Method and device for stabilising disordered breathing

• US 20090299430A1
• Filed: 04/20/2007
• Published: 12/03/2009
• Est. Priority Date: 04/21/2006
• Status: Abandoned Application

• Current Assignee: Imperial Innovations Limited (Imperial College London)
• Original Assignee: Imperial Innovations Limited (Imperial College London)
• Inventors: Davies, Ceri, Willson, Keith, Manisty, Charlotte, Francis, Darrel
• Application Number:
  US12/297,974
• Publication Number:
  US 20090299430A1
• Time in Patent Office: Days
• US Class Current: 607/22
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/145 Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissuemeasuring of blood pressure or blood flow A61B5/02; non-radiation detecting or locating of foreign bodies in blood A61B5/06
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61M 16/0045 Means for re-breathing exhaled gases, e.g. for hyperventilation treatment
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 16/12 by mixing different gases
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2202/0225 Carbon oxides, e.g. Carbon dioxide
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 2230/202 partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/208 pH-value
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/435 : partial O2 pressure (P-O2)
• CPC Class Codes: A61M 2230/60 : Muscle strain, i.e. measured on the user
• CPC Class Codes: A61M 2230/63 : Motion, e.g. physical activity
• CPC Class Codes: A61M 2230/65 : Impedance, e.g. conductivity, capacity
• CPC Class Codes: A61N 1/3601 : of respiratory organs
• CPC Class Codes: A61N 1/36521 : the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/3655 : controlled by body or blood temperature
• CPC Class Codes: A61N 1/36557 : controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36564 : controlled by blood pressure

Abstract

A device and method for improving the stability of a ventilation pattern of a patient (1) uses a sensor (4) for sensing a parameter which reflects a level of lung gas in a patient, such as oxygen or carbon dioxide. The output signal of the sensor is received by a processor (3) which assesses the level of lung gas of the patient and activates means (18,20) for increasing the lung gas level of the patient beyond what it would otherwise have been without treatment in response to a decreasing level or a predicted decreasing level of the lung gas. Thus the device can be used to retard a decrease in said lung gas level, thereby reducing oscillations in the respiration.

Claims

1. A device for improving the stability of a ventilation pattern of a patient comprising

at least one sensor for sensing a parameter which reflects a level of lung gas in a patient and for producing an output signal indicative of said parameter, and

a processor adapted to receive and process the sensor output signal to assess the lung gas level, the processor being in communication with means for increasing the lung gas level of the patient, and being configured to produce a control signal for instructing said means in response to a decreasing level or a predicted decreasing level of lung gas, so as to retard a decrease in said lung gas level.

2. A device as claimed in claim 1, wherein the control signal instructs the lung gas increasing means such that the level of lung gas is increased at the point when the rate of decrease in the natural endogenous lung gas level is equal to or greater than a predetermined value.

3. A device as claimed in claim 1, wherein the processor is configured to identify a cyclic pattern of the lung gas level.

4. A device as claimed in claim 1, wherein the control signal is adapted to cause the output of the lung gas increasing means to follow a predetermined pattern.

5. A device as claimed in claim 4, wherein the pattern has a generally square, saw-tooth or sinusoidal profile.

6. A device as claimed in claim 1, wherein the control signal is adapted to cause the output of the lung gas increasing means to vary in response to real time variations detected in the lung gas level.

7. A device as claimed in claim 1, wherein the processor is configured to control said lung gas increasing means to have a maximum output so as to have a greatest effect on the lung gas level when the natural endogenous level of lung gas would, if untreated, be decreasing at its fastest rate.

8. A device as claimed in claim 1, wherein the control signal instructs the lung gas increasing means such that its output increases incrementally from one breathing cycle to the next breathing cycle.

9. A device as claimed in claim 8, wherein the control signal causes the output to remain constant from one breathing cycle to the next if an increase in output would destabilise breathing.

10. A device as claimed in claim 1, further comprising a memory unit to store the sensor output signal or a derivation thereof for access by the processor.

11. A device as claimed in claim 10, wherein the lung gas increasing means comprises a source of the lung gas in fluid communication with a delivery device configured to deliver the gas to a patient.

12. A device as claimed in claim 11, wherein the delivery device is a facemask or nasal cannula.

13. A device as claimed in claim 11, wherein the source is selected from the group consisting of:

a pressurised canister or cylinder of the pure or dilute gas;

an atmospheric pressure reservoir of the pure or dilute gas; and

a reservoir of exhaled air collected from the patient.

14. A device as claimed in claim 11, further comprising a tube connected to the gas source and an electromechanical device associated with the tube, the control signal being adapted to operate the electromechanical device to adjust the pneumatic resistance of the tube.

15. A device as claimed in claim 11, further comprising a tube connected to the gas source and a valve associated with the gas source, the control signal being adapted to operate the valve to adjust the release of the gas from the source.

16. A device as claimed in claim 1, wherein the lung gas is carbon dioxide.

17. A device as claimed in claim 16, wherein the carbon dioxide increasing means comprises a pacemaker device, the operation of which is controlled by the control signal.

18. A device as claimed in claim 17, wherein the pacemaker is configured to increase a patient'"'"'s heart rate in response to the control signal.

19. A device as claimed in claim 17, wherein the pacemaker is configured to pace a selected cardiac chamber in response to the control signal.

20. A device as claimed in claim 16, wherein the carbon dioxide increasing means comprises a hypoxic gas source.

21. A device as claimed in claim 16, wherein the carbon dioxide increasing means comprises an airflow control element adapted to adjust the degree of the patient'"'"'s respiratory flow.

22. A device as claimed in claim 21, wherein the airflow control element is a physical restraint adapted to reduce the volume of breath taken in by the patient.

23. A device as claimed in claim 1, wherein the lung gas is oxygen.

24. A device as claimed in claim 23, wherein the oxygen increasing means comprises a pacemaker device, the control signal being adapted to operate the pacemaker to cause a reduction in a patient'"'"'s cardiac output.

25. A device as claimed in claim 1, wherein the sensor and the processor are in communication via electrical wires or via wireless communication means.

26. A device as claimed in claim 1, wherein the processor and the lung gas increasing means are in communication via electrical wires or via wireless communication means.

27. A device as claimed in claim 1, wherein the sensor is one or more of selected from the group consisting of:

a ventilatory sensor, a heart rate monitor, a blood velocity, heart rate or thoracic impedance monitor, a respiratory strain gauge, a blood carbon dioxide, oxygen, lactate or pH level monitor, an expired carbon dioxide or oxygen monitor, a thermistor or a peripheral oxygen saturation monitor, and a combination thereof.

49. A method as claimed in claim 28—

being carried out using the device of claim 1.

28. A method of improving the stability of a ventilation pattern of a patient comprising:

detecting a parameter which reflects a level of lung gas in a patient; and

causing a retardation of a decrease in said level of lung gas in response to a decreasing level or predicted decreasing level of lung gas.

29. A method as claimed in claim 28, wherein the step of retarding a decrease in the level of the lung gas is commenced so as to cause a retardation of the decrease in the lung gas level at the point when the rate of decrease in the natural endogenous lung gas level is equal to or greater than a predetermined level.

30. A method as claimed in claim 28, further comprising identifying a cyclic pattern of the lung gas level.

31. A method as claimed in claim 28, wherein the step of retarding a decrease in the level of lung gas is carried out for a duration less than the period of the cyclic pattern.

32. A method as claimed in claim 28, wherein the retarding step involves a retarding force, the magnitude of which is determined according to a pre-set pattern.

33. A method as claimed in claim 32, wherein the pattern has a generally square, saw-tooth or sinusoidal profile with time.

34. A method as claimed in claim 28, wherein the retarding step involves a retarding force, the magnitude and duration of which is varied in response to real time variations detected in the lung gas level.

35. A method as claimed in claim 28, wherein the maximum retarding force is caused when the natural endogenous level of lung gas would, if untreated, decrease at its fastest rate.

36. A method as claimed in claim 32, wherein the magnitude of the retarding force is increased incrementally from one breathing cycle to the next breathing cycle.

37. A method as claimed in claim 36, wherein the retarding force remains constant from one breathing cycle to the next breathing cycle if an increase would destabilise breathing.

38. A method as claimed in claim 28, further comprising:

analysing the detected lung gas level over a period of time to determine the phase and amplitude of the lung gas cycle; and

comparing the phase and amplitude with reference phase and amplitude data to determine a suitable treatment regime.

39. A method as claimed in claim 38, wherein the comparison step includes interpolating the reference phase and amplitude data to the phase and amplitude of the detected signal.

40. A method as claimed in claim 38, wherein the reference phase, amplitude and treatment regime data are updated by the processor based on the patient'"'"'s response to treatment.

41. A method as claimed in claim 40 wherein the processor can monitor the patient'"'"'s response to treatment carried out to stabilise a breathing pattern.

42. A method as claimed in claim 40, wherein the processor can monitor the patient'"'"'s response to doses of test treatment.

43. A method as claimed in claim 28, wherein the decrease in the level of lung gas in the lungs is retarded by delivering the lung gas to the patient from a source of the gas.

44. A method as claimed in claim 28, wherein the lung gas is carbon dioxide.

45. A method as claimed in claim 44, wherein the decrease in the level of carbon dioxide in the lungs is retarded by delivering a hypoxic gas mixture to the patient from a gas source.

46. A method as claimed in claim 44, wherein the decrease in the level of carbon dioxide in the lungs is retarded by varying the pacing parameters of a pacemaker to cause an increase in cardiac output.

47. A method as claimed in claim 28, wherein the lung gas is oxygen.

48. A method as claimed in claim 47, wherein the decrease in the level of oxygen in the lungs in retarded by varying the pacing parameters of a pacemaker to cause a reduction in cardiac output.