Apparatus for measuring and predicting patients' respiratory stability

Patent metadata

Field	Value
Publication number	US-9554740-B2
Application number	US-86606709-A
Country	US
Kind code	B2
Filing date	Feb 2, 2009
Priority date	Feb 7, 2008
Publication date	Jan 31, 2017
Grant date	Jan 31, 2017

Abstract

An apparatus ( 10 ) for predicting patient respiratory stability includes a patient data memory ( 24 ) which stores patient data for a patient ( 12 ) and an analyzer ( 34 ) in communication with the memory computes a measure of patient respiratory stability. The analyzer applies one or more rules to the patient data that are based on a plurality of parameters which in combination, have been identified as being predictive of patient respiratory instability, such as mean airway pressure (MAWP), plateau pressure (PP), arterial oxygen saturation (SaO2 or SpO2), and heart rate (HR). Based on the application of the rules, the analyzer determines the measure of patient respiratory stability.

First claim

Having thus described the preferred embodiments, the invention is now claimed to be:

1. An apparatus for predicting onset of patient respiratory instability wherein patient respiratory instability is defined as a condition associated with a low ratio of arterial oxygen partial pressure (PaO 2 ) to fraction of inspired oxygen (FiO 2 ), the apparatus comprising:
a vital signs display monitor configured to acquire and display patient data of a patient related to respiratory stability including at least Mean Airway Pressure (MAWP) and Plateau Pressure (PP) parameters; and
an analyzer comprising a microprocessor or microcontroller, the analyzer programmed to compute at least one measure of predicted patient respiratory stability over a prediction time interval of duration 36 hours or less and having a starting time in a range of a current time to 24 hours in the future, the analyzer applying at least one rule to the patient data, the at least one rule being based on a plurality of parameters including at least one of the MAWP and PP parameters monitored by the monitoring system which, in combination, have been identified as being predictive of patient respiratory instability, and based on the application of the at least one rule, determines the measure of predicted patient respiratory stability over the prediction time interval, the analyzer further configured to output an alert when the measure of predicted patient respiratory stability over the prediction time interval meets a threshold indicative of respiratory instability;
wherein the vital signs display monitor is further configured to display the measure of predicted patient respiratory stability over the prediction time interval computed by the analyzer.

2. The apparatus of claim 1 , further comprising a model in communication with the analyzer which stores the at least one rule.

3. The apparatus of claim 1 , wherein the plurality of parameters further include at least two of the group consisting of:
an oxygen saturation measure (SpO2 or SaO2);
Heart rate (HR);
Peak inspiration pressure (PIP);
Dynamic lung/chest compliance (C dyn );
Static respiratory compliance (C stat );
Respiratory rate (RR);
White Blood Cell Count (WBC); and
Net Fluid Balance.

4. The apparatus of claim 3 , wherein the plurality of parameters include the group consisting of:
Mean airway pressure (MAWP);
Plateau pressure (PP);
Saturation of peripheral oxygen (SpO2); and
Heart rate (HR).

5. The apparatus of claim 4 , wherein the at least one rule comprises:
(1) if MAWP>17 mmHg then patient respiration is unstable;
(2) if MAWP>12.6 mmHg and SpO2<=97% and HR>86.5 beats per minute then patient respiration is unstable;
(3) if PP>23.8 mmHg and HR>90.5 beats per minute and SpO2<=97.5% then patient respiration is unstable; and
(4) if rules (1), (2), and (3) are not met, then patient respiration is stable.

6. The apparatus of claim 1 , wherein the at least one rule comprises a set of rules, each rule specifying a threshold for at least one of the parameters which must be met for the rule to be satisfied to determine the measure of predicted patient respiratory stability over the prediction time interval.

7. The apparatus of claim 6 , wherein the set of rules includes a first rule which specifies a threshold for a first of the parameters and a second rule which specifies a threshold for a second of the parameters.

8. The apparatus of claim 7 , wherein the second rule specifies a different threshold for the first parameter from the first rule.

9. The apparatus of claim 1 , wherein the measure of predicted patient respiratory stability over the prediction time interval is a binary measure.

10. The apparatus of claim 1 , wherein the measure of predicted patient respiratory stability over the prediction time interval is a variable value.

11. The apparatus of claim 1 , wherein the at least one rule applied by the analyzer is dependent on the prediction time interval.

12. A method for predicting onset of patient respiratory instability caused by gas exchange compromise in the lungs, the method comprising:
monitoring a plurality of parameters related to respiratory stability including at least Mean Airway Pressure (MAWP) and Plateau Pressure (PP) by acquiring patient data for a patient and displaying the acquired patient data on a vital signs display monitor;
computing a measure of patient respiratory stability over a prediction time interval of duration 36 hours or less and having a starting time in a range of a current time to 24 hours in the future by operations performed by a microprocessor or microcontroller including (i) applying at least one rule to the patient data, the at least one rule operating on the monitored plurality of parameters including at least one of the MAWP and PP parameters, (ii) determining the measure of patient respiratory stability based on the applied at least one rule, and (iii) applying a threshold to the measure of patient respiratory stability to generate a prediction regarding onset of patient respiratory instability; and
displaying the computed measure on the vital signs display monitor.

13. The method of claim 12 , further comprising:
acquiring a corpus of patient data of prior patient data comprising data for cases in which respiratory instability was subsequently observed for a set of patients;
classifying patients according to whether the patients exhibited respiratory instability; and
generating the at least one rule based on the acquired corpus and patient classifications.

14. The method of claim 13 , wherein the measure of predicted patient respiratory stability is computed over a prediction time interval of duration 36 hours or less and having a starting time in a range of a current time to 24 hours in the future and wherein the prediction time interval includes a first selectable time interval and a second selectable time interval, the method further comprising:
generating a first set of rules of the at least one rule applicable to a first selectable time interval; and
generating a second set of rules of the at least one rule applicable to a second selectable time interval.

Assignees

• Saeed Mohammed
• Lee Kwok Pun
• Ennett Colleen M
• Eshelman Larry
• Nielsen Larry
• Gross Brian
• Koninklijke Philips Nv

Inventors

• Saeed Mohammed
• Lee Kwok Pun
• Ennett Colleen M
• Eshelman Larry
• Nielsen Larry
• Gross Brian

Classifications

• A61M2205/3584

  using modem, internet or Bluetooth® · CPC title

• G06F19/345

  Physics · mapped topic

• A61B5/0816

  Measuring devices for examining respiratory frequency (measuring frequency of electric signals G01R23/00) · CPC title

• A61M2230/06

  Heartbeat rate only · CPC title

• A61M16/0051

  with alarm devices · CPC title