Bilateral Phrenic Nerve Pacing for Smooth Breathing

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Solution Overview

Problem

Current phrenic nerve stimulation techniques for negative-pressure ventilation often result in hiccup-like breathing patterns due to irregular and inconsistent flow and volume waveforms, failing to achieve smooth breathing patterns necessary for effective patient ventilation.

Innovation Solution

The method involves determining individual contraction thresholds for the left and right diaphragm portions and delivering customized pacing signals with specific amplitudes to each side, where one side is stiffened with a voltage below its threshold and the other side is contracted with a voltage equal to or greater than its threshold, to achieve synchronized diaphragmatic movement.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If conventional phrenic nerve stimulation is used, then the diaphragm can be stimulated to provide ventilation, but the breathing pattern becomes irregular and hiccup-like

Engineering Contradiction:

Improvebreathing pattern regularityVSAvoidbreathing smoothness

Core Design Contradiction:

ReliabilityVSEase of operation

Solution Approach 1:

The patent divides the diaphragm into two independent portions (left and right sides) and applies different stimulation protocols to each side. The first portion receives stimulation at a first rate while the second portion receives stimulation at a second rate, allowing each side to be optimized independently to achieve smooth, coordinated breathing patterns without the hiccup-like irregularities of conventional uniform stimulation.

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The patent applies different stimulation characteristics to different regions of the diaphragm. Specifically, one portion is stimulated with parameters optimized for its contraction threshold and mechanical properties, while the other portion receives differently optimized parameters. This local customization of stimulation quality ensures each region contributes optimally to smooth breathing.

Inventive Principle:

Principle #3Local quality

2Reliability

If positive pressure ventilation is used, then ventilation can be provided to patients, but detrimental effects such as diaphragm dystrophy and ventilator-associated pneumonia occur

Engineering Contradiction:

Improveventilation effectivenessVSAvoidpatient complications

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The patent replaces the mechanical positive pressure ventilation system with a neurostimulation-based system that activates the patient's own diaphragm. By stimulating the phrenic nerves to directly activate diaphragm contraction, the system substitutes the natural respiratory mechanism for the artificial positive pressure system, thereby eliminating the harmful effects associated with prolonged positive pressure ventilation while maintaining effective ventilation.

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

3Device complexity

If uniform stimulation voltage is applied to both diaphragm sides, then the stimulation protocol is simple, but smooth breathing patterns cannot be achieved

Engineering Contradiction:

Improvestimulation protocol simplicityVSAvoidbreathing pattern quality

Core Design Contradiction:

Device complexityVSReliability

Solution Approach 1:

The patent implements dynamic, adaptive stimulation protocols where the stimulation parameters (voltage, rate) for each diaphragm portion are independently adjusted based on individual contraction thresholds and mechanical interactions. This dynamic customization allows the system to achieve reliable smooth breathing patterns by continuously optimizing the stimulation approach for each patient's specific physiology, rather than using fixed uniform parameters.

Inventive Principle:

Principle #15Dynamics

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 the delivery of smooth breathing patterns with a desired tidal volume, reducing the risk of complications associated with positive pressure ventilation and improving patient outcomes by mimicking natural breathing mechanics.

Implementation Method 1

stimulating the phrenic nerves of the diaphragm

Methodology Applied

Scientific EffectPhrenic nerve stimulation:

Implementation Method 2

a first portion of diaphragm muscles contract to draw a first desired tidal volume into lungs

Methodology Applied

Scientific EffectMuscle contraction:

Data Source

PatentUS12036409B2Achieving smooth breathing by modified bilateral phrenic nerve pacing

Publication Date: 2024.07.16 COVIDIEN LP

AI summary

A system for stimulating phrenic nerves to provide smooth breathing patterns is provided. More specifically, by identifying contraction threshold voltages for muscles associated with each of the left and right portions of a patient's diaphragm, a phrenic nerve pacing signal customized for each phrenic nerve may be provided to a patient. More specifically, a voltage of a pacing voltage provided to a first phrenic nerve may be less than the contraction threshold while a voltage of a pacing voltage provided to a second phrenic nerve may be greater than the contraction threshold.