Systems and methods for automatic cycling or cycling detection

Abstract

Systems and methods for novel ventilation that allows the ventilator to detect a patient intention to cycle exhalation are provided. Further, systems and methods for cycling exhalation based on a muscle pressure are provided.

What is claimed is: 
     
         1 . A ventilator system comprising:
 at least one sensor;   a gas-delivery system configured to deliver ventilation gases to a patient;   at least one processor; and   at least one memory comprising computer-executable instructions that when executed by the at least one processor cause the ventilator system to:
 receive one or more sensor measurements from the at least one sensor during inhalation of the patient; 
 based on the one or more sensor measurements, estimate a physiological parameter of the patient during the inhalation of the patient; 
 in response to determining that the physiological parameter meets a cycling threshold, determine a patient intention to cycle from inhalation to exhalation; 
 evaluate one or more characteristics of the patient intention to cycle from inhalation to exhalation; 
 when the one or more characteristics of the patient intention to cycle from inhalation to exhalation are abnormal, determine a missed cycling effort; and 
 perform an action in response to the missed cycling effort. 
   
     
     
         2 . The ventilator system of  claim 1 , wherein ventilation is delivered to the patient based on one of: a volume support (VS) breath type, a pressure support (PS) breath type, or a tube compensated (TC) breath type. 
     
     
         3 . The ventilator system of  claim 2 , wherein the computer-executable instructions further causing the ventilator system to:
 temporarily switch to a proportional assist (PA) breath type; and   while delivering the temporary PA breath type, receive the one or more sensor measurements from the at least one sensor during the inhalation of the patient.   
     
     
         4 . The ventilator system of  claim 3 , wherein the computer-executable instructions further causing the ventilator system to:
 estimate a respiratory mechanics parameter based on the one or more sensor measurements received while delivering the temporary PA breath type; and   based on the estimated respiratory mechanics parameter, estimate the physiological parameter of the patient during the inhalation of the patient.   
     
     
         5 . The ventilator system of  claim 4 , wherein the estimated respiratory mechanics parameter is at least one of: a resistance or a compliance of the patient. 
     
     
         6 . The ventilator system of  claim 2 , wherein the computer-executable instructions further causing the ventilator system to:
 determine a percent support setting based on one of a pressure support setting or a volume support setting.   
     
     
         7 . The ventilator system of  claim 1 , wherein the physiological parameter is an estimate of a muscle pressure (P MUS ). 
     
     
         8 . The ventilator system of  claim 1 , wherein the computer-executable instructions further causing the ventilator system to determine a percent support setting based on one of a pressure support setting or a volume support setting. 
     
     
         9 . The ventilator system of  claim 8 , wherein the computer-executable instructions further causing the ventilator system to:
 temporarily switch to a proportional assist (PA) breath type; and   deliver at least one breath based on the determined percent support setting.   
     
     
         10 . The ventilator system of  claim 1 , wherein the action is at least one of displaying a notification or automatically adjusting a target setting for spontaneous ventilation. 
     
     
         11 . A ventilator system comprising:
 at least one sensor;   a gas-delivery system configured to deliver ventilation gases to a patient;   at least one processor; and   at least one memory comprising computer-executable instructions that when executed by the at least one processor cause the ventilator system to:
 receive one or more sensor measurements from the at least one sensor during inhalation of the patient; 
 based on the one or more sensor measurements, estimate a muscle pressure (P MUS ) of the patient during the inhalation of the patient; 
 determine a P MUS -based metric based on the estimate of P MUS ; and 
 in response to determining that the P MUS -based metric meets a cycling threshold, determine a patient intent to cycle from inhalation to exhalation. 
   
     
     
         12 . The ventilator system of  claim 11 , wherein the computer-executable instructions further causing the ventilator system to:
 in response to determining the patient intent to cycle, compare a timing of the patient intent to cycle to a timing of exhalation delivery by the ventilator system; and   when the timing of the patient intent to cycle exceeds a timing threshold, determine a missed cycling effort.   
     
     
         13 . The ventilator system of  claim 12 , wherein the computer-executable instructions further causing the ventilator system to:
 in response to the missed cycling effort, perform at least one of: displaying a notification or automatically adjusting a target setting for spontaneous ventilation.   
     
     
         14 . The ventilator system of  claim 11 , wherein the computer-executable instructions further causing the ventilator system to:
 in response to determining that the P MUS -based metric meets a cycling threshold, cycle from inhalation to exhalation.   
     
     
         15 . The ventilator system of  claim 11 , wherein ventilation is delivered based on one of: a volume support (VS) breath type, a pressure support (PS) breath type, or a tube compensated (TC) breath type. 
     
     
         16 . A method for detecting a patient intention to cycle during spontaneous ventilation of a patient on a ventilator, comprising:
 receiving one or more sensor measurements from at least one sensor during inhalation of the patient;   based on the one or more sensor measurements, estimating a physiological parameter of the patient during the inhalation of the patient;   in response to determining that the physiological parameter meets a cycling threshold, determining a patient intention to cycle from inhalation to exhalation;   evaluating one or more characteristics of the patient intention to cycle from inhalation to exhalation;   when the one or more characteristics of the patient intention to cycle from inhalation to exhalation are abnormal, determining a missed cycling effort; and   perform an action in response to the missed cycling effort.   
     
     
         17 . The method of  claim 16 , wherein the action is one of displaying a notification or automatically adjusting a target setting for spontaneous ventilation. 
     
     
         18 . The method of  claim 16 , wherein the physiological parameter is an estimate of a muscle pressure (P MUS ). 
     
     
         19 . The method of  claim 16 , wherein ventilation is delivered based on one of: a volume support (VS) breath type, a pressure support (PS) breath type, or a tube compensated (TC) breath type. 
     
     
         20 . The method of  claim 16 , further comprising:
 temporarily switching to a proportional assist (PA) breath type; and   while delivering the temporary PA breath type, receiving the one or more sensor measurements from the at least one sensor during the inhalation of the patient.