System and method for supporting sub-physiologic and physiologic tidal volumes in spontaneous or non-spontaneous breathing during high frequency ventilation

Patent metadata

Field	Value
Publication number	US-10058664-B2
Application number	US-201013515458-A
Country	US
Kind code	B2
Filing date	Dec 1, 2010
Priority date	Dec 15, 2009
Publication date	Aug 28, 2018
Grant date	Aug 28, 2018

Abstract

A device for providing a high frequency ventilation to a patient that includes a pressure generating system that delivers a flow of breathing gas to the patient, where the flow has a first and second positive pressure levels that alternate with one another in a plurality of cycles in the flow so as to have a frequency and an amplitude. The flow generates a mean airway pressure. A controller, coupled to the pressure generating system, is configured to make a determination, as to a spontaneous breathing, or an attempt, by the patient, or a change in a user settings by a user, and in response adjusts the mean airway pressure, modulates the frequency and a duty cycle of the flow, or modulates a level of the flow and the amplitude of the flow, or two or more flows.

First claim

What is claimed is:

1. A method of providing high frequency positive pressure ventilation (HFPPV) to a patient, comprising acts of:
delivering a flow of breathing gas to the patient, the flow of breathing gas having a first positive pressure level and a second positive pressure level, the first and second positive pressure levels alternating with one another in a plurality of cycles in the flow of breathing gas to have a frequency and an amplitude, the flow of breathing gas to the patient generating a mean airway pressure and having a flow amplitude;
performing by a controller a determination of spontaneous breathing efforts by the patient, wherein the spontaneous breathing efforts comprise one of a spontaneous breathing, an attempt at spontaneous breathing and non-spontaneous breathing;
performing by the controller a simultaneous control of: an adjustment of the mean airway pressure, a modulation of the frequency and a duty cycle of the flow of breathing gas, and a modulation of the flow amplitude of the flow of breathing gas, to implement an HFPPV mode with an extended range for the frequency, the duty cycle, a flow level, and the mean airway pressure of positive pressure ventilation including 2 Hz and 25 Hz based on the simultaneous control; and
providing by the controller physiologic volumes interspersed with high frequency sub-physiologic volumes by intermittently modulating the mean airway pressure,
wherein the mean airway pressure is modulated by intermittently varying an exhalation resistance,
wherein the simultaneous control and the implementing of the HFPPV mode is in response to the determination, and
wherein the HFPPV mode is implemented by delivering the modulated flow of breathing gas via a pressure generating system through a patient circuit, in accordance with the adjusted mean airway pressure, and the modulated frequency and duty cycle.

2. The method of claim 1 , wherein the mean airway pressure of the patient is controlled by adjusting an active exhalation valve.

3. The method of claim 2 , wherein the active exhalation valve, the frequency and an inspiratory time of the flow of breathing gas, and the flow level of the breathing gas are controlled proportionally to a spontaneous breathing pattern.

4. The method of claim 2 , wherein the active exhalation valve, the frequency and the duty cycle of the flow of breathing gas, and the flow level of the breathing gas are controlled in a bi-level manner for inhalation and exhalation phases of a spontaneous breathing pattern of the spontaneous breathing efforts.

5. The method of claim 2 , wherein the active exhalation valve, the frequency and the duty cycle of the flow of breathing gas, and the flow level of the breathing gas are controlled in a manner as determined by user settings for high frequency ventilation (HFV) and a user intervention.

6. A high frequency positive pressure ventilation (HFPPV) support system, comprising:
a pressure generating system;
a patient circuit operatively coupled to the pressure generating system and adapted to be coupled to a patient; and
a controller operatively coupled to the pressure generating system, the controller being configured to:
control the pressure generating system to deliver a flow of breathing gas to the patient through the patient circuit, the flow of breathing gas having a first positive pressure level and a second positive pressure level, the first and second positive pressure levels alternating with one another in a plurality of cycles in the flow of breathing gas to have a frequency and an amplitude, the flow of breathing gas having a mean airway pressure and a flow amplitude;
perform a determination of spontaneous breathing efforts by the patient;

wherein the spontaneous breathing efforts comprise one of a spontaneous breathing, an attempt at spontaneous breathing and non-spontaneous breathing,
the controller being further configured to:
perform a simultaneous control of: an adjustment of the mean airway pressure, a modulation of the frequency and a duty cycle of the flow of breathing gas, and a modulation of the flow amplitude of the flow of breathing gas;
implement an HFPPV mode with an extended range for the frequency, the duty cycle, a flow level of breathing gas, and the mean airway pressure of a positive pressure ventilation including 2 Hz and 25 Hz based on the simultaneous control; and
provide physiologic volumes interspersed with high frequency sub-physiologic volumes by intermittently modulating the mean airway pressure,

wherein the mean airway pressure is modulated by intermittently varying an exhalation resistance,
wherein the simultaneous control and the implementing of the HFPPV mode is in response to the determination.

7. The pressure support system of claim 6 , wherein the mean airway pressure is controlled by adjusting an active exhalation valve.

8. The pressure support system of claim 7 , wherein the active exhalation valve, the frequency and the duty cycle of the flow of breathing gas, and the flow level of the breathing gas are controlled proportionally to a spontaneous breathing pattern of the spontaneous breathing efforts.

9. The pressure support system of claim 7 , wherein the active exhalation valve, the frequency and the duty cycle of the flow of breathing gas, and the flow level of the breathing gas are controlled in a bi-level manner for an inhalation and an exhalation phases of a spontaneous breathing pattern of the spontaneous breathing efforts.

10. The pressure support system of claim 7 , wherein the active exhalation valve, the frequency and the duty cycle of the flow of breathing gas, and the flow level of the breathing gas are controlled in a bi-level manner as determined by user settings for high frequency ventilation and a user intervention.

11. The pressure support system of claim 6 , wherein the controller is further configured to provide physiologic volumes interspersed with high frequency sub-physiologic volumes by intermittently modulating the mean airway pressure, wherein the mean airway pressure is modulated by intermittently varying the flow amplitude of the flow of breathing gas.

12. The pressure support system of claim 6 , wherein the controller is further configured to provide providing physiologic volumes interspersed with high frequency sub-physiologic volumes by intermittently modulating the mean airway pressure, wherein the mean airway pressure is modulated by intermittently varying the frequency.

13. The pressure support system of claim 6 , wherein the controller is further configured to provide physiologic volumes interspersed with high frequency sub-physiologic volumes by intermittently modulating the mean airway pressure, wherein the mean airway pressure is modulated by intermittently varying the duty cycle.

14. The pressure support system of claim 6 , wherein the mean airway pressure is modulated by intermittently varying one of the exhalation resistance, the amplitude, the frequency, the duty cycle, and combinations thereof.

15. The pressure support system of claim 6 , wherein the controller is further configured to provide physiologic volumes interspersed with high frequency sub-physiologic volumes by intermittently modulating the mean airway pressure, wherein modulating the mean airway pressure is configured to achieve physiologic volumes to provide for the spontaneous breathing.

16. The pressure support system of claim 6 , wherein the controller is further configured to provide physiologic volumes interspersed with high frequency sub-physiologic volumes by intermittently modulating the mean airway pressure, wherein

Assignees

• Kimm Gardner
• Garde Smita
• Arcilla Mabini
• Koninklijke Philips Nv

Inventors

• Kimm Gardner
• Garde Smita
• Arcilla Mabini

Classifications

• A61M16/204

  used for inhalation control · CPC title

• A61M2016/0036

  in the breathing tube and used in both inspiratory and expiratory phase · CPC title

• A61M16/0066

  Blowers or centrifugal pumps · CPC title

• A61M2205/50

  with microprocessors or computers · CPC title

• A61M2230/65

  Impedance, e.g. conductivity, capacity · CPC title