Ventilator-initiated prompt or setting regarding detection of asynchrony during ventilation

Abstract

This disclosure describes systems and methods for monitoring and evaluating ventilatory parameters, analyzing those parameters and providing useful notifications and recommendations to clinicians. That is, modern ventilators monitor, evaluate, and graphically represent multiple ventilatory parameters. However, many clinicians may not easily recognize data patterns and correlations indicative of certain patient conditions, changes in patient condition, and/or effectiveness of ventilatory treatment. Further, clinicians may not readily determine appropriate ventilatory adjustments that may address certain patient conditions and/or the effectiveness of ventilatory treatment. Specifically, clinicians may not readily detect or recognize the presence of asynchrony during ventilation. According to embodiments, a ventilator may be configured to monitor and evaluate diverse ventilatory parameters to detect asynchrony and may issue notifications and recommendations suitable for a patient to the clinician when asynchrony is implicated. The suitable notifications and recommendations may further be provided in a hierarchical format.

1 .- 20 . (canceled) 
     
     
         21 . A ventilator-implemented method for detecting and mitigating asynchrony during ventilation of a patient, the method comprising:
 collecting data associated with ventilatory parameters from at least one sensor;   processing the collected ventilatory parameter data, wherein the step of processing the collected ventilatory parameter data comprises deriving ventilatory parameter data from the collected ventilatory parameter data based at least on a background trigger type;   determining that the asynchrony is implicated upon detecting that the processed ventilatory parameter data breaches a received at least one predetermined threshold; and   determining an appropriate ventilator adjustment for mitigating the asynchrony;   implementing the appropriate ventilator adjustment for mitigating the asynchrony.   
     
     
         22 . The method of  claim 21 , wherein the step of determining asynchrony further requires determining that the processed ventilatory parameter data breaches the received at least one predetermined threshold at a predetermined frequency. 
     
     
         23 . The method of  claim 21 , wherein the processed ventilatory parameter data comprises:
 at least one of airway flow, airway pressure, and neural respiratory output, and wherein the processed ventilatory parameter data comprises:   at least one of a detected inspiratory trigger and a detected expiratory trigger.   
     
     
         24 . The method of  claim 21 , wherein the background trigger type is an IE Sync trigger type. 
     
     
         25 . The method of  claim 21 , wherein the step of determining that the asynchrony is implicated comprises:
 receiving the at least one predetermined threshold, the at least one predetermined threshold comprising:
 a number of first patient efforts detected by the background trigger type must be equal to a number of second patient efforts detected by an active trigger type in a predetermined amount of time; 
   determining the number of first patient efforts detected by the background trigger type and determining the number of second patient efforts detected by the active trigger type in the predetermined amount of time; and   determining that the number of first patient efforts detected by the background trigger type is not equal to the number of second patient efforts detected by the active trigger type in the predetermined amount of time.   
     
     
         26 . The method of  claim 21 , wherein the step of determining that the asynchrony is implicated comprises:
 receiving the at least one predetermined threshold, the at least one predetermined threshold comprising:
 a first patient effort detected by a background breath type must occur within 60 milliseconds of a second patient effort detected by an active breath type; 
   determining when the first patient effort is detected by the background breath type and determining when the second patient effort is detected by the active breath type;   determining that the first patient effort detected by the background breath type is more than 60 milliseconds from the second patient effort detected by the active breath type.   
     
     
         27 . The method of  claim 21 , wherein the step of determining that the asynchrony is implicated comprises:
 receiving the at least one predetermined threshold, the at least one predetermined threshold comprising:
 a first inspiratory patient effort and an expiratory patient effort is detected by the background trigger type before a second inspiratory patient effort is detected by an active trigger type; 
   determining when the first inspiratory patient effort and the expiratory patient effort is detected by the background trigger type and determining when the second inspiratory patient effort is detected by the active trigger type;   determining that the first inspiratory patient effort and the expiratory patient effort are detected by the background trigger type before a second patient effort is detected by the active trigger type.   
     
     
         28 . The method of  claim 21 , further comprising:
 issuing a message when the asynchrony is implicated;   determining an appropriate notification for the message based at least in part on a type of asynchrony detected.   
     
     
         29 . The method of  claim 21 , further comprising:
 identifying one or more ventilatory settings associated with a ventilatory treatment of the patient,   wherein the appropriate ventilator adjustment includes a change to the one or more ventilatory settings, and   wherein the one or more ventilatory settings include at least one of a breath type, an inspiration time, an exhalation time, an inspiratory sensitivity, an expiratory sensitivity, a flow rate, a rise time, a flow pattern, a tidal volume, and an inspiratory pressure.   
     
     
         30 . The method of  claim 21 , wherein determining the appropriate ventilator adjustment for mitigating the asynchrony comprises:
 identifying a type of asynchrony detected, wherein the type of asynchrony is selected from a group including: missed breath, early cycle, flow mismatch, late cycle, false trigger, inadequate flow, late trigger, high tidal volume, double trigger, and long inspiratory time.   
     
     
         31 . The method of  claim 30 , wherein the appropriate ventilator adjustment comprises one of:
 a change to a square flow pattern;   a switch to a pressure-targeted breath type;   an increase in flow rate;   an increase in trigger sensitivity;   a change in trigger type;   an increase in expiratory sensitivity;   an increase in set PEEP;   lower a set respiration rate;   a decrease in trigger sensitivity;   enable leak compensation;   an increase in inspiration time;   a decrease in inspiration time;   a decrease in support setting;   an increase in tidal volume;   a decrease in tidal volume;   an increase in inspiration pressure;   an increase in rise time; and   a decrease in flow rate.   
     
     
         32 . A ventilatory system for adjusting ventilator settings to mitigate a detected asynchrony during ventilation of a patient, comprising:
 at least one processor; and   at least one memory, communicatively coupled to the at least one processor and containing instructions that, when executed by the at least one processor cause the ventilator system to:
 collect data associated with ventilatory parameters from at least one sensor; 
 process the collected ventilator parameter data; 
 detect that asynchrony is implicated for the patient based on a background trigger type utilizing the processed ventilator parameter data; 
 determine an appropriate message when the asynchrony is implicated; and 
 issue the appropriate message. 
   
     
     
         33 . The ventilatory system of  claim 32 , the instructions further comprising:
 determine the processed ventilatory parameter data that implicated the asynchrony, and   wherein the determine the appropriate message is based at least in part on the processed ventilatory parameter data that implicated the asynchrony.   
     
     
         34 . The ventilatory system of  claim 32 , wherein the appropriate message includes a notification that the asynchrony is implicated and information regarding the processed ventilatory parameter data that implicated the asynchrony. 
     
     
         35 . The ventilatory system of  claim 32 , the instructions further comprising:
 determine one or more ventilatory settings associated with a ventilatory treatment of the patient; and   wherein the determine the appropriate message is based at least in part on evaluating the one or more ventilatory settings.   
     
     
         36 . The ventilatory system of  claim 35 , wherein the one or more ventilatory settings is a breath type. 
     
     
         37 . The ventilatory system of  claim 32 , wherein the appropriate message comprises at least one of:
 change to a square flow pattern;   switch to a pressure-targeted breath type;   increase in flow rate;   increase in trigger sensitivity;   change in trigger type;   increase in expiratory sensitivity;   increase in set PEEP;   lower a set respiration rate;   decrease in trigger sensitivity;   enable leak compensation;   increase in inspiration time;   decrease in inspiration time;   decrease in support setting;   increase in tidal volume;   decrease in tidal volume;   increase in inspiration pressure;   increase in rise time; and   decrease in flow rate.   
     
     
         38 . The ventilatory system of  claim 32 , wherein the appropriate message comprises at least one of:
 change to an IE Sync breath trigger type;   change to a DEA trigger type;   change to an IE Sync breath type;   change to a DEA breath type;   decrease in tidal volume;   increase in expiration sensitivity;   decrease in inspiration time;   decrease in a support setting if greater than 80%;   decrease in respiration rate;   decrease in respiration rate if exhalation volume is high;   change to a spontaneous breath type;   change to a flow pattern to square;   change to a pressure targeted breath type; and   change in trigger type.   
     
     
         39 . The ventilatory system of  claim 32 , wherein the determine the appropriate message comprises:
 determining if a secondary condition is implicated; and   identifying a type of asynchrony detected, wherein the type of asynchrony is selected from a group including: missed breath, early cycle, flow mismatch, late cycle, false trigger, inadequate flow, late trigger, high tidal volume, double trigger, and long inspiratory time.   
     
     
         40 . A ventilator system comprising:
 a pressure generating system that generates a flow of breathing gas;   a ventilation tubing system that delivers the flow of breathing gas from the pressure generating system to a patient;   one or more sensors operatively coupled to at least one of the pressure generating system, the patient, and the ventilation tubing system, wherein the one or more sensors collect data associated with ventilatory parameters;   a data processing module, the data processing module processes the collected ventilatory parameter data based on a background breath type;   a ventilation module, the ventilation module controls ventilation of the patient according to ventilator settings;   an asynchrony detection module, the asynchrony detection module determines that an asynchrony is implicated upon detecting that the processed ventilatory parameter data breaches a received at least one predetermined threshold; and   a smart prompt module, the smart prompt module issues a message when the asynchrony is implicated.