Systems and methods for tracking spontaneous breathing in a mechanically ventilated patient
Inventors
Elia, Liron • Iddan, Gavriel J.
Assignees
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Publication Number
US-10967142-B1
Publication Date
2021-04-06
Expiration Date
Abstract
There is provided system for monitoring spontaneous breathing of a mechanically ventilated target individual, including: a feeding tube for insertion into a distal end of an esophagus of the individual, sensor(s) disposed on the feeding tube at a location such that the sensor(s) is located at the distal end of the esophagus of the individual when the feeding tube is in use, wherein the sensor(s) is positioned for sensing values by contact with the tissue of the esophagus including a lower esophageal sphincter (LES) and/or tissue in proximity to the LES, and code for computing an indication of a frequency band of diaphragm movement of the individual according to an analysis of values sensed by the sensor(s), and for adjustment of parameter(s) of a mechanical ventilator for mechanically ventilating the individual, wherein the instructions for adjustment are computed while the feeding tube is in use.
Core Innovation
The invention provides systems for mechanically ventilating a target individual using a probe inserted into a distal end of an esophagus. The probe includes at least one sensor with an impedance electrode or at least one pressure sensor positioned near a distal end of the probe such that the electrode or pressure sensor is located in the distal esophagus when the probe is located within the esophagus and in use.
The sensor is positioned to sense impedance values or pressure values when contacting tissue of the esophagus including at least one of a lower esophageal sphincter (LES) and tissue in proximity to the LES. From the sensed impedance values or pressure values, the system extracts a frequency band of diaphragm movement and a phase of the diaphragm movement of the mechanically ventilated target individual, including from signals that include much larger amplitude signals generated based on a mechanical ventilator.
The invention computes instructions to adjust ventilation frequencies and ventilation phases of the mechanical ventilator. The computed instructions mechanically ventilate the target individual by synchronizing a waveform of the ventilator to a waveform of the diaphragm movement in frequency band and phase of diaphragm movement, including embodiments where diaphragm movement is extracted from impedance-sensing electrodes and pressure sensing is associated with diaphragm-created pressure changes near the LES.
Claims Coverage
The consolidated content includes three independent claim themes. The inventive features focus on an esophageal probe with sensors positioned at or near the LES, extracting a diaphragm movement frequency band and phase from impedance, pressure, or electrical signals that include much larger ventilator-generated signals, and adjusting ventilator ventilation frequencies and ventilation phases by synchronizing the ventilator waveform to a diaphragm movement waveform in the extracted band and phase.
Esophageal impedance sensing electrodes at or near the LES for diaphragm band and phase extraction despite ventilator amplitude
A probe for insertion into a distal end of an esophagus, with at least one electrode for sensing impedance values disposed near a distal end of the probe at a location such that the electrode is located at the distal end of the esophagus in use, where the electrode is positioned for sensing impedance values when contacting tissue of the esophagus including at least one of a lower esophageal sphincter (LES) and tissue in proximity to the LES.
Extracting diaphragm movement frequency band and phase from impedance values including much larger ventilator-generated signals
Code executed by a computing device causes the computing device to extract a frequency band of diaphragm movement and a phase of the diaphragm movement from the impedance values sensed by the electrode, where the sensed impedance values include much larger amplitude signals generated based on a mechanical ventilator.
Synchronizing ventilator frequency and phase to the diaphragm movement waveform
Compute instructions adjust ventilation frequencies and ventilation phases of the mechanical ventilator for mechanically ventilating the target individual by synchronizing to a wave form of the diaphragm movement in frequency band and phase of diaphragm movement for matching a waveform of the ventilator to the waveform of the diaphragm movement.
Esophageal pressure sensors at or near the LES sensing diaphragm-related pressure changes
A probe for insertion into a distal end of an esophagus, with at least one pressure sensor set for sensing pressure values near a distal end of the probe at least at one of a lower esophageal sphincter (LES) and tissue in proximity to the LES, where pressure values sensed include pressure changes created by the movement of the diaphragm.
Extracting diaphragm movement frequency band and phase from pressure values including much larger ventilator-generated signals
Code executed by a computing device causes the computing device to extract a frequency band of diaphragm movement and a phase of the diaphragm movement from the pressure values sensed by the at least one pressure sensor, where the pressure values include much larger amplitude signals generated based on a mechanical ventilator.
Computing device extracting diaphragm band and phase from diaphragm-indication electrical signals
A computing device for converting electrical signals including an indication of diaphragm movement to instructions for operating a mechanical ventilator, comprising a probe inserted into a distal end of an esophagus and at least one electrode for sensing impedance values disposed near a distal end of the probe such that the electrode is located at the distal end of the esophagus in use, positioned for sensing impedance values when contacting tissue of the esophagus including at least one of a lower esophageal sphincter (LES) and tissue in proximity to the LES.
Across the independent claims, the core coverage is a ventilator system and a computing device that use an esophageal probe with electrodes or pressure sensors positioned at or near the LES to extract a diaphragm movement frequency band and phase from impedance, pressure, or electrical signals that include much larger ventilator-generated signals. The system then computes instructions to adjust ventilation frequencies and ventilation phases by synchronizing the ventilator waveform to the diaphragm movement waveform in the extracted band and phase.
Stated Advantages
Improved mechanically ventilating a target individual by synchronizing a waveform of the ventilator to a waveform of the diaphragm movement in frequency band and phase for matching the waveform of the ventilator to the waveform of the diaphragm movement.
Extracting diaphragm movement frequency band and phase from impedance values or pressure values/electrical signals despite much larger amplitude signals generated based on a mechanical ventilator.
Documented Applications
Mechanically ventilating a target individual using a mechanical ventilator with ventilation parameters adjusted based on diaphragm movement frequency band and phase.
Weaning from mechanical ventilation [procedural detail omitted for safety].
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