System and method for treating lung disease using positive pressure airway support

Patent metadata

Field	Value
Publication number	US-9901692-B2
Application number	US-200913131902-A
Country	US
Kind code	B2
Filing date	Nov 21, 2009
Priority date	Dec 19, 2008
Publication date	Feb 27, 2018
Grant date	Feb 27, 2018

Abstract

A method of treating lung disease, such as asthma or COPD, is provided that includes determining a parameter indicative of a patient's pulmonary mechanics (such as, without limitation, airway resistance or lung compliance), and delivering positive pressure support to the airway of the patient, wherein the pressure level (which may be constant or variable) of the positive pressure support during at least a portion of the inspiratory phase of the patient is determined based on the determined parameter.

First claim

What is claimed is:

1. A method of treating lung disease in a patient, comprising:
determining, with a controller, a parameter indicative of the patient's pulmonary mechanics, the parameter determination comprising:
(1) measuring, with one or more sensors, flow responses produced by two different parameter determination inspiratory positive airway pressure (IPAP) levels delivered to the patient during two successive breaths, subtracting the flow responses from one another, and performing a least squares error fit on flow data that results from the subtraction; or
(2) randomly varying a level of parameter determination pressure support delivered to the patient during the two successive breaths, determining a differential volume signal by subtracting volume responses measured during the two successive breaths from one another, and estimating a steady-state response of the differential volume signal;

generating, with a pressure support system, therapy positive pressure support for delivery to an airway of the patient, wherein a pressure level of the therapy positive pressure support during at least a portion of an inspiratory phase of the patient is determined based on the determined parameter,
wherein the pressure level of the therapy positive pressure support during at least a portion of the inspiratory phase includes a peak pressure, and
determining a second pressure level that is below the peak pressure of the therapy positive pressure support, the second pressure level being determined during an expiratory phase of the patient, the second pressure level determined based on the determined parameter.

2. The method according to claim 1 , wherein generating the therapy positive pressure support for delivery to an airway of the patient comprises delivering bi-level positive pressure support to an airway of the patient, the bi-level positive pressure support having an IPAP level and an expiratory positive airway pressure (EPAP) level, wherein the IPAP level and the EPAP level of the bi-level positive pressure support are determined based on the determined parameter.

3. The method according to claim 1 , wherein the determining a parameter step is performed prior to the generating therapy positive pressure support step.

4. The method according to claim 1 , wherein the lung disease is asthma.

5. The method according to claim 1 , wherein the lung disease is COPD.

6. The method according to claim 1 , wherein the parameter is upper airway resistance.

7. The method according to claim 1 , wherein the parameter is lung compliance.

8. The method according to claim 1 , wherein the generating is performed by the pressure support system and wherein the determining the parameter indicative of the patient's pulmonary mechanics comprises determining the parameter with a device external to the pressure support system and providing the parameter to the pressure support system.

9. The method according to claim 1 , wherein the generating is performed by the pressure support system and wherein the determining the parameter indicative of the patient's pulmonary mechanics comprises determining the parameter external to the pressure support system and manually inputting the parameter into the pressure support system.

10. The method according to claim 1 , further comprising repeating the method one or more times a day regardless of whether the patient is suffering acute symptoms of lung disease to reduce the patient's reliance on medication.

11. A pressure support system for treating lung disease, comprising:
a pressure generating system adapted to produce a flow of breathing gas;
a patient circuit operatively coupled to the pressure generating system to deliver the flow of breathing gas to an airway of a patient; and
a controller operatively coupled to the pressure generating system, the controller being adapted to:
determine a parameter indicative of the patient's pulmonary mechanics, the parameter determination comprising:
(1) measuring, with one or more sensors, flow responses produced by two different parameter determination inspiratory positive airway pressure (IPAP) levels delivered to the patient during two successive breaths, subtracting the flow responses from one another, and performing a least squares error fit on flow data that results from the subtraction; or
(2) randomly varying a level of parameter determination pressure support delivered to the patient during the two successive breaths, determining a differential volume signal by subtracting volume responses measured during the two successive breaths from one another, and estimating a steady-state response of the differential volume signal; and

control the pressure generating system to deliver the flow of breathing gas to the patient at a therapy pressure level during at least a portion of an inspiratory phase of the patient, wherein the therapy pressure level is determined based on the determined parameter,
wherein the therapy pressure level of the flow of breathing gas during the portion of the inspiratory phase includes a peak pressure, and
the controller is adapted to control the pressure generating system to deliver the flow of breathing gas to the patient at a second therapy pressure level that is below the peak pressure, the second therapy pressure level being determined during an expiratory phase of the patient, the second therapy pressure level determined based on the determined parameter.

12. The system according to claim 11 , wherein the controller is adapted to control the pressure generating system to deliver the flow of breathing gas to the patient at a therapy bi-level pressure support IPAP level during the portion of the inspiratory phase of the patient and deliver the flow of breathing gas to the patient at a therapy bi-level pressure support expiratory positive airway pressure (EPAP) level during at least a portion of an expiratory phase of the patient, wherein the therapy bi-level pressure support IPAP level and EPAP level are determined based on the determined parameter.

13. The system according to claim 11 , wherein the controller is adapted to determine the parameter prior to the controlling of the pressure generating system.

14. The system according to claim 11 , wherein the parameter is upper airway resistance.

15. The system according to claim 11 , wherein the parameter is lung compliance.

16. The system according to claim 11 , wherein the lung disease is asthma or COPD.

17. The system according to claim 11 , wherein the one or more sensors are operatively coupled to the controller, the one or more sensors being adapted to measure one or more characteristics associated with the flow of breathing gas and to generate one or more signals indicative thereof, wherein the controller is adapted to determine the parameter using the one or more signals.

18. A method of treating lung disease, comprising:
(a) generating, with a pressure support system, a first bi-level positive pressure support for delivery to an airway of a patient at an IPAP/EPAP differential for a first number of respiratory cycles wherein the IPAP/EPAP differential is a pressure determined by subtracting an expiratory positive airway pressure (EPAP) from an inspiratory positive airway pressure (IPAP) for a given respiratory cycle, the IPAP/EPAP differential of the first bi-level positive pressure support being a baseline level based on a predetermined baseline IPAP level and a predetermined baseline EPAP level;
(b) determining, with a controller, a parameter indicative of the patent's pulmonary mechanics, the parameter determ

Assignees

• Mechlenburg Douglas
• Coldren Richard J
• Koninklijke Philips Nv

Inventors

• Mechlenburg Douglas
• Coldren Richard J

Classifications

• A61M16/202

  electrically actuated · CPC title

• A61M16/024

  including calculation means, e.g. using a processor · CPC title

• A61M2016/0039

  in the inspiratory circuit · CPC title

• A61M2016/003

  with a flowmeter · CPC title

• A61M16/021

  operated by electrical means (A61M16/202 – A61M16/205 take precedence) · CPC title