Proportional pressure assist ventilation controlled by a diaphragm electromyographic signal
First Claim
1. A method for monitoring/adjusting the level of positive end expiratory pressure produced by a pressure assist device in relation to a signal representative of inspiratory effort in view of minimizing the level of pre-inspiratory effort, comprising:
- a) receiving a signal representative of inspiratory flow;
b) calculating from said inspiratory flow signal an onset time for inspiration;
c) receiving a signal representative of inspiratory effort having an amplitude;
d) calculating a signal representative of pre-inspiratory effort in response to said onset time and said signal representative of inspiratory effort; and
e) increasing or decreasing the level of positive end expiratory pressure in relation to said signal representative of pre-inspiratory effort.
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Abstract
A closed loop system uses (a) the intensity of the diaphragm electromyogram (EMG) for a given inspiratory volume; (b) the inspiratory volume for a given EMG intensity; or (c) a combination of (a) and (b); in view of controlling the level of gas flow, gas volume or gas pressure delivered by a mechanical (lung) ventilator. The closed loop ventilator system enables for automatic or manual adjustment of the level of inspiratory support in proportion to changes in the neuro-ventilatory efficiency such that the neural drive remains stable at a desired target level. An alarm can also be used to detect changes in neuroventilatory efficiency in view of performing manual adjustments.
110 Citations
24 Claims
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1. A method for monitoring/adjusting the level of positive end expiratory pressure produced by a pressure assist device in relation to a signal representative of inspiratory effort in view of minimizing the level of pre-inspiratory effort, comprising:
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a) receiving a signal representative of inspiratory flow;
b) calculating from said inspiratory flow signal an onset time for inspiration;
c) receiving a signal representative of inspiratory effort having an amplitude;
d) calculating a signal representative of pre-inspiratory effort in response to said onset time and said signal representative of inspiratory effort; and
e) increasing or decreasing the level of positive end expiratory pressure in relation to said signal representative of pre-inspiratory effort. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A controller for monitoring/adjusting the level of positive end expiratory pressure produced by a pressure assist device in relation to a signal representative of inspiratory effort in view of minimizing the level of pre-inspiratory effort, comprising:
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a) a first input for receiving a signal representative of inspiratory flow having an onset time for inspiration;
b) a second input for receiving a signal representative of inspiratory effort having an amplitude;
c) a computer device responsive to said onset time and said signal representative of inspiratory effort to compute signal representative of pre-inspiratory effort; and
d) an adder/subtractor for adding a preset increment to or subtracting a preset decrement from the level of positive end expiratory pressure in relation to said signal representative of pre-inspiratory effort. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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Specification