Ventilator with biofeedback monitoring and control for improving patient activity and health
Inventors
Wondka, Anthony D. • King, Angela • Cipollone, Joseph
Assignees
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Publication Number
US-10252020-B2
Publication Date
2019-04-09
Expiration Date
Abstract
A respiratory support ventilator apparatus mechanically supports the work of respiration of a patient. The ventilator apparatus is highly portable and optionally wearable so as to promote mobility and physical activity of the patient, and to improve the overall health of the patient. The respiratory support ventilator may monitor a physical activity level and overall health status of the patient, and process this information. The information is used to track efficacy of the ventilation therapy relative to activity level and quality of life, and or to titrate or optimize the ventilation parameters to improve, maintain or optimize the physical activity level and overall health status of the patient.
Core Innovation
The invention relates to a portable or wearable ventilator system adapted to be coupled to a patient for permitting ambulation while providing ventilation gas delivery to support a portion of work for respiratory muscles. The ventilator comprises a ventilation gas source, a ventilation gas delivery circuit, a patient interface in communication with the circuit, and a control unit that includes a processor and memory. The ventilator is capable of providing ventilation gas delivery at an instantaneous flow rate of over 30 liters per minute while the patient performs ambulation.
The control unit predicts a chronic obstructive pulmonary disease exacerbation based upon measurements from at least one breath sensor and at least one patient activity sensor or at least one health status measuring sensor. The control unit then adjusts the ventilation gas delivery based upon the prediction to avoid or alleviate the chronic obstructive pulmonary disease exacerbation. The measured ventilation parameters stored in memory prior to a chronic obstructive pulmonary disease exacerbation are used to program a signature for predicting future chronic obstructive pulmonary disease exacerbations.
In the disclosed embodiments, breath sensor information includes spontaneous respiration metrics such as spontaneous breath rate, spontaneous breathing I:E ratio, spontaneous inspiratory and expiratory time, spontaneous depth of breathing, or combinations thereof. Patient activity and health status measurement inputs are used together with breath measurements to support the prediction and ventilation adjustment workflow. The system is also described as including additional mechanisms for monitoring, trending, reporting, and exercise testing, including operating modes that support ambulation-related adjustments and precursor-trend based exacerbation detection and prediction, including prevention or alleviation actions based on patient-specific signatures and a Health Status Index.
Claims Coverage
The independent claims are clm-00001 and clm-00020. Each independent claim shares a common core: ambulation-capable ventilation at an instantaneous flow rate over 30 liters per minute, COPD-exacerbation prediction using sensor measurements, and ventilation adjustment based on the prediction with a learned patient-specific signature formed from pre-exacerbation measured ventilation parameters stored in memory.
Ambulation-capable ventilator with high instantaneous flow rate
A ventilator system with a ventilator comprising a ventilation gas source, a ventilation gas delivery circuit, and a control unit; a patient interface in communication with the ventilation gas delivery circuit; and adaptation to be coupled to a patient for permitting ambulation while providing ventilation gas delivery to perform a portion of work for respiratory muscles, the ventilator capable of providing ventilation gas delivery at an instantaneous flow rate of over 30 liters per minute.
COPD exacerbation prediction and ventilation adjustment using breath and activity sensors
The control unit predicts a chronic obstructive pulmonary disease exacerbation based upon measurements from the at least one breath sensor and the at least one patient activity sensor, and adjusts the ventilation gas delivery based upon the prediction to avoid or alleviate the chronic obstructive pulmonary disease exacerbation.
Patient-specific COPD signature programmed from pre-exacerbation ventilation parameters
The control unit comprises a processor and a memory, where the memory stores measured ventilation parameters regarding activity level of the patient, and after a chronic obstructive pulmonary disease exacerbation the measured ventilation parameters stored in the memory prior to the chronic obstructive pulmonary disease exacerbation are used to program a signature for predicting future chronic obstructive pulmonary disease exacerbations.
COPD exacerbation prediction and ventilation adjustment using breath and health status sensors
The control unit predicts a chronic obstructive pulmonary disease exacerbation based upon measurements from the at least one breath sensor and the at least one health status measuring sensor, and adjusts the ventilation gas delivery based upon the prediction to avoid or alleviate the chronic obstructive pulmonary disease exacerbation.
Patient-specific COPD signature programmed from pre-exacerbation health-status ventilation parameters
The control unit comprises a processor and a memory, where the memory stores measured ventilation parameters regarding the patient health status, and after a chronic obstructive pulmonary disease exacerbation the measured ventilation parameters stored in the memory prior to the chronic obstructive pulmonary disease exacerbation are used to program a signature for predicting future chronic obstructive pulmonary disease exacerbations.
Across the independent claims, the inventive coverage centers on predicting COPD exacerbation using breath sensor measurements combined with either patient activity sensors or health status measuring sensors, then adjusting ventilation to avoid or alleviate the predicted exacerbation, with a patient-specific signature programmed from measured ventilation parameters stored prior to prior exacerbations for future prediction.
Stated Advantages
Avoid or alleviate the chronic obstructive pulmonary disease exacerbation.
Predict chronic obstructive pulmonary disease exacerbations based on a patient-specific signature.
Permit ambulation while providing ventilation gas delivery at an instantaneous flow rate of over 30 liters per minute.
Documented Applications
Ambulation while delivering ventilation gas, including an ambulation-capable open-airway ventilator system supporting work for respiratory muscles while the patient performs a portion of work for respiratory muscles.
Chronic obstructive pulmonary disease use for predicting and avoiding or alleviating chronic obstructive pulmonary disease exacerbations, including predicting future exacerbations using signatures programmed after prior exacerbations.
Exercise testing mode is described, including a six-minute walk test.
Monitoring, trending, and reporting to a remote clinician are described as part of the system operation.
Auto-ambulation mode is described to adjust ventilator settings based on activity with sensor corroboration.
Detection and prevention of respiratory exacerbations are described, including precursor-trend based generation of a patient-specific signature for predicting future chronic obstructive pulmonary disease exacerbations.
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