number should be interpreted as an exact value. This suggests that it does not exist.

[0278] All publications referred to herein are the methods and the subject matter of these publications. / or to disclose and explain the materials by quoting the entire contents thereof as part of this specification. The publications discussed herein are those prior to the filing date of this application. Provided solely for disclosure purposes. Nothing in this specification implies that this technology is based on prior art. It should not be understood as an acknowledgment that it does not precede such publications. Furthermore, the given publication date may differ from the actual publication date, and this must be independently verified. It's okay to have a need.

[0279] The terms "comprise" and "comprising" are not exclusively interchangeable. It must be interpreted as referring to an element, component, or step, and the referenced element An element, component, or step may be in combination with other elements, components, or steps that are not explicitly stated. This indicates that they can coexist, be used, or be combined together. Therefore, the entire Specified Terms Through the body, unless the context demands the opposite, "to prepare" and "to be prepared" The term includes the step or element, or group of steps or elements, that is mentioned. This does not exclude any other steps or elements, or groups of steps or elements. It will be understood as implying that. The term "including" as used in this specification " or "including" ("including", "which includes", or "that includes") Any one of the terms also contains at least one element / characteristic that follows that term. It is an open term that means not excluding anything else. Therefore, "including" "Ru" is synonymous with "to be equipped" and means this.

[0280] The various methods or processes outlined herein are applicable to various operating systems or platforms. Software that can run on one or more processors that adopt one of the following forms It may also be coded as software. Furthermore, such software has many suitable properties. Using a programming language and / or either a programming or scripting tool It may be written using an executable that can run on a framework or virtual machine. It may also be compiled as machine language code or intermediate code.

[0281] In this regard, various progressive concepts have been proposed for one or more computers or other processors During execution on the server, the method for implementing the various embodiments of this technology described above is implemented. A processor-readable medium or code encoded in one or more programs or processor control instructions. Computer-readable storage media (or a number of such storage media) (e.g., computer memo One or more floppy disks, compact disks, optical disks, magnetic tapes, In flash memory, field-programmable gate arrays, or other semiconductor devices It is implemented as a circuit configuration, or other persistent medium, or tangible computer storage medium. Computer-readable media can be portable, and programs stored on them may be used. The gram is loaded onto one or more different computers or other processors, Various embodiments of the present technology discussed above can be implemented.

[0282] The terms “program” or “software” in this specification refer to the implementations described above. A computer or other processor is programmed to implement various forms of the configuration. Any type of computer code or set of computer executables that can be used to do so It is used in the general sense to indicate an instruction. Furthermore, according to one aspect, at runtime, the technology One or more computer programs that implement the law may be a single computer or processor It does not need to be installed internally, and can be modularly used across many different computers or processors. It must be understood that the method may be distributed in a way that allows for the implementation of the surgical procedures of this technology. It must be. For example, some versions of this technology are as described herein. This includes a server that accesses either computer-readable or processor-readable media. The server may be on a communication network, an internet, or Through networks such as the Internet, Electronic devices such as speakers or smart speakers receive processor control instructions or processor instructions from the medium. It may be configured to receive requests to download executable instructions. However Electronic devices may also include media that execute instructions from a medium. Similarly, The technology is implemented as a server method for accessing any of the media described herein. This may be done. This method involves the server receiving the media of the electronic device via the network. The receiving of a request to download the Rosser executable instructions, and this request Depending on the circumstances, this may include transmitting a medium command to an electronic device. The server may access the medium in order to execute the instructions on the medium.

[0283] Computer-executable instructions are created by one or more computers or other devices. It can take many forms, such as a program module that is executed by [something]. Generally, [something] Ram modules perform specific tasks or implement specific abstract data types. This includes routines, programs, objects, components, data structures, etc. Usually, it is a program. The functions of the RAM module can be combined or distributed as desired in various embodiments. It may also be used.

[0284] Furthermore, the data structure may be stored in a computer-readable medium in any preferred form. Example To simplify the explanation, the data structure is associated with the fields through their location within the data structure. It may be shown as having a rud. Such a relationship communicates the relationship between fields. By assigning field memory to a location in a computer-readable medium. , similarly may be achieved. However, any preferred mechanism may be used between data elements. Data structure fees such as using pointers, tags, or other storage to build relationships. You may construct relationships between pieces of information in the Rud.

[0285] Although the techniques described herein have been explained with reference to specific examples, these examples are not representative of the techniques of this invention. It must be understood that these are merely examples of principles and applications. For example, sound generators. And acoustic monitoring technology, in particular, relates in this specification to the use and components of RPT devices. As described in the embodiments, such sound generators and sound monitoring technologies are used by patients Air controlled at the therapeutic flow level via the user interface High-flow therapy (HFT) devices and other respiratory therapy (RT) devices that provide a flow of air. It will be understood that the same may be done with the components. The CI is similar to a pressure-controlled RPT device, but is adapted to perform flow control. It is composed of a trower. In such an embodiment, the sound generator is an HFT device It may also be configured to measure the gas properties associated with the high-flow therapy generated. , patient circuit, its conduit coupler, and / or gas of the patient interface of the HFT device It may be integrated to sample the flow. Therefore, the HFT device is acoustic. To receive acoustic / sound signals generated by a generator-implementing HFT device, this specification Processing techniques for acoustic analysis, as considered in the above, and an acoustic receiver can be selected arbitrarily. It's a good idea to be prepared.

[0286] In some examples herein, terms and symbols are not required for the implementation of the Art. It may also imply specific details. For example, "the first" and "the second" While terminology may be used, unless otherwise specified, it is intended to indicate any order. Alternatively, it may be used to distinguish between other elements. Furthermore, the process in methodology The steps may be explained or illustrated in a certain order, but such ordering is not necessary. Those skilled in the art will understand that such ordering may be changed, and / or that The actions may be performed simultaneously or synchronously.

[0287] Therefore, without departing from the gist and scope of this technology, numerous examples of the illustrated embodiments are provided. It is understood that changes may be made, and other arrangements may be devised. It must be done.

[0288] [5.12 List of Reference Codes] [Table 2-1] [Table 2-2] [Table 2-3]

[0289] [5.13 References] [1] Partial CO2 rebreathing technology for non-invasive measurement of cardiac output (Partial CO 2rebreathing Fick technique for noninvasive measurement of cardic output), Bai ley, PL;Haryadi, DG;Orr, JA.;Westenskow, DR Anesthesia & Analgesia, April 1998, Vol. 86, 4S edition, page 53 (see reference)

Claims

1. It is configured to administer respiratory therapy to a patient, and the air circuit is applied to the patient's interface. A respiratory therapy system equipped with a flow generator configured to produce compressed air supply, One or more to generate indicators of the status of the patient, the system, or both. A method by the processor, To obtain cepstrum data, a sound representing the sound in the air circuit from the microphone is obtained. Processing signals and Based on the acoustic signature of the cepstrum data, a time-series delay estimate is generated. In this case, the acoustic signature is, each, along the air circuit, the patient input This represents the reflection of sound from the surface. The aforementioned time-series analysis of the delay estimation fluctuations, To generate one or more output indicators based on the aforementioned fluctuations, and here, the one or more output The force index relates to the status of the patient, the system, or both. A method that includes this.

2. The generation of the aforementioned time series is The process involves separating the acoustic signature from the cepstrum in the aforementioned cepstrum data, To estimate the acoustic signature delay for the aforementioned time-series delay estimation, Repeating the separation and estimation as described above. The method according to claim 1, including the method described in claim 1.

3. The aforementioned analysis involves filtering the time-series delayed estimates to determine the frequency of respiratory rate. The method according to claim 1 or 2, comprising passing a frequency within a wavenumber band.

4. The aforementioned analysis is performed to obtain the time-series delayed estimate of carbon dioxide in the air circuit. The method according to any one of claims 1 to 3, further comprising converting to a concentration reading.

5. The one or more output indicators are the carbon dioxide concentration at the end of the patient's exhalation (EtCO2). ２ ) The method according to any one of claims 1 to 4, including the degree.

6. EtCO ２ Further adjustment of the parameters of the respiratory therapy system based on the indications. The method according to claim 5, which includes the above.

7. The one or more output indicators include the estimation of the patient's cardiac output, as per any of claims 1 to 6. The method described in item 1.

8. Applying the revised Fick technique function and the E generated by the time-series delayed estimation mentioned above tCO ２ The further includes measuring the change in the indicator to generate an estimate of the cardiac output, The method according to claim 7.

9. By repeating the above analysis, multiple estimates of the patient's cardiac output can be generated. The method according to claim 7, including the method described in claim 7.

10. Claim 9 further includes determining the trend in multiple estimates of the patient's cardiac output. Methods used.

11. This further includes taking action based on the determination of trends in the aforementioned multiple estimations. The method according to claim 10.

12. Taking the aforementioned action affects output communication or display or both. The method according to claim 11, comprising generating an output.

13. The aforementioned analysis is performed by Determining one or more environmental parameters of the respiratory therapy system, During the determination of the carbon dioxide concentration, one or more environmental parameters are corrected. The method according to any one of claims 1 to 12 as dependent on claim 4, further comprising:

14. The one or more environmental parameters mentioned above include air temperature, ambient pressure, ambient carbon dioxide concentration, The method according to claim 13, comprising background noise or a combination thereof.

15. The aforementioned background noise is generated by a sound sensor different from the sound sensor that generated the sound signal. The method according to claim 14.

16. The above analysis removes the fluctuations in the frequency band of respiratory rate from the time-series delayed estimation. The method comprising obtaining a time-series non-respiratory delay estimate, any one of claims 1 to 15. The method described in section [section number].

17. The one or more output indicators are the air circuit or the patient interface or thereafter. The method according to claim 16, comprising indicators of the exchange conditions for both components.

18. The aforementioned analysis involves estimating the non-respiratory delay in the time series of the air circuit. Any one of claims 16 and 17 further includes mapping to the resulting length value. Methods used.

19. The above analysis indicates that the increase in the length of the air circuit over numerous treatment sessions is threshold The method according to claim 18, further comprising determining whether the value is greater than or equal to a certain value.

20. The analysis described above involves examining the variation in the length of the air circuit over a single respiratory therapy session. The method according to claim 18, further comprising determining sex.

21. The above processing involves processing the sound signal to remove background noise from the environment of the respiratory therapy system. The method according to any one of claims 1 to 20, comprising removing iodide.

22. The one or more output indicators mentioned above are: (a) A control signal for controlling the adjustment of the therapeutic output of the therapeutic device, (b) Output communication or display output and The method according to any one of claims 1 to 21, further comprising one or more of the above.

23. It is configured to administer respiratory therapy to a patient, and pressurized air is supplied to the patient interface along the air circuit. A respiratory therapy system equipped with a flow generator configured to produce a supply of vital energy, A device for generating an indication of the status of a person, a system, or both. That is, A sensor configured to generate an audio signal representing sound in the aforementioned air circuit, and one or more A controller comprising a processor and memory, The one or more processors, according to the program instructions stored in the memory, A device configured to perform the method described in any one of items 1 to 22.

24. The system further includes a blower, and the controller is configured to control the operation of the blower. The device according to claim 23.

25. It is configured to administer respiratory therapy to a patient, and pressurized air is supplied to the patient interface along the air circuit. A respiratory therapy system equipped with a flow generator configured to produce a supply of vital energy, A device for generating an indication of the status of a person, a system, or both. That is, A sensor configured to generate an audio signal representing the sound in the aforementioned air circuit, and a control - Equipped with, The aforementioned controller, The process of obtaining cepstrum data by processing the sound signal representing the sound in the air circuit, Based on the acoustic signature in the aforementioned cepstrum data, a time-series delay estimation is generated. To accomplish, and here, the acoustic signature is, each along the air circuit, the patient This represents the reflection of sound from the interface. The aforementioned time-series analysis of the delay estimation fluctuations, To generate one or more output indicators based on the aforementioned fluctuations, and here, the one or more output The force index relates to the status of the patient, the system, or both. A device configured to perform the following actions.

26. The system is configured to generate an audio signal representing background noise in the environment of the respiratory therapy system. The device according to claim 25, further comprising a second sensor.

27. The controller represents the background noise in the environment of the respiratory therapy system. Using the sound signal generated, a previous signal is generated to represent the sound in the air circuit. From the recorded signal, remove the background noise from the environment of the respiratory therapy system. The device according to claim 26, further comprising the configuration described above.

28. To generate the aforementioned time series, the controller, The process involves separating the acoustic signature from the cepstrum in the aforementioned cepstrum data, To estimate the acoustic signature delay for the aforementioned time-series delay estimation, Repeating the separation and estimation as described above. The device according to any one of claims 25 to 27, configured to perform the following:

29. The controller filters the time-series delayed estimates in order to analyze the fluctuations. A ring configured to allow frequencies to pass within the frequency band of the respiratory rate, claim A device as described in any one of items 25 to 28.

30. The controller analyzes the fluctuations by using the time-series delay estimates, and the empty space Claims 25-29, configured to convert into an indicator of the concentration of carbon dioxide in the gas circuit. A device as described in any one of the items.

31. The one or more output indicators are the patient's end-tidal carbon dioxide concentration (EtCO2). ２ ) indication A device according to any one of claims 25 to 30, including the device described in any one of claims 25 to 30.

32. The aforementioned controller is EtCO ２ Based on the indication, the parameters of the respiratory therapy system The device according to claim 31, further configured to adjust the ta.

33. The one or more output indicators include the estimation of the patient's cardiac output, according to claims 25 to 32. Any of the devices described in item 1.

34. The controller applies a revised fix technique function, and the time series is delayed. EtCO generated by delay estimation ２ To measure the change in the indicator and generate an estimate of cardiac output. The device according to claim 33, configured to perform the following.

35. The controller repeats the analysis to estimate the patient's cardiac output multiple times. The device according to claim 33, configured to generate a number.

36. The controller determines the trend in multiple estimates of the patient's cardiac output. The device according to claim 35, configured as described above.

37. The controller takes action based on the trends of the multiple estimations determined. The device according to claim 36, further configured as follows.

38. The aforementioned action includes output to output communication, display, or both. The device according to claim 37, which includes generating.

39. The controller analyzes the fluctuations by using the time-series delayed estimation to determine the respiratory rate. It is configured to remove frequency band fluctuations and obtain a time-series non-respiratory delay estimate. The device according to any one of claims 25 to 38.

40. The one or more output indicators are the air circuit or the patient interface or thereafter. The device according to claim 39, including an indication of the exchange conditions for both components.

41. The controller performs non-respiratory delay estimation of the time series in order to analyze the fluctuations. The air circuit is configured to map to the time-series length values ​​of the air circuit, claim The device described in either paragraph 39 or 40.

42. The controller analyzes the fluctuations across multiple treatment sessions, The configuration described in claim 41 is configured to determine whether the increase in the length of the air circuit exceeds a threshold. A device that is installed.

43. The controller analyzes the variability over a single respiratory therapy session. The device according to claim 41, configured to determine the variability of the length of the air circuit. vinegar.

44. The one or more output indicators mentioned above are: (a) A control signal for controlling the adjustment of the therapeutic output of the therapeutic device, (b) Output communication or display output and The apparatus according to any one of claims 25 to 43, further comprising one or more of the above.

45. The system is configured to generate a supply of pressurized air from the outlet along the air circuit to the patient interface. A sound signal representing sound in the air circuit of a respiratory therapy system equipped with a flow generator is generated. The means to achieve it, To obtain cepstrum data, the sound signal representing the sound in the air circuit is processed. Steps and, Based on the acoustic signature in the aforementioned cepstrum data, a time-series delay estimation is generated. Means for doing so, and here, the acoustic signature is, each along the air circuit, the patient This represents the reflection of sound from the interface. A means for analyzing the fluctuations in the aforementioned time-series delay estimation, means for generating one or more output indicators based on the aforementioned fluctuations, and here, the one or more output The force index relates to the status of the patient, the system, or both. A device equipped with the following features.

46. It is configured to administer respiratory therapy to a patient, and pressurized air is supplied to the patient interface along the air circuit. Associated with respiratory therapy systems equipped with flow generators configured to produce a supply of vital energy. One or more of the status indicators for the patient interface that were generated. A processor-based method, To obtain cepstrum data, the sound signal representing the sound in the air circuit is processed. Toto, The process involves separating the acoustic signature from the cepstrum data, and here, the acoustic signature The sticky sound represents the reflection of sound along the air circuit from the patient interface. To estimate the internal delay of the aforementioned acoustic signature, where the internal delay is the masked The sound represents the reflection from each component of the patient interface separated by the tube. This is the delay between the two parts of the Hibiki signature. To generate the estimated internal delay in the aforementioned time series, the above processing is separated from the above processing. Repeating the process of making estimations, Analyzing the estimation of the internal delay in the aforementioned time series, Based on the above analysis, one or more output indicators are generated, and here, the one or more The output indicators relate to the status of the patient interface. A method that includes this.

47. The aforementioned analysis involves filtering the time-series estimation of internal delays to determine the respiratory rate. The method according to claim 46, comprising passing frequencies within a frequency band.

48. The above analysis involves analyzing the estimated internal delay in the filtered time series. The claim further includes generating an indicator of the carbon dioxide concentration in the mask tube. Method 47.

49. The above analysis involves estimating the internal delay in the time series and determining the change in the frequency band of the respiratory rate. Claims 46-4 include removing motion to obtain an estimate of non-respiratory internal delay in a time series. The method described in any one of item 8.

50. The aforementioned analysis estimates the non-respiratory internal delay of the time series, and the masked The method according to claim 49, further comprising mapping to the time-series length values ​​of B Law.

51. The aforementioned analysis involves increasing the length of the mask tube over a number of treatment sessions. The method according to claim 50, further comprising determining whether the addition exceeds a threshold.

52. The aforementioned analysis involves the length of the mask tube over a single respiratory therapy session. The method according to claim 50, further comprising determining the variability of the

53. It is configured to administer respiratory therapy to a patient, and pressurized air is supplied to the patient interface along the air circuit. Associated with respiratory therapy systems equipped with flow generators configured to produce a supply of vital energy. A device that generates an indication of the status of the patient interface, 、 A sensor configured to generate an audio signal representing sound in the aforementioned air circuit, and one or more A controller comprising a processor and memory, The one or more processors, according to the program instructions stored in the memory, A device configured to perform the method described in any one of items 46 to 52.

54. It is configured to administer respiratory therapy to a patient, and pressurized air is supplied to the patient interface along the air circuit. For a respiratory therapy system equipped with a flow generator configured to produce a supply of vital energy, A device that generates status indicators for the patient interface, A sensor configured to generate an audio signal representing the sound in the aforementioned air circuit, and a control - Equipped with, The aforementioned controller, To obtain cepstrum data, the sound signal representing the sound in the air circuit is processed. Toto, The process involves separating the acoustic signature from the cepstrum data, and here, the acoustic signature The sticky sound represents the reflection of sound along the air circuit from the patient interface. To estimate the internal delay of the aforementioned acoustic signature, where the internal delay is the masked The reflections from the corresponding components of the patient interface, separated by the tubes, This represents the delay between the two parts of the aforementioned acoustic signature, To generate the estimated internal delay in the aforementioned time series, the above processing is separated from the above processing. Repeating the process of making estimations, Analyzing the estimation of the internal delay in the aforementioned time series, Based on the above analysis, one or more output indicators are generated, and here, the one or more The output indicators relate to the status of the patient interface. A device configured to perform the following actions.

55. The controller analyzes the time series by determining the internal delay of the time series. It is configured to filter out the constants and allow frequencies to pass through within the frequency band of the respiratory rate. The device according to claim 54.

56. The controller analyzes the time series by filtering the time series. The estimated internal delay is analyzed to generate an indication of the carbon dioxide concentration in the mask tube. The device according to claim 55, further configured to do so.

57. The controller analyzes the time series by determining the internal delay of the time series. By removing fluctuations in the frequency band of the respiratory rate from the constant value, an estimate of the time-series non-respiratory related internal delay is obtained. The device according to any one of claims 54 to 56, configured to do so.

58. The controller analyzes the time series, and the non-respiratory related data obtained from the time series. The internal delay is estimated and mapped to the time-series length values ​​of the mask tube. The device according to claim 57, further comprising the above.

59. The controller analyzes the time series across numerous treatment sessions. The system is further configured to determine whether the increase in the length of the mask tube exceeds a threshold. The device according to claim 58.

60. The controller analyzes the time series over a single respiratory therapy session. The invention further comprises a configuration for determining the variability of the length of the mask tube, The device described in 59.

61. The system is configured to generate a supply of pressurized air from the outlet along the air circuit to the patient interface. A sound signal representing sound in the air circuit of a respiratory therapy system equipped with a flow generator is generated. The means to achieve it, To obtain cepstrum data, the sound signal representing the sound in the air circuit is processed. Steps and, From the cepstrum, the sound reflection along the air circuit from the patient interface Means for separating the represented acoustic signatures, Means for estimating the internal delay of the acoustic signature, where the internal delay is masked The reflections from the corresponding components of the patient interface, separated by the tubes, This represents the delay between the two parts of the aforementioned acoustic signature. To generate the estimated internal delay in the aforementioned time series, the above processing is separated from the above processing. A means of repeatedly making estimations, A means for analyzing the estimation of the internal delay in the aforementioned time series, A means for generating one or more output indicators based on the analysis, wherein the one or more The output indicators relate to the status of the patient interface. A device equipped with the following features.

62. A respiratory therapy system for administering respiratory treatment to patients, A flow generator configured to produce a supply of pressurized air, The flow generator is connected to deliver the supply of pressurized air to the patient interface. The air circuit, The respiratory therapy system allows for the status of the patient, the system, or both. A device according to any one of claims 25 to 44 that generates an indicator A system equipped with these features.

63. A flow generator configured to produce a supply of pressurized air, The flow generator is connected to deliver the supply of pressurized air to the patient interface. The air circuit, Claims 54-6 for generating status indicators relating to the patient interface The device described in any one of item 0 and A respiratory therapy system equipped with [specific features / equipment] for administering respiratory treatment to patients.

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