369 results about "Respiratory cycle" 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 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 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.

Apparatus and methods are provided for use with a subject who is undergoing respiration. A motion sensor senses motion of a subject. A breathing pattern analysis unit analyzes components of the sensed motion that result from the subject's respiration. The breathing pattern analysis unit includes double-movement-respiration-cycle-pattern-identification functionality that designates respiration cycles as being double-movement-respiration-cycles (DMRC's) by determining that the cycles define two subcycles. Double-movement-respiration-cycle-event-identification functionality of the breathing pattern analysis unit identifies a DMRC event by detecting that the subject has undergone a plurality of DMRC's. An output is generated that is indicative of the subject having used accessory muscles in breathing, in response to identification of the double-movement-respiration-cycle event. Other embodiments are also described.

Devices, systems and methods of neurostimulation for treating obstructive sleep apnea. The system is adapted to send an electrical signal from an implanted neurostimulator through a stimulation lead to a patient's nerve at an appropriate phase of the respiratory cycle based on input from a respiration sensing lead. External components are adapted for wireless communication with the neurostimulator. The neurostimulator is adapted to deliver therapeutic stimulation based on inputs.

A system and method for delivering a flow of breathing gas to an airway of a patient. The system monitors a characteristic that varies based on variations of the flow of the breathing gas and determines a Target Flow for the gas to be delivered to the patient based on the monitored characteristic. The Target Flow is set to a level sufficient to treat Cheyne-Stokes respiration or a sleep disordered breathing event. The system also alters the Target Flow based on a determination that the patient is experiencing a sleep disordered breathing event. In a further embodiment, the system determines an apnea detection time (Tapnea) as Tinsp plus a constant, and delivers a machine triggered breath if an amount since the start of inspiration reaches Tapnea. Yet another embodiment, monitors the characteristic during an inspiratory phase of a respiratory cycle, and controls the flow of gas during the inspiratory phase of the respiratory cycle based on a result of this comparison.

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.

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.

The present invention refers to the field of cardiac electrophysiology (EP) and, more specifically, to image-guided radio frequency ablation and pacemaker placement procedures. For those procedures, it is proposed to display the overlaid 2D navigation motions of an interventional tool intraoperatively obtained from the same projection angle for tracking navigation motions of an interventional tool during an image-guided intervention procedure while being navigated through a patient's bifurcated coronary vessel or cardiac chambers anatomy in order to guide e.g. a cardiovascular catheter to a target structure or lesion in a cardiac vessel segment of the patient's coronary venous tree or to a region of interest within the myocard. In such a way, a dynamically enriched 2D reconstruction of the patient's anatomy is obtained while moving the interventional instrument. By applying a cardiac and / or respiratory gating technique, it can be provided that the 2D live images are acquired during the same phases of the patient's cardiac and / or respiratory cycles. Compared to prior-art solutions which are based on a registration and fusion of image data independently acquired by two distinct imaging modalities, the accuracy of the two-dimensionally reconstructed anatomy is significantly enhanced.

Disclosed herein are methods, systems, and apparatus for treating a medical condition of a patient, involving detecting a physiological cycle or cycles of the patient and applying an electrical signal to a portion of the patient's vagus nerve through an electrode at a selected point in the physiological cycle(s). The physiological cycle can be the cardiac and / or respiratory cycle. The selected point can be a point in the cardiac cycle correlated with increased afferent conduction on the vagus nerve, such as a point from about 10 msec to about 800 msec after an R-wave of the patient's ECG, optionally during inspiration by the patient. The selected point can be a point in the cardiac cycle when said applying increases heart rate variability, such as a point from about 10 msec to about 800 msec after an R-wave of the patient's ECG, optionally during expiration by the patient.

A method for four-dimensional (4D) image verification in respiratory gated radiation therapy, includes: acquiring 4D computed tomography (CT) images, each of the 4D CT images representing a breathing phase of a patient and tagged with a corresponding time point of a first surrogate signal; acquiring fluoroscopic images of the patient under free breathing, each of the fluoroscopic images tagged with a corresponding time point of a second surrogate signal; generating digitally reconstructed radiographs (DRRs) for each breathing phase represented by the 4D CT images; generating a similarity matrix to assess a degree of resemblance in a region of interest between the DRRs and the fluoroscopic images; computing a compounded similarity matrix by averaging values of the similarity matrix across different time points of the breathing phase during a breathing period of the patient; determining an optimal time point synchronization between the DRRs and the fluoroscopic images by using the compounded similarity matrix; and acquiring a third surrogate signal and turning a treatment beam on or off according to the optimal time point synchronization.

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 for collecting computed tomography (CT) image data includes determining a number of intervals N into which a respiratory cycle is to be divided, determining a number of respiratory cycles M to be covered in one gantry rotation, and rotating a gantry to collect at least M×N sets of CT image data of at least a portion of a patient, wherein each set of the CT image data corresponds to a phase of a respiratory cycle.

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.

Improved methods and devices perform respiratory control of a person due to conditions such as sleep apnea. According to one embodiment, a respiratory control method includes delivering stimulation signals according to one or more stimulation parameters to phrenic nerves of a person. The person's chest activity is monitored, e.g., by sensing signals in a chamber of the person's heart, to determine the person's respiratory cycle. The stimulation cycle and respiratory cycle are compared. In response, the one or more stimulation parameters are adjusted. In subsequent stimulation cycle(s), the method delivers the stimulation signals according to the adjusted stimulation parameters. This feedback mechanism may continue until respiratory control is captured.

Provided is a configuration capable of executing a detection test for a comfort level including the quality of sleep, which is measurable at home without requiring the measurement of brain waves or electrocardiogram. The respiratory waveform of a subject during sleep is continuously measured and recorded from the respiratory gas flow, etc., and is window-Fourier transformed at each measurement time to generate a frequency spectrum, and a bandwidth including a respiratory frequency is extracted. The index indicating the regularity of the respiratory period of the subject is also calculated at each time point during the sleep, and the time-dependency of this index during the sleep is represented as a graph. A medical device includes a sleep evaluation system equipped with a control means for performing control so that a sleep cycle repeated at a cycle of about 90 minutes is clearly observed if the comfort level including the quality of sleep of the subject is favorable.

A method for controlling operation of a CPAP apparatus. The apparatus has a blower (2), a patient interface (6), an air delivery conduit (8) for delivering air from the blower (2) to the patient interface (6), a sensor (4p) for determining the pressure in the patient interface (6), and a control mechanism (15) that causes air to be delivered at a desired pressure to the patient interface (6) and that detects transitions between inhalation and exhalation of a respiratory cycle of a patient in order to synchronise the blower output with the patient's efforts. In one form the CPAP apparatus provides pressure in accordance with a bi-level waveform with at least one characterising parameter of the waveform being automatically adjusted in accordance with indications of sleep disordered breathing. The indications of sleep disordered breathing can be one or more of snoring, apnea, hypopnea, and flow limitation.

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.

A method for position tracking includes placing an internal reference probe in a reference location within a heart of a subject, and collecting and processing first location coordinates of the internal reference probe during one or more respiratory cycles so as to define a range of the location coordinates corresponding to the reference location. An active device is inserted into the heart, and second location coordinates of the active device are collected. The first and second location coordinates are jointly processed so as to find relative location coordinates of the active device in a cardiac frame of reference. When a deviation of the first location coordinates from the range is detected, the relative location coordinates are corrected to compensate for displacement of the reference probe from the reference location.

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) repetitively cycling the respiration assembly so that during the inhalation phase, gas in the inhalation passage flows to the patient, 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, (c) monitoring the pressure within at least one of the passages during the exhalation phase, and (d) determining whether a circuit disconnect or an occlusion exists based on the pressure monitoring.