Providing Automated or Manual Guidance on Dynamic Patient Positioning Based on Measured Variables for Ventilation Control

Abstract

Methods and systems that incorporate automated or manual control of ventilation and kinetic rotation therapy are provided. In one exemplary embodiment, an artificial ventilator is used to artificially ventilate one of the patient's lungs, the status of the artificially ventilated lung is determined by measuring one or more ventilation status measures, and one or more of the ventilation status measures is used to provide feedback for controlling the positioning of the patient. In some exemplary embodiments, the feedback is used for automated control of the positioning of the patient, while in other exemplary embodiments, the feedback is used as guidance for manual control of the positioning of the patient.

1 - 29 . (canceled) 
     
     
         30 . A system for optimizing treatment for a patient, the system comprising:
 a bed having a support surface that is adjustable between two or more positions having distinct position parameters;   an artificial ventilator configured to artificially ventilate a lung of the patient, the artificial ventilator having one or more adjustable ventilation parameters;   measuring equipment configured to obtain values for at least one of: physiological parameters, ventilation parameters, and position parameters;   one or more information processors coupled to the measuring equipment to receive the values from the measuring equipment, the one or more information processors configured to output a signal indicative of an adjustment to the position of the support surface based on the values obtained by the measuring equipment.   
     
     
         31 . The system of  claim 30 , where the one or more information processors are also configured to adjust the one or more ventilation parameters. 
     
     
         32 . The system of  claim 30 , where the support surface is rotatable about its longitudinal axis. 
     
     
         33 . The system of  claim 30  where the support surface is configured to adjust the pitch of the patient. 
     
     
         34 . The system of  claim 30 , where the support surface comprises adjustable air bladders. 
     
     
         35 . The system of  claim 30 , where the control system automatically adjusts one or more ventilation parameters and one or more position parameters to minimize a cost function. 
     
     
         36 . The system of  claim 30  where the information processor is configured to output an audible or visible indicator indicative of values of one or more ventilation parameters and position parameters that minimize the cost function. 
     
     
         37 . The method of  claim 30 , where the information processor is configured to determine a desired position of the support surface by minimizing the value of a cost function that is based on one or more physiological parameters, ventilation parameters, and position parameters. 
     
     
         38 . A method of optimizing the treatment of a patient, the method comprising:
 using an artificial ventilator to artificially ventilate a lung of the patient that is supported on a support surface that is adjustable between two or more positions having distinct position parameters;   obtaining with measuring equipment a value of a physiological parameter of the patient; and   determining with an information processor position parameters that are expected to improve the physiological parameter;   adjusting the position parameters of the support surface in accordance with the determined position parameters.   
     
     
         39 . The method of  claim 38 , further comprising:
 obtaining a value of a ventilation parameter of artificial ventilation provided to the patient;   determining with the information processor ventilation parameter that are expected to improve the physiological parameter; and   adjusting the ventilation parameter in accordance with the determined ventilation parameter.   
     
     
         40 . The method of  claim 39 , where the information processor determines the position parameters and the ventilation parameter by minimizing the value of a cost function that is based on the physiological parameter, the ventilation parameter, and the position parameters. 
     
     
         41 . An apparatus for improving treatment of a patient, the controller comprising:
 an information processor configured to:
 receive signals indicative of one or more ventilation parameters, signals indicative of position parameters indicative of the position of a patient support surface, and signals indicative of one or more physiological parameters of a patient; 
 determine position parameters that are expected to improve the physiological parameter based on the one or more physiological parameters and the one or more ventilation parameters; and 
 output a signal indicative of the determined position parameters. 
   
     
     
         42 . The apparatus of  claim 41 , where the information processor is configured to determine the position parameters by minimizing the value of a cost function that is based on one or more physiological parameters, ventilation parameters, and position parameters. 
     
     
         43 . The apparatus of  claim 41 , where the information processor is further configured to:
 determine one or more ventilation parameters that are expected to improve the physiological parameter based on the position parameters, the one or more physiological parameters, and the one or more ventilation parameters; and   output a signal indicative of the determined ventilation parameters.   
     
     
         44 . The apparatus of  claim 43 , where the information processor is configured to determine the ventilation parameters by minimizing the value of a cost function that is based on one or more physiological parameters, ventilation parameters, and position parameters. 
     
     
         45 . The apparatus of  claim 43 , where the information processor is configured to output the signals indicative of the determined position parameters and the determined ventilation parameters to one or more controllers that are configured to automatically adjust a ventilation parameter to approximately a determined ventilation parameter, and to automatically adjust the position of the patient support to approximately correspond to the determined position parameters. 
     
     
         46 . The apparatus of  claim 43 , where the information processor is configured to:
 receive a signal indicative of a first value of a first physiological parameter when a first ventilation parameter is at an initial value and the support surface is in a first position;   receive a signal indicative of a second value of the first physiological parameter when the first ventilation parameter is at a subsequent value;   receive a signal indicative of a third value of the first physiological parameter when the support surface is in a second position; and   calculate a minimum value of a cost function to determine desired values of the first ventilation parameter and for the position parameters, wherein the cost function is calculated using: the initial and subsequent values of the first ventilation parameter, position parameters corresponding to the first and second positions of the support surface, and the first, second and third values of the first physiological parameter.   
     
     
         47 . The apparatus of  claim 46 , where the information processor is configured to:
 obtain a first value of a second physiological parameter when the first ventilation parameter is at the initial value and the support surface is in the first position;   obtain a second value of the second physiological parameter when the first ventilation parameter is at the subsequent value;   obtain a third value of the second physiological parameter when the support surface is in the second position; and   calculate a minimum value of the cost function to determine desired values for the first ventilation parameter and for the position of the support surface, wherein the cost function is calculated using the initial and subsequent values of the first ventilation parameter, the first and second positions of the support surface, and the first, second and third values of the first and second physiological parameters.   
     
     
         48 . The apparatus of  claim 39 , where the cost function is defined using one or more of the following measurements: the air viscosity factor of the patient's lungs, the barometric pressure, the lung elastance factor of the patient, the measured levels of carbon dioxide and oxygen of the patient, and the metabolic rate ratio of the patient. 
     
     
         49 . The apparatus of  claim 41 , where the one or more physiological parameters comprise one or more of: a respiratory parameter, direct VO 2 , paO 2 , pulmonary mechanics measurements, upper and lower inflection points of the expiratory and inspiratory pressure-volume curves and the airway pressure at the point of maximal pressure-volume compliance (Pmax), a hemodynamic parameter, DO 2 , indirect VO 2 , SpO 2 , invasive cardiac output, cardiac stroke work, stroke volume, right heart end diastolic volumes, pulmonary vascular resistance, pulmonary capillary pressures, pulmonary vascular compliance, O 2  extraction ratio, Qs/Qt shunt fraction, and extravascular lung water measurements.