WO2006024107A1 - Adjustment of target ventilation in a servoventilator - Google Patents

Adjustment of target ventilation in a servoventilator Download PDF

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Publication number
WO2006024107A1
WO2006024107A1 PCT/AU2005/001336 AU2005001336W WO2006024107A1 WO 2006024107 A1 WO2006024107 A1 WO 2006024107A1 AU 2005001336 W AU2005001336 W AU 2005001336W WO 2006024107 A1 WO2006024107 A1 WO 2006024107A1
Authority
WO
WIPO (PCT)
Prior art keywords
ventilation
level
target ventilation
patient
target
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/AU2005/001336
Other languages
English (en)
French (fr)
Inventor
David John Bassin
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Resmed Pty Ltd
Original Assignee
Resmed Pty Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from AU2004905022A external-priority patent/AU2004905022A0/en
Priority to EP12172101.3A priority Critical patent/EP2526991B1/en
Priority to JP2007529304A priority patent/JP4884390B2/ja
Priority to US11/574,057 priority patent/US9205210B2/en
Priority to EP05777824A priority patent/EP1789120A4/en
Priority to AU2005279717A priority patent/AU2005279717B2/en
Application filed by Resmed Pty Ltd filed Critical Resmed Pty Ltd
Priority to CN2005800377454A priority patent/CN101052432B/zh
Priority to NZ553429A priority patent/NZ553429A/en
Publication of WO2006024107A1 publication Critical patent/WO2006024107A1/en
Anticipated expiration legal-status Critical
Priority to US14/918,765 priority patent/US10688263B2/en
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
    • A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
    • A61M2016/0021—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with a proportional output signal, e.g. from a thermistor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3331—Pressure; Flow
    • A61M2205/3334—Measuring or controlling the flow rate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502—User interfaces, e.g. screens or keyboards

Definitions

  • the present invention relates to the field of ventilatory assistance, and in particular, to methods and apparatus for determining suitable ventilator settings in patients with alveolar hypoventilation during sleep, and for delivery of those settings.
  • a servoventilator incorporates a mechanism for slowly changing the target ventilation over a period of time, according to a preprogrammed schedule set by the physician.
  • the intention will be that the target ventilation increases over a period of time, from a first level to a second level, then stay at the second level thereafter. This increase could occur according to any arbitrary increasing function of time.
  • the rate of increase, R may be calculated from the initial target ventilation V 1 , the final target ventilation V 2 , and a target ventilation ramp time t r , all these settings being entered by the clinician using the following equations:
  • the rate of increase of target ventilation may be lowered or even set to zero temporarily, so it takes longer to reach the final target ventilation, or in some cases the final target ventilation may never be achieved.
  • Fig. 1 illustrates an embodiment of my invention.
  • the x-axis shows time
  • the y-axis shows ventilator target ventilation.
  • Fig. 2 illustrates servo-ventilator apparatus 5 suitable to perform the invention.
  • An electric motor 20 has an impeller Ij) and is under the control of a controller circuit 40. In use the motor and impeller is housed in a volute 25, which in use allows a flow of pressurized air to pass along the air delivery conduit 60 to a suitable patient interface 50.
  • the patient interface 50 may be a nasal mask, or nose and mouth mask, a full-face mask or some other suitable device.
  • a pressure sense tube 70 between the patient interface 50 and a pressure sensor 75 allows the controller 40 to sense pressure in the patient interface 50.
  • the controller 40 can also determine the flow rate and of air along the air delivery conduit 60 via a flow sensor (not shown).
  • the apparatus includes a display 90 and keyboard 80 which allow someone, for example a clinician, to set appropriate target ventilators and ramp times in accordance with an embodiment of the invention.
  • target ventilation settings may be accomplished as described in US patent 6,644,312, the disclosure of which is incorporated by reference.
  • suitable initial target ventilator settings for use with a servoventilator may be determined by measurements and observations made on the subject patient while awake during a learning period.
  • the target ventilation may be a fixed percentage of an average ventilation taken over a portion of the learning period.
  • the servo-control of ventilation is disabled, and the device is set to deliver a fixed minimum degree of support, typically 6 cmH2O chosen to make the patient feel comfortable.
  • ventilation is measured and oxygen saturation levels may be measured by an oximeter.
  • a target ventilation for use during sleep is selected or determined based on the ventilation measurements and optionally oxygen saturation measurements. Where the PCO2 of the subject patient would be higher than desired by the clinician, a final target ventilation can be determined by multiplying an initial target ventilation by the ratio of the PCO2 value to a desired PCO2 value.
  • a clinical algorithm embodying the invention is:
  • the pressure support level can be programmed, after an initial hold time, to increase at a certain rate until it reaches a final pressure support level.
  • the second duration may be several weeks.
  • the change in level of ventilation is an increase.
  • the change in level of ventilation is automatically controlled.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pulmonology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Hematology (AREA)
  • General Health & Medical Sciences (AREA)
  • Emergency Medicine (AREA)
  • Veterinary Medicine (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Percussion Or Vibration Massage (AREA)
  • Respiratory Apparatuses And Protective Means (AREA)
PCT/AU2005/001336 2004-09-03 2005-09-02 Adjustment of target ventilation in a servoventilator Ceased WO2006024107A1 (en)

Priority Applications (8)

Application Number Priority Date Filing Date Title
NZ553429A NZ553429A (en) 2004-09-03 2005-09-02 Adjustment of target ventilation in a servoventilator
JP2007529304A JP4884390B2 (ja) 2004-09-03 2005-09-02 サーボ式人工呼吸器の目標換気量の調節
US11/574,057 US9205210B2 (en) 2004-09-03 2005-09-02 Adjustment of target ventilation in a servoventilator
EP05777824A EP1789120A4 (en) 2004-09-03 2005-09-02 ADJUSTING THE TARGET FAN IN A SERVO FAN
AU2005279717A AU2005279717B2 (en) 2004-09-03 2005-09-02 Adjustment of target ventilation in a servoventilator
EP12172101.3A EP2526991B1 (en) 2004-09-03 2005-09-02 Adjustment of target ventilation in a servoventilator
CN2005800377454A CN101052432B (zh) 2004-09-03 2005-09-02 伺服呼吸机中目标通气量的调节
US14/918,765 US10688263B2 (en) 2004-09-03 2015-10-21 Adjustment of target ventilation in a servoventilator

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AU2004905022 2004-09-03
AU2004905022A AU2004905022A0 (en) 2004-09-03 Adjustment of Target Ventilation in a Servoventilator

Related Child Applications (2)

Application Number Title Priority Date Filing Date
US11/574,057 A-371-Of-International US9205210B2 (en) 2004-09-03 2005-09-02 Adjustment of target ventilation in a servoventilator
US14/918,765 Continuation US10688263B2 (en) 2004-09-03 2015-10-21 Adjustment of target ventilation in a servoventilator

Publications (1)

Publication Number Publication Date
WO2006024107A1 true WO2006024107A1 (en) 2006-03-09

Family

ID=35999646

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/AU2005/001336 Ceased WO2006024107A1 (en) 2004-09-03 2005-09-02 Adjustment of target ventilation in a servoventilator

Country Status (6)

Country Link
US (2) US9205210B2 (https=)
EP (2) EP2526991B1 (https=)
JP (1) JP4884390B2 (https=)
CN (3) CN101052432B (https=)
NZ (2) NZ587821A (https=)
WO (1) WO2006024107A1 (https=)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013152403A1 (en) * 2012-04-13 2013-10-17 Resmed Limited Apparatus and methods for ventilatory treatment
WO2021005168A1 (en) * 2019-07-09 2021-01-14 O2Matic Aps Device for regulating oxygen for automated oxygen therapy
US11291787B2 (en) 2014-06-10 2022-04-05 ResMed Pty Ltd Methods and apparatus for treatment of respiratory disorders

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CN102056538B (zh) 2008-06-06 2014-10-15 柯惠有限合伙公司 用于在换气系统中确定患者努力及/或呼吸参数的系统及方法
US8302602B2 (en) 2008-09-30 2012-11-06 Nellcor Puritan Bennett Llc Breathing assistance system with multiple pressure sensors
CN102114284B (zh) * 2009-12-31 2013-07-10 北京谊安医疗系统股份有限公司 用于电动电控呼吸机的吸气保持方法
US8714154B2 (en) 2011-03-30 2014-05-06 Covidien Lp Systems and methods for automatic adjustment of ventilator settings
US9364624B2 (en) 2011-12-07 2016-06-14 Covidien Lp Methods and systems for adaptive base flow
US9498589B2 (en) 2011-12-31 2016-11-22 Covidien Lp Methods and systems for adaptive base flow and leak compensation
US8844526B2 (en) 2012-03-30 2014-09-30 Covidien Lp Methods and systems for triggering with unknown base flow
US10362967B2 (en) 2012-07-09 2019-07-30 Covidien Lp Systems and methods for missed breath detection and indication
US10384023B2 (en) * 2012-08-03 2019-08-20 Breathe Technologies, Inc. Selective ramping of therapeutic pressure in a patient breathing apparatus
US9981096B2 (en) 2013-03-13 2018-05-29 Covidien Lp Methods and systems for triggering with unknown inspiratory flow
EP3043852A4 (en) * 2013-09-10 2017-04-26 Samir S. Ahmad Zero pressure start continuous positive airway pressure therapy
US9808591B2 (en) 2014-08-15 2017-11-07 Covidien Lp Methods and systems for breath delivery synchronization
US9950129B2 (en) 2014-10-27 2018-04-24 Covidien Lp Ventilation triggering using change-point detection
US9925346B2 (en) 2015-01-20 2018-03-27 Covidien Lp Systems and methods for ventilation with unknown exhalation flow
TWI688524B (zh) * 2015-03-17 2020-03-21 美商陶氏全球科技有限責任公司 用於撓性容器之撓性配件
WO2018177913A1 (en) * 2017-03-31 2018-10-04 Koninklijke Philips N.V. Systems and methods for concurrent airway stabilization and pulmonary stretch receptor activation
EP3793656A1 (en) 2018-05-14 2021-03-24 Covidien LP Systems and methods for respiratory effort detection utilizing signal distortion
US11752287B2 (en) 2018-10-03 2023-09-12 Covidien Lp Systems and methods for automatic cycling or cycling detection
US11324954B2 (en) 2019-06-28 2022-05-10 Covidien Lp Achieving smooth breathing by modified bilateral phrenic nerve pacing
US12257437B2 (en) 2020-09-30 2025-03-25 Covidien Lp Intravenous phrenic nerve stimulation lead

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WO2003075991A1 (en) 2002-03-08 2003-09-18 Kaerys S.A. Apparatus to assist a patient's breathing with a variable ramp period to rise to treatment pressure

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US5117819A (en) 1990-09-10 1992-06-02 Healthdyne, Inc. Nasal positive pressure device
US5682878A (en) 1995-12-07 1997-11-04 Respironics, Inc. Start-up ramp system for CPAP system with multiple ramp shape selection
US6467477B1 (en) 1999-03-26 2002-10-22 Respironics, Inc. Breath-based control of a therapeutic treatment
US6401713B1 (en) 1999-05-05 2002-06-11 Respironics, Inc. Apparatus and method of providing continuous positive airway pressure
WO2002002169A1 (en) 2000-07-05 2002-01-10 Compumedics Sleep Pty. Ltd. Dual-pressure blower for positive air pressure device
WO2003030804A2 (en) 2001-10-12 2003-04-17 Ric Investments, Inc. Auto-titration pressure support system and method of using same
WO2003075991A1 (en) 2002-03-08 2003-09-18 Kaerys S.A. Apparatus to assist a patient's breathing with a variable ramp period to rise to treatment pressure

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Title
See also references of EP1789120A4

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013152403A1 (en) * 2012-04-13 2013-10-17 Resmed Limited Apparatus and methods for ventilatory treatment
US11291787B2 (en) 2014-06-10 2022-04-05 ResMed Pty Ltd Methods and apparatus for treatment of respiratory disorders
WO2021005168A1 (en) * 2019-07-09 2021-01-14 O2Matic Aps Device for regulating oxygen for automated oxygen therapy
US12239793B2 (en) 2019-07-09 2025-03-04 O2Matic Aps Device for regulating oxygen for automated oxygen therapy

Also Published As

Publication number Publication date
NZ553429A (en) 2010-11-26
US9205210B2 (en) 2015-12-08
US20090013999A1 (en) 2009-01-15
CN101052432B (zh) 2013-03-27
CN101052432A (zh) 2007-10-10
CN102058924B (zh) 2014-03-05
EP1789120A4 (en) 2009-10-28
EP2526991A1 (en) 2012-11-28
US20160038698A1 (en) 2016-02-11
CN103170043A (zh) 2013-06-26
CN103170043B (zh) 2017-03-01
US10688263B2 (en) 2020-06-23
EP1789120A1 (en) 2007-05-30
NZ587821A (en) 2012-03-30
JP2008511372A (ja) 2008-04-17
CN102058924A (zh) 2011-05-18
JP4884390B2 (ja) 2012-02-29
EP2526991B1 (en) 2019-02-20

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