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Publication Number
US-9174046-B2
Publication Date
2015-11-03
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 provides apparatus and methods for assisting breathing of a subject who is intubated or has recently been extubated by treating the subject with an apparatus that senses when the subject is exhaling and delivers treatment during at least part of the expiratory phase. The apparatus includes a sensor suitable for detecting when a subject is exhaling and a device adapted to deliver an electrical stimulus in response to a signal generated by the sensor. The electrical stimulus is effective to cause or increase contraction of at least some muscles of expiration during at least part of the expiratory phase.
The sensing of exhalation/expiration is performed by detecting thorax or abdomen movement and may be implemented using respiratory inductive plethysmography sensors, strain gauge sensors, or piezoelectric respiratory effort sensors, including a sensor incorporated into a belt or garment and/or an adhesive patch. The system includes components such as a controller and signal conditioning that use information from one or more preceding breathing cycles and associated breathing patterns, posture, and activity to determine stimulus timing and parameters.
The delivery of stimulus is timed to avoid delivering significant stimulus during inhalation, including synchronizing stimulation near onset of exhalation/end inspiration, and may include electrical or mechanical forms of expiratory-phase stimulation. In addition, multi-mode operation is described in which one mode provides tactile sensory cues without eliciting expiratory muscle contraction, while other modes deliver stimulation effective to cause or increase contraction during expiratory phase.
Claims Coverage
The partial claim set provided includes one independent claim. The inventive features center on detecting exhalation and delivering an electrical stimulus effective to increase expiratory muscle contraction during at least part of the expiratory phase for a subject who is intubated or has recently been extubated.
Detecting exhalation with a sensor
A method of assisting breathing using an apparatus comprising a sensor suitable for detecting when a subject is exhaling, wherein the sensor generates a signal used for response-based treatment.
Electrical expiratory-phase muscle stimulation in response to the sensor
A device adapted to deliver an electrical stimulus to at least some muscles of expiration during at least part of the expiratory phase in response to the signal generated by said sensor.
Stimulus effective to cause or increase contraction during expiration
The electrical stimulus is effective to cause or increase contraction of said muscle(s) during at least part of the expiratory phase of the subject's breathing.
Method applied to an intubated or recently extubated subject
The method comprises treating a subject who is intubated or has recently been extubated.
Across the provided claim text, the core inventive coverage is the combination of an exhalation-detecting sensor and an apparatus delivering an electrical stimulus effective to cause or increase contraction of expiration muscles specifically during at least part of the expiratory phase for an intubated or recently extubated subject.
Stated Advantages
Reducing end expiratory lung volume (EELV), including reducing dynamic and static hyperinflation.
Improving expiratory flow rate.
Providing respiratory muscle training/biofeedback and supporting expiratory activity.
Supporting ventilator weaning or reducing need for non-invasive support or oxygen.
Documented Applications
Assisting breathing in subjects with obstructive respiratory diseases, notably COPD.
Assisting breathing of a subject who is intubated or has recently been extubated.
Reducing end expiratory lung volume (EELV) / functional residual capacity (FRC) and related hyperinflation in such subjects.
Supporting ventilator weaning or reducing need for non-invasive support or oxygen in such subjects.
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