VENTILATION MACHINE AND METHOD OF VENTILATING A PATIENT

Abstract

A ventilation machine is disclosed that includes a conduit interface configured to be connected to a respiratory system of a human or animal patient, an air flow generator configured to deliver air through the conduit interface into the respiratory system of the patient, a processing unit in communication with the air flow generator and configured to control the airflow generator to deliver air into the respiratory system of the patient according to a breathing scheme, and an induction device for activating a diaphragm of the patient. The induction device is in communication with the processing unit. The processing unit is configured to control the induction device to activate the diaphragm in coordination with the breathing scheme.

Claims

1-78. (canceled)

79. A ventilation machine, preferably being a single assembly, comprising: a conduit interface configured to be connected to a respiratory system of a human or animal patient; an air flow generator configured to deliver air through the conduit interface into the respiratory system of the patient; a processing unit in communication with the air flow generator and configured to control the airflow generator to deliver air into the respiratory system of the patient according to a breathing scheme; and an induction device, preferably an electro-magnetic induction device, for activating a diaphragm of the patient, wherein the induction device is in communication with the processing unit, and the processing unit is configured to control the induction device to activate the diaphragm in coordination with the breathing scheme.

80. The ventilation machine of claim 79, wherein the processing unit comprises an input interface and the processing unit is configured such that the breathing scheme can be inputted via the input interface.

81. The ventilation machine of claim 79, wherein the breathing scheme comprises a time gap between start of operation of the induction device and start of operation of the air flow generator.

82. The ventilation machine of claim 79, wherein the air flow generator is configured to deliver air through the conduit interface into the respiratory system of the patient by applying cycles of forwarding air into the respiratory system of the patient and allowing exhalation of air from the respiratory system in accordance with the breathing scheme.

83. The ventilation machine of claim 82, wherein the processing unit is configured to control the induction device to activate the diaphragm between the cycles of the breathing scheme and, preferably, right before each start of one of the cycles of the breathing scheme.

84. The ventilation machine of claim 82, wherein the processing unit is configured to control the induction device to activate the diaphragm in synchrony with inhalation cycles of the breathing scheme.

85. The ventilation machine of claim 79, wherein the air flow generator comprises an inspiration valve configured to allow delivery of air through the conduit interface into the respiratory system of the patient, and an expiration valve configured to allow patient exhalation, wherein, in accordance with the breathing scheme, the inspiration valve is synchronized with the activity of the induction device and the expiration valve is synchronized with inactivity of the induction device.

86. The ventilation machine of claim 79, wherein the induction device comprises at least one electrode configured to activate the diaphragm by transcutaneously stimulating a Phrenic nerve under control of the processing unit, and/or an electro-magnetic field generator with a coil design configured to generate a spatial electro-magnetic field having a targeted shape, wherein the induction device preferably is configured to activate the diaphragm by the spatial electro-magnetic field stimulating a Phrenic nerve under control of the processing unit and/or wherein the induction device preferably comprises a mounting arrangement holding the coil design of the electro-magnetic field generator, the mounting arrangement being configured to hold the coil design of the electro-magnetic field generator at the patient.

87. The ventilation machine of claim 79, wherein the induction device comprises a focused ultrasound device to activate the diaphragm by transcutaneously stimulating a Phrenic nerve under control of the processing unit, and/or at least one electrode configured to activate the diaphragm percutaneously.

88. The ventilation machine of claim 79, wherein the processing unit is configured to stop activity of the induction device in synchrony with an end of each inhalation cycle of the breathing scheme.

89. The ventilation machine of claim 79, comprising a sensor member configured to detect an activation of the diaphragm and, preferably, configured to trigger the induction device and the air flow generator.

90. The ventilation machine of claim 89, wherein the processing unit is configured to activate the induction device and the air flow generator with an adjustable time gap towards the trigger from the sensor member, and/or to trigger the induction device upon a signal characteristic of the sensor member measuring diaphragm activation and to trigger the air flow generator upon a signal characteristic from the sensor member measuring indirect diaphragm activation, and/or to automatically vary plural breathing scheme parameters and/or field strength of the spatial electro-magnetic field and/or ramp duration of the spatial electro-magnetic field and/or overall air flow duration and/or flow field strengths and/or expiration phase duration.

91. The ventilation machine of claim 89, comprising a calibration unit, wherein the induction device comprises an electro-magnetic field adjustment mechanism configured to automatically adjust the position of the spatial electro-magnetic field generated by the coil design, the processing unit is in communication with the sensor member of the induction device and with the electro-magnetic field adjustment mechanism of the induction device, the processing unit is configured to control the electro-magnetic field adjustment mechanism of the induction device to automatically vary the position of the spatial electro-magnetic field generated by the coil design of the induction device, the processing unit is configured to receive an activation feedback signal from the sensor member of the induction device upon detection of the activation of the diaphragm, and the processing unit is configured to control the electro-magnetic field adjustment mechanism of the induction device to automatically stop variation of the position of the spatial electro-magnetic field generated by the coil design of the induction device and to automatically stop variation of the field strength of the electro-magnetic field generated by the coil design of the induction device.

92. The ventilation machine of claim 91, wherein the electro-magnetic field adjustment mechanism is configured to automatically adjust a field strength of the electro-magnetic field generated by the coil design, the processing unit is configured to control the electro-magnetic field adjustment mechanism of the induction device to automatically vary the field strength of the electro-magnetic field generated by the coil design of the induction device, and the processing unit is configured to control the electro-magnetic field adjustment mechanism of the induction device to automatically stop variation of the field strength of the electro-magnetic field generated by the coil design of the induction device.

93. The ventilation machine of claim 89, wherein the sensor member comprises a flow sensor connected to the conduit interface and configured to detect an air flow change induced by an activity of the diaphragm, wherein the flow sensor of the sensor member preferably is integral with the conduit interface, and/or a pressure sensor having an adaptor connectable to a respiratory system of the human or animal body, the pressure sensor being configured to detect a pressure change induced by an activity of the diaphragm.

94. The ventilation machine of claim 89, comprising a breathing activity sensor arranged to sense breathing of the patient, wherein the processing unit is configured to control the airflow generator to deliver air into the respiratory system of the patient according to a breathing scheme upon the breathing activity sensor failing to sense sufficient breathing of the patient, and optionally to control the induction device to activate the diaphragm in coordination with the breathing scheme upon the breathing activity sensor failing to sense sufficient breathing of the patient.

95. A process of manufacturing a ventilation machine, preferably embodied as a single piece assembly, comprising: assembling to the ventilation machine a conduit interface configured to be connected to a respiratory system of a human or animal patient, an air flow generator configured to deliver air through the conduit interface into the respiratory system of the patient, a processing unit in communication with the air flow generator and configured to control the airflow generator to deliver air into the respiratory system of the patient according to a breathing scheme, and an induction device, preferably an electro-magnetic induction, device for activating a diaphragm of the patient to the ventilation machine, wherein the induction device is in communication with the processing unit; and configuring the processing unit to control the induction device to activate the diaphragm in coordination with the breathing scheme.

96. The process of claim 95, wherein the breathing scheme comprises a time gap between start of operation of the induction device and start of operation of the air flow generator.

97. The process of claim 95, comprising providing the processing unit is provided with an input interface and the processing unit is configured such that the breathing scheme can be inputted via the input interface, and/or configuring the air flow generator to deliver air through the conduit interface into the respiratory system of the patient by applying cycles of forwarding air into the respiratory system of the patient and allowing exhalation of air from the respiratory system in accordance with the breathing scheme, preferably, comprising configuring the processing unit to control the induction device to activate the diaphragm between the cycles of the breathing scheme, preferably, comprising configuring the processing unit to control the induction device to activate the diaphragm right before each start of one of the cycles of the breathing scheme.

98. The process of claim 95, wherein the processing unit is configured to control the induction device to activate the diaphragm in synchrony with inhalation cycles of the breathing scheme, and/or the air flow generator comprises an inspiration valve configured to allow delivery of air through the conduit interface into the respiratory system of the patient, and an expiration valve configured to allow patient exhalation, wherein, in accordance with the breathing scheme, the inspiration valve is synchronized with the activity of the induction device and the expiration valve is synchronized with inactivity of the induction device.

99. The process of claim 95, comprising providing the induction device with at least one electrode configured to activate the diaphragm by transcutaneously stimulating a Phrenic nerve under control of the processing unit, and/or providing the induction device with an electro-magnetic field generator with a coil design and configuring the coil design to generate a spatial electro-magnetic field having a targeted shape, and/or configuring the induction device to activate the diaphragm by the spatial electro-magnetic field stimulating a Phrenic nerve under control of the processing unit.

100. The process of claim 99, comprising providing the induction device with a mounting arrangement holding the coil design of the electro-magnetic field generator, and configuring the mounting arrangement to hold the coil design of the electro-magnetic field generator at the patient.

101. The process of claim 95, comprising configuring the processing unit to stop activity of the induction device in synchrony with an end of each inhalation cycle of the breathing scheme, and/or providing the ventilation machine with a sensor member configured to detect an activation of the diaphragm, wherein, preferably, the sensor member is configured to trigger the induction device and the air flow generator.

102. The process of claim 101, comprising configuring the processing unit to activate the induction device and the air flow generator with an adjustable time gap towards the trigger from the sensor member, and/or to trigger the induction device upon a signal characteristic of the sensor member measuring diaphragm activation and to trigger the air flow generator upon a signal characteristic from the sensor member measuring indirect diaphragm activation, and/or to automatically vary plural breathing scheme parameters and/or field strength of the spatial electro-magnetic field and/or ramp duration of the spatial electro-magnetic field and/or overall air flow duration and/or flow field strengths and/or expiration phase duration and/or temporal characteristics of the electro-magnetic field.

103. The process of claim 101, comprising providing the ventilation machine with a calibration unit, wherein the induction device is provided with an electro-magnetic field adjustment mechanism configured to automatically adjust the position of the spatial electro-magnetic field generated by the coil design and optionally to automatically adjust a field strength of the electro-magnetic field generated by the coil design, the processing unit is in communication with the sensor member of the induction device and with the electro-magnetic field adjustment mechanism of the induction device, the processing unit is configured to control the electro-magnetic field adjustment mechanism of the induction device to automatically vary the position of the spatial electro-magnetic field generated by the coil design of the induction device and optionally to automatically vary the field strength of the electro-magnetic field generated by the coil design of the induction device, the processing unit is configured to receive an activation feedback signal from the sensor member of the induction device upon detection of the activation of the diaphragm, and the processing unit is configured to control the electro-magnetic field adjustment mechanism of the induction device to automatically stop variation of the position of the spatial electro-magnetic field generated by the coil design of the induction device and optionally to automatically stop variation of the field strength of the electro-magnetic field generated by the coil design of the induction device.

104. The process of claim 103, comprising providing the sensor member with a flow sensor connected to the conduit interface and configured to detect an air flow change induced by an activity of the diaphragm, wherein the flow sensor of the sensor member preferably is integral with the conduit interface.

105. The process of claim 95, comprising assembling an alarm unit into the induction device, wherein the tracker is connected to the alarm unit and configured to activate the alarm unit when the detected movement exceeds a range of compensation achievable by changing the position of the spatial electro-magnetic field generated by the two coils via the electro-magnetic field adjustment mechanism, and/or assembling a breathing activity sensor arranged to sense breathing of the patient into the induction device, configuring the processing unit to control the airflow generator to deliver air into the respiratory system of the patient according to a breathing scheme upon the breathing activity sensor failing to sense sufficient breathing of the patient, and optionally configuring the processing unit to control the induction device to activate the diaphragm in coordination with the breathing scheme upon the breathing activity sensor failing to sense sufficient breathing of the patient.

106. A method of ventilating a human or animal patient comprising: connecting a conduit interface to a respiratory system of the human or animal patient; delivering air through the conduit interface into the respiratory system of the patient; controlling the delivery of air into the respiratory system of the patient according to a breathing scheme; and activating a diaphragm of the patient in coordination with the breathing scheme.

107. The method of claim 106, wherein the breathing scheme comprises a time gap between start of operation of the induction device and start of operation of the air flow generator.

108. The method of claim 106, comprising defining the breathing scheme in accordance with an intended therapy plan.

109. The method of claim 106, wherein the delivering air into the respiratory system of the patient according to the breathing scheme comprises applying cycles of forwarding air into the respiratory system of the patient and allowing exhalation of air from the respiratory system, wherein the diaphragm preferably is activated between the cycles of the breathing scheme, and the diaphragm preferably is activated right before each start of one of the cycles of the breathing scheme.

110. The method of claim 106, wherein the induction device activates the diaphragm in synchrony with inhalation cycles of the breathing scheme.

111. The method of claim 106, wherein the air flow generator comprises an inspiration valve configured to allow delivery of air through the conduit interface into the respiratory system of the patient, and an expiration valve configured to allow patient exhalation, wherein, in accordance with the breathing scheme, the inspiration valve is synchronized with the activity of the induction device and the expiration valve is synchronized with inactivity of the induction device.

112. The method of claim 106, wherein activating a diaphragm of the patient in coordination with the breathing scheme comprises stimulating a Phrenic nerve, wherein the Phrenic nerve preferably is stimulated by a spatial electro-magnetic field having a targeted shape generated by a coil design, and the coil design preferably is held at the patient.

113. The method of claim 106, comprising sensing for activation of the diaphragm, preferably, by detecting an air flow change in the respiratory system of the patient induced by an activity of the diaphragm.

114. The method of claim 112, comprising automatically adjusting the position of the spatial electro-magnetic field generated by the coil design, automatically adjusting a field strength of the electro-magnetic field generated by the coil design, automatically varying the position of the spatial electro-magnetic field generated by the coil design of the induction device, automatically varying the field strength of the electro-magnetic field generated by the coil design of the induction device, receiving an activation feedback signal upon detection of an activation of the diaphragm, and automatically stopping variation of the position of the spatial electro-magnetic field generated by the coil design of the induction device when the activation feedback signal is received and automatically stopping variation of the field strength of the electro-magnetic field generated by the coil design of the induction device when the activation feedback signal is received.

115. The method of claim 106, wherein the breathing scheme defines repetitively activating the diaphragm of the patient, wherein the repetitively activating the diaphragm of the patient preferably is ten to fifty stimulations per minute.

116. The method of claim 106, wherein activity of the induction device is stopped in synchrony with an end of each inhalation cycle of the breathing scheme.

117. The method of claim 106, wherein a sensor member triggers the induction device and the air flow generator, wherein the induction device and the air flow generator preferably are activated with an adjustable time gap towards the trigger from the sensor member, and/or wherein the induction device preferably is triggered upon a signal characteristic of the sensor member measuring diaphragm activation and to trigger the air flow generator upon a signal characteristic from the sensor member measuring indirect diaphragm activation.

118. The method of claim 106, wherein plural breathing scheme parameters and/or field strength of the spatial electro-magnetic field and/or ramp duration of the spatial electro-magnetic field and/or overall air flow duration and/or flow field strengths and/or expiration phase duration temporal characteristics of the electro-magnetic field are varied.

119. The method of claim 106, comprising sensing breathing of the patient, delivering air into the respiratory system of the patient according to a breathing scheme upon sensing sufficient breathing of the patient fails, and optionally activating the diaphragm in coordination with the breathing scheme upon sensing sufficient breathing of the patient fails.

120. A method of transcutaneous induction of a Phrenic nerve for a diagnostic purpose to assess diaphragm function, or sleep apnea, or other forms of sleep-disordered breathing, for repetitive regular transcutaneous induction of a Phrenic nerve for therapeutic use in patients with no spontaneous breath, for example for reanimation and keeping alive patient who have no function of a respiratory center, or for repeated transcutaneous induction of a Phrenic nerve for therapeutic use in patients with no or insufficient spontaneous diaphragm contractions who have at least a partly intact Phrenic nerve, by means of a ventilation machine according to claim 79.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0100] The ventilation machine according to the invention as well as the process according to the invention and method according to the invention are described in more detail herein below by way of exemplary embodiments and with reference to the attached drawings, in which:

[0101] FIG. 1 shows a first embodiment of a ventilation machine according to the invention having a first variant of a electro-magnetic induction device;

[0102] FIG. 2 shows an electro-magnetic field generator of the electro-magnetic induction device of FIG. 1;

[0103] FIG. 3 shows an electro-magnetic field generated by the electro-magnetic induction device of FIG. 1;

[0104] FIG. 4 shows a second embodiment of a ventilation machine according to the invention having a second variant of an electro-magnetic induction device;

[0105] FIG. 5 shows an electro-magnetic field generator of a third variant of an electro-magnetic induction device in a tilted state;

[0106] FIG. 6 shows the electro-magnetic field generator of FIG. 5 in an non-tilted state;

[0107] FIG. 7 shows a third embodiment of a ventilation machine according to the invention having a fourth variant of an electro-magnetic induction device;

[0108] FIG. 8 shows a flow scheme of a first embodiment of a method of ventilating a human or animal patient according to the invention; and

[0109] FIG. 9 shows a graphical representation of an exemplary breathing scheme defined in the method of FIG. 8.

DESCRIPTION OF EMBODIMENTS

[0110] In the following description certain terms are used for reasons of convenience and are not intended to limit the invention. The terms “right”, “left”, “up”, “down”, “under” and “above” refer to directions in the figures. The terminology comprises the explicitly mentioned terms as well as their derivations and terms with a similar meaning. Also, spatially relative terms, such as “beneath”, “below”, “lower”, “above”, “upper”, “proximal”, “distal”, and the like, may be used to describe one element's or feature's relationship to another element or feature as illustrated in the figures. These spatially relative terms are intended to encompass different positions and orientations of the devices in use or operation in addition to the position and orientation shown in the figures. For example, if a device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be “above” or “over” the other elements or features. Thus, the exemplary term “below” can encompass both positions and orientations of above and below. The devices may be otherwise oriented (rotated 90 degrees or at other orientations), and the spatially relative descriptors used herein interpreted accordingly. Likewise, descriptions of movement along and around various axes include various special device positions and orientations.

[0111] To avoid repetition in the figures and the descriptions of the various aspects and illustrative embodiments, it should be understood that many features are common to many aspects and embodiments. Omission of an aspect from a description or figure does not imply that the aspect is missing from embodiments that incorporate that aspect. Instead, the aspect may have been omitted for clarity and to avoid prolix description. In this context, the following applies to the rest of this description: If, in order to clarify the drawings, a figure contains reference signs which are not explained in the directly associated part of the description, then it is referred to previous or following description sections. Further, for reason of lucidity, if in a drawing not all features of a part are provided with reference signs it is referred to other drawings showing the same part. Like numbers in two or more figures represent the same or similar elements.

[0112] FIG. 1 shows a first embodiment of a ventilation machine 1 according to the invention. The ventilation machine 1 has a first implementation an electro-magnetic induction device 2 (in the following also referred to as EMI device). The EMI device 2 comprises an electro-magnetic field generator 21 with two coils 211 as coil design. The coils 211 are located in one common plane and configured to generate a spatial electro-magnetic field 212. As can particularly be seen in FIG. 3, when operated, the two coils 211 generate the electro-magnetic field 212 towards a neck 52 of a patient 5. The electro-magnetic field 212 has a central targeted shape with a target area 213 at which the electro-magnetic field 212 maximally extends into the neck 52.

[0113] Turning back to FIG. 1, the EMI device 2 has a mounting arrangement 22 with a neck arc 221 arranged at the neck 52 of the patient 5 and fixed to a bed 51 the patient 5 lies on. The neck arc 221 is equipped with a joint 222 as repositioning structure of an electro-magnetic field adjustment mechanism of the EMI device 2. The joint 222 holds the coils 211 at the neck 52 of the patient 5.

[0114] The ventilation machine 1 further comprises a ventilator 11 as air flow generator from which ventilation tubes 13 extend. The ventilation machine 1 has a mouthpiece 12 as conduit interface of the ventilation machine 1 or as adapter of the EMI device. The mouthpiece 12 is applied to a mouth as entry point into the respiratory system of the patient 5. The ventilation tubes 13 are coupled to a flow sensor 41 of a sensor member 4 of the ventilation machine 1 or the EMI device 2.

[0115] The ventilation machine 1 further has a controller 3 as a processing unit with a calibration unit 31 and a field adjustment unit 32 of the electro-magnetic field adjustment mechanism. The controller 3 is in communication with the flow sensor 41, the ventilator 11 and the joint 222 via respective wires 33.

[0116] The calibration unit 31 is configured to manipulate the joint 222 to automatically vary the position of the target area 213 of the electro-magnetic field 212 generated by the coils 211 and the controller 3 to vary the field strength of the electro-magnetic field 212. The aim of varying field strength and position of the electro-magnetic filed 212 is to adjust the electro-magnetic field 212 such that it specifically stimulates a Phrenic nerve 53 of the patient 5 as can be best seen in FIG. 3. Upon stimulation of the Phrenic nerve 53, a diaphragm of the patient 5 is activated. Thereby, an airflow or breathing is induced which is sensed by the flow sensor 41.

[0117] The calibration unit 31 is configured to receive an activation feedback signal from the flow sensor 41 upon detection of activation of the diaphragm or upon detection of the airflow. Further, it is configured to stop variation of the position of the target area 213 of the electro-magnetic field 212 and the controller 3 to stop variation of the field strength of the electro-magnetic field 212 when the activation feedback is received.

[0118] The ventilator 11 is configured to deliver air through the mouthpiece 12 into the respiratory system of the patient 5. Thereby, the controller 3 is configured to control the ventilator 11 to deliver air into the respiratory system according to a breathing scheme defined in the controller 3. In particular, the controller 3 regulates the activation of the diaphragm in coordination with the breathing scheme such that activation of the diaphragm via the Phrenic nerve 53 is coordinated with the ventilation of the patient 5.

[0119] In FIG. 2 the coils 211 of the electro-magnetic field generator 21 are shown on more detail. Thereby, it can be seen that the coils 211 are connected to the neck arc 221 via the joint 222. As indicated by the arrows in FIG. 2, the joint 222 can be tilted via the controller 3 such that also the coils 211 are commonly tilted or rotated. During calibration of the EMI device 2, the calibration unit 31 automatically tilts the coils 211 relative to the neck 52 of the patient 5 by moving the joint 222. Thereby, the electromagnetic field 212 and particularly its target area 213 is moved correspondingly. In addition to that, the calibration unit 31 varies the field strength of the electro-magnetic field 212 until the Phrenic nerve is in within the target area 213 and thereby stimulated.

[0120] The EMI device 2 is further equipped with a tracker 23 which is configured to detect a movement of the patient 5 relative to the coils 211 and to automatically induce a change of the position of the target area 213 of the electro-magnetic field 212 to compensate the detected movement of the patient 5. The tracker 23 is in communication with an alarm unit. It activates the alarm unit when the detected movement exceeds a range of compensation achievable by changing the position of the target area 213 of the electro-magnetic field 212.

[0121] The controller 3 is equipped with a wireless adapter to be connected to a mobile device such as a smartphone, tablet or the like as input interface. When the mobile device is connected, an operator can input an appropriate cyclic breathing scheme suitable for treating the patient 5. The breathing scheme is embodied such that the controller 3 induces operation in a predefined patient specific manner. Thereby, the ventilator 11 delivers air through the mouthpiece 12 into the respiratory system of the patient 5 by applying cycles of forwarding air into the respiratory system of the patient 5 and allowing exhalation of air from the respiratory system in accordance with the breathing scheme. Further, the EMI device 2 activates the diaphragm right before each start of one of the cycles of the breathing scheme.

[0122] FIG. 4 shows a second embodiment of a ventilation machine 10 according to the invention. It comprises a second implementation of an EMI device 20 which is equipped with an electro-magnetic field generator 210 with two coils 2110. The coils 2110 are configured to generate a spatial electro-magnetic field with a targeted shape. The EMI device 20 further has a mounting arrangement 220 with a tape 2210. The tape 2210 is provided with an adhesive and attached to a neck 520 of a patient 50.

[0123] The EMI device 20 is equipped with a shaft 2220 as repositionable element extending towards the coils 2110 and can tilt the electro-magnetic field around an axis of the shaft.

[0124] The ventilation machine 10 comprises a ventilator 110 as air flow generator from which ventilation tubes 130 extend. The EMI device 20 has a mouthpiece 120 as adapter or as conduit interface of the ventilation machine 10. The mouthpiece 120 is applied to a mouth as entry point into the respiratory system of the patient 50.

[0125] The ventilation machine 10 has a controller 30 as a processing unit with a calibration unit 310 and a field adjustment unit 320 of the electro-magnetic field adjustment mechanism. On the body of the patient 50 a plurality of electrodes 410 comprised by a sensor member 40 for detecting activation of the diaphragm. The controller 30 is in communication with the electrodes 410 and magnetic stimulator 325 which connects to the shaft 2220 via respective wires 330. The controller 30 further is wirelessly in communication with the ventilator 110.

[0126] The calibration unit 310 is configured to automatically vary the position of a spatial electro-magnetic field by automatically inducing the field adjustment unit 320 to reposition the shaft 2220 and by automatically varying the electro-magnetic field field strength. In particular, the shaft 2220 influences the alignment of the electromagnetic field around the axis of the shaft and thereby the location of the target area 213. Thus, by moving the shaft 2220, the targeted shape of the electro-magnetic field can be relocated. Like this, the spatial electro-magnetic field can be moved within the neck 520 of the patient 50. In particular, the calibration unit 310 is configured to vary the position of the spatial electro-magnetic field and to vary the field strength of the electro-magnetic field. Like this, the electro-magnetic field can be adjusted such that it specifically stimulates a Phrenic nerve of the patient 50. Upon stimulation of the Phrenic nerve, a diaphragm of the patient 50 is activated which is sensed by the electrodes 410.

[0127] The calibration unit 310 is configured to receive an activation feedback signal from the electrodes 410 upon detection of activation of the diaphragm. Further, it is configured to stop variation of the position of the spatial electro-magnetic field and to control the controller 30 to stop variation of the field strength of the electro-magnetic field when the activation feedback is received. The ventilator 110 is configured to deliver air through the mouthpiece 120 into the respiratory system of the patient 50. The controller 30 is configured to control the ventilator 110 such that its delivery of air into the respiratory system is in line with a breathing scheme defined in the controller 30. In particular, the controller 30 regulates the activation of the diaphragm in coordination with the breathing scheme such that activation of the diaphragm via the Phrenic nerve is coordinated with the ventilation and breathing of the patient 50.

[0128] The controller 30 is equipped with a wireless adapter to be connected to a mobile device such as a smartphone, tablet or the like as input interface. When the mobile device is connected, an operator can input an appropriate cyclic breathing scheme suitable for treating the patient 50. The breathing scheme is embodied such that the controller 30 induces ventilation and Phrenic nerve stimulation in a predefined and patient specific manner. Thereby, the ventilator 110 delivers air through the mouthpiece 120 into the respiratory system of the patient 50 by applying cycles of forwarding air into the respiratory system of the patient 50 and allowing exhalation of air from the respiratory system in accordance with the breathing scheme. Further, the EMI device 20 activates the diaphragm right before each start of one of the cycles of the breathing scheme.

[0129] In FIG. 5 an electro-magnetic field generator 219 of a third embodiment of an EMI device is shown. The electro-magnetic field generator 219 comprises a housing in which two coils 2119 are positioned. The coils 2119 are fixed to each other such that they can be moved or manipulated together as one unit. The coils 2119 are connected to cables 2139 at their lateral end sides. Starting from the coils 2119, the cables 2139 are redirected by respective pulleys 2129 and guided through an opening out of the housing.

[0130] In FIG. 5 the coils 2119 are depicted in a tilted state in which the left coil 2119 is higher than the right coil 2119. For changing the tilting of the coils 2119, one of the cables 2139 can be pulled. As can be seen in FIG. 6, for moving the coils 2119 back to a straight position, the left cable 2139 is pulled such that the coils 2119 are rotated counter-clockwise.

[0131] FIG. 7 shows a third embodiment of a ventilation machine 18 according to the invention having a fourth embodiment of an EMI device 28. The EMI device 28 comprises an electro-magnetic field generator 218 with two coils 2118 as coil design. The electro-magnetic field generator 218 has a housing 2128 into which a shaft 2228 of a mounting arrangement 228 extends. The shaft 2228 is coupled to a shaft drive 2238 by which the shaft 2238 can be moved in the electro-magnetic field once created by the coils 2118.

[0132] The ventilation machine 18 comprises a ventilator as air flow generator from which ventilation tubes are connected to a mouthpiece 128 as conduit interface via a flow sensor 418 of a sensor member 48. The mouthpiece 128 is applied to a mouth of a patient 58 as entry point into his respiratory system.

[0133] The ventilation machine 18 has a controller 38 as a processing unit with a calibration unit and a field adjustment unit. The housing 2128 of the electro-magnetic field generator 218 the shaft drive 2238 and the controller 38 are attached to the patient 58 and, particularly, the electro-magnetic field generator 218 to his neck 528. Thereby, an adhesive of the mounting arrangement 228 is used. The controller 38 is in communication with the flow sensor 418 and the shaft drive 2238 by means of wires 338.

[0134] The ventilation apparatus 18 is correspondingly operated as the ventilation apparatus 10 described above in connection with FIG. 4.

[0135] FIG. 8 shows an embodiment of a method of ventilating a human or animal patient according to the invention. The method involves any one of the ventilation machines described above or another embodiment of a ventilation machine according to the invention.

[0136] In a first step 101, a breathing scheme is defined by an operator. In particular, the operator defines the breathing scheme via a user interface provided by the ventilation machine. In a second step 102, a conduit interface of the ventilation machine is connected to a respiratory system of the patient. In particular, a mouthpiece of the conduit interface is mounted to a head of the patient such that nose and mouth are covered by the mouthpiece.

[0137] In a third step 103, air is delivered through the conduit interface into the respiratory system of the patient. More specifically, in sub-step 103i a flow sensor of the ventilating machine detects a spontaneous activity of the diaphragm by sensing an air flow inside the conduit interface. A first time gap predefined in the breathing scheme after such spontaneous activity is detected, in a sub-step 103ii, an electro-magnetic induction device of the ventilation machine stimulates the Phrenic nerve by applying a spatial electro-magnetic field. For such stimulation, a coil design of the electro-magnetic induction device, which is mounted to a neck of the patient, is energized. In particular, a train of electro-magnetic impulses is generated which are continuously increased in intensity until a target intensity is reached. Thereby, the diaphragm of the patient is activated. A second time gap predefined in the breathing scheme after such activation of the diaphragm, in a sub-step 103iii, an air flow generator of the ventilation machine delivers air through the conduit interface into the patient. In a sub-step 103iv, activation of the diaphragm as well as delivery of air is stopped and air is passively exhaled from the respiratory system of the patient. Then, in sub-step 103v, the ventilation is paused until in sub-step 103i the spontaneous activity is detected again.

[0138] The delivery of air into the respiratory system of the patient of step 103 is controlled by a processing unit of the ventilation machine in an ongoing or continuous step 104.

[0139] In FIG. 9 a graph of the breathing scheme defined in step 101 of the method of FIG. 8 is shown. In this graph the bottom horizontal arrow represents time, the first horizontal arrow 103-A represents signals detected by the flow sensor, the second horizontal arrow 103-B represents the activity of an electro-magnetic induction device of the ventilation machine and the third horizontal arrow 103-C represents the activity of an air flow generator of the ventilation machine.

[0140] As can be seen in the graph of FIG. 9, the flow sensor detects a trigger event 103-D in the form of an air flow resulting from eventually weak spontaneous inhalation of the patient and transfers a respective signal to the processing unit of the ventilation machine. The processing unit then operates the electro-magnetic induction device such that it generates a spatial electro-magnetic field with a peak providing a train 103-E of electro-magnetic pulses. More specifically, the train 103-E comprise a number of electro-magnetic pulses which follow each other with a temporal width w, which can be in a range of about 33 milliseconds to about 66 milliseconds. Thereby, in the beginning of the train 103-E the intensity of the pulses stepwise increases until a target intensity is reached. Like this, impulses of the target intensity can smoothly be provided such that a resistance of the patient or discomfort can be decreased. The electro-magnetic induction device is mounted to a neck of the patient and adjusted to stimulate the Phrenic nerve. Thus, by providing the train 103-E the diaphragm of the patient is activated such it contracts and the patient inhales.

[0141] After the respective time gap Δt predefined in the breathing scheme, the processing unit operates the air flow generator such that an active air delivery 103-F into the respiratory system of the patient is provided via the conduit interface. During the air delivery 103-F the train 103-E is still provided such that in this phase inhalation is induced in parallel by the air flow generator and the electro-magnetic induction device. The flow sensor continuously senses the pressure and/or flow volume in the conduit interface. After the inhalation flow and/or pressure decreases a predefined threshold, the processing unit stops the air flow generator and the electro-magnetic induction device. Inhalation is then ended and the patient starts to spontaneously exhale. A further cycle then starts upon the flow sensor detecting a next trigger event 103-D.

[0142] This description and the accompanying drawings that illustrate aspects and embodiments of the present invention should not be taken as limiting-the claims defining the protected invention. In other words, while the invention has been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative or exemplary and not restrictive. Various mechanical, compositional, structural, electrical, and operational changes may be made without departing from the spirit and scope of this description and the claims. In some instances, well-known circuits, structures and techniques have not been shown in detail in order not to obscure the invention. Thus, it will be understood that changes and modifications may be made by those of ordinary skill within the scope and spirit of the following claims. In particular, the present invention covers further embodiments with any combination of features from different embodiments described above and below. For example, it is possible to operate the invention in embodiments with the following features: [0143] During the complete application of the ventilation machine a base pressure can be applied by the air flow generator to the respiratory system of the patient. [0144] The trigger event in the breathing scheme as starting point for the activation of the diaphragm can be provided by other means than the sensor member of the ventilation machine itself or a further sensor member. For example, a myogram can be used for detecting the trigger event. [0145] The breathing scheme can define two different trigger events, one for inducing operation of the electro-magnetic induction device and one for inducing operation of the air flow generator. For example, the first trigger event can be based on a sensed activity of the diaphragm and the second trigger event based on a specific sensed flow and/or pressure. [0146] The breathing scheme can define that operation of the air flow generator starts a predefined time after the electro-magnetic induction device. Or, it can start when a specific value is measured such as oxygen pressure in the blood or the like.

[0147] The disclosure also covers all further features shown in the Figs. individually although they may not have been described in the afore or following description. Also, single alternatives of the embodiments described in the figures and the description and single alternatives of features thereof can be disclaimed from the subject matter of the invention or from disclosed subject matter. The disclosure comprises subject matter consisting of the features defined in the claims or the exemplary embodiments as well as subject matter comprising said features.

[0148] Furthermore, in the claims the word “comprising” does not exclude other elements or steps, and the indefinite article “a” or “an” does not exclude a plurality. A single unit or step may fulfil the functions of several features recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. The terms “essentially”, “about”, “approximately” and the like in connection with an attribute or a value particularly also define exactly the attribute or exactly the value, respectively. The term “about” in the context of a given numerate value or range refers to a value or range that is, e.g., within 20%, within 10%, within 5%, or within 2% of the given value or range. Components described as coupled or connected may be electrically or mechanically directly coupled, or they may be indirectly coupled via one or more intermediate components. Any reference signs in the claims should not be construed as limiting the scope.