Neurally Triggered Ventilation During High Frequency Oscillation
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Solution Overview
Problem
Existing ventilation systems face challenges in providing precise and robust patient-triggered support during high frequency ventilation (HFV) due to difficulties in accurately distinguishing patient breathing efforts from high frequency pressure oscillations, leading to imprecise pneumatic triggering.
Innovation Solution
A ventilation system that incorporates a bioelectric sensor arrangement to measure bioelectric signals, such as electromyographic (EMG) signals, to control the delivery of breathing gas, allowing for neurally triggered support ventilation (NAVA) that is independent of high frequency pressure oscillations, combining HFV with neurally adjusted ventilatory assist (NAVA) to provide precise and robust support.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Extent of automation
If pneumatic triggering is used to detect patient breathing efforts during HFV, then the system can provide patient-triggered support ventilation, but the measurement precision deteriorates due to difficulty in distinguishing patient breathing efforts from high frequency pressure oscillations
Solution Approach 1:
The patent replaces the pneumatic triggering system with a bioelectric sensor system that measures EMG signals from the diaphragm. This substitution eliminates the interference between HFV pressure oscillations and patient breathing detection, as the bioelectric signal is independent of pneumatic pressure changes. The control unit processes the EMG signal to identify patient breathing efforts and triggers ventilator support accordingly, achieving both automation and measurement precision.
2Quantity of substance
If the bias flow is increased to supply sufficient gas during spontaneous breathing, then the gas supply adequacy improves, but the mean positive airway pressure control deteriorates
Solution Approach 1:
The patent implements a dynamic bias flow system where the continuous flow rate is automatically adjusted based on real-time detection of patient breathing efforts through EMG monitoring. When spontaneous breathing is detected, the control unit increases the bias flow to ensure adequate gas supply. The system continuously monitors both EMG signals and airway pressure, dynamically balancing gas delivery with pressure control to maintain mean positive airway pressure within the desired range while providing sufficient ventilation during spontaneous breaths.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach enables more accurate and precise patient-triggered ventilation support by synchronizing gas delivery with the patient's natural breathing efforts, improving the accuracy of support ventilation during HFV and allowing the system to switch between different ventilation modes.
Implementation Method 1
a bioelectric sensor arrangement configured to measure a bioelectric signal indicative of the patient's efforts to breathe
Implementation Method 2
an oscillator arrangement for superimposing high frequency oscillation onto said breathing gas
Data Source
AI summary
A ventilation system provides patient-triggered support ventilation to a spontaneously breathing patient during ongoing high frequency ventilation (HFV), and has a pneumatic unit operated by a control computer for delivery of breathing gas in response to an effort to breathe by the patient, and an oscillator for superimposing high frequency oscillation onto the breathing gas. The system further includes a bioelectric sensor that measures a bioelectric signal indicative of the patient's efforts to breathe, and the control computer controls the delivery of breathing gas in response to the patient's effort to breathe, based on this bioelectric signal. The ventilation system is hence designed for neurally triggered support ventilation during ongoing HFV, which makes the trigger mechanism of the ventilation system more precise and robust compared to known trigger mechanisms of HFV ventilation systems.