U.S. patent application number 14/768113 was filed with the patent office on 2016-01-07 for breathing apparatus with ventilation strategy tool.
This patent application is currently assigned to Maquet Critical Care AB. The applicant listed for this patent is MAQUET CRITICAL CARE AB. Invention is credited to Madlene Lahtivuori, Ake Larsson, Arne Lindy, Anette Sunna.
Application Number | 20160001024 14/768113 |
Document ID | / |
Family ID | 47739249 |
Filed Date | 2016-01-07 |
United States Patent
Application |
20160001024 |
Kind Code |
A1 |
Larsson; Ake ; et
al. |
January 7, 2016 |
BREATHING APPARATUS WITH VENTILATION STRATEGY TOOL
Abstract
A system includes a breathing apparatus, a display unit and a
processing unit that is operatively connected to the display unit.
The processing unit is configured to provide a graphical
visualization on the display unit. The graphical visualization in
turn includes a combination of a target indication for at least one
ventilation related parameter of a ventilation strategy for a
patient ventilated by the apparatus, and a reciprocating animation
of the at least one ventilation related parameter relative the
target indication. The target indication is for instance based on
input of a user, such as an operator of the breathing apparatus.
Alternatively, or in addition, it may be a default value stored on
a memory unit being operatively connected to the processing unit.
Alternatively, or in addition, the target indication is based on a
measurement value of said patient's physiology or anatomy. In this
manner, the system informs clinicians in a clear and easily
understandable way how a current patient ventilation is related to
a chosen ventilation strategy.
Inventors: |
Larsson; Ake; (Jarfalla,
SE) ; Lahtivuori; Madlene; (Johanneshov, SE) ;
Sunna; Anette; (Johanneshov, SE) ; Lindy; Arne;
(Bromma, SE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
MAQUET CRITICAL CARE AB |
Solna |
|
SE |
|
|
Assignee: |
Maquet Critical Care AB
Solna
SE
|
Family ID: |
47739249 |
Appl. No.: |
14/768113 |
Filed: |
February 15, 2013 |
PCT Filed: |
February 15, 2013 |
PCT NO: |
PCT/EP2013/053073 |
371 Date: |
August 14, 2015 |
Current U.S.
Class: |
128/205.23 |
Current CPC
Class: |
G09B 23/288 20130101;
G06F 19/00 20130101; A61M 2230/40 20130101; A61M 16/0051 20130101;
A61M 2205/502 20130101; G16H 40/63 20180101; G06T 13/00 20130101;
A61M 16/0003 20140204; A61M 16/021 20170801 |
International
Class: |
A61M 16/00 20060101
A61M016/00; G09B 23/28 20060101 G09B023/28; G06T 13/00 20060101
G06T013/00 |
Claims
1. A system including a breathing apparatus, a display unit and a
processing unit being operatively connected to said display unit,
said processing unit being configured to provide on said display
unit a graphical visualization including a combination of: a target
indication for at least one ventilation related parameter of a
ventilation strategy for a patient ventilated by said apparatus,
said target indication preferably being based on user input, such
as of an operator of said breathing apparatus, a measurement value
of said patient's physiology or anatomy, or a default value stored
on a memory unit being operatively connected to said processing
unit, and a reciprocating animation of said at least one
ventilation related parameter relative said target indication.
2. The system of claim 1, wherein said target indication being
displayed at a first position on said screen, wherein said first
position is fixed during said animation
3. The system of claim 1, wherein said reciprocating animation is
in synchronism with a breathing cycle or said ventilation related
parameter as measured for a ventilated patient, and moving from a
starting point to an end point in a to-and-fro motion relative said
target indication; wherein said starting point is preferably
variable with said ventilation related parameter at a breathing
cycle start time and synchronized therewith, and said end point is
preferably variable with said ventilation related parameter at an
end expiratory time of said breathing cycle and synchronized
therewith.
4. The system of claim 1, wherein said target indication is updated
at an interval during said ventilation.
5. The system of claim 1, wherein said graphical visualization
includes a plurality of said ventilation related parameters in a
combined target indication and reciprocating animation, each for
different ventilation related parameters, and wherein said combined
target indications and reciprocating animations are provided
adjoining each other.
6. The system of claim 5, wherein first and second combined target
indications and reciprocating animations are provided in different
graphical layout.
7. The system of claim 1, wherein said reciprocating animation
comprises different layouts for top values of said ventilation
related parameter larger than a first threshold larger than said
target indication, or less than a second threshold less than said
target indication, or lying outside of a range including said
target indication.
8. The system of claim 1, wherein said graphical visualization has
a graphical appearance dependent on operational parameters of said
breathing apparatus, including display of alarm limits, and
different graphical appearances when alarm limits or target values
are exceeded, display of additional metrics of ventilation related
parameters than of said reciprocating animation, such as a maximum
inspiratory pressure, a Positive End-Expiratory Pressure (PEEP), an
average airway pressure (Pmean) and a Plateau Pressure (PPlat).
9. The system of claim 1, including a further animating for an
ongoing respiration of said patient.
10. The system of claim 1, wherein said processing unit being
configured to receive input from an operator for selection of said
ventilation related parameter of said ventilation strategy and/or
for adjustment of a value for said target indication within a
pre-defined range; or said ventilation related parameter is a
default ventilation related parameter and/or said value for said
target indication is a default value stored in a memory of said
system accessible for said processing unit.
11. The system of claim 1, wherein said display unit is integrated
into said breathing apparatus and/or a separate display unit
communicative with said breathing apparatus.
12. The system of claim 1, wherein said graphical visualization is
provided as a graphical decision support means for said operator to
achieve said ventilation strategy.
13. A decision support system including comprising a breathing
apparatus, a display unit and a processing unit being operatively
connected to said display unit, said processing unit being
configured to provide on said display unit a graphical
visualization including a combination of: a target indication for
at least one ventilation related parameter of a ventilation
strategy for a patient ventilated by said apparatus, said target
indication preferably being based on user input, such as of an
operator of said breathing apparatus, a measurement value of said
patient's physiology or anatomy, or a default value stored on a
memory unit being operatively connected to said processing unit, a
reciprocating animation of said at least one ventilation related
parameter relative said target indication; and wherein said
graphical visualization facilitates said operator to take decisions
related to adjustments of ventilatory settings of said breathing
apparatus to pursue said ventilation strategy.
14. A computer-readable non-transitory, data storage medium encoded
with programming instructions, said data storage medium being
loaded into a processor of a system including comprising a
breathing apparatus, and a display unit operatively connected to
said processor, said processor being configured to provide on said
display unit a graphical visualization, and said programming
instructions causing said processor to include, in said graphical
visualization, a combination of a target indication for at least
one ventilation related parameter of a ventilation strategy for a
patient ventilated by said apparatus, said target indication
preferably being based on user input, such as of an operator of
said breathing apparatus, a measurement value of said patient's
physiology or anatomy, or a default value stored on a memory unit
being operatively connected to said processing unit, and a
reciprocating animation of said at least one ventilation related
parameter relative said target indication.
15. A graphical user interface for a system comprising a breathing
apparatus, a display unit and a processing unit operatively
connected to said display unit, said processing unit being
configured to provide on said display unit said graphical user
interface including a graphical visualization including a
combination of: a target indication for at least one ventilation
related parameter of a ventilation strategy for a patient
ventilated by said apparatus, said target indication preferably
being based on user input, such as of an operator of said breathing
apparatus, a measurement value of said patient's physiology or
anatomy, or a default value stored on a memory unit being
operatively connected to said processing unit, and a reciprocating
animation of said at least one ventilation related parameter
relative said target indication.
Description
BACKGROUND OF THE INVENTION
[0001] 1. Field of the Invention
[0002] This invention pertains in general to the field of breathing
systems for ventilating patients, the systems including apparatuses
having a display for providing graphical user interfaces
(GUI's).
[0003] 2. Description of Prior Art
[0004] During ventilation of a patient clinicians often seek to
maintain a certain ventilation strategy for a treatment which is
believed particularly advantageous for a ventilated patient.
[0005] However, there is hitherto no flexible tool to provide
clinicians with a status of an on-going ventilation in a clear and
easily understandable way when it comes to the crucial point of how
the current patient ventilation is related to a chosen ventilation
strategy.
[0006] Such a tool would in particular be desired to be adaptable
to the status an on-going ventilation of a patient during the
ventilation itself. Also, it would be desired if the tool provided
a feedback to the clinician that can be understood from a distance
from a breathing apparatus. It would be desired for instance to
provide a quick overview of a current ventilation strategy to the
clinical user. Each ventilation strategy has a target. A quick
identification of compliance of an ongoing ventilation with this
target to the clinical user would be desired and allow for faster
clinical decision taking related to the ventilation strategy. For
instance, a patient in an isolation room or during an x-ray
examination might not be approached by the clinician with undue
burden.
[0007] Thus, such a tool would be advantageous if it provided the
clinician with a current status of a ventilation in relation to a
desired strategy, even from a distance of a breathing
apparatus.
[0008] For instance for education of clinicians, it would be
advantageous if this tool was provideable without a patient
connected to the breathing apparatus, e.g. in a simulated
ventilation. This is for instance not achieved by an animated pair
of lungs moving synchronized with a breathing pattern as it only
visualizes an ongoing ventilation by animating inspiration and
expiration phases, but no information is provided by the animation
which is related to the clinical status of the ventilation. If a
ventilation strategy is changed by a clinical user, these
animations remain unchanged. Further, these animations are
identical for different patients and do not take into consideration
any individual characteristics of specific patients and their
influence on a ventilation strategy.
[0009] Hence, there is a need for such a tool implemented in a
system including a breathing apparatus that can provide the
ventilation, and based on adjustments thereof pursues the desired
ventilation strategy. Clinical decisions related to the treatment
of a ventilated patient might then be facilitated. Treatment of the
ventilated patient may be improved. Cost of care can potentially
reduced by the more effective treatment that can be provided when
considering such a clear and easily understandable way how the
current patient ventilation is related to the chosen strategy.
[0010] Thus, an improved breathing system for providing a clear and
easily understandable feedback for an on-going ventilation strategy
in relation to a desired outcome thereof would be advantageous.
[0011] This need is addressed by the solution according to the
current disclosure.
SUMMARY OF THE INVENTION
[0012] Accordingly, embodiments of the present disclosure
preferably seek to mitigate, alleviate or eliminate one or more
deficiencies, disadvantages or issues in the art, such as the
above-identified, singly or in any combination by providing
systems, methods, etc., according to the appended patent
claims.
[0013] According to an aspect of the disclosure, a system is
provided. The system includes a breathing apparatus, a display unit
and a processing unit that is operatively connected to the display
unit, the processing unit being configured to provide on the
display unit a graphical visualization including a combination of:
[0014] a target indication for at least one ventilation related
parameter of a ventilation strategy for a patient ventilated by the
apparatus, said target indication preferably being based on user
input, such as of an operator of said breathing apparatus, a
measurement value of said patient's physiology or anatomy, or a
default value stored on a memory unit being operatively connected
to said processing unit, and [0015] a reciprocating animation of
the at least one ventilation related parameter relative the target
indication.
[0016] This provides for clinicians accessing in a clear and easily
comprehensible way how the current patient ventilation is related
to the chosen strategy.
[0017] The ventilation strategy may include one or more ventilation
related parameters desired to obtain a certain value for the
specific patient, which is believed to be of particular value for
the patient's treatment. Ventilation related parameter might be a
desired ventilation per patient body weight, i.e. a tidal volume
per kg body weight [mL/kg Ideal Body Weight] and/or a certain
airway pressure. Other ventilation related parameters of such
ventilation strategies are for instance the inspiratory oxygen
concentration, the positive end expiratory pressure (PEEP), that
are desired to obtain certain values during ventilation to pursue
the ventilation strategy.
[0018] Another ventilatory parameter desired to obtain a certain
value for the specific patient within a desired ventilation
strategy is based on Inspired O2 (FiO2) and PEEP. A ratio of FiO2
to PEEP may be a suitable clinical parameter for a desired
ventilation strategy. Suitable values for the ratio may be selected
by the clinician or from a default value. The default value may for
instance be based on input of a target FiO2 or target PEEP only,
whereupon the processing unit automatically calculates a desired
ratio. Alternatively, or in addition, the two parameters may be
provided with their current values and individual targets,
respectively, in graphical visualizations aggregates comprising
multiple graphical visualizations as will be elucidated in the
detailed description.
[0019] Input of patient length and body weight may gives a default
target indication value, e.g. a Vt for a certain patient length and
body weight.
[0020] The graphical visualizations of the disclosure are
visualizations of a ventilatory strategy. It should be noted that
the visualizations are particularly advantageous in many clinical
applications.
[0021] For instance, it may be of particularly considerable value
when the ventilatory strategy is affected by ventilatory parameters
that are not directly linked to each other.
[0022] An example is when during Pressure Support Mode or Pressure
Control Mode of a breathing apparatus a ventilatory strategy
related to tidal volumes, as in some examples described below, is
desired, adjustments of ventilatory parameters of the breathing
apparatus are only related to ventilatory pressures, but no
adjustment of a volume to be delivered to the patient is possible.
The tidal volume delivered to the patient will result depending on
the patient's anatomy, the tubing used, etc. The graphical
visualizations as disclosed herein provide for an advantageous,
immediate feedback to the clinical user of which volume is
delivered to the patient in relation to a desired volume to be
delivered. Any deviations may quickly be corrected by adjusting
ventilatory parameters other than the ventilatory parameters of the
desired strategy. In the example, target pressures may be adjusted
accordingly by the clinical user such that a desired target
ventilation per patient body weight, i.e. a tidal volume per kg
body weight [mL/kg Ideal Body Weight], of the ventilatory strategy
is obtained upon the adjustment made. It should be noted that no
target volume can be directly set by the clinical user for
operating the breathing apparatus during Pressure Support Mode or
Pressure Control Mode.
[0023] Another example where the graphical visualizations of the
disclosure are of particularly considerable value is a Volume
controlled breathing mode. Here, the clinical user may adjust
volume related targets in the breathing apparatus, like a minute
volume of breathing gas to be delivered to the patient. However, it
may as part of a ventilation strategy be desired to keep patient
pressures within certain ranges, below certain threshold values,
etc. As pressures are resulting from the volume related adjustments
and targets for the pressures may not be entered in these
ventilation modes, the graphical visualizations of the disclosure
provide a particularly advantageous tool for the clinical user.
Again, any deviations from target pressures of a ventilation
strategy may quickly be corrected by adjusting ventilatory
parameters other than the ventilatory parameters of the desired
strategy. In the example, target minute volumes may be adjusted
accordingly by the clinical user such that a desired target
pressure of the ventilatory strategy is obtained.
[0024] Another example where the graphical visualizations of the
disclosure are of particularly considerable value is a spontaneous
breathing patient in a Volume Support breathing mode. In this mode,
a target of a ventilation strategy may be to provide a desired
minute volume to the patient. Again, any deviations from target
minute volume of such a ventilation strategy may quickly be
corrected by adjusting ventilatory parameters other than the
ventilatory parameters of the desired strategy. In the example,
Oxygen contents of the inspiratory breathing gas may be increased,
the breathing mode may be changed to a mechanical (non-spontaneous)
ventilation mode, etc. The clinical user is provided with a useful
tool providing support for taking clinical decisions related to the
treatment of the patient such that a treatment is obtained by
following a desired ventilation strategy.
[0025] The reciprocating animation of the at least one ventilation
related parameter relative the target indication described herein
for aspects of the disclosure, and of which examples are given in
the detailed description below may take various forms. It
represents a current value of the parameter. During a simulation,
without connected patient, it may be a simulated value thereof.
[0026] One form is a continuous form of the animation. For instance
in examples having a bar graph, the movement of the front of the
bar may be continuously. Continuous movement may be synchronized
with the breathing cycle. The movement may for instance be
forwardly (e.g. for a bar) or outwardly (e.g. for a sphere) during
inspiration and vice versa during expiration, turning at a top
value apex. Continuous movement may be provided in real time, based
on measured values, for instance in case the values are provideable
continuously. In case the values are only provideable
intermittently, an averaging may be done to provide a continuous
form of the animation. The movement is relative the target
indication.
[0027] Alternatively movement of the ventilation strategy indicator
may be non-continuously, such as stepwise. This movement may for
instance be provided when the values for the parameter are updated
or provided intermittently. Then the animation may be provided
stepwise.
[0028] The animation is in all cases moving towards an end value of
the reciprocating animation. It may be not important in which
fashion the animation reaches this end value (or top value).
However, the motion may provide useful information to the clinical
user, e.g. its acceleration. The end value provides very useful
information to the clinical user as it indicates the relation to
the target value of the ventilator strategy.
[0029] According to another aspect of the disclosure, a decision
support system is provided. The decision support system includes a
breathing apparatus, a display unit and a processing unit being is
operatively connected to the display unit. The processing unit is
configured to provide on the display unit a graphical
visualization. The graphical visualization includes a combination
of: [0030] a target indication for at least one ventilation related
parameter of a ventilation strategy for a patient ventilated by the
apparatus, said target indication preferably being based on user
input, such as of an operator of said breathing apparatus, a
measurement value of said patient's physiology or anatomy, or a
default value stored on a memory unit being operatively connected
to said processing unit, and [0031] a reciprocating animation of
the at least one ventilation related parameter relative the target
indication.
[0032] Moreover, the graphical visualization facilitates the
operator to take decisions related to adjustments of ventilatory
settings of the breathing apparatus to pursue the ventilation
strategy.
[0033] According to a further aspect of the disclosure, a
computer-readable medium having embodied thereon a computer program
for processing by a processing unit is provided. The processing
unit is comprised in a breathing system including a breathing
apparatus, and a display unit. The processing unit is operatively
connected to the display unit, wherein the processing unit is
configured to provide a graphical visualization on the display
unit. The computer program comprises code segments for providing
the graphical visualization including a combination of [0034] a
target indication for at least one ventilation related parameter of
a ventilation strategy for a patient ventilated by the apparatus,
said target indication preferably being based on user input, such
as of an operator of said breathing apparatus, a measurement value
of said patient's physiology or anatomy, or a default value stored
on a memory unit being operatively connected to said processing
unit, and [0035] a reciprocating animation of the at least one
ventilation related parameter relative the target indication.
[0036] According to yet a further aspect of the disclosure, a
graphical user interface is provided for a breathing system. The
system includes a breathing apparatus, a display unit and a
processing unit operatively connected to the display unit. The
processing unit is configured to provide a graphical visualization
on the display unit. The graphical visualization in turn includes a
combination of a target indication for at least one ventilation
related parameter of a ventilation strategy for a patient
ventilated by the apparatus, and a reciprocating animation of the
at least one ventilation related parameter relative the target
indication.
[0037] The target indication is for instance based on input of a
user, such as an operator of the breathing apparatus.
[0038] Alternatively, or in addition, it may be a default value
stored on a memory unit being operatively connected to the
processing unit.
[0039] Alternatively, or in addition, the target indication is
based on a measurement value of said patient's physiology or
anatomy. Measurement values may for instance include blood gas
values, measured lung time constants, brain signals, nerve signals,
such as of the vagus nerve stimulating the diaphragm of the
patient, etc.
[0040] Alternatively, or in addition, user input may be made by a
separate input device, such as a personal communication device,
communicating with the breathing apparatus and/or processing unit,
e.g. via a wired or wireless link known in the art. In this manner,
the system can inform clinicians in a clear and easily
understandable way how a current patient ventilation is related to
a chosen ventilation strategy.
[0041] Further embodiments of the invention are defined in the
dependent claims, wherein features for the second and subsequent
aspects of the invention are as for the first aspect mutatis
mutandis.
[0042] The target indication may be displayed at a first position
on the screen, wherein the first position is fixed during the
animation.
[0043] The reciprocating animation may be in synchronism with a
breathing cycle of a ventilated patient. Alternatively, the
reciprocating animation may be in synchronism with the ventilation
related parameter as measured for a ventilated patient. The
reciprocating animation may be moving from a starting point to an
end point in a to-and-fro motion relative the target indication.
This provides for an indication how ventilation strategy is
fulfilled using the graphic visualization in which the ventilation
process during ventilation is animated. In the end-inspiratory,
and/or end-expiratory moment, the animation will stop at a level
that can be related to the specified strategy.
[0044] The starting point may be variable with the ventilation
related parameter at a breathing cycle start time and synchronized
therewith. The end point may be variable with the ventilation
related parameter at an end expiratory time of the breathing cycle
and synchronized therewith. This provides for a measure for the
ventilation strategy without being limited to reciprocating
processes directly synchronized with the breathing cycle.
[0045] The target indication may be updated at an interval during
the ventilation.
[0046] This provides for instance for achieving a flexible
ventilation strategy that is adaptable to a patient's treatment
progress.
[0047] The graphical visualization may include a plurality of the
ventilation related parameters in a combined target indication and
reciprocating animation, each for different ventilation related
parameters, and wherein the combined target indications and
reciprocating animations are provided adjoining each other.
[0048] This provides for a comprehensive overall picture of even
complex ventilation strategies.
[0049] The first and second combined target indications and
reciprocating animations may be provided in different graphical
layout.
[0050] This provides for a comprehensive overall picture of the
ventilation strategy with nuanced details and easy access to
details related to the progress of ventilation in relation to the
ventilation strategy.
[0051] The reciprocating animation may comprise different layouts
for top values of the ventilation related parameter larger than a
first threshold larger than the target indication, or less than a
second threshold less than the target indication, or lying outside
of a range including the target indication.
[0052] This provides for an easily perceivable indication if the
pursued ventilation strategy is exceeded, falls short, or not.
[0053] The graphical visualization may have a graphical appearance
dependent on operational parameters of the breathing apparatus,
including display of alarm limits, and different graphical
appearances when alarm limits are exceeded, display of additional
metrics of ventilation related parameters than of the reciprocating
animation, such as a maximum inspiratory pressure, a Positive
End-Expiratory Pressure (PEEP), an average airway pressure (Pmean)
and a Plateau Pressure (PPlat).
[0054] It should be observed that alarm limit are not a ventilation
strategy target. Thus, alarm limits are not a basis for the target
indication and should not be confused with the latter.
[0055] The system may include a further animating for an on-going
ventilation of the patient.
[0056] The processing unit of the system may be configured to
receive input from an operator for selection of the ventilation
related parameter of the ventilation strategy and/or for adjustment
of a value for the target indication within a pre-defined range.
The processing unit of the system may be configured to receive the
ventilation related parameter as a default ventilation related
parameter and/or the value for the target indication from a default
value stored in a memory of the system accessible for the
processing unit.
[0057] This provides for operational safety as access to certain
adjustment can be restricted for some operators of the breathing
system.
[0058] The display unit may be integrated into the breathing
apparatus. It may be a separate display unit communicative with the
breathing apparatus.
[0059] This provides for a flexible system with advantageous user
acceptance. The graphical visualization may be provided as a
graphical decision support means for the operator to achieve the
ventilation strategy.
[0060] This provides for easy identification if adjustments of
ventilation settings are needed to achieve a desired ventilation
strategy,
[0061] The disclosure provides for a tool that is executable
without a patient connected to the breathing apparatus, e.g. in a
simulated ventilation, The tool may be advantageous for instance
for education of clinicians allowing them to be trained to
effectively determine and clinically follow ventilation strategies
to the benefit of patient treatment.
BRIEF DESCRIPTION OF THE DRAWINGS
[0062] FIGS. 1A, 1B, 1C are schematic illustrations of a first,
second and third system.
[0063] FIG. 2 is a schematic illustration of a first example of a
graphical visualization in a first state.
[0064] FIG. 3 is a schematic illustration of the first example of a
graphical visualization in a second state.
[0065] FIG. 4 is a schematic illustration of a second example of a
graphical visualization in a first state.
[0066] FIG. 5 is a schematic illustration of the second example of
a graphical visualization in a second state.
[0067] FIG. 6 is a schematic illustration of a third example of a
graphical visualization in a first state.
[0068] FIG. 7 is a schematic illustration of the third example of a
graphical visualization in a second state.
[0069] FIG. 8 is a schematic illustration of a fourth example of a
graphical visualization.
[0070] FIG. 9 is an example of a graphical user interface (GUI)
including a graphical visualization as shown in FIG. 8.
[0071] FIGS. 10A, 10B, 10C are schematic illustrations of a third,
fourth, and fifth system.
[0072] FIG. 11 is a schematic illustration of a computer-readable
medium having embodied thereon a computer program for processing by
a processing unit.
[0073] FIG. 12 is a schematic illustration of a GUI.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0074] Specific embodiments of the invention will now be described
with reference to the accompanying drawings. This invention may,
however, be embodied in many different forms and should not be
construed as limited to the embodiments set forth herein; rather,
these embodiments are provided so that this disclosure will be
thorough and complete, and will fully convey the scope of the
invention to those skilled in the art. The terminology used in the
detailed description of the embodiments illustrated in the
accompanying drawings is not intended to be limiting of the
invention. In the drawings, like numbers refer to like
elements.
[0075] FIGS. 1A, 1B, 1C are schematic illustrations of examples of
systems of the disclosure, including a first system 1, a second
system 2, and a third system 3. The systems 1, 2, 3 include
configurations of a breathing apparatus 10, a display unit 30 and a
processing unit 20 that is operatively connected to the display
unit 30. The patient 40 is fluidly connected to the system for
ventilation via an inspiratory line 11 and an expiratory line 12.
The processing unit 20 is configured to provide on the display unit
30 a graphical visualization. Examples for such graphical
visualizations are illustrated in FIGS. 2-9 and 12, which are
described in more detail below.
[0076] The graphical visualization includes a combination of at
least one target indication for a ventilation strategy and a
related animation of at least one current ventilation related
parameter.
[0077] The target indication is either user adjusted or based on a
default value. A default value for the target indication may
alternatively, or in addition to operator input be based on
alternative data or input sources for that value. The default
target indication value may for instance be provided from an
accessible database. The default value may be based on patient
data, for instance based on body weight and length of a patient
connected to a breathing apparatus of the system. The default value
may be included in a default range of values. The default value may
be based on measured values of a patient connected to the breathing
apparatus. The breathing apparatus may then provide a recommended
value or a range of values from which the user can select a target
value. All the aforementioned alternatives, alone or in
combination, are included in the term "default" (value) for the
target indication as used herein.
[0078] Examples for the ventilation related parameter include
[0079] IBW Body weight V/kg within a certain range e.g. 4-15 ml
iVT/kg BW, e.g. 4, 6, 8
[0080] Ventilation related pressure parameters: PEEP, P-peak, a
ratio of such parameters, such as e.g. PEEP/FiO2, and Index,
etc.
[0081] In the ventilator 10 a desired ventilation strategy may for
instance be specified by the user. The ventilation strategy is for
example a tidal Volume in mL/predicted body weight of the patient
to be ventilated. A predicted or ideal body weight can be entered
directly by the clinician or calculated from patient height and
gender.
[0082] During ventilation it is indicated how a ventilation
strategy is fulfilled using a graphic visualization in which the
ventilation process (e.g. tidal ventilation) is animated. In the
end-inspiratory (or end-expiratory) moment, the animation will stop
at a level that can be related to the specified strategy.
[0083] This means, if a strategy such as 6 mL/kg tidal volume per
kg body weight is used and the patient is ventilated with less than
6 mL/kg tidal volume per kg body weight, the visualization will not
arrive at a (fixed) graphic dividing line, the strategy target
indicator. If the provided ventilation is greater than 6 mL/kg
tidal volume per kg body weight, the animation will pass the
graphic dividing line.
[0084] The animation is preferably paced with the respiratory
rate.
[0085] The visualization can be provided as a circle, a sphere, a
bar graph, a height above the horizon, a 3D object for instance
expanding and collapsing, etc.
[0086] The graphical visualizations of the disclosure are
visualizations only. As such, the display unit 30 does not need to
be a touch sensitive. However, in certain examples the display 30
may be a touch screen providing further advantages in a suitable
graphical user interface.
[0087] The animation, animated progress, or
reciprocating/oscillating movement is provided for the progress
over time of the ventilation related parameter. The reciprocating
animation may be in synchronism with a breathing cycle of a
ventilated patient. In particular, the reciprocating portion of the
animation may be paced with the respiratory rate of a currently
ventilated patient. Alternatively, the reciprocating animation may
be in synchronism with the ventilation related parameter as
measured for a ventilated patient, which may differ from the
breathing cycle. The reciprocating animation may be moving from a
starting point to an end point in a to-and-fro motion relative the
target indication. This provides for an indication how ventilation
strategy is fulfilled using the graphic visualization in which the
ventilation process during ventilation is animated. In the
end-inspiratory, and/or end-expiratory moment, the animation will
stop at a level that can be related to the specified strategy.
[0088] The starting point may be variable with the ventilation
related parameter at a breathing cycle start time and synchronized
therewith. The end point may be variable with the ventilation
related parameter at an end expiratory time of the breathing cycle
and synchronized therewith. This provides for a measure for the
ventilation strategy without being limited to reciprocating
processes directly synchronized with the breathing cycle.
[0089] The reciprocating animation may comprise different layouts
for top values of the ventilation related parameter larger than a
first threshold larger than the target indication, or less than a
second threshold less than the target indication, or lying outside
of a range including the target indication.
[0090] This provides for an easily perceivable indication if the
pursued ventilation strategy is exceeded, falls short, or not.
[0091] For instance, when the reciprocating animation is having a
top/end value that is in a certain vicinity of the target
indication, the animation may change a graphical layout to provide
an easily perceivable indication. The indication may notify the
user of a certain status of the patient in relation to the
strategy. The status may include: within the allowable limits of
the ventilation strategy, exceeding the allowable limits of the
ventilation strategy, or falling short of the allowable limits of
the ventilation strategy. This allows for an advantageous current
status of the ventilation provided in relation to the desired
ventilation strategy. The aforementioned allowable limits may be
limits within a certain upper and lower threshold relative the
target indication value. For instance, a threshold percentage of
the target may provide the threshold/limits. An example is +/-X% of
the target indication value: for too low/normal/too high. An
example is +/-20%. The graphical layout change may include color
changes of the graphical visualization to indicate/emphasize
whether the strategy is exceeded, falls short, or not.
[0092] The graphical visualization may have a graphical appearance
dependent on operational parameters of the breathing apparatus,
including display of alarm limits, and different graphical
appearances when alarm limits are exceeded, display of additional
metrics of ventilation related parameters than of the reciprocating
animation, such as a maximum inspiratory pressure, a Positive
End-Expiratory Pressure (PEEP), an average airway pressure (Pmean)
and a Plateau Pressure (PPlat).
[0093] A processing unit of systems as described herein may be
configured to receive input from an operator for selection of the
ventilation related parameter of the ventilation strategy and/or
for adjustment of a value for the target indication within a
pre-defined range. The processing unit of the system may be
configured to receive the ventilation related parameter as a
default ventilation related parameter and/or the value for the
target indication from a default value stored in a memory of the
system accessible for the processing unit.
[0094] This provides for operational safety, as access to certain
adjustment can be restricted for some operators of the breathing
system. This may be provided or administered on a care unit level
in a hospital. Access to certain adjustments as input of values for
the target indication, choice or selection of ventilation related
parameters of desired ventilation strategies, etc., may be
restricted, e.g. requiring entry of an access code.
[0095] A user definable strategy may be provided. Preferably, the
strategy target(s) are adjustable by the user within certain limits
for input from a default range, e.g. 4-15 ml/kg (tidal volume/body
weight).
[0096] In this manner, excessive values outside of the default
range are avoided, which is advantageous from a safety aspect.
[0097] The target indication may be displayed at a first position
on the screen, wherein the first position is fixed during the
animation.
[0098] When the first position of the target indication is at a
fixed position, it may for instance be a static line, a reference
line, or a reference indication other than a line.
[0099] The target indication is illustrating a desired goal or
result of the ventilation strategy by means of a desired value
based on one or more ventilation related parameters.
[0100] The target indication may be updated at an interval during
the ventilation. This provides for instance for achieving a
flexible ventilation strategy that is adaptable to a patient's
treatment progress.
[0101] The ventilation strategy indicator is preferably updated
with a different interval, such as every completed breath. The
processing unit may suggest, provide for user confirmation, or
automatically adjust the value of the target indication, e.g. when
patient status changes during on-going ventilation. The target
indication may be moved to a new location relative the previous
value's location. Alternatively, or in addition, a numerical value
displayed for or at the target indication may be updated.
[0102] During ventilation it is indicated how ventilation strategy
is fulfilled using a graphic visualization in which the ventilation
process (e.g. tidal ventilation) is animated. In the
end-inspiratory (or end-expiratory) moment, the animation will stop
at a level that can be related to the specified strategy.
[0103] This graphical visualization should not be confused with
(user) adjusted ventilation parameters themselves. The graphical
visualization puts the ventilation parameters values as obtained in
relation to a desired ventilation strategy.
[0104] This means, if a strategy such as 6 mL/kg tidal volume per
kg body weight is used and the patient is ventilated with less than
6 mL/kg tidal volume per kg body weight, the visualization will not
arrive at a (fixed) graphic dividing line. If the provided
ventilation is greater than 6 mL/kg tidal volume per kg body
weight, the animation will pass the graphic dividing line, i.e. the
target indicator 110.
[0105] In the first system 1, breathing apparatus 10, display unit
30 and processing unit 20 are integrated into a single unit. A
memory unit 25 and the processing unit as well as the display 30
are for instance integrated into a single housing. The display may
however be connected to a housing of a pneumatic portion (not
separately illustrated) of the breathing apparatus.
[0106] The display unit 30 may be integrated into the breathing
apparatus 10 as in the example of the first system 1. It may be a
separate display unit communicative with the breathing apparatus.
This provides for a flexible system with advantageous user
acceptance.
[0107] Data for the current ventilation related parameters may be
transferred from the breathing apparatus to a remote display for
the graphical visualization. For instance, the display may be a
bedside monitor system, such as of a patient monitor unit. The
display may be a remote display, e.g. at a central nursing station.
The display may be part of a portable device, such as a portable
communications device. An applet on this device may provide the
graphical visualization based on data received from the breathing
apparatus. The processing unit may be present anywhere suitable in
the system, i.e. for instance in the breathing apparatus or the
display or a portable unit including the display. Data is processed
by the processing unit and sent to the display unit for providing
the graphical visualization thereon. Data may comprise numerical
data related tot the ventilation related parameters' values, or
graphical data. Sending graphical data to a display unit dispenses
with the need for a processing unit at the display unit, as the
numerical data is already processed by the processing unit and
graphical data is thus already prepared for readily displaying the
graphical visualization described herein.
[0108] In the second system 2, breathing apparatus 10 includes the
memory unit. Processing unit 20 is provided at the display unit 30,
which is in communication with the breathing apparatus 10.
Communication may be wireless. Processing unit receives data from
the breathing apparatus, which has a separate processing unit
communicating with memory 25.
[0109] Other examples of systems (not shown) may have no processing
unit as described herein at the display unit 30.
[0110] In the third system 3, the breathing apparatus 10 includes
the processing unit 20 and memory unit 25. Display unit 30 is in
communication with the breathing apparatus 10. Communication may be
wireless.
[0111] Turning now to FIGS. 2-9, examples of graphical
visualizations for providing feedback for a ventilation strategy
related to an on-going ventilation are described. Breathing
apparatus 10 is in operation ventilating the patient 40.
[0112] In FIGS. 2 and 3, an example of a ventilation strategy
fulfillment indicator is illustrated as a bar graph to visualize
the ventilation strategy in relation to the bar graph. A graphical
visualization 100 including a bar graph 101 can be seen. The
graphical visualization 100 includes a target indication 110 for at
least one ventilation related parameter of a ventilation strategy
for a patient ventilated by the apparatus. Further, the graphical
visualization 100 includes an animation 120 of the at least one
ventilation related parameter relative the target indication 110.
The movement of the bar is illustrated by an arrow 121. In the
embodiments having a bar graph, the movement of the (front of the)
bar is referred to. Movement of the ventilation strategy indicator,
here in form of a bar graph may be continuously, such as
reciprocating. Alternatively movement of the ventilation strategy
indicator may be non-continuously, such as stepwise. The front is
in this example reciprocatingly moving from the left to the right
and then back. A top value 122 of the animation is reached at the
point of return, or apex of the bar graph portion of the animation.
The top value is in embodiments the value of interest for the
clinical user. The top value may be below, on point, or exceeding
the ventilation strategy target. This information of the current
top value of the ventilation parameter related to the ventilation
strategy in relation to the target of the ventilation allows the
clinical user to take decisions for continued ventilation of the
patient. Adjustments of settings of the breathing apparatus may be
made when necessary.
[0113] FIG. 2 is a schematic illustration of the first example of
the graphical visualization in a first state, namely when the top
value 122 of the reciprocating animation is less than the value of
the target indication. Here, the reciprocating animation part of
the bar graph has its apex before reaching the target indication
110.
[0114] FIG. 3 is a schematic illustration of the first example of
the graphical visualization in a second state, namely the top value
122 of the reciprocating animation exceeds the value of the target
indication. Here, the reciprocating animation part of the bar graph
has its apex after reaching the target indication 110.
[0115] In FIGS. 4-9 examples of ventilation strategy fulfillment
indicators are illustrated as curved objects. The curved objects
are illustrated as circular objects in the examples to visualize a
ventilation strategy in relation to the curved objects, illustrated
as circles. Circles are merely an example of curved objects. The
object may also have other curved shapes, such as elliptical
shapes, sinusoidal shapes, helical shapes, etc.
[0116] In FIGS. 4 and 5 a further example of a ventilation strategy
fulfillment indicator is illustrated as a circular object to
visualize the ventilation strategy in relation to a circle.
[0117] A graphical visualization 200 including a circular object
having a center can be seen. The graphical visualization 200
includes a target indication 110, here in the shape of a dotted
circular line.
[0118] The ventilatory strategy target indication, here in form of
a dotted line does not necessarily need to be a line, such as a
dotted line, as long as it indicates the ventilation strategy
target for at least one ventilation related parameter of a
ventilation strategy for a patient ventilated by the apparatus. Any
visual indication may be used, thicket lines, colours, shapes etc.
In addition, such colour, shape etc. may change when the current
ventilation is outside of the set ventilation strategy.
[0119] Further, the graphical visualization 200 includes a
reciprocating animation 120 of the at least one ventilation related
parameter relative the target indication 110. The reciprocating
movement is illustrated by an arrow 121. The outer periphery of the
filled circle is in this example reciprocatingly expanding from the
center to the periphery, and then back towards the center. A top
value 122 of the animation is reached at the point of return, or
apex of the exemplary filled circle of the graph portion of the
animation 120. The corresponding point of return of the animation
at a lowest value of the ventilation related parameter is
illustrated with an inner circle line 123. The values of the
ventilation related parameter reciprocatingly move between the
inner circle line 123 and the top value 122. It should be noted
that the lower value as illustrated by circle 123 as well as the
top value 122 as illustrated in the Figures are not constant values
but updated based on the current values provided by the breathing
apparatus 10.
[0120] The animation 120 may also be in the shape of a
reciprocating 3D object. An example of such a 3D object is a
sphere, or bubble.
[0121] FIG. 4 is a schematic illustration of this example of the
graphical visualization in a first state, namely when the top value
122 of the reciprocating animation is less than the value of the
target indication 110. Here, the reciprocating animation part of
the circular object has its apex before reaching the target
indication 110. FIG. 5 is a schematic illustration of this first
example of the graphical visualization in a second state, namely
the top value 122 of the reciprocating animation exceeds the value
of the target indication 110. Here, the reciprocating animation
part of the circular object has its apex beyond the target
indication 110, which in this illustrated example is after reaching
the target indication 110.
[0122] The graphical visualization may include multiple/a plurality
of the ventilation related parameters in a combined target
indication and reciprocating animation, each for different
ventilation related parameters, and wherein the combined target
indications and reciprocating animations are provided adjoining
each other. This provides for a comprehensive overall picture of
even complex ventilation strategies. Examples of such graphical
visualization that include multiple ventilation related parameters
and target indications related to each of the latter, are described
below with reference to FIGS. 6 to 9.
[0123] Multiple visualizations provide for a comprehensive overall
picture of the ventilation strategy. Multiple combined target
indications/animations for same ventilation strategy give
comprehensiveness.
[0124] Multiple target indications for same ventilation related
parameter might be displayed (e.g. a line for 4 ml/kg tidal volume
per kg body weight and another line for 6 ml/kg tidal volume per kg
body weight). Range of selectable (useful) values for target
indicators may be shown as range indicators in relation to a
current target indicator.
[0125] Examples for multiple ventilation related parameters include
Vol+Target pressure, Vol or Pressure+Ppeak/(ml/kg).
[0126] In FIGS. 6 and 7 a further example of a ventilation strategy
fulfillment indicator is illustrated. The graphical visualization
includes a circular object 200 to visualize the ventilation
strategy in relation to a circle, as described above with reference
to FIGS. 4 and 5. The graphical visualization 200 includes a
circular object having a center. The graphical visualization 200
includes a first target indication 110. In the illustration, the
target indication is precisely met for the ventilation related
parameter visualized by the graphical visualization 200. The
graphical visualization 200 will not be described in further detail
and reference is made to the above section related to FIGS. 4 and
5.
[0127] The indicator illustrated in FIGS. 6 and 7 includes a second
graphical visualization 300. The second graphical visualization 300
is arranged concentric to the first graphical visualization 200. It
may also be arranged non concentric in other examples. The second
(or further) graphical visualization is arranged adjacent to the
first (or other) graphical visualization 200 to provide an
aggregate of multiple graphical visualizations for the same
ventilation strategy. Each graphical visualization is related to a
specific ventilation related parameter of the same ventilation
strategy and has its own target indication and reciprocating
animation part.
[0128] In aggregate 301, the graphical visualization 300 is
provided in the shape of a bent bar graph. The target indication
310 is illustrated in a 6 o'clock position, but may also be
arranged at other radial positions or at other sectors than 6
o'clock. Further, the graphical visualization 300 includes a
reciprocating animation 320 of the ventilation related parameter
relative the target indication 310. The reciprocating movement is
illustrated by a double pointed arrow 321. The bent bar graph has a
front with a top value 322.
[0129] The front is in this example reciprocatingly moving in a
circle from a starting position, e.g. at the top of the circle, to
an end position, e.g. at the bottom of the circle, and then turns
back. This cycle is then repeated, wherein start and end values may
be updated and changed continuously.
[0130] FIG. 6 is a schematic illustration of this example of the
graphical visualization 300 in a first state, namely when the top
value 322 of the reciprocating animation 320 is less than the value
of the target indication 310. Here, the reciprocating animation
part of the bar graph has its apex before reaching the target
indication 310.
[0131] In an example, the first graphical visualization may refer
to a tidal volume per kg body weight [mL/kg] and the second
graphical visualization may refer to a pressure.
[0132] FIG. 7 is a schematic illustration of the example of the
graphical visualization 300 in a second state, namely the top value
322 of the reciprocating animation exceeds the value of the target
indication. Here, the reciprocating animation part of the bar graph
has its apex after reaching the target indication 310.
[0133] The starting point of the reciprocating animation may be at
a position larger than the target indication 310. In FIG. 6, a
visualization of a ventilation less than the strategic target level
can be seen. The animation of the first graphical visualization 200
visualizing tidal ventilation reaches out to the reference circle.
However, the second graphical visualization 300 providing
visualization of pressure levels ends below the strategic limit of
the target indication 310, The breath-to-breath presentation does
not reach the fixed reference point, namely the target indication
310, e.g. at the 6 o'clock position.
[0134] In FIG. 7 the second graphical visualization 300 reaches and
passes the reference line of the target indication 310. A
visualization of pressure levels exceeding the strategic limit is
given. The breath to the breath presentation reaches over the fixed
reference point, namely the target indication 310.
[0135] The first and second combined target indications and
reciprocating animations may be provided in different graphical
layout.
[0136] This provides for a comprehensive overall picture of the
ventilation strategy with nuanced details and easy access to
details related to the progress of ventilation in relation to the
ventilation strategy.
[0137] A comprehensive overall picture of the currently followed
ventilation strategy is provided with nuanced details and easy
access to detailed information related to the ventilation
strategy.
[0138] In addition metrics may be displayed for the target
indication value.
[0139] A text may be provided for identifying the ventilation
related parameter of the ventilation strategy to be followed.
[0140] FIG. 8 is a schematic illustration of another example of
such a graphical visualization.
[0141] Like the aggregate 301 of graphical visualizations in FIGS.
6 and 7, the aggregate 401 illustrated in FIG. 8 includes multiple
graphical visualizations and some further elements. The graphical
visualization includes a circular object 200 to visualize the
ventilation strategy in relation to a circle, as described above.
The graphical visualization 200 includes a circular object having a
center. The graphical visualization 200 includes a first target
indication 110. In the illustration, the target indication is not
reached by the ventilation related parameter visualized by the
graphical visualization 200. The graphical visualization 200 will
not be described in further detail and reference is made to the
above sections.
[0142] The indicator illustrated in FIG. 8 includes a second
graphical visualization 400. The second graphical visualization 400
is arranged concentric to the first graphical visualization 200. It
may also be arranged non concentric in other examples. The second
graphical visualization 400 is arranged adjacent to the first
graphical visualization 200 providing an aggregate of multiple
graphical visualizations for the same ventilation strategy. Each
graphical visualization is related to a specific ventilation
related parameter of the same ventilation strategy and has its own
target indication and reciprocating animation part.
[0143] The graphical visualization 400 is provided in the shape of
a bent bar graph, like the second graphical visualization 300
described with reference to FIGS. 6 and 7. The graphical
visualization 400 is in this example positioned to the right in the
FIG. 8. A target indication 410 is illustrated in a 6 o'clock
position, but may also be arranged at other radial positions or at
other sectors than the 6 o'clock position. Further, the graphical
visualization 400 includes a reciprocating animation 420 of the
ventilation related parameter relative the target indication 410.
The target indication 410 is further provided with a o numerical
value 415 to visualize the numerical value of the target indication
for the specific ventilation related parameter of the graphical
visualization 400. In the example, value 415 is "30". The value 415
may alternatively also be displayed together with the correct unit,
here for a pressure for instance the unit [cmH2O]. The graphical
visualization 400 is reciprocating between the start value
indicated by a start indication 421 and the top value indicated by
a top value indication 422 where the animation turns back. The
range between these start and top values is illustrated by a bar
422. Bar 422 also includes a center indication.
[0144] In the example, the second graphical visualization 400
refers to a pressure. A text 430 is provided at the graphical
visualization 400 for easy identification of this displayed
parameter to the clinical user.
[0145] The target indication 110, in this example provided as a
dotted circle, may furthermore be provided with one or more text
and/or numerical objects 211. The text and/or numerical objects
211, such as the illustrated objects 212, 214 provide for a further
elucidation of the current value of the target indication 110 of
the current ventilation strategy. This facilitates for the clinical
user to identify a current absolute value instead of a relative
value only for the ventilation strategy target. A text may, like
text 430, facilitate identification of the specific ventilation
related parameter, or chosen values respectively default values
therefor or input values for the latter. The text object 214
provides for such support of the user, which may be advantageous in
particular for a decision support system. In the example, the
numerical value of 6 with a corresponding unit "ml/kg", i.e. a
tidal volume for a certain body weight of the ventilated patient,
is provided for the ventilation strategy target. This is a value
either chosen by a user, based on a measured value, provided as a
default value, etc. as described above.
[0146] An indication line 213 to the target indication 110 provides
the user with an easily identifiable link of the text object 213 to
the target indication 213 without obstructing the animation
120.
[0147] Likewise, a text and/or numerical object may be provided as
a metrics 212. In the example illustrated in FIG. 8, the metrics
includes an abbreviated text VTBW for the term tidal volume (VT)
per body weight (BW) allowing the user to identify the ventilation
related parameter of this part of the ventilation strategy. The
current value of the ventilation related parameter, here VTBW, is
displayed as object 212. The current value in the example of FIG.
8, which is a still picture of an animation, is 4 ml/kg (tidal
volume/body weight). The ventilation strategy target of "6 ml/kg"
(text object 214 and corresponding target indication 110) is
currently not reached as the current value of "4 ml/kg" fails to
reach the target value. The clinical user may take suitable
decisions to adapt and update the current ventilation settings so
that the ventilation strategy is obtained.
[0148] A system as described herein may include a further animation
for an ongoing ventilation of the patient. The further animation is
advantageously integrated with or provided adjacent a graphical
visualization or aggregate of multiple graphical visualization--as
described herein. An example for such a further animation is for
instance a plurality of bubbles 500 as illustrated in FIG. 8. The
bubbles 500 are in the illustrated example provided moving back and
forth. In the example, the bubbles move back and forth in relation
to the center of the aggregate of graphical visualizations through
an opening in circular graphical visualizations of ventilation
related parameters. The further animation, such as the bubbles 500,
and the motion shown therewith may be synchronized with inspiration
and expiration for each direction respectively. Alternatively or in
addition the further animation may provide additional information,
e.g. for a leakage occurring during ventilation. A leakage may be
illustrated by bubbles moving in one direction, such as outwardly
in FIG. 8 without returning towards the center. Leakage
illustrating bubbles may move in a different direction than the
illustrated bubbles 500 in FIG. 8. In this manner, an
advantageously compact visualization of multiple ventilation
related parameters and the ventilation itself is provided without
overloading the clinical user with information.
[0149] The animation for an ongoing ventilation of the patient,
such as bubbles 500, is synchronized with the current breathing
cycle of the patient. It should be noted that the periods of the
reciprocating animations of the ventilation related parameters may
be different than the current breathing cycle as ventilation
strategies may be based on measured parameters or parameters that
are not in synchronicity with the current breathing cycle. Hence, a
single aggregate of graphical visualizations may have graphical
visualizations oscillating at different frequencies providing the
clinical user with additional information otherwise not readily
available for taking decisions when updating a treatment strategy
for the patient.
[0150] An example for such a parameter asynchronous with the
breathing cycle is the electrical activity of the diaphragm. This
may be advantageous during certain modes of ventilation. One such
mode of ventilation is for instance Neurally Adjusted Ventilatory
Assist (NAVA), which is a mode of ventilation that delivers
ventilatory assist in proportion to and in synchrony with the
patient's Edi signal, i.e. the electrical activity of the
diaphragm. Edi is for instance measured using an esophageal
measurement catheter. A ventilatory strategy target may be based on
a desired measured Edi signal.
[0151] The Edi signal may be put in relation to the tidal volume
(VT). A ventilatory strategy target may be a value for Edi/VT
[.mu.V/mL]. Edi/VT may be illustrated in a way as described herein
with reference to tidal volume per kg body weight. This is an
example for a measurement value of said patient's physiology or
anatomy mentioned above. Apart from the diphragmal EMG (Edi) other
respiratory bioelectric signals and muscular signals in synchrony
with breathing may be considered for the same purpose.
[0152] Another example for such a parameter asynchronous with the
breathing cycle is cardiac output.
[0153] Another example for such a parameter asynchronous with the
breathing cycle is the Respiratory Systolic Variation, i.e.
variations in the arterial blood pressure related to breathing.
Such a parameter may be provided by the Respiratory Systolic
Variation Test (RSVT) as described in U.S. Pat. No. 5,769,082 of
Azriel Perel, which is incorporated herein in its entirety for all
purposes.
[0154] Measurement values of said patient's physiology or anatomy
may thus be provided for the ventilation strategy from measurements
systems external to the breathing apparatus or not directly related
to patient gas measurements.
[0155] FIG. 9 is an example of a graphical user interface (GUI)
including a graphical visualization aggregate 500 as shown in FIG.
8. The aggregate 401 is illustrated as part of other graphical
objects related to a current ventilation of a patient. Metrics
objects 650, 651, 652, 653 illustrate current values of ventilatory
parameters. A metrics object 650 displays a inspiratory tidal
Volume VTi. A metrics object 651 displays a Peak airway pressure
Ppeak. A metrics object 652 displays a Respiratory Rate RR. A
metrics object 653 displays an expiratory tidal Volume VTe. A curve
object 652 is for instance illustrating a pressure time curve and a
flow time curve.
[0156] In examples of graphical visualizations, color changes of at
least parts of aggregates described herein can be provided to
indicate/emphasize whether the desired ventilation strategy is
exceeded or not--as described above.
[0157] If further strategic parameters of an ongoing ventilation
are to be displayed, the graphical visualization may be provided
with an adapted graphical layout, such as the color or shape
thereof. For instance when alarm limits are exceeded, different
colors may be used than when no alarm limits are exceeded.
[0158] Other aspects of the ventilation strategy, for example,
maximum pressure may be indicated in relation to the bar graph or
circle as described above. This ventilation strategy indicator is
preferably updated with a different interval, such as every
completed breath. Other pressures can be indicated, such as
Positive End-expiratory pressure, PEEP, average pressure, Pmean and
Plateau Pressure, PPlat.
[0159] The graphical visualization may be provided as a graphical
decision support means for the operator to achieve the ventilation
strategy.
[0160] This provides for easy identification if adjustments of
ventilation settings are needed to achieve a desired ventilation
strategy.
[0161] If adjustments are made by a user, an easy interpreted
feedback may be provided for an adjustment of the desired
ventilation strategy.
[0162] FIGS. 10A, 10B, and 10C are schematic illustrations of
examples of further systems of the disclosure, including a fourth
system 4, a fifth system 5, and a sixth system 6. These systems 4,
5, 6 are a decision support systems and include, like the above
described systems 1,2 3 a breathing apparatus 10, a display unit 30
and a processing unit 20 operatively connected to the display unit
30. In addition to the first to third systems, the fourth to sixth
systems may provide a graphical visualization facilitates the
operator to take decisions related to adjustments of ventilatory
settings of the breathing apparatus to pursue the ventilation
strategy.
[0163] FIG. 11 is a schematic illustration of a computer-readable
medium 700 having embodied thereon a computer program 701 for
processing by a processing unit 20. The processing unit 20 is
comprised in a breathing system as described above, The processing
unit 20 is, as mentioned above, operatively connected to the
display unit 30 providing the graphical visualization on the
display unit 30. The computer program 701 comprises code segments
710, 720 for providing the graphical visualization including a
first code segment 710 for providing a target indication for at
least one ventilation related parameter of a ventilation strategy
for a patient ventilated by the apparatus, the target indication
being based for instance on input of an operator of the breathing
apparatus or a default value stored on a memory unit 25 being
operatively connected to the processing unit 20. Further, a second
code segment 720 is provided for providing a reciprocating
animation of the at least one ventilation related parameter
relative the target indication in the graphical visualization.
[0164] FIG. 12 is a schematic illustration of a graphical user
interface (GUI) 800. The GUI is provided for a breathing system as
described above. The graphical user interface including a graphical
visualization and includes a combination of: [0165] a target
indication for at least one ventilation related parameter of a
ventilation strategy for a patient ventilated by the breathing
apparatus 10, the target indication being based on for instance
input of an operator of the breathing apparatus 10 or a default
value stored on a memory unit 25 being operatively connected to the
processing unit 20, and [0166] a reciprocating animation of the at
least one ventilation related parameter relative the target
indication.
[0167] The present disclosure includes above specific examples.
However, other embodiments than the above described are equally
possible within the scope of the disclosure. Different method steps
than those described above, performing the method by hardware or
software, may be provided within the scope of the invention. The
different features and steps of the examples may be combined in
other combinations than those described. The scope of the invention
is only limited by the appended patent claims.
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