System for automated adjustment of a pressure set by a ventilation device
Inventors
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Assignees
Member
Hamilton MedicalHamilton Medical is focused on the development, manufacturing, and training for advanced respiratory support technologies. The company provides intelligent ventilation systems, high flow oxygen therapy, noninvasive ventilation, and educational platforms for healthcare professionals. Their offerings emphasize patient safety, data-driven decision making, and regulatory compliance across intensive care, transport, neonatal, and emergency settings.
Hamilton Medical is focused on the development, manufacturing, and training for advanced respiratory support technologies. The company provides intelligent ventilation systems, high flow oxygen therapy, noninvasive ventilation, and educational platforms for healthcare professionals. Their offerings emphasize patient safety, data-driven decision making, and regulatory compliance across intensive care, transport, neonatal, and emergency settings.
Publication Number
US-10518049-B2
Publication Date
2019-12-31
Expiration Date
Abstract
The invention suggests a system for automated adjustment of a pressure set by a ventilation device, in particular a positive and-expiratory pressure and/or a maximum airway pressure, the system comprising a pressure detection arrangement for detecting a transpulmonary pressure at the end of an expiration phase and/or for detecting a transpulmonary pressure at the end of an inspiration phase, and a means for automated adjustment of the pressure set by the ventilation device on the basis of the transpulmonary pressure detected at the end of the expiration phase and/or the transpulmonary pressure detected at the end of the inspiration phase.
Core Innovation
The invention provides a ventilation device and a method that automatically adjusts a pressure set by the ventilation device. The method determines an alveolar pressure and an esophageal pressure and determines a transpulmonary pressure from the difference between the respective alveolar pressure and the respective esophageal pressure. The method determines transpulmonary pressure at the end of an inspiration phase and/or at the end of an expiration phase and uses the detected transpulmonary pressure to drive the automated adjustment of the pressure set.
The pressure set includes pressure setpoints such as positive end-expiratory pressure (PEEP) and/or a maximum airway pressure. The method bases the adjustment on transpulmonary pressure detected at the end of expiration phase and/or the end of inspiration phase, with breath-cycle integration designed to minimize disruption. The disclosed approach targets preventing alveolar collapse associated with negative end-expiratory transpulmonary pressure while avoiding overdistension and cardiovascular impairment associated with excessive inspiratory pressures.
In determining transpulmonary pressure and/or alveolar pressure, the method includes computing transpulmonary pressure using end-phase alveolar pressure that is inferred from airway pressure and resistance or via end-phase airway occlusion. Esophageal pressure is determined using an esophageal balloon probe, and end-phase values such as Ptp_ee, Paw_ee, Peso_ee and Ptp_ei, Paw_ei, Peso_ei are used. The disclosed control logic includes thresholds and cycle-to-cycle adjustment concepts such as prior-cycle averaging, deviation and normalized transpulmonary pressure (Ptp_ee_norm / Ptp_ee_ideal), including an occlusion-augmented accuracy improvement strategy.
Claims Coverage
The independent claims cover automated adjustment of ventilation-device pressure setpoints using transpulmonary pressure computed from alveolar pressure and esophageal pressure at defined end phases, with additional dependent features that specify which setpoint is adjusted, how alveolar pressure is determined, and how cycle-to-cycle updates are gated or computed.
Automated pressure set adjustment using end-phase transpulmonary pressure
Determining an alveolar pressure and an esophageal pressure, determining a transpulmonary pressure at the end of an inspiration phase and/or at the end of an expiration phase based on a difference between the respective alveolar pressure and the respective esophageal pressure, and automatically adjusting the pressure set by the ventilation device on the basis of the transpulmonary pressure detected at the end of the expiration phase and/or the transpulmonary pressure detected at the end of the inspiration phase.
End-expiration-based positive end-expiratory pressure adjustment
Automatically adjusting a positive end-expiratory pressure set by the ventilation device using transpulmonary pressure detected at the end of the expiration phase.
End-inspiration-based maximum airway pressure adjustment
Automatically adjusting a ventilation device’s maximum airway pressure based on the transpulmonary pressure detected at the end of the inspiration phase.
Occlusion-based determination of alveolar pressure from inlet-side airway pressure
Determining inlet-side airway pressure and using inlet-side airway pressure detected during an occlusion at the end of expiration and/or at the end of inspiration to determine alveolar pressure at the corresponding phase ends.
Threshold-gated cycle-to-cycle adjustment of PEEP and maximum airway pressure
Comparing subsequent breathing-cycle positive end-expiratory pressure and maximum airway pressure with the values for the current cycle, identifying differences, and changing each pressure only when the corresponding difference exceeds a predetermined threshold value.
Deviation from normalized end-expiratory transpulmonary pressure over m preceding cycles
Determining a positive end-expiratory pressure for a subsequent breathing cycle based on a deviation of end-expiratory transpulmonary pressure detected over m preceding breathing cycles from a normalized end-expiratory transpulmonary pressure, where m is greater than or equal to 1.
Overall, the claim coverage centers on using transpulmonary pressure computed from alveolar pressure and esophageal pressure at the end of inspiration and/or the end of expiration to automatically adjust ventilation-device pressure setpoints, with further refinements specifying PEEP and maximum airway pressure adjustments, an occlusion-based alveolar-pressure determination approach, and cycle-to-cycle update logic including threshold gating and deviation-from-normalized logic over m preceding cycles.
Stated Advantages
Prevention of alveolar collapse associated with negative end-expiratory transpulmonary pressure.
Avoidance of overdistension associated with excessive inspiratory pressures.
Avoidance of cardiovascular impairment associated with excessive inspiratory pressures.
Minimal disruption of breath-cycle integration.
Documented Applications
Automatic ventilation pressure control in a ventilation system using transpulmonary pressure derived from alveolar pressure and esophageal pressure to adjust pressure setpoints such as PEEP and maximum airway pressure.
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