Electrical stimulation for preservation and restoration of diaphragm function
First Claim
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1. A medical device for use with a mechanical ventilator and breathing circuit coupled to a patient, said medical device comprising:
- a subcutaneous electrode pair positioned proximate at least one phrenic nerve in the neck of said patient;
a stimulator/controller connected to said electrode pair via a lead cable, said stimulator/controller delivering electrical stimulation to said electrode pair at a pulse repetition rate, with a current and a waveform sufficient to at least partially activate the patient'"'"'s diaphragm;
an instrumented wye coupled to said patient and coupled to said mechanical ventilator via tubing of the breathing circuit, providing a wye flow measurement and a wye pressure measurement to said stimulator/controller;
said stimulator/controller selecting one of several breaths defining a single selected breath;
said stimulator/controller beginning stimulation at the beginning of an inspiratory event in response to an inspiratory trigger event, said event corresponding to a preset specific flow at said instrumented wye;
said stimulator/controller ending stimulation at the end of an inspiratory event triggered by an end inspiratory trigger event, said event corresponding to a specific flow at said instrumented wye;
said inspiratory event trigger and said end inspiratory event trigger together defining a duration for the stimulation within the inspiratory phase of said single selected breath;
a power/work measuring device coupled to said instrumented wye measuring the instantaneous work throughout the inspiratory phase of said single selected breath, by comparing a predicted pressure at the wye and a measured pressure at the wye, and indicating work only if the predicted pressure differs from the measured pressure at said instrumented wye.
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Abstract
A system and method are presented that electrically stimulates the phrenic nerve whereby said stimulation results in muscle activation of the diaphragm as observed by a measurement of work or power of breathing associated with the inspiratory portion of a stimulated breath.
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Citations
7 Claims
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1. A medical device for use with a mechanical ventilator and breathing circuit coupled to a patient, said medical device comprising:
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a subcutaneous electrode pair positioned proximate at least one phrenic nerve in the neck of said patient; a stimulator/controller connected to said electrode pair via a lead cable, said stimulator/controller delivering electrical stimulation to said electrode pair at a pulse repetition rate, with a current and a waveform sufficient to at least partially activate the patient'"'"'s diaphragm; an instrumented wye coupled to said patient and coupled to said mechanical ventilator via tubing of the breathing circuit, providing a wye flow measurement and a wye pressure measurement to said stimulator/controller; said stimulator/controller selecting one of several breaths defining a single selected breath; said stimulator/controller beginning stimulation at the beginning of an inspiratory event in response to an inspiratory trigger event, said event corresponding to a preset specific flow at said instrumented wye; said stimulator/controller ending stimulation at the end of an inspiratory event triggered by an end inspiratory trigger event, said event corresponding to a specific flow at said instrumented wye; said inspiratory event trigger and said end inspiratory event trigger together defining a duration for the stimulation within the inspiratory phase of said single selected breath; a power/work measuring device coupled to said instrumented wye measuring the instantaneous work throughout the inspiratory phase of said single selected breath, by comparing a predicted pressure at the wye and a measured pressure at the wye, and indicating work only if the predicted pressure differs from the measured pressure at said instrumented wye. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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Specification