Synchronizing mechanical in-exsufflation and diaphragmatic pacing

Patent metadata

Field	Value
Publication number	US-10137262-B2
Application number	US-201314422013-A
Country	US
Kind code	B2
Filing date	Aug 13, 2013
Priority date	Aug 20, 2012
Publication date	Nov 27, 2018
Grant date	Nov 27, 2018

Abstract

Systems and methods for synchronizing machine-induced inexsufflation with diaphragmatic pacing of a subject, e.g. through a diaphragm pacer, use the detected onset of an inhalation and/or exhalation of a subject. The detection is based on output signals generated by one or more sensors.

First claim

What is claimed is:

1. A system for synchronizing machine-induced inexsufflation with a diaphragmatic pacing of a subject, the system comprising;
a pressure generator configured to generate a pressurized flow of breathable gas for delivery to an airway of the subject;
one or more sensors configured to generate one or more output signals conveying information related to one or both of
i) one or more gas parameters of a flow of breathable gas being breathed by the subject and/or
ii) one or more respiratory parameters of the subject; and
one or more processors configured to execute computer program modules, the computer program modules comprising:
a configuration module configured to obtain one or more configurable operational settings of the diaphragmatic pacing of the subject;
a detection module configured to detect onsets of inhalations of the subject such that, for a first respiratory cycle, the detection module detects an onset of a first inhalation of the subject based on the one or more output signals, wherein the first inhalation is included in the first respiratory cycle;
a target module configured to determine a target parameter for machine-induced inexsufflation during respiratory cycles such that, responsive to detection of the onset of the first inhalation, the target module determines the target parameter for machine-induced inexsufflation during a second respiratory cycle such that the machine-induced inexsufflation occurs in synchrony with the diaphragmatic pacing of the subject, wherein the second respiratory cycle is subsequent to the first respiratory cycle, and wherein the target parameter corresponds to an onset of inhalation during the second respiratory cycle or an onset of exhalation during the second respiratory cycle; and
a control module configured to control the pressure generator to inexsufflate the subject such that during the second respiratory cycle the control module controls the pressure generator to inexsufflate the subject in accordance with the target parameter for machine-induced inexsufflation, wherein:
inexsufflating the subject comprises controlling the pressure generator to generate a pressure cycle providing a positive pressure during a first time period, a negative pressure during a second time period, and a pause in pressure generation during a third time period, wherein the third time period occurs subsequent to the second time period and the second time period occurs subsequent to the first time period; and
at least two of the first, second, or third time periods are adjusted based on the target parameter in one or more subsequent pressure cycles to enhance synchronization of the machine-induced inexsufflation with the diaphragmatic pacing over multiple pressure or respiratory cycles.

2. The system of claim 1 , further comprising a user interface configured to provide an interface between the system and a user through which the user can provide information to the system, wherein the configuration module is configured to obtain one or more configurable operational settings through the user interface.

3. The system of claim 1 , wherein the configuration module is configured to obtain one or more operational settings through electronic signal transfer from a diaphragm pacing device configured to perform the diaphragmatic pacing of the subject.

4. The system of claim 1 , wherein the one or more sensors include a pressure band configured to generate one or more output signals conveying information related to one or more respiratory parameters of the subject, wherein the detection module detects the onset of the first inhalation based on the one or more output signals generated by the pressure band, and wherein the configuration module is configured to obtain the one or more configurable operational settings based on the output signals generated by the pressure band.

5. The system of claim 1 , wherein the one or more output signals convey information related to one or more gas parameters of the flow of breathable gas being breathed by the subject during one or more respiratory cycles, and wherein the configuration module is configured to obtain the one or more configurable operational settings based on the one or more output signals.

6. A method for synchronizing machine-induced inexsufflation with diaphragmatic pacing of a subject, the method comprising;
generating one or more output signals conveying information related to one or both of
i) one or more gas parameters of a flow of breathable gas being breathed by the subject and/or one,
ii) or more respiratory parameters of the subject;

obtaining one or more configurable operational settings of diaphragmatic pacing of the subject;
detecting an onset of a first inhalation of the subject, for a first respiratory cycle, the detection based on the one or more output signals, wherein the first inhalation is included in a first respiratory cycle; and
determining, responsive to detection of the onset of the first inhalation of the subject, a target parameter for machine-induced inexsufflation during a second respiratory cycle such that the machine-induced inexsufflation occurs in synchrony with diaphragmatic pacing of the subject, wherein:
the second respiratory cycle is subsequent to the first respiratory cycle,
the target parameter corresponds to an onset of inhalation during the second respiratory cycle or an onset of exhalation during the second respiratory cycle,
inexsufflating the subject comprises controlling the pressure generator to generate a pressure cycle providing a positive pressure during a first time period, a negative pressure during a second time period, and a pause in pressure generation during a third time period,
the third time period occurs subsequent to the second time period and the second time period occurs subsequent to the first time period, and
at least of the first, second, or third time periods are adjusted based on the target parameter in one or more subsequent pressure cycles to enhance synchronization of the machine-induced inexsufflation with the diaphragmatic pacing over multiple pressure or respiratory cycles.

7. The method of claim 6 , further comprising obtaining information from the user through a user interface, wherein one or more configurable operational settings are obtained from the user through the user interface.

8. The method of claim 6 , wherein the one or more configurable operational settings are obtained through electronic signal transfer from a diaphragm pacing device configured to perform the diaphragmatic pacing of the subject.

9. The method of claim 6 , wherein the one or more output signals that convey information related to one or more respiratory parameters of the subject are generated by a pressure band, wherein detecting the onset of the first inhalation is based on the one or more output signals generated by the pressure band, and wherein determining the target parameter is based on the one or more output signals generated by the pressure band.

10. The method of claim 6 , wherein the one or more output signals convey information related to one or more gas parameters of the flow of breathable gas being breathed by the subject, wherein obtaining the one or more configurable operational settings is based on the one or more output signals.

11. A system configured for synchronizing machine-induced inexsufflation with a diaphragmatic pacing of a subject, the system comprising;
pressure means for generating a pressurized flow of breathable gas for delivery to an airway of the subject;
means for generating one or more output signals conveying information related to one or both of
i) one or more gas parameters of a flow of breathable gas being b

Assignees

• Koninklijke Philips Nv

Inventors

• Lee Seunghyun
• Grace Richard
• Kissel Michael Howard
• Mcdermott Mark Christopher

Classifications

• A61M16/0003 Primary

  Accessories therefor, e.g. sensors, vibrators, negative pressure · CPC title

• A61N1/3601

  of respiratory organs · CPC title

• A61M2205/054

  with electrotherapy · CPC title

• A61M2230/40

  Respiratory characteristics · CPC title

• A61M2230/005

  Parameter used as control input for the apparatus · CPC title