Systems, devices and methods for modulating a respiratory drive of a patient
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Solution Overview
Problem
Current mechanical ventilation methods, including invasive and non-invasive positive pressure ventilation, cause ventilator-induced diaphragm dysfunction (VIDD) and lung injury (VILI), particularly in critically ill patients and premature babies, due to inadequate control of respiratory drive and lung distending pressures, with insufficient solutions for non-invasive high flow nasal cannula techniques.
Innovation Solution
A mechanical ventilation system with multiple sub-systems that modulate respiratory drive by detecting neural signals, applying synchronized airway CO2 dilution, sub-diaphragmatic unloading, and positive pressure assist, using a controller to adjust therapeutic contributions to each sub-system for lung-protecting muscle unloading without increasing lung-distending pressures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If positive pressure mechanical ventilation is applied to support respiratory function, then life-saving ventilation efficiency is improved, but lung-distending pressures and volumes increase causing ventilator-induced lung injury
Solution Approach 1:
The invention divides the single positive pressure ventilation function into multiple independent sub-systems: a first sub-system delivers positive pressure to airways, while a second sub-system applies negative pressure to the abdomen. This segmentation allows the positive pressure component to maintain ventilation efficiency while the negative pressure abdominal component counteracts the harmful lung-distending pressures, thereby preventing ventilator-induced lung injury.
2Reliability
If positive pressure ventilation assist is increased to control respiratory drive, then respiratory support is improved, but diaphragm activation is suppressed causing ventilator-induced diaphragm dysfunction
Solution Approach 1:
The invention segments the respiratory support function into airway positive pressure delivery and abdominal negative pressure delivery. The abdominal negative pressure sub-system specifically targets the diaphragm region, providing mechanical assistance that reduces the workload on the diaphragm without completely suppressing its activation, thereby preventing ventilator-induced diaphragm dysfunction while maintaining adequate respiratory support.
Solution Approach 2:
The invention introduces the abdominal negative pressure system as an intermediary mechanism between the positive pressure ventilation and the diaphragm. By applying negative pressure to the abdomen, the system creates a mechanical advantage that assists diaphragm function indirectly, reducing the direct suppressive effect of positive pressure ventilation on diaphragm activation.
3Ease of operation
If continuous high flow nasal cannula is applied to reduce work of breathing, then respiratory effort is improved, but lung hyperinflation occurs causing complications
Solution Approach 1:
The invention segments the flow delivery system into synchronized inspiratory flow delivery and continuous expiratory flow delivery. The inspiratory flow is synchronized with patient breathing efforts to reduce work of breathing, while the expiratory flow is controlled to prevent lung hyperinflation, thereby eliminating the harmful effect of continuous high flow nasal cannula while preserving its beneficial effects.
Solution Approach 2:
The invention implements periodic action by synchronizing the inspiratory flow delivery with the patient's respiratory cycle. Flow is delivered during inspiration when it is needed to reduce work of breathing, and reduced or stopped during expiration to prevent lung hyperinflation, replacing the continuous flow approach with a rhythmically modulated approach.
Data Source
AI summary
A mechanical ventilation system comprises a plurality of ventilation therapy sub-systems. Each of the ventilation therapy sub-systems is adapted to assist a respiratory function of the patient. The system also comprises a detector of the respiratory drive of the patient, an operator interface receiving one or more control parameters, and a main controller. The main controller assigns a therapeutic contribution to each of the ventilation therapy sub-systems based on the respiratory drive of the patient and on the control parameters. The controller modulates the respiratory drive of a patient by controlling each of the plurality of the ventilation therapy sub-systems according to its assigned therapeutic contribution. Distinct ventilation therapy sub-systems may apply negative pressure on the abdomen of the patient, deliver a non-pressurizing inspiratory flow to the patient, or induce a positive pressure in the airways of the patient.