Ventilatory assist system and methods to improve respiratory function
First Claim
1. A method of increasing lung compliance on a breath by breath basis by supporting mechanical respiration of a patient with a diaphragm stimulation system comprising an external stimulator and one or more electrodes configured to be implanted at one or more sites in a diaphragm, the external stimulator configured to stimulate the one or more electrodes independently, the method comprising:
- initiating a breath by initiating airflow into the lungs of a patient receiving positive mechanical ventilation from a positive pressure mechanical ventilator (PPMV), constraining the PPMV to a maximal airway pressure, andpreferentially stimulating different regions of the diaphragm over a portion of an inspiration with the one or more electrodes to direct airflow from the PPMV to a region of the lung and thereby increase tidal volume and preventing pressure from the PPMV from exceeding the maximal airway pressure during the breath, thereby improving respiratory compliance on a breath by breath basis.
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Accused Products
Abstract
Systems and methods are provided to improve respiratory function. Systems include an external electrical stimulator coupled to electrodes that stimulates diaphragm contraction and may optionally include a positive pressure mechanical ventilator. The system further includes an electrode suitable for temporary implantation. Electrical stimulation is provided to specific portions of the diaphragm, such as one hemidiaphragm preferentially over another. By preferentially contracting one hemidiaphragm, a specific portion of a lung may be expanded, such as a posterior portion. By the provision of the negative intrathoracic pressure from diaphragm contraction, greater expansion of specific portion of lung is achieved in relationship to air pressure within the lung, thereby improving compliance. Supplementation of stimulated diaphragm contraction with positive pressure driven air flow from a PPMV directs the air flow to specific portions of the lung. Such portion may include a posterior portion of a lung, and may cause a clearing of atelectasis in that portion.
209 Citations
32 Claims
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1. A method of increasing lung compliance on a breath by breath basis by supporting mechanical respiration of a patient with a diaphragm stimulation system comprising an external stimulator and one or more electrodes configured to be implanted at one or more sites in a diaphragm, the external stimulator configured to stimulate the one or more electrodes independently, the method comprising:
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initiating a breath by initiating airflow into the lungs of a patient receiving positive mechanical ventilation from a positive pressure mechanical ventilator (PPMV), constraining the PPMV to a maximal airway pressure, and preferentially stimulating different regions of the diaphragm over a portion of an inspiration with the one or more electrodes to direct airflow from the PPMV to a region of the lung and thereby increase tidal volume and preventing pressure from the PPMV from exceeding the maximal airway pressure during the breath, thereby improving respiratory compliance on a breath by breath basis. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32)
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Specification