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Publication Number
US-12329716-B2
Publication Date
2025-06-17
Expiration Date
Abstract
The present invention provides, among other things, apparatus and methods of use for treating a subject in need of assistance with breathing. In some embodiments the subject suffers from airflow obstruction. In some embodiments, the subject suffers from chronic obstructive pulmonary disease.
Core Innovation
The invention relates to breathing-assistance methods and apparatus in which a subject is treated by sensing when the subject is exhaling and delivering a stimulus to the subject’s thorax or abdomen during at least part of the expiratory phase of breathing in response to the sensing. The delivered stimulus is configured to assist the subject with exhalation, and the treatment decreases the subject’s end expiratory lung volume (EELV) as compared with the subject’s EELV when unassisted.
The described approach targets abnormal breathing characterized by abnormally high EELV and hyperinflation, including dynamic hyperinflation absent the stimulus. The invention also includes synchronizing the delivered stimulus with the expiratory phase so that the stimulus is delivered during at least part of the expiratory phase based on when the subject is exhaling.
Sensing and stimulus delivery are described as being implemented with wearable or externally applied components, including sensing thorax or abdomen movement using inductive plethysmography, strain gauge sensors, and piezoelectric sensors, as well as sensing based on airflow, pressure, and temperature. Stimulus delivery may include electrical stimulation to muscles of expiration via electrodes and/or mechanical compression of the abdomen or lower anterior thorax, including inflatable compartments, and may further include a controller that processes sensor signals and supports delivery based on breath-pattern and activity.
The invention further characterizes stimulus targeting and mechanisms, including delivering electrical stimulation to one or more muscles of expiration and/or to efferent nerve(s) supplying one or more muscles of expiration to cause contraction of the muscle(s) or increase expiratory force generated by the muscle(s). Example muscle targets include the rectus abdominis and lower internal intercostal muscles, and the techniques can be used in contexts such as weaning from mechanical ventilation and non-invasive ventilation.
Claims Coverage
The document includes one independent claim, supported by dependent claims that refine how exhalation is sensed and how the stimulus is delivered, while preserving the core requirement that the treatment decreases EELV versus unassisted breathing. The main inventive features focus on expiratory-phase sensing and thorax/abdomen stimulation that assists exhalation to reduce EELV.
Exhalation sensing and expiratory-phase thorax/abdomen stimulation to decrease EELV
A method of treating a subject comprising sensing when the subject is exhaling and delivering a stimulus to the subject’s thorax or abdomen during at least part of the expiratory phase of breathing in response to said sensing, so as to assist the subject with exhalation, wherein the method decreases the subject’s end expiratory lung volume (EELV) as compared with the subject’s EELV when unassisted.
Abnormally high EELV without the stimulus
The method wherein the subject has an abnormally high EELV when the stimulus is absent.
Detecting thorax or abdomen respiratory movement using inductive plethysmography
The method further including detecting a subject’s thorax or abdomen respiratory movement using inductive plethysmography.
Electrical stimulation to muscles of expiration and/or efferent nerve(s)
The method further including delivering electrical stimulation to one or more muscles of expiration and/or to efferent nerve(s) supplying one or more muscles of expiration, wherein said stimulus is sufficient to cause contraction of said muscle(s) or increase the expiratory force generated by said muscle(s).
Electrical stimulation to rectus abdominis
The method including delivering electrical stimulation to the rectus abdominis muscle as part of step (b).
Mechanical compression of the abdomen or lower anterior thorax
The method including, in step (b), mechanically compressing the subject’s abdomen or lower anterior thorax.
Overall claim coverage is centered on sensing exhalation and delivering a thorax/abdomen stimulus during at least part of the expiratory phase to assist exhalation such that EELV is decreased versus unassisted breathing. Dependent features further specify conditions such as abnormally high EELV, sensing implementation such as inductive plethysmography, and stimulus mechanisms including electrical stimulation to muscles of expiration/efferent nerve(s), specific abdominal muscle targeting, and mechanical compression of the abdomen or lower anterior thorax.
Stated Advantages
Decreases the subject’s end expiratory lung volume (EELV) compared with unassisted breathing.
Helps address abnormal breathing including abnormally high EELV and hyperinflation, including dynamic hyperinflation absent the stimulus.
Documented Applications
Weaning from mechanical ventilation.
Non-invasive ventilation (CPAP/non-invasive ventilation).
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