PAP Titration Support via EIT Cardiac Output Monitoring
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Solution Overview
Problem
Current PAP therapy systems lack the ability to adapt to changing cardiac states in patients with congestive heart failure (CHF), leading to increased mortality risk and inefficient treatment due to the static nature of titration processes.
Innovation Solution
A titration support system for PAP devices that utilizes an external sensor, such as an EIT sensor, to monitor cardiac output and adjust PAP therapy automatically to restore normal cardiac output levels, while also sensing sympathetic nervous system activity to prevent excessive sympathetic activation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If PAP therapy is delivered to CHF patients without adaptive control, then airway support is provided, but cardiac output may diminish and mortality risk increases
Solution Approach 1:
The system continuously monitors cardiac output using EIT sensors and feeds this information back to the controller, which automatically adjusts PAP therapy parameters to maintain cardiac output within safe ranges, thereby preventing mortality risk associated with cardiac output diminishment
Solution Approach 2:
The system performs self-adjustment of PAP therapy parameters based on real-time cardiac output monitoring, eliminating the need for continuous clinical intervention and enabling automatic prevention of harmful cardiac output changes in CHF patients
2Adaptability or versatility
If titration is performed as a single-night study, then initial PAP parameters are established, but the system cannot adapt to changing cardiac states over time
Solution Approach 1:
The system implements continuous monitoring of cardiac output and continuous adjustment of PAP therapy parameters over extended periods beyond single-night studies, maintaining adaptive titration ongoing to accommodate changing cardiac states without requiring repeated clinical visits
Solution Approach 2:
The system performs automatic long-term titration adjustments based on continuous cardiac output monitoring, eliminating the need for repeated manual re-titration studies and enabling ongoing adaptation to changing patient conditions
3Reliability
If ASV therapy is applied to HFrEF patients without cardiac output monitoring, then ventilation support is improved, but sympathetic activation may increase excessively
Solution Approach 1:
The system monitors cardiac output and sympathetic activation markers in real-time and uses this feedback to modulate ASV therapy parameters, preventing excessive sympathetic activation while maintaining effective ventilation support in HFrEF patients
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
The system effectively adapts PAP therapy to individual patient needs, reducing the risk of mortality and improving clinical outcomes for CHF patients by ensuring cardiac output normality and preventing excessive sympathetic activation.
Implementation Method 1
an external sensor (114) comprising at least an electrical impedance tomography (EIT) sensor
Data Source
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AI summary
A titration support system/method (100) for a positive air pressure (PAP) device, including: at least an EIT sensor to: determine whether the it is coupled to skin; establish communication with at least one controller (120, 190, 194) when determining that the external sensor (114) is coupled to the skin of the user; sense a physiological parameter of the user and form corresponding sensor information; determine whether cardiac output is diminished based upon the sensor information; and transmit the sensor information including an indication of whether the cardiac output is diminished to the at least one controller to: control therapeutic air assist to the user; receive the information from the external sensor; determine whether the information comprises the indication that the cardiac output is diminished; and begin auto titration to restore the cardiac output to homeopathic levels in response to determining that the cardiac output is diminished.