204 results about "Respiratory circulation" patented technology

Methods, systems, devices and kits for performing lung volume reduction in patients suffering from chronic obstructive pulmonary disease or other conditions using and comprising minimally invasive instruments introduced through the mouth (endotracheally) to isolate a target lung tissue segment from other regions of the lung and reduce lung volume. Isolation is achieved by deploying an obstructive device in a lung passageway leading to the target lung tissue segment. Once the obstructive device is anchored in place, the segment can be aspirated through the device. This may be achieved by a number of methods, including coupling an aspiration catheter to an inlet port on the obstruction device and aspirating through the port. Or, providing the port with a valve which allows outflow of gas from the isolated lung tissue segment during expiration of the respiratory cycle but prevents inflow of air during inspiration. In addition, a number of other methods may be used. The obstructive device may remain as an implant, to maintain isolation and optionally allow subsequent aspiration, or the device maybe removed at any time.

A system including methods and apparatus for treatment of a medical disorder such as obstructive sleep apnea or congestive heart failure. The system involves applying separate and independent gains to flow rates of pressurized gas delivered to a patient during inspiratory and expiratory phases of a respiratory cycle to deliver the pressurized gas in proportion to the respective gains during inspiration and expiration. A base pressure may be applied in addition to the gain-modified pressures and an elevated pressure profile may be employed to assist or control inspiration. The system may be fully automated responsive to feedback provided by a flow sensor that determines the estimated patient flow rate. A leak computer can be included to instantaneously calculate gas leakage from the system. The system may be utilized in connection with conventional continuous positive airway pressure (bi-level PAP) equipment to effect various beneficial treatment applications.

A medical ventilator system and method that triggers, cycles, or both based on patient effort, which is determined from cross-correlating patient flow and patient pressure. The medical ventilator is also controlled such that sensitivity to a patient initiated trigger increases as the expiratory phase of the breathing cycle progresses. The present invention also provides adaptive adjustment of cycling criteria to optimize the cycling operation.

A system including methods and apparatus for treatment of a medical disorder such as obstructive sleep apnea or congestive heart failure. The system involves applying separate and independent gains to flow rates of pressurized gas delivered to a patient during inspiratory and expiratory phases of a respiratory cycle to deliver the pressurized gas in proportion to the respective gains during inspiration and expiration. A base pressure may be applied in addition to the gain-modified pressures and an elevated pressure profile may be employed to assist or control inspiration. The system may be fully automated responsive to feedback provided by a flow sensor that determines the estimated patient flow rate. A leak computer can be included to instantaneously calculate gas leakage from the system. The system may be utilized in connection with conventional continuous positive airway pressure (bi-level PAP) equipment to effect various beneficial treatment applications.

A system including methods and apparatus for treatment of a medical disorder such as obstructive sleep apnea or congestive heart failure. The system involves applying a gain to flow rate of pressurized gas delivered to a patient during inspiratory and / or expiratory phases of a respiratory cycle to deliver the pressurized gas in proportion to the respective gains during inspiration and / or expiration. A base pressure may be applied in addition to the gain-modified pressures and an elevated pressure profile may be employed to assist or control inspiration. The system may be fully automated responsive to feedback provided by a flow sensor that determines the estimated patient flow rate. A leak computer can be included to instantaneously calculate gas leakage from the system. The system may be utilized in connection with conventional continuous positive airway pressure treatments, such as CPAP or bi-level positive airway pressure equipment to effect various beneficial treatment applications.

A system and method for providing a therapeutic treatment, such as a flow of breathing gas, to a patient at variable treatment levels. A respiratory cycle monitor detects the patient's respiratory cycles and a control unit incrementally adjusts the treatment level from a first predetermined level to a second predetermined level over a first predetermined number of respiratory cycles. The amount of the incremental adjustment and the frequency of such adjustments over the course of the first predetermined number of respiratory cycles can be controlled to achieve a desired change in the therapeutic treatment over the course of the patient's respiration.

Disclosed is an apparatus and method for the delivery of inspired gas, e.g., supplemental O2, to a person combined with gas sampling, including for the purpose of monitoring of the ventilation of the person. In the invention, the delivery of inspired gas and gas sampling are accomplished without the use of a sealed face mask. The apparatus of one embodiment of the present invention comprises an oxygen delivery device, nasal airway pressure sampling devices, optionally an oral airway pressure sampling device and at least one pressure analyzer connected to the sampling devices which determine the phase of the person's respiration cycle and the person's primary airway. The oxygen delivery device is connected to a controller such that it delivers a higher flow of oxygen to the person during the inhalation phase of the person's respiratory cycle. The invention thus increases end tidal oxygen concentrations. The invention further comprises carbon dioxide sampling tubes that continuously sample gas from two nasal sites and the mouth. The nasal sampling tubes are connected to a switching valve that is in turn connected to a capnometer which determines carbon dioxide concentration during exhalation. The oral gas sampling site is connected to a second capnometer.

A device and method is provided for electrically stimulating the diaphragm to control breathing while inhibiting respiratory drive. A stimulation phase is identified. The stimulation phase is a period of time within the breathing cycle in which stimulation will inhibit respiratory drive. The respiratory drive inhibition may be used in a number of applications including but not limited to: improving or remodeling the heart in heart failure patients, treating apnea, chronic obstructive pulmonary disorder (COPD), and hypertension.

A method of treating a patient, comprising: sensing a biological parameter indicative of respiration; analyzing the biological parameter to identify a respiratory cycle; identifying an inspiratory phase of the respiratory cycle; and delivering stimulation to a hypoglossal nerve of the patient, wherein stimulation is delivered if a duration of the inspiratory phase of the respiratory cycle is greater than a predetermined portion of a duration of the entire respiratory cycle.

Disclosed is an apparatus and method for the delivery of supplemental oxygen gas to a person combined with the monitoring of the ventilation of the person with both being accomplished without the use of a sealed face mask. Preferred embodiments of the present invention combine an oxygen delivery device, a nasal airway pressure sampling device, an oral airway pressure sampling device, and a pressure analyzer connected to the sampling devices to determine the phase of the person's respiration cycle and the person's primary airway. The oxygen delivery device is connected to a controller such that it delivers a higher flow of oxygen to the person during the inhalation phase of the person's respiratory cycle. The invention thus increases end tidal oxygen concentrations with improved efficiency comparative to known open airway devices. Embodiments of the invention can include carbon dioxide sampling tubes that continuously sample air from the nose and mouth to determine carbon dioxide concentration during exhalation.

A method and system for gating therapeutic or diagnostic energy to a tissue volume of a medical patient during a selected portion of the patient's respiratory cycle, to thereby diminish inaccuracies in the assumed spatial position of the tissue volume arising from displacements induced by the patient's respiration. The gases flowing to and from the patient's lungs are monitored to provide quasi-continuous measurements as a function of time, of (a) flow rate, (b) pressure, (c) patient lung volume and (d) carbon dioxide concentration. The measurements are utilized to trigger the time period during which the energy is gated on, at the beginning of the selected portion of the respiration cycle; and the time period during which the energy is gated on, is terminated at the end of the selected portion of the respiration cycle.

Systems and methods provide a self-contained, intermittent positive airway pressure system for treating sleep apnea, snoring, and other respiratory disorders. The systems and methods provide an air flow director that can be worn in or over the nose of the individual in communication with an upper airway. The systems and methods provide an airflow regulation assembly that can also be worn in its entirety by the individual in communication with the air flow director. The airflow regulation assembly includes a source of positive pressure. The airflow regulation assembly intermittently operates the source of positive pressure to increase positive air pressure in the air flow director sufficient to resist tissue collapse in the upper airway during only a portion of the respiratory cycle less than the entire respiratory cycle.

An improved method and apparatus for respiratory audio-visual biofeedback are disclosed. A guide patterned after a breathing cycle comfortable to the patient serves as a target. The target is displayed as a bar moving vertically upward during inhale and vertically downward during exhale, between fixed end ex-hale and end in-hale limits. The patient's current respiratory position is also displayed as a bar, oriented parallel to the target bar so that the difference between the current position and the target position is easy for the patient to see.

A system and method, for maintaining a predetermined level of a treatment gas in a patient while conserving use of the treatment gas, comprising a source of the treatment gas, a sensing device for sensing a breathing cycle of a patient, a conserver for controlling intermittent supply of the treatment gas to the patient in response to the sensed breathing cycle. In a first mode, when the sensing device senses breathing, the treatment gas is intermittently supplied to the patient at a supply rate coordinated with the breathing cycle. In a second mode, when the sensing device is unable to sense breathing, the treatment gas is supplied to the patient at a second intermittent cycle, determined independently of the patient breathing cycle, which is selected to overlap an assumed patient breathing cycle such that at least a desired level of the treatment gas is maintained in the patient.

Techniques are provided for detecting the onset of an episode of apnea / hypopnea substantially in real-time. A moving threshold is generated based on recent respiration cycles and differences are accumulated between amplitudes of new respiration cycles and the moving threshold. Apnea / hypopnea is then detected based upon a comparison of the accumulated differences against a fixed threshold. The technique exploits the fact that many episodes of hypopnea begin with a sharp drop in respiration and many episodes of apnea are preceded by a sharp drop in respiration. By accumulating differences between new respiration amplitudes and a short term moving average, any sharp drop in respiration is thereby promptly detected. In many cases, by the time the amplitudes of individual respiration cycles drop to levels directly indicative of apnea / hypopnea, the episode of apnea / hypopnea will have already been detected based upon the sudden sharp drop in respiration amplitude and therapy will have already been initiated.

A medical ventilator system and method that triggers, cycles, or both based on patient effort, which is determined from cross-correlating patient flow and patient pressure. The medical ventilator is also controlled such that sensitivity to a patient initiated trigger increases as the expiratory phase of the breathing cycle progresses. The present invention also provides adaptive adjustment of cycling criteria to optimize the cycling operation.

The invention comprises a patient respiration monitoring and / or control method and apparatus used in conjunction with multi-axis charged particle or proton beam radiation therapy of cancerous tumors. The respiration monitoring system uses thermal and / or force sensors to determine where a patient is in a respiration cycle in combination with a feedback signal control delivered to the patient to inform the patient when breath control is required. The resulting breath control is timed with charged particle delivery to the tumor to enhance accuracy, precision, and / or efficiency of tumor treatment.

A small oxygen enriching apparatus which can supply oxygen-enriched gas at high flow rate without imparting unnatural sensation to a user, as well as a controller and recording medium therefore. In step 100, a judgment is made as to whether a flow rate set by use of a flow-rate setting unit 45 is equal to or less than a continuous base flow rate (3 liters / min). When the set flow rate is a low flow rate of not greater than 3 liters / min, breath-synchronized operation is not performed (continuous supply is to be performed), and therefore, in step 110, oxygen-enriched gas is supplied continuously at the set flow rate. When the set flow rate is a high flow rate of greater than 3 liters / min, breath-synchronized operation is to be performed, and therefore, in step 120, the orifice is set to an opening that enables supply at 5 liters / min. In step 140, in order to perform breath-synchronized operation, control for opening and closing an electromagnetic valve 47 is performed. Through this operation, the oxygen-enriched gas is supplied at a high flow rate (5 liters / min) in the inhalation period of each breathing cycle and at a low flow rate (2 liters / min) in the exhalation period via a bypass flow passage 50.

A method of operating a ventilator assembly having inhalation and exhalation passages communicating with one another, and a respiration assembly that can perform repetitive respiratory cycles. The method includes (a) connecting the conduit with an open end of an endotracheal tube positioned within the trachea so that the open end leads into the airway below the vocal cords, (b) repetitively cycling the respiration assembly so that during the inhalation phase, gas in the inhalation passage flows through the endotracheal tube and into the airway, and during the exhalation phase, an exhalation valve is maintained relatively closed and the exhaled gases flow pass the vocal cords and out of the mouth thereby facilitating the patient's ability to speak, and (c) monitoring ring the pressure within at least one of the passages during both phases for determining the pressure within the patient for use in operating the ventilator assembly.

The present invention provides improved methods, systems, devices and kits for performing lung volume reduction in patients suffering from chronic obstructive pulmonary disease or other conditions where isolation of a lung segment or reduction of lung volume is desired. The methods are minimally invasive with instruments being introduced through the mouth (endotracheally) and rely on isolating the target lung tissue segment from other regions of the lung. Isolation is achieved by deploying an obstructive device in a lung passageway leading to the target lung tissue segment. Once the obstructive device is anchored in place, the segment can be aspirated through the device. This may be achieved by a number of methods, including coupling an aspiration catheter to an inlet port on the obstruction device and aspirating through the port. Or, providing the port with a valve which allows outflow of gas from the isolated lung tissue segment during expiration of the respiratory cycle but prevents inflow of air during inspiration. In addition, a number of other methods may be used. The obstructive device may remain as an implant, to maintain isolation and optionally allow subsequent aspiration, or the device may be removed at any time.

A method and system for ventilating a patient that compensates for leaks occurring within the patient breathing circuit while limiting the volume of breathing gas delivered to the patient. During the operation of a ventilator to supply breathing gases to a patient, the ventilator monitors for leak volumes occurring during the inspiratory phase and expiratory phase of the breathing cycle. Based upon the leak volumes sensed, the volume of breathing gas delivered by the ventilator is increased such that the tidal volume delivered to the patient is the desired tidal volume set by a clinician. The ventilator operates to generate a leak alarm when the leak volume exceeds an alarm threshold. If the leak alarm is generated, the tidal volume delivered to the patient is limited to the tidal volume being delivered prior to generation of the leak alarm. During compensation of the breathing gases delivered to the patient, the system and method determines whether the compensated tidal volume exceeds a maximum tidal volume threshold and limits the compensated tidal volume to the maximum tidal volume threshold.

A system and method for assessing pulmonary performance through transthoracic impedance monitoring is described. Transthoracic impedance measures are directly collected through an implantable medical device. The transthoracic impedance measures are correlated to pulmonary functional measures relative to performance of at least one respiration cycle. The transthoracic impedance measures are grouped into at least one measures set corresponding to one of an inspiratory phase and an expiratory phase. The at least one transthoracic impedance measures set are evaluated to identify a respiratory pattern relative to the inspiratory phase or the expiratory phase to represent pulmonary performance.

The invention relates to a method and a device for detecting leaks in respiratory gas supply systems. Both the pressure and the volume flow of the respiratory gas are detected and the relevant values are supplied to an evaluation device. The evaluation device is used to calculate both the respiratory parameter resistance and compliance and the leak for at least two successive breathing cycles. At least one control parameter with different signal amplitudes is pre-determined for the successive breathing cycles. The leak resistance is determined from the resulting differential sequences of pressure and flow for the successive breathing cycles.

Adventitious lung sounds indicative of lung congestion are detected using an implantable sensor. The sensor is adapted to be positioned adjacent to a pulmonary system and to output signals indicative of lung sounds in response to pulmonary system activity. A controller receives the signals and processes the signals to detect the presence of adventitious lung sounds. A respiratory cycle sensor operating in conjunction with the lung-sound sensor enables classification of an adventitious lung sound according to its time occurrence within the respiratory cycle. Posture sensing in conjunction with lung-sound sensing provides valuable additional information as to the severity of the lung congestion.

A small oxygen enriching apparatus which can supply oxygen-enriched gas at high flow rate without imparting unnatural sensation to a user, as well as a controller and recording medium therefore. In step 100, a judgment is made as to whether a flow rate set by use of a flow-rate setting unit 47 is equal to or less than a continuous base flow rate (2 liters / min). When the set flow rate is a low flow rate of not greater than 2 liters / min, breath-synchronized operation is not performed (continuous supply is to be performed), and therefore, in step 110, oxygen-enriched gas is supplied continuously at the set flow rate. When the set flow rate is a high flow rate of greater than 2 liters / min, breath-synchronized operation is to be performed (supply during the inhalation period only of each breathing cycle), and therefore, in step 120, oxygen-enriched gas is continuously supplied at the continuous base flow rate. In step 140, in order to perform breath-synchronized operation, control for opening and closing an electromagnetic valve 45 is performed. That is, oxygen-enriched gas is supplied during the inhalation period only of each breathing cycle, and supply of oxygen-enriched gas is stopped during the exhalation period.

An apparatus and method for providing a nebula or aerosol to a patient. In one aspect, a nebulizer is pressure sensitive so that nebulization is coordinated with a breathing cycle of the patient. The nebulizer includes a movable gas diverter that diverts pressurized gas across a liquid outlet. The diverter is moved in response to the patient's breathing cycle. In one aspect, a biasing member moves the diverter. According to another aspect of the nebulizer, an annular liquid orifice disperses an aerosol in a radial direction in response to a pressurized gas flow from an orifice located concentrically thereto. Multiple liquid orifices may be provided. In a further aspect of the nebulizer, a reservoir includes an upper, wide portion and a lower narrow portion to apply relatively uniform pressure at a liquid orifice.

There is provided a system for the delivery of inhalable medicament comprising a monitor (40) for monitoring the breath cycle of a patient, a medicament container (2) having a release mechanism (4, 5) for releasing inhalable medicament therefrom, and an actuator (50) for actuating said release mechanism, the actuator (50) being actuable in response to a signal from the monitor (40). The monitor (40) provides the signal at a trigger point which is coupled to the end of the exhalation part of the breath cycle.