# US 11,298,486 B2 · Systems and methods for concurrent airway stabilization and pulmonary stretch receptor activation

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- Number: US 11,298,486 B2
- Document ID: US11298486B2
- Status: Granted
- Kind: B2
- Application number: 16/021,680
- Filed: 2018-06-28
- Published: 2019-01-03
- Granted: 2022-04-12
- Earliest claimed: 2017-06-30
- Assignees: Koninklijke Philips N.V.
- Applicants: Koninklijke Philips N.V.
- Inventors: Jonathan Sayer Grashow; Gregory Delano Matthews; Michael Thomas Kane; Eugene Nelson Scarberry
- Web page: https://patentgrep.com/patent/US11298486B2

## CPC

- A61M 16/026: {specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis}
- A61M 16/0003: {Accessories therefor, e.g. sensors, vibrators, negative pressure}
- A61M 16/0051: {with alarm devices}
- A61M 16/0069: {the speed thereof being controlled by respiratory parameters, e.g. by inhalation}
- A61M 16/024: {including calculation means, e.g. using a processor}
- A61M 16/202: {electrically actuated}
- A61M 16/204: {used for inhalation control}
- A61M 16/06: Respiratory or anaesthetic masks
- A61M 16/08: Bellows; Connecting tubes {(having means for taking samples G01N1/22); Water traps; Patient circuits}
- A61M 16/16: Devices to humidify the respiration air {(A61M16/1045 takes precedence)}
- A61M 16/205: {used for exhalation control}
- A61M 2016/0027: {pressure meter}
- A61M 2016/0033: {electrical}
- A61M 2016/0039: {in the inspiratory circuit}
- A61M 2205/15: Detection of leaks
- A61M 2205/3331: Pressure; Flow
- A61M 2205/3334: Measuring or controlling the flow rate
- A61M 2205/3365: Rotational speed
- A61M 2205/50: with microprocessors or computers
- A61M 2230/40: Respiratory characteristics
- A61M 2230/42: Rate
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}

## Abstract

Concurrent treatment of obstructive sleep apnea and hypertension in a patient, via a pressure generating device, includes providing a flow of treatment gas to an airway of a patient in accordance with an initial set of flow parameters with respect to an obstructive sleep apnea mode. Responsive to determining that the patient has achieved stable breathing while receiving the flow of treatment gas, the flow parameters are increased above the initial set of flow parameters with respect to a hyper-ventilation mode. The flow of treatment gas is then provided to the airway of the patient in accordance with the increased flow parameters for a predetermined period of time. The increased flow parameters are configured to bring the patient's breath into accordance with target patient breath parameters configured to inflate the patient's lungs beyond a threshold for activating pulmonary stretch receptors of the airway of the patient.

## Claims

### Claim 1

A method for concurrent treatment of obstructive sleep apnea and hypertension in a patient, the method comprising:
a) providing a flow of treatment gas, via a gas flow generator of a pressure generating device and a controller coupled to the gas flow generator, to an airway of the patient, via a patient circuit coupled to the gas flow generator, in accordance with an initial set of flow parameters with respect to an obstructive sleep apnea mode of the pressure generating device;
b) determining that the patient has achieved stable breathing, via the controller, while providing the flow of treatment gas in accordance with the initial set of flow parameters;
c) increasing the flow parameters above the initial set of flow parameters, via the controller, in response to the controller determining that the patient has achieved stable breathing;
d) providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the increased flow parameters until a predetermined period of time has elapsed, the increased flow parameters being associated with a hyper-ventilation mode of the pressure generating device and configured to bring the patient's breath into accordance with target patient breath parameters configured to inflate the patient's lungs by an additional 50-400% of nominal tidal volume beyond a first threshold for activating pulmonary stretch receptors of the airway of the patient and triggering a reflex, governed by the patient's autonomic nervous system, to dilate peripheral blood vessels;
e) further increasing the flow parameters above the increased flow parameters in response to the predetermined period of time having elapsed; and
f) providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the further increased flow parameters for another predetermined period of time, the further increased flow parameters being associated with a continuation in the hyper-ventilation mode of the pressure generating device and further configured to bring the patient's breath into accordance with the target patient breath parameters configured to further inflate the patient's lungs by an additional 50-400% of the nominal tidal volume beyond a second threshold, different from the first threshold, for re-activating pulmonary stretch receptors of the airway of the patient and further re-triggering the reflex, governed by the patient's autonomic nervous system, to further dilate peripheral blood vessels, up to a maximum hyperinflation threshold that should not be exceeded.

### Claim 2 (depends on 1)

The method of claim 1, further comprising repeatedly performing steps d) and e) until the controller determines an occurrence of an exit indicator indicative of exiting the hyper-ventilation mode.

### Claim 3 (depends on 2)

The method of claim 2, further comprising providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the initial set of flow parameters in response to determining, via the controller, the occurrence of the exit indicator.

### Claim 4 (depends on 3)

The method of claim 3, wherein determining the occurrence of the exit indicator comprises determining, via the controller, an expiration of an overall time limit for the hyper-ventilation mode.

### Claim 5 (depends on 1)

The method of claim 1, wherein increasing the flow parameters comprises increasing the flow parameters above the initial set of flow parameters by a first predetermined increment.

### Claim 6 (depends on 5)

The method of claim 5, further comprising determining, via the controller, an occurrence of a stop condition while providing the flow of treatment gas, and responsive to determining the occurrence of the stop condition:
decreasing the flow parameters, via the controller, below the increased flow parameters or below the further increased flow parameters; and
providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the decreased flow parameters.

### Claim 7 (depends on 6)

The method of claim 6, wherein decreasing the flow parameters comprises decreasing the flow parameters below the increased flow parameters or below the further increased flow parameters by a second predetermined increment.

### Claim 8 (depends on 7)

The method of claim 7, wherein the second predetermined increment is less than the first predetermined increment.

### Claim 9 (depends on 6)

The method of claim 6, further comprising, determining, via the controller, a ceasing of the stop condition, and responsive to determining the ceasing of the stop condition:
increasing the flow parameters, via the controller, above the decreased flow parameters; and
providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the increased flow parameters above the decreased flow parameters.

### Claim 10 (depends on 6)

The method of claim 6, further comprising, determining, via the controller, a non-ceasing of the stop condition, and responsive to determining the non-ceasing of the stop condition:
further decreasing the flow parameters, via the controller, below the decreased flow parameters; and
providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the further decreased flow parameters.

### Claim 11 (depends on 1)

An airway pressure support system configured for concurrent treatment of obstructive sleep apnea and hypertension in a patient, comprising
a gas flow generator; and
a controller, wherein the controller is programmed to carry out the method of claim 1.

### Claim 12 (depends on 1)

A non-transitory machine readable medium encoded with instructions executable by a controller for causing the controller to carry out the method of claim 1 for concurrent treatment of obstructive sleep apnea and hypertension in a patient.

### Claim 13

A method for concurrent treatment of obstructive sleep apnea and hypertension in a patient, the method comprising:
a) providing a flow of treatment gas, via a gas flow generator of a pressure generating device and a controller coupled to the gas flow generator, to an airway of the patient, via a patient circuit coupled to the gas flow generator, in accordance with an initial set of flow parameters with respect to an obstructive sleep apnea mode of the pressure generating device;
b) determining a stable breathing condition of the patient, via the controller, while providing the flow of treatment gas in accordance with the initial set of flow parameters;
c) increasing the flow parameters above the initial set of flow parameters, via the controller, in response to determining that the patient has achieved stable breathing;
d) providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the increased flow parameters until a predetermined period of time has elapsed, the increased flow parameters being associated with a hyper-ventilation mode of the pressure generating device and configured to bring the patient's breath into accordance with target patient breath parameters configured to inflate the patient's lungs by an additional 50-400% of nominal tidal volume beyond a first threshold for activating pulmonary stretch receptors of the airway of the patient and triggering a reflex, governed by the patient's autonomic nervous system, to dilate peripheral blood vessels;
e) determining, via the controller, whether a stop increasing indicator has occurred, in response to determining that the predetermined period of time has elapsed, wherein the stop increasing indicator is configured to indicate that no further increases to the flow parameters should be made,
e(1)) wherein, responsive to determining an occurrence of the stop increasing indicator, further determining, via the controller, whether an exit hyper-ventilation mode indicator has occurred, wherein, (i) responsive to determining an occurrence of the exit hyper-ventilation mode indicator, then exiting the hyper-ventilation mode and providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient in accordance with the initial set of flow parameters, and wherein, (ii) responsive to not determining the occurrence of the exit hyper-ventilation mode indicator, then returning to the act of providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient in accordance with the increased flow parameters, and
e(2)) wherein, responsive to not determining the occurrence of the stop increasing indicator, then further increasing the flow parameters above the increased flow parameters, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the further increased flow parameters for another predetermined period of time, the further increased flow parameters being associated with a continuation in the hyper-ventilation mode of the pressure generating device and configured to further bring the patient's breath into accordance with the target patient breath parameters configured to inflate the patient's lungs by an additional 50-400% of the nominal tidal volume beyond a second threshold, different from the first threshold, for re-activating pulmonary stretch receptors of the airway of the patient and further re-triggering the reflex, governed by the patient's autonomic nervous system, to further dilate peripheral blood vessels, up to a maximum hyperinflation threshold that should not be exceeded.

### Claim 14 (depends on 13)

The method of claim 13, further comprising determining, via the controller, an occurrence of a stop condition while providing the flow of treatment gas, and responsive to determining the occurrence of the stop condition:
decreasing the flow parameters, via the controller, below the increased flow parameters or below the further increased flow parameters; and
providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the decreased flow parameters.

### Claim 15 (depends on 14)

The method of claim 14, wherein increasing the flow parameters comprises increasing the flow parameters above the initial set of flow parameters by a first predetermined increment, wherein decreasing the flow parameters comprises decreasing the flow parameters below the increased flow parameters by a second predetermined increment, and wherein the second predetermined increment is less than the first predetermined increment.

### Claim 16 (depends on 14)

The method of claim 14, further comprising, determining, via the controller, a non-ceasing of the stop condition, and responsive to determining the non-ceasing of the occurrence of the stop condition:
further decreasing the flow parameters, via the controller, below the decreased flow parameters; and
providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the further decreased flow parameters.

### Claim 17 (depends on 14)

The method of claim 14, further comprising, determining, via the controller, a ceasing of the stop condition, and responsive to determining the ceasing of the stop condition:
determining, via the controller, whether a stable breathing condition of the patient has occurred, while providing the flow of treatment gas in accordance with the decreased flow parameters,
wherein, responsive to determining that the stable breathing condition of the patient has occurred, then determining, via the controller, whether the stop increasing indicator has occurred and proceeding with the acts e(1)) and e(2)), and
wherein, responsive to determining that the stable breathing condition of the patient has not occurred, then continuing with the act of providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the decreased flow parameters.

### Claim 18 (depends on 13)

The method of claim 13, further comprising determining, via the controller, an occurrence of an exit indicator, the exit indicator configured to indicate exiting of the hyper-ventilation mode, wherein, responsive to not determining the occurrence of the exit indicator, then repeatedly performing the acts of d) and e) until the controller determines the occurrence of the exit indicator.

### Claim 19 (depends on 18)

The method of claim 18, wherein responsive to determining the occurrence of the exit indicator, then providing the flow of treatment gas, via the gas flow generator and the controller, to the airway of the patient, via the patient circuit, in accordance with the initial set of flow parameters.

### Claim 20 (depends on 19)

The method of claim 19, wherein determining the occurrence of the exit indicator comprises determining, via the controller, an expiration of an overall time limit for the hyper-ventilation mode.