Maquet Critical Care Ab

Abb Ab

Magnus Hallbäck

Erik Cardelius

Pär Emtell

Åke Larsson

Christer Ahlmén

Mario Loncar

Rolf Castor

Lars Wallen

Bengt Rydholm

Mathias Eklund

Sigun Israelsson

Carl-Erik Troili

Mari Andersson

Carl Erik Troili

Lars Wallén

Anders Häggström

Gerardo Tusman

Göte Tallbäck

Stephan Boehm

Fernando Suarez Sipman

Stefan Lindström

Fredrik Norrby

Per Lennart Eriksson

Sven Karlsson

Stephan BÖHM

Fernando Suarez Sipmann

A method for controlling a ventilator arrangement might be suitable for maintaining or achieving a desired end expiratory lung volume, EELV, of a subject when an external manoeuvre is performed on the subject ventilated by the ventilator arrangement. The ventilator arrangement applies a set positive end-expiratory pressure, PEEP, level for performing the ventilation.

Ventilator arrangement and method for controlling a ventilator arrangement

A method for changing the effective ventilation of a mechanically ventilated subject to enable or carry out non-invasive determination of hemodynamic parameters is disclosed. The method includes a step of ventilating the subject using a ventilation pattern comprising at least one phase of increased ventilation and at least one phase of decreased ventilation, wherein the phase of decreased ventilation comprises at least one prolonged breath including a respiratory pause (IRP). The respiratory pause is initiated when the lung pressure (P) of the subject is between a minimum lung pressure and a maximum lung pressure of the subject during the prolonged breath.

Ventilation pattern for hemodynamic parameter determination during mechanical ventilation

A ventilation system includes a breathing apparatus which provides mechanical ventilation to a patient. The breathing apparatus is configured to perform an automated full recruitment manoeuvre, FRM, comprising a recruitment phase and a PEEP titration phase. In the PEEP titration phase the breathing apparatus is configured to gradually decrease the level of PEEP and to deliver a number of breaths at each of a plurality of PEEP levels, monitor at least one parameter from which an optimal PEEP of the patient may be determined, predict whether the optimal PEEP will be possible to reliably determine later on during the PEEP titration phase, and automatically abort the FRM manoeuvre if it is predicted that it will not be possible to reliably determine the optimal PEEP.

Lung recruitment in mechanical ventilation

A medical device measures a pressure of a pressurized breathing gas and includes a pressure sensor arranged at a point of measurement and measures the pressure of a sample gas at a sampling point. The sampling point and the point of measurement are connected by a pressure sampling tube in which a pressure wave of the sample gas can propagate from the sampling point to the point of measurement. The tube has a sampling tube volume and an acoustic impedance. The device further includes a damping arrangement fluidly communicating with the tube. The damping arrangement includes a flow restrictor and a receptor chamber arrangement. The receptor arrangement includes a receptor chamber which receives the pressure wave. The restrictor correlates to the acoustic impedance to prevent acoustic resonance in the tube. The receptor chamber correlates at least to the tube volume to prevent acoustic resonance in the tube.

Medical pressure measuring device and breathing apparatus

A method, a computer program and a breathing apparatus relates to determination of at least one physiological parameter including the neuromechanical efficiency [NME] of a patient being mechanically ventilated by the breathing apparatus. This is achieved by obtaining samples of an airway pressure (P), a patient flow (&#xd8;), a change in lung volume (V) caused by the patient flow, and an electrical activity of a respiratory muscle of the patient, during ventilation of the patient at a first level of ventilatory assist and a second and different level of ventilatory assist, and determining the at least one physiological parameter, including NME, from the airway pressure samples, the patient flow samples, the samples of the change in lung volume, and the samples of the electrical activity of the respiratory muscle, obtained at the different levels of ventilatory assist.

Determination of neuromuscular efficiency during mechanical ventilation

The present disclosure relates to a method for determination of cardiac output or EPBF of a mechanically ventilated subject. The method comprises the steps of introducing a change in the effective ventilation of the subject, measuring expiratory flow and CO2 during a sequence of analyzed breaths during which the effective ventilation of the subject varies, and determining the cardiac output or EPBF of the subject using the flow and CO2 measurements. The method further comprises the steps of measuring also a relative variation in cardiac output or EPBF during the sequence of analyzed breaths, and using the relative variation in the determination of cardiac output or EPBF.

Determination of cardiac output or effective pulmonary blood flow during mechanical ventilation

A breathing apparatus has a first delivery device for adding a volume of a substance to a gas flow, the delivery device having a gas inlet and a gas outlet. A unit monitors a presence of the substance in a gas downstream the delivery device using a first sensor unit at the gas outlet that provides a first measurement value based on an acoustic property of a gas in a first conduit. A second sensor unit at the gas inlet provides a second measurement value based on an acoustic property of a gas present in the second conduit. A control unit determines the presence of the substance based on the first measurement value or based on a comparison of the first measurement value and the second measurement value.

Breathing apparatus with monitored delivery device

A breathing apparatus provides high frequency oscillatory ventilation [HFO] to a patient by supplying breathing gas to the patient according to an oscillating pressure profile oscillating between a positive pressure and a negative pressure. The breathing apparatus has a patient circuit including an inspiratory line for conveying breathing gas to the patient, and an expiratory line for conveying gas away from the patient, and an inspiration valve for regulating a flow of pressurised breathing gas into the inspiration line, and a control computer that controls the inspiration valve. The control computer operates to cause the oscillating pressure profile by controlling the inspiration valve to oscillate between a top flow position in which the flow of breathing gas through the inspiration valve assumes a top flow value, and a minimum flow position in which the flow through the inspiration valve assumes a minimum flow value.

Valve controlled high frequency oscillatory ventilation

A capnotracking method for continuous determination of cardiac output or EPBF of a mechanically ventilated subject includes the steps of measuring expiratory CO2 of the subject and determining a first value of cardiac output or EPBF of the subject at a first point in time; controlling the mechanical ventilation of the subject to keep a level of venous CO2 of the subject substantially constant between the first point in time and a second point in time; determining from the expiratory CO2 measurements a change in alveolar CO2 of the subject between the first and second points in time; and determining a second and updated value of cardiac output or EPBF of the subject based on the first value and the change in alveolar CO2.

Capnotracking of cardiac output or effective pulmonary blood flow during mechanical ventilation

In a method and breathing apparatus for prediction of fluid responsiveness of a subject connected to a breathing apparatus, at least one parameter is monitored that is indicative of a degree of carbon dioxide elimination of the subject, and a positive end expiratory pressure PEEP regulator of the breathing apparatus is operated to apply a PEEP maneuver in which a PEEP applied to the subject is changed from a first PEEP level to a second PEEP level. A processor predicts the fluid responsiveness of the subject based on a change in the monitored parameter, following the change in PEEP.

Method and apparatus for prediction of fluid responsiveness in mechanically ventilated subjects

In a method for continuous and non-invasive determination of the effective lung volume, the cardiac output, and/or the carbon dioxide content of venous blood of a subject during a sequence of respiratory cycles, the inspiratory and expiratory flow, and the carbon dioxide content of at least the expiration gas are measured. In each respiratory cycle, a first parameter related to the subject's fraction of alveolar carbon dioxide, a second parameter related to the carbon dioxide content of the subject's arterial blood, and a third parameter related to the subject's carbon dioxide elimination are determined based on the measured inspiratory flow, expiratory flow and carbon dioxide content. The effective lung volume, the cardiac output, and/or the carbon dioxide content of venous blood of the subject is determined based on the correlation of the first, second and third parameters.

Method for continuous and non-invasive determination of effective lung volume and cardiac output

A breathing system for ventilating a patient has a gas channel enclosing a gas channel volume (V), and a compliance (C). The system has a flow calculation unit operative to determine a gas flow estimate (Fe) at a flow estimate location in the gas channel. The gas flow estimate (Fe) is based on a relationship between a monitored gas flow (Fm) in the gas channel and a compressible gas flow (Fc) which depends on the compliance (C) in the gas channel. The monitored gas flow (Fm) is a gas flow at a monitoring location in the gas channel and the compressible gas flow (Fc) is a flow of gas in the gas channel between the flow estimate location and the monitoring location, and the flow estimate location is remote from the monitoring location.

Breathing system with flow estimation

In a method, ventilator and ventilator control unit for determining an end-expertorial lung volume (EELV) for a mechanically ventilated patient, a breathing gas is provided to the patient that has a first fixed N2/O2 gas composition, at least until the N2/O2 gas composition in air expired from the patient is constant. At least once, at a first predetermined point in time, the N2/O2 gas composition in the breathing gas is changed to a second fixed composition. The change in the N2/O2 gas composition exhaled by the patient for each breath is measured until a second point in time at which the level of expired Oin at least two subsequent breadths is substantially stable. The measurement is made downstream of the expiratory tube of the ventilator. The total gas volume is determined for each breath, and the EELV of the patient's lungs is determined based on the change in Olevel between the first and second points in time.

Growing community of inventors

Danderyd, Sweden

Magnus Hallbäck