# US 9,750,906 B2 · Methods, systems and apparatus for paced breathing > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 9,750,906 B2 - Document ID: US9750906B2 - Status: Granted - Kind: B2 - Application number: 14/334,240 - Filed: 2014-07-17 - Published: 2014-11-06 - Granted: 2017-09-05 - Earliest claimed: 2008-04-15 - Assignees: ResMed Limited - Applicants: ResMed Limited - Inventors: Dion Charles Chewe Martin; David John Bassin - Web page: https://patentgrep.com/patent/US9750906B2 ## CPC - A61M 16/0003: {Accessories therefor, e.g. sensors, vibrators, negative pressure} - A61M 16/0069: {the speed thereof being controlled by respiratory parameters, e.g. by inhalation} - 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 16/0672: {Nasal cannula assemblies for oxygen therapy} - A61M 16/202: {electrically actuated} - A61M 16/204: {used for inhalation control} - A61M 16/0468: {with valves at the proximal end limiting exhalation, e.g. during speaking or coughing (air passages from trachea to oesophagus or to pharynx, artificial epiglottis A61F2/203)} - A61M 2016/0018: {electrical} - A61M 2016/0036: {in the breathing tube and used in both inspiratory and expiratory phase} - A61M 2205/502: User interfaces, e.g. screens or keyboards - A61M 2230/06: Heartbeat rate only - A61M 2230/205: partial oxygen pressure (P-O2) - 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 Methods, systems and/or apparatus for slowing a patient's breathing by using positive pressure therapy. In certain embodiments, a current interim breathing rate target is set, and periodically the magnitude of a variable pressure waveform that is scaled to the current interim breathing rate target is increased if the patient's breathing rate is greater than the interim breathing rate target in order to lengthen the patient's breath duration. The magnitude of the pressure increase may be a function of the difference between the interim breathing rate target and the patient's breathing rate. The interim breathing rate target may be periodically reduced in response to the patient's breathing rate slowing down toward the current interim breathing rate target. The variable pressure waveform cycles from an inhalation phase to an exhalation phase when the patient airflow decreases to a cycle threshold, the cycle threshold being a function of flow versus time within a breath and generally increasing with time. Different interim breathing rate targets have different cycle threshold functions, and the cycle threshold functions allow easier cycling as the interim breathing rate targets decrease. Similarly, the variable pressure waveform triggers from an exhalation phase to an inhalation phase when the patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. Different interim breathing rate targets have different trigger threshold functions, and the trigger threshold functions allow easier triggering as the interim breathing rate targets decrease. ## Claims ### Claim 1 A method for slowing a patient's breathing by using positive pressure therapy comprising the steps of: applying a variable pressure waveform to the patient's airway, setting an interim breathing rate target, increasing the magnitude of the variable pressure waveform when the patient's breathing rate is greater than the interim breathing rate target in order to lengthen the patient's breath duration, and reducing the interim breathing rate target in response to the patient's breathing rate slowing down toward the interim breathing rate target. ### Claim 2 (depends on 1) The method of claim 1 wherein the variable pressure waveform cycles from an inhalation phase to an exhalation phase when the patient airflow decreases to a cycle threshold, the cycle threshold being (1) a function of flow versus time within a breath and (2) generally increasing with time. ### Claim 3 (depends on 2) The method of claim 2 wherein different interim breathing rate targets have different cycle threshold functions, and the cycle threshold functions allow easier cycling as the interim breathing rate target decreases. ### Claim 4 (depends on 1) The method of claim 1 wherein the variable pressure waveform triggers from an exhalation phase to an inhalation phase when the patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. ### Claim 5 (depends on 4) The method of claim 4 wherein different interim breathing rate targets have different trigger threshold functions, and the trigger threshold functions allow easier triggering as the interim breathing rate target decreases. ### Claim 6 (depends on 1) The method of claim 1 wherein the magnitude of the variable pressure waveform is decreased if the patient's breathing rate is less than the interim breathing rate target. ### Claim 7 (depends on 6) The method of claim 6 wherein the magnitude of a variable pressure waveform magnitude increase or decrease is a function of the difference between the interim breathing rate target and the patient's breathing rate. ### Claim 8 (depends on 1) A method in accordance with claim 1 wherein the interim breathing rate target is reduced along a predetermined path, but the reduction is paused if the patient's breathing rate is excessively high for the interim breathing rate target. ### Claim 9 (depends on 1) A method in accordance with claim 1 wherein the duration of the variable pressure waveform is adjusted in accordance with the interim breathing rate target. ### Claim 10 A method for slowing a patient's breathing by using positive pressure therapy comprising the steps of: applying a variable pressure waveform to the patient's airway, setting an interim breathing rate target, increasing the magnitude of the variable pressure waveform that is scaled to the interim breathing rate target if the patient's breathing rate is greater than the interim breathing rate target in order to lengthen the patient's breath duration, the magnitude of the variable pressure waveform magnitude increase being a function of the difference between the interim breathing rate target and the patient's breathing rate, and reducing the interim breathing rate target in response to the patient's breathing rate slowing down toward or below the interim breathing rate target. ### Claim 11 (depends on 10) The method of claim 10 wherein said variable pressure waveform cycles from an inhalation phase to an exhalation phase when the patient airflow decreases to a cycle threshold, the cycle threshold being (1) a function of flow versus time within a breath and (2) generally increasing with time. ### Claim 12 (depends on 11) The method of claim 11 wherein different interim breathing rate targets have different cycle threshold functions, and the cycle threshold functions allow easier cycling as the interim breathing rate target decreases. ### Claim 13 (depends on 10) The method of claim 10 wherein the variable pressure waveform triggers from an exhalation phase to an inhalation phase when the patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. ### Claim 14 (depends on 13) The method of claim 13 wherein different interim breathing rate targets have different trigger threshold functions, and the trigger threshold functions allow easier triggering as the interim breathing rate target decreases. ### Claim 15 (depends on 10) The method of claim 10 wherein said variable pressure waveform cycles from an inhalation phase to an exhalation phase when the patient airflow decreases to a cycle threshold, the cycle threshold being a function of flow versus time within a breath and generally increasing with time, and the variable pressure waveform triggers from an exhalation phase to an inhalation phase when the patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. ### Claim 16 (depends on 15) The method of claim 15 wherein different interim breathing rate targets have different cycle threshold functions and the cycle threshold functions allow easier cycling as the interim breathing rate target decreases, and different interim breathing rate targets have different trigger threshold functions and the trigger threshold functions allow easier triggering as the interim breathing rate target decreases. ### Claim 17 A method for slowing a patient's breathing by using a ventilator coupled to a patient's airway comprising the steps of: setting an interim breathing rate target, increasing the air supplied to the patient's airway from the ventilator during patient breaths if the patient's breathing rate is greater than the interim breathing rate target in order to lengthen the patient's breath duration, reducing the interim breathing rate target in response to the patient's breathing rate slowing down toward the interim breathing rate target, and interrupting the air increase and interim breathing rate target reduction steps if the patient exhibits opposition to breath duration lengthening, the air increase and interim breathing rate target reduction steps being controlled to take place over a period of minutes to hours in the absence of patient opposition. ### Claim 18 (depends on 17) The method of claim 17 wherein the magnitude of an air increase is a function of the difference between the interim breathing rate target and the patient's breathing rate. ### Claim 19 (depends on 17) The method of claim 17 wherein the ventilator is operated so as to synchronize to the patient's breathing rate rather than the interim breathing rate target. ### Claim 20 (depends on 17) The method of claim 17 wherein the ventilator is controlled to cycle from an inhalation phase to an exhalation phase when patient airflow decreases to a cycle threshold, the cycle threshold being (1) a function of flow versus time within a breath and (2) generally increasing with time. ### Claim 21 (depends on 20) The method of claim 20 wherein different interim breathing rate targets have different cycle threshold functions, and the cycle threshold functions allow easier cycling as the interim breathing rate target decreases. ### Claim 22 (depends on 17) The method of claim 17 wherein the ventilator triggers from an exhalation phase to an inhalation phase when patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. ### Claim 23 (depends on 22) The method of claim 22 wherein different interim breathing rate targets have different trigger threshold functions, and the trigger threshold functions allow easier triggering as the interim breathing rate target decreases. ### Claim 24 (depends on 17) The method of claim 17 wherein the ventilator cycles from an inhalation phase to an exhalation phase when patient airflow decreases to a cycle threshold, the cycle threshold being a function of flow versus time within a breath and generally increasing with time, and the ventilator triggers from an exhalation phase to an inhalation phase when patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. ### Claim 25 (depends on 24) The method of claim 24 wherein the magnitude of an air increase is a function of the difference between the interim breathing rate target and the patient's breathing rate. ### Claim 26 (depends on 24) The method of claim 24 wherein the ventilator is operated so as to synchronize to the patient's breathing rate rather than the interim breathing rate target. ### Claim 27 (depends on 24) The method of claim 24 wherein different interim breathing rate targets have different cycle threshold functions and the cycle threshold functions allow easier cycling as the interim breathing rate target decreases, and different interim breathing rate targets have different trigger threshold functions and the trigger threshold functions allow easier triggering as the interim breathing rate target decreases. ### Claim 28 (depends on 27) The method of claim 27 wherein the magnitude of an air increase is a function of the difference between the interim breathing rate target and the patient's breathing rate. ### Claim 29 (depends on 28) The method of claim 28 wherein the ventilator is operated so as to synchronize to the patient's breathing rate rather than the interim breathing rate target. ### Claim 30 (depends on 27) The method of claim 27 wherein the ventilator is operated so as to synchronize to the patient's breathing rate rather than the interim breathing rate target. ### Claim 31 A ventilator for slowing a patient's breathing by using positive pressure therapy comprising: a blower for applying a variable pressure waveform to the patient's airway, at least one sensor for detecting the breathing rate of the patient, and a controller, wherein the controller is configured to: set an interim breathing rate target, cause the blower to increase the magnitude of the variable pressure waveform when the patient's breathing rate is greater than the interim breathing rate target in order to lengthen the patient's breath duration, and reduce the interim breathing rate target in response to detection of the patient's breathing rate slowing down toward the interim breathing rate target. ### Claim 32 (depends on 31) The ventilator of claim 31 wherein the controller is configured to cause the variable pressure waveform to cycle from an inhalation phase to an exhalation phase when the patient airflow decreases to a cycle threshold, the cycle threshold being (1) a function of flow versus time within a breath and (2) generally increasing with time. ### Claim 33 (depends on 32) The ventilator of claim 32 wherein different interim breathing rate targets have different cycle threshold functions, and the cycle threshold functions allow easier cycling as the interim breathing rate target decreases. ### Claim 34 (depends on 31) The ventilator of claim 31 wherein the controller is configured to cause the variable pressure waveform to trigger from an exhalation phase to an inhalation phase when the patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. ### Claim 35 (depends on 34) The ventilator of claim 34 wherein different interim breathing rate targets have different trigger threshold functions, and the trigger threshold functions allow easier triggering as the interim breathing rate target decreases. ### Claim 36 (depends on 31) The ventilator of claim 31 wherein the controller is configured to cause the magnitude of the variable pressure waveform to decrease if the patient's breathing rate is less than the interim breathing rate target. ### Claim 37 (depends on 36) The ventilator of claim 36 wherein the controller is configured to cause the magnitude of a variable pressure waveform magnitude increase or decrease to be a function of the difference between the interim breathing rate target and the patient's breathing rate. ### Claim 38 (depends on 31) A ventilator in accordance with claim 31 wherein the controller is configured to cause the interim breathing rate target to be reduced along a predetermined path, but causes the reduction to pause if the patient's breathing rate is excessively high for the interim breathing rate target. ### Claim 39 (depends on 31) A ventilator in accordance with claim 31 wherein the controller is configured to cause the duration of the variable pressure waveform to be adjusted in accordance with the interim breathing rate target. ### Claim 40 A ventilator for slowing a patient's breathing by using positive pressure therapy comprising: a blower for applying a variable pressure waveform to the patient's airway, at least one sensor for detecting the breathing rate of the patient, and a controller, wherein the controller is configured to: set an interim breathing rate target, cause the blower to increase the magnitude of the variable pressure waveform that is scaled to the interim breathing rate target if the patient's breathing rate is greater than the interim breathing rate target in order to lengthen the patient's breath duration, the magnitude of the variable pressure waveform magnitude increase being a function of the difference between the interim breathing rate target and the patient's breathing rate, and reduce the interim breathing rate target in response to the patient's breathing rate slowing down toward the interim breathing rate target. ### Claim 41 (depends on 40) The ventilator of claim 40 wherein said controller is configured to cause the variable pressure waveform to cycle from an inhalation phase to an exhalation phase when the patient airflow decreases to a cycle threshold, the cycle threshold being (1) a function of flow versus time within a breath and (2) generally increasing with time. ### Claim 42 (depends on 41) The ventilator of claim 41 wherein different interim breathing rate targets have different cycle threshold functions, and the cycle threshold functions allow easier cycling as the interim breathing rate target decreases. ### Claim 43 (depends on 40) The ventilator of claim 40 wherein said controller is configured to cause the variable pressure waveform to trigger from an exhalation phase to an inhalation phase when the patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. ### Claim 44 (depends on 43) The ventilator of claim 43 wherein different interim breathing rate targets have different trigger threshold functions, and the trigger threshold functions allow easier triggering as the interim breathing rate target decreases. ### Claim 45 (depends on 40) The ventilator of claim 40 wherein said controller is configured to cause the variable pressure waveform to cycle from an inhalation phase to an exhalation phase when the patient airflow decreases to a cycle threshold, the cycle threshold being a function of flow versus time within a breath and generally increasing with time, and said controller causes the variable pressure waveform to trigger from an exhalation phase to an inhalation phase when the patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. ### Claim 46 (depends on 45) The ventilator of claim 45 wherein different interim breathing rate targets have different cycle threshold functions and the cycle threshold functions allow easier cycling as the interim breathing rate target decreases, and different interim breathing rate targets have different trigger threshold functions and the trigger threshold functions allow easier triggering as the interim breathing rate target decreases. ### Claim 47 A ventilator for slowing a patient's breathing comprising: a blower coupled to a patient's airway, at least one sensor for monitoring the breathing of the patient, and a controller, wherein the controller is configured to: set an interim breathing rate target, cause the air supplied to the patient's airway from the blower during patient breaths to increase if the patient's breathing rate is greater than the interim breathing rate target in order to lengthen the patient's breath duration, reduce the interim breathing rate target in response to the patient's breathing rate slowing down toward the interim breathing rate target, and interrupt the air increase and interim breathing rate target reduction if the patient exhibits opposition to breath duration lengthening, the controller causing the air increase and interim breathing rate target reduction to take place over a period of minutes to hours in the absence of patient opposition. ### Claim 48 (depends on 47) The ventilator of claim 47 wherein the magnitude of an air increase is a function of the difference between the interim breathing rate target and the patient's breathing rate. ### Claim 49 (depends on 47) The ventilator of claim 47 wherein the controller is configured to cause the blower to operate so as to synchronize it to the patient's breathing rate rather than the interim breathing rate target. ### Claim 50 (depends on 47) The ventilator of claim 47 wherein the controller is configured to cause the blower to cycle from an inhalation phase to an exhalation phase when patient airflow decreases to a cycle threshold, the cycle threshold being (1) a function of flow versus time within a breath and (2) generally increasing with time. ### Claim 51 (depends on 50) The ventilator of claim 50 wherein different interim breathing rate targets have different cycle threshold functions, and the cycle threshold functions allow easier cycling as the interim breathing rate target decreases. ### Claim 52 (depends on 47) The ventilator of claim 47 wherein the controller is configured to cause the blower to trigger from an exhalation phase to an inhalation phase when patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. ### Claim 53 (depends on 52) The ventilator of claim 52 wherein different interim breathing rate targets have different trigger threshold functions, and the trigger threshold functions allow easier triggering as the interim breathing rate target decreases. ### Claim 54 (depends on 47) The ventilator of claim 47 wherein the controller is configured to cause the blower to cycle from an inhalation phase to an exhalation phase when patient airflow decreases to a cycle threshold, the cycle threshold being a function of flow versus time within a breath and generally increasing with time, and the controller causes the blower to trigger from an exhalation phase to an inhalation phase when patient airflow increases to a trigger threshold, the trigger threshold being a function of flow versus time within a breath and generally decreasing with time. ### Claim 55 (depends on 54) The ventilator of claim 54 wherein the controller is configured to cause the magnitude of an air increase to be a function of the difference between the interim breathing rate target and the patient's breathing rate. ### Claim 56 (depends on 54) The ventilator of claim 54 wherein the controller is configured to cause the blower to operate so as to synchronize to the patient's breathing rate rather than the interim breathing rate target. ### Claim 57 (depends on 54) The ventilator of claim 54 wherein the controller is configured to cause different interim breathing rate targets to have different cycle threshold functions and the cycle threshold functions allow easier cycling as the interim breathing rate target decreases, and the controller causes different interim breathing rate targets to have different trigger threshold functions and the trigger threshold functions allow easier triggering as the interim breathing rate target decreases. ### Claim 58 (depends on 57) The ventilator of claim 57 wherein the controller is configured to cause the magnitude of an air increase to be a function of the difference between the interim breathing rate target and the patient's breathing rate. ### Claim 59 (depends on 58) The ventilator of claim 58 wherein the controller is configured to cause the blower to operate so as to synchronize to the patient's breathing rate rather than the interim breathing rate target. ### Claim 60 (depends on 57) The ventilator of claim 57 wherein the controller is configured to cause the blower to operate so as to synchronize to the patient's breathing rate rather than the interim breathing rate target.