Automatic adjustment of applied levels of ventilatory support and extrinsic peep by closed-loop control of neuro-ventilatory efficiency

A closed loop system for controlling the level of gas flow, gas volume or gas pressure delivered by a mechanical lung ventilator, comprising:

• means for measuring (a) the intensity of the diaphragm electromyogram (EMG) for a given Inspiratory volume, (b) the inspiratory volume for a given EMG intensity, and/or (c) a combination of (a) and (b);
• and
• means for controlling the level of gas flow, gas volume or gas pressure delivered by a mechanical lung ventilator in response to measurement of (a) the intensity of the diaphragm electromyogram (EMG) for a given inspiratory volume, (b) the inspiratory volume for a given EMG intensity and/or (c) the combination of (a) and (b);
• wherein the closed loop system enables for automatic or manual adjustment of the level of inspiratory support in proportion to changes in the neuro-ventilatory efficiency such that the neural drive remains stable at a desired target level.