Abstract: 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.

Abstract: The present disclosure relates to a method for continuous and noninvasive estimation of mixed venous blood saturation [SvO2] in a mechanically ventilated subject (3). The method comprises the steps of measuring (S1; S10) an expiratory carbon dioxide [CO2] content in expiration gas exhaled by the subject, measuring (S2; S20) an expiratory flow or volume of expiration gas exhaled by the subject, estimating (S3; S30) a cardiac output [CO] or an effective pulmonary blood flow [EPBF] of the subject from the measured expiratory CO2 content and the measured expiratory flow or volume using a capnodynamic Fick method, and estimating (S4; S40) SvO2 based on the estimated CO or the EPBF of the subject.

Abstract: 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.

Abstract: 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 (Paw), a patient flow (Ø), 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.

Abstract: The present disclosure relates to a method for automatic evaluation of a filling volume of an oesophageal balloon catheter (26) inserted into a mechanically ventilated patient (3). The method comprises obtaining (S3-S4) samples of an airway pressure, Paw, and an oesophageal pressure, Pes, of the patient during an occlusion period in which respiration of the patient is prevented, evaluating (S5) the filling volume of the oesophageal balloon catheter by determining a ratio, ?Pes/?Paw, between Pes and Paw from a regression analysis of the Pes and Paw samples, and communicating (S6) a result of the evaluation to a user.

Abstract: 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.

Abstract: 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 (Palv) of the subject is between a minimum lung pressure and a maximum lung pressure of the subject during the prolonged breath.

Abstract: 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.

Abstract: 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.

Abstract: 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.

Abstract: 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.

Abstract: The present disclosure relates to a method for controlling a ventilator arrangement. The method 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.

Abstract: The present invention relates to non-invasive determination of the effective lung volume [ELV], cardiac output, effective pulmonary blood flow [EPBF] and/or the carbon dioxide content of venous blood of a mechanically ventilated subject (3). The subject (3) is ventilated using a ventilation pattern comprising at least one phase of decreased ventilation and at least one phase of increased ventilation, wherein each of said phases comprises at least two breaths during which a level of CO2 expired by said subject assumes a substantially steady state (SS1, SS2). At least one of said phases of decreased and increased ventilation comprises at least a first breath for generating a substantial change in the level of expired CO2 compared to a preceding breath, and at least a second breath being different in duration and/or volume than said first breath, for causing the level of expired CO2 to assume said substantially steady state (SS1, SS2).

Abstract: The present disclosure relates to a medical pressure measuring device (100) for measuring a pressure of a pressurized breathing gas supplied to a subject by a breathing apparatus (200). The device (100) comprises a pressure sensor (110) arranged at a point of measurement (195) and configured to measure the pressure of a sample gas at a sampling point (190). The sampling point (190) and the point of measurement (195) are connected by a pressure sampling tube (180) in which a pressure wave of the sample gas can propagate from the sampling point (190) to the point of measurement (195). The pressure sampling tube (180) has a sampling tube volume and an acoustic impedance. The medical pressure measuring device (100) further comprises a damping arrangement (120) arranged to be brought into fluid communication with the pressure sampling tube (180). The damping arrangement (120) comprises a flow restrictor (130) and a receptor chamber arrangement (140).

Abstract: 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.

Abstract: The present disclosure relates to a method, computer program and breathing apparatus for determination of at least one physiological parameter including the neuromechanical efficiency [NME] of a patient (3) being mechanically ventilated by the breathing apparatus (1). This is achieved by obtaining (S2, S4) samples of an airway pressure (Paw), a patient flow (Ø), a change in lung volume (V) caused by the patient flow, and an electrical activity of a respiratory muscle of the patient (3), during ventilation of the patient at a first level of ventilatory assist and a second and different level of ventilatory assist, and determining (S5) 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.

Abstract: The present disclosure relates to a capnotracking method for continuous determination of cardiac output or EPBF of a mechanically ventilated subject (3), comprising the steps of measuring (S1) expiratory CO2 of the subject and determining (S2) a first value of cardiac output or EPBF of the subject at a first point in time. The method further comprises the steps of controlling (S3) 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 (S4) from the expiratory CO2 measurements a change in alveolar CO2 of the subject between the first and second points in time, and determining (S5) a second and updated value of cardiac output or EPBF of the subject based on the first value and the change in alveolar CO2 .

Abstract: The present disclosure relates to a method for determination of cardiac output or EPBF of a mechanically ventilated subject (3). The method comprises the steps of introducing (S2) a change in the effective ventilation of the subject (3), measuring (S1) expiratory flow and CO2 during a sequence of analysed breaths during which the effective ventilation of the subject (3) varies, and determining (S3) the cardiac output or EPBF of the subject (3) using the flow and CO2 measurements. The method further comprises the steps of measuring (S1) also a relative variation in cardiac output or EPBF during the sequence of analysed breaths, and using the relative variation in the determination (S3) of cardiac output or EPBF.

Abstract: 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.

Abstract: 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.