[특허]Administration of CPAP treatment pressure in presence of apnea

Administration of CPAP treatment pressure in presence of apnea 원문보기

IPC분류정보
국가/구분	United States(US) Patent 등록
국제특허분류(IPC7판)	A61M-016/00
출원번호	US-0477505 (2012-05-22)
등록번호	US-8684000 (2014-04-01)
우선권정보	AU-PP0269 (1997-11-07)
발명자 / 주소	Berthon-Jones, Michael Farrugia, Steven Paul
출원인 / 주소	ResMed Limited
대리인 / 주소	Lerner, David, Littenberg, Krumholz & Mentlik, LLP
인용정보	피인용 횟수 : 0 인용 특허 : 155

초록 ▼

CPAP treatment apparatus is disclosed having a controllable flow generator (34, 38, 40) operable to produce breathable gas at a treatment pressure elevated above atmosphere to a patient by a delivery tube (32) coupled to a mask (30) having connection with a patient's airway. A sensor (44, 50, 56, 58) generates a signal representative of patient respiratory flow, that is provided to a controller (54, 62, 64). The controller (54, pressure. In one preferred form the increase in pressure is zero if the treatment pressure before the apnea exceeds a pressure threshold. Below the pressure threshold the increase in pressure is an increasing function of the duration of the apnea multiplied by the difference between the pressure threshold and the current treatment pressure.

대표청구항 ▼

1. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient, comprising the steps of: determining the occurrence of a respiratory event in the patient's upper airway;if the respiratory event is an apnea and the treatment pressure is below a first predetermined value, then responding to the presence of the apnea by increasing the treatment pressure in a first manner; andif the respiratory event is a partial upper airway obstruction and the treatment pressure is below a second predetermined value, then responding to the presence of the partial upper airway obstruction by increasing the treatment pressure in a second manner;said first predetermined value being less than said second predetermined value. 2. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient in accordance with claim 1 wherein the presence of an apnea is determined based on a measured respiratory flow rate of air of the patient. 3. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient in accordance with claim 2 wherein the presence of an apnea is determined by the measured respiratory flow rate of air of the patient being reduced below a threshold value. 4. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient in accordance with claim 1 wherein the presence of a partial upper airway obstruction is determined by detecting the presence of snoring and/or detecting the presence of inspiratory airflow limitation. 5. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient in accordance with claim 4 wherein detecting the presence of inspiratory airflow limitation is determined by monitoring changes in shape of the inspiratory flow versus time curve of the patient. 6. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient in accordance with claim 1 wherein said first predetermined value is about 10 cmH20. 7. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient in accordance with claim 1 wherein said second predetermined value is about 20 cmH20. 8. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient in accordance with claim 1 wherein said first predetermined value is a pressure above which apneas are more likely to be central apneas than obstructive apneas. 9. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient in accordance with claim 1 wherein if no respiratory event is detected, the treatment pressure is gradually reduced towards a minimum pressure with a predetermined time constant. 10. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient in accordance with claim 1 wherein the predetermined time constant is between approximately ten minutes and approximately twenty minutes. 11. A method of automatically adjusting a continuous positive airway treatment pressure delivered to a patient in accordance with claim 1 further comprising the step of determining airway patency by using a forced oscillation method. 12. A method of automatically adjusting a CPAP treatment pressure to avoid stimulating the Hering-Breuer reflex comprising the steps of: providing a supply of air or breathable gas at an automatically adjustable positive treatment pressure to an entrance of the airway of a patient in a range from a minimum pressure to a maximum pressure;detecting the presence of patient apnea and flow-limitation using a flow-based algorithm;increasing the treatment pressure in response to flow limitation that occurs when the treatment pressure is in the range from the minimum pressure to the maximum pressure;increasing the treatment pressure in response to the detection of a patient apnea that occurs when the treatment pressure is below a threshold pressure, said threshold pressure being a pressure that leads to stimulation of the Hering-Breuer reflex and being a pressure less than the maximum pressure; andleaving the treatment pressure unchanged in response to a patient apnea that occurs at a treatment pressure above said threshold pressure. 13. A method of automatically adjusting a CPAP treatment pressure to avoid stimulating the Hering-Breuer reflex in accordance with claim 12 wherein the presence of patient apnea is detected only when the treatment pressure is below the threshold pressure. 14. A method of automatically adjusting a CPAP treatment pressure to avoid stimulating the Hering-Breuer reflex in accordance with claim 12 wherein said threshold pressure is about 10 cmH20. 15. A method of automatically adjusting a CPAP treatment pressure to avoid stimulating the Hering-Breuer reflex in accordance with claim 12 wherein said maximum pressure is about 20 cmH20. 16. A method of automatically adjusting a CPAP treatment pressure to avoid stimulating the Hering-Breuer reflex in accordance with claim 12 further including the step of determining a conductance of the patient's airway and increasing the pressure only when the conductance is below a conductance threshold. 17. A method of automatically adjusting a CPAP treatment pressure to avoid stimulating the Hering-Breuer reflex in accordance with claim 12 wherein the conductance is determined by using a forced oscillation procedure at 4 Hz. 18. An automatically adjusting CPAP apparatus comprising: a source of air or breathable gas arranged to provide an adjustable positive treatment pressure to an entrance of the airway of a patient; anda controller that adjusts said positive treatment pressure(a) in a first manner when the treatment pressure is in a first pressure range to respond to:(i) indications of the presence of apnea; and(ii) indications of the presence of inspiratory flow limitation; and(b) in a second manner when the treatment pressure is in a second, higher pressure range to respond to indications of inspiratory flow limitation. 19. An automatically adjusting CPAP apparatus in accordance with claim 18 wherein in accordance with the first manner the controller increases the treatment pressure to respond to indications of the presence of apnea or indications of the presence of inspiratory flow limitation. 20. An automatically adjusting CPAP apparatus in accordance with claim 18 wherein in accordance with the second manner the controller increases the treatment pressure to respond to indications of inspiratory flow limitation. 21. An automatically adjusting CPAP apparatus in accordance with claim 20 wherein in accordance with the second manner the controller leaves the treatment pressure unchanged in response to apneas. 22. An automatically adjusting CPAP apparatus in accordance with claim 18 wherein said first pressure range is about 4 cmH20 to about 10 cmH20. 23. An automatically adjusting CPAP apparatus in accordance with claim 18 wherein said second pressure range is about 10 cmH20 to about 20 cmH20. 24. An automatically adjusting CPAP apparatus in accordance with claim 18 wherein said first pressure range is a pressure range in which an obstructive apnea is more likely to occur than a central apnea. 25. An automatically adjusting CPAP apparatus in accordance with claim 18 wherein said second pressure range is a pressure range in which an open airway apnea is more likely to occur than a closed airway apnea. 26. An automatically adjusting CPAP apparatus in accordance with claim 18 wherein in the first manner and the second manner the controller also adjusts said positive treatment pressure in response to indications of the presence of snoring. 27. An automatically adjusting CPAP apparatus in accordance with claim 18 wherein said controller determines a conductance of the airway using a forced oscillation method and classifies an apnea as either an open airway apnea or a closed airway apnea using said conductance. 28. An automatically adjusting CPAP apparatus that is responsive to the presence of an apnea in accordance with a function of treatment pressure, the apparatus comprising a source of air or breathable gas arranged to provide an adjustable positive treatment pressure to an entrance of the airway of a patient; and a controller that controls said positive treatment pressure according to a first procedure defined by the function when an evaluation of the treatment pressure is such that an obstructive apnea is more likely than a central apnea, and controls said positive treatment pressure according to a second procedure defined by the function when an evaluation of the treatment pressure is such that a central apnea is more likely than an obstructive apnea. 29. The automatically adjusting CPAP apparatus of claim 28 wherein said function gives rise to an increase in treatment pressure when an obstructive apnea is more likely than a central apnea. 30. The automatically adjusting CPAP apparatus of claim 28 wherein said function gives rise to substantially no increase in treatment pressure when a central apnea is more likely than an obstructive apnea. 31. The automatically adjusting CPAP apparatus of claim 28 wherein said controller determines that a central apnea pressure is above a threshold value. 32. The automatically adjusting CPAP apparatus of claim 31 wherein said threshold value is about 10 cmH20. 33. The automatically adjusting CPAP apparatus of claim 28 wherein said controller determines a conductance of the airway using a forced oscillation method and classifies an apnea as an open airway apnea or a closed airway apnea using said conductance. 34. The automatically adjusting CPAP apparatus of claim 28 whereby a treatment pressure increase in a presence of any apnea may occur below a first treatment pressure limit but not above the first treatment pressure limit and a treatment pressure increase in a presence of flow limitation may occur above the first treatment pressure limit and below a second treatment pressure limit, wherein the second treatment pressure limit is a treatment pressure limit higher than the first treatment pressure limit. 35. The automatically adjusting CPAP apparatus of claim 28 wherein said controller is configured to determine that a central apnea is more likely than an obstructive apnea without using a forced oscillation method. 36. The automatically adjusting CPAP apparatus of claim 28 wherein the controller is configured to gradually reduce treatment pressure towards a minimum pressure in the absence of a detection of apnea. 37. A continuous positive airway pressure device for treating partial or complete upper airway obstruction comprising: a mask sealingly engaged with a patient's face, and including an exhaust port;a motor driven blower providing a supply of air at positive pressure to an air delivery hose;said air delivery hose receiving the supply of air from said blower and delivering it to said mask;a pressure sensor for sensing the pressure at an entrance of the patient's airway;a flow sensor for sensing the flow rate of air through said mask; anda controller programmed (a) to detect the presence of inspiratory flow limitation in the patient by analyzing said flow rate, (b) to detect the presence of an apnea in the patient, (c) upon detection of an apnea, if the entrance pressure is less than a first pressure threshold, to operate in a first mode to cause an increase in the entrance pressure, and (d) upon detection of the presence of inspiratory flow limitation, if the entrance pressure is less than a second pressure threshold, to operate in a second mode to cause an increase in the entrance pressure;wherein said first pressure threshold is less than said second pressure threshold. 38. A continuous positive airway pressure device for treating partial or complete upper airway obstruction in accordance with claim 37 wherein said controller is programmed to detect the presence of inspiratory flow limitation by analyzing changes in the shape of the inspiratory flow-versus-time curve. 39. A continuous positive airway pressure device for treating partial or complete upper airway obstruction in accordance with claim 37 wherein said first pressure threshold is about 10 cmH20. 40. A continuous positive airway pressure device for treating partial or complete upper airway obstruction in accordance with claim 37 wherein said second pressure threshold is about 20 cmH20. 41. A continuous positive airway pressure device for treating partial or complete upper airway obstruction in accordance with claim 37 wherein said controller determines a conductance of the airway using a forced oscillation method and classifies an apnea as either an open airway apnea or a closed airway apnea using said conductance. 42. A CPAP apparatus comprising: a source of air or breathable gas to provide a positive treatment pressure to an entrance of the airway of a patient;at least one sensor that facilitates detection of an apnea; anda controller that in response to an apnea detection adjusts the positive treatment pressure more aggressively when the existing CPAP pressure is low and it is likely that an apnea is of the closed airway variety, and adjusts the positive treatment pressure less aggressively when the existing CPAP pressure is high and it is likely that an apnea is of the open airway variety. 43. An automatically adjusting CPAP apparatus comprising: a source of air or breathable gas to provide a positive treatment pressure to an entrance of the airway of a patient; anda controller that detects an apnea and in response thereto increases the positive treatment pressure in a first manner provided the pressure does not exceed a predetermined apnea pressure limit, and detects a partial upper airway obstruction and in response thereto increases the positive treatment pressure in a second manner provided the pressure does not exceed a maximum pressure limit;wherein said apnea pressure limit is less than said maximum pressure limit. 44. An automatically adjusting CPAP apparatus in accordance with claim 43 wherein said apnea pressure limit is about 10 cmH20. 45. An automatically adjusting CPAP apparatus in accordance with claim 43 wherein said maximum pressure limit is about 20 cmH20. 46. An automatically adjusting CPAP apparatus in accordance with claim 43 wherein said controller determines a conductance of the airway using a forced oscillation method and classifies an apnea as either an open airway apnea or a closed airway apnea using said conductance.

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Sackner Marvin A. (Miami Beach FL), Noninvasive method for measuring and monitoring intrapleural pressure in newborns.
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Hete Bernie F. (Trafford PA) Srock James D. (Valencia PA), Oxygen mixing in a blower-based ventilator.
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Johnson Robert J. (Riverside CA), Passive inspiratory nebulizer system.
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Bellin Howard T. (New York NY) Dingwall Robert P. (Clinton Corners NY), Patient monitor sheets.
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Le Bec Yves (Grigny FRX), Pheumatic alarm for respirator.
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DiBenedetto John P. (Norwood MA) Krasner Jerome L. (Ashland MA), Physiological detector and monitor.
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Mawhinney Daniel D. (Livingston NJ), Physiological monitoring system.
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Harris John C. (Gaithersburg MD) Olsen Dale E. (Columbia MD), Polygraph automated scoring systems.
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Roberts Josephine A. (7509 Ben Avon Rd. Bethesda MD 20817) Burwell Jephthae W. (3119 Adams Mill Rd. ; NW. Washington DC 20010), Positive-pressure ventilator system with controlled access for nebulizer component servicing.
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Servidio John L. (Marietta GA) Beverly Bruce (Marietta GA), Pressure support ventilatory assist system.
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Gropper Charles M. (Yorba Linda CA) Ellestad Raymond A. (Rialto CA), Pressure-limited, time-cycled pulmonary ventilation with volume-cycle override.
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Champain Roger (Les Loges en Josas FRX) Theurant Gilbert (Vitry-sur-Seine FRX), Process and device for supplying respiratory oxygen.
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Riker Douglas M. (Brookline MA), Pulmonary function tester.
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Gattinoni Luciano (Via Porpora 187 Milan ITX), Pulmonary pressure and volume measurement.
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Durkan Gerald (Altoona PA), Respirating gas supply method and apparatus therefor.
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Manus Eugene A. (1005 Kentwood Dr. Blacksburg VA 24060) Wiley Paris H. (1907 Ceder Brooke Dr. Lutz FL 33549), Respiration and heart rate monitoring apparatus.
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Raemer Daniel B. (Brookline MA), Respiration detector.
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McKenna Kevin (58 W. Gradwell Ave. Maple Shade NJ 08052), Respiration monitor.
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Kearns Kenneth L. (12822 N. 26th Dr. Phoenix AZ 85029), Respiration monitor and x-ray triggering apparatus.
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McDonald ; Jr. Lewis D. (701-17th Ave. Seattle WA 98122), Respiration sensor set.
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Hakkinen Taisto (Hameenlinna FIX), Respiration therapy apparatus.
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Campbell ; Jr. William G. (2019 Orangeview La. Orange CA 92667), Respiratory and cardiac monitor.
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Jaffe Michael B. (Anaheim CA) Luper Charles R. (Anaheim CA) Mabry Eric (Westminster CA) Reid Howard J. (Brea CA), Respiratory gas analysis instrument having improved volume calibration method and apparatus.
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Schebler Bernard J. (Davenport IA), Selector valve for an aircraft on board oxygen generation system with high pressure oxygen backup.
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Daigle Louis J. L. (Manchester CT), Sensor and meter for measuring the mass flow of a fluid stream.
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Bowers David L. (La Mesa CA) Kienle Gunther W. (El Cajon CA), Sleep apnea monitor.
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Karakasoglu Ahmet ; Hung Chin N. ; Matouk Anthony F. ; Grotte Lawrence C., Sleep apnea screening and/or detecting apparatus and method.
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Estes Mark C. (Irwin PA) Cattano Janice M. (Gibsonia PA), Sleep apnea treatment apparatus.
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Estes Mark C. ; Cattano Janice M., Sleep apnea treatment apparatus.
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Mechlenburg Douglas M. (Pittsburgh PA) Kimmel Steven A. (Greensburg PA) Fiore John H. (Pittsburgh PA), Sleep apnea treatment apparatus.
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Mechlenburg Douglas M. (Pittsburgh PA) Kimmel Steven A. (Greensburg PA) Fiore John H. (Irwin PA), Sleep apnea treatment apparatus and passive humidifier for use therewith.
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Estes Mark C. ; Cattano Janice M., Sleep apnea treatment apparatus with a therapy delay circuit arrangement.
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Ogino Hiroyuki (Nara JPX), Sleep detecting apparatus.
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Froehlich James P. (Berlin PA) Mitchell Joseph N. (Rockwood PA) Jones Stephen M. (Turtle Creek PA), Standby control for CPAP apparatus.
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Kimm Gardner J. (Carlsbad CA) Gee Glen N. (Encinitas CA) Fennema Paul J. (Fallbrook CA) Sanborn Warren G. (Escondido CA), System and method for flow triggering of pressure supported ventilation by comparison of inhalation and exhalation flow.
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Brisson A. Glen (Arlington Heights IL), Temperature control system with alarm and shut down for non-tracking condition of dual thermometers.
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Eichler, Rudiger, Testing of the airways and pulmonary tract of a patient, particularly for sensitivity to aerosols.
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Wilkinson Mark A. (Marietta GA), Thermistor airflow sensor assembly.
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Pearce Stephen D. (14 Malabu Dr. Highland Heights KY 41076), Transducer for detecting apnea.
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McWilliams Roger D. (San Diego CA), Triggering of patient ventilator responsive to a precursor signal.
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Hkkinen Taisto (Hmeenlinna FIX), Ultrasonic atomizer.
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Holscher Russell L. (Olathe KS), Valve for use with inhalation/exhalation respiratory phase detection circuit.
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Osborn ; John J., Variable orifice gas flow sensing head.
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McKelvey Wilfred G. (Palos Verdes CA), Variable pitch axial fan.
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Weismann Dieter (Gross Gronau DEX) Colla Gregory-Alan (North Sydney AUX) Fiebelkron Dirk (Lubeck DEX), Ventilating system for supplying a patient with respiratory gas and method for triggering the respiratory phases in said.
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Visveshwara Nadarasa (Fresno CA) Freeman Bruce J. (Fresno CA), Ventilation synchronizer.
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Strom Christer,SEX, Ventilator for respiratory treatment.
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Rowland Robert O. (Hemet CA), Ventilator monitor and alarm apparatus.
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IPC	Description
A	생활필수품
A62	인명구조; 소방(사다리 E06C)
A62B	인명구조용의 기구, 장치 또는 방법(특히 의료용에 사용되는 밸브 A61M 39/00; 특히 물에서 쓰이는 인명구조 장치 또는 방법 B63C 9/00; 잠수장비 B63C 11/00; 특히 항공기에 쓰는 것, 예. 낙하산, 투출좌석 B64D; 특히 광산에서 쓰이는 구조장치 E21F 11/00)
A62B-1/08	.. 윈치 또는 풀리에 제동기구가 있는 것

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 국가코드, 자료구분, 상태, 출원번호, 출원일자, 공개번호, 공개일자, 등록번호, 등록일자, 발명명칭(한글), 발명명칭(영문), 출원인(한글), 출원인(영문), 출원인코드, 대표IPC 관리번호, 국가코드, 자료구분, 상태, 출원번호, 출원일자, 공개번호, 공개일자, 공고번호, 공고일자, 등록번호, 등록일자, 발명명칭(한글), 발명명칭(영문), 출원인(한글), 출원인(영문), 출원인코드, 대표출원인, 출원인국적, 출원인주소, 발명자, 발명자E, 발명자코드, 발명자주소, 발명자 우편번호, 발명자국적, 대표IPC, IPC코드, 요약, 미국특허분류, 대리인주소, 대리인코드, 대리인(한글), 대리인(영문), 국제공개일자, 국제공개번호, 국제출원일자, 국제출원번호, 우선권, 우선권주장일, 우선권국가, 우선권출원번호, 원출원일자, 원출원번호, 지정국, Citing Patents, Cited Patents
저장형식	Text(ASCII format) Excel format PIAS분석(.xls)
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증

Administration of CPAP treatment pressure in presence of apnea 원문보기

초록 ▼

대표청구항 ▼

연구과제 타임라인

이 특허에 인용된 특허 (155)

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연합인증

Administration of CPAP treatment pressure in presence of apnea 원문보기

초록 ▼

대표청구항 ▼

연구과제 타임라인

전체(0) 논문(0) 특허(0) 보고서(0)

전체(0) 논문(0) 특허(0) 보고서(0)

이 특허에 인용된 특허 (155)

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IPC 상위 출원인

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

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