Method of operating ventilator

Abstract

To provide a system which comprises a therapy device for performing a therapy, and at least one hose system for gas-conducting connection between the therapy device and a patient.SOLUTION: The therapy device has at least one gas source 101 for generating a positive and / or negative pressure so as to at least temporarily provide the positive and / or negative pressure to the hose system for performing the therapy. The system further comprises at least one control unit, at least one user interface, at least one storage device, and at least one sensor. The control unit has at least one of: a therapy mechanism for starting the therapy; a therapy reminder mechanism for reminding of the therapy; and a therapy repetition mechanism for extending and / or repeating the therapy. Each of the therapy mechanisms is based on user actions, patient data, and / or therapy data.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present invention relates to a system and a treatment device having a mechanism for automatically initiating treatment and / or secretion management, or automatically reminding thereof.

Background Art

[0002] In the prior art, mechanical insufflators / exsufflators for assisting patients in coughing up secretions are known. Mechanical insufflators / exsufflators are typically used independently of ventilators. For treatment, it is necessary to switch from a ventilator to a treatment device. The use of mechanical insufflators / exsufflators is rare, and their use is not particularly pleasant, so patients tend to forget to use them regularly. In that case, a relatively large amount of secretions may accumulate in the patient's airway, leading to a deterioration of the ventilation situation. In that case, prophylactic use of a mechanical insufflator / exsufflator or prophylactic (manual) suction of secretions improves the ventilation situation and leads to the regular removal of secretions from the lungs. In addition to insufflators / exsufflators, suction devices, which are used, for example, depending on the available time in a hospital, for removing secretions from the upper airway or the oral area, are also known.

Summary of the Invention

Problems to be Solved by the Invention

[0003] An object of the present invention is to provide a system for regular and timely secretion management.

Means for Solving the Problems

[0004] The present invention relates to a system comprising at least one treatment device for performing treatment, and at least one hose system for gas conduction connection between the treatment device and a patient, wherein the treatment device has at least one gas source for generating positive pressure and / or at least one gas sink for generating negative pressure, and provides positive and / or negative pressure to the hose system at least temporarily for performing treatment, and the system further comprises at least one control unit, at least one user interface, at least one storage device, and at least one sensor. The system has a control unit having a treatment mechanism for initiating treatment, and / or a treatment reminder mechanism for reminding treatment, and / or a treatment repeat mechanism for extending and / or repeating treatment, which are based on user actions, patient data, and / or treatment data, respectively.

[0005] In some embodiments, the system is characterized in that the control unit is configured to allow setting treatment and / or treatment initiation, and / or treatment repetition and / or extension, via a user interface and / or external interface.

[0006] In some embodiments, the system is characterized in that the treatment initiation mechanism and / or reminder mechanism and / or treatment repetition mechanism can be canceled and / or postponed via a user interface.

[0007] In some embodiments, the system is characterized in that a control unit is configured to automatically adapt data characterizing the patient, such as pulmonary function (vital capacity / forced inspiratory volume, lung compliance / thoracic compliance, etc.), age, weight, ventilation data, pathology / underlying disease data, and experience with cough assistance techniques (Husten-Manoever), for the frequency of treatment reminders and / or initiations, via a user interface and / or via a storage device.

[0008] In some embodiments, the system is characterized in that, based on detected data, particularly measured and stored values ​​of SpO2, pulse rate, and / or CO2, and / or altered pressure / volume flow rate behavior, if the data indicates that treatment would be beneficial in removing secretions from the airway, treatment is automatically initiated, or the patient is suggested to initiate treatment, and / or reminded to initiate treatment.

[0009] In some embodiments, the system is characterized in that the treatment device is connected to a ventilator, or the treatment device and ventilator are combined as a single device, and data is provided by the ventilator.

[0010] When a treatment device generates only positive pressure, it is beneficial for the treatment device and the ventilator to be formed as the same device. For example, the treatment device can be formed as at least one hardware module and / or software module of the ventilator.

[0011] In some embodiments, the system indicates that the underlying data specifically includes SpO2 values, and when a threshold for SpO2 saturation is reached, treatment is initiated and / or a treatment reminder and / or treatment is repeated and / or treatment is extended.

[0012] In some embodiments, the system is characterized in that the SpO2 threshold is stored in the system and can be arbitrarily set.

[0013] In some embodiments, the system is characterized in that the effect of the treatment being performed on the transition of at least one of the following amounts: SpO2, CO2, pressure, flow rate, tidal volume, acoustic signal / sound, and signal-to-noise ratio (SNR) is stored and / or processed in the treatment device and / or coupled ventilator, and these stored and / or processed data are taken into consideration when making decisions about initiating treatment and / or repeating treatment and / or reminding treatment.

[0014] In some embodiments, the system is configured to evaluate the signal-to-noise ratio (SNR) of underlying data, particularly pressure and / or flow rate signals, and when the SNR value reaches a threshold, it initiates or extends treatment or its reminder.

[0015] In some embodiments, the system is characterized by the fact that the procedure is initiated via a ventilator, which is exclusively and / or additionally coupled with a reminder or possibility for initiating the procedure.

[0016] In some embodiments, the system is characterized by the initiation of treatment and / or treatment reminders and / or treatment repetitions, which involve changes in specific parameters of the ventilator.

[0017] In some embodiments, the system is characterized in that the detected effect on the changes in at least one of the following quantities due to the treatment performed—SpO2, CO2, flow rate, tidal volume, and signal-to-noise ratio (SNR)—changes the ventilation parameters of the ventilator.

[0018] In some embodiments, the system is characterized in that the treatment device and the ventilator can be pneumatically coupled, thereby directly combining ventilation with mechanical insulation and exsufflation.

[0019] In some embodiments, the system is characterized by the fact that two device functions, ventilation and mechanical insufflation and exsufflation, are realized in a single device.

[0020] In some embodiments, the system is characterized in that, based on detected data, particularly measured and stored values ​​of pressure, flow rate, tidal volume, SpO2, pulse rate, and / or CO2, or data from past cough assistance techniques such as Peak Cough Flow (PCF), or treatment initiation and / or reminder and / or treatment repetition, and repeated insufflation and exsufflation, repeated insufflation and exsufflation are automatically performed and / or suggested to the patient when these data indicate that further secretions need to be removed from the airway.

[0021] In some embodiments, the system is characterized by the fact that detected and / or stored data is uploaded to a cloud-based system, and a cloud-based algorithm makes treatment-related decisions, and these decisions are also made available from the cloud to the treatment device to adapt the treatment or treatment initiation time.

[0022] In some embodiments, the system is characterized in that user feedback regarding the subjective perception of automatically performed treatment initiation and / or repetition and / or reminders is possible through the user interface and / or via an app on a mobile terminal device coupled to the treatment device, and this user feedback is stored and / or processed and taken into consideration for subsequent decisions regarding treatment initiation and / or treatment repetition and / or treatment initiation reminders.

[0023] In some embodiments, the system is characterized in that cough treatment can be started and / or repeated and / or terminated by the treatment device via a remote control and / or an app on a mobile terminal device coupled with the treatment device, as a result of treatment reminders.

[0024] In some embodiments, the system is characterized by the fact that it attempts to automatically initiate treatment based on detected data, and that treatment parameters are automatically adapted based on the detected data.

[0025] In some embodiments, the system is characterized in that a notification indicating automatic treatment start is generated on the treatment device and / or the coupled ventilator.

[0026] In some embodiments, the system is characterized in that the automatic treatment start can be aborted and / or postponed in time via the user interface.

[0027] In some embodiments, the system is characterized in that the treatment device comprises at least one gas source for generating positive pressure in order to at least temporarily provide positive pressure for inflation to the hose system for performing the treatment.

[0028] In some embodiments, the system is characterized in that the treatment device comprises at least one gas sink for generating negative pressure in order to at least temporarily provide negative pressure for secretion suction and / or for exhalation to the hose system for performing the treatment.

[0029] In some embodiments, the system comprises at least one gas source for generating positive pressure, at least one gas sink for generating negative pressure, and switching means on the treatment device, the switching means being set to at least temporarily provide positive pressure for inflation and / or negative pressure for exhalation to the hose system, and the control unit being set to provide positive pressure to the hose system for inflation for a predetermined period under a predetermined pressure and / or pressure profile and preferably subsequently to provide negative pressure to the hose system for exhalation for a predetermined period under a predetermined pressure and / or pressure profile.

[0030] In some embodiments, the system is characterized in that at least one control unit, at least one storage device, at least one user interface, and at least one sensor are part of the treatment device.

[0031] The present invention also relates to a therapeutic device comprising at least one gas source for generating positive pressure, wherein the therapeutic device further comprises at least one control unit, a user interface, a storage device and a sensor, the therapeutic device can be connected to at least one hose for connecting a patient to the therapeutic device, and the therapeutic device has at least one switching means configured to provide positive pressure for inflation to the hose system at least temporarily. The therapeutic device is characterized in that the control unit comprises a therapeutic initiation mechanism for initiating treatment and / or a reminder mechanism for reminding treatment, and / or a therapeutic repetition mechanism for extending and / or repeating treatment, each based on user actions, patient data and / or treatment data.

[0032] In some embodiments, the treatment device further comprises a gas sink for generating negative pressure, and a switching means is configured to provide at least temporarily positive pressure for insufflation and / or negative pressure for exsufflation to the hose system, and a control unit is configured a. To provide a hose system with positive pressure for inflation for a predetermined period of time under a predetermined pressure and / or pressure profile, b. Preferably thereafter, the system is set to provide negative pressure for exsufflation for a predetermined period of time under a predetermined pressure and / or pressure profile.

[0033] In some embodiments, this is characterized in that the treatment device also includes a ventilation function and / or can be coupled to a ventilation device.

[0034] The features described individually in the claims can be combined in any way that is technically meaningful to illustrate further embodiments of the invention. The following description will characterize and clarify the invention, particularly in relation to the figures.

[0035] It should be further noted that the conjunction "and / or" between two features used herein, connecting them to one another, should always be interpreted as meaning that in a first embodiment of the subject matter according to the present invention, only the first feature may exist; in a second embodiment, only the second feature may exist; and in a third embodiment, both the first and second features may exist.

[0036] A ventilator is understood as any device that assists the user's or patient's natural breathing, is responsible for the ventilation of the user or organism (e.g., patient and / or neonatal and / or premature infant), and / or is used in respiratory therapy, and / or otherwise affects the user's or patient's breathing. This includes, but is not limited to, CPAP and BiLevel devices, anesthesia or anesthetic devices, respiratory therapy devices, ventilators (in hospitals, outside hospitals, or in emergency rooms), and high-flow therapy devices. A ventilator can also be understood as a diagnostic device for ventilation. In this case, the diagnostic device can generally be used to detect the organism's medical and / or respiratory-related parameters. This also includes devices that can detect and optionally process a patient's medical parameters in combination with or solely related to respiration.

[0037] Unless otherwise specified, any measuring device and peripheral equipment intended for interaction with a living organism, particularly for therapeutic or diagnostic purposes, can be understood as a patient interface. In particular, a patient interface can be understood as a ventilator mask or a mask connected to a ventilator. This mask may be a full-face mask, i.e., a mask that covers the nose and mouth, or a nose mask, i.e., a mask that covers only the nose. Tracheal hoses or tracheal cannulas, and so-called nasal cannulas, can also be used as masks or patient interfaces. In many cases, a patient interface may also be a simple mouthpiece, such as a tube, through which the organism at least exhales and / or inhales.

[0038] In the context of this invention, a gas source for generating positive pressure is synonymous with a positive pressure gas source. A gas sink for generating negative pressure is synonymous with a negative pressure gas source. It should be clearly stated that a positive pressure gas source can also be a source of negative pressure gas. That is, depending on the embodiment, a common source for both positive and negative pressure gas can be found. However, alternatively or supplementarily, separate sources for positive and negative pressure gas can also be provided.

[0039] In the course of describing the present invention, the term “treatment” generally refers to secretion management unless otherwise specified. Secretion management may include, for example, cough treatment, cough assistance, insufflation, insufflation followed by exsufflation, and / or suctioning of secretions from the mouth or airway. For example, in the case of a patient receiving ventilation via a tracheostomy tube, suctioning of secretions via the tube may also be considered treatment in the sense of the present invention. By insufflation and optionally followed by exsufflation, the patient being treated is, for example, encouraged to cough and / or assisted in doing so. In this case, coughing helps to expel or remove secretions from the airway and / or lungs by coughing. In this case, the treatment usually includes several cough assistance techniques, which are also divided into several cough cycles. A cough cycle usually includes at least one insufflation and one exhale or cough. In some embodiments, a cough cycle includes at least one insufflation and one exhale.

[0040] Insufflation refers to a deep, pressure-assisted inspiration of a patient, where the inspiratory pressure and, in some cases, the inspiratory length are longer than those of normal inspiration within the range of (mechanical) ventilation. In connection with this, the flow rate and / or volume may also be greater. Insufflation can be performed, for example, in several stages, with pauses in place of exhalation between these stages (air stacking). Alternatively, insufflation can be performed in a single stroke. A single stroke can be, for example, longer and / or deeper compared to normal inspiration. For example, exsufflation may follow insufflation, or the patient may perform deep, forced exhalation (coughing).

[0041] Exsufflation refers to the optional and sudden introduction of negative pressure (compared to normal ambient pressure) after insufflation, thereby inducing a deep exhale or cough in the patient. In this case, introducing negative pressure can increase the pressure difference, enabling a more efficient cough.

[0042] The initiation of treatment can be characterized by various aspects, some of which depend on their respective prerequisites. If the treatment device is a standalone device and the patient interface and / or hoses must be replaced, the initiation of treatment can be considered, for example, when the patient interface is replaced. The initiation of treatment can also be defined by switching on the treatment device and / or preparing the treatment device. In some embodiments, the initiation of treatment is the point at which the treatment device initiates and / or prepares the first cough assistance technique. Preparation is, for example, one or more breaths before the first cough cycle. Warming up and / or starting the treatment device and / or operating the blower can also be considered the initiation of treatment.

[0043] The end of treatment can be defined by the completion of the last treatment cycle. Treatment may also be considered to have ended when the treatment device is switched off or stopped. If the treatment device is connected to a ventilator, for example, at least for data transmission, this state is considered to be the termination of the treatment device when the treatment device is no longer actively providing treatment and / or is only exchanging data with the connected ventilator. Treatment may also be considered to have ended when the patient interface for cough treatment is replaced or removed.

[0044] This system includes, at a minimum, a mechanism for reminding treatment, and / or a mechanism for initiating treatment, and / or a mechanism for repeating and / or extending treatment. The system may be intended to include at least two or all three of these mechanisms. In that case, the mechanisms can be activated and / or deactivated at will. In that case, it may also be intended that at least one of the mechanisms is activated and / or deactivated automatically. For example, if the treatment device is connected to a ventilator, at least one of the mechanisms can be activated. In this case, activation / deactivation does not mean that treatment is performed immediately, but rather that a decision can be made on when treatment should be performed, and in some cases, that it be initiated or a corresponding message is generated.

[0045] In this case, the system includes at least one control unit, at least one memory device, at least one user interface, and at least one sensor. In this case, the control unit is configured and formed to have a treatment initiation mechanism and / or a treatment repetition mechanism and / or a treatment reminder mechanism. In some embodiments, the control unit is part of the treatment device. However, it is also possible to intend for the control unit to be located at least locally independently of the treatment device in the system. For example, the control unit can be located in a ventilator which is optionally coupled to the treatment device.

[0046] The system includes at least one therapeutic device formed to perform a treatment.

[0047] In some embodiments, the system comprises at least one therapeutic device configured to generate positive pressure from at least one gas source and to apply this positive pressure to a hose system. The therapeutic device is exemplary, for example, configured to perform saffron by positive pressure. The system also exemplary, additionally, includes a switching means that stops applying positive pressure to the hose system by a sudden switch, thereby causing a sudden pressure drop in the patient and possibly causing the patient to take a deep, forced exhale or cough.

[0048] In some embodiments, the treatment device includes, alternatively or supplementarily, a gas sink for generating negative pressure. In some embodiments, secretions can be aspirated from the patient's airway via the negative pressure. In some embodiments, the gas source and sink for generating negative pressure can be combined, so that the sink can be used simultaneously or temporarily as a gas source. For example, the treatment device can be used simultaneously or temporarily for ventilation of the patient, for example, by negative pressure, and then switched to secretion management. In some embodiments, negative pressure can be provided to a hose system for exsufflation.

[0049] In some embodiments, the system comprises at least one therapeutic device configured to generate sufflation and / or ex-sufflation by at least one controllable source or sink for negative and / or positive pressure. In some embodiments, the therapeutic device comprises a gas source for generating positive pressure and a gas sink for generating negative pressure. In this case, the source and sink can be combined, i.e., the source can be used simultaneously as a sink. That is, the therapeutic device is configured to assist the patient in coughing and / or to induce the patient to cough. The purpose of coughing is, for example, secretion management, in particular to expel secretions by coughing or to remove them from the patient's airway (including the lungs). The therapeutic device can also be configured to perform the patient's cough. Whether the patient is supplied with positive pressure gas or negative pressure gas can be controlled by a switching means.

[0050] [Mechanisms for reminding patients about treatment] In some embodiments, the system includes a mechanism for reminding patients about treatment, i.e., a treatment reminder mechanism. The reminder mechanism is configured to provide treatment reminders based on available data. Such reminders can be configured in various forms that can be optionally combined with each other.

[0051] One form of reminder involves, for example, a system generating a notification and / or alarm indicating to the patient and / or caregiver that treatment should and / or must be performed. Such notifications can be output, for example, through a user interface. In this case, the notification may be intended to contain only the message that treatment should be performed. In some embodiments, the notification / alarm may include additional information. This additional information may include, for example, a recommended form of treatment and / or one or more reasons for treatment and / or a message regarding the next steps for performing the treatment. Reasons for performance may include, for example, the time elapsed since the last treatment and / or medical relevance such as, for example, the accumulation of secretions in the airways and / or regular secretion management. Furthermore, there may be medical relevance in the case of illness, for example, infection or being infected. In addition, other medical measurements such as respiratory flow rate, SpO2, CO2, blood pressure, blood glucose levels, or medication use may influence the reminder.

[0052] Messages regarding the next steps in treatment may include, for example, instructions to be taken. Optionally, these instructions may progress step-by-step in accordance with the actions of the patient and / or caregiver. For example, if the current instruction step intends for the patient interface to be connected, the instructions move to the next step once the patient interface is recognized as connected. For actions that the system cannot recognize on its own, confirmation may be provided via the user interface.

[0053] Alternatively or supplementally, the prominence of reminders can be graded. If reminders are based, for example, on the time elapsed since the last treatment, a simple reminder can be generated at the earliest scheduled time for treatment, for example, containing a message that a certain period of time has elapsed since the last treatment and / or that treatment can or should be performed. This initial simple reminder may be discontinued, ignored, and / or postponed in time by the patient and / or user. After a further period, a more prominent reminder can be generated, for example, so that the patient and / or caregiver recognizes that the performance of treatment is more imminent, i.e., that treatment needs to be performed soon or in the near future.

[0054] In that case, it may be intended that minimum and maximum periods be set between the two treatments. For example, the reminder may be designed to become more prominent as the current period approaches the maximum period. The reminder may be made more prominent by, for example, color design, font size, animation (e.g., flashing display) and / or sound support. For example, when the maximum period since the last treatment has been reached, the reminder may be made into a clearly perceptible alarm, for example, by an audible alarm.

[0055] In some embodiments, it may be intended that reminders can be delayed over time. If a reminder is generated by the mechanism but the patient and / or caregiver are not ready to treat, the reminder can be acknowledged, for example, by accepting it, thereby generating a new reminder at a later time. It may also be intended that reminders cannot be postponed any further once the maximum period since the last treatment has been reached. In some embodiments, if a special escalation stage is intended, for example by an audible signal, the reminder is simply provided silently but not stopped.

[0056] Treatment reminders are intended at least on the treatment device. Reminders can also be extended to other devices. For example, a treatment device can be connected to a ventilator, in which case data is exchanged between the devices at least temporarily. In that case, reminders can be additionally or alternatively generated on the ventilator, i.e., patients and / or nurses can be reminded to perform treatment via the ventilator. Reminders can also be generated and / or displayed via external partner stations (Gegenstellen), for example, on cloud-connected mobile terminal devices and / or computer applications.

[0057] In some embodiments, following and / or along with a reminder, the patient and / or caregiver are prompted to select a treatment setting. At the very least, they may be able to select to initiate treatment. Alternatively or supplementarily, the patient and / or user are prompted to select a treatment type and / or to input and / or select various parameters related to the treatment.

[0058] [Mechanism for initiating treatment] In some embodiments, the system includes, alternatively or supplementarily, a mechanism for initiating treatment, which is a treatment initiation mechanism. The initiation mechanism is configured to initiate treatment based on available data. Such initiations can be configured in various forms that are optionally combined with one another.

[0059] One form of treatment initiation is treatment preparation. If the system recognizes available data, for example based on existing data, it can initiate treatment in the sense of treatment preparation. Preparation includes, for example, loading a treatment program that includes multiple procedures and / or cycles. Other parameters related to the treatment, such as treatment intensity, can also be stored in the treatment program. Alternatively or supplementarily, treatment preparation includes, for example, preparing the treatment device by startup and / or warm-up. One embodiment of preparation is characterized by simply giving the patient and / or caregiver the possibility of initiation. For example, this can be done by activating a start button and / or displaying it on a touch-sensitive screen (touchscreen). In some embodiments, the system may be prepared by a treatment initiation mechanism, and the execution of the treatment may be initiated via an application on a remote partner station, such as a mobile terminal device.

[0060] Furthermore, the preparation for treatment can also display the steps of the treatment to be performed. These steps may include, for example, changes to the patient interface, and / or the input or inquiry of additional declarations / data / information / parameters for treatment.

[0061] Alternatively or supplementally, the initiation mechanism may be designed to put the system into a state where the patient and / or caregiver only need to operate an initiation button to perform the treatment.

[0062] In some embodiments, the system is coupled to a ventilator such that a therapeutic device is used for at least one data exchange. Exemplarily, the user interface display of the therapeutic device may be used to extend the ventilator's display when the therapeutic device is not in use. In this case, the treatment initiation mechanism can have various effects on this coupling.

[0063] For example, the initiation mechanism may be designed to terminate at least one extended display at the start of treatment. Alternatively or additionally, an additional display regarding the initiation of treatment may be generated on the ventilator's display. If the ventilator's extended display is terminated by the initiation mechanism, a display corresponding to the initiation of treatment may be designed to appear on the treatment device's display. If the treatment device is coupled to the ventilator in a manner in which data is exchanged, the ventilator's data may also be designed to be included in the available data used as a basis for determining the initiation mechanism.

[0064] In some embodiments of the system, the treatment device is pneumatically coupled to a ventilator as an alternative or supplement. In this case, the pneumatic coupling may be intended to require only a change in the patient interface for implementation. It may also be intended that a patient interface suitable for both ventilation and cough treatment is used. That is, the treatment initiation mechanism may be intended to automatically start the execution of treatment.

[0065] For example, in the case of pneumatic coupling, a valve can be provided to switch between the air pressure of the ventilator and the air pressure of the treatment device. If the treatment initiation mechanism determines that treatment should be performed based on available data, for example, it may be intended that treatment be initiated automatically. In this case, for example, a valve can be used to switch from the air pressure of the ventilator to the air pressure of the treatment device, thereby enabling treatment. In other words, treatment can be initiated without any action from the patient and / or caregiver.

[0066] Alternatively or supplementally, notifications can be generated via the treatment device and / or ventilator to indicate to the nurse and / or patient that treatment is about to be initiated. For example, a visual message can be used to alert the patient and / or nurse. An audible signal can also be used to indicate to the patient and / or nurse that treatment is imminent. Optionally, several messages can be given at specific time intervals, for example, before treatment begins. For example, a visual message can be used to alert the patient and / or nurse a certain time before treatment begins. As treatment is about to begin, an audible signal can be used to supplement the visual message, so that the patient and / or nurse are not startled by the start of treatment. Automatic initiation of treatment may also include automatic selection of a treatment program.

[0067] Based on available data, if the system determines that there is an urgent situation where immediate initiation of treatment is meaningful, treatment may be initiated without further message. In some embodiments, an alarm message indicating the urgent situation may also be generated, for example, via a remote partner station such as a connected server and / or mobile terminal device.

[0068] In some embodiments, the system includes a combined ventilator and a treatment device. In this case, the mechanism for initiating treatment can function as if the treatment device and the ventilator were pneumatically coupled. In this case, the combined device switches between ventilation mode and treatment mode to initiate treatment.

[0069] Alternatively or supplementally, a combination of a treatment initiation mechanism and a reminder mechanism can be considered. Depending on the available data, for example, a treatment reminder can be initiated before treatment begins. Exemplarily, treatment is reminded at least once. If the user ignores the reminder, and / or when the time to start treatment and / or the available data is reached, the system can be designed to switch from the reminder mechanism to the initiation mechanism. The initiation mechanism can, for example, generate a message indicating that treatment will be initiated after a certain period of time. After this period, treatment is initiated according to the treatment initiation mechanism described above. In the case of pneumatically coupled ventilators and treatment devices, and combined treatment devices / ventilators, for example, the execution of treatment can be started automatically. In contrast, for devices that are not coupled, or coupled only for data exchange, treatment initiation can be designed to correspond to treatment preparation, such as warming up / starting up the device / individual components.

[0070] [Mechanism for repeating treatment] In some embodiments, the system includes, alternatively or supplementarily, a treatment repetition mechanism, which is a mechanism for repeating treatment. The repetition mechanism determines, based on available data, whether the treatment is repeated and / or extended. Available data may include, for example, data detected during the treatment currently being performed. To determine treatment repetition and / or treatment extension, it may be intended to evaluate whether the treatment is effective and / or to what extent it is effective. For example, it may be recognized that the patient's cough is too little or no, and / or other data indicate insufficient treatment. For example, if the Peak Cough Flow (PCF) is too low and / or does not reach a certain pressure, the treatment is insufficient. In some embodiments, this may alternatively or supplementarily indicate (too high) leakage or too low oxygen saturation (SpO2). Subsequently, it may be intended that additional cough assistance techniques and / or cough cycles are added to the current treatment in the form of treatment extension. For example, cycles and / or techniques are added until a certain threshold of data indicating the patient's cough and / or at least sufficient treatment is reached. Optionally, additional procedures and / or cycles may be intended to have adapted parameters. If data obtained during the current treatment indicate, for example, that the intensity of a cycle or procedure is too low to induce coughing, or, for example, to elicit a response in the patient by switching between positive and negative pressure, then subsequent and / or additional cycles and / or procedures may be intended to have appropriately adapted intensity.

[0071] Alternatively or supplementally, a repetition of the treatment may be planned. For example, the same treatment may then be performed again, optionally with a configurable, fixed, and / or automatically detected time delay. In some embodiments, instead of the same treatment, a treatment that is at least partially modified may be planned as a repetition. For example, the modification may be based on data detected during the initial treatment.

[0072] In some embodiments, a therapeutic combination mechanism can be conceived that combines at least two of the functions of the aforementioned mechanisms. For example, the combination mechanism may combine the functions of a reminder mechanism and an initiation mechanism. Combinations of a reminder mechanism and a repetition mechanism, and / or a repetition mechanism and an initiation mechanism are also conceivable. In some embodiments, the therapeutic combination mechanism includes the functions of a therapeutic reminder, a therapeutic initiation, and a therapeutic repetition mechanism.

[0073] [Integration of treatment device and ventilator] In some embodiments, the system includes a ventilator coupled to the treatment device, in addition to the treatment device. Coupling and / or pneumatic coupling of the devices may be provided for data exchange between them.

[0074] When devices are coupled for data exchange, the treatment device and the ventilator are connected to each other via a data line. This data line may be wired and / or wireless. Data exchange allows both devices to access data detected by the other device. For example, since the ventilator is used for a longer period than the treatment device, it may also detect a larger amount of data. In particular, the ventilator detects data during patient ventilation. For example, this data can be used to evaluate whether treatment by the treatment device is meaningful and / or should be performed. In some embodiments, when coupled to a ventilator, the treatment device is configured to at least temporarily extend the display of the ventilator via an indicator in the user interface of the treatment device.

[0075] In the case of coupling for data exchange, it may be intended that some calculations and / or evaluations of ventilator data be performed in the therapeutic device. For example, the therapeutic device may perform an evaluation of the data to determine whether treatment is necessary. In some embodiments, the ventilator may be configured to spontaneously perform an evaluation to determine the need for treatment and transmit the corresponding results to the therapeutic device. Alternatively or supplementarily, ventilator data may also be used by the therapeutic device to adapt treatment parameters and / or to select a treatment form or treatment program.

[0076] In some embodiments, it is intended that data detected by the treatment device during treatment can be evaluated, at least in part, to determine whether and / or how it can be adapted to ventilation by a ventilator. For this purpose, evaluation can be performed by the treatment device and / or the ventilator. That is, data detected by the ventilator can influence treatment, and / or data detected by the treatment device can influence ventilation.

[0077] In some embodiments of the system, the treatment device is pneumatically coupled to the ventilator, either as an alternative or supplemental measure. The pneumatic coupling can be performed independently of or in conjunction with coupling for data exchange. In the case of pneumatic coupling, for example, it may be possible to switch between the ventilator's pneumatic pressure and the treatment device's pneumatic pressure without the need to change the hose system between the patient and the device. For example, a valve device may be connected to both pneumatic pressures and controlled by a control unit to switch between ventilation and treatment. Alternatively, a combined treatment device and ventilator may be provided. The combined device may include, for example, separate devices for performing treatment and ventilation, and / or devices capable of providing both treatment and ventilation.

[0078] [Data usable as a basis] The available data will be used as the basis for mechanisms for treatment reminders and / or treatment initiation and / or treatment repetition. The available data may include multiple data points and parameters.

[0079] In some embodiments, available data used as the basis for at least one of the mechanisms (treatment reminder, treatment initiation, treatment repetition) includes at least one period. The period may be, for example, the period since the last treatment. The method for evaluating the period may be, for example, predetermined and fixed, determined by the patient and / or caregiver, and / or based on the last and / or next treatment.

[0080] Treatment (which may be repeated as needed) could be, for example, regular secretion management, which is performed periodically to remove accumulated secretions from the patient's airways. In healthy individuals, this is usually done without assistance, for example, almost unnoticed, and / or by, for example, deep breathing or spontaneous coughing. In contrast, for some individuals, this secretion management needs to be assisted or compulsory. In such cases, secretion management may include, exemplarily, inflation and subsequent coughing, combined inflation / exufflation, and / or aspiration of secretions from the airways. A period of time may be provided between treatments, after which a new treatment may be performed. In this case, each mechanism, for example, a treatment reminder mechanism and / or a treatment initiation mechanism, may be activated in response to, for example, the elapsed time, to trigger the reminder and / or treatment initiation. Alternatively or supplementally, schedules may be planned or set with different periods of time between treatments as needed. Such schedules may, for example, have shorter intervals between treatments during the patient's waking phase and longer intervals during the sleeping phase, or the intervals may be chosen so that no treatment is performed during the sleeping phase.

[0081] Alternatively or supplementally, available data may include a treatment plan that specifies the time points at which treatment reminders and / or treatment initiation are triggered. Various forms of treatment intended for specific time points may also be stored in the treatment plan. In some embodiments, the specified time points may be the period during which treatment is to be performed. For example, a treatment reminder mechanism may be intended to generate the first reminder at the beginning or point in time of the period. In embodiments combining a reminder mechanism and an initiation mechanism, a reminder may be generated first at a specified time point, and treatment initiation may be triggered after a specified and / or configurable number of reminders.

[0082] In some embodiments, the available data may include, alternatively or supplementarily, data and / or information entered by the patient and / or caregiver, for example, via a user interface. This data and / or information may be patient data such as gender, age, height, weight, and / or disease. In some embodiments, a treatment reminder mechanism and / or a treatment initiation mechanism and / or a treatment repetition mechanism may be intended to determine and / or recommend the time between two treatments based on the entered data and / or information. It may also be intended that the treatment form is determined by each mechanism and / or recommendations regarding the treatment form are generated. It may be further intended that the patient and / or caregiver can enter additional information and / or data between two treatments, taking into account the following timeframes. For example, the patient's infection can be confirmed and this can be entered as information between the two treatments, thereby, for example, the time between treatments and / or the treatment form or intensity can be adapted and / or recommendations regarding the adaptation can be generated.

[0083] For example, if it is entered that a patient has an infection, the time between two treatments may be shortened. In connection with this, it may be optionally intended that additional other configurable possibilities related to the treatment be proposed. In some embodiments, different types and / or severity of infections may be reported, and based on this, each mechanism may make and / or propose different modifications to the duration and / or other treatment parameters.

[0084] In some embodiments, the available data may additionally or alternatively include data detected by the treatment device. Data detected by the treatment device may be, for example, ventilation data and / or treatment data. For example, during treatment, the treatment device may detect and evaluate data such as, for example, sensor data. This may include, for example, at least flow rate and / or pressure and / or the number of times such as respiratory rate and / or cough count. The treatment device may be designed to evaluate the detected data. Based on the evaluation of the data, a reminder mechanism and / or initiation mechanism and / or repetition mechanism may determine when and / or whether treatment should be performed and / or repeated and / or extended. For example, a live evaluation of the data may be performed, and based on that evaluation, the treatment repetition mechanism may be able to determine whether repetition or extension of treatment is necessary. The treatment repetition mechanism may also be designed to output recommendations regarding repetition and / or extension that can be carried out and / or modified by the patient and / or caregiver. The treatment reminder mechanism and / or treatment initiation mechanism may be designed to adapt the time to the next treatment based on data detected during treatment, optionally combined with other data and information. The treatment pattern may also be adapted based on the detected data.

[0085] For example, when evaluating data using one of the evaluation units and / or mechanisms, if the number and / or intensity of coughs is deemed insufficient, the treatment repetition mechanism may be designed to extend and / or repeat treatment. In this case, the repetition mechanism may be designed to repeat treatment with a time delay rather than immediately. Alternatively or supplementarily, the repetition mechanism may be designed to specify or set a shorter interval between treatments. For treatment reminder mechanisms and / or treatment initiation mechanisms, if coughs are insufficient, the interval between treatments may be shortened and / or the treatment form or intensity may be adjusted.

[0086] For example, it may be intended to detect cough flow, particularly the peak cough flow (PCF). The PCF can provide a message about whether, for example, cough assistance techniques and / or cough cycles were effective. For example, a treatment repetition mechanism can use the PCF to determine whether the cough was too weak and whether to repeat and / or extend the treatment. For example, in the case of extension, additional cough assistance techniques and / or cycles are added to the current treatment.

[0087] In some embodiments, alternatively or supplementarily, the available data may include data detected by the ventilator. This may include, for example, sensor data or values ​​detected by the ventilator during ventilation. Ventilator data may be considered, particularly in the case of coupling for data transmission between the treatment device and the ventilator. Based on the data detected by the ventilator, it may be possible to assess, for example, whether treatment is necessary. For example, ventilation data such as flow rate and / or pressure may indicate that a certain amount of secretions have accumulated in the patient's airway and need to be removed by treatment. In some embodiments, ventilation data may indicate the progression of worsening and / or improvement of the patient's secretion accumulation. In such cases, for example, it may be possible to automatically and / or dynamically adjust the time until the next treatment reminder and / or the start of treatment. It may also be possible to adjust the treatment form and / or treatment intensity.

[0088] For example, a ventilator can be used to detect SpO2 and / or CO2 and / or other blood gas and / or other respiratory gas values. Based on the evaluation of these values, it can be determined, for example, that coughing is necessary. An exemplary approach is the method by John R. Bach. In this case, it is considered that in certain types of patients, for example, those with chronic illnesses, a drop in SpO2 below a threshold indicates the accumulation of secretions, i.e., that coughing is meaningful and / or necessary. The threshold is, for example, 90% to 98%, preferably 93.5% to 96%. For example, the threshold is 95% or 94%.

[0089] Supplementally or alternatively, the signal-to-noise ratio (SNR) of, for example, pressure signals and / or flow rates can be detected and / or evaluated. For instance, a high SNR can be expected to indicate a larger amount of secretion. This also leads to a shorter time between the next reminder and / or action.

[0090] Supplementary or alternative, fluctuations in pressure and / or flow rate can be detected and / or evaluated. Detected fluctuations may, among other things, result from stalls and / or blockages / reopenings, and may indicate relatively large amounts of secretions. This evaluation can, for example, lead to a reduction in the time interval until the next reminder and / or execution.

[0091] In some embodiments, acoustic signals and / or sounds can also be detected and evaluated as an alternative, supplementary, or additional measure. For example, it may be possible to recognize whether secretions or other fluids have accumulated in the patient's lungs. For example, it may be possible to detect and evaluate the patient's breath sounds.

[0092] In some embodiments, multiple data sources are used. For example, a treatment urgency index may be specified. The urgency index may be calculated from, for example, the time elapsed since the last treatment and other data. Treatment reminders and / or treatment initiation are triggered, for example, when the urgency index reaches a defined, arbitrarily configurable threshold. For example, the urgency index may be designed to increase as the time elapsed since the last treatment increases. The urgency index may be further increased in response to further data evaluation. For example, if data evaluation indicates an increasing accumulation of secretions in the patient's airways, this may result in an additional increase in the urgency index. Optionally, a baseline value for the urgency index may be specified based on available data. For example, if the patient is infected, the baseline value for the urgency index may be designed to be higher than if the patient is not infected. As a result, the threshold will be reached in a shorter period of time.

[0093] In some embodiments, the treatment device is intended to be configured to perform long-term prognosis and / or long-term evaluation. Such prognosis and / or evaluation can achieve greater accuracy, for example, regarding the patient's need for treatment. For example, it can evaluate how various treatment forms, treatment parameters, and / or treatment intensities affect the patient's development. For example, prognosis and / or evaluation can be intended to confirm that certain treatment parameters have a positive effect on the patient, for example, by reducing the need for treatment.

[0094] In some embodiments, alternatively or supplementarily, data detected by the treatment device and / or ventilator is intended to be uploaded to a cloud-based system. The cloud-based system is configured to make treatment-related decisions, for example, regarding the frequency, form, and / or intensity of treatment, using algorithms. These decisions are also loaded from the cloud to the treatment device and / or ventilator, and based on these decisions, the treatment device and / or ventilator performs fitting of treatment parameters (e.g., frequency, form, intensity). Thus, the treatment-related decisions can also result in fitting of treatment initiation mechanisms, treatment reminder mechanisms, and / or treatment repetition mechanisms. For example, the treatment initiation time and / or the time between two treatments can be fitted.

[0095] According to the present invention, treatment reminders and / or treatment initiations and / or treatment repetitions are performed based on available data. In this case, various data can be used. For example, treatment reminders can be based primarily on, for example, the time elapsed since the last treatment, and treatment repetitions can be based on data from the current and / or last treatment, optionally supplemented with input data such as, for example, patient parameters. For example, treatment initiation can be triggered based on aspiration data, in particular, if aspiration data indicates that coughing and exhalation appear meaningful and / or necessary. However, initiation can also be based solely on time elapsed.

[0096] In some embodiments, alternatively or supplementarily, the treatment reminder mechanism is intended to include at least a kind of wake-up function, and based on available data, reminders are output via the treatment device and / or optionally coupled ventilators and / or remote stations. Optionally, several reminder stages may be provided, and optionally, messages in the form of images and / or sounds may be progressively escalated. In some embodiments, the reminders may also give the patient and / or caregiver the option to select, for example, the type and / or intensity of treatment and / or the time until the next reminder.

[0097] In some embodiments, alternatively or supplementarily, the treatment reminder mechanism may be designed to become less noticeable over a relatively long period (several days / weeks / months). For example, the goal may be for the patient to become accustomed to the repeated treatment and to begin treatment regularly on their own initiative. Optionally, the reminder may be designed to be less noticeable and / or to become noticeable again if the patient and / or caregiver forget the treatment once and / or several times.

[0098] The integration of therapeutic devices and ventilators offers various possibilities. Pure data exchange is possible, with each device interpreting the data independently. In the case of pure data exchange, reminders and other information can be displayed on the ventilator. In addition to "cable coupling," wireless / Bluetooth / WLAN coupling can also be considered. Control of therapeutic devices, such as starting / stopping treatment, can also be considered via the ventilator. Furthermore, mutual influence is conceivable, where treatment outcomes / information can lead to changes in ventilation, and conversely, treatment can be adapted based on ventilation data (patient and device-related). Alternatively or supplementarily, the computing power of the therapeutic device can be used to perform evaluation and / or analysis of the ventilation device while ventilation is being performed by the ventilator, i.e., when the therapeutic device is not being used by the patient.

[0099] Treatment reminders can be followed by the initiation of treatment. After treatment initiation, it is possible to repeat the treatment. For example, after a certain period, reminders are given until a threshold period is reached. After that, a decision is made as to whether or not to start treatment. There are various types of "forced" treatment initiation, which are more meaningful when devices are coupled. For example, if the devices are pneumatically coupled, treatment can be easily started after a period of time, after notification, even without the patient explicitly requesting it. In that case, treatment parameters can be set according to the available data, and it is possible to distinguish whether it was a forced initiation or whether the patient initiated the treatment themselves.

[0100] The present invention will be described in detail with reference to Figures 1 to 3. [Brief explanation of the drawing]

[0101] [Figure 1] This shows a system equipped with a treatment device connected to the patient via a hose system. [Figure 2] A schematic diagram illustrating the consideration of individual data streams related to treatment is shown. [Figure 3] A simplified decision-making diagram is schematically shown for determining whether to activate treatment initiation, treatment reminders, and / or treatment repetition. [Figure 4] An exemplary system equipped with a treatment device is shown. [Figure 5] An exemplary system equipped with a treatment device is shown. [Modes for carrying out the invention]

[0102] Figure 1 shows a system 1 comprising a treatment device 100 connected to a patient 300 via a hose system 200.

[0103] The treatment device 100 comprises at least one controllable source of gas for generating positive pressure. System 1 further comprises a switching means 102 through which positive pressure can be applied to the hose system 200, for example, to perform insulation. System 1 is configured by the switching means 102 to abruptly stop by applying positive pressure to the hose system 200, forcing the patient 300 to exhale and / or cough.

[0104] In some embodiments, the treatment device 100 comprises at least one controllable gas source for generating positive pressure gas, a compressed gas source for generating negative pressure gas or at least one controllable gas source for generating positive pressure, and a controllable gas sink for generating negative pressure. Exemplarily, the treatment device 100 includes a combined compressed gas source 101 for generating negative pressure gas and positive pressure gas, or a single compressed gas source 101 is used as a gas source and gas sink for controllably generating positive and / or negative pressure. For this purpose, the compressed gas source 101 comprises, for example, at least one blower and a pneumatic device having a switching means 102 that enables the blower to provide negative pressure gas or positive pressure gas to the hose system 200 depending on the switch. Alternatively or supplementally, two blowers connected in parallel with opposite feed directions may be provided, and the switching means 102 controls whether negative pressure gas or positive pressure gas is supplied to the hose system 200.

[0105] An exemplary therapeutic device 100 further comprises a storage device 103 for storing data, values, and information that can be input, for example, via a user interface 107, a sensor 105, an evaluation unit 106, and / or via a ventilator (not shown) coupled for data exchange. The storage device 103 is designed to make data, values, and / or information available to a control unit 104, an evaluation unit 106, a therapeutic reminder mechanism 108, a therapeutic repetition mechanism 109, and / or a therapeutic initiation mechanism 110. The therapeutic reminder mechanism 108, the therapeutic repetition mechanism 109, and / or the therapeutic initiation mechanism 110 may reside, for example, as software modules in the evaluation unit 106 and / or the control unit 104. In some embodiments, the therapeutic mechanisms 108, 109, and 110 may include separate hardware modules and / or operate with a common hardware module. It may also be intended that the data, values, and / or information from the storage device 103 can be displayed via the user interface 107. The data, values, and information stored in the memory device 103 may include, in particular, at least parameters for treatment, such as treatment length, treatment intensity, and / or treatment type. It may also include data about the patient 300.

[0106] For example, the treatment device 100 includes three treatment mechanisms: a treatment reminder mechanism 108, a treatment repetition mechanism 109, and a treatment initiation mechanism 110. Since each mechanism has already been described in detail, it will be briefly described here as an example.

[0107] The treatment reminder mechanism 108 is configured to remind the patient 300 and / or the caregiver of treatment based on available data. For example, the time elapsed since the last treatment is used as data. The treatment reminder mechanism 108 generates an exemplary corresponding message for display, for example, on the user interface 107. This message may indicate, for example, that a certain period of time has elapsed since the last treatment and therefore a new treatment needs to be started. To this end, the message may also include step-by-step instructions indicating the steps of treatment, such as what preparations are needed. In some embodiments, the patient 300 or the caregiver can mark the reminder as seen and / or postpone it, thereby intending for a new message to be generated after a certain period of time.

[0108] In some embodiments, the treatment reminder mechanism 108 can also be configured to prepare the treatment device 100 for treatment. For example, it can load a treatment program, automatically set treatment settings or parameters, and / or warm up / start the treatment device. The treatment reminder mechanism 108 can also be configured to prepare the treatment so that the patient 300 and / or nurse only need to confirm the execution of the treatment, for example, via the user interface 107. As already described, in addition to the period, other factors, data, values, and / or information can also be included in the usable data.

[0109] The treatment repetition mechanism 109 is exemplary configured to initiate repetition and / or extension of treatment based on available data. In this case, the available data may include, in particular, values ​​from sensor 105 detected during treatment. For example, the treatment repetition mechanism 109 may conclude, by evaluating the data, that the treatment is insufficient or still insufficient. If the treatment is insufficient, a repetition may be attempted. For the repetition, for example, the same treatment settings or treatment parameters may be used again. However, to achieve a better treatment, specific parameters such as intensity and / or treatment form may also be modified. If the treatment is still insufficient, exemplary, the treatment may be attempted to be extended by at least one cycle, or by the length of at least one procedure. In some embodiments, a protection mechanism is provided to prevent the treatment from being too long, even if it is still insufficient. In this case, for example, a message or alarm may be additionally generated indicating that the maximum treatment length has been reached but is still insufficient.

[0110] The treatment initiation mechanism 110 is configured, for example, to automatically start treatment. The treatment initiation mechanism 110 can be configured similarly to the treatment reminder mechanism 108 with respect to available data. Automatic treatment initiation is possible, in particular, when the treatment device 100 is pneumatically coupled to a ventilator 400 (not shown). The treatment initiation mechanism 110 can attempt automatic initiation, for example, when the maximum treatment period and / or the maximum number of reminders have been exceeded.

[0111] To perform the treatment, the compressed gas source 101 and the switching means 102 are controlled according to predefined values ​​stored, for example, in the memory device 103. When performing the treatment, the patient 300 is first supplied with positive pressure gas for insulation via the hose system 200 so that the patient 300 can inhale and air can reach behind the secretions that are to be coughed out. Next, the treatment device 100 or the switching means 102 abruptly stops the supply of positive pressure gas and / or switches to negative pressure gas, thereby inducing coughing in the patient 300, which in turn expels the secretions. During the treatment, several coughs or cycles are usually planned, with one cycle consisting of inhalation and exhalation or coughing. Depending on the treatment settings, the strength of the cough, such as the pressure difference and / or switching speed, can be changed. Typically, a pause of 0.1 sec to 10 sec is provided between two treatment cycles. In some embodiments, the treatment can be divided into several procedures, each procedure also comprising multiple cycles. The pause between two procedures may be intended to be longer than the pause between two cycles, for example, longer than 10 seconds.

[0112] After the completion of treatment, it is possible to enable the patient 300 and / or nurse to input feedback about the treatment, such as their subjective perception of the treatment's effectiveness, via the user interface 107. They may also request that the treatment be continued.

[0113] In some embodiments, System 1 or the treatment device 100 is configured to perform ventilation for the patient. Positive pressure ventilation or respiratory support for the patient can be performed, for example, via a gas source for generating positive pressure. That is, in some embodiments, the treatment device 100 is combined as a ventilation and treatment device. In this case, the control unit 104 is configured and configured to control other modules, such as a compressed gas source 101 or a switching means 102, to perform conventional ventilation configurations.

[0114] Figure 2 shows a schematic diagram of considering individual data streams related to treatment. For example, the treatment device 100 is coupled to the ventilator 400 at least for data exchange.

[0115] For example, user input 901 received via the user interface 107 of the treatment device 100 and sensor values ​​902 detected via one or more sensors 105 of the treatment device 100 are processed in internal processing 903. The processed data can be made available, in particular, to a treatment reminder mechanism and / or a treatment initiation mechanism and / or a treatment repetition mechanism. The initiation mechanism or reminder mechanism can, for example, initiate / remind treatment 904 based on the available data from internal processing 903, which leads to the execution of treatment 912. During treatment, additional sensor values ​​902 are recorded, for example, so that a repetition 914 can be planned by the treatment repetition mechanism after the end of treatment 913. Alternatively or supplementarily, treatment repetition 914 can also be performed based on user input 901.

[0116] When the treatment device 100 is coupled to the ventilator 400, data, values, and / or information from the ventilator 400 may also be considered for treatment. For example, the ventilator 400 detects its own user inputs 906 and / or sensor values ​​907, which are, exemplary, processed and / or evaluated in the internal processing 908 of the ventilator 400. In some embodiments, the ventilator 400 may be intended to detect control commands 909 from the user inputs 906 and / or sensor values ​​907. Optionally processed user inputs 911 and sensor values ​​910, as well as the control commands 909, are transmitted to the coupled treatment device 100.

[0117] In the treatment device 100, the processing of external data 905, such as data from a ventilator 400, is intended as an example. In this case, at least user input 911 and / or sensor values ​​910 may be evaluated to, for example, initiate / remind treatment 904. For example, user input 911 and / or sensor values ​​910 from the ventilator 400 may indicate that a certain amount of secretions have accumulated and that it would be meaningful to cough them up.

[0118] In addition, control commands 909 from the ventilator 400 to the treatment device 100 can be executed by process 905. For example, internal data processing 908 in the ventilator 400 may be intended to confirm, through evaluation, that treatment should be performed. That is, processing 905 of the control command 909 in the treatment device 100 may lead to the initiation of treatment start / reminder 904.

[0119] Alternatively or supplementally, the treatment device 100 may also adjust the treatment settings and / or the time between two treatments or to the next treatment based on user data 901, 911 and / or sensor data 902, 910.

[0120] In addition, in some embodiments, treatment settings (duration, form, intensity, time between two treatments) can be directly configured via user input 906 on the ventilator 400 and transmitted to the treatment device 100, for example, as control commands 909.

[0121] Figure 3 schematically shows a considerably simplified decision-making process for deciding whether to activate treatment initiation, treatment reminders, and / or treatment repetition. In Figure 3, the letter y represents an affirmative response to the inquiry, and the letter n represents a negative response.

[0122] Starting from the starting point 801, the first inquiry 802, as an example, is an inquiry about whether a specific threshold has been reached or exceeded regarding the time elapsed since the last treatment. If the threshold for the time elapsed since the last treatment has been reached, inquiry 802 is evaluated as "y". If inquiry 802 regarding the time threshold is positive, treatment initiation and / or treatment reminder 805 follows. If the evaluation is "n", the next inquiry is made.

[0123] The next inquiry 803 is, exemplarily, a question of whether the treatment device 100 is coupled to the ventilator 400 for data exchange, or whether the corresponding data is transmitted by the ventilator 400. If no data coupling exists, a negative answer "n" is given, and the decision-making process returns to starting point 801. If the answer is positive, the next inquiry follows.

[0124] For example, the following inquiry 804 asks whether the data transmitted by the ventilator 400 indicates an accumulation of secretions that should be coughed up. The data can be evaluated, for example, by the ventilator 400 or by the treatment device 100. If the answer is negative, the decision-making process returns to starting point 801. Alternatively or supplementary inquiries may be attempted.

[0125] If available data indicates an accumulation of secretions, inquiry 804 is answered positively, followed by a treatment reminder and / or initiation of treatment 805.

[0126] During and / or after treatment, it is intended that, for example, inquiries 806 regarding the treatment outcome, such as whether the treatment resulted in sufficient cough, may follow. If the treatment was sufficient, a new decision to initiate / remind treatment is initiated at initiation point 801. If the treatment was insufficient, a new initiation and / or treatment reminder 805 may be initiated.

[0127] In addition to the illustrated procedure, the decision-making diagram can be optionally extended. For example, other data, values, and / or information can be queried to make a decision. For instance, the time period to be elapsed before the next treatment can be specified based on this data / values / information, and this can be intended to be inserted, for example, between the start 801 and the first query 802 after the period has elapsed.

[0128] For example, if a pneumatic connection also exists between the treatment device 100 and the ventilator 400, a further corresponding inquiry can be inserted, such as whether a patient interface switch is necessary.

[0129] Figure 4 shows an exemplary system 1 comprising a treatment device 100, the treatment device 100, which includes a controllable compressed gas source 101, is configured to perform at least one insufflation of patient 300 via a hose system 200. The treatment device 100 is exemplary, configured to perform treatment. In some specific embodiments, the treatment device 100 is a combination device that can also ventilate patient 300 as a ventilator, at least temporarily.

[0130] System 1 further includes a switching means 102 through which positive pressure can be applied to the hose system 200, for example, to perform insulation. System 1 is configured to abruptly stop by applying positive pressure to the hose system 200 via the switching means 102, forcing the patient 300 to exhale and / or cough.

[0131] An exemplary therapeutic device 100 further comprises a storage device 103 for storing data, values, and information that can be input, for example, via a user interface 107, a sensor 105, an evaluation unit 106, and / or via a ventilator (not shown) coupled for data exchange. The storage device 103 is designed to make data, values, and / or information available to a control unit 104, an evaluation unit 106, a therapeutic reminder mechanism 108, a therapeutic repetition mechanism 109, and / or a therapeutic initiation mechanism 110. The therapeutic reminder mechanism 108, the therapeutic repetition mechanism 109, and / or the therapeutic initiation mechanism 110 may reside, for example, as software modules in the evaluation unit 106 and / or the control unit 104. In some embodiments, the therapeutic mechanisms 108, 109, and 110 may include separate hardware modules and / or operate with a common hardware module. It may also be intended that the data, values, and / or information from the storage device 103 can be displayed via the user interface 107. The data, values, and information stored in the memory device 103 may include, in particular, at least parameters for treatment, such as treatment length, treatment intensity, and / or treatment type. It may also include data about the patient 300.

[0132] For example, the treatment device 100 includes three treatment mechanisms: a treatment reminder mechanism 108, a treatment repetition mechanism 109, and a treatment initiation mechanism 110. Since each mechanism has already been described in detail, it will be briefly described here as an example.

[0133] The treatment reminder mechanism 108 is configured to remind the patient 300 and / or the caregiver of treatment based on available data. For example, the time elapsed since the last treatment is used as data. The treatment reminder mechanism 108 generates an exemplary corresponding message for display, for example, on the user interface 107. This message may indicate, for example, that a certain period of time has elapsed since the last treatment and therefore a new treatment needs to be started. To this end, the message may also include step-by-step instructions indicating the steps of treatment, such as what preparations are needed. In some embodiments, the patient 300 or the caregiver can mark the reminder as seen and / or postpone it, thereby intending for a new message to be generated after a certain period of time.

[0134] In some embodiments, the treatment reminder mechanism 108 can also be configured to prepare the treatment device 100 for treatment. For example, it can load a treatment program, automatically set treatment settings or parameters, and / or warm up / start the treatment device. The treatment reminder mechanism 108 can also be configured to prepare the treatment so that the patient 300 and / or nurse only need to confirm the execution of the treatment, for example, via the user interface 107. As already described, in addition to the period, other factors, data, values, and / or information can also be included in the usable data.

[0135] The treatment repetition mechanism 109 is exemplary configured to initiate repetition and / or extension of treatment based on available data. In this case, the available data may include, in particular, values ​​from sensor 105 detected during treatment. For example, the treatment repetition mechanism 109 may conclude, by evaluating the data, that the treatment is insufficient or still insufficient. If the treatment is insufficient, a repetition may be attempted. For the repetition, for example, the same treatment settings or treatment parameters may be used again. However, to achieve a better treatment, specific parameters such as intensity and / or treatment form may also be modified. If the treatment is still insufficient, exemplary, the treatment may be attempted to be extended by at least one cycle, or by the length of at least one procedure. In some embodiments, a protection mechanism is provided to prevent the treatment from being too long, even if it is still insufficient. In this case, for example, a message or alarm may be additionally generated indicating that the maximum treatment length has been reached but is still insufficient.

[0136] The treatment initiation mechanism 110 is configured, for example, to automatically start treatment. The treatment initiation mechanism 110 can be configured similarly to the treatment reminder mechanism 108 with respect to available data. Automatic treatment initiation is possible, in particular, when the treatment device 100 is pneumatically coupled to a ventilator 400 (not shown). The treatment initiation mechanism 110 can attempt automatic initiation, for example, when the maximum treatment period and / or the maximum number of reminders have been exceeded.

[0137] To perform the treatment, the compressed gas source 101 and the switching means 102 are controlled according to predefined values ​​stored, for example, in the memory device 103. When performing the treatment, the patient 300 is first supplied with positive pressure gas for insulation via the hose system 200 so that the patient 300 can inhale and air can reach behind secretions to be coughed out. Next, the treatment device 100 or the switching means 102 abruptly stops the supply of positive pressure gas, thereby inducing a cough in the patient 300, which expels the secretions. During the treatment, several coughs or cycles are usually planned, with one cycle consisting of inhalation and exhalation or coughing. The strength of the cough, such as the pressure difference and / or switching speed, can be varied according to the treatment settings. Typically, a pause of 0.1 to 10 seconds is provided between two treatment cycles. In some embodiments, the treatment can be divided into several procedures, each procedure also including multiple cycles. It is also possible to intend to make the pause between two procedures longer than the pause between two cycles, for example, longer than 10 seconds.

[0138] After the completion of treatment, it is possible to enable the patient 300 and / or nurse to input feedback about the treatment, such as their subjective perception of the treatment's effectiveness, via the user interface 107. They may also request that the treatment be continued.

[0139] In some embodiments, System 1 or the treatment device 100 is configured to perform ventilation for the patient. Positive pressure ventilation or respiratory support for the patient can be performed, for example, via a gas source for generating positive pressure. That is, in some embodiments, the treatment device 100 is combined as a ventilation and treatment device. In this case, the control unit 104 is configured and configured to control other modules, such as a compressed gas source 101 or a switching means 102, to perform conventional ventilation configurations.

[0140] Figure 5 shows an exemplary system 1 equipped with a treatment device 100, which includes a gas sink for generating negative pressure within a hose system 200. For example, the negative pressure makes it possible to aspirate secretions from the oral cavity and / or pharyngeal cavity of a patient 300.

[0141] In the exemplary system 1, the control unit 104 having mechanisms 108, 109, and 110, the storage device 103, the sensor 105, the evaluation unit 106, and the user interface 107 are located at least spatially independent of the treatment device 100. In some embodiments, the control unit 104 having mechanisms 108, 109, and 110, the storage device 103, the sensor 105, the evaluation unit 106, and the user interface 107 can be located in a ventilator or integrated as a separate device to monitor the patient's respiration and / or at least secretion status.

[0142] An exemplary system 100 includes a storage device 103 for storing data, values, and information that can be input, for example, via a user interface 107, a sensor 105, an evaluation unit 106, and / or via a ventilator (not shown) coupled for data exchange. The storage device 103 is designed to make data, values, and / or information available to a control unit 104, an evaluation unit 106, a treatment reminder mechanism 108, a treatment repetition mechanism 109, and / or a treatment initiation mechanism 110. The treatment reminder mechanism 108, the treatment repetition mechanism 109, and / or the treatment initiation mechanism 110 may exist, for example, as software modules in the evaluation unit 106 and / or the control unit 104. In some embodiments, the treatment mechanisms 108, 109, and 110 may include separate hardware modules and / or operate with a common hardware module. It may also be intended that the data, values, and / or information from the storage device 103 can be displayed via the user interface 107. The data, values, and information stored in the memory device 103 may include, in particular, at least parameters for treatment, such as treatment length, treatment intensity, and / or treatment type. It may also include data about the patient 300.

[0143] Exemplary, system 100 includes three treatment mechanisms: a treatment reminder mechanism 108, a treatment repetition mechanism 109, and a treatment initiation mechanism 110. Since each mechanism has already been described in detail, a very brief, illustrative explanation will be provided here.

[0144] The treatment reminder mechanism 108 is configured to remind the patient 300 and / or the caregiver of treatment based on available data. For example, the time elapsed since the last treatment is used as data. The treatment reminder mechanism 108 generates an exemplary corresponding message for display, for example, on the user interface 107. This message may indicate, for example, that a certain period of time has elapsed since the last treatment and therefore a new treatment needs to be started. To this end, the message may also include step-by-step instructions indicating the steps of treatment, such as what preparations are needed. In some embodiments, the patient 300 or the caregiver can mark the reminder as seen and / or postpone it, thereby intending for a new message to be generated after a certain period of time.

[0145] In some embodiments, the treatment reminder mechanism 108 can also be configured to prepare the treatment device 100 for treatment. For example, it can load a treatment program, automatically set treatment settings or parameters, and / or warm up / start the treatment device. The treatment reminder mechanism 108 can also be configured to prepare the treatment so that the patient 300 and / or nurse only need to confirm the execution of the treatment, for example, via the user interface 107. As already described, in addition to the period, other factors, data, values, and / or information can also be included in the usable data.

[0146] The treatment repetition mechanism 109 is exemplary configured to initiate repetition and / or extension of treatment based on available data. In this case, the available data may include, in particular, values ​​from sensor 105 detected during treatment. For example, the treatment repetition mechanism 109 may conclude, by evaluating the data, that the treatment is insufficient or still insufficient. If the treatment is insufficient, a repetition may be attempted. For the repetition, for example, the same treatment setting value or treatment parameter may be used again. However, to achieve a better treatment, it may also be attempted to modify certain parameters, such as intensity and / or treatment mode. If the treatment is still insufficient, exemplary, the treatment may be attempted to be extended by at least one run. In some embodiments, a protection mechanism is provided to prevent the treatment from being too long, even if it is still insufficient. In this case, for example, a message or alarm may be additionally generated indicating that the maximum treatment length has been reached but is still insufficient.

[0147] The treatment initiation mechanism 110 is configured, for example, to automatically initiate treatment. The treatment initiation mechanism 110 can be configured similarly to the treatment reminder mechanism 108 with respect to available data. Automatic initiation of treatment is possible, in particular, when the treatment device 100 is pneumatically coupled to a ventilator or when the treatment device 100 is integrated into a ventilator. The treatment initiation mechanism 110 can attempt automatic initiation, for example, when the maximum duration of treatment and / or the maximum number of reminders have been exceeded.

[0148] To perform the treatment, a negative pressure is generated in the hose system 200 by the sink 111, and the switching means 102 can provide the negative pressure to the hose system 200, or stop providing it. The hose system 200 is, for example, a hose that optionally has a special end piece for aspirating secretions. The secretions are aspirated from the patient through the hose and, if applicable, collected in or on the treatment device 100 in a collection container 112.

[0149] After the completion of treatment, it is possible to enable the patient 300 and / or nurse to input feedback about the treatment, such as their subjective perception of the treatment's effectiveness, via the user interface 107. They may also request that the treatment be continued.

[0150] In some embodiments, the treatment device 100 of System 1 can be combined with and / or coupled to a ventilator. For example, the ventilator can be configured to ventilate the patient through a tracheostomy tube. In this case, the treatment device 100 can be combined with and / or incorporated into the ventilator, for example, to aspirate secretions through the tracheostomy tube. [Explanation of symbols]

[0151] 1 System 100 treatment equipment 101 Compressed gas source 102 Switching means 103 Storage device 104 Control Unit 105 Sensor 106 evaluation units 107 User Interface 108 Treatment Reminder Mechanism 109 Mechanism of repeated treatment 110 Mechanism of Treatment Initiation 111 Sink 112 Collection containers 801 Starting point 802 Inquiry about elapsed time 803 Data exchange inquiry 804 Inquiry regarding the accumulation of secretions 805 Initiation of treatment / reminder 806 Inquiry about treatment results 901 User Input 902 Sensor Value 903 Internal Processing 904 Start / Reminder Mechanism 905 Processing external data 906 User Input 907 Sensor Value 908 Internal Processing 909 Control Command 910 Sensor Value 911 User Input 912 Execution of treatment 913 End of treatment 914 Repeating Mechanisms

Claims

1. 1. A system comprising at least one treatment device for performing a treatment, and at least one hose system for gas conducting connection between the treatment device and a patient, wherein the treatment device has at least one gas source for generating positive pressure and / or at least one gas sink for generating negative pressure, and at least temporarily provides positive pressure and / or negative pressure to the hose system for performing the treatment, the system further comprising at least one control unit, at least one user interface, at least one memory device, and at least one sensor, wherein the control unit has at least one of the following treatment mechanisms: a treatment mechanism for starting a treatment, a treatment reminder mechanism for reminding a treatment, and a treatment repeat mechanism for extending and / or repeating a treatment, each of the treatment mechanisms being based on user actions, patient data, and / or treatment data.

2. 10. The system of claim 1, wherein the treatment comprises cough therapy, cough assistance, insufflation, insufflation followed by exsufflation, suction of secretions from the mouth or airway, or a combination of at least two of these examples.

3. 2. The system of claim 1, wherein the control unit is configured to automatically adapt, via the user interface and / or an additional interface and / or from the storage device, data characterizing the patient, in particular regarding lung function, age, weight, ventilation, underlying diseases, experience with assisted coughing maneuvers, to the number of treatment reminders and / or initiations.

4. 2. The system of claim 1, wherein, if the detected data, in particular the measured and stored values ​​of SpO2, pulse, CO2, and / or the changing pressure and / or volume flow behavior, indicate that treatment to remove secretions from the airways would be beneficial, treatment is automatically initiated, the patient is suggested to start treatment, or the patient is reminded to start treatment, based on the detected data.

5. 10. The system of claim 1, wherein the therapy device is coupled to a ventilator, or the therapy device and ventilator are combined into one device, and data for the at least one therapy mechanism is provided by the ventilator.

6. 6. The system of claim 5, wherein the detected effect of the administered therapy on a transition in at least one of SpO2, CO2, flow, tidal volume, and signal-to-noise ratio (SNR) changes ventilation parameters of the ventilator.

7. 6. The system of claim 5, wherein the therapy device and the ventilator are pneumatically coupleable, thereby allowing direct combination of ventilation with mechanical insufflation and exsufflation.

8. 6. The system of claim 5, wherein the treatment or the reminder to start the treatment is provided exclusively or additionally via the coupled ventilator.

9. 2. The system of claim 1, wherein the data on which the at least one treatment mechanism is based includes an SpO2 value, and when the SpO2 value reaches an SpO2 threshold, at least one of the following functions is performed: remind the treatment, start the treatment, repeat the treatment, or extend the treatment.

10. 2. The system of claim 1, wherein the effect of an administered therapy on the progression of at least one of the following quantities: SpO2, CO2, pressure, flow, tidal volume, acoustic signal, signal to noise ratio (SNR) in the therapy device and / or in a coupled ventilator is stored and / or processed, and the stored and / or processed data is taken into account when determining at least one of the following functions: initiating the therapy, repeating the therapy, reminding the therapy.

11. 2. The system of claim 1, wherein the system is configured to evaluate a signal-to-noise ratio (SNR) of a pressure signal and / or a flow signal, and to initiate or extend the initiation of the therapy or the reminder of the therapy when the SNR value reaches an SNR threshold.

12. 2. The system of claim 1, wherein repeated insufflation and exsufflation are automatically performed and / or suggested to the patient based on sensed data, in particular measured and stored values ​​of pressure, flow, tidal volume, SpO2, pulse, and / or CO2, or based on data from previous assisted cough maneuvers, in particular cough flow, if said data indicates that further secretions should be removed from the airway.

13. 10. The system of claim 1, wherein the detected and / or stored data is uploaded to a cloud-based system, a cloud-based algorithm makes decisions regarding treatment, and the decisions are made available from the cloud to the treatment device to adapt the treatment or the starting point of the treatment.

14. 2. The system of claim 1, wherein user feedback regarding the subjective sensation of the automatically executed initiation process of the treatment and / or the repetition of the treatment and / or the reminder of the treatment is possible at the user interface and / or via an app on a mobile terminal device coupled to the treatment device, and wherein the user feedback is stored and / or processed and taken into account in deciding to start the treatment and / or to repeat the treatment and / or to remind the treatment to start.

15. 2. The system of claim 1, wherein as a result of the treatment reminder, a cough treatment can be initiated and / or repeated and / or terminated at the user's end by the treatment device via remote control and / or an app on a mobile terminal device coupled to the treatment device.

16. The system of claim 1 , wherein automatic initiation of the therapy is contemplated based on the sensed data, and the therapy parameters are automatically adapted based on the sensed data.

17. 10. The system of claim 1, wherein the treatment device at least temporarily provides positive pressure for insufflation in the hose system and / or at least temporarily provides negative pressure for aspirating secretions and / or for exsufflation.

18. The system of claim 1 , wherein the at least one control unit, the at least one memory device, the at least one user interface, and the at least one sensor are part of the treatment device.

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