DEVICE AND SYSTEM FOR RESPIRATORY THERAPY

Abstract

A device for respiratory therapy of a patient comprises a respiratory gas source for specifying different respiratory gas parameters, comprising at least one control unit, and comprising a signal unit for outputting at least one signal. The at least one signal is used for signaling changing respiratory gas parameters and is sensorially perceptible by the patient.

Claims

1. A device for respiratory therapy of a patient, wherein the device comprises a respiratory gas source for specifying different respiratory gas parameters, comprising at least one control unit, and a signal unit for outputting at least one signal, the at least one signal being used for signaling changing respiratory gas parameters and being sensorially perceptible by the patient.

2. The device of claim 1, wherein the signal unit emits the signal to the patient before a change of a respiratory gas parameter.

3. The device of claim 1, wherein the at least one signal is transmitted to an airway of the patient pneumatically and includes a modulation of a specified respiratory gas with respect to pressure and/or flow and/or volume.

4. The device of claim 1, wherein the at least one signal is sensorially perceptible by the patient via her mechanoreceptors and/or cold receptors and/or smell receptors and/or taste receptors.

5. The device of claim 1, wherein the signal unit is configured for generating pneumatic signals.

6. The device of claim 1, wherein the signal unit is controlled by the control unit.

7. The device of claim 1, wherein the changing respiratory gas parameter is a respiratory gas pressure provided by the device.

8. The device of claim 1, wherein the respiratory gas parameter is changed upon switching from insufflation to coughing phase.

9. The device of claim 1, wherein the changing respiratory gas parameter is a positive respiratory gas pressure, which is dissipated following an insufflation phase for a coughing phase or is switched to negative pressure.

10. The device of claim 1, wherein the device carries out an insufflation with overlaid oscillation, the at least one signal being an oscillation which is changed before switching to a coughing phase.

11. The device of claim 1, wherein the device carries out an insufflation without oscillation, the at least one signal being a specific modulation of the respiratory gas with respect to pressure and/or flow and/or volume.

12. The device of claim 1, wherein the at least one signal includes a modulation of pressure and/or flow.

13. The device of claim 1, wherein the at least one signal is a modulated-on oscillation having a fixed or changing frequency and/or amplitude.

14. The device of claim 13, wherein the oscillation has a frequency from 1 to 40 Hz, and an amplitude of the oscillation is from 0.2 to 50 hPa.

15. The device of claim 1, wherein the at least one signal is a brief positive or negative pressure and/or flow pulse on an air column.

16. The device of claim 1, wherein the at least one signal changes between a beginning of the at least one signal and a moment of switching.

17. The device of claim 1, wherein the device further comprises a generator for generating a detector signal and a sensor for determining a change of the detector signal, the detector signal being suitable for detecting changes of a patency of airways and/or an at least advanced or complete filling of a lung and the sensor determining this change of the detector signal.

18. The device of claim 17, wherein automatic switching to a coughing phase takes place when, based on the detector signal, a change of the patency of the airways or an at least advanced or complete filling of the lung is determined.

19. The device of claim 18, wherein the automatic switching is based on an oscillatory pressure, flow, and/or volume signal.

20. A system for respiratory therapy of a patient, wherein the system comprises the device of claim 1, and further comprises a patient interface and a respiratory gas hose.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0120] The invention is illustrated in more detail on the basis of exemplary embodiments shown in the following drawings. In the drawings,

[0121] FIG. 1 schematically shows an exemplary embodiment of a device of the invention for respiratory therapy of a patient.

[0122] FIG. 2 schematically shows a further exemplary embodiment of a device of the invention for respiratory therapy of a patient.

[0123] FIG. 3 schematically shows a further exemplary embodiment of a device of the invention for respiratory therapy of a patient.

[0124] FIG. 4 schematically shows two exemplary pressure curves a) and b) of an insufflation and exsufflation or expiration.

[0125] FIG. 5 schematically shows another exemplary pressure curve of an insufflation and exsufflation or expiration.

[0126] FIG. 6 schematically shows another exemplary pressure curve of an insufflation and exsufflation or expiration.

[0127] FIG. 7 schematically shows another exemplary pressure curve of an insufflation and exsufflation or expiration.

[0128] FIG. 8 schematically shows another exemplary pressure curve of an insufflation and exsufflation or expiration.

[0129] FIG. 9 schematically shows another exemplary pressure curve of an insufflation and exsufflation or expiration.

DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS

[0130] The particulars shown herein are by way of example and for purposes of illustrative discussion of the embodiments of the present invention only and are presented in the cause of providing what is believed to be the most useful and readily understood description of the principles and conceptual aspects of the present invention. In this regard, no attempt is made to show details of the present invention in more detail than is necessary for the fundamental understanding of the present invention, the description in combination with the drawings making apparent to those of skill in the art how the several forms of the present invention may be embodied in practice.

[0131] FIG. 1 schematically shows an exemplary embodiment of a device 100 for respiratory therapy of a patient 109. The device 100 comprises, for example, a flow or pressure source in the form of a fan 101, for example, driven by a controllable motor unit 102. At least one valve 107 and a signal unit 106 for generating a signal 204 for signaling changing respiratory gas parameters, for example, are pneumatically connected to the fan 101. The signal unit 106 is, for example, at the same time also an oscillation valve 110 for generating an oscillation of the pressure and/or flow. A pneumatic connection to the patient 109 is established via a hose system and patient interface (not shown) via the device outlet 108. Pressure and/or flow values are recorded, for example, via sensors 105.

[0132] At least the control of the motor unit 102 for driving the fan 101 and the control of the valve 107 and the signal unit 106 is implemented via the control unit 103.

[0133] An exemplary respiratory therapy comprises an insufflation 201 of the patient 109, wherein the overpressure of insufflation 201 is stopped suddenly or immediately (<500 ms) by switching 202. A (forced) expiration or an exsufflation 203 of the patient 109 follows thereon, also referred to as a coughing phase in the scope of the invention. The exemplary device 100 is configured so that an insufflation 201 and an exsufflation 203 are possible using the fan 101. During exsufflation 203, a negative pressure (in relation to the ambient pressure) is generated. Switching 202 from insufflation 201 to exsufflation 203 is possible, for example, by the valve 107. The suction side of the fan 101 is switched from ambient air to respiratory gas path by switching the valve 107. During insufflation 201, the fan 101 sucks in the ambient air and delivers this as respiratory gas in the direction of the patient 109. After switching, the suction side of the fan 101 is connected to the respiratory gas path; the fan thus sucks in on the side of the patient 109 and delivers in the direction of ambient air. A negative pressure on the side of the patient thus arises during an exsufflation 203. In some embodiments, it can be provided that the device 100 is additionally or alternatively configured so that, during the exemplary respiratory therapy, the insufflation 201 is not followed by exsufflation 203, rather the provision of an overpressure ends abruptly after insufflation 209 and thus an expiration and ideally a cough of the patient 109 is forced.

[0134] In some embodiments, it can be provided that switching from insufflation 201 to an expiration 203a is possible without switching the valve 107. For example, for this purpose the speed of the fan 101 is suddenly reduced to generate a pressure drop.

[0135] The change of respiratory gas parameters by switching 202 from insufflation 201 to expiration 203a and/or exsufflation 203 is signaled or announced according to the invention by a signal 204. In this case, this is preferably a pneumatic signal 204, which is generated in the exemplary device 100 via the signal unit 106. For example, the signal unit is in the form of an oscillation valve, which generates an oscillation of the insufflation pressure and/or flow, wherein the oscillation is at least used as the signal 204. In some embodiments, insufflation 201 is overlaid with an oscillation apart from the signal 204, generated by the oscillation valve 110. A signal 204 can be generated, for example, by stopping the oscillation or modulating the oscillation, for example, the amplitude and/or frequency change.

[0136] To generate the signal 204, for this purpose the signal unit 106 is activated accordingly by the control unit 103 and activated using corresponding control signals, for example, to implement specifications on the beginning, end, amplitude, and/or frequency of the signal 204 in the form of an oscillation.

[0137] If the signal 204 consists in an oscillation, the oscillation thus has a frequency from about 1 Hz to about 40 Hz, preferably from about 2 Hz to about 30 Hz. In some embodiments, the frequency of the oscillation is preferably from about 3 Hz to about 15 Hz. The amplitude of the oscillation which is used as the signal 204 is, for example, from about 0.2 hPa to about 50 hPa, preferably from about 0.5 hPa to about 30 hPa. In some embodiments, the amplitude of the oscillation of the signal 204 is from about 1 hPa to about 20 hPa. The amplitude designates the distance of the two peaks from one another.

[0138] Various respiratory gas parameters can be detected via the flow and/or pressure sensors 105. For example, it can be provided that it is determined via the oscillation during insufflationboth as the signal 204 and also apart from the signal 204whether and/or when switching 202 is to take place. It can be provided that a minimum and/or maximum time is set and/or specified for insufflation. If the minimum insufflation time is reached, for example, the signal can be generated. The switching can then take place after a set or fixed period of time for which the signal 204 is generated. Alternatively or additionally, it can be provided that the switching takes place when it is established via the oscillation that switching is supposed to take place. In some embodiments, the settable or fixed period of time for the signal 204 becomes a maximum period of time, the switching thus takes place at the latest after expiration of the signal time. In some embodiments, alternatively or additionally, a maximum insufflation time is provided, after the expiration of which the switching 202 takes place independently of the oscillation measurements. For example, the maximum insufflation time can correspond to a minimum insufflation time plus a signal time. In some embodiments, in particular if no minimum insufflation time is provided, it can be provided that the signal 204 is generated in accordance with the duration of the signal 204 before the expiration of the maximum insufflation time.

[0139] It can alternatively or additionally be established via the sensors 105 whether the lung of the patient 109 is fully filled and switching 202 from insufflation 201 to expiration 203a or exsufflation 203 is to take place. For example, an approach of the flow to 0 /lmin can indicate a fully filled lung, so that the control unit 103 activates the signal unit 106 such that the signal 204 is generated to signal changing respiratory gas parametersthe switching from insufflation to exsufflation 203 or expiration 203a here.

[0140] Inputs of data, information, and/or parameters, for example, are possible via the user interface 104. Inter alia, parameters for the signal 204 can be input. For example, time before switching, period of time, frequency, amplitude, and/or intensity of the signal 204 can be set. The time is, for example, a period of time of the signal 204 and/or from when before the switching 202 from insufflation 201 to exsufflation 203 or expiration the signal 204 is generated. For example, it can be fixed and/or settable that the signal is generated over a period of time of 0.1 to 2 seconds. The settable and/or fixed period of time is preferably 0.5 seconds to 1.5 seconds. In some embodiments, the settable and/or fixed period of time is preferably 0.8 seconds to 1.2 seconds.

[0141] In some embodiments, alternatively or additionally, the fan 101 or the motor unit 102 and/or the valve 107 can be designed as the signal unit 106. For example, it can be provided that the device 100 comprises multiple signal units 106, which can generate various types of signals 204. It will be explained in more detail by way of example in FIGS. 2 and 3 how the fan 101 and/or the valve 107 can be used as signal units 106.

[0142] A further exemplary embodiment of the device 100 is schematically shown in FIG. 2. The exemplary device 100 includes at least one respiratory gas source in the form of a fan 101, which is driven by a motor unit 102 controllable by the control unit 103.

[0143] The device 100 furthermore includes a valve 107, which can switch between an insufflation 201 and an exsufflation 203, as also in the embodiment described in FIG. 1. The gas feed is switched here so that the suction side of the fan 101 is connected during insufflation 201 to an intake area for ambient air. For exsufflation 203, the valve is switched so that the suction side of the fan 101 is connected to the respiratory gas path to or from the patient 109 and thus generates a negative pressure to the patient 109.

[0144] The valve 107 is moreover configured as a signal unit 106 and can be activated by the control unit 103 to generate a pneumatic signal 204 in order to signal changing respiratory gas parameters. In particular, the signal 204 can signal switching 202 from insufflation 201 to exsufflation 203 or expiration 203a.

[0145] The signal 204 can be, for example, an adjustment of the pressure and/or flow during insufflation 201. It can also be provided that an oscillation can be generated as the signal 204 by deliberate switching of the valve 107.

[0146] For example, an adjustment of the pressure and/or flow to generate the signal 204 can thus take place. At a fixed and/or settable time before the switching, the pressure and/or the flow is increased or decreased in this case. A single brief reduction of the pressure can take place, for example, by briefly switching the valve 107, so that for a brief moment the suction side of the fan 101 is connected to the respiratory gas path from/to the patient 109 and thus briefly reduces the pressure there. In some embodiments, for example, for a longer time in which a lower pressure is to be used as the signal 204, a reduction of the speed of the fan 101 can be provided. Similarly, an increase of the pressure as the signal 204 can be achieved by an increase of the speed of the fan 101.

[0147] The sensor unit 105 and the user interface 104 are embodied by way of example as in the embodiments of FIG. 1.

[0148] FIG. 3 schematically shows an exemplary embodiment of the device 100 for respiratory therapy of a patient 109. The device 100 includes a respiratory gas source in the form of a fan 101 driven by a motor unit 102, which is also designed at the same time as a signal unit 106. The fan 101 is configured, for example, to provide an overpressure to the patient 109 during an insufflation 201. By suddenly switching to expiration 203a, for example sudden deceleration of the fan 101, an expiration can be forced and a cough can be triggered in the patient 109. A switch to the coughing phase thus takes place before the insufflation 201. In order to signal these changing respiratory gas parameters, among other things, a pneumatic signal can be generated by the signal unit 106.

[0149] To generate the signal 204, the motor 102 is activated by the control unit 103 so that the fan 101 can generate variations in the provided pressure during the insufflation 201. For example, it is provided that the generation of the signal 204 begins a time before the switching and then lasts for a period of time.

[0150] For example, an oscillatory signal 204 can be generated by a periodic reduction and increase 15 of the speed. In some embodiments, it can be provided that the entire insufflation 201 is overlaid with an oscillation, the signal 201 can then consist, for example, in the oscillation being modulated, thus changed in frequency and/or amplitude. It can also be provided that the signal 204 is generated by stopping the oscillation.

[0151] In some embodiments, it is provided that the signal 204 is a change of the pressure and/or flow. For example, to generate the signal 204, the speed of the fan 101 is increased, which results in an at least temporarily rising pressure and/or flow and signals changing respiratory gas parameters to the patient 109, in particular switching from insufflation 201 to expiration 203a. In some embodiments, it can be provided that the pressure and/or flow increase does not last over the entire period of time until switching, but only for a shorter period of time 25 before switching. Alternatively or additionally, it can be provided as the signal 204 that the signal 204 is an at least temporary reduction of the pressure. For example, the pressure is briefly reduced and then raised back to the plateau level of insufflation 201 before the switching takes place.

[0152] The sensor unit 105 and the user interface 104 are embodied, for example, as in the embodiments of FIG. 1.

[0153] FIGS. 4 to 9 schematically show by way of example various pressure curves of an insufflation 201 and exsufflation 203 or expiration 203a. FIG. 4 a) describes by way of example a pressure curve of insufflation 201 and exsufflation 203 according to the prior art, FIG. 4 b) shows an expiration 203a instead of an exsufflation 203. In FIGS. 5 to 9, various signals 204 before the switching are shown by way of example on the basis of a pressure curve having insufflation 201 and exsufflation 203. The signals 204 can similarly also be transferred to embodiments in which exsufflation 203 does not take place after the switching, rather switching to an expiration 203a is provided. In the illustrated diagrams, the x axis designates the pressure p and the y axis designates the time t. The zero line shown relates here relative to the ambient pressure. A pressure p of zero corresponds here to the ambient pressure.

[0154] FIG. 4 schematically shows an exemplary pressure curve a) for an insufflation 201 with subsequent exsufflation 203 according to the prior art. At the beginning of insufflation 201, the pressure p increases until a plateau level is reached. This plateau is maintained for a time until insufflation 201 is ended and switching 202 to exsufflation 203 takes place. The pressure sinks rapidly due to the switching 202 to exsufflation 203 and forces the patient into an expiration and/or a cough. In exsufflation 203, a negative pressure (relative to the ambient pressure) is provided at the patient or a negative pressure is applied in the direction of the airways of the patient 109, by which the expiration or the cough is forced more strongly.

[0155] FIG. 4 also shows schematically an exemplary pressure curve b) for an insufflation 201 in which a switching 202 to expiration 203a takes place. In contrast to exsufflation 203, a negative pressure relative to the ambient pressure is not provided here, but rather the overpressure provided during insufflation 201 is strongly and suddenly reduced and approaches the ambient pressure in some embodiments. The patient is forced into an expiration 203a by the strong reduction of the pressure, possibly accompanied by a cough.

[0156] An exemplary embodiment of the signal 204 is schematically shown in FIG. 5. The signal 204 is shown, for example, in an embodiment having insufflation 201 and exsufflation 203, but can similarly also be transferred to embodiments in which insufflation 201 is followed by an expiration 203a, without a negative pressure being provided. After an increase, the pressure reaches a plateau level during insufflation 201, at which the pressure for the insufflation 201 is kept essentially constant and the patient 109 is ventilated using an overpressure. At a settable or fixed time before the switching 202, changing respiratory gas parameters, here, for example, the switching 202 from insufflation 201 to exsufflation 203, is signaled to the patient 109 by the signal 204. Changing respiratory gas parameters in this case are at least the pressure and/or the flow which change due to the switching 202. The signal 204 is generated, for example, for a settable or fixed period of time. This period of time can be, for example, between 0.1 seconds and 2 seconds, preferably between 0.5 seconds and 1.5 seconds. In some embodiments, the period of time of the signal 204 is preferably between 0.8 seconds and 1.2 seconds. The time before switching at which the generation of the signal 204 begins is, for example, between 0.1 seconds and 2 seconds, preferably between 0.5 seconds and 1.5 seconds, more preferably between 0.8 seconds and 1.2 seconds.

[0157] In the embodiment shown in FIG. 5, the signal 204 consists of an oscillation 205 of the pressure. The oscillation 205 can be generated, for example, by a periodic increase and decrease of the speed of a fan 101 and/or by the switching of an oscillation valve 110. In some embodiments, a valve 107 which switches over the suction side of the fan 101, can also generate an oscillation 205 of the pressure and thus a pneumatic signal 204.

[0158] The amplitude of the oscillation 205 is from about 0.2 hPa to about 50 hPa, preferably from about 0.5 hPa to about 30 hPa. In some embodiments, the amplitude is preferably from about 1 hPa to about 20 hPa. The amplitude refers here to the distance of the peaks from one another.

[0159] The frequency of the oscillation 205 is from about 1 Hz to about 40 Hz, preferably from about 2 Hz to about 30 Hz. In some embodiments, the frequency of the oscillation 205 is preferably from about 3 Hz to about 15 Hz.

[0160] In some embodiments, it can be provided that the frequency and/or amplitude of the oscillation 205 change by rising and/or change by falling during the generation of the signal. It can alternatively or additionally also be provided that the frequency and/or amplitude change dynamically. In some embodiments, it can be provided that the amplitude and/or frequency initially increases and then falls again. For example, amplitude and/or frequency can themselves isolate, thus periodically increase and decrease. In some embodiments, it can be provided that the frequency and/or amplitude of the oscillation 205 increase toward the point in time of the switching 202 and reach their maximum immediately before the switching 202.

[0161] It can be provided by way of example that the time before the switching 202, the period of time of the signal 204, the frequency and/or amplitude of the oscillation 205 are settable via the user interface 104. Additionally or alternatively, it can be provided that the time before the switching 202, the period of time of the signal 204, the frequency and/or amplitude of the oscillation 205 are fixed and/or can be selected from fixed values.

[0162] In some embodiments, it can be provided that the oscillation 205 used as the signal 204 is also used for measurement purposes, for example, to conclude various respiration parameters, such as the fill level of the lung of the patient 109 and/or secretion deposits, via respiratory gas signals.

[0163] A further exemplary embodiment of the signal 204 for signaling changing respiratory parameters, in particular the switching 202 from insufflation 201 to exsufflation 203 or expiration 203a (not shown here) is schematically shown in FIG. 6.

[0164] For example, insufflation 201 is overlaid with an oscillation 207. The signal 204 consists in this case in switching off 206 the oscillation 207. At a fixed and/or settable time before the switching 202 from insufflation 201 to exsufflation 203, the oscillation 207 is switched off in order to signal to the patient 109 that after a period of time the switching 202 from insufflation 201 to exsufflation 203 will take place.

[0165] The period of time can be, for example, from about 0.1 seconds to about 2 seconds, preferably from about 0.5 seconds to about 1.5 seconds. In some embodiments, the period of time of the signal 204 is preferably from about 0.8 seconds to about 1.2 seconds. The time before the switching, at which the generation of the signal 204 begins, is, for example, from about 0.1 seconds to about 2 seconds, preferably from about 0.5 seconds to about 1.5 seconds, more preferably from about 0.8 seconds to about 1.2 seconds. In some embodiments, the period of time corresponds to the time before the switching.

[0166] In some embodiments, it can be provided that insufflation 201 takes place for a fixed and/or settable time. Alternatively or additionally, it can be provided that the time of insufflation 201 is dynamically adjusted, for example, on the basis of values picked up by the sensors 105. For example, a degree of filling of the lung of the patient 109 can be determined. If a specific degree of filling is reached, it can be provided that the switching 202 is signaled. In some embodiments, the oscillation 207 can be used to determine various respiration parameters of the patient 109, which are then evaluated, for example, as to whether switching 202 should take place.

[0167] In some embodiments, in the case of an oscillation 207 during insufflation 201, a modulation 208 of the oscillation can also be provided to signal changing respiratory gas parameters, such as the switching 202 from insufflation 201 to exsufflation 203. Such an embodiment is shown by way of example in FIG. 7. At a time before the switching 202, a pneumatic signal 204 is generated for the patient 109 via a modulation 208 of the oscillation, which signals the imminent changing respiratory gas parameters. For example, the amplitude and/or frequency of the oscillation is increased or decreased.

[0168] The amplitude of the modulated oscillation 208 is from about 0.2 hPa to about 50 hPa, preferably from about 0.5 hPa to about 30 hPa. In some embodiments, the amplitude is preferably from about 1 hPa to about 20 hPa. The amplitude refers here to the distance of the peaks from one another.

[0169] The frequency of the modulated oscillation 208 is from about 1 Hz to about 40 Hz, preferably from about 2 Hz to about 30 Hz. In some embodiments, the frequency of the oscillation 205 is preferably from about 3 Hz to about 15 Hz.

[0170] The period of time of the signal 204 can be, for example, from about 0.1 seconds to about 2 seconds, preferably from about 0.5 seconds to about 1.5 seconds. In some embodiments, the period of time of the signal 204 is preferably from about 0.8 seconds to about 1.2 seconds. The time before the switching, at which the generation of the signal 204 begins, is, for example, from about 0.1 seconds to about 2 seconds, preferably from about 0.5 seconds to about 1.5 seconds, more preferably from about 0.8 seconds to about 1.2 seconds. In some embodiments, the period of time corresponds to the time before the switching.

[0171] In some embodiments, the signal 204 consists in a temporary increase 209 of the pressure, as shown by way of example in FIG. 8. At a time before the switching 202, the plateau pressure of the insufflation 201 is raised further here in order to provide a then maximum pressure. This raised pressure 209 remains in existence, for example, for a period of time. The switching from insufflation 201 to exsufflation 203 then takes place from the raised pressure 209 of the signal 204 without returning to the plateau level. In some embodiments, it can alternatively or additionally be provided that the raised pressure 209 is not maintained until switching 202, but rather first sinks back to plateau level and the switching 202 to exsufflation 203 only takes place after a further period of time. Alternatively or additionally, it can be provided that the pressure increases continuously until the switching and reaches the maximum immediately before the switching 202.

[0172] The period of time of the signal 204 can be, for example, from about 0.1 seconds to about 2 seconds, preferably from about 0.5 seconds to about 1.5 seconds. In some embodiments, the period of time of the signal 204 is preferably from about 0.8 seconds to about 1.2 seconds.

[0173] The time before the switching, at which the generation of the signal 204 begins, is, for example, from about 0.1 seconds to about 2 seconds, preferably from about 0.5 seconds to about 1.5 seconds, more preferably from about 0.8 seconds to about 1.2 seconds. In some embodiments, the period of time corresponds to the time before the switching.

[0174] To generate the signal 204, the pressure can be temporarily raised, for example, in a range of from about 0.2 hPa to about 8 hPa. The pressure is preferably temporarily raised in a range from about 0.5 hPa to about 5 hPa. The raising 209 of the pressure can be generated, for example, via an increased speed of the fan 101.

[0175] In some embodiments, the signal 204 consists in a temporary reduction 210 of the pressure, as shown by way of example in FIG. 9. At a time before the switching 202, the plateau pressure of the insufflation 201 is at least temporarily lowered. This lowered pressure 210 remains in existence for a period of time, for example. The switching from insufflation 201 to exsufflation 203 then takes place from the lowered pressure 210 of the signal 204 without returning to the plateau level. In some embodiments, it can alternatively or additionally be provided that the lowered pressure 210 is not maintained until the switching 202, but rather is first raised back to plateau level and the switching 202 to exsufflation 203 only takes place after a further period of time. Alternatively or additionally, it can be provided that the pressure decreases continuously until the switching and switching takes place from there directly to exsufflation 203.

[0176] The period of time of the signal 204 can be, for example, from about 0.1 seconds to about 2 seconds, preferably from about 0.5 seconds to about 1.5 seconds. In some embodiments, the period of time of the signal 204 is preferably from about 0.8 seconds to about 1.2 seconds.

[0177] The time before the switching, at which the generation of the signal 204 begins, is, for example, from about 0.1 seconds to about 2 seconds, preferably from about 0.5 seconds to about 1.5 seconds, more preferably from about 0.8 seconds to about 1.2 seconds. In some embodiments, the period of time corresponds to the time before the switching.

[0178] To generate the signal 204, the pressure can be temporarily lowered, for example, in a range of from about 0.2 hPa to about 8 hPa. The pressure is preferably temporarily lowered in a range from about 0.5 hPa to about 5 hPa. The lowering 210 of the pressure can be generated, for example, via a decreased speed of the fan 101.

[0179] To sum up, the present invention provides: [0180] 1. A device for respiratory therapy of a patient, wherein the device comprises a respiratory gas source for specifying different respiratory gas parameters, comprising at least one control unit, and a signal unit for outputting at least one signal, the at least one signal being used for signaling changing respiratory gas parameters and being sensorially perceptible by the patient. [0181] 2. The device of item 1, wherein the signal unit emits the signal to the patient before a change of a respiratory gas parameter. [0182] 3. The device of at least one of the preceding items, wherein the at least one signal is transmitted to an airway of the patient pneumaticallythus via the air path (device, hose system; patient interface)and includes a modulation of a specified respiratory gas with respect to pressure and/or flow and/or volume. [0183] 4. The device of at least one of the preceding items, wherein the at least one signal is sensorially perceptible by the patient via her mechanoreceptors and/or cold receptors and/or smell receptors and/or taste receptors. [0184] 5. The device of at least one of the preceding items, wherein the signal unit is configured for generating pneumatic signals and includes, for example, a valve and/or a fan. [0185] 6. The device of at least one of the preceding items, wherein the signal unit is controlled by the control unit. [0186] 7. The device of at least one of the preceding items, wherein the changing respiratory gas parameter is a respiratory gas pressure provided by the device. [0187] 8. The device of least one of the preceding items, wherein the respiratory gas parameter is changed upon switching from insufflation to coughing phase (expiration and/or exsufflation). [0188] 9. The device of at least one of the preceding items, wherein the changing respiratory gas parameter is a positive respiratory gas pressure, which is dissipated following an insufflation phase for a coughing phase (expiration) or is switched to negative pressure (exsufflation). [0189] 10. The device of at least one of the preceding items, wherein the device carries out an insufflation with overlaid oscillation, the at least one signal being an oscillation which is changed before switching to a coughing phase (exsufflation and/or expiration). [0190] 11. The device of at least one of the preceding items, wherein the device carries out an insufflation without oscillation, the at least one signal being a specific modulation of the respiratory gas with respect to pressure and/or flow and/or volume. [0191] 12. The device of at least one of the preceding items, wherein the at least one signal includes a modulation of pressure and/or flow (pneumatic signal). [0192] 13. The device of at least one of the preceding items, wherein the at least one signal is a modulated-on oscillation having a fixed or changing frequency and/or amplitude. [0193] 14. The device of item 13, wherein the oscillation has a frequency from about 1 to about 40 Hz, preferably a frequency from about 2 to about 30 Hz, and an amplitude of the oscillation (peak to peak) is from about 0.2 to about 50 hPa, preferably from about 0.5 to about 30 hPa. [0194] 15. The device of at least one of the preceding items, wherein the at least one signal is a brief positive or negative pressure and/or flow pulse on an air column. [0195] 16. The device of at least one of the preceding items, wherein the at least one signal changes between the beginning of the at least one signal and a moment of switching. [0196] 17. The device of at least one of the preceding items, wherein the device further comprises a generator for generating a detector signal and a sensor for determining a change of the detector signal, the detector signal being suitable for detecting changes of a patency of the airways (closure of glottis) and/or an at least advanced or complete filling of the lung and the sensor determining this change of the detector signal. [0197] 18. The device of item 17, wherein automatic switching to the coughing phase takes place when, based on the detector signal, a change of the patency of the airways (closure of the glottis) or an at least advanced or complete filling of the lung is determined. [0198] 19. The device of at least one of items 17 and 18, wherein the automatic switching is based on an oscillatory pressure, flow, and/or volume signal. [0199] 20. The device of at least one of items 17 to 19, wherein the switching also takes place before expiration of a stored or set period of time if a glottis closure is established metrologically by a detector signal. [0200] 21. The device of at least one of items 17 to 20, wherein an oscillation takes place during insufflation, the oscillation being simultaneously used as basis for the detector signal and switching takes place when, based on the detector signal, a closure of the glottis and/or an at least substantially completely filled lung can be concluded before expiration of the set insufflation time. [0201] 22. The device of at least one of items 17 to 21, wherein the oscillation as basis for the detector signal for the glottis closure is added in the course of the insufflation, the insufflation being ended by a detected glottis closure or with expiration of the set maximum insufflation time. [0202] 23. The device of at least one of the preceding items, wherein the pneumatic signal is generated for a fixed and/or settable period of time and/or wherein the pneumatic signal is generated from a fixed and/or settable time before switching to the coughing phase. [0203] 24. A system for respiratory therapy of a patient, wherein the system comprises a device according to at least one of the preceding items, and further comprises a patient interface and a respiratory gas hose.