Methods and apparatus for detecting and treating respiratory insufficiency

Patent metadata

Field	Value
Publication number	US-9827388-B2
Application number	US-75117410-A
Country	US
Kind code	B2
Filing date	Mar 31, 2010
Priority date	Apr 29, 2009
Publication date	Nov 28, 2017
Grant date	Nov 28, 2017

Abstract

Devices and systems provide methods of detecting a severity change in respiratory insufficiency (RI) or chronic obstructive pulmonary disease (COPD) condition of a patient. In an example embodiment, a detection monitoring device determines one or more severity change indicators based on a measure of supplied pressure or other representative measure determined by the device. The supplied pressure may optionally be determined during pressure treatment that satisfies a target ventilation. The supplied pressure or representative data may be compared to one or more thresholds that are selected to represent a change in the condition of the RI or COPD patient such as an exacerbation of a prior condition. Results of the comparisons may trigger one or more warnings or messages to notify a patient or physician of a pending change to the patient's RI or COPD condition so that the patient may more immediately seek medical attention to treat the condition.

First claim

The invention claimed is:

1. A device for monitoring a patient to evaluate a respiratory insufficiency condition of the patient comprising:
a transducer to generate a signal representative of a pressure delivered by a flow generator; and
a processor, coupled with the transducer, the processor configured to control an evaluation of a severity change indicator based on detecting, using a measure of determined pressure from the signal, a change in the measure of determined pressure from a plurality of treatment sessions, the evaluation comprising a detection of a continuous rise in the measure of determined pressure successively through the plurality of treatment sessions, the indicator representing information about a change in severity of a respiratory insufficiency condition of the patient,
wherein the respiratory insufficiency condition is attributable to an insufficiency condition of the patient's lungs.

2. The device of claim 1 further comprising the flow generator configured to generate a flow of breathable gas at a pressure above atmospheric pressure to a patient interface, wherein the processor is configured to control the flow generator.

3. The device of claim 2 wherein the flow generator is configured to generate the flow of breathable gas at a pressure above atmospheric pressure to maintain a target ventilation, and wherein the measure of determined pressure comprises a measure of pressure generated by the flow generator in order to maintain the target ventilation.

4. The device of claim 3 wherein the target ventilation is a minute ventilation and the measure of determined pressure is an average pressure.

5. The device of claim 3 wherein the target ventilation is an estimate of alveolar ventilation.

6. The device of claim 3 wherein the evaluation of the severity change indicator comprises a threshold comparison of the continuous rise in the measure of determined pressure successively through the treatment sessions.

7. The device of claim 6 wherein the threshold comparison involves the measure of determined pressure from one of the plurality of treatment sessions and a prior measure of determined pressure used to maintain the target ventilation during a prior treatment session of the plurality of treatment sessions.

8. The device of claim 6 wherein the threshold comparison represents an indication of a repeated rise in the measure of determined pressure over a period of days.

9. The device of claim 6 wherein the threshold comparison involves a difference between the measure of determined pressure from one of the plurality of treatment sessions and a prior measure of determined pressure used to maintain the target ventilation during a prior treatment session of the plurality of treatment sessions.

10. The device of claim 6 wherein the threshold comparison includes a ratio of the measure of determined pressure from one of the plurality of treatment sessions and a prior measure of determined pressure used to maintain the target ventilation during a prior treatment session of the plurality of treatment sessions.

11. The device of claim 6 wherein the evaluation of the severity change indicator further comprises a further threshold comparison involving a determined respiratory rate and a prior respiratory rate.

12. The device of claim 11 wherein the further threshold comparison represents an indication of a repeated rise in the determined respiratory rate over a period of days.

13. The device of claim 6 wherein the processor is configured to activate a warning based on the severity change indicator.

14. The device of claim 13 wherein the warning comprises an activated light.

15. The device of claim 13 wherein the warning comprises a message.

16. The device of claim 1 wherein the processor is configured to control transmitting of an electronic message including data representing a result of the evaluation of the severity change indicator.

17. The device of claim 3 further comprising a transmitter coupled with the processor, wherein the processor is further configured to control transmitting of a message including data representing the severity change indicator.

18. A system for monitoring a patient to evaluate a respiratory insufficiency condition of the patient comprising:
a pressure means to generate a signal representative of the pressure delivered by a flow generator; and
processing means for controlling an evaluation of a severity change indicator based on detecting, using a measure of determined pressure from the signal, a change in the measure of determined pressure from a plurality of treatment sessions, the evaluation comprising a detection of a continuous rise in the measure of determined pressure successively through the plurality of treatment sessions, the indicator representing information about a change in severity of a respiratory insufficiency condition of the patient,
wherein the respiratory insufficiency condition is attributable to an insufficiency condition of the patient's lungs.

19. The system of claim 18 further comprising means for transmitting a message representing the indicator.

20. The system of claim 18 further comprising means for warning a user of the system based on the indicator.

21. The system of claim 18 further comprising the flow generator configured to generate a flow of breathable gas at a pressure above atmospheric pressure to a patient interface to satisfy a target ventilation.

22. The system of claim 21 wherein the target ventilation is an estimate of alveolar ventilation.

23. A device for monitoring a patient to evaluate a respiratory insufficiency condition of a patient comprising:
a sensor to generate a signal associated with a pressure therapy treatment of the respiratory system of a patient; and
a processor configured to control an evaluation of a severity change indicator based on detecting, using a measure of determined pressure from the signal, a change in the measure of determined pressure from the signal of the sensor from a plurality of treatment sessions, the evaluation comprising a detection of a continuous rise in the measure of determined pressure successively through the plurality of treatment sessions, the severity change indicator representing information about a change in severity of a respiratory insufficiency condition of the patient,
wherein the respiratory insufficiency condition is attributable to an insufficiency condition of the patient's lungs.

24. The device of claim 23 wherein the measure of determined pressure represents a degree of respiratory assistance therapy determined from the signal of the sensor.

25. The device of claim 24 wherein the control of the evaluation of the severity change indicator includes assessing detected data associated with inspiratory flow limitation to rule out upper airway obstruction.

26. The device of claim 23 wherein the control of the evaluation of the severity change indicator includes assessing a measure representing a respiratory rate.

27. The device of claim 23 wherein the control of the evaluation of the severity change indicator includes assessing a measure representing a respiratory duty cycle determined from the signal of the sensor.

28. The device of claim 23 wherein the control of the evaluation of the severity change indicator includes assessing a measure representing an intrinsic positive end expiratory pressure.

Assignees

• Schindhelm Klaus Henry
• Bassin David John
• Richards Glenn
• Resmed Ltd

Inventors

• Schindhelm Klaus Henry
• Bassin David John
• Richards Glenn

Classifications

• A61M2230/46

  Resistance or compliance of the lungs · CPC title

• A61M2230/42

  Rate · CPC title

• A61M2230/205

  partial oxygen pressure (P-O2) · CPC title

• A61M2230/04

  Heartbeat characteristics, e.g. ECG, blood pressure modulation · CPC title

• A61M2205/502

  User interfaces, e.g. screens or keyboards · CPC title