Stimulatory device and methods to electrically stimulate the phrenic nerve

• US 6,587,726 B2
• Filed: 05/29/2002
• Issued: 07/01/2003
• Est. Priority Date: 06/11/1998
• Status: Expired due to Term

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Advanced Circulatory Systems, Inc. (Asahi Kasei Corporation)
• Inventors: Zielinski, Todd M., Patterson, Robert, McKnite, Scott, Lindner, Karl, Samniah, Nemer, Lurie, Keith G., Voelckel, Wolfgang
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US10/158,528
• Publication Number:
  US 20020188332A1
• Time in Patent Office: 398 Days
• Field of Search: 607/2, 607/42, 607/48, 607/77, 601/15, 601/41, 128/206.24, 128/206.25, 128/898
• US Class Current: 607/42
• CPC Class Codes: A61H 2031/002 fixed on the chest by adhesives
• CPC Class Codes: A61H 2201/165 Wearable interfaces
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2201/5043 Displays
• CPC Class Codes: A61H 2201/5048 Audio interfaces, e.g. voice or music controlled
• CPC Class Codes: A61H 2201/5061 Force sensors
• CPC Class Codes: A61H 31/00 Artificial respiration or heart stimulation, e.g. heart massage artificial respiration by treatment with gas or air, e.g. mouth-to-mouth respiration A61M16/00; applying electric currents by contact electrodes for stimulation, e.g. heart pace-makers A61N1/36 ; teaching or training models, demonstration models for medical purposes G09B23/288
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61H 31/006 Power driven
• CPC Class Codes: A61H 31/007 Manual driven
• CPC Class Codes: A61M 16/0084 self-reinflatable by elasticity, e.g. resuscitation squeeze bags
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/0683 Holding devices therefor
• CPC Class Codes: A61M 16/205 used for exhalation control
• CPC Class Codes: A61M 16/209 Relief valves
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2230/08 Other bio-electrical signals
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/50 : Temperature
• CPC Class Codes: A61N 1/0456 : Specially adapted for transcutaneous electrical nerve stimulation [TENS]
• CPC Class Codes: A61N 1/046 : Specially adapted for shock therapy, e.g. defibrillation
• CPC Class Codes: A61N 1/3601 : of respiratory organs
• CPC Class Codes: A61N 1/36031 : using physiological parameters for adjustment
• CPC Class Codes: A61N 1/36034 : specified by the stimulation parameters
• CPC Class Codes: A61N 1/39044 : in combination with cardiopulmonary resuscitation [CPR] therapy
• CPC Class Codes: A61N 1/39046 : User protection from shock
• CPC Class Codes: A61N 2/002 : in combination with another treatment

Abstract

The invention provides exemplary devices and methods electrically stimulating the phrenic nerve. In one embodiment, electrodes are placed posterior and anterior in the region of the cervical vertebrae. Electrical current having a multi-phasic waveform is periodically applied to the electrodes to stimulate the phrenic nerve, thereby causing the diaphragm to contract.

Claims

1. A method for treating a patient suffering from shock, the method comprising:

coupling a flow control system to the patient'"'"'s airway, wherein the flow control system is configured to limit or prevent the flow of respiratory gases into the patient'"'"'s lungs for at least some time; and

permitting the patient to gasp or inspire air, with the flow control system limiting or preventing the flow of respiratory gases into the lungs for at least some time during the gasp or breath to decrease the patient'"'"'s intrathoracic pressure and to increase venous return to the right chambers of the heart from the peripheral venous vasculature to improve hemodynamic parameters of the patient and thereby treat the patient for shock.

2. A method as in claim 1, wherein the flow control system comprises an impedance threshold valve that is configured to prevent respiratory gases from flowing to the lungs until a threshold actuating pressure is achieved.

3. A method as in claim 2, wherein the impedance threshold valve is configured to open when the negative intrathoracic pressure is in the range from about −

5 cm H2O to about −

30 cm H2O.

4. A method as in claim 1, wherein the patient is suffering from a type of shock selected from a group consisting of hypovolemic shock, hemorrhagic shock or cardiogenic shock.

5. A method as in claim 1, further comprising stimulating the patient to cause the patient to gasp.