WO2022221863A1 - Systems and methods for measuring patient lung pressure - Google Patents
Systems and methods for measuring patient lung pressure Download PDFInfo
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- WO2022221863A1 WO2022221863A1 PCT/US2022/071729 US2022071729W WO2022221863A1 WO 2022221863 A1 WO2022221863 A1 WO 2022221863A1 US 2022071729 W US2022071729 W US 2022071729W WO 2022221863 A1 WO2022221863 A1 WO 2022221863A1
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- 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
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/03—Measuring fluid pressure within the body other than blood pressure, e.g. cerebral pressure ; Measuring pressure in body tissues or organs
-
- 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
- A61M16/024—Control means therefor including calculation means, e.g. using a processor
-
- 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
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
- A61M2016/0036—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the breathing tube and used in both inspiratory and expiratory phase
-
- 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
- A61M2205/3365—Rotational speed
-
- 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
- A61M2205/505—Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
-
- 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
- A61M2230/00—Measuring parameters of the user
- A61M2230/40—Respiratory characteristics
- A61M2230/46—Resistance or compliance of the lungs
Definitions
- the present technology is generally directed to ventilator systems and methods of use, and in particular to measuring patient lung pressure and other physiologic metrics.
- Mechanical ventilators are typically connected to a patient using a patient circuit. Once connected to the patient, the ventilators drive inspiratory gases into the patient’s lungs to assist with the patient’s breathing. Gas flow can be controlled either using pressure-controlled ventilation or volume-controlled ventilation.
- pressure-controlled ventilation the ventilator delivers air to the patient until a predetermined pressure is reached. Once the predetermined pressure is reached, an expiratory valve in the patient circuit opens, reducing pressure in the patient circuit and enabling gases to flow out of the patient’ s lungs and exit the patient circuit via the expiratory valve.
- volume-controlled ventilation the ventilator delivers a predetermined volume of air to the patient. Once the predetermined volume of air is delivered to the patient, flow is reduced, and air naturally flows out of the patient’ s lungs back toward the ventilator.
- FIG. 1 is a schematic diagram of a ventilator system configured in accordance with embodiments of the present technology.
- FIG. 2 illustrates a flow-waveform graph, a pressure-waveform graph, and a blower-speed graph for three respiratory cycles generated in accordance with embodiments of the present technology.
- FIG. 3 is an enlarged view of a portion of the flow-waveform graph, pressure- waveform graph, and blower-speed graph of FIG. 2 illustrating a hold maneuver for measuring patient lung pressure in accordance with embodiments of the present technology.
- FIG. 4A is a schematic diagram illustrating a ventilator control module for use with an active patient circuit and configured to perform a hold maneuver for measuring patient lung pressure in accordance with embodiments of the present technology.
- FIG. 4B is a schematic diagram illustrating a ventilator control module for use with a passive patient circuit and configured to perform a hold maneuver for measuring patient lung pressure in accordance with embodiments of the present technology.
- FIG. 5 is a schematic illustration of a ventilator configured to perform a hold maneuver for measuring patient lung pressure and configured in accordance with embodiments of the present technology.
- FIG. 6 is a flowchart of a method for measuring patient lung pressure in a patient during ventilation in accordance with embodiments of the present technology.
- the present technology is generally directed to systems and methods for measuring patient lung pressure during pressure-controlled or volume-controlled mechanical ventilation.
- the present technology further provides systems and methods for calculating patient static compliance and/or patient airway resistance based on the measured patient lung pressure.
- the present technology includes operating a ventilator blower at a first speed during an inspiratory phase of a breath to direct gas from the ventilator to the patient along a flow path, and, after the inspiratory phase and before an expiratory phase of the breath, operating the blower at a second speed less than the first speed to achieve a zero-flow state in the flow path during which gas neither flows into nor out of the patient’s lungs.
- the pressure in the flow path is equal or at least approximately equal to the patient lung pressure. Accordingly, pressure can be measured at any position along the flow path during the zero-flow state to determine patient lung pressure. The measured patient lung pressure can then be used to automatically calculate patient static compliance and/or patient airway resistance. As described in detail herein, such measurements may assist in monitoring a patient’s pulmonary health during ventilation, selecting an appropriate therapy level for the patient, or the like.
- Patient lung pressure (e.g., the pressure in the patient’s lungs at any given point during the respiratory cycle) varies throughout an inspiratory/expiratory respiratory cycle.
- pressure in the patient’s lungs generally increases during the inspiratory phase of a breath as air moves into and inflates the lungs.
- patient lung pressure is generally at or proximate its peak value (e.g., also known as plateau pressure). Patient lung pressure then decreases during the expiratory phase as air moves out of the lungs and the lungs deflate.
- Patient lung pressure cannot be directly measured during a standard inspiratory- expiratory respiration cycle. This is because patient lung pressure generally is not equal to pressure at the patient connection (or any other position along the flow path between the ventilator and the patient’ s mouth) during ventilation due to the resistance of the patient’ s airway (e.g., trachea). For example, pressure at the patient’s mouth generally will be greater than patient lung pressure at any given moment during the inspiratory phase (e.g., due to patient airway resistance), and pressure at the patient’s mouth will generally be less than patient lung pressure at any given moment of the expiratory phase (e.g., also due to patient airway resistance).
- measuring pressure at the patient’ s mouth (or at another position along the flow path between the ventilator and the patient’s mouth) during the inspiratory or expiratory phase does not provide an accurate estimate of patient lung pressure. Therefore, patient lung pressure cannot be measured simply by placing a pressure sensor on a patient connection at the patient’ s mouth.
- patient lung pressure can be assessed using a hold maneuver immediately following the inspiratory phase.
- an expiratory valve in the patient circuit is held in a closed position following termination of the inspiratory phase.
- This causes a zero-flow state in the patient circuit, during which air neither flows into nor out of the patient’s lungs. Because there is zero flow, the patient airway resistance does not affect the pressure in the patient’s lungs. Accordingly, the pressure measured during the zero-flow state (known as the “plateau pressure”) along the flow path between the ventilator and the patient is representative of the patient’s peak lung pressure.
- the present technology therefore provides systems and methods for measuring patient lung pressure, such as in in systems without an actively controlled expiratory valve.
- the present technology automatically controls operation of the blower to achieve a zero-flow state during a hold maneuver to permit a plateau pressure, and thus patient lung pressure, to be measured.
- a plateau pressure that is too high (e.g., greater than about 20 cmthO, greater than about 25 cmthO, greater than about 30 cmthO, or another patient-specific parameter) during or at the end of a hold maneuver may indicate the patient’s lungs are over-inflated, which can cause barotrauma and lead to lung damage.
- a plateau lung pressure that is too low during or at the end of a hold maneuver may indicate the patient is not receiving sufficient air during respiration.
- ventilation therapy parameters can be selected to achieve a patient lung pressure at the end of the inspiratory phase (e.g., the plateau pressure) within a clinically acceptable range for a particular patient.
- Patient static compliance e.g., the distensibility /ability of the lung to stretch or expand in volume for a given pressure
- patient airway resistance e.g., the resistance to air flow generated by the patient’s anatomy
- a low patient lung compliance may indicate the patient has a “stiff’ or fibrotic lung
- a high patient lung compliance may indicate the patient’s lungs are overly pliable.
- patient static compliance and patient airway resistance cannot be directly measured during pressure-controlled or volume-controlled ventilation.
- the present technology can utilize the measured patient lung pressure values to calculate patient compliance and patient airway resistance.
- FIG. 1 is a schematic illustration of a ventilation system 100 (“the system 100”) for providing ventilation therapy to a patient 102 and configured in accordance with embodiments of the present technology.
- the system 100 includes a ventilator 110, a patient circuit 106, and a patient connection 104.
- the ventilator 110 can be coupled to the patient 102 via the patient circuit 106 and the patient connection 104.
- the patient circuit 106 can include a conduit or lumen (e.g., tubing) for transporting gases to and/or from the patient 102.
- the patient circuit 106 can include a passive patient circuit or an active patient circuit, such as those described in U.S. Patent Nos.
- the patient connection 104 can be any suitable interface coupled to the patient circuit 106 for delivering gases to the patient 102, such as a full rebreather mask, a partial rebreather mask, a nasal mask, a mouthpiece, a tracheal tube, or the like.
- the ventilator 110 can include a ventilation assembly 120 having a blower 122 for providing inspiratory gases (e.g., “air 126”) to the patient 102.
- the air 126 is received by the ventilator 110 via a patient air intake 124, which is coupled to the ventilation assembly 120. While identified as being “air,” those of ordinary skill in the art will appreciate that the air 126 may include ambient air or pressurized air obtained from any source external to the ventilator 110.
- the air 126 may also optionally include concentrated oxygen, as described in U.S. Patent Nos. 10,245,406 and 10,315,002, the disclosures of which are incorporated by reference herein in their entireties and for all purposes.
- the blower 122 controls the flow of air 126 to the patient 102.
- the blower 122 can direct air 126 to the patient 102 via a flow path that includes the patient air intake 124, the ventilation assembly 120, the main ventilator connection 116, the patient circuit 106, and the patient connection 104.
- Operation of the blower during the expiratory phase depends on the mode of therapy provided by the system 100.
- the blower 122 also directs air 126 to the main ventilator connection 116 during the expiratory phase.
- the ventilator 110 may receive expiratory gases during the expiratory phase.
- the ventilator 110 may purge expiratory gases via the patient air intake 124, and/or may have a separate outlet port (not shown) for venting patient expiratory gases.
- the system 100 can further include one or more sensors, such as a flow sensor 118 and/or a pressure sensor 119.
- the flow sensor 118 can be positioned at any suitable position along the flow path between the patient air intake 124 and the patient connection 104.
- the flow sensor 118 is positioned between the patient air intake 124 and the ventilation assembly 120.
- the flow sensor 118 is configured to measure the flow of gas (e.g., in liters per minute or LPM) between the patient air intake 124 and the patient 102.
- the pressure sensor 119 can be positioned at any suitable position for measuring a pressure within the flow path between the patient air intake 124 and the patient 102.
- the pressure sensor 119 can be positioned within the ventilator 110 between the ventilation assembly 120 and the main ventilator connection 116.
- the system 100 can optionally include a secondary flow sensor 105 proximate the patient 202.
- the ventilator 110 may further include a control module 112 for controlling operation of the ventilator 110.
- the control module 112 can generate one or more signals for controlling operation of the ventilation assembly 120, such as to automatically control a speed of the blower 122 (e.g., to provide a suitable flow of air 126 to the patient and/or to synchronize operation of the ventilator 110 with the patient’s breath).
- the control module 112 may direct the blower 122 to operate at a first speed during an inspiratory phase of a breath and a second speed slower than the first speed during an expiratory phase of the breath.
- the control module 112 may also receive signals from the flow sensor 118 and/or the pressure sensor 119.
- the control module 112 may receive a signal from the flow sensor 118 during an inspiratory phase and, based on the received signal, automatically and in real-time calculate the volume of air delivered to the patient during the inspiratory phase. Once the calculated volume reaches a predetermined threshold, the control module 112 can control the ventilation assembly 120 to initiate the expiratory phase (e.g., by slowing the speed of the blower 122). Further yet, as described in detail with respect to FIGS. 2- 6, the control module 112 can also automatically control the speed of the blower 122 based on the signals received from the flow sensor 118 to achieve a zero-flow state within the flow path during a hold maneuver in order to measure patient lung pressure.
- the ventilator 110 can further include a user interface 114.
- the user interface 114 is configured to receive input from a user (e.g., the patient, a caregiver, a clinician, or other user associated with the patient 102) and provide that input to the control module 112.
- the input received via the user interface 114 can include ventilator settings, parameters of operation, modes of operation, and the like.
- a user may initiate a hold maneuver using the user interface 114 to measure patient lung pressure.
- the user interface 114 can further be configured to display information to the user and/or patient, including selected ventilator settings, parameters of operation, modes of operation, physiologic parameters, and the like.
- the user interface 114 can be any suitable user interface known in the art, such as a touch-screen having a digital display of ventilator settings and operating parameters.
- the system 100 can optionally include additional features and functions beyond those described above.
- the system 100 can include one or more of an oxygen assembly for providing supplemental oxygen to the patient 102, a cough-assist assembly for providing cough assistance to the patient 102, a nebulizer assembly for providing drug-therapy to the patient, a suction assembly for providing suction to the patient 102, or the like.
- one or more of the foregoing assemblies e.g., the cough-assist assembly
- the system 100 can provide multiple respiratory therapies to the patient 102 without disconnecting the patient from the patient circuit 106. Additional features of ventilators suitable for use with the present technology are described in U.S. Patent No. 9,956,371, the disclosure of which is incorporated by reference herein in its entirety and for all purposes.
- the system 100 can be used to measure and/or calculate patient lung pressure, patient static compliance, and/or patient airway resistance during mechanical ventilation.
- patient lung pressure can be measured by controlling operation of the blower 122 to reduce net flow in the system 100 to zero following the inspiratory phase.
- Patient static compliance and patient airway resistance can be calculated using the measured patient lung pressure.
- FIG. 2 includes a first graph 210 showing a representative flow waveform for three respiratory cycles 200a-c during volume-controlled ventilation (e.g., using the system 100 shown in FIG. 1), a second graph 220 showing a representative pressure waveform for the same three respiratory cycles 200a-c, and a third graph 230 showing the blower (e.g., the blower 122 shown in FIG. 1) speed for the same three respiratory cycles 200a-c.
- the first cycle 200a and the third cycle 200c are standard respiratory cycles having an inspiratory phase I immediately followed by an expiratory phase E.
- the second cycle 200b includes a hold maneuver used to measure peak patient lung pressure (e.g., plateau pressure) in accordance with embodiments of the present technology.
- FIG. 3 is an enlarged view of the second cycle 200b showing the hold maneuver, with the other cycles omitted for clarity.
- the second cycle 200b includes an inspiratory phase I and an expiratory phase E.
- the second cycle 200b also includes a zero-flow phase F between the inspiratory phase I and the expiratory phase E.
- the blower is set (e.g., automatically set) to a speed that achieves and maintains zero flow in the flow path between the patient air intake 124 and the patient 102, as described in detail below.
- the pressure plateaus during the zero-flow phase F (labeled as PPLAT in FIG. 3), generally at a value less than the maximum pressure observed at the end of the inspiratory phase but greater than the baseline pressure observed at the end of the expiratory phase.
- the plateau pressure PPLAT in the flow path during the zero-flow phase F is equal or at least approximately equal to the pressure in the patient’s lungs.
- the third graph 230c shows operation of the blower 122 to maintain zero flow during the zero-flow phase F (e.g., gas neither flows into nor out of the patient’s lungs).
- the blower 122 cannot simply turn off or even return to its baseline speed to achieve zero flow. If the blower 122 were turned off immediately following the inspiratory phase I, the patient’s lungs would deflate and air would flow out of the patient’s lungs and into the patient circuit, resulting in negative flow (e.g., flow toward the ventilation assembly 120).
- the blower 122 If the blower 122 were returned to its baseline speed immediately following the inspiratory phase I, such as in the first and third cycles 200a and 200c, the patient’s lungs would still deflate in a normal expiratory event and air would flow out of the patient’s lungs and into the patient circuit, also resulting in negative flow. If the blower 122 was maintained at or near its speed during the inspiratory phase I, the blower 122 would continue to move air into the patient’s lungs, resulting in positive flow (e.g., flow toward the patient). Accordingly, to achieve zero flow, the blower 122 operates at an intermediate speed during the zero-flow phase F that is between its peak speed during the inspiratory phase I and its baseline speed during the expiratory phase E.
- FIG. 4A is a flowchart illustrating a first ventilator control module 112a for use with an active patient circuit and configured to automatically control the speed of the blower to achieve a zero-flow state during the hold maneuver.
- a flow reference value e.g., a target flow
- the control module 412a can estimate (e.g., using a look up table having predetermined correlations between pressure, flow, and blower speed) a blower speed suitable for achieving the flow reference value.
- a first PI controller can also compare measured flow to the flow reference value to determine whether the flow is at the flow reference value.
- a second PI controller can automatically control the speed of the blower to the estimated speed (e.g., by controlling the duty cycle of the motor that drives the blower). Once the blower is operating at the estimated speed, the first PI controller can further fine-tune the speed of the blower to achieve and maintain the flow reference value.
- FIG. 4B is a flowchart illustrating a second ventilator control module 112b for use with a passive patient circuit and configured to automatically control the speed of the blower to achieve a zero-flow state during the hold maneuver.
- the second ventilator control module 112b can be substantially similar to the first ventilator control module 112a described previously with respect to FIG. 4B. However, relative to the first ventilator control module 112a, the second ventilator control module 112b uses patient estimated flow to control speed of the blower to account for leaks in the passive patient circuit or any leaks at the patient connection.
- patient static compliance and patient airway resistance can be calculated using variations of the following equation, in which P is pressure, Q is flow, R p is patient airway resistance, V t is tidal volume, and CL is patient lung compliance:
- patient airway resistance can also be calculated.
- the system 100 can automatically determine patient lung pressure, patient static compliance, and/or patient airway resistance once a hold maneuver is initiated.
- the control module 112 can include a computing module that automatically measures patient lung pressure during a hold maneuver and then automatically calculates patient static compliance and patient airway resistance based on the measured patient lung pressure.
- the system 100 can then display patient lung pressure, patient static compliance, and/or patient airway resistance (e.g., using the user interface 114).
- FIG. 5 is a schematic illustration of the user interface 114 of the ventilator 110 of FIG. 1 illustrating a user-input hold maneuver control 550 (e.g., button, switch, toggle, etc.) for initiating a hold maneuver.
- a user can activate (e.g., press) the hold maneuver control 550 to initiate a hold maneuver that maintains a zero-flow state for measuring patient lung pressure.
- the control module 112 FIG. 1
- the hold maneuver continues for as long as the user activates (e.g., presses) the hold maneuver control 550, subject to a maximum hold period, described below.
- the user interface 114 can display a pressure- waveform graph 552 in real-time. Accordingly, when the user activates the hold maneuver control 550, the user can simultaneously view the pressure-waveform graph to ensure that a plateau pressure is achieved before releasing the hold maneuver control 550 and terminating the hold maneuver (hold maneuver pressure waveform not shown in FIG. 5). The user interface 114 can also display the most recently-measured plateau pressure metric 554 and the most recently-calculated static compliance metric 556.
- a user can therefore initiate a hold maneuver using the user interface 114 to measure patient lung pressure at various times throughout the day (e.g., on-demand measurements).
- the duration of the hold maneuver can be preset (e.g., 1 second, 2 seconds, 3 seconds, 4 seconds, 5 seconds, or 6 seconds), or can be controlled by the user, as described above.
- the system 100 can include a maximum hold duration (e.g., 6 seconds) after which the system 100 returns to standard ventilation even if the user keeps the hold maneuver control 550 activated.
- the system 100 can automatically initiate a hold maneuver at pre-set intervals.
- the system 100 can be programmed to initiate a hold maneuver once per day, twice per day, three times per day, four times per day, five times per day, six times per day, etc.
- FIG. 6 is a flowchart of a method 600 for measuring patient lung pressure in a patient during pressure-controlled or volume-controlled ventilation.
- the method 600 can begin in step 602 by operating a ventilator blower (e.g., the blower 122 of the system 100) at a first speed during an inspiratory phase of the breath.
- the first speed can be sufficient to direct gas from the ventilator to the patient via a flow path that can include a patient circuit and a patient connection.
- the gas is supplied at a sufficient flow to inflate the patient’s lungs.
- step 604 can continue in step 604 by operating the blower at a second speed that is less than the first speed to achieve a zero-flow state in the flow path (e.g., preventing the patient from exhaling).
- This can include, for example, measuring the flow of gas in the flow path (e.g., using the flow sensor 118 of the system 100) and, based on the measured flow, automatically adjusting the speed of the blower to achieve and maintain the zero-flow state.
- the zero-flow state can be maintained for between about 1 second and about 6 seconds, such as for about 1 second, about 2 seconds, about 3 seconds, about 4 seconds, about 5 seconds, or about 6 seconds.
- the method 600 further includes measuring the plateau pressure during the zero- flow state at step 606. This can include, for example, measuring pressure using a pressure sensor positioned within the ventilator. Of note, and as previously described, the plateau pressure measured during the zero-flow state is equal or at least approximately equal to the patient lung pressure. The measured plateau pressure can therefore be displayed to a user as the patient lung pressure. Patent static compliance can also be calculated using the measured patient lung pressure, as described above. Similarly, patient airway resistance can be calculated using the calculated static compliance, as also described above. After the plateau pressure is measured in step 606, the method 600 can continue by operating the blower at a third speed that is less than the second speed to permit the user to expire the gas delivered during the inspiratory phase of the breath. Examples
- a method for measuring patient lung pressure in a patient during ventilation using a ventilator connected to the patient by a patient circuit and a patient connection comprising: operating a blower of the ventilator at a first speed during an inspiratory phase of a breath to direct gas from the ventilator to the patient along a flow path including the patient circuit and the patient connection; after the inspiratory phase and before an expiratory phase of the breath, operating the blower at a second speed less than the first speed to achieve a zero-flow state in the flow path during which gas neither flows into nor out of the lungs of the patient; and measuring a plateau pressure in the flow path during the zero-flow state, wherein the measured plateau pressure is equal or approximately equal to the patient lung pressure.
- operating the blower at the second speed less than the first speed to achieve the zero-flow state comprises: measuring, via a flow sensor, gas flow in the flow path; and based on the measured gas flow, automatically adjusting the speed of the blower to achieve and maintain the zero-flow state.
- measuring the plateau pressure in the flow path includes measuring the plateau pressure using a pressure sensor positioned within the ventilator. 6. The method of any of examples 1-5 wherein operating the blower at the second speed includes maintaining the zero-flow state for between about 1 second and about 6 seconds.
- a ventilator system comprising: a ventilation assembly having a blower configured to control the flow of gas to a patient; a control module configured to control the blower, the control module including — one or more processors, and a memory storing instructions for performing a hold maneuver to measure patient lung pressure, wherein the instructions, when executed by the one or more processors, cause the ventilator system to perform operations comprising: operating the blower at a first speed during an inspiratory phase of a breath to direct gas from the ventilator to the patient along a flow path including a patient circuit and a patient connection, and after the inspiratory phase and before an expiratory phase of the breath, reducing the speed of the blower to achieve a zero-flow state in the flow path during which gas neither flows into nor out of the lungs of the patient; and a pressure sensor configured to measure a plateau pressure in the flow path during the zero-flow state, wherein the measured plateau pressure is equal or approximately equal to the patient lung pressure.
- the system of example 10 further comprising a flow sensor configured to measure gas flow in the flow path, and wherein the operation of reducing the speed of the blower to achieve a zero-flow state further includes: receiving a signal from the flow sensor indicative of gas flow in the flow path, and based on the received signal, automatically adjusting the speed of the blower to achieve and maintain the zero-flow state.
- the systems and methods described herein can be implemented with and/or distributed across computing architecture.
- many of the systems described herein include a memory storing data, software modules, instructions, or the like.
- the memories described herein can include one or more of various hardware devices for volatile and non volatile storage, and can include both read-only and writable memory.
- a memory can comprise random access memory (RAM), various caches, CPU registers, read-only memory (ROM), and writable non-volatile memory, such as flash memory, hard drives, floppy disks, CDs, DVDs, magnetic storage devices, tape drives, device buffers, and so forth.
- RAM random access memory
- ROM read-only memory
- writable non-volatile memory such as flash memory, hard drives, floppy disks, CDs, DVDs, magnetic storage devices, tape drives, device buffers, and so forth.
- a memory is not a propagating signal divorced from underlying hardware; a memory is thus non-transitory.
- the memory
- the words “comprise,” “comprising,” and the like are to be construed in an inclusive sense, as opposed to an exclusive or exhaustive sense; that is to say, in the sense of “including, but not limited to.”
- the terms “connected,” “coupled,” or any variant thereof means any connection or coupling, either direct or indirect, between two or more elements; the coupling of connection between the elements can be physical, logical, or a combination thereof.
- the words “herein,” “above,” “below,” and words of similar import when used in this application, shall refer to this application as a whole and not to any particular portions of this application.
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Priority Applications (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202280040407.XA CN117440847A (zh) | 2021-04-15 | 2022-04-14 | 用于测量患者肺部压力的系统和方法 |
| CA3216818A CA3216818A1 (en) | 2021-04-15 | 2022-04-14 | Systems and methods for measuring patient lung pressure |
| JP2023562697A JP2024518030A (ja) | 2021-04-15 | 2022-04-14 | 患者肺圧を測定するためのシステムおよび方法 |
| EP22789130.6A EP4323041A4 (en) | 2021-04-15 | 2022-04-14 | SYSTEMS AND METHODS FOR MEASURING PULMONARY PRESSURE OF A PATIENT |
| US18/555,240 US20240165351A1 (en) | 2021-04-15 | 2022-04-14 | Systems and methods for measuring patient lung pressure |
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| Application Number | Priority Date | Filing Date | Title |
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| US202163175405P | 2021-04-15 | 2021-04-15 | |
| US63/175,405 | 2021-04-15 |
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| WO2022221863A1 true WO2022221863A1 (en) | 2022-10-20 |
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| PCT/US2022/071729 Ceased WO2022221863A1 (en) | 2021-04-15 | 2022-04-14 | Systems and methods for measuring patient lung pressure |
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| Country | Link |
|---|---|
| US (1) | US20240165351A1 (https=) |
| EP (1) | EP4323041A4 (https=) |
| JP (1) | JP2024518030A (https=) |
| CN (1) | CN117440847A (https=) |
| CA (1) | CA3216818A1 (https=) |
| WO (1) | WO2022221863A1 (https=) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE102024116894A1 (de) * | 2024-06-17 | 2025-12-18 | Drägerwerk AG & Co. KGaA | Vorrichtung und Verfahren zum Erzeugen eines Vordruckes an einem Regelventil eines Beatmungsgerätes |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US3961627A (en) * | 1973-09-07 | 1976-06-08 | Hoffmann-La Roche Inc. | Automatic regulation of respirators |
| US5850835A (en) * | 1996-03-28 | 1998-12-22 | Suzuki Motor Corporation | Respirator system |
| US6371113B1 (en) * | 1996-10-10 | 2002-04-16 | Datex-Ohmeda, Inc. | Zero flow pause during volume ventilation |
| US20060032503A1 (en) * | 1999-01-15 | 2006-02-16 | Michael Berthon-Jones | Method and apparatus to counterbalance intrinsic positive end expiratory pressure |
| FR2939049A1 (fr) | 2008-11-28 | 2010-06-04 | Taema | Appareil de fourniture de gaz respiratoire a un patient |
| US9956371B2 (en) | 2015-03-24 | 2018-05-01 | Ventec Life Systems, Inc. | Ventilator with integrated cough-assist |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE69532011T2 (de) * | 1994-10-14 | 2004-07-29 | Bird Products Corporation, Palm Springs | Ausatmungsventil |
| US6257234B1 (en) * | 1998-08-21 | 2001-07-10 | Respironics, Inc. | Apparatus and method for determining respiratory mechanics of a patient and for controlling a ventilator based thereon |
| US9399109B2 (en) * | 2012-03-02 | 2016-07-26 | Breathe Technologies, Inc. | Continuous positive airway pressure (CPAP) therapy using measurements of speed and pressure |
| WO2018065246A1 (en) * | 2016-10-07 | 2018-04-12 | Koninklijke Philips N.V. | Estimating lung compliance and lung resistance using a pressure controlled breath to allow all respiratory muscle recoil generated pressure to vanish |
| US10980954B1 (en) * | 2020-06-30 | 2021-04-20 | ION-Biomimicry | Patient ventilator control using constant flow and breathing triggers |
-
2022
- 2022-04-14 JP JP2023562697A patent/JP2024518030A/ja active Pending
- 2022-04-14 EP EP22789130.6A patent/EP4323041A4/en active Pending
- 2022-04-14 CN CN202280040407.XA patent/CN117440847A/zh active Pending
- 2022-04-14 WO PCT/US2022/071729 patent/WO2022221863A1/en not_active Ceased
- 2022-04-14 CA CA3216818A patent/CA3216818A1/en active Pending
- 2022-04-14 US US18/555,240 patent/US20240165351A1/en active Pending
Patent Citations (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3961627A (en) * | 1973-09-07 | 1976-06-08 | Hoffmann-La Roche Inc. | Automatic regulation of respirators |
| US5850835A (en) * | 1996-03-28 | 1998-12-22 | Suzuki Motor Corporation | Respirator system |
| US6371113B1 (en) * | 1996-10-10 | 2002-04-16 | Datex-Ohmeda, Inc. | Zero flow pause during volume ventilation |
| US20060032503A1 (en) * | 1999-01-15 | 2006-02-16 | Michael Berthon-Jones | Method and apparatus to counterbalance intrinsic positive end expiratory pressure |
| FR2939049A1 (fr) | 2008-11-28 | 2010-06-04 | Taema | Appareil de fourniture de gaz respiratoire a un patient |
| US9956371B2 (en) | 2015-03-24 | 2018-05-01 | Ventec Life Systems, Inc. | Ventilator with integrated cough-assist |
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| US10245406B2 (en) | 2015-03-24 | 2019-04-02 | Ventec Life Systems, Inc. | Ventilator with integrated oxygen production |
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| US10518059B2 (en) | 2015-03-24 | 2019-12-31 | Ventec Life Systems, Inc. | Passive leak valve |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE102024116894A1 (de) * | 2024-06-17 | 2025-12-18 | Drägerwerk AG & Co. KGaA | Vorrichtung und Verfahren zum Erzeugen eines Vordruckes an einem Regelventil eines Beatmungsgerätes |
Also Published As
| Publication number | Publication date |
|---|---|
| US20240165351A1 (en) | 2024-05-23 |
| JP2024518030A (ja) | 2024-04-24 |
| EP4323041A1 (en) | 2024-02-21 |
| CN117440847A (zh) | 2024-01-23 |
| CA3216818A1 (en) | 2022-10-20 |
| EP4323041A4 (en) | 2025-02-26 |
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