(12) United States Patent (16) Patent N6.= US …...U.S. Patent Apr. 8, 2003 Sheet 16 0f 20 US...

US006543449B1

(12) United States Patent (16) Patent N6.= US 6,543,449 B1 W00dring et al. (45) Date of Patent: Apr. 8, 2003

(54) MEDICAL VENTILATOR 4,637,385 A * 1/1987 RusZ ................... .. 128/204.21 4,867,152 A * 9/1989 K011 e161. ........... .. 128/204.21

Inventors: Paul I4I woodring, Del Mar, A * ViCeIlZi et al. . . . . . . . .. Gardner J. Kimm, Carlsbad, CA (US); 2732798; 2 31338 gobayashi 6‘ a1- ~~~~ ~1‘2‘213/52/(1y9‘92-i , , 1 1n ................... .. .

Rob?" Listephenson’ Carlsbad’ CA 5,117,819 A * 6/1992 SCIEVidiO et al. ..... .. 128/204.18 (US), David R. Rogers, Solana Beach, 5 211 170 A 5/1993 P 128

_ _ , , ress ................... .. /204.18

CAGE); Donald J- N°Vk°V> Enclmtas’ 5,231,981 A 8/1993 Schreiber et al. 128/205.23 CA(US); Rebecca A- Mabry, Rancho 5,320,489 A 6/1994 McKenna .............. .. 415/208.3 Santo Margarita, CA (US); Steve 5,495,077 A 2/1996 Miller et al. Harrington, Cardiff, CA (US) 5,537,997 A 7/1996 Mechlenburg et al.

5,660,171 A 8/1997 Kimm et al. (73) Assignee: Respironics, Inc. 5,678,539 A 10/1997 Schubert et al. ..... .. 128/204.21

5,694,926 A 12/1997 DeVries et al. ( * ) Notice: Subject to any disclaimer, the term of this

patent is extended or adjusted under 35 FOREIGN PATENT DOCUMENTS

U.S.C. 154(b) by 0 days. W0 WO 98/41267 9/1998 W0 WO 98/41269 9/1998

. W0 W0 98/41270 9/1998 (21) Appl' NO" 09/156’463 W0 W0 98/41271 9/1998

(22) Filed: Sep. 18, 1998 , Cited by examiner

Related U-S- Application Data Primary Examiner—Aaron J. LeWis (60) Provisional application No. 60/059,676, ?led on Sep. 19, (74) Attorney) Agent) Or Firm_TrOutman Sanders LLP;

1997' Gerald R. Boss; Ryan A. Schneider (51) Int. Cl.7 ............................................. .. A61M 16/00 (52) US. Cl. .......................... .. 128/204.18; 128/204.21; (57) ABSTRACT

128/205-23 A ventilatory system Which may be operated in an invasive (58) Field of Search ..................... .. 128/204.18, 204.21, and a non-invasive mode is provided utilizing a graphical

128/20423, 205.23 user interface for presenting only those controlled param eters utiliZed for that speci?c mode of operation. Volume and

(56) References Cited pressure ventilatory support parameters are included for U S PATENT DOCUMENTS invasive ventilation and non-invasive ventilation control

' ' parameters are provided for non-invasive ventilatory assis

3,250,458 A 5/1966 Caldwell .................. .. 230/129 tance. The graphical user interface enables an operator to 3,676,013 A 7/1972 Albertson - - - - - - - - - - -- 415/128 select the desired mode of operation Wherein only those

3,976,064 A * 8/1976 Wood et a1~ ~~ 128/204~21 parameters related to that speci?c mode of operation are

2 i g0)‘ cf ali ~ ~ ~ ~ ~ ~ ~ ~~ presented. Furthermore, a bloWer is provided for providing , , oemg e a. . . ~ ~ ~ -

4,345,612 A * 8/1982 KOIli et al. 128/204.21 to the Vennlator enabhng the Vennlator to be

4,380,233 A * 4/1983 Caillot . . . . . . . . . . . . .. 128/204.21 '

4,579,115 A * 4/1986 Wallroth et al. 128/204.21 4,584,996 A * 4/1986 Blum .................. .. 128/20421 29 Claims, 20 Drawing Sheets

,20

o o o o o o o I o o a o 0 WW Alum All/m M. :61." @ mums - M."

8 Mmnw M M.

26 24

U.S. Patent Apr. 8,2003 Sheet 1 0f 20 US 6,543,449 B1

U.S. Patent Apr. 8,2003 Sheet 2 0f 20 US 6,543,449 B1

U.S. Patent Apr. 8,2003 Sheet 3 0f 20 US 6,543,449 B1

,20 ,/

Fooooo 500G001] O O Notmal Alarm Alarm ‘lam Salary @ ‘00% Screen Enlmal '-— Binlry —- MUM

High Med/Low non Valve '31 Lock Emmy In Us: Chlrqmq Law

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26 24

FIG 3

U.S. Patent Apr. 8,2003 Sheet 4 0f 20 US 6,543,449 B1

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FIG 4

U.S. Patent Apr. 8,2003 Sheet 5 0f 20 US 6,543,449 B1

U.S. Patent Apr. 8,2003 Sheet 7 0f 20 US 6,543,449 B1

U.S. Patent Apr. 8,2003 Sheet 8 0f 20 US 6,543,449 B1

U.S. Patent Apr. 8,2003 Sheet 9 0f 20 US 6,543,449 B1

"4 146 I44

'06 F IG J3

1-76.14

US 6,543,449 B1 Sheet 10 0f 20 U.S. Patent Apr. 8,2003

47? — M7 —-\\ FIG J6

Ill/1111010,“ .\ // /58

I I58

U.S. Patent Apr. 8,2003 Sheet 11 0f 20 US 6,543,449 B1

300

302

304

306

508

FIG 19

U.S. Patent Apr. 8,2003 Sheet 12 0f 20 US 6,543,449 B1

FIG 20

402

I46

404

U.S. Patent Apr. 8, 2003 Sheet 13 0f 20 US 6,543,449 B1

Setting ?ange Units Ventilation Type Volume. Pressure, none

Non-invasive Mode (Volume Ventilation) A/C. SIMV. CPAP none Mode (Pressure Control Ventilation) A/C, SlMV, CPAP none Mode (Noninvasive Ventilation) Spent/Timed, Spont none Apnea Interval 10 - 60 seconds

Apnea Rate 1 - 80 Bpm Wave Form Square, Ramp none Peak Flow 3 - 140 Lpm Tidal Volume 50 - 2500 ml

Respiratory Rate 1 - 80 Bpm Plateau 0.0 - 2.0 seconds

Pressure Sensitivity 0.1 - 20.0 cmH2O E-Trigger 10 - 45 % Peak Flow PEEP/CPAP 0 - 35 cmH20

Pressure Support (PSV) O - 100 cmH20 Risetime 0.1 to 0.9 seconds 02% 21 - 100 % Oxygen

lPAP 2 - 35 cmH20 EPAP 2 - 25 cmH20 l-Time .1 to 9.9 seconds Pressure Control 5 to 100 cmH20 Patient Type Adult, Pediatric

FIG 22

U.S. Patent Apr. 8, 2003 Sheet 14 0f 20

174 204 206 164

US 6,543,449 B1

166

{160/ 172/ 162 1/ / 1,200 ‘[202’

Monitor “Patient Data Active Mode: Pressure-Assist/Control

2”’ FIG 23

Monitor Patient Data Active Mode: Pressure - Assist/Control H 10:05 AM

Vdume Pressure I Noninvasive I] Alarms LA/C ill SIMV [tcPAP | Q 19 —->

[1 Rate 1 12 W 02 J 21 92° [TidalVolumel5OO mL Plateau [0.0 gm

Peak Flow 1 30 W Apnea Rate I 12 ILPM

H.’ r O cmHzO _PatjegltPDa7tg8 crnH2O Mend In PSV “H2O 1922x120 Assist 0 ‘4MP

VE 811 L

“ l-Trigger 1 2,0 “H2O Vt 394 mL Plateau _

“t E-Trigger J 25 % :jppfn l Rise-Time l 0.1 Sec Expligle

-20

FIG 24

Volume / Presstfe I Ng/nlnvasive/ J1 / Alarms 193 I 7 I I I

NC HLSIMV I CPAP [\WH | k 4 Active 1,192 120 194

Rate I 12 am 02 1 21 % _//

Tidal Volume 1500 m Ptateau 1 0.0 w _/,196 Peak Flow l 30 W Apnea Rate 12 PM —

PEEP I 0 —Pat1ent Data “H2O P1P 7248 cmH2O Mand

Psv I 0 MAP 108 cmH2O PmH2O RR 13 BPM Assist '

_ VE 81.1 L _<]H'P l-Trtgger l 2,0 ammo vt 394 mL Plateau _ )208

E-Trigger 25 0 Support '/ ' l _ A Spont

[L01 e

U.S. Patent Apr. 8,2003 Sheet 15 0f 20 US 6,543,449 B1

Volume Pressure

—~120 I No slmvjFcPAp | | Rate l 12 8PM

I“ Tidal Volume I 500 m I H Peak Flow [ 30 W "Crease

ll PEEP l 0 MO 128% _ [L PSV I O cmH2O Decrease

‘ll l-Trigger I 20 OM20 H E-Trigger I 25 %

Risemme 1 0-1 see Cancel Accept H 20

Monitor [Patient Data

FIG 25 f 209

Volume _‘ Pressure I Nonlnvasivgl ] Alarms . Volume Control '

lHHlgh Pressure] 35 mm NarmsActive _120 — Settjn s ——— -

'1 Low Pressure 3 crnH2O Rateg 12 BPM _ Vt 600 l.

I 0/002 21 % _ cmHzO PEEP O cmH20

I~Tngger 2.0 cmH20 - Low Vt Mand l O '"L ~Patient Data——— Mend *

PIP 332 H2O - LOWVtSpOHt l 0 mL 53520 Assist _QH|P - VE 86.7 L Plateau a

High Rate I 150 BPM Vt 649 mL Support ~

Low vE 1 1,00 L Spont - Exhale (lb ' 20

I Apnea I 20 Sec ‘

Monitor I Patient Data Active Mode: Pressure - Assist/Control1I1 0:08 AMJ

FIG 26

U.S. Patent Apr. 8, 2003 Sheet 16 0f 20 US 6,543,449 B1

210

212

214

216

218

220

222

224

///// /

/

‘ Volume I Pressure Nonlnvasg I Alarms | NC I" SIMV ?cPAP l] .3 Active

l Rate I 12 W 02 L21 % _12o Pressure I 20 mL Apnea Rate 1 12 PM *

l-Time 1 ‘L0 ~PatientData——— H PEEP I O M‘iiii 2%2

“H2O 6E 811.? ?PM Manci - ‘m PSV I O cmH2O v‘ 394 mL Assist 9 ‘QHIP

ll "Trigger I 2-0 CW0 Plateau _

m E-Trigger l 25 0/ support me Spom

H I [Sec Exha|e A 20

Monitor Patient Data Active Mode: Pressure - Assist/Control I 9:59 AM

FIG 27

Monitor Patient Data I[Active Mode: Pressure-Assist/Control 11:11AM

[209 Volume I Pressure ] Noninvasive? I Alarms _ Activate

lnHigh Pressure I 35 “1H2 0 Volume Control #120

“Low Pressurej 3 mm w seglaggs 1;; _ VI 600 me _

[l Low PEEP I 0 MKS/5V2“ glib/fl” - cmHzO PEEP O crnH2O _

[LOW Mandi O L l Trigger 240 cmH2O _ I "‘ —Patient Data—‘— Mend -

PllP 78.9 crnH2O - “Lowvtspont l 0 mL MAP 63.4 cmH2o Assist <1HiP

RR 32 BPM Plat - VE 68.6 L eau _

H Hlgh Rate I 150 m W 330 m5 Support _

I" LowVE I 100 L 8mm Exhale (I) ‘

Apnea l 20 sec ‘ 20

FIG 28

U.S. Patent Apr. 8, 2003 Sheet 17 0f 20 US 6,543,449 B1

1 Volume 1 Pressure Noninvasive I Alarms Press C trol

i Apnea I 20 320 “High Pressure 35 WHO 1" Settings ~ _

; Rate 12 BPM _

“Low Pressure l 3 “H2O Nixie 8 Elmo _ 0/002 21 % PEEP 0 cm i H Low I 0 cmH2O i-Tn'gger 2.0 cmtgig —

Low vi Mand ~Patient Data — - H I 0 mL PIP 105 crni-i2O Mend - H Low VtSpont I 0 MS: is): $82520 Assist _<iHIP

' ‘"L VE 17.7 L Plateau

Iii High Rate 1 150 W W 34 ml Support ~

H Low VE l 1,00 Spont i L Exhale (D 20

i HlghvE I 60.0 L -

Monitor I Patient Data Active Mode: Pressure-Assisi/Control | 10:08AM

226\ Volume’ ] Pressure 1 Noninvasive Alarms 55f?‘ Spont/T LSpont i mi Active

_ Rate I 12 W 02 l 21 / _120 232 _

EPAP 1 5 Apnea Rate I 12 PM cmH2O ‘

‘PAP L 5 ePatlent Data -— m; Mill: are

. RR 13

238 l-Time J 1.0 Sec VE 81.1 EPM Mand -

Rise-Tim l 0 5 Vt 394 mL Assist 6 a 240 e ' Sec Plateau —

_ ' s 242 i Trigger [ 3_() W uppori I Spont

E'Tr'gger L 25 0/c Exhale A" 20

Monitor I Patient Data Active Mode: Pressure-Assist/Contmi 10:03AM ll

FIG 30

U.S. Patent Apr. 8,2003 Sheet 18 0f 20 US 6,543,449 B1

Volume '1 Pressure I Noninvasive Alarms Noninvasive Control 120

“Low Pressure 1 3 Alarms Act’ve - “H2O — Settings _

I Rate 12 BPM

‘1 LOW I O IPAP 6 cmH2O ml- EPAP 6 crnH2O

%02 21 % i-Tirne 1.0 See

LOW Vt 1 O L i-Trigger 3.0 LPM m

—Patient Data "*

'9 a e 150 BPM MAP 63.4 cmH2O Assist _ RR 32 BPM VE 68.6 L Plateau _

In Low VE l L Vt 330 mL Support ‘ - _

Spont w _

Exh | v.4 H Apnea I 20 Sec 89 ®_2O

Monitor IJPatient Data lpicuve Mode: Pressure-Assist/Controi ‘10:09AM

FIG 3/! 244

f

Voiume I Pressure Noninvasive Alarms —Pressure —— ~Voiume ———~——- Rate 120

PiP Tidal Vol Spont Rate _ I

33.2 549 7.4 " cmH2O rnL BPM '

MAP SpontVE Rate

54.0 61.1 88 cmH2O L 8PM

End Exp Totai VE F/Vt Mand "

-6.8 86.7 346 Assisi ?HIP °mH2O L Plateau 4

Plateau %O2 i:E Ratio Support

33.4 97.5 2.011 Spent _

CmH2O 3c 5].. Exhaie (D _ 20

Monitor 1Patient Data Active Mode: Pressure-Assist/Controi [I 11:14AM

‘2" FIG 32

U.S. Patent Apr. 8, 2003 Sheet 19 0f 20 US 6,543,449 B1

/ 246

Volume I] Pressure I Noninvasive Alarms P Patient Data — —Setl1'ngs _ _12O

Tidal Vol Rate Peak Flow _

549 1 2 30 “ mL BPM LPM

Rate Tidal Volume PEEP

88 500 0 - 5PM m_ cmHZé _

Total VE %o2 Mam “

86.7 21 Assist _4H|P '- % Plateau _

PIP Support 1

33.2 Spam 5 cmH2O q

Exhale (I) _ 20

MOi'iitOf Patient Data Active Mode: Pressure - Assist/Control 11:14 AM

246 f

‘H Volume I Pressure I Noninvasive Alarms — Patient Data — —Setti ngs _ _12O

Tidal Vol Rate l-Time _

394 1 2 l 1.0 - mL BPM Sec

Rate Pressure PEEP

13 20 J o 5PM cmH2U cmH20

Total VE %O2 Mand -

81.1 21 Assist 9 'KJHiP

pip L % Plateau

72.8 SUPPO" cmH2O Spont

Exhale

Monitor mPatient Data ILActlve Mode: Pressure - Assist/Control I 11:14 AM

FIG 34