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Publication Number
US-11020322-B2
Publication Date
2021-06-01
Expiration Date
Abstract
There is provided a method comprising: computing a target nutritional goal to reach at an end of a time interval based on a real time energy expenditure of a patient, wherein the target nutritional goal comprises a volume to be delivered (VTBD) by the end of the time interval corresponding to a target amount of energy expenditure of the patient over the time interval, computing a target feeding profile defining a target feeding rate for enteral feeding of the patient for reaching the VTBD by the end of the time interval, continuously monitoring the real time energy expenditure, adapting the target nutritional goal and corresponding VTBD to compute a maximum VTBD to reach at the end of the time interval according to the monitoring, and dynamically adapting the target feeding rate and the corresponding target feeding profile for a remaining portion of the time interval for reaching the maximum VTBD.
Core Innovation
The invention describes a system and a method for automated enteral feeding of a patient that targets a target amount of energy expenditure by computing a target nutritional goal including a volume to be delivered (VTBD) by an end of a time interval. The system measures a resting energy expenditure (REE) over a portion of the time interval based on CO2 production rate and/or O2 consumption rate estimates made by measurements of at least one sensor, and a basal metabolic rate is computed as REE divided by the portion of the time interval.
The invention computes a target feeding profile that defines a target feeding rate that is up to a defined maximal feeding rate for enteral feeding by an automated enteral feeding device to reach the VTBD by the end of the time interval. In parallel, the system continuously monitors real time energy expenditure over the time interval based on continuous measurements of basal metabolic rate derived from REE measurements and dynamically adapts the target nutritional goal and corresponding VTBD to compute a maximum VTBD (max VTBD) based on dynamic adaptations of the monitored real time energy expenditure.
The system dynamically sends a control signal to the automated enteral feeding device so that feedings are automatically delivered to adapt the target feeding rate and the corresponding target feeding profile for a remaining portion of the time interval in order to reach the max VTBD by the end of the time interval. Related implementations describe baseline feeding profiles, pause intervals that form feeding deficits, and compensation using higher feeding rates to reach the target nutritional goal, while monitoring and adaptations are used to manage reflux-related risk.
Claims Coverage
Independent claims include three distinct formulations: a system for automated enteral feeding, a system that pauses or slows feeding and compensates to meet the target nutritional goal, and a method of automated enteral feeding. Across these independent claims, there are four core inventive features: sensor-based REE measurement from CO2 production and/or O2 consumption estimates, time-interval normalization into a basal metabolic rate and extrapolation to compute VTBD-based energy goals, real-time dynamic adaptation with control signals to an automated enteral feeding device capped by a defined maximal feeding rate, and baseline feeding profile pause-and-compensate logic.
Sensor-based resting energy expenditure to basal metabolic rate
measuring, over a portion of a time interval, a resting energy expenditure (REE) of the patient based on CO2 production rate and/or O2 consumption rate estimates of the patient made by measurements of at least one sensor, wherein a basal metabolic rate of the patient is equal to the REE divided by the portion of the time interval
Target nutritional goal using VTBD and energy expenditure extrapolation
computing a target nutritional goal to reach at an end of a time interval, wherein the target nutritional goal comprises a volume to be delivered (VTBD) by the end of the time interval that matches to a target amount of energy expenditure of the patient over the time interval computed according to the basal metabolic rate from the portion of the time interval; and computing a target nutritional goal ... computed by extrapolating the basal metabolic rate from the portion of the time interval
Real-time dynamic adaptation of feeding profile with max VTBD
continuously monitoring the real time energy expenditure of the patient over the time interval based on continuous measurements of the basal metabolic rate based on REE measurements ... and dynamically adapting the target nutritional goal and corresponding VTBD to compute a maximum VTBD (max VTBD) ... dynamically sending a control signal to the automated enteral feeding device that automatically delivers feedings ... for adapting the target feeding rate and the corresponding target feeding profile for a remaining portion of the time interval for reaching the max VTBD by the end of the time interval
Baseline feeding profile with pause time intervals and compensation
defining a baseline feeding profile of a patient by matching to the target feeding profile, wherein the patient is automatically fed ... according to the baseline feeding profile for reaching the target nutritional goal; pausing or slowing down the enteral feeding ... for at least one pause time interval; wherein a feeding deficit is formed ... during each pause time interval; and adjusting the baseline feeding profile to a higher feeding rate ... to compensate the feeding deficit for reaching the target nutritional goal at the end of the time interval
The independent claims cover automated enteral feeding that derives basal metabolic rate from sensor-based REE estimates, uses that to compute a VTBD-based target nutritional goal across a time interval, and performs closed-loop dynamic adaptation by continuously monitoring real-time energy expenditure and sending control signals to adjust a feeding profile within a defined maximal feeding rate, including pause-and-compensate logic in the additional independent system claim.
Stated Advantages
Targets enteral feeding to match a target amount of energy expenditure of the patient by computing a target nutritional goal including VTBD by the end of the time interval.
Continuously adapts the target nutritional goal and VTBD based on dynamic adaptations of monitored real time energy expenditure, and uses control signals to automatically deliver feedings for reaching a maximum VTBD by the end of the time interval.
Maintains a feeding profile that matches to changes of the basal metabolic rate while not exceeding a defined maximal feeding rate.
Compensates for feeding deficits formed during pause time intervals by adjusting the baseline feeding profile to a higher feeding rate to reach the target nutritional goal at the end of the time interval.
Documented Applications
Automated enteral feeding of a patient using an automated enteral feeding device with dynamic adaptation of a target feeding profile based on sensor-based REE, basal metabolic rate, and real-time energy expenditure monitoring.
Automated enteral feeding that includes baseline feeding profiles, pause or slowing down during pause time intervals, formation of feeding deficits, and compensation with increased feeding rates to meet the target nutritional goal.
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