BREATHING ASSISTANCE SYSTEM WITH SPEECH DETECTION

• US 20150202395A1
• Filed: 08/22/2013
• Published: 07/23/2015
• Est. Priority Date: 08/22/2012
• Status: Active Grant

• Current Assignee: ResMed Paris SAS (ResMed Incorporated)
• Original Assignee: ResMed Paris SAS (ResMed Incorporated)
• Inventors: Fromentin, Cyril
• Granted Patent: US 10,406,310 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61M 16/0006 with means for creating vibrations in patients' airways
• CPC Class Codes: A61M 16/021 operated by electrical means A61M16/202 – A61M16/205 take precedence
• CPC Class Codes: A61M 16/0468 with valves at the proximal end limiting exhalation, e.g. during speaking or coughing air passages from trachea to oesophagus or to pharynx, artificial epiglottis A61F2/203
• CPC Class Codes: A61M 16/105 Filters A61M16/047, A61M16/22 take precedence; water traps A61M16/08
• CPC Class Codes: A61M 16/107 in the inspiratory path
• CPC Class Codes: A61M 16/20 Valves specially adapted to medical respiratory devices
• CPC Class Codes: A61M 2205/07 having air pumping means
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3375 Acoustical, e.g. ultrasonic, measuring means
• CPC Class Codes: A61M 2205/35 Communication
• CPC Class Codes: A61M 2205/75 with filters

Abstract

Disclosed is a breathing assistance system (10) comprising: a ventilator (12), a breathing lumen (14) arranged to communicate a flow of air between the ventilator and a tracheostomy tube (16) in the trachea of a patient, and a sensor (24) configured to generate a vibration signal representing vocal cord vibrations of the patient. The system is configured to facilitate the flow of exhaled air to the atmosphere via the upper airway of the patient in response to detection in the vibration signal of speech or attempted speech by the patient.

Claims

1. A breathing assistance system comprising:

a ventilator,

a breathing lumen connectable to a tracheostomy tube in the trachea of a patient and arranged to communicate a flow of air between the ventilator and the tracheostomy tube, and

a sensor configured to generate a vibration signal representing vocal cord vibrations of the patient,

wherein the system is configured to facilitate the flow of exhaled air to the atmosphere via the upper airway of the patient in response to detection in the vibration signal of speech or attempted speech by the patient.

2. A system according to claim 1, configured to facilitate the flow of exhaled air to the atmosphere via the upper airway of the patient by setting a positive end-expiratory pressure to a value that is larger than a normal value.

3. A system according to claim 1, further comprising a valve in communication with the tracheostomy tube.

4. A system according to claim 3, wherein the valve is in communication with the breathing lumen.

5. A system according to claim 3, wherein the valve is co-located with the ventilator.

6. A system according to claim 3, configured to facilitate the flow of exhaled air to the atmosphere via the upper airway of the patient by urging the valve towards its closed state.

7. A system according to claim 3, configured to facilitate the flow of exhaled air to the atmosphere via the upper airway of the patient by sealing the outlet of the valve by using a secondary valve located between the outlet of the valve and the atmosphere.

8. A system according to claim 1, wherein the sensor comprises a contact vibration sensor in contact with the patient.

9. A system according to claim 8, wherein the sensor is a throat microphone attached externally to the throat of the patient.

10. A system according to claim 8, wherein the sensor is insensitive to audible noise other than vibrations generated by the patient.

11. A system according to claim 1, being further configured to cease the facilitation of the flow of exhaled air to the atmosphere via the upper airway of the patient after the end of detection in the vibration signal of speech or attempted speech by the patient.

12. A system according to claim 11, configured to cease the facilitation of the flow of exhaled air to the atmosphere via the upper airway of the patient a predetermined period after the end of detection of speech or attempted speech.

13. A system according to claim 12, wherein the predetermined period is of duration one second.

14. A system according to claim 1, wherein the detection of speech or attempted speech in the vibration signal is performed by a voice detection module.

15. A system according to claim 14, wherein the voice detection module comprises a filter.

16. A system according to claim 14, wherein the facilitating is performed by a command module in communication with the voice detection module.

17. A system according to claim 1, wherein the detection of speech or attempted speech in the vibration signal occurs when the vibration signal exhibits one or more of the group of characteristics consisting of:

quasi-periodic and non-stationary; and

within a range of audible frequencies.

18. A system according to claim 17, wherein the detection of speech or attempted speech in the vibration signal occurs when the vibration signal exhibits one or more of the group of characteristics throughout a contiguous time window, optionally of duration about 200 ms.

19. A system according to claim 17, wherein the detection of speech or attempted speech in the vibration signal occurs when the signal exhibits one or more of the group of characteristics multiple times within an interval, optionally of duration about 500 ms.

20. A system according to claim 1, wherein the ventilator is configured to support ventilation of the patient by facilitating upstream and downstream air flow in the tracheostomy tube in synchrony with exhalation and inhalation portions respectively of breathing cycles of the patient.

21. A voice detection module configured to interact with a breathing assistance system, the module being adapted to:

provide a vibration signal representing vocal cord vibrations of a patient whose ventilation is being supported by the breathing assistance system via a tracheostomy tube in the trachea of the patient;

detect in the vibration signal speech or attempted speech by the patient; and

in response to detection in the vibration signal of speech or attempted speech, provide a control signal configured to modify the behaviour of the breathing assistance system so as to facilitate or improve the quality of the speech, wherein the modifying comprises facilitating the flow of exhaled air via the upper airway of the patient.

22. A voice detection module of claim 21, configured to modify the behaviour of the breathing assistance system for a predetermined period after the end of detection of speech or attempted speech.

23. A voice detection module of claim 22, wherein the predetermined period is one second in duration.

24. A voice detection module of claim 21, wherein the detection of speech or attempted speech occurs when the vibration signal exhibits one or more of the group of characteristics consisting of:

quasi-periodic and non-stationary; and

within a range of audible frequencies.

25. A voice detection module of claim 24, wherein the detection of speech or attempted speech occurs when the vibration signal exhibits one or more of the group of characteristics throughout a contiguous time window, optionally of duration about 200 ms.

26. A voice detection module of claim 24, wherein the detection of speech or attempted speech occurs when the vibration signal exhibits one or more of the group of characteristics multiple times within an interval, optionally of duration about 500 ms.

27. A voice detection module of claim 21, comprising a sensor configured to generate the vibration signal representing vocal cord vibrations of a patient.

28. A voice detection module according to claim 27, wherein the sensor comprises a contact vibration sensor in contact with the patient.

29. A voice detection module according to claim 28, wherein the sensor is a throat microphone attached externally to the throat of the patient.

30. A voice detection module according to claim 28 wherein the sensor is insensitive to audible noise other than vibrations generated by the patient.

31. A voice detection module according to claim 21, wherein the facilitating of the flow of exhaled air via the upper airway is to the atmosphere.

32. A voice detection module according to claim 31, wherein the facilitating comprises closing a valve located between the outlet of a primary valve in communication with the tracheostomy tube and the atmosphere.

33. A method of facilitating or improving the quality of speech by a tracheostomised patient, the method comprising:

supporting ventilation by the patient via a tracheostomy tube in the trachea of the patient,

detecting speech or attempted speech by the patient, and

facilitating the flow of exhaled air to the atmosphere via the upper airway of the patient in response to detection of speech or attempted speech by the patient.

34. A method according to claim 33, wherein the facilitating the flow of exhaled air to the atmosphere via the upper airway of the patient comprises setting a positive end-expiratory pressure to a value that is larger than a normal value.

35. A method according to claim 33, wherein the facilitating the flow of exhaled air to the atmosphere via the upper airway of the patient comprises urging a valve in communication with the tracheostomy tube towards its closed state.

36. A method according to claim 33, wherein the facilitating the flow of exhaled air to the atmosphere via the upper airway of the patient comprises sealing the outlet of a valve in communication with the tracheostomy tube using a secondary valve located between the outlet of the valve and the atmosphere.

37. A method according to claim 33, further comprising ceasing the facilitation of the flow of exhaled air to the atmosphere via the upper airway of the patient after the end of detection of speech or attempted speech by the patient.

38. A method according to claim 37, wherein the ceasing occurs a predetermined period after the end of detection of speech or attempted speech.

39. A method according to claim 38, wherein the predetermined period is of duration one second.

40. A method according to claim 33, wherein the detection of speech or attempted speech comprises analysing a vibration signal representing vocal cord vibrations of the patient to detect one or more of the group of characteristics consisting of:

quasi-periodic and non-stationary; and

within a range of audible frequencies.

41. A method according to claim 40, wherein the detection of speech or attempted speech occurs when the vibration signal exhibits one or more of the group of characteristics throughout a contiguous time window, optionally of duration about 200 ms.

42. A method according to claim 40, wherein the detection of speech or attempted speech in the vibration signal occurs when the vibration signal exhibits one or more of the group of characteristics multiple times within an interval, optionally of duration about 500 ms.

43. A method according to claim 33, wherein the supporting ventilation by the patient comprises facilitating upstream and downstream air flow in the tracheostomy tube in synchrony with exhalation and inhalation portions respectively of breathing cycles of the patient.