Systems and methods for dynamic control of enteral feeding according to energy expenditure
Inventors
Elia, Liron • Iddan, Gavriel J.
Assignees
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Publication Number
US-10898413-B2
Publication Date
2021-01-26
Expiration Date
Abstract
A computer-implemented method of adjusting enteral feeding of a patient by an enteral feeding controller, comprising: computing an estimate of energy expenditure of the patient based on oxygen measurements and carbon dioxide measurements of the patient, computing a target composition and target feeding rate for the enteral feeding according to the computed estimate of energy expenditure, when the target composition and target feeding rate differ from a current enteral feeding composition and feeding rate by a requirement, generating instructions for adjustment, by an enteral feeding controller, of the rate of delivery of the enteral feeding according to the target composition, wherein the receiving the oxygen measurement, receiving the carbon dioxide measurement, and computing the estimate of energy expenditure are performing iteratively for every first time interval, and the generating instructions for adjustment are performed for a second time interval that is larger than the first time interval.
Core Innovation
The invention provides a computer-implemented method for adjusting enteral feeding by using outputs from a carbon dioxide sensor and a flow sensor that sense at least one of inspiration and expiration of a patient. The method computes energy expenditure of the patient based on the carbon dioxide sensor output and the flow sensor output.
The method computes a target nutritional goal for the enteral feeding that provides 100% or near 100% of the computed energy expenditure of the patient irrespective of a predictive equation. Based on the target nutritional goal, the method selects a target feeding formula from a plurality of feeding formulas and generates instructions for adjustment by an enteral feeding controller for delivery of the target feeding formula.
The method provides the generated instructions to the enteral feeding controller to deliver enteral feedings to the patient via an enteral feeding tube from at least one feed inlet according to at least one of a feeding rate and a feeding composition defined by the generated instructions. Additional described aspects include dynamic adjustment, rest-state gating for computing resting energy expenditure, and reflux avoidance using a feeding rate below an estimated reflux feeding level based on gastro residual volume.
The described system includes sensors, a computing device, an enteral feeding controller for enteral feeding tube delivery, and stored feeding records, with a formulation database and a graphical user interface for selecting and confirming feeding formulations and optional supplemental protein addition and intermittent feeding schedules. It can also include similarity scoring for records versus the target nutritional goal, including fallback matching among component sets when records do not match.
Claims Coverage
The partial content identifies three independent claims (clm-00001, clm-00019, clm-00020) that cover a computer-implemented method, a system, and a computer program product. Across these independent claims, the coverage centers on sensor-based energy expenditure computation, a target nutritional goal providing 100% or near 100% of computed energy expenditure irrespective of a predictive equation, and selecting a target feeding formula with generated controller instructions for enteral delivery.
Sensor-based energy expenditure computation from carbon dioxide and flow
Receiving output of a carbon dioxide sensor that senses at least one of inspiration and expiration of the patient; receiving output of a flow sensor that senses at least one of inspiration and expiration of the patient; computing energy expenditure of the patient based on the output of the carbon dioxide sensor and the flow sensor.
Target nutritional goal providing near-computed energy expenditure without predictive equation
Computing a target nutritional goal for the enteral feeding that provides 100% or near 100% of the computed energy expenditure of the patient irrespective of a predictive equation.
Formula selection according to target nutritional goal
Selecting a target feeding formula from a plurality of feeding formulas according to the target nutritional goal.
Generated controller instructions for tube delivery using feeding rate and/or feeding composition
Generating instructions for adjustment, by an enteral feeding controller, for delivery of the target feeding formula; providing the generated instructions to the enteral feeding controller to deliver enteral feedings to the patient via an enteral feeding tube from at least one feed inlet of at least one feeding tube according to at least one of a feeding rate and a feeding composition defined by the generated instructions.
Computing system implementation with stored code and communication interface
A non-transitory memory having stored there a code for execution by at least one hardware processor of a computing system, the code comprising receiving, computing, computing a target nutritional goal, selecting a target feeding formula, generating instructions, and providing the generated instructions to the enteral feeding controller via a communication interface.
Computer program product implementation for sensor-driven enteral adjustment
A non-transitory memory having stored there a code for execution by at least one hardware processor of a computing system, comprising instructions for receiving sensor outputs, computing energy expenditure, computing a target nutritional goal providing 100% or near 100% irrespective of a predictive equation, selecting a target feeding formula, generating instructions for adjustment, and providing the generated instructions to the enteral feeding controller via a communication interface.
The independent claims collectively define a closed-loop enteral feeding adjustment framework in which carbon dioxide and flow sensor outputs are used to compute energy expenditure, a target nutritional goal is computed to provide 100% or near 100% of that computed energy expenditure without reliance on a predictive equation, and a target feeding formula is selected and used to generate instructions for an enteral feeding controller to deliver feedings via an enteral feeding tube using a feeding rate and/or feeding composition. The system and program product claims implement the same logic via stored code and controller communication.
Stated Advantages
Provides 100% or near 100% of the computed energy expenditure of the patient irrespective of a predictive equation.
Documented Applications
Adjusting enteral feeding of a patient using an enteral feeding controller based on carbon dioxide and flow sensor outputs and a target nutritional goal.
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