Interested in licensing this patent?
MTEC can help explore whether this patent might be available for licensing for your application.
Publication Number
US-11304878-B2
Publication Date
2022-04-19
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 relates to a system for automated enteral feeding of a subject in which a hardware processor executes code that measures resting energy expenditure (REE) over a portion of a time interval. The REE is based on CO2 production rate and/or O2 consumption rate estimates made by measurements of at least one sensor. The system computes a target nutritional goal to reach at the end of the time interval, where the target nutritional goal comprises a volume to be delivered (VTBD) that matches a target amount of energy expenditure over the time interval by extrapolating the REE from the portion to the time interval.
The processor also computes a target feeding profile defining a target feeding delivery rate that is up to a defined maximal feeding delivery rate for enteral feeding by an automated enteral feeding device. The system continuously monitors real time energy expenditure of the subject over the time interval based on continuous measurements of the REE measurements computed from CO2 production rate and/or O2 consumption rate estimates. The system 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.
Based on the dynamically computed max VTBD, the system dynamically sends a control signal to the automated enteral feeding device for adapting the target feeding delivery rate and the corresponding target feeding profile for a remaining portion of the time interval. The delivered feedings are performed to adapt the target feeding delivery rate and the corresponding target feeding profile for reaching the max VTBD by the end of the time interval. In this way, the target feeding profile matches changes of the REE and does not exceed the defined maximal feeding delivery rate.
The invention further describes embodiments that define a baseline feeding profile matched to a target feeding profile, pause or slow down enteral feeding for at least one pause time interval, and form a feeding deficit during each pause time interval between the target feeding profile and the baseline feeding profile. The system then adjusts the baseline feeding profile to a higher feeding delivery rate to compensate for the feeding deficit so as to reach the target nutritional goal at the end of the time interval. Additional embodiments include selecting formulations from in-stock pre-prepared clinical feeding formulations, accounting for hidden calories from prescribed medications, computing protein nutritional goals and protein deficits, and extending goal computation across intervals.
Claims Coverage
The document includes two independent claims, each covering distinct control approaches for automated enteral feeding. Across these independent claims, the main inventive features are centered on end-of-interval nutritional goal attainment via adaptive feeding delivery profiles.
Resting energy expenditure-based target nutritional goal extrapolation
measuring, over a portion of a time interval, a resting energy expenditure (REE) of the subject based on CO2 production rate and/or O2 consumption rate estimates of the subject made by measurements of at least one sensor; computing a target nutritional goal to reach at an end of the 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 subject over the time interval computed by extrapolating the REE from the portion to the time interval;
Target feeding profile constrained by a maximal feeding delivery rate
computing a target feeding profile defining a target feeding delivery rate that is up to a defined maximal feeding delivery rate for enteral feeding of the subject by an automated enteral feeding device for reaching the VTBD by the end of the time interval; wherein the target feeding profile matches to changes of the REE and does not exceed the defined maximal feeding delivery rate.
Continuous REE monitoring with dynamic max VTBD adaptation
continuously monitoring the real time energy expenditure of the subject over the time interval based on continuous measurements of the REE measurements computed from CO2 production rate and/or O2 consumption rate estimates of the subject made by measurements of the at least one sensor; dynamically adapting the target nutritional goal and corresponding VTBD to compute a maximum VTBD (max VTBD) to reach at the end of the time interval according to dynamic adaptations of the monitored real time energy expenditure of the subject;
Dynamic control signal to adapt feeding delivery for remaining time
dynamically sending a control signal to the automated enteral feeding device that automatically delivers feedings to the subject for adapting the target feeding delivery 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-induced feeding deficit and compensation
defining a baseline feeding profile of a subject by matching to the target feeding profile, wherein the subject is automatically fed by the automated enteral feeding device according to the baseline feeding profile for reaching the target nutritional goal at the end of the time interval; pausing or slowing down the enteral feeding by the automated enteral feeding device for at least one pause time interval; wherein a feeding deficit is formed between the target feeding profile and the baseline feeding profile during each pause time interval, the feeding deficit denoting a deficit to reach the target nutritional goal at the end of the time interval; and adjusting the baseline feeding profile to a higher feeding delivery rate that is higher than a feeding delivery rate of the corresponding target feeding profile to compensate the feeding deficit for reaching the target nutritional goal at the end of the time interval.
Across the independent claims, the core coverage combines sensing-based REE measurement and extrapolated VTBD target setting with continuous monitoring and dynamic adaptation of a maximum VTBD, and target feeding profiles implemented through a baseline profile that is paused or slowed to create a deficit and compensated by raising the feeding delivery rate to still reach the end-of-interval nutritional goal.
Stated Advantages
Continuously adapts feeding control signals based on monitored real time energy expenditure while reaching a dynamically updated maximum VTBD by the end of the time interval.
Enforces that the target feeding profile matches changes of REE and does not exceed a defined maximal feeding delivery rate.
Maintains end-of-time-interval nutritional goal attainment despite pausing or slowing feeding by compensating the feeding deficit with an adjusted baseline feeding profile at a higher feeding delivery rate.
Documented Applications
Automated enteral feeding of an ICU subject, with real-time monitoring and adaptation based on energy expenditure measurement.
End-of-interval nutritional goal computation and compensation during feed interruptions, described in terms of pause time intervals and feeding deficit compensation.
Accounting for effects of medications via hidden calories and adjusting feeding targets accordingly.
Protein nutritional goal handling via computation of optimal protein nutritional goal and protein deficit and generating instructions to address the deficit.
Interested in licensing this patent?