Insufflating-exsufflating system

Patent metadata

Field	Value
Publication number	US-9114219-B2
Application number	US-200913129887-A
Country	US
Kind code	B2
Filing date	Oct 29, 2009
Priority date	Nov 19, 2008
Publication date	Aug 25, 2015
Grant date	Aug 25, 2015

Abstract

A system ( 10 ) and method of insufflating-exsufflating a subject ( 12 ) that enables monitoring and/or control over an enhanced set of breathing parameters during insufflation-exsuffiation. The system and/or method may include automatic triggering and/or notification to a caregiver of insufflation-exsuffiation. The insufflation-exsuffiation of the subject may be preceded by a secretion loosing routine that loosens secretions in the airway of the subject without moving the loosened secretions up the airway.

First claim

What is claimed is:

1. A system to extract secretions from the airway of a subject, the system comprising:
(a) a circuit to control the pressure at the airway of a subject by generating a flow of gas having a controlled pressure that is delivered to the airway of the subject by an airway interface that communicates the circuit with the airway of the subject; and
(b) a processor to control the circuit such that the flows of gas generated by the circuit move secretions up the airway of the subject by:
(1) use of a secretion loosening module for fluctuating the pressure in the airway of the subject up and down between positive and negative pressures for a plurality of loosening cycles such that the fluctuation of the pressure in the airway of the subject during the loosening cycles loosens secretions in the airway of the subject without moving the secretions up the airway of the subject, followed by
(2) use of an inexsufflation module for fluctuating the pressure in the airway of the subject up and down for one or more insufflation-exsufflation cycles such that a given insufflation-exsufflation cycle insufflates and exsufflates the subject, thereby moving secretions up the airway of the subject.

2. The system of claim 1 , wherein the processor controls the circuit such that:
a loosening cycle of the plurality of loosening cycles causes gas to flow within the airway of the subject at a minimum flow rate at some point during the loosening cycle and an insufflation-exsufflation cycle of the one or more insufflation-exsufflation cycles causes gas to flow within the airway of the subject at a minimum flow rate at some point during the insufflation-exsufflation cycle, and
a lowest minimum flow rate of any of the plurality of loosening cycles is greater than a highest minimum flow rate of any of the one or more insufflation-exsufflation cycles.

3. The system of claim 2 , wherein the processor controls the circuit such that the loosening cycle causes gas to flow within the airway of the subject at a maximum flow rate at some point during the loosening cycle, and wherein the gas moving through the airway of the subject at the minimum and maximum flow rates of the loosening cycle loosen secretions in the airway of the subject without substantially moving the loosened secretions in the airway of the subject.

4. The system of claim 1 , wherein the processor controls the circuit such that:
a loosening cycle of the plurality of loosening cycles takes place over a cycle period corresponding to the loosening cycle and an insufflation-exsufflation cycle takes place over a cycle period corresponding to the insufflation-exsufflation cycle, and
the cycle period corresponding to any of the plurality of loosening cycles is less than the cycle period corresponding to any of the one or more insufflation-exsufflation cycles.

5. The system of claim 1 , wherein the processor controls the circuit such that the one or more insufflation-exsufflation cycles occurs immediately after the plurality of loosening cycles.

6. The system of claim 1 , further comprising:
one or more sensors in communication with gas within the circuit that generate output signals conveying information related to one or more additional parameters of the gas within the circuit in addition to information related to the pressure of the gas within the circuit, wherein the processor further controls the circuit to insufflate-exsufflate the subject, wherein responsive to the processor receiving the output signals generated by the one or more sensors, the processor implements information conveyed in the one or more output signals related to the one or more additional parameters of the gas within the circuit in controlling the circuit during insufflation-exsufflation.

7. The system of claim 6 , wherein the one or more additional parameters of the gas include one or more of a flow rate, a volume, a flow profile, or a pressure profile.

8. The system of claim 6 , wherein the processor implements information conveyed in one or more output signals related to the one or more additional parameters to control at least one of the one or more additional parameters of the gas in the circuit.

9. The system of claim 6 , wherein the processor further determines a baseline measurement for one or more key parameters of gas in the respiratory system of the subject; and controls the circuit to insufflate-exsufflate the subject such that one or more key parameters of the gas in the respiratory system of the subject do not breach the baseline measurement.

10. The system of claim 9 , further comprising a user interface that enables the user to input the baseline measurement to the processor.

11. The system of claim 9 , wherein the one or more key parameters include at least one of pressure and volume.

12. A method of extracting secretions from the airway of a subject, the method comprising steps of:
loosening secretions within the airway of a subject, via a processor controlled gas flow and pressure circuit, without extracting amounts of secretions by delivering gas to the airway of the subject such that pressure in the airway of the subject is fluctuated up and down between positive and negative pressures for a plurality of loosening cycles; and followed by
insufflating-exsufflating the subject, via the processor controlled gas flow and pressure circuit, to extract secretions from the airway of the subject by delivering gas to the airway of the subject such that pressure in the airway alternates the pressure in the airway of the subject between positive pressure and negative pressure for one or more insufflation-exsufflation cycles, thereby extracting secretions from the airway of the subject.

13. The method of claim 12 , wherein a loosening cycle of the plurality of loosening cycles causes gas to flow within the airway of the subject at a minimum flow rate at some point during the loosening cycle and an insufflation-exsufflation cycle of the one or more insufflation-exsufflation cycles causes gas to flow within the airway of the subject at a minimum flow rate at some point during the insufflation-exsufflation cycle, and wherein a lowest minimum flow rate of any of the plurality of loosening cycles is greater than a highest minimum flow rate of any of the one or more insufflation-exsufflation cycles.

14. The method of claim 13 , wherein the loosening cycle causes gas to flow within the airway of the subject at a maximum flow rate at some point during the loosening cycle, and wherein the gas moving through the airway of the subject at the minimum and maximum flow rates of the loosening cycle loosen secretions in the airway of the subject without substantially moving the loosened secretions in the airway of the subject.

15. The method of claim 12 , wherein a loosening cycle of the plurality of loosening cycles takes place over a cycle period corresponding to the loosening cycle and an insufflation-exsufflation cycle of the one or more insufflation-exsufflation cycles takes place over a cycle period corresponding to the insufflation-exsufflation cycle, and wherein the cycle period corresponding to any of the plurality of loosening cycles is less than the cycle period corresponding to any of the one or more insufflation-exsufflation cycles.

16. The method of claim 12 , wherein the one or more insufflation-exsufflation cycles occurs immediately after the plurality of loosening cycles.

17. The method of claim 12 , further for insufflating-exsufflating the subject comprising steps of:
(a) controlling, via the processor controlled gas flow and pressure circuit, the flow of

Assignees

• Kimm Gardner
• Garde Smita
• Arcilla Mabini
• Ahmad Samir
• Koninkl Philips Nv

Inventors

• Kimm Gardner
• Garde Smita
• Arcilla Mabini
• Ahmad Samir

Classifications

• A61M2230/46

  Resistance or compliance of the lungs · CPC title

• A61M2230/43

  Composition of exhalation · CPC title

• A61M2016/0039

  in the inspiratory circuit · CPC title

• A61M2205/3584

  using modem, internet or Bluetooth® · CPC title

• A61M2016/0027

  pressure meter · CPC title