Ventilator Setting Adjustment System

Abstract

An automatic ventilator adjusting system has a three-way inline adapter coupled to 1) a breath sample line, 2) a ventilator (either invasive or non-invasive), and 3) a patient. The breath sample line is coupled to a Gas Exchange Monitor (GEM) and preferably has a female Luer lock end. Ventilator settings can be automatically set and/or adjusted using 1) an algorithm preferably having a feedback loop and 2) inputs including one or more of: gPaO.sub.2 (calculated arterial partial pressure of O.sub.2 by GEM), oxygen deficit, gPaCO.sub.2 (calculated arterial partial pressure of CO.sub.2), gPaCO.sub.2/gPaO.sub.2, PiO.sub.2-PETO.sub.2, TLC (Total Lung Capacity), FRC (Functional Residual Capacity), and Vd/Vt (deadspace ratio). Preferably, one or more of the inputs (e.g., gPaO.sub.2 gPaCO.sub.2, and oxygen deficit) are obtained non-invasively from a patient's normal breathing gas samples as calculated by MediPines Gas Exchange Monitor (GEM).

Claims

1. A method of adjusting a setting of a ventilator, comprising: receiving a signal from a real-time monitoring system of a patient's exhalation; using the signal as an input to an algorithm to calculate an adjustment value for a setting of the ventilator; and automatically adjusting one or more settings of the ventilator based on the adjustment value.

2. The method of claim 1, wherein the signal is selected from the group consisting of: gPaO.sub.2 oxygen Deficit, gPaCO.sub.2, PETCO.sub.2, gPaCO.sub.2/gPaO.sub.2, PiO.sub.2-PETO.sub.2, TLC, and FRC output.

3. The method of claim 1, wherein the setting is selected from the group consisting of: FiO.sub.2, PEEP, respiratory rate, tidal volume, inspiratory time, and inspiratory pressure.

4. The method of claim 1, further comprising producing a visual or audio message prompting a user to manually adjust the settings if the target value cannot be achieved within a reasonable period of time.

5. The method of claim 1, wherein the algorithm comprises comparing the signal with a target value of the signal.

6. The method of claim 1, wherein the step of automatically adjusting one or more settings of the ventilator comprises at least one of 1) increasing FiO.sub.2 and/or PEEP if measured gPaO.sub.2 is lower than a target value, and lowering FiO.sub.2 and/or PEEP if measured gPaO.sub.2 is higher than a target value; 2) increasing tidal volume and/or respiratory rate if measured gPaCO.sub.2 is higher than a target value, and decreasing tidal volume and/or respiratory rate if measured gPaCO.sub.2 is lower than the a target value; and 3) increasing support to a patient when gPaCO.sub.2/gPaO.sub.2 ratio is greater than 1.

7. The method of claim 1, wherein the step of automatically adjusting one or more settings of the ventilator comprises at least one of: 1) increasing the PEEP to reduce difference between PiO.sub.2-PETO.sub.2 output and a limit set by an operator; 2) decreasing the PEEP to reduce difference between PiO.sub.2-PETO.sub.2 output and a limit set by an operator.

8. The method of claim 1, wherein at least one of TLC output signal and FRC output signal is created by temporarily decreasing FiO.sub.2, and measuring the combined PETO.sub.2 and PETCO.sub.2 outputs.

9. The method of claim 1, wherein at least one of TLC and FRC output signal is fed into a closed loop algorithm that sets a tidal volume of the ventilator.

10. The method of claim 1, wherein at least one of volume, flow, and pressure signals from the ventilator is used to as an input to at least one of Vd/Vt calculation, FRC calculation, TLC calculation, and oxygen uptake calculation.

11. A system for adjusting ventilator settings, comprising: a processor configured to execute software instructions stored on a non-transitory storage medium, wherein the software instructions comprise: receiving a signal measured from a patient's exhalation; comparing the signal with a target value of the signal; calculating an adjustment value for a setting of the ventilator; and automatically adjusting the setting of the ventilator based on the adjustment value.

12. The system in claim 11, further comprising a ventilator coupled to the processor.

13. The system in claim 11, further comprising a Gas Exchange Monitor adapter coupled to the ventilator.

14. The system in claim 11, further comprising a sample line coupled to the Gas Exchange Monitor adapter.

15. The system in claim 11, further comprising an inline GEM adapter to ventilator circuit coupled to the ventilator.

16. A method of adjusting a setting of a ventilator, comprising: receiving a signal from a real-time monitoring system of a patient's exhalation; using the signal to calculate a deadspace ratio; using the deadspace ratio as an input to an algorithm to calculate an adjustment value for a setting of the ventilator; and automatically adjusting one or more settings of the ventilator based on the adjustment value.

17. The method of claim 16, wherein the signal is selected from the group consisting of: gPaO.sub.2, oxygen deficit, gPaCO.sub.2, gPaCO.sub.2/gPaO.sub.2, PiO.sub.2-PETO.sub.2, TLC, and FRC output.

18. The method of claim 16, wherein the deadspace ratio (Vd/Vt) is calculated using an equation, wherein the equation comprises Vd/Vt=(gPaCO.sub.2PETCO.sub.2)/gPaCO.sub.2.

19. The method of claim 16, wherein the setting is PEEP.

20. The method of claim 16, wherein the algorithm comprises comparing the calculated deadspace ratio with a target deadspace ratio set by an operator.

Description

BRIEF DESCRIPTION OF THE DRAWING

[0038] FIG. 1A is a schematic diagram of an embodiment of a GEM adapter, having a breath sample line and an inline adapter to an invasive ventilator circuit.

[0039] FIG. 1B is an enlarged schematic diagram of the breath sample line and the inline adaptor to ventilator circuit in FIG. 1A.

[0040] FIG. 2 is a schematic diagram of an embodiment of a GEM adapter, having a breath sample line with adapter to a non-invasive ventilator circuit.

DETAILED DESCRIPTION

[0041] The following discussion provides many example embodiments of the inventive subject matter. Although each embodiment represents a single combination of inventive elements, the inventive subject matter is considered to include all possible combinations of the disclosed elements. Thus if one embodiment comprises elements A, B, and C, and a second embodiment comprises elements B and D, then the inventive subject matter is also considered to include other remaining combinations of A, B, C, or D, even if not explicitly disclosed.

[0042] As used in the description herein and throughout the claims that follow, the meaning of a, an, and the includes plural reference unless the context clearly dictates otherwise. Also, as used in the description herein, the meaning of in includes in and on unless the context clearly dictates otherwise.

[0043] Unless the context dictates the contrary, all ranges set forth herein should be interpreted as being inclusive of their endpoints, and open-ended ranges should be interpreted to include only commercially practical values. Similarly, all lists of values should be considered as inclusive of intermediate values unless the context indicates the contrary.

[0044] The recitation of ranges of values herein is merely intended to serve as a shorthand method of referring individually to each separate value falling within the range. Unless otherwise indicated herein, each individual value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g. such as) provided with respect to certain embodiments herein is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention otherwise claimed. No language in the specification should be construed as indicating any non-claimed element essential to the practice of the invention.

[0045] Groupings of alternative elements or embodiments of the invention disclosed herein are not to be construed as limitations. Each group member can be referred to and claimed individually or in any combination with other members of the group or other elements found herein. One or more members of a group can be included in, or deleted from, a group for reasons of convenience and/or patentability. When any such inclusion or deletion occurs, the specification is herein deemed to contain the group as modified thus fulfilling the written description of all Markush groups used in the appended claims.

[0046] As used herein, and unless the context dictates otherwise, the term coupled to is intended to include both direct coupling (in which two elements that are coupled to each other contact each other) and indirect coupling (in which at least one additional element is located between the two elements). Therefore, the terms coupled to and coupled with are used synonymously.

[0047] It should be apparent to those skilled in the art that many more modifications besides those already described are possible without departing from the inventive concepts herein. The inventive subject matter, therefore, is not to be restricted except in the scope of the appended claims. Moreover, in interpreting both the specification and the claims, all terms should be interpreted in the broadest possible manner consistent with the context. In particular, the terms comprises and comprising should be interpreted as referring to elements, components, or steps in a non-exclusive manner, indicating that the referenced elements, components, or steps may be present, or utilized, or combined with other elements, components, or steps that are not expressly referenced. Where the specification claims refers to at least one of something selected from the group consisting of A, B, C . . . and N, the text should be interpreted as requiring only one element from the group, not A plus N, or B plus N, etc.

[0048] It should be noted that any language directed to a computer system should be read to include any suitable combination of computing devices, including servers, interfaces, systems, databases, agents, peers, engines, controllers, storage systems, or other types of computing devices operating individually or collectively. Computer systems may have full operating systems capable of executing complex processing tasks, or may be bare bones systems whose only function is to store, receive, and transmit data to memory storage units. One should appreciate the computing devices comprise a processor configured to execute software instructions stored on a tangible, non-transitory computer readable storage medium (e.g., hard drive, solid state drive, RAM, flash, ROM, etc.). The software instructions preferably configure the computing device to provide the roles, responsibilities, or other functionality as discussed below with respect to the disclosed apparatus. In especially preferred embodiments, the various servers, systems, databases, or interfaces exchange data using standardized protocols or algorithms, possibly based on Fiber-Channel, PCIe Interface, NVMe, NVMe over Fabric, TCP, UDP, IP, HTTP, HTTPS, AES, public-private key exchanges, web service APIs, known financial transaction protocols, or other electronic information exchanging methods, including proprietary communication interfaces. Data exchanges preferably are conducted over a packet-switched network, the Internet, LAN, WAN, VPN, or other type of packet switched network. Computer software that is programmed with instructions is developed, compiled, and saved to a computer-readable non-transitory medium specifically to accomplish the tasks and functions set forth by the disclosure when executed by a computer processor.

[0049] FIG. 1A is a schematic diagram of an embodiment of a GEM adapter, having a breath sample line 110 and an inline adapter 140 to an invasive ventilator circuit. The inline adapter 140 is coupled to a ventilator unit through wye 150. The breath sample line 110 is on one end coupled to the inline adapter 140, and on the other end coupled to a Gas Exchange Monitor (GEM). The inline adapter 140, through a series of standard respiratory tube adapters (e.g., 120), is coupled to an endotracheal tube 130 connected to a patient.

[0050] FIG. 1B is an enlarged schematic diagram of the breath sample line 110 and inline adaptor in FIG. 1A. The breath sample line 110 comprises a breath sample line 111 and a female luer lock end 112. The inline adapter 140 has a broader end 141 and a narrower end 142. In preferred embodiments, the broader end 141 has a 22 mm outer diameter (OD), and the narrower end 142 has a 15 mm outer diameter (OD).

[0051] FIG. 2 is a schematic diagram of an embodiment of a GEM adapter, having a breath sample line 210 with an inline adapter 240 for a non-invasive ventilator circuit. The inline adapter 240 is coupled to a ventilator unit through a series of standard respiratory tube adapters (e.g., 220). The breath sample line 210 is on one end coupled to the inline adapter 240, and on the other end coupled to a Gas Exchange Monitor (GEM). The inline adapter 240 is coupled to a patient breathing mask 230 worn by a patient.