# US 11,433,200 B2 · Mechanical in-exsufflation > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,433,200 B2 - Document ID: US11433200B2 - Status: Granted - Kind: B2 - Application number: 15/754,643 - Filed: 2016-08-26 - Published: 2018-08-30 - Granted: 2022-09-06 - Earliest claimed: 2015-08-26 - Assignees: Koninklijke Philips N.V. - Applicants: Koninklijke Philips N.V. - Inventors: Seunghyun Lee - Web page: https://patentgrep.com/patent/US11433200B2 ## CPC - A61M 16/024: {including calculation means, e.g. using a processor} - A61B 5/0823: {Detecting or evaluating cough events} - A61M 16/0051: {with alarm devices} - A61M 16/0069: {the speed thereof being controlled by respiratory parameters, e.g. by inhalation} - G16H 40/63: for local operation - A61M 16/0057: {Pumps therefor} - A61M 16/0066: {Blowers or centrifugal pumps} - A61M 16/0072: {Tidal volume piston pumps} - A61M 16/0075: {Bellows-type} - A61M 2016/0015: {inhalation detectors} - A61M 2016/0027: {pressure meter} - A61M 2016/003: {with a flowmeter} - A61M 2016/0036: {in the breathing tube and used in both inspiratory and expiratory phase} - A61M 2016/102: {Measuring a parameter of the content of the delivered gas} - A61M 2205/332: Force measuring means - A61M 2205/3368: Temperature - A61M 2205/35: Communication - A61M 2205/3553: remote, e.g. between patient's home and doctor's office - A61M 2205/3561: local, e.g. within room or hospital - A61M 2205/3584: using modem, internet or Bluetooth® - A61M 2205/3592: using telemetric means, e.g. radio or optical transmission - A61M 2205/50: with microprocessors or computers - A61M 2205/502: User interfaces, e.g. screens or keyboards - A61M 2230/40: Respiratory characteristics - A61M 2230/42: Rate - A61M 2230/43: Composition of exhalation - A61M 2230/50: Temperature - G16H 20/40: relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture - 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)} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA ## Abstract The present disclosure pertains to a method and system configured for cough synchronization in a mechanical insufflation-exsufflation system. The system is configured to synchronize (712) the transition from an insufflation mode to an exsufflation mode to a patient initiated cough by detecting cough effort of the patient e.g. at the end of the insufflation phase. The detection of cough effort of the patient is based on one or more parameters associated with gas in the system. Upon detecting that the patient is initiating a cough, the system automatically switches the insufflation mode to the exsufflation mode to assist the patient to generate an effective cough. ## Claims ### Claim 1 A mechanical insufflation-exsufflation system, the system comprising: a pressure generator configured to operate in: an insufflation mode, wherein the pressure generator generates a positive pressurized flow of breathable gas for delivery to an airway of a subject via a subject interface, and an exsufflation mode, wherein the pressure generator generates a negative pressurized flow of breathable gas to draw gas from the airway of the subject via the subject interface; one or more sensors configured to generate output signals related to one or more parameters associated with gas in the system; and one or more processors operatively connected to the one or more sensors to receive the output signals and configured to: during the insufflation mode, determine an initiation of a cough by the subject based on one or more of: a decrease of a flow rate associated with the breathable gas in the subject interface, an increase of a pressure level associated with the breathable gas in the subject interface, an increase of a pressure waveform slope associated with the breathable gas in the subject interface in comparison with a preset pressure waveform slope value, and/or a decrease of a flow rate slope associated with the breathable gas in the subject interface in comparison with a preset flow slope value; synchronize a transition of the pressure generator from the insufflation mode to the exsufflation mode with the initiation of the cough by the subject without manual configuration; and control generation and delivery of the pressurized flow of breathable gas to the airway of the subject in the exsufflation mode to exsufflate the subject. ### Claim 2 (depends on 1) The system of claim 1, wherein the one or more processors operatively connected to the one or more sensors to receive the output signals are configured to determine the initiation of the cough by the subject based on the decrease of the flow rate associated with the breathable gas in the subject interface. ### Claim 3 (depends on 2) The system of claim 2, wherein the decrease of the flow rate associated with the breathable gas in the subject interface is an abrupt decrease. ### Claim 4 (depends on 1) The system of claim 1, wherein the one or more processors operatively connected to the one or more sensors to receive the output signals are configured to determine the initiation of the cough by the subject based on the increase of the pressure level associated with the breathable gas in the subject interface. ### Claim 5 (depends on 4) The system of claim 4, wherein the increase of the pressure level associated with the breathable gas in the subject interface is an abrupt increase. ### Claim 6 (depends on 1) The system of claim 1, wherein the one or more processors operatively connected to the one or more sensors to receive the output signals are configured to determine the initiation of the cough by the subject based on the increase of the pressure waveform slope associated with the breathable gas in the subject interface in comparison with the preset pressure waveform slope value. ### Claim 7 (depends on 1) The system of claim 1, wherein the one or more processors operatively connected to the one or more sensors to receive the output signals are configured to determine the initiation of the cough by the subject based on the decrease of the flow rate slope associated with the breathable gas in the subject interface in comparison with the preset flow slope value. ### Claim 8 A method of cough synchronization in a mechanical insufflation-exsufflation system, the method comprising: generating a pressurized flow of breathable gas for delivery to an airway of the subject in an insufflation mode and an exsufflation mode; during the insufflation mode, determining an initiation of a cough by the subject based on one or more of; a decrease of a flow rate associated with the breathable gas in the subject interface, an increase of a pressure level associated with the breathable gas in the subject interface, an increase of a pressure waveform slope associated with the breathable gas in the subject interface in comparison with a preset pressure waveform slope value, and/or a decrease of a flow rate slope associated with the breathable gas in the subject interface in comparison with a preset flow slope value; and synchronizing a transition of the pressure generation from the insufflation mode to the exsufflation mode with the initiation of the cough by the subject. ### Claim 9 (depends on 8) The method of claim 8, wherein the initiation of the cough by the subject is determined based on the decrease of the flow rate associated with the breathable gas in the subject interface. ### Claim 10 (depends on 9) The method of claim 9, wherein the decrease of the flow rate associated with the breathable gas in the subject interface is an abrupt decrease. ### Claim 11 (depends on 8) The method of claim 8, wherein the initiation of the cough by the subject is determined based on the increase of the pressure level associated with the breathable gas in the subject interface. ### Claim 12 (depends on 11) The method claim 11, wherein the increase of the pressure level associated with the breathable gas in the subject interface is an abrupt increase. ### Claim 13 (depends on 8) The method of claim 8, wherein the initiation of the cough by the subject is determined based on the increase of the pressure waveform slope associated with the breathable gas in the subject interface in comparison with the preset pressure waveform slope value. ### Claim 14 (depends on 8) The method of claim 8, wherein the initiation of the cough by the subject is determined based on the decrease of the flow rate slope associated with the breathable gas in the subject interface in comparison with the preset flow slope value.