Respiratory Muscle Nerve Stimulation for Ventilator-Induced Atrophy
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Solution Overview
Problem
Critical care patients on mechanical ventilation experience rapid respiratory muscle atrophy and diaphragm weakness, leading to prolonged dependence on external respiratory support, increased healthcare costs, and morbidity, with existing methods lacking effective solutions to strengthen respiratory muscles for independent breathing.
Innovation Solution
The use of a system and method involving nerve stimulation, where a stimulator is positioned adjacent to respiratory muscles to cause controlled contractions, with energy delivery at intervals or low duty cycles to strengthen and increase endurance, allowing patients to breathe without external support.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If mechanical ventilation is provided continuously to support respiratory function, then patient survival is improved, but respiratory muscle atrophy and weakness worsen
Solution Approach 1:
The patent applies periodic action by delivering electrical stimulation to respiratory muscles at specific intervals rather than continuously. The stimulation is provided during selected breaths (e.g., every 5th or 10th breath) or during wakeful periods, allowing the muscles to experience both stimulation and rest periods. This periodic intervention maintains muscle strength while the patient receives continuous mechanical ventilation support.
Solution Approach 2:
The patent implements self-service by enabling patients to actively participate in their own respiratory muscle strengthening through voluntary breathing efforts. The electrical stimulation works synergistically with the patient's own neural drive to activate respiratory muscles, transforming passive mechanical ventilation into an active rehabilitation process where patients regain control over their respiratory function.
2Duration of action of moving object
If mechanical ventilation is prolonged to ensure adequate respiratory support, then respiratory function is maintained, but healthcare costs and morbidity increase
Solution Approach 1:
The patent applies preliminary action by initiating respiratory muscle stimulation early in the mechanical ventilation course, before significant muscle atrophy occurs. By starting the strengthening protocol promptly and continuing it throughout ventilation, the system prevents the development of severe weakness, thereby reducing the overall duration of ventilation needed and decreasing associated healthcare costs and complications.
Solution Approach 2:
The patent implements continuity of useful action by maintaining respiratory muscle stimulation throughout the duration of mechanical ventilation. Rather than providing intermittent or short-term intervention, the system continuously engages respiratory muscles during wakeful periods or selected breaths, ensuring progressive strengthening that parallels the ventilation course and accelerates weaning.
3Speed
If electrical stimulation is applied frequently to strengthen respiratory muscles, then muscle strength improves rapidly, but muscle fatigue increases
Solution Approach 1:
The patent applies partial action by providing electrical stimulation to only a subset of breaths rather than every breath. The system stimulates during selected breaths (e.g., 10-30% of total breaths) or during wakeful periods, delivering sufficient stimulus to promote muscle strengthening while allowing adequate rest between stimulations to prevent fatigue and maintain muscle endurance.
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 effectively strengthens respiratory muscles, reducing the need for external respiratory support, mitigating muscle atrophy, and improving patient outcomes by enhancing inspiratory strength and endurance, thereby reducing healthcare costs and morbidity.
Implementation Method 1
a stimulator is positioned adjacent to respiratory muscles to cause controlled contractions
Data Source
AI summary
This disclosure describes methods and systems for stimulating a respiratory muscle of a patient. The methods herein may include positioning a stimulator adjacent a nerve capable of activating the respiratory muscle; activating the stimulator to cause the respiratory muscle to contract; and ceasing the activation of the stimulator for a period of time. The level and the time of the stimulation may be adjusted for various applications. One or more of the steps in the methods may be repeated. The systems herein may include a stimulator for positioning adjacent a nerve capable of activating the respiratory muscle; a signal generator for providing stimulation energy to the stimulator; a sensor for detecting a response of the respiratory muscle to the stimulation energy; and a controller programmed to control the signal generator for providing stimulation with desired level and time.