Systems and methods for assessment of lung transpulmonary pressure

Inventors

Elia, Liron • Iddan, Gavriel J.

Assignees

Art Medical Ltd

Abstract

There is provided a system for monitoring transpulmonary pressure of a mechanically ventilated individual, comprising: a feeding tube, at least one esophageal body, a pressure sensor, and a memory having stored thereon code for: computing an estimate of esophageal wall pressure according to pressure in the esophageal body when inflated and contacting the inner wall of the esophagus, computing the transpulmonary pressure of the mechanically ventilated target individual according to the esophageal wall pressure, periodically inflating and deflating the esophageal body for periodic monitoring of the transpulmonary pressure of the mechanically ventilated target patient while the feeding tube is in use, and computing instructions for adjustment of parameter(s) of a mechanical ventilator that automatically ventilates the target individual according to the computed transpulmonary pressure, wherein the instructions for adjustment of parameter(s) of the mechanical ventilator are computed while the feeding tube is in place without removal of the feeding tube.

Core Innovation

A system is described for monitoring transpulmonary pressure of a mechanically ventilated target individual. The system includes a feeding tube for insertion into a distal end of an esophagus, and at least one esophageal body having a pressure dependent volume coupled to a distal portion of the feeding tube. A pressure sensor senses pressure on the esophageal body while the feeding tube is in use, and hardware processors execute code to synchronize monitoring with operation of a mechanical ventilator.

During a plurality of iterations synchronized with operation of the mechanical ventilator, a first inflation stage occurs before the mechanical ventilator pushes air into lungs. In the first inflation stage, the esophageal body is inflated for contacting the esophageal wall to balance alveoli pressure applied by the lungs, and a first pressure is sensed on the esophageal body. A second inflation stage then occurs after air is pushed into the lungs and after at least one of a selected volume is inserted and a selected pressure is reached within the esophageal body, and before the mechanical ventilator extracted air from the lungs; a second pressure is sensed.

The system computes the transpulmonary pressure based on the second pressure and the first pressure. The described approach supports near-continuous monitoring during ventilator cycles by inflating and deflating the esophageal body while the feeding tube remains in place, and it includes generation of ventilator parameter adjustment instructions based on the computed transpulmonary pressure. The clinical intent includes prevention and prediction in acute respiratory distress syndrome (ARDS) using trends, and it further describes computation and presentation of lung stiffness (Young modulus), future transpulmonary pressure prediction with alerts, as well as optional impedance-based gastric reflux detection and lung fluid estimation using electrodes.

Claims Coverage

The partial content includes two independent claims (clm-00001 and clm-00022). Across these claims, the core coverage is a synchronized two-stage inflation/sensing sequence around mechanical ventilator push/extract phases, and computing transpulmonary pressure from first and second esophageal body pressures.

Both independent claims center on synchronizing esophageal body inflation with mechanical ventilator operation, sensing a first and a second esophageal body pressure at different inflation stages, and computing transpulmonary pressure from the first and second sensed pressures. Dependent claim coverage in the provided set additionally indicates computing work of breathing and performing ARDS-related thresholding, trend/graph and prediction presentations, and optional impedance-based gastric reflux detection.

Stated Advantages

Documented Applications