RESPIRATORY OR SURGICAL HUMIDIFIER AND METHOD OF USE
20230166064 · 2023-06-01
Inventors
Cpc classification
A61M13/003
HUMAN NECESSITIES
A61M16/0003
HUMAN NECESSITIES
A61M16/1005
HUMAN NECESSITIES
A61M16/024
HUMAN NECESSITIES
International classification
Abstract
An improved system and method of controlling the operation of a respiratory or surgical humidifier system that can provide humidified gases of substantially constant humidity in dependence upon only one monitored variable, being signals received from a temperature sensor. A power controller can be configured to control a level of power supplied to a heater plate in dependence upon heater plate temperature and a humidity profile so as to drive an operating point of the humidifier towards the humidity profile. The rate of change of a heater plate temperature setpoint can be variably controlled in dependence upon a heater plate temperature setpoint and heater plate temperature.
Claims
1. A respiratory or surgical humidifier for delivering gases at a desired level of humidity and/or a desired temperature comprising: a. a housing configured to receive a humidifier chamber; b. a heating assembly located at least partially within the housing, the heating assembly including: i. a heat transfer body configured to transfer heat to the humidifier chamber when the humidifier chamber is received by the housing; ii. a heat transfer body temperature sensor configured to sense the temperature of the heat transfer body; and iii. a heater configured to heat the heat transfer body; and c. a power controller configured to control a level of power supplied to the heater in dependence upon a temperature signal received from the heat transfer body temperature sensor and one or more humidity profiles defining heat transfer body temperature and heater power supply level combinations associated with a desired humidity value.
2. A respiratory or surgical humidifier as claimed in claim 1 wherein the heat transfer body temperature and heater power supply level combinations of each humidity profile form a curve associated with a constant humidity value over a desired operating range of the humidifier.
3. A respiratory or surgical humidifier as claimed in claim 1 or claim 2 wherein each humidity profile describes a relationship between heat transfer body temperatures and heater power supply levels delivering a desired constant humidity value over a desired operating range of the humidifier.
4. A respiratory or surgical humidifier as claimed in claim 1 wherein the heat transfer body temperature and heater power supply level combinations of each humidity profile consist of a plurality of discrete heat transfer body temperature and heater power supply level combinations delivering a desired constant humidity value over a desired operating range of the humidifier.
5. A respiratory or surgical humidifier as claimed in any one of claims 1 to 4 wherein each humidity profile may be selected from one of a number of profiles for different constant humidity values.
6. A respiratory or surgical humidifier as claimed in any one of the preceding claims wherein the power controller controls the level of power supplied to the heater in dependence only upon temperature signals received from the heat transfer body temperature sensor.
7. A respiratory or surgical humidifier as claimed in any one of claims 1 to 5 including an ambient temperature sensor.
8. A respiratory or surgical humidifier as claimed in claim 6 wherein the ambient temperature sensor is selected from: an infrared detector, a negative temperature coefficient thermistor and a positive temperature coefficient thermistor.
9. A respiratory or surgical humidifier as claimed in claim 6 or claim 7 wherein each humidity profile is modified based on ambient temperature.
10. A respiratory or surgical humidifier as claimed in claim 8 wherein each humidity profile is scaled based on ambient temperature.
11. A respiratory or surgical humidifier as claimed in claim any one of the preceding claims wherein the desired humidity value is a substantially constant steady state humidity value.
12. A respiratory or surgical humidifier as claimed in any one of the preceding claims including non-volatile memory storing one or more humidity profiles.
13. A respiratory or surgical humidifier as claimed in any one of the preceding claims wherein the power controller continuously controls the level of power supplied to the heater.
14. A respiratory or surgical humidifier as claimed in any one of the preceding claims wherein the power controller includes a heater control circuit which varies the level of power supplied to the heater at least in part in dependence upon the difference between the temperature signal and a heater plate temperature setpoint value.
15. A respiratory or surgical humidifier as claimed in claim 14 wherein the heater control circuit varies the level of power supplied to the heater at least in part in dependence upon proportional and/or integral and/or derivative components of the difference between the temperature signal and a heater plate temperature setpoint value.
16. A respiratory or surgical humidifier as claimed in claim 15 wherein the heater control circuit includes a feed forward circuit which modifies the level of power supplied to the heater based on an expected steady state power level for the heater plate temperature setpoint value.
17. A respiratory or surgical humidifier as claimed in claim 16 wherein the expected steady state power level is determined by finding the power level associated with the heater plate temperature setpoint value in the humidity profile.
18. A respiratory or surgical humidifier as claimed in claim 17 wherein the power level from the humidity profile is modified by a derivative value of the heater plate temperature setpoint value.
19. A respiratory or surgical humidifier as claimed in claim 18 wherein a derivative value of the heater plate temperature setpoint value is added to the power level from the humidity profile.
20. A respiratory or surgical humidifier as claimed in any one of claims 14 to 19 wherein the power controller includes a heater plate temperature setpoint controller that produces a heater plate temperature setpoint value based at least in part upon the heater power supply level or one or more components thereof and a rate signal based on temperature information.
21. A respiratory or surgical humidifier as claimed in claim 20 wherein the heater plate temperature setpoint controller develops a target temperature based on a target temperature associated with the heater power supply level in the humidity profile and modifies the heater plate temperature setpoint based at least in part on the target temperature and the rate signal.
22. A respiratory or surgical humidifier as claimed in claim 21 wherein the heater plate temperature setpoint controller determines the difference between a prior heater plate temperature setpoint and a target heater plate temperature setpoint and integrates this difference to produce a new heater plate temperature setpoint value.
23. A respiratory or surgical humidifier as claimed in claim 21 wherein the heater plate temperature setpoint controller determines the difference between a prior heater plate temperature setpoint and a target heater plate temperature setpoint and combines proportional and integrated components of this difference to produce a new heater plate temperature setpoint value.
24. A respiratory or surgical humidifier as claimed in any one of claims 20 to 23 wherein the heater power supply level or one or more components thereof supplied to the heater plate temperature setpoint controller are adjusted in dependence upon humidifier chamber fluid level.
25. A respiratory or surgical humidifier as claimed in claim 24 wherein the heater power supply level supplied to the heater plate temperature setpoint controller is increased with lowering humidifier chamber fluid level.
26. A respiratory or surgical humidifier as claimed in any one of claims 22 to 25 wherein the rate signal modifies the difference between a prior heater plate temperature setpoint and a target heater plate temperature setpoint prior to integration.
27. A respiratory or surgical humidifier as claimed in any one of claims 20 to 26 wherein the rate signal is based at least in part on the temperature signal and the heater plate temperature setpoint value.
28. A respiratory or surgical humidifier as claimed in claim 27 wherein the rate signal reduces the rate of change of the integral component in dependence upon the absolute difference between the temperature signal and heater plate temperature setpoint value.
29. A respiratory or surgical humidifier as claimed in any one of claims 20 to 28 wherein the heater plate temperature setpoint is a predetermined value at start-up.
30. A respiratory or surgical humidifier as claimed in any one of the preceding claims wherein the heater is a heating element.
31. A respiratory or surgical humidifier as claimed claim 30 wherein the heating element is a resistive heating element.
32. A respiratory or surgical humidifier as claimed claim 31 wherein the heating element is formed of nichrome wire.
33. A respiratory or surgical humidifier as claimed claim 31 or 32 wherein the heating element is wound and provided within or in thermal contact with the heat transfer body.
34. A respiratory or surgical humidifier as claimed in any one of claims 30 to 33 wherein the heat transfer body temperature sensor produces the temperature signal based on a resistance profile of the heating element.
35. A respiratory or surgical humidifier as claimed in any one of claims 1 to 33 wherein the heat transfer body temperature sensor is a negative temperature coefficient thermistor.
36. A respiratory or surgical humidifier as claimed in any one of claims 1 to 33 wherein the heat transfer body temperature sensor is a positive temperature coefficient thermistor.
37. A respiratory or surgical humidifier as claimed in any one of claims 1 to 33 wherein the heat transfer body temperature sensor is a thermocouple.
38. A respiratory or surgical humidifier as claimed in any one of claims 1 to 33 wherein the heat transfer body temperature sensor is an infrared sensor.
39. A respiratory or surgical humidifier as claimed in any one of the preceding claims including two heat transfer body temperature sensors.
40. A respiratory or surgical humidifier as claimed in any one of the preceding claims wherein the power controller includes one or more microprocessor.
41. A respiratory or surgical humidifier as claimed in any one of the preceding claims wherein the heat transfer body is a heater plate.
42. A respiratory or surgical humidifier as claimed in any one of the preceding claims including a humidifier chamber having an inlet for receiving gases and an outlet for supplying humidified gases.
43. A respiratory or surgical humidifier for delivering gases at a desired level of humidity and/or a desired temperature comprising: a. a housing configured to receive a humidifier chamber; b. a heating assembly located at least partially within the housing, the heating assembly including: i. a heat transfer body configured to transfer heat to the humidifier chamber when the humidifier chamber is received by the housing; ii. a heat transfer body temperature sensor configured to sense the temperature of the heat transfer body and provide a temperature signal; and iii. a heater configured to heat the heat transfer body; and c. a power controller configured to: i. determine a heater plate temperature setpoint required for the humidifier to deliver gases at a desired level of humidity based at least in part on a level of power supplied to the heater and the temperature signal, wherein a rate of change of the heater plate temperature setpoint is variably controlled in dependence at least in part upon the difference between the heater plate temperature setpoint and the temperature signal; and ii. control the level of power supplied to the heater based on the heater plate temperature setpoint and the temperature signal.
44. A respiratory or surgical humidifier as claimed in claim 43 wherein the rate of change of the heater plate temperature setpoint is controlled in dependence upon a rate signal which is based on the current heater plate temperature setpoint and both the temperature signal and an estimated temperature of a fluid within a humidifier chamber when in use.
45. A respiratory or surgical humidifier as claimed in claim 44 wherein the estimated temperature is obtained by low pass filtering the temperature signal.
46. A respiratory or surgical humidifier as claimed in claim 44 wherein the estimated temperature is obtained by using the heater plate temperature signal when the low pass filtered signal is greater than the heater plate temperature and using the low pass filtered signal when the low pass filtered signal is less than the heater plate temperature.
47. A respiratory or surgical humidifier as claimed in any one of claims 43 to 46 wherein both the temperature signal and the estimated temperature are compared with the heater plate temperature setpoint to produce error signals which are combined to produce a rate signal controlling the rate of change of the heater plate temperature setpoint.
48. A respiratory or surgical humidifier as claimed in claim 43 wherein the rate of change of the heater plate temperature setpoint is controlled in dependence upon the current heater plate temperature setpoint and the temperature signal.
49. A respiratory or surgical humidifier as claimed in claim 48 wherein a polynomial function is applied to the difference between the current heater plate temperature setpoint and the temperature signal and inverted to produce the rate signal.
50. A respiratory or surgical humidifier as claimed in claim 48 wherein an exponential function is applied to the difference between the current heater plate temperature setpoint and the temperature signal and inverted to produce the rate signal.
51. A respiratory or surgical humidifier as claimed in any one of claims 48 to 50 wherein a constant is added to the difference between the current heater plate temperature setpoint and the temperature signal and squared and then inverted to produce the rate signal.
52. A respiratory or surgical humidifier as claimed in any one of claims 49 to 51 wherein the rate signal is filtered.
53. A respiratory or surgical humidifier as claimed in claim 52 wherein the rate signal is filtered by an asymmetric filter.
54. A respiratory or surgical humidifier as claimed in any one of claims 43 to 53 wherein the power controller includes a heater plate temperature setpoint controller that produces a heater plate temperature setpoint value based at least in part upon the heater power supply level and the rate signal.
55. A respiratory or surgical humidifier as claimed in claim 54 wherein the heater plate temperature setpoint controller develops a target temperature based on a target temperature associated with a heater power level of the humidity profile and modifies the target temperature based at least in part on the rate signal to produce a heater plate temperature setpoint.
56. A respiratory or surgical humidifier as claimed in claim 55 wherein the heater plate temperature setpoint controller determines the difference between a prior heater plate temperature setpoint and a target heater plate temperature setpoint and integrates this difference to produce a new heater plate temperature setpoint value.
57. A respiratory or surgical humidifier as claimed in claim 55 wherein the heater plate temperature setpoint controller determines the difference between a prior heater plate temperature setpoint and a target heater plate temperature setpoint to produce a difference signal and combines proportional and integral components of the difference signal to produce a new heater plate temperature setpoint.
58. A respiratory or surgical humidifier as claimed in claim 56 or 57 wherein the rate signal modifies an integral input used to produce the integrated component.
59. A respiratory or surgical humidifier as claimed in claim 58 wherein the rate signal reduces the integral input with increasing difference between the temperature signal and heater plate temperature setpoint value.
60. A respiratory or surgical humidifier as claimed in claim 58 wherein the rate signal reduces the integral input with increasing difference between the heater plate temperature setpoint value and both the temperature signal and estimated temperature.
61. A respiratory or surgical humidifier as claimed in any one of claims 43 to 60 wherein the power controller is configured to control a level of power supplied to the heater in dependence upon temperature signals received from the heat transfer body temperature sensor and one or more humidity profiles defining heat transfer body temperature and heater power supply level combinations associated with a desired humidity value.
62. A respiratory or surgical humidifier as claimed in claim 61 wherein the heat transfer body temperature and heater power supply level combinations form a curve associated with a constant humidity value over a desired operating range of the humidifier.
63. A respiratory or surgical humidifier as claimed in claim 61 or claim 62 wherein the humidity profile may be selected from one of a number of profiles for different constant humidity values.
64. A respiratory or surgical humidifier as claimed in any one of claims 60 to 63 including an ambient temperature sensor.
65. A respiratory or surgical humidifier as claimed in claim 64 wherein the ambient temperature sensor is an infrared detector, a negative temperature coefficient thermistor or a positive temperature coefficient thermistor.
66. A respiratory or surgical humidifier as claimed in claim 64 or claim 65 wherein the one or more humidity profiles are modified based on ambient temperature.
67. A respiratory or surgical humidifier as claimed in claim 66 wherein the one or more humidity profiles are scaled based on ambient temperature.
68. A respiratory or surgical humidifier as claimed in claim any one of claims 60 to 67 wherein the desired humidity value is a substantially constant steady state humidity value.
69. A respiratory or surgical humidifier as claimed in any one of claims 60 to 68 including non-volatile memory storing the one or more humidity profiles.
70. A respiratory or surgical humidifier as claimed in any one of claims 60 to 69 wherein the power controller continuously controls the level of power supplied to the heater.
71. A respiratory or surgical humidifier as claimed in any one of claims 60 to 70 wherein the power controller controls the level of power supplied to the heater in dependence upon only one monitored variable, being a temperature signal received from the heat transfer body temperature sensor.
72. A respiratory or surgical humidifier as claimed in any one of claims 43 to 71 wherein the heater is a heating element.
73. A respiratory or surgical humidifier as claimed claim 72 wherein the heating element is a resistive heating element.
74. A respiratory or surgical humidifier as claimed claim 73 wherein the heating element is formed of nichrome wire.
75. A respiratory or surgical humidifier as claimed claim 73 or 74 wherein the heating element is wound and provided within or in thermal contact with the heat transfer body.
76. A respiratory or surgical humidifier as claimed in any one of claims 72 to 75 wherein the heat transfer body temperature sensor produces the temperature signal based on a resistance profile of the heating element.
77. A respiratory or surgical humidifier as claimed in any one of claims 43 to 71 wherein the heat transfer body temperature sensor is a negative temperature coefficient thermistor.
78. A respiratory or surgical humidifier as claimed in any one of claims 43 to 71 wherein the heat transfer body temperature sensor is a positive temperature coefficient thermistor.
79. A respiratory or surgical humidifier as claimed in any one of claims 43 to 71 wherein the heat transfer body temperature sensor is a thermocouple.
80. A respiratory or surgical humidifier as claimed in any one of claims 43 to 71 wherein the heat transfer body temperature sensor is an infrared sensor.
81. A respiratory or surgical humidifier as claimed in any one of claims 43 to 80 wherein the heat transfer body temperature sensor comprises two temperature sensors.
82. A respiratory or surgical humidifier as claimed in any one of claims 43 to 81 wherein the power controller includes one or more microprocessors.
83. A respiratory or surgical humidifier as claimed in any one of claims 43 to 82 wherein the heat transfer body is a heater plate.
84. A respiratory or surgical humidifier as claimed in any one of claims 43 to 83 including a humidifier chamber having an inlet for receiving gases and an outlet for supplying humidified gases.
85. A respiratory or surgical humidifier for delivering gases at a desired level of humidity and/or a desired temperature comprising: a. a housing configured to receive a humidifier chamber; b. a heating assembly located at least partially within the housing, the heating assembly including: i. a heat transfer body configured to transfer heat to the humidifier chamber when the humidifier chamber is received by the housing; ii. a heat transfer body temperature sensor configured to sense the temperature of the heat transfer body and provide a temperature signal; and iii. a heater configured to heat the heat transfer body; and c. a power controller configured to: i. determine a heater plate temperature setpoint required for the humidifier to achieve a desired operating point based at least in part on the temperature signal and a level of power supplied to the heater wherein a rate of change of the heater plate temperature setpoint is variably controlled in dependence at least in part upon the difference between the heater plate temperature setpoint and the temperature signal; and ii. control the level of power supplied to the heater in dependence upon the temperature signal and one or more humidity profiles defining heat transfer body temperature and heater power supply level combinations associated with a desired humidity value.
86. A method of controlling a respiratory or surgical humidifier so as to maintain gases at a desired humidity level and/or a desired temperature by controlling the temperature of a heat source heating a liquid in a chamber based at least in part on a heat source temperature setpoint determined in dependence upon: a. power supplied to the heat source; b. heat source temperature; and c. one or more humidity profiles defining heat source temperature and heat source power supply level combinations associated with a respective desired humidity value, so as to drive an operating point of the humidifier towards a combination of values of the or a selected humidity profile.
87. A method as claimed in claim 86 wherein the or a selected humidity profile defines a curve and the level of power is controlled to drive an operating point towards the curve.
88. A respiratory or surgical humidifier for delivering gases at a desired level of humidity and/or a desired temperature comprising: a. a housing configured to receive a humidifier chamber; and b. a heater plate assembly located at least partially within the housing, the heater plate assembly including: i. a heater plate configured to contact a base of the humidifier chamber when the humidifier chamber is received by the housing; ii. a heater plate temperature sensor located at or near the heater plate; and iii. a heating element configured to heat the heater plate; and c. a power controller configured to control a level of power supplied to the heating element in dependence upon the temperature signal and one or more humidity profile defining heat transfer body temperature and heater power supply level combinations associated with a respective desired humidity value.
89. A respiratory or surgical humidifier for delivering gases at a desired level of humidity and/or a desired temperature comprising: a. a housing configured to receive a humidifier chamber; and b. a heater plate assembly located at least partially within the housing, the heater plate assembly including: i. a heater plate configured to contact a base of the humidifier chamber when the humidifier chamber is received by the housing; ii. a heater plate temperature sensor located at or near the heater plate; and iii. a heating element configured to heat the heater plate; and c. a power controller including: i. a temperature monitoring circuit configured to determine heater plate temperature based on signals received from the heater plate temperature sensor; ii. memory storing one or more humidity profiles defining heating plate temperature and heating element power supply level combinations associated with a respective desired humidity value; and iii. a power level controller configured to control the level of power supplied to the heating element based upon power level and heater plate temperature values so as to drive an operating point of the humidifier towards the or a selected humidity profile to achieve the desired humidity value.
90. A respiratory or surgical humidifier for delivering gases at a desired level of humidity and/or a desired temperature comprising: a. a housing configured to receive a humidifier chamber; and b. a heater plate assembly located at least partially within the housing, the heater plate assembly including: i. a heater plate configured to contact a base of the humidifier chamber when the humidifier chamber is received by the housing; ii. a heater plate temperature sensor configured to sense the temperature of the heater plate and provide a temperature signal; and iii. a heating element configured to heat the heater plate; and c. a power controller configured to: i. determine a heater plate temperature setpoint required for the humidifier to achieve a desired operating point based on the temperature signals and a power level applied to the heating element by: a. determining a target temperature of the heater plate based on the power level; b. determining an error signal based on a difference between the target temperature and the current heater plate temperature setpoint; c. developing a new heater plate temperature setpoint based on proportional and/or integral values of the error signal, wherein the error signal is modified in dependence upon the heater plate temperature setpoint and the temperature signal before integration; and ii. controlling the level of power supplied to the heating plate based on the heater plate temperature setpoint and temperature signal.
91. A respiratory or surgical humidifier for delivering gases at a desired level of humidity and/or a desired temperature comprising: a. a housing configured to receive a humidifier chamber; and b. a heater plate assembly located at least partially within the housing, the heater plate assembly including: i. a heater plate configured to contact a base of the humidifier chamber when the humidifier chamber is received by the housing; ii. a heater plate temperature sensor configured to sense the temperature of the heater plate and provide a temperature signal; and iii. a heating element configured to heat the heater plate; and c. a power controller configured to: i. determine a heater plate temperature setpoint required for the humidifier to achieve a desired operating point based on temperature signals and a power level applied to the heating element by: a. determining a target temperature of the heater plate based on a defined relationship with the power signal; b. developing an error signal based on a difference between the target temperature and the temperature signal; and c. developing a heater plate temperature setpoint based on proportional and/or integrated values of the error signal, wherein the error signal is modified in dependence upon the difference between the heater plate temperature setpoint and the temperature signal and/or a filtered temperature signal before integration; and ii. controlling the level of power supplied to the heating element based on the heater plate temperature setpoint and temperature signal.
92. A respiratory or surgical humidifier for delivering gases at a desired level of humidity and/or a desired temperature comprising: a. a heater configured to transfer heat to a humidifier chamber; b. a temperature sensor configured to sense the temperature of the heater; and c. a power controller configured to continuously control a level of power supplied to the heater in dependence upon only one monitored variable, being signals received from the temperature sensor.
93. A respiratory or surgical humidifier as claimed in claim 92 wherein the power controller stores one or more humidity profiles defining heater temperature and heater power supply level combinations associated with a desired humidity value and drives operation of the humidifier towards values stored in the humidity profile.
94. A respiratory or surgical humidifier or method as claimed in any one of the preceding claims wherein the desired level of humidity is a desired level of absolute humidity.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0086] These and other features, aspects, and advantages of the present disclosure are described with reference to the drawings of certain embodiments, which are intended to schematically illustrate certain embodiments and not to limit the disclosure.
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DETAILED DESCRIPTION
[0107] Although certain embodiments and examples are described below, those of skill in the art will appreciate that the disclosure extends beyond the specifically disclosed embodiments and/or uses and obvious modifications and equivalents thereof. Thus, it is intended that the scope of the disclosure herein disclosed should not be limited by any particular embodiments described below. For example, component values and operating parameters are examples only and are not limiting.
[0108] Example Respiratory or Surgical Humidifier
[0109] The present disclosure provides examples of a respiratory humidifier configured to supply humidified and/or heated gas to a patient or user in multiple modes. The modes for the respiratory humidifier can include at least an invasive mode (for example, for patients with a bypassed airway) and a non-invasive mode (for example, for patients or users with breathing masks). Each mode can have a number of humidity settings, which can be expressed as a dew point or absolute humidity. The respiratory humidifier is controlled to deliver, at an outlet of the humidification chamber and/or the patient end of the gas supply tube, humidified gases having a dew point (or absolute humidity) at or near a predetermined humidity level. For example, a user can select a setting appropriate for the current mode of operation. A number of target humidity settings may be provided, for example, the humidity settings may be equivalent to a dew point of about 37 degrees Celsius, about 31 degrees Celsius, about 29 degrees Celsius, about 27 degrees Celsius, or others and each target humidity setting may have an acceptable tolerance range. The humidity setting equivalent to a dew point of 37 degrees Celsius may be suitable for invasive therapy (i.e., where the patient's upper airways are bypassed) whereas the other humidity settings may be suitable for non-invasive therapy, although the humidity settings may not be restricted to a particular type of therapy. For example, a user can select a humidity setting of about 34 degrees Celsius which may be suitable for both invasive or non-invasive therapy. Alternatively, each humidity setting may be continuously variable between upper and lower limits. A lower humidity setting may be selected by the user to reduce condensation or “rain-out” in the gas supply tube, or a higher humidity setting may be selected to improve patient comfort or physiological benefits. Some respiratory humidifier systems disclosed herein can also include a high flow, unsealed mode or any other modes known to those of skill in the art. High flow therapy as discussed herein is intended to be given its typical ordinary meaning, as understood by a person of skill in the art, which generally refers to a respiratory assistance system delivering a targeted flow of humidified respiratory gases via an intentionally unsealed patient interface with flow rates generally intended to meet or exceed inspiratory flow of a patient. Typical patient interfaces include, but are not limited to, a nasal or tracheal patient interface. Typical flow rates for adults often range from, but are not limited to, about fifteen liters per minute to about sixty liters per minute or greater. Typical flow rates for pediatric patients (such as neonates, infants and children) often range from, but are not limited to, about one liter per minute per kilogram of patient weight to about three liters per minute per kilogram of patient weight or greater. High flow therapy can also optionally include gas mixture compositions including supplemental oxygen and/or administration of therapeutic medicaments. High flow therapy is often referred to as nasal high flow (NHF), humidified high flow nasal cannula (HHFNC), high flow nasal oxygen (HFNO), high flow therapy (HFT), or tracheal high flow (THF), among other common names. For example, in some configurations, for an adult patient ‘high flow therapy’ may refer to the delivery of gases to a patient at a flow rate of greater than or equal to about 10 litres per minute (10 LPM), such as between about 10 LPM and about 100 LPM, or between about 15 LPM and about 95 LPM, or between about 20 LPM and about 90 LPM, or between about 25 LPM and about 85 LPM, or between about 30 LPM and about 80 LPM, or between about 35 LPM and about 75 LPM, or between about 40 LPM and about 70 LPM, or between about 45 LPM and about 65 LPM, or between about 50 LPM and about 60 LPM. In some configurations, for a neonatal, infant, or child patient ‘high flow therapy’ may refer to the delivery of gases to a patient at a flow rate of greater than 1 LPM, such as between about 1 LPM and about 25 LPM, or between about 2 LPM and about 25 LPM, or between about 2 LPM and about 5 LPM, or between about 5 LPM and about 25 LPM, or between about 5 LPM and about 10 LPM, or between about 10 LPM and about 25 LPM, or between about 10 LPM and about 20 LPM, or between about 10 LPM and 15 LPM, or between about 20 LPM and 25 LPM. A high flow therapy apparatus with an adult patient, a neonatal, infant, or child patient, may deliver gases to the patient at a flow rate of between about 1 LPM and about 100 LPM, or at a flow rate in any of the sub-ranges outlined above.
[0110] High flow therapy can be effective in meeting or exceeding the patient's inspiratory demand, increasing oxygenation of the patient and/or reducing the work of breathing. Additionally, high flow therapy may generate a flushing effect in the nasopharynx such that the anatomical dead space of the upper airways is flushed by the high incoming gases flow. The flushing effect can create a reservoir of fresh gas available of each and every breath, while minimizing re-breathing of carbon dioxide, nitrogen, etc.
[0111] The patient interface for use in a high flow therapy can be a non-sealing interface to prevent barotrauma, which can include tissue damage to the lungs or other organs of the patient's respiratory system due to difference in pressure relative to the atmosphere. The patient interface can be a nasal cannula with a manifold and nasal prongs, and/or a face mask, and/or a nasal pillows mask, and/or a nasal mask, and/or a tracheostomy interface, or any other suitable type of patient interface.
[0112] The circuits and methods described below in relation to respiratory humidifier with reference to
[0113] In the embodiment of
[0114] The apparatus 1 comprises, for example, a heater. The heater can comprise a heater plate on the base unit 3, for example. The heater is configured to heat humidification liquid in the chamber 5 to generate vapor. The humidification liquid is typically, but not necessarily, water. Gas from the gas source 9 flows into the chamber 5 and passes over the heated humidification liquid, thus taking up vapor and increasing in humidity level prior to delivery to the patient via the gas delivery conduit 13. The chamber 5 may alternatively or additionally comprise an integral heater or a heater located inside the chamber 5.
[0115] The gas delivery conduit 13 can also comprise or be provided with a heater. A heater for the gas delivery conduit 13 can ensure that the gas temperature is maintained at a desired level along the conduit 13 as well as minimize or eliminate the formation of condensation. A heater for the gas delivery conduit 13 can have a resistance wire provided in or attached to the conduit 13, or a wire or other heater element provided inside the conduit 13. A heater for the gas delivery conduit 13 may be electronically connected to the base unit 3 or to the chamber 5, for example by an electrical cable 19 to power the heater. Additionally or alternatively, the conduit 13 may be thermally insulated.
[0116] The apparatus 1 comprises a controller 21 arranged to control the apparatus 1, and in particular to control the flow rate, temperature, and humidity of gas delivered to the patient to be appropriate for the type of medical procedure for which the apparatus is being used. The controller 21 therefore controls, among other things, a heater for the humidification chamber 5 and/or a heater for the gas delivery conduit 13, if provided. The controller 21 can also control a regulator that regulates the flow rate of gas through the apparatus 1. The regulator may comprise a flow inducer and/or inhibiter such as a motorized fan. Valves and/or vents may additionally or alternatively be used to control flow rate. The controller 21 may comprise an electronic controller, that may be microprocessor-based, for example. The system can comprise memory and any electronic components capable of performing calculations as would be understood by those of skill in the art.
[0117] Referring to
[0118] The humidifier heater plate 120 can have a heater plate temperature sensor. An analog or digital temperature sensor may be used. The temperature sensor may be a temperature transducer, thermocouple, infrared sensor, a temperature sensor that produces a temperature signal based on the resistance profile of the heating element, a negative temperature coefficient thermistor, a positive temperature coefficient thermistor or other suitable type of sensor. The temperature sensor can measure a temperature of the heater plate 120. The temperature sensor can be in electrical communication with the controller in the heater base unit 102 so that the controller can monitor the temperature of the heater plate 120.
[0119] The humidifier chamber 103 can be removably received and retained on the heater base unit 102, such that the humidifier chamber base is positioned in contact with the heater plate 120 in the heater base unit 102. Referring to
[0120] With continued reference to
[0121] A tube heating element 110 (such as one or more heater wires embedded in the gas supply tube wall, contained within the gas supply tube, or wrapped around the outside of the gas supply tube) can be provided in the breathing circuit 106. The tube heating element 110 reduces condensation and ensures the temperature and/or humidity of gases is maintained in a predetermined range, for example keeping the temperature of gases in the tube above a selected dew point. The tube heating element 110 can also optionally be in electrical communication with the controller in the heater base unit 102. As shown in
[0122] The controller of the respiratory humidifier system 100 can control at least the heater plate 120, and preferably or optionally also the tube heating element 110, without additional sensors (for example, in the humidifier chamber, at the chamber outlet, in the breathing circuit, and/or elsewhere in the system). This can be achieved by estimating a heater plate operating point required to deliver a required humidity. For a given respiratory humidifier system, the controller can determine an appropriate level of power to apply to the heater plate 120. Applying power to the heater 120 can generate humidity and heat the gases. The heater plate power and temperature can be controlled to generate a predetermined amount of humidity. Additionally, the parameters can also optionally be used by the controller to provide a more appropriate level of energization to the tube heating element 110. As shown in
[0123] As shown in
[0124] The humidity level can be adjusted by pressing the humidity settings push button 134, which can also be a momentary push button. The front panel can also include a plurality of alarm indicators 138 (which can include LED lights) to indicate the following non-limiting examples of conditions: “water out” condition (including low water and water-out), tube heating element adaptor not connected, audible alarm muted, and a “See Manual” indication used to indicate that a fault has occurred within the system 101.
[0125] The system 101 can be suitable for providing respiratory therapy for different purposes, such as for critical care (for example, in the hospital) and home care. The system 101 is suitable for providing invasive, non-invasive and high flow therapies for both adult and pediatric patients.
[0126]
[0127] As illustrated in a further refined embodiment shown in
[0128] With reference to
[0129] A user can select a humidity setting via button 134 (see
[0130] A heater plate temperature setpoint signal 205 is provided by a heater plate setpoint controller 209 in a second control loop. The difference or error between the temperature signal 204 and heater plate temperature setpoint 205 is determined at node 206 to produce an error signal 207 which is provided to heater plate temperature controller 201 to provide negative feedback control.
[0131] As shown in
[0132] The heater plate temperature controller 201 may optionally include a feedforward controller 210 which can modify the level of power supplied to the heater plate 203 based on an expected steady state power level required to be supplied to the heater plate 203 to achieve a desired target humidity level based on the current heater plate temperature setpoint value 205. Feedforward control enables a faster response during steady state operation by directly feeding the expected heater plate power for the given heater plate temperature setpoint to the output and relying less on the slower integral component. Feedforward controller 210 can use the humidity profile selected above defining heater plate temperature and heater plate power supply level combinations associated with a desired steady state humidity value (as per curve D shown in
[0133] A modified form of feedforward control is shown in
[0134] The feedforward component 211 from
[0135] Referring now to
[0136] With reference to
[0137]
[0138] During certain events, for example at start-up or when water is added to a humidifier chamber, it may be desirable to avoid rapid change in the heater plate temperature setpoint to maintain stable operation and/or to more rapidly reach a desired operating point. In the above example the temperature of water in the humidifier chamber is not be measured directly and is based on heater plate temperature.
[0139] Transient events with large deviation from heater plate setpoint temperature (e.g. during start-up and when water is added) may cause the power output by the heater plate temperature controller to fluctuate rapidly. This can potentially lead to large changes in heater plate setpoint temperature, which can then cause even larger power fluctuations, thereby creating oscillations and potentially leading to instability.
[0140] Water exhibits a large specific heat capacity which causes a phase lag between actual water temperature and heater plate temperature. This is significant when there is a large volume of water present. For example, the water may be in the process of heating up and require a larger power input, but the heater plate temperature may already appear to be at the heater plate setpoint temperature.
[0141] It can thus be desirable to slow down the rate of change of the setpoint in such situations to avoid oscillations of the setpoint or instability and/or to more rapidly reach a desired operating point.
[0142] Referring again to
[0143] Referring to
[0144] In a lower branch the heater plate temperature signal 204 is filtered by low pass filter 231 to provide an estimated water temperature signal 232 (T.sub.H.sub.
[0145] In an upper branch at node 235 the heater plate temperature setpoint value 205 is subtracted from the heater plate temperature signal 204 to produce a heater plate temperature error signal 236 (e.sub.T.sub.
[0146] At nodes 237 and 239 the value 1 is added to both the estimated water temperature error signal 234 (e.sub.TH.sub.
[0147] It will be seen that the rate signal 224 decreases as either error signal e.sub.T.sub.
[0148] An alternative form of rate controller is shown in
[0149] where e.sub.T.sub.
[0150] Using this equation the rate signal 253 reduces quadratically with the magnitude of error. This equation results in similar behaviour to the example shown in
[0151] Ideally T.sub.H.sub.
[0154] The above examples and controllers may be implemented as microprocessor-based systems or circuits using discrete circuit components. One or more humidity profiles may be stored in non-volatile memory in the form of a relationship producing a continuous curve, such as defined by a polynomial equation. Alternatively, the humidity profile may by represented by a piecewise function. A relationship for modifying the one or more humidity profiles based on ambient temperature may also be stored. Alternatively, discontinuous values, such as a series of pairs of heat transfer body temperature and heater power supply level combinations delivering a desired steady state humidity value may be stored in suitable memory, such as in a look up table.
[0155] Methods and processes described herein may be embodied in, and partially or fully automated via, software code modules executed by one or more general and/or special purpose computers. The word “module” refers to logic embodied in hardware and/or firmware, or to a collection of software instructions, possibly having entry and exit points, written in a programming language, such as, for example, C or C++. A software module may be compiled and linked into an executable program, installed in a dynamically linked library, or may be written in an interpreted programming language such as, for example, BASIC, Perl, or Python. It will be appreciated that software modules may be callable from other modules or from themselves, and/or may be invoked in response to detected events or interrupts. Software instructions may be embedded in non-volatile memory, such as an erasable programmable read-only memory (EPROM). It will be further appreciated that hardware modules may comprise connected logic units, such as gates, flip-flops and/or application specific integrated circuits, and/or may comprise programmable units, such as programmable gate arrays and/or processors. The modules described herein can be implemented as software modules, but also may be represented in hardware and/or firmware. Moreover, although in some embodiments a module may be separately compiled, in other embodiments a module may represent a subset of instructions of a separately compiled program and may not have an interface available to other logical program units.
[0156] In certain embodiments, code modules may be implemented and/or stored in any type of computer-readable medium or other computer storage device. In some systems, data (and/or metadata) input to the system, data generated by the system, and/or data used by the system can be stored in any type of computer data repository, such as a relational database and/or flat file system. Any of the systems, methods, and processes described herein may include an interface configured to permit interaction with users, operators, other systems, components, programs, and so forth.
[0157] It should be emphasized that many variations and modifications may be made to the embodiments described herein, the elements of which are to be understood as being among other acceptable examples. All such modifications and variations are intended to be included herein within the scope of this disclosure and protected by the following claims. Further, nothing in the foregoing disclosure is intended to imply that any particular component, characteristic or process step is necessary or essential.