Methods and apparatus for providing ventilation to a patient

Abstract

An apparatus to generate pressure support ventilation and a method to control pressure support ventilation. The apparatus comprises: at least one sensor adapted to measure at least one respiratory parameter; a flow generator adapted for coupling with a patient respiratory interface; and a controller, coupled to the at least one sensor and the flow generator. The flow generator is configured to provide a flow of breathable gas for pressure support ventilation to the patient respiratory interface. The controller is configured to control the pressure support ventilation with the flow generator. The controller is further configured with a rest mode and an exercise mode. The rest mode comprises a first value set of control parameters for the pressure support ventilation and the exercise mode comprises a second value set of control parameters for the pressure support ventilation.

1 . An apparatus to generate pressure support ventilation, comprising:
 at least one sensor adapted to measure at least one respiratory parameter;   a flow generator adapted for coupling with a patient respiratory interface, the flow generator configured to provide a flow of breathable gas for pressure support ventilation to the patient respiratory interface; and   a controller, coupled to the at least one sensor and the flow generator, the controller configured to control the pressure support ventilation with the flow generator, the controller being further configured with a rest mode and an exercise mode, the rest mode comprising a first value set of control parameters for the pressure support ventilation and the exercise mode comprising a second value set of control parameters for the pressure support ventilation,   wherein the controller is configured to receive a user activated trigger stimulus, and to select, in response to the trigger stimulus, the second value set of control parameters for the exercise mode,   wherein the apparatus further comprises one or more sensors configured to activate the controller, wherein the one or more sensors are configured to actuate the trigger stimulus, wherein the one or more sensors comprise a diaphragm electromyogram sensor and/or a vagal nerve sensor.   
     
     
         2 . The apparatus of  claim 1  wherein, in response to the trigger stimulus, the controller sets a target respiratory control parameter as a function of a presently detected respiratory parameter sensed with the sensor. 
     
     
         3 . The apparatus of  claim 2  wherein the target respiratory control parameter is a target respiratory rate and the detected respiratory parameter is a measured respiratory rate. 
     
     
         4 . The apparatus of  claim 3  wherein the target respiratory control parameter is a target ventilation and the detected respiratory parameter is a measure of ventilation. 
     
     
         5 . The apparatus of  claim 4  wherein the target ventilation is a target tidal volume and the measure of ventilation is a measure of tidal volume. 
     
     
         6 . The apparatus of  claim 5  wherein the target ventilation is a target minute ventilation and the measure of ventilation is a measure of minute ventilation. 
     
     
         7 . The apparatus of  claim 5  wherein the second value set of control parameters comprises an increase in target values with respect to the first value set of control parameters. 
     
     
         8 . The apparatus of  claim 2  further comprising at least one user accessible button to activate the controller, the button being configured for actuating the trigger stimulus. 
     
     
         9 . The apparatus of  claim 2  wherein the one or more sensors comprise the diaphragm electromyogram. 
     
     
         10 . The apparatus of  claim 2  wherein the one or more sensors comprises the vagal nerve sensor. 
     
     
         11 . The apparatus of  claim 1 , wherein the controller is further configured with a cool down mode, and to receive another user activated trigger stimulus to initiate the cool down mode, the cool down mode comprising a third value set of control parameters for the pressure support ventilation. 
     
     
         12 . The apparatus of  claim 11  wherein a value of the control parameters of the cool down mode is varied from a respective value of the control parameters of the exercise mode toward a respective value of the control parameters of the rest mode. 
     
     
         13 . The apparatus of  claim 12  wherein a value of the control parameters of the cool down mode is ramped from a respective value of the control parameters of the exercise mode toward a respective value of the control parameters of the rest mode. 
     
     
         14 . A method for control of pressure support ventilation, comprising:
 measuring at least one respiratory parameter with a sensor;   generating pressure support ventilation with a flow generator adapted for coupling with a patient respiratory interface;   controlling, with a processor, the pressure support ventilation in a rest mode and an exercise mode, the rest mode comprising a first value set of control parameters for controlling the pressure support ventilation and the exercise mode comprising a second value set of control parameters for controlling the pressure support ventilation; and   
       receiving, in the processor, a user activated trigger stimulus, and, in response to the trigger stimulus, selecting the second value set of control parameters for the exercise mode
 wherein one or more sensors activate the controller, wherein the one or more sensors actuate the trigger stimulus, wherein the one or more sensors comprise a diaphragm electromyogram sensor and/or a vagal nerve sensor. 
 
     
     
         15 . The method of  claim 14  further comprising, in response to the trigger stimulus, setting a target respiratory control parameter as a function of a presently detected respiratory parameter sensed with the sensor. 
     
     
         16 . The method of  claim 15  wherein the target respiratory control parameter is a target respiratory rate and the detected respiratory parameter is a measured respiratory rate. 
     
     
         17 . The method of  claim 15  wherein the target respiratory control parameter is a target ventilation and the detected respiratory parameter is a measure of ventilation. 
     
     
         18 . The method of  claim 17  wherein the target ventilation is a target tidal volume and the measure of ventilation is a measure of tidal volume. 
     
     
         19 . The method of  claim 17  wherein the target ventilation is a target minute ventilation and the measure of ventilation is a measure of minute ventilation. 
     
     
         20 . The method of  claim 17  wherein the second value set of control parameters comprises an increase in target values with respect to the first value set of control parameters. 
     
     
         21 . The method of  claim 14 , wherein a user accessible button actuates the trigger stimulus. 
     
     
         22 . The method of  claim 14 , wherein the diaphragm electromyogram sensor actuates the trigger stimulus. 
     
     
         23 . The method of  claim 14 , wherein the vagal nerve sensor actuates the trigger stimulus. 
     
     
         24 . The method of  claim 14 , further comprising controlling pressure support ventilation in a cool down mode in response to receiving another user activated trigger stimulus, the cool down mode comprising a third value set of control parameters for the pressure support ventilation. 
     
     
         25 . The method of  claim 24  wherein a value of the control parameters of the cool down mode is varied from a respective value of the control parameters of the exercise mode toward a respective value of the control parameters of the rest mode. 
     
     
         26 . The method of  claim 25  wherein a value of the control parameters of the cool down mode is ramped from a respective value of the control parameters of the exercise mode toward a respective value of the control parameters of the rest mode.