STIMULATION METHODS FOR AN ELECTROMAGNETICALLY OR ELECTRICALLY CONTROLLED SPONTANEOUS RESPIRATION

Abstract

The invention relates to an electrostimulation appliance for stimulating one or more nerves and/or muscles of a living being with electrical signals, having the following features: a) the electrostimulation appliance has at least one signal output device through which electrical stimulation signals can be fed into at least one nerve and/or one muscle, b) the electrostimulation appliance has at least one control device which is configured to activate the at least one signal output device in such a way that the stimulation signals output by the at least one signal output device are able to generate muscle contractions in the living being, by which the respiration of the living being can be influenced in a targeted manner.

Claims

1. An electrostimulation appliance for stimulating one or more nerves and/or muscles of a living being with electrically, electromagnetically and/or magnetically generated stimulation signals, comprising: a) at least one signal output device through which electrically, electromagnetically and/or magnetically generated stimulation signals can be fed into at least one nerve and/or one muscle, bat least one control device which is configured to activate the at least one signal output device in such a way that the stimulation signals output by the at least one signal output device are able to generate muscle contractions in the living being, by which the respiration of the living being can be influenced in a targeted manner.

2. The electrostimulation appliance according to claim 1, wherein the control device is configured to modify the strength of the stimulation signals, output by the at least one signal output device, over the course of a respiratory cycle of the living being in several steps and/or uniformly.

3. The electrostimulation appliance according to claim 1, wherein the control device is configured to keep the strength of the stimulation signals, output by the at least one signal output device, at an increased level during the exhalation phase of the living being, at which level the muscle contraction generated by stimulation signals is greater than zero, but at least so high that up to 75% of the inspiratory reserve volume is still present in the lungs at the end of the exhalation.

4. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to control or regulate the respiration of the living being to a predetermined value, value range and/or temporal change of the depth of respiration.

5. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to control or regulate the respiration of the living being to a respiratory frequency of more than 40 respiratory cycles per minute.

6. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to control or regulate the respiration of the living being, for a limited time period, to a depth of respiration that is too low for a life-supporting gas exchange of the living being.

7. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to prevent complete exhalation, by shortening the duration of the expiration phase of the living being to 0.2 to 1.3 times the duration of the inspiration phase.

8. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to control the characteristics of the respiratory cycles to predetermined target characteristics of the respiratory cycles.

9. The electrostimulation appliance according to claim 1, wherein current measured values of characteristics of the respiratory cycle of the living being are determined continuously by at least one sensor and supplied to the control device, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to regulate the characteristics of the respiratory cycles to predetermined target characteristics of the respiratory cycles, as a function of the measured values.

10. The electrostimulation appliance according to claim 1, wherein current measured values of the spontaneous respiration impulses are determined continuously by at least one spontaneous respiration impulse sensor, which is able to detect the spontaneous respiration impulses of the living being, and are supplied to the control device, wherein the control device is configured to modify parameters of the stimulation signals, output by the at least one signal output device, as a function of the measured values of the spontaneous respiration impulses, in particular in a manner synchronized with the spontaneous respiration impulses.

11. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to control or regulate the intra-abdominal pressure of the living being to a predetermined value, value range and/or temporal change.

12. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to perform a targeted excitation of the respiratory nerves and/or the respiratory centre.

13. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to control or regulate, over a large number of respiratory cycles, the characteristics of the respiratory cycles to predetermined target characteristics of the respiratory cycles, thereafter, over a large number of respiratory cycles, to have no influence on the respiratory cycles of the living being, and thereafter, again over a large number of respiratory cycles, to control or regulate the characteristics of the respiratory cycles to predetermined target characteristics of the respiratory cycles.

14. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to excite, over a large number of respiratory cycles, muscle contractions of the respiratory muscles of the living being which are not necessary for the gas exchange that is to be performed by the respiration of the living being and which thus produce muscle training.

15. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to control or regulate the respiratory state to an increased value and/or to shift the respiratory state to the inspiration phase.

16. The electrostimulation appliance according to claim 1, wherein current measured values of the depth of respiration are determined continuously by at least one depth of respiration sensor, which is able to detect measured values of the depth of respiration of the living being, and are supplied to the control device, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to regulate the respiration of the living being, on the basis of the measured values of the depth of respiration, to a predetermined value, value range and/or temporal change of the depth of respiration.

17. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to limit the depth of respiration and/or the volumetric flow in the inspiration phase to a predetermined maximum value.

18. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to limit the volumetric flow in the expiration phase to a predetermined maximum value and/or to reduce it in relation to the average intrinsic volumetric flow of the living being in the expiration phase.

19. The electrostimulation appliance according to claim 1, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to reduce the duration of the expiration phase in relation to the average intrinsic duration of the expiration phase of the living being.

20. The electrostimulation appliance according to claim 1, wherein over the course of a respiratory cycle, the control device is configured to increase the strength of the stimulation signals, output by the at least one signal output device, in the inspiration phase and to reduce it again in the expiration phase.

21. The electrostimulation appliance according to claim 1, wherein the control device is configured to variably activate a throughflow control actuator, which is coupled pneumatically and/or electrically to the respiratory system of the living being and by which the volumetric flow of the air stream flowing into and/or flowing out of the living being is adjustable, over the course of a respiratory cycle, in such a way that the volumetric flow in the inspiration phase and/or the expiration phase is at least temporarily limited or reduced by the throughflow control actuator.

22. The electrostimulation appliance according to claim 1, wherein the spontaneous respiration impulse sensor is designed as a nerve impulse sensor which is able to detect nerve impulse signals of the living being that control the respiration of the living being.

23. The electrostimulation appliance according to claim 1, wherein the control device is connectable via an interface to a ventilator which is configured to ventilate the living being by generating variable positive pressure and/or negative pressure, wherein the control device is configured for data exchange with a control device of the ventilator.

24. The electrostimulation appliance according to claim 1, wherein the control device is configured to store characteristics of one or more respiratory cycles of the living being that quantitatively characterize the respective respiratory cycle.

25. The electrostimulation appliance according to claim 1, wherein the control device is configured to initially bring about deep inhalation in the respiratory cycle by suitably adapting the strength of the stimulation signals output by the at least one signal output device.

26. The electrostimulation appliance according to claim 25, wherein, subsequent to the deep inhalation, and by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to bring about one or more partial exhalations with, compared to the average exhalation, a shortened exhalation duration and/or an increased strength of the stimulation signals.

27. The electrostimulation appliance according to claim 25, wherein by setting parameters of the stimulation signals output by the at least one signal output device, the control device is configured to stimulate secretion mobilization and, subsequent to the stimulation of secretion mobilization, to bring about deep inhalation.

28. The electrostimulation appliance according to claim 1, wherein, on the basis of the output stimulation signals, the control device is configured to alternately stimulate purely thoracic breathing, purely abdominal breathing or a combination thereof, wherein the strengths of the stimulation of the abdominal breathing and of the thoracic breathing can be adaptable independently of each other.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0214] The invention is explained in more detail below on the basis of illustrative embodiments and with reference to drawings.

[0215] In the drawings:

[0216] FIG. 1 shows the use of an electrostimulation appliance on a living being,

[0217] FIG. 2 shows the use of an electrostimulation appliance in conjunction with positive-pressure ventilation on a living being,

[0218] FIGS. 3 to 5 show time diagrams of respiratory states,

[0219] FIG. 6 shows the change of the air volume in the lungs in a respiratory cycle over time,

[0220] FIG. 7 shows the change of the transpulmonary pressure in a respiratory cycle over time.

DESCRIPTION OF THE INVENTION

[0221] FIG. 1 shows a living being 1 in a recumbent position. To make matters clear, advantageous stimulation positions of the phrenic nerve 2 and of the intercostal nerves 3 are shown on the living being 1. In the present illustrative embodiment, it is assumed that the phrenic nerve 2 is intended to be stimulated by electromagnetic stimulation.

[0222] FIG. 1 shows an electrostimulation appliance 4 which is connected by electrical lines to signal output elements 10, e.g. coils, for feeding magnetic fields into the living being 1. By way of the signal output elements 10, the electrostimulation appliance can generate stimulation signals in the living being, which stimulation signals can generate muscle contractions by which the respiration of the living being 1 can be influenced in a targeted manner.

[0223] The electrostimulation appliance 4 can be designed, for example, as a computer-controlled electrostimulation appliance. It has a computer 5, a stimulation signal generator 6, a memory 7 and operating elements 8. A display device for displaying operational data can additionally be present. In the memory 7, a computer program is stored with which some or all of the functions of the electrostimulation appliance 4 can be executed. The computer 5 executes the computer program in the memory 7. In this way, the stimulation signal generator 6 outputs corresponding stimulation signals to the signal output device 10, by which the desired magnetic fields are generated. The above-described functions for the ventilation of the living being 1 by the stimulation signals, or the processes to be carried out by the user, can be influenced by the user via the operating elements 8, e.g. by setting parameters of respiratory cycles.

[0224] The artificial ventilation of the living being 1 by electrostimulation can be controlled by the described elements. If certain parameters are also to be regulated, it is necessary that one or more measured values of characteristics of respiratory cycles of the living being 1 are suppled to the electrostimulation appliance 4. For example, it may be expedient to detect the volumetric flow inhaled by the living being 1 and the exhaled volumetric flow. This can be effected, for example, by means of a face mask 13 in which a flow sensor is arranged. The face mask 13 or the flow sensor has practically no influence on the respiratory flow. However, quantitative variables that characterize the volumetric flow can be detected and supplied to the electrostimulation appliance 4. The evaluation of the sensor signals can be effected, for example, by the computer 5.

[0225] The electrostimulation appliance 4 can additionally have an interface 9 for connection to other appliances, e.g. for data exchange with other appliances. In this way, further measured values can be supplied to the electrostimulation appliance 4 without the electrostimulation appliance 4 having to be equipped with its own sensors.

[0226] FIG. 2 illustrates the use of the electrostimulation appliance 4 on the living being 1 in conjunction with a positive-pressure ventilator 11. The ventilator 11 has an air delivery unit 18 through which air can be suctioned from the environment via a port 19 and can be fed by means of a breathing mask 13 into the airways of the living being 1 via an air line 12. The breathing mask 13 or the air line 12 can have a defined leakage 14. Inside the ventilator 11, a pressure sensor 16 and a volumetric flow sensor 17, e.g. a pneumotachograph, are connected to the air line 12. The ventilator 11 has its own control unit 15, to which the sensors 16, 17 are connected. The control unit 15 actuates the air delivery unit 18 according to predefined algorithms, in order in this way to generate desired volumetric flow curves and/or pressure curves in the organs of respiration of the living being 1 via the breathing mask 13.

[0227] It will be seen that the electrostimulation appliance 4 is connected via its interface 9 to the ventilator 11. By way of the interface 9, the corresponding measured values, and optionally additional values calculated internally in the ventilator 11 and concerning characteristics of the respiratory cycles of the living being, are supplied to the electrostimulation appliance 4. In this way, the electrostimulation appliance 4 receives, for example, current measured values of the pressure and of the volumetric flow of the respiratory cycles of the living being 1.

[0228] FIGS. 3 to 5 each show several respiratory cycles plotted over time t for various respiratory states. The air volume V located in each case in the lungs is plotted on the ordinate.

[0229] FIG. 3 shows the respiratory state with tidal volumes during respiration at rest (AZV) and a maximum possible exhalation, by which the normal respiratory state during respiration at rest and the end-expiratory reserve volume (ERV) are intended to be illustrated. The inspiratory reserve volume (IRV) is also characterized here and is illustrated in FIG. 4 by the maximum possible inhalation. FIG. 5, finally, shows the shift of the respiratory state under respiration at rest into the inhalation, which is characterized in that the tidal volumes of the respiration at rest are at an increased ERV and a reduced IRV.

[0230] The respiratory profiles shown in FIGS. 3 to 5 can be suitably controlled or regulated by the electrostimulation appliance 4 according to the invention and the methods according to the invention, i.e. corresponding stimulation signals are fed by the electrostimulation appliance into at least one nerve and/or one muscle of the living being 1, as a result of which the corresponding muscle contractions of the respiratory muscles are generated, which ultimately bring about the illustrated respiratory cycles.

[0231] FIGS. 6 and 7 show a respiratory cycle in an enlarged view. The respiratory cycle consists of an inspiration phase I and an expiration phase E. FIG. 6 shows the air volume V over time, while FIG. 7 shows the transpulmonary pressure TPP over time. It will be seen that the inspiration phase I according to FIG. 6 begins at the lower vertex and ends at the upper vertex. The expiration phase E begins at the upper vertex and ends at the subsequent lower vertex of the curve. The profile of the pressure TPP is phase-shifted in relation to the profile of the volume V.

[0232] The electrostimulation appliance 4 can, for example, generate the profiles of the respiratory cycles shown in FIG. 6 and FIG. 7. According to the selected function, the duration of the inspiration phase and/or the duration of the expiration phase can be influenced separately. The amplitude of the volume profile and/or of the pressure profile can also be influenced separately, and also the respective positions of the maxima and minima of the curve profiles.