Device for supportive respiration of a living being and computer program

1 . A device for supportive ventilation of a living being, comprising:

a sensor arrangement,

a programmable control unit, and

an air delivery unit controllable by the programmable control unit,

wherein the sensor arrangement comprises a pressure sensor and an air flow sensor which are respectively designed for temporally successive detection of respiratory air pressure values of the living being and temporally successive detection of respiratory air flow values of the living being over one or more respiratory cycles,

wherein the programmable control unit is designed to evaluate respiratory air pressure curves and respiratory air flow curves formed from the temporally successive respiratory air pressure values and the temporally successive respiratory air flow values detected by the sensor arrangement, by an evaluation configured to include identifying characteristic features of the respiratory air flow curves and characteristic features of the respiratory air pressure curves, which are characteristic of frustrated breathing movement,

wherein the programmable control unit is further designed to detect frustrated breathing movements of the living being by a detecting based on a combination of the identified characteristic features of the respiratory air pressure curves and the identified characteristic features of the respiratory air flow curves, the detecting being configured to indicate detection of a detected frustrated breathing movement based at least in part on detecting at least one of the identified characteristic features of the respiratory air pressure curves being related, at least temporally, to at least one of the identified characteristic features of the respiratory air flow curves,

wherein the detecting is further configured to include distinguishing of the detected frustrated breathing between being:

a frustrated breathing movement occurring as a result of an intrinsic PEEP of the living being, and

a frustrated breathing movement occurring as a result of a trigger insufficiency, and

wherein the detecting of the detected frustrated breathing movement and the distinguishing of the frustrated breathing movement are performed based on evaluation of the relation between the respiratory air pressure and respiratory air flow curves measured for the same breath, without requiring comparison of the respiratory air pressure or air flow curves with stored abnormal reference waveforms, and

wherein the distinguishing is based at least in part on a shape feature of the at least one of the identified characteristic features of the respiratory air pressure curves that the detecting determined as being related, at least temporally, to the at least one of the identified characteristic features of the respiratory air flow curves.

2 . The device as claimed in claim 1 , wherein:

the characteristic features of the respiratory air pressure curves comprise maxima, minima, bulges, turning points, saddle points, amplitudes, integrals, and/or gradients or derivatives at predefined time points and/or time segments of the respiratory air pressure curves, and

the characteristic features of the respiratory air flow curves comprise maxima, minima, bulges, turning points, saddle points, amplitudes, integrals, and/or gradients or derivatives at predefined time points and/or time segments of the respiratory air flow curves.

3 . The device as claimed in claim 1 wherein the characteristic features of the respiratory air pressure curves comprise characteristic deviations from predefined reference respiratory air pressure curves and/or the characteristic features of the respiratory air flow curves comprise characteristic deviations from predefined reference respiratory air flow curves.

4 . The device as claimed in claim 1 wherein the programmable control unit comprises a memory unit for storing predefined reference respiratory air pressure curves and/or predefined reference respiratory air flow curves and/or reference features for characteristic features of frustrated breathing movements.

5 . The device as claimed in claim 4 , wherein the memory unit has various disease-specific reference respiratory air pressure curves and/or various disease-specific reference respiratory air flow curves and/or various disease-specific reference features for characteristic features of frustrated breathing movements.

6 . The device as claimed in claim 1 wherein the programmable control unit is further designed such that the distinguishing of the detected frustrated breathing movement as being a frustrated breathing movement occurring as a result of a trigger insufficiency includes further distinguishing, based on the at least one of the identified characteristic features of the respiratory air flow curves and the shape feature of the at least one of the identified characteristic features of the respiratory air pressure curves determined as being related, at least temporally, to the at least one of the identified characteristic features of the respiratory air flow curves, the detected frustrated breathing movement between being a frustrated breathing movement occurring as a result of a leakage-related trigger insufficiency and a frustrated breathing movement occurring as a result of a parameter-related trigger insufficiency.

7 . The device as claimed in claim 1 wherein the programmable control unit is further designed to perform detection of at least one of the frustrated breathing movements based at least in part on a time point, a time span, and/or a form of a respiratory air pressure increase or reduction and/or a respiratory air flow increase or reduction, appearing in the respiratory air pressure curves and/or in the respiratory air flow curves.

8 . The device as claimed in claim 1 wherein the programmable control unit is further designed to perform oscillometric airway resistance measurements.

9 . The device as claimed in claim 1 wherein the programmable control unit is further designed to:

determine, based on instances wherein a result of the distinguishing is that the detected frustrated breathing movement is a frustrated breathing movement occurring as a result of an intrinsic PEEP of the living being, a frequency and/or an intensity of the intrinsic PEEP of the living being, and/or

determine, based on instances wherein a result of the distinguishing is that the detected frustrated breathing movement is a frustrated breathing movement occurring as a result of a trigger insufficiency, a frequency and/or an intensity of the trigger insufficiency.

10 . The device as claimed in claim 9 , wherein the programmable control unit is further designed to output an acoustic, optical and/or haptic alarm signal when a predefined threshold value for the frequency and/or the intensity of the intrinsic PEEP or of the trigger insufficiency is exceeded.

11 . The device as claimed in claim 1 wherein the programmable control unit is further designed to automatically vary control parameters of the air delivery unit in response to detection of one or more of the frustrated breathing movements.

12 . The device as claimed in claim 11 , wherein the programmable control unit is further designed for continuous regulating automatic variation of control parameters of the air delivery unit, in a manner to reduce and/or eliminate occurrences of the characteristic features of the respiratory air pressure curves and/or occurrences of the characteristic features of the respiratory air flow curves.

13 . The device as claimed in claim 11 wherein the programmable control unit is further designed to automatically vary control parameters of the air delivery unit in a manner to reduce occurrences of the characteristic features of the respiratory air pressure curves and/or reduce occurrences of the characteristic features of the respiratory air flow curves, according to a predefined intrinsic minimum PEEP.

14 . The device as claimed in claim 13 , wherein the programmable control unit is further designed to determine the predefined intrinsic minimum PEEP on the basis of pCO2 measurements.

15 . The device as claimed in claim 11 wherein a control parameter predefined by the programmable control unit functions as an inspiration trigger or an expiration trigger for changing the device from an inspiration mode to an expiration mode, or vice versa.

16 . The device as claimed in claim 11 wherein a control parameter predefined by the programmable control unit functions as a respiratory air pressure curve and/or a respiratory air flow curve of air delivered by the air delivery unit.

17 . The device as claimed in claim 11 wherein a control parameter predefined by the programmable control unit functions as a counterpressure and/or a counterpressure curve and/or a counterpressure amplitude and/or a counterpressure wait time during the expiration phase.

18 . The device as claimed in claim 17 , wherein the counterpressure amplitude and/or the counterpressure wait time is settable as a function of each other and/or as a function of an IPAP value or a IPAP value range and/or as a function of a differential pressure of IPAP to EPAP.

19 . The device as claimed in claim 1 wherein the programmable control unit is further designed such that based on distinguishing of a detected frustrated breathing movement occurring as a result of an intrinsic PEEP of the living being,

the programmable control unit automatically reduces a backup frequency and/or reduces an IPAP value and/or reduces a maximum inspiration time to automatically increase an expiration trigger sensitivity after elimination of a detected frustrated breathing movement occurring as a result of an intrinsic PEEP of the living being, and/or

the programmable control unit automatically increases the backup frequency and/or increases the IPAP value and/or increases the maximum inspiration time to automatically reduce the expiration trigger sensitivity after elimination of a detected frustrated breathing movement occurring as a result of the intrinsic PEEP of the living being.

20 . The device as claimed in claim 1 wherein the programmable control unit comprises a pattern recognition unit designed for recognizing characteristic features of the respiratory air pressure curves and/or the characteristic features of the respiratory air flow curves.

21 . A computer program with program code encoded on a non-transient storage medium-designed to carry out a method for supportive ventilation of a living being with a ventilator when the computer program is executed on a computing unit of the ventilator,

wherein a pressure sensor and an air flow sensor of the ventilator respectively detect temporally successive respiratory air pressure values of the living being and temporally successive respiratory air flow values of the living being over one or more respiratory cycles,

wherein a programmable control unit of the ventilator evaluates respiratory air pressure curves and respiratory air flow curves formed from the temporally successive respiratory air pressure values and the temporally successive respiratory air flow values detected by the pressure sensor and the air flow sensor, by an evaluation that includes identifying characteristic features of the respiratory air pressure curves, which are characteristic of frustrated breathing movement, and characteristic features of the respiratory air flow curves, which are characteristic of frustrated breathing movement, and

wherein the programmable control unit of the ventilator

indicates a detected frustrated breathing movement of the living being based at least in part on detecting at least one of the identified characteristic features of the respiratory air pressure curves being related, at least temporally, to at least one of the identified characteristic features of the respiratory air flow curves, and associated with indicating the detected frustrated breathing movement, the distinguishes the detected frustrated breathing movement between being:

a frustrated breathing movement occurring as a result of an intrinsic PEEP of the living being, and

a frustrated breathing movement occurring as a result of a trigger insufficiency,

by a distinguishing that is based at least in part on a shape feature of the least one of the identified characteristic features of the respiratory air pressure curves detected as related, at least temporally, to the at least one of the identified characteristic features of the respiratory air flow curves.

22 . The device as claimed in claim 7 wherein the programmable control unit is further designed such that distinguishing of a detected frustrated breathing movement between being a frustrated breathing movement occurring as a result of an intrinsic PEEP of the living being and a frustrated breathing movement occurring as a result of a trigger insufficiency is further based on the time point, the time span and/or the form of the respiratory air pressure increase or reduction and/or the respiratory air flow increase or reduction in the respiratory air pressure curves and/or the respiratory air flow curves.

23 . The device as claimed in claim 1 ,

wherein the distinguishing of a detected frustrated breathing movement between being a frustrated breathing movement occurring as a result of an intrinsic PEEP of the living being and a frustrated breathing movement occurring as a result of a trigger insufficiency comprises determining a respective temporal relation between a respective time of one of the identified characteristic features of the respiratory air pressure curves and a respective time of one of the identified characteristic features of the respiratory air pressure curves.