(19)
(11)EP 3 291 868 B1

(12)EUROPEAN PATENT SPECIFICATION

(45)Mention of the grant of the patent:
16.09.2020 Bulletin 2020/38

(21)Application number: 16721240.6

(22)Date of filing:  21.04.2016
(51)Int. Cl.: 
A61M 16/00  (2006.01)
A61M 16/20  (2006.01)
(86)International application number:
PCT/IB2016/052252
(87)International publication number:
WO 2016/178111 (10.11.2016 Gazette  2016/45)

(54)

SYSTEMS FOR IMPROVED COUGH SEGMENTATION

SYSTEME FÜR VERBESSERTE HUSTENSEGMENTIERUNG

SYSTÈMES POUR UNE SEGMENTATION AMÉLIORÉE DE LA TOUX


(84)Designated Contracting States:
AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

(30)Priority: 05.05.2015 US 201562157205 P

(43)Date of publication of application:
14.03.2018 Bulletin 2018/11

(73)Proprietor: Koninklijke Philips N.V.
5656 AG Eindhoven (NL)

(72)Inventors:
  • BRAND, Maarten Leonardus Christian
    5656 AE Eindhoven (NL)
  • MAHADEVAN, Anandi
    5656 AE Eindhoven (NL)
  • GARSTECK, James Scott
    5656 AE Eindhoven (NL)

(74)Representative: Philips Intellectual Property & Standards 
High Tech Campus 5
5656 AE Eindhoven
5656 AE Eindhoven (NL)


(56)References cited: : 
WO-A1-2013/118061
WO-A2-2012/085787
WO-A1-2015/033288
  
      
    Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in a written reasoned statement. It shall not be deemed to have been filed until the opposition fee has been paid. (Art. 99(1) European Patent Convention).


    Description

    BACKGROUND OF THE INVENTION


    1. Field of the Invention



    [0001] The present disclosure pertains to a system for controlling cough segmentation for patients, and, in particular, to control the opening and closing (as well as partially opening and/or partially closing) of a valve to establish and disestablish a fluid communication between the airway of the subject and atmospheric pressure.

    2. Description of the Related Art



    [0002] It is well-known that coughing is important in human respiratory systems. It is known that, for a variety of medical reasons, some patients cannot cough well enough to obtain the full benefits of coughing.

    [0003] For example, WO 2012/085787 A2 discloses a system and method for providing inexsufflation to a subject. One or more of exsufflation pressure, one or more insufflation parameters, and/or parameters of transitions between insufflation and exsufflation can be adjusted in order to maintain gas flow during exsufflation at or near a target level.

    [0004] WO 2013/118061 A1 provides a system and method configured to utilize patient effort to increase cough flow of a subject by limiting airway collapse by causing a series of exsufflation events over an individual exhalation of the subject.

    [0005] WO 2015/033288 A1 discloses a method of estimating a parameter indicative of respiratory flow of a patient being administered flow therapy.

    SUMMARY OF THE INVENTION



    [0006] According to the invention, there is provided a system according to claim 1. The dependent claims define preferred embodiments of the invention.

    BRIEF DESCRIPTION OF THE DRAWINGS



    [0007] 

    FIG. 1 schematically illustrates a system configured to control cough segmentation and/or aid coughing for a subject, in accordance with one or more embodiments of the present invention;

    FIG. 2 illustrates graphs representing pressure levels during the use of different embodiments of a system configured to control cough segmentation and/or aid coughing for a subject; and

    FIG. 3 illustrates a method, not forming part of the invention, to control cough segmentation and/or aid coughing for a subject, according to one or more embodiments.


    DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS



    [0008] As used herein, the singular form of "a", "an", and "the" include plural references unless the context clearly dictates otherwise. As used herein, the statement that two or more parts or components are "coupled" shall mean that the parts are joined or operate together either directly or indirectly, i.e., through one or more intermediate parts or components, so long as a link occurs. As used herein, "directly coupled" means that two elements are directly in contact with each other. As used herein, "fixedly coupled" or "fixed" means that two components are coupled so as to move as one while maintaining a constant orientation relative to each other.

    [0009] As used herein, the word "unitary" means a component is created as a single piece or unit. That is, a component that includes pieces that are created separately and then coupled together as a unit is not a "unitary" component or body. As employed herein, the statement that two or more parts or components "engage" one another shall mean that the parts exert a force against one another either directly or through one or more intermediate parts or components. As employed herein, the term "number" shall mean one or an integer greater than one (i.e., a plurality).

    [0010] Directional phrases used herein, such as, for example and without limitation, top, bottom, left, right, upper, lower, front, back, and derivatives thereof, relate to the orientation of the elements shown in the drawings and are not limiting upon the claims unless expressly recited therein.

    [0011] FIG. 1 illustrates a system 10 configured to control cough segmentation and/or aid coughing for a subject 106, in accordance with one or more embodiments of the invention. During typical, natural, or non-aided coughing in users who cough well enough to obtain all or most of the benefits of coughing, the pressure level in the airway may be rapidly decreased between a higher pressure level (e.g. immediately after inhalation) and a lower pressure level (e.g. immediately after exhalation). The term rapidly may refer to a cough occurring in less than 5 seconds, less than 4 seconds, less than 3 seconds, less than 2 seconds, less than 1 second, less than 0.5 seconds, and/or another suitable period. In some case, the pressure level in the airway may fluctuate between different pressure levels, for example one or more higher pressure levels and one or more lower pressure levels. Such fluctuations may occur at a frequency of about 1 Hz, about 2 Hz, about 3 Hz, about 4 Hz, about 5 Hz, about 6 Hz, about 7 Hz, about 8 Hz, about 9 Hz, about 10 Hz, and/or other suitable frequencies for the purpose of coughing. Individual fluctuations may be referred to as cough segments, and having or controlling multiple fluctuations may be referred to as cough segmentation.

    [0012] System 10 is configured to control cough segmentation for subject 106 who breathes independently. In some embodiments, system 10 may be configured to control cough segmentation for subject 106 having one or more medical issues related to respiratory function and/or lung function. In some embodiments, system 10 may be configured to operate during and/or in conjunction forceful exhalation by subject 106 for one or more exhalations.

    [0013] System 10 includes a cough delivery structure 11, one or more sensors 142, a pressure generator 14, one or more physical processors 20, various computer program components, electronic storage 18, a user interface structure 76, and optionally other components. The computer program components include a parameter determination component 111, a target component 112, a valve control component 113, a comparison component 114, an adjustment component 115, and optionally other components.

    [0014] Cough delivery structure 11 includes a subject interface appliance 184, a valve 12, a conduit 182, and optionally other components. Cough delivery structure 11 is configured and/or positioned such that subject 106 exhales into cough delivery structure 11. Conduit 182 may include a rigid or flexible length of hose, tubing, and/or other conduit, and/or combination thereof that fluidly communicated with user 106 and/or subject interface appliance 184. In embodiments that include pressure generator 14, conduit 182 may form a flow path that fluidly connects pressure generator 14 with user 106 and/or subject interface appliance 184. Conduit 182 may comprise a standard 22 mm diameter hose (other common diameters range between ¾" and 1") or, in certain embodiments, a much smaller diameter hose that is in the range of ⅓ of a standard size hose. Such a hose, which may be referred to as a restricted flow hose or limited flow hose, (for example, having a diameter ranging between ¼" and ⅓", or alternatively between 6 mm and 9 mm) may have a greater resistance to gas flow and/or may be smaller and/or less obtrusive.

    [0015] Valve 12 may be configured to open and close as well as partially open and/or partially close. Valve 12 is configured to open and close selectively, controllably, and programmatically under control of processor 20 and/or valve control component 113. In some embodiments, valve 12 may be configured to be controlled, e.g. by valve control component 113, to varying levels of resistance, including levels corresponding to valve 12 being partially open and/or partially closed. Valve 12 may be configured to alternate between multiple levels of resistance according to a particular rate, e.g. the target frequency. Controlling valve 12 (as well as partially opening and/or partially closing) establishes and disestablishes flow paths from the airway of user 106. Opening valve 12 establishes fluid communication between the airway of user 106 (and subject interface appliance 184, and one or more components of cough delivery structure 11) and the atmosphere. As used herein, the term near-atmospheric may refer to pressure levels at or below 1 cm-H2O. In some embodiments, valve 12 may be an exhalation valve.

    [0016] In some embodiments, valve 12 may be a one-way valve. As used in this disclosure, whenever opening and closing valve 12 is described, partially opening and/or partially closing valve 12 is intended to be included in the scope, and envisioned in some embodiments. As used in this disclosure, the term opening (a valve) may refer to any degree of increasing the flow through a valve and/or reducing the resistance to flow through a valve and/or conduit by virtue of moving at least some component of the valve. As used in this disclosure, the term closing (a valve) may refer to any degree of decreasing the flow through a valve and/or increasing the resistance to flow through a valve and/or conduit by virtue of moving at least some component of the valve.

    [0017] Opening valve 12 causes a reduction of a pressure level in or near the airway of subject 106 (and in or near cough delivery structure 11, at or near valve 12, and optionally elsewhere within system 10), e.g. from a pressure level at or above a target pressure level (e.g. a target exhalation pressure threshold) to an atmospheric pressure level or a near-atmospheric pressure level. Closing valve 12 causes an increase of a pressure level in or near the airway of subject 106 (and in or near cough delivery structure 11, at or near valve 12, and optionally elsewhere within system 10), e.g. from an atmospheric pressure level or a near-atmospheric pressure level to a pressure level above an atmospheric pressure level or a near-atmospheric pressure level. Closing valve 12 while subject 106 is exhaling increases the pressure level in or near the airway of subject 106 (and in or near cough delivery structure 11, at or near valve 12, and optionally elsewhere within system 10).

    [0018] The illustration of valve 12 including one member in FIG. 1 is not intended to be limiting. System 10 includes one or more valves. The illustration of a particular symbol or icon for valve 12 in FIG. 1 is exemplary and not intended to be limiting in any way. In some embodiments, valve 12 may be configured to be opened by a fraction, a percentage, a degree, a maximum flow rate, and/or any other manner that is neither fully open nor fully closed.

    [0019] Pressure generator 14 of system 10 in FIG. 1 may be integrated, combined, coupled, and/or connected with a (positive) airway pressure device (PAP/CPAP/BiPAP®/etc.). In some embodiments, pressure generator 14 may be configured to aid and/or generate one or more desired pressure levels for the purpose of coughing. In some embodiments, pressure generator 14 may be configured to provide a pressurized flow of breathable gas for delivery to the airway of subject 106, e.g. via conduit 182, subject interface appliance 184, cough delivery structure 11, and/or another component of system 10. Subject 106 may initiate one or more phases of respiration. Respiratory therapy may be implemented as cough control, cough segmentation control, pressure control, pressure support, volume control, and/or other types of support and/or control. For example, to support inspiration, the pressure of the pressurized flow of breathable gas may be adjusted to an inspiratory pressure. Alternatively, and/or simultaneously, to support expiration, the pressure and/or flow of the pressurized flow of breathable gas may be adjusted to an expiratory pressure. Adjustments may be made numerous times in implementations using auto-titrating for providing respiratory support through the delivery of the pressurized flow of breathable gas.

    [0020] In addition to alternating between multiple pressure, flow, or volume levels, the inhalation pressure level (and/or other levels) may ramp up or down according to a predetermined slope (absolute and/or relative, e.g. dependent on breathing rate) for any specified section of a phase. Similar features may be available for exhalation phases. The pressure levels may be either predetermined and fixed, follow a predetermined dynamic characteristic, or they may dynamically change breath-to-breath or night-to-night depending on sensed breathing, breathing disorder, or other physiological characteristics. Pressure generator 14 may be configured to adjust one or more of pressure levels, flow, humidity, velocity, acceleration, and/or other parameters of a pressurized flow of breathable gas, e.g. in substantial synchronization with the breathing cycle of the subject.

    [0021] Subject interface appliance 184 of system 10 in FIG. 1 is configured to deliver the pressurized flow of breathable gas to the airway of subject 106. As such, subject interface appliance 184 may include any appliance suitable for this function. In some embodiments, pressure generator 14 is a dedicated ventilation device and subject interface appliance 184 is configured to be removably coupled with another interface appliance being used to deliver respiratory therapy to subject 106. For example, subject interface appliance 184 may be configured to engage with and/or be inserted into an endotracheal tube, a tracheotomy portal, and/or other interface appliances. In one embodiment, subject interface appliance 184 is configured to engage the airway of subject 106 without an intervening appliance. In this embodiment, subject interface appliance 184 may include one or more of an endotracheal tube, a nasal cannula, a tracheotomy tube, a nasal mask, a nasal/oral mask, a full-face mask, a total facemask, and/or other interface appliances that communicate a flow of gas with an airway of a subject. The present disclosure is not limited to these examples, and contemplates delivery of the pressurized flow of breathable gas to subject 106 using any subject interface.

    [0022] One or more sensors 142 of system 10 in FIG. 1 are configured to generate output signals conveying information related to physiological, environmental, and/or subject-specific (medical) parameters, pressure levels, and optionally other information. The pressure levels are a pressure level within the airway of subject 106 and/or cough delivery structure 11, and optionally other components of system 10. In some embodiments, the conveyed information may further be related to parameters associated with the state and/or condition of subject 106, motion of subject 106, wakefulness and/or sleep state of the subject, the breathing of subject 106, the heart rate of subject 106, the respiratory rate of subject 106, vital signs of subject 106, including one or more temperatures, oxygen saturation of arterial blood (SpO2), whether peripheral or central, and/or other parameters.

    [0023] Sensors 142 may include one or more of a light sensor, an optical sensor, a temperature sensor, a pressure sensor, a weight sensor, an electromagnetic (EM) sensor, an infra-red (IR) sensor, a microphone, a transducer, a still-image camera, a video camera, and/or other sensors and combinations thereof.

    [0024] The illustration of sensor 142 including one member in FIG. 1 is not intended to be limiting. System 10 includes one or more sensors. The illustration of a particular symbol or icon for sensor 142 in FIG. 1 is exemplary and not intended to be limiting in any way. Resulting signals or information from one or more sensors 142 are transmitted to processor 20, user interface structure 76, electronic storage 18, and optionally other components of system 10. This transmission can be wired and/or wireless.

    [0025] One or more sensors 142 may be configured to generate output signals in an ongoing manner, e.g. throughout a minute, an hour, a day, a week, a month, and/or year(s). This may include generating signals intermittently, periodically (e.g. at a sampling rate), continuously, continually, at varying intervals, and/or in other ways that are ongoing during at least a portion of period of a day, week, month, or other duration. The sampling rate may be about 0.01 ms, 0.1 ms, 1 ms, 0.01 second, 0.1 second, 1 second, about 10 seconds, about 1 minute, and/or other sampling rates. It is noted that multiple individual sensors may operate using different sampling rates, as appropriate for the particular output signals and/or (frequencies related to particular) parameters derived therefrom. For example, in some embodiments, the generated output signals may be considered as a vector of output signals, such that a vector includes multiple samples of information conveyed related to one or more parameters of the subject. Different parameters may be related to different vectors. A particular parameter determined in an ongoing manner from a vector of output signals may be considered as a vector of that particular parameter.

    [0026] Physical processor 20 (interchangeably referred to herein as processor 20) is configured to provide information processing and/or system control capabilities in system 10. As such, processor 20 may include one or more of a digital processor, an analog processor, a digital circuit designed to process information, an analog circuit designed to process information, and/or other mechanisms for electronically processing information. In order to provide the functionality attributed to processor 20 herein, processor 20 may execute one or more components. The one or more components may be implemented in software; hardware; firmware; some combination of software, hardware, and/or firmware; and/or otherwise implemented. Although processor 20 is shown in FIG. 1 as a single entity, this is for illustrative purposes only. In some embodiments, processor 20 may include a plurality of processing units. These processing units may be physically located within the same device, or processor 20 may represent processing functionality of a plurality of devices operating in coordination.

    [0027] As is shown in FIG. 1, processor 20 is configured to execute one or more computer program components. The one or more computer program components include parameter determination component 111, target component 112, valve control component 113, comparison component 114, adjustment component 115, and optionally other components. Processor 20 may be configured to execute components 111-115 by software; hardware; firmware; some combination of software, hardware, and/or firmware; and/or other mechanisms for configuring processing capabilities on processor 20.

    [0028] It should be appreciated that although components 111-115 are illustrated in FIG. 1 as being co-located within a single processing unit, in embodiments in which processor 20 includes multiple processing units, one or more of components 111-115 may be located remotely from the other components.

    [0029] As used herein, the term "determine" (and derivatives thereof) may include measure, calculate, compute, estimate, approximate, generate, and/or otherwise derive, and/or any combination thereof. As used herein, the term "obtain" (and derivatives thereof) may include active and/or passive retrieval, determination, derivation, transfer, upload, download, submission, and/or exchange of information, and/or any combination thereof.

    [0030] Parameter determination component 111 is configured to determine parameters based on output signals generated by sensor 142. Parameter determination component is configured to determine a pressure level based on output signals generated by sensor 142. Parameter determination component 111 is configured to determine a pressure level in or near the airway of subject 106, in or near cough delivery structure 11, at or near valve 12, and optionally elsewhere within system 10.

    [0031] Target component 112 is configured to obtain a target exhalation pressure threshold. In some embodiments, a target exhalation pressure threshold may be about 25 cm-H2O, about 30 cm-H2O, about 35 cm-H2O, about 40 cm-H2O, about 50 cm-H2O, about 60 cm-H2O, about 70 cm-H2O, about 80 cm-H2O, about 90 cm-H2O, about 100 cm-H2O, and/or other suitable pressure level. Target component 112 is configured to obtain one or both of: a target frequency for controlling valve 12, the target frequency corresponding to a rate of opening and closing valve 12 and being, in some embodiments, about 1 Hz, about 2 Hz, about 3 Hz, about 4 Hz, about 5 Hz, about 6 Hz, about 7 Hz, about 8 Hz, about 9 Hz, about 10 Hz, and/or other suitable frequencies for the purpose of coughing; and a target duty cycle for controlling valve 12, the target duty cycle reflecting a first duration of opening valve 12 and a second duration for closing valve 12. The first and second duration may be represented by amounts of time, by percentages of the period that includes opening and closing valve 12 once, and/or in other ways that correspond hereto. For example, a target duty cycle for opening and closing may be about 50%-50%, about 60%-40%, about 40%-60%, about 70%-30%, about 30%-70%, about 80%-20%, about 20%-80%, about 90%-10%, about 10%-90%, and/or other percentages, respectively.

    [0032] In some embodiments, user 106 may set, select, and/or adjust the target exhalation pressure threshold. In some embodiments, a caregiver and/or medical professional may set, select, and/or adjust the target exhalation pressure threshold, e.g. via a remote and/or networked connection to system 10. In some embodiments, system 10 may be configured to determine an adjustment of the target exhalation pressure threshold, during operation of system 10.

    [0033] Valve control component 113 is configured to control valve 12. Controlling valve 12 includes opening, closing, partially opening, and/or partially closing valve 12. In some embodiments, valve component 113 may be configured to open valve 12 by a fraction, a percentage, a degree, a maximum flow rate, and/or any other manner that is neither fully open nor fully closed. Valve control component 113 is configured to control, open, and close valve 12 based on a target frequency and/or a target duty cycle, and on a target exhalation pressure threshold. By way of non-limiting example, valve control component 113 may be configured to control, open, and/or close valve 12 based on a target frequency of about 5 Hz and a target duty cycle of about 50%.

    [0034] Comparison component 114 is configured to compare pressure levels to pressure thresholds, including a target exhalation pressure threshold. Comparison component 114 is configured to determine whether a particular pressure level reaches one or more particular pressure thresholds, including a target exhalation pressure threshold.

    [0035] In some embodiments, comparison component 114 may be configured to perform multiple comparisons during a single exhalation by subject 106. Results of comparisons by comparison component 114 are used by other computer program components, including adjustment component 115.

    [0036] Adjustment component 115 is configured to determine and effectuate adjustments to the control of valve 12. Adjustments are based on determinations and comparisons by other components, including comparison component 114. Adjustments include adjustments to a target exhalation pressure threshold, adjustments to one or both of a target frequency and a target duty cycle, and optionally other adjustments to the operation of system 10. Adjustments are made during the same exhalation by subject 106 as was used for a determination and comparison by other components, including comparison component 114.

    [0037] Adjustment component 115 is configured to determine and effectuate adjustments to the control of valve 12 in response to a particular pressure level not reaching the target exhalation pressure threshold. The particular pressure level is a pressure level within the airway of subject 106 and/or cough delivery structure 11. For example, adjustments may include a reduction of the target frequency for controlling valve 12. For example, adjustments may include an adjustment of the target duty cycle such that the duration of valve 12 being open is reduced and/or the duration of valve 12 being closed is increased.

    [0038] Valve control component 113 is configured to control valve 12 based on one or more adjustments as determined and effectuated by adjustment component 15.

    [0039] By way of illustration, FIG. 2 illustrates graphs 200-201-202-203-204 representing pressure levels during the use of different embodiments and/or different scenarios for the operation of system 10. In graph 200, level 210 indicates a target exhalation pressure threshold. In graph 201, level 211 indicates a target exhalation pressure threshold. In graph 202, level 212 indicates a target exhalation pressure threshold. In graph 203, level 213 indicates a target exhalation pressure threshold. In graph 204, level 214 indicates a target exhalation pressure threshold.

    [0040] For example, the pressure level in graph 200 represents a subject coughing by virtue of a cough delivery structure such as cough delivery structure 11 (shown in FIG. 1) at a particular frequency (e.g. 5 Hz) and duty cycle (e.g. 50%) for a particular number of cough segments (as shown here, seven cough segments). As indicated in graph 200, the pressure level reaches level 210 repeatedly, for consecutive cough segments. Accordingly, the particular frequency and the particular duty cycle may not need to be adjusted as described elsewhere in this disclosure.

    [0041] For example, the pressure level in graph 201 represents a subject coughing by virtue of a cough delivery structure such as cough delivery structure 11 (shown in FIG. 1) at a particular frequency (e.g. 5 Hz) and duty cycle (e.g. 50%) for a particular number of cough segments for which the pressure level reaches level 211 (as shown here, the pressure level reaches level 211 for two cough segments). The pressure level fails to reach level 211 for the third cough segment. As indicated in graph 201, the particular frequency is reduced (e.g. to 4 Hz) such that more time is available for the pressure level to reach level 211. As shown in graph 201, the pressure level reaches level 211 for the fourth, fifth, and sixth cough segments. Note that the duty cycle has not been adjusted in the example illustrated by graph 201.

    [0042] For example, the pressure level in graph 202 represents a subject coughing by virtue of a cough delivery structure such as cough delivery structure 11 (shown in FIG. 1) at a particular frequency (e.g. 5 Hz) and duty cycle (e.g. 50%) for a particular number of cough segments for which the pressure level reaches level 212 (as shown here, the pressure level reaches level 212 for two cough segments). The pressure level fails to reach level 212 for the third cough segment. As indicated in graph 202, the particular duty cycle is altered such that the valve (e.g. valve 12 as shown in FIG. 1) is closed for more than 50% of each cycle of opening and closing the valve (e.g. to 70%) such that more time is available for the pressure level to reach level 212. As shown in graph 202, the pressure level reaches level 212 for the fourth, fifth, sixth and seventh cough segments. Note that the frequency has not been adjusted in the example illustrated by graph 202.

    [0043] For example, the pressure level in graph 203 represents a subject coughing by virtue of a cough delivery structure such as cough delivery structure 11 (shown in FIG. 1) at a particular frequency (e.g. 5 Hz) and duty cycle (e.g. 50%) for a particular number of cough segments for which the pressure level reaches level 213 (as shown here, the pressure level reaches level 213 for two cough segments). The pressure level fails to reach level 213 for the third cough segment. As indicated in graph 203, the particular duty cycle is altered such that the valve (e.g. valve 12 as shown in FIG. 1) is closed for more than 50% of each cycle of opening and closing the valve (e.g. to 75%) such that more time is available for the pressure level to reach level 213. As indicated in graph 203, the particular frequency is reduced (e.g. to 4 Hz) such that more time is available for the pressure level to reach level 213. As shown in graph 203, the pressure level reaches level 212 for the fourth, fifth, and sixth cough segments. Note that both the frequency and the duty cycle have been adjusted in this example.

    [0044] For example, the pressure level in graph 204 represents a subject coughing by virtue of a cough delivery structure such as cough delivery structure 11 (shown in FIG. 1) at a particular frequency (e.g. 5 Hz) and duty cycle (e.g. 50%) for a particular number of cough segments for which the pressure level reaches level 214 (as shown here, the pressure level reaches level 214 for one cough segment). The pressure level fails to reach level 214 for the second cough segment. As indicated in graph 204, level 214 is lowered at point 215 and the particular frequency is reduced (e.g. to 4 Hz) such that more time is available for the pressure level to reach adjusted level 214. As shown in graph 204, the pressure level reaches adjusted level 214 for the third cough segment, but not for the fourth cough segment. In response to the pressure level not reaching adjusted level 214, both the particular frequency and the duty cycle are adjusted, such that more time is available for the pressure level to reach adjusted level 214. As shown in graph 204, the pressure level reaches adjusted level 214 for the fifth and sixth cough segments. Note that both the frequency and the duty cycle have been adjusted in this example.

    [0045] Referring to FIG. 1, in some embodiments, system 10 may be configured to first adjust the duty cycle in an attempt to reach a target exhalation pressure threshold, and subsequently adjust the target frequency. In some embodiments, system 10 may be configured to first adjust the target frequency in an attempt to reach a target exhalation pressure threshold, and subsequently adjust the duty cycle.

    [0046] User interface structure 76 is configured to provide an interface between system 10 and a user through which the user can provide and/or receive information. This enables data, results, and/or instructions and any other communicable items, collectively referred to as "information," to be communicated between the user and system 10. Examples of interface devices suitable for inclusion in user interface structure 76 include a keypad, buttons, switches, a keyboard, knobs, levers, a display screen, a touch screen, speakers, a microphone, an indicator light, an audible alarm, and a printer. Information may be provided to the subject by user interface structure 76 in the form of auditory signals, visual signals, tactile signals, and/or other sensory signals.

    [0047] By way of non-limiting example, user interface structure 76 may include a light source capable of emitting light. The light source may include, for example, one or more of at least one LED, at least one light bulb, a display screen, and/or other sources. User interface structure 76 may control the light source to emit light in a manner that conveys to the subject information related to operation of system 10. Note that subject 106 and the user of system 10 may be one and the same person.

    [0048] It is to be understood that other communication techniques, either hardwired or wireless, are also contemplated herein as user interface structure 76. For example, in one embodiment, user interface structure 76 may be integrated with a removable storage interface provided by electronic storage 18. In this example, information is loaded into system 10 from removable storage (e.g., a smart card, a flash drive, a removable disk, etc.) that enables the user(s) to customize the implementation of system 10. Other exemplary input devices and techniques adapted for use with system 10 as user interface structure 76 include, but are not limited to, an RS-232 port, RF link, an IR link, modem (telephone, cable, Ethernet, internet or other). In short, any technique for communicating information with system 10 is contemplated as user interface structure 76.

    [0049] Electronic storage 18 of system 10 in FIG. 1 comprises physical electronic storage media that electronically stores information, e.g. digital information. The electronic storage media of electronic storage 18 may include one or both of system storage that is provided integrally (i.e., substantially non-removable) with system 10 and/or removable storage that is removably connectable to system 10 via, for example, a port (e.g., a USB port, a FireWire port, etc.) or a drive (e.g., a disk drive, etc.). Electronic storage 18 may include one or more of optically readable storage media (e.g., optical disks, etc.), magnetically readable storage media (e.g., magnetic tape, magnetic hard drive, floppy drive, etc.), electrical charge-based storage media (e.g., EPROM, EEPROM, RAM, etc.), solid-state storage media (e.g., flash drive, etc.), network-attached storage (NAS), and/or other electronically readable storage media. Electronic storage 18 may include virtual storage resources, such as storage resources provided via a cloud and/or a virtual private network. Electronic storage 18 may store software algorithms, information determined by processor 20, information received via user interface 76, and/or other information that enables system 10 to function properly. For example, electronic storage 18 may record or store a target frequency, target duty cycle, and/or other parameters (as discussed elsewhere herein), and/or other information. Electronic storage 18 may be a separate component within system 10, or electronic storage 18 may be provided integrally with one or more other components of system 10 (e.g., processor 20).

    [0050] FIG. 3 illustrates a method 300 for controlling cough segmentation. The operations of method 300 presented below are intended to be illustrative. In some embodiments, method 300 may be accomplished with one or more additional operations not described, and/or without one or more of the operations discussed. Additionally, the order in which the operations of method 300 are illustrated in FIG. 3 and described below is not intended to be limiting.

    [0051] In some embodiments, method 300 may be implemented in one or more processing devices (e.g., a digital processor, an analog processor, a digital circuit designed to process information, an analog circuit designed to process information, and/or other mechanisms for electronically processing information). The one or more processing devices may include one or more devices executing some or all of the operations of method 300 in response to instructions stored electronically on an electronic storage medium. The one or more processing devices may include one or more devices configured through hardware, firmware, and/or software to be specifically designed for execution of one or more of the operations of method 300.

    [0052] At an operation 302, output signals are generated that convey information related to a pressure level within one or both of the cough delivery structure and/or an airway of the subject. In some embodiments, operation 302 is performed by a sensor the same as or similar to sensor 142 (shown in FIG. 1 and described herein).

    [0053] At an operation 304, the pressure level is determined based on the generated output signals. In some embodiments, operation 304 is performed by a parameter determination component the same as or similar to parameter determination component 111 (shown in FIG. 1 and described herein).

    [0054] At an operation 306, a target exhalation pressure threshold is obtained. In some embodiments, operation 306 is performed by a target component the same as or similar to target component 112 (shown in FIG. 1 and described herein).

    [0055] At an operation 308, one or both of a target frequency and/or a target duty cycle is obtained. The target frequency is for establishing fluid communication between the cough delivery structure and atmosphere by opening the valve. The target duty cycle is for opening and closing the valve. In some embodiments, operation 308 is performed by a target component the same as or similar to target component 112 (shown in FIG. 1 and described herein).

    [0056] At an operation 310, the valve is controlled to open and close based on one or both of the target frequency for establishing the fluid communication and/or the target duty cycle. In some embodiments, operation 310 is performed by a valve control component the same as or similar to valve control component 113 (shown in FIG. 1 and described herein).

    [0057] At an operation 312, the pressure level during a first exhalation by the subject is compared with the target exhalation pressure threshold. In some embodiments, operation 312 is performed by a comparison component the same as or similar to comparison component 114 (shown in FIG. 1 and described herein).

    [0058] At an operation 314, in response to the pressure level during the first exhalation by the subject not reaching the target exhalation pressure threshold, one or both of the target frequency for establishing the fluid communication and/or the target duty cycle is adjusted. In some embodiments, operation 314 is performed by a adjustment component the same as or similar to adjustment component 115 (shown in FIG. 1 and described herein).

    [0059] At an operation 316, the valve is controlled to open and close based on one or both of the adjusted target frequency for establishing the fluid communication and/or the adjusted target duty cycle. In some embodiments, operation 316 is performed by a valve control component the same as or similar to valve control component 113 (shown in FIG. 1 and described herein).

    [0060] In the claims, any reference signs placed between parentheses shall not be construed as limiting the claim. The word "comprising" or "including" does not exclude the presence of elements or steps other than those listed in a claim. In a device claim enumerating several means, several of these means may be embodied by one and the same item of hardware. The word "a" or "an" preceding an element does not exclude the presence of a plurality of such elements. In any device claim enumerating several means, several of these means may be embodied by one and the same item of hardware. The mere fact that certain elements are recited in mutually different dependent claims does not indicate that these elements cannot be used in combination.


    Claims

    1. A system (100) configured to control cough segmentation, the system (100) comprising:

    a cough delivery structure (11) configured to fluidly communicate with an airway of a subject (106), wherein the cough delivery structure includes a valve (12), wherein the valve (12) is configured to selectively control a fluid communication between the cough delivery structure (11) and atmosphere;

    one or more sensors (142) configured to generate output signals conveying information related to a pressure level within the cough delivery structure (11) and/or the airway of the subject (106); and

    one or more physical processors (20) configured via computer-readable instructions to:

    determine the pressure level based on the generated output signals;

    obtain a target exhalation pressure threshold (210-214);

    obtain one or both of a target frequency for controlling the valve (12), the target frequency corresponding to a rate of opening and closing the valve (12), and a target duty cycle for controlling the valve (12), the target duty cycle reflecting a first duration of opening the valve (12) and a second duration for closing the valve (12);

    control the valve (12) based on the obtained one or both of a target frequency and a target duty cycle such that, during a first exhalation by the subject (106) during which cough segmentation is controlled by the system, the valve is opened and closed a plurality of times according to the obtained one or both of a target frequency an a target duty cycle to define a plurality of cough segments; and

    compare the pressure level determined during a cough segment of the first exhalation with the obtained target exhalation pressure threshold (210-214);

    characterised in that the one or more physical processors (20) are further configured via computer-readable instructions to:
    in response to the pressure level determined during the cough segment of the first exhalation by the subject not reaching the obtained target exhalation pressure threshold (210-214), adjust the obtained one or both of a target frequency and a target duty cycle; and subsequently control the valve (12) at least during another cough segment of the first exhalation based on the adjusted one or both of a target frequency and a target duty cycle.


     
    2. The system of claim 1, wherein the adjustment of the obtained one or both of a target frequency and a target duty cycle includes a reduction of the obtained target frequency and a reduction of the first duration of opening the valve (12).
     
    3. The system of claim 1, wherein the obtained target exhalation pressure threshold is at least 25 cm-H2O.
     
    4. The system of claim 1, wherein the one or more physical processors (20) are configured to obtain both of a target frequency for controlling the valve (12) and a target duty cycle for controlling the valve (12), wherein the one or more physical processors (20) are configured to adjust the obtained target duty cycle and control the valve (12) based on the adjusted target duty cycle, wherein the one or more physical processors (20) are further configured to:

    compare the pressure level determined during a subsequent cough segment of the first exhalation by the subject (106) with the obtained target exhalation pressure threshold subsequent to adjustment of the obtained target duty cycle;

    in response to the pressure level determined during the subsequent cough segment of during the first exhalation by the subject (106) not reaching the obtained target exhalation pressure threshold, adjust the obtained target frequency;
    and

    subsequently control the valve (12) at least during another cough segment of the first exhalation based on the adjusted target frequency.


     


    Ansprüche

    1. System (100), das konfiguriert ist, um die Hustensegmentierung zu steuern, wobei das System (100) umfasst:

    eine Hustenabgabestruktur (11), die konfiguriert ist, um mit einem Atemweg eines Subjekts (106) fluidisch zu kommunizieren, wobei die Hustenabgabestruktur ein Ventil (12) umfasst, wobei das Ventil (12) konfiguriert ist, um selektiv eine Fluidkommunikation zwischen der Hustenabgabestruktur (11) und Atmosphäre zu steuern;

    einen oder mehrere Sensoren (142), die konfiguriert sind, um Ausgangssignale zu erzeugen, die Informationen bezüglich eines Druckniveaus innerhalb der Hustenabgabestruktur (11) und/oder der Atemwege des Subjekts (106) übermitteln; und

    einen oder mehrere physikalische Prozessoren (20), die über computerlesbare Anweisungen konfiguriert sind, um:

    Bestimmen des Druckniveaus basierend auf den erzeugten Ausgangssignalen;

    Erhalten einer Ziel-Ausatmungsdruckschwelle (210-214) ;

    Erhalten einer oder beider einer Zielfrequenz zum Steuern des Ventils (12), wobei die Zielfrequenz einer Geschwindigkeit des Öffnens und Schließens des Ventils (12) entspricht, und einen Ziel-Arbeitszyklus zum Steuern des Ventils (12), wobei der Ziel-Arbeitszyklus eine erste Dauer des Öffnens des Ventils (12) und eine zweite Dauer zum Schließen des Ventils (12) widerspiegelt;

    Steuern des Ventils (12) basierend auf der erhaltenen einen oder beiden einer Zielfrequenz und einen Ziel-Arbeitszyklus, so dass während eines ersten Ausatmens durch das Subjekt (106), während dessen die Hustensegmentierung durch das System gesteuert wird, das Ventil wird mehrere Male gemäß der erhaltenen einen oder beiden einer Zielfrequenz und eines Zielarbeitszyklus geöffnet und geschlossen, um mehrere Hustensegmente zu definieren; und

    Vergleichen des während eines Hustensegments der ersten Ausatmung bestimmte Druckniveaus mit der erhaltenen Ziel-Ausatmungsdruckschwelle (210-214);

    dadurch gekennzeichnet, dass der eine oder die mehreren physischen Prozessoren (20) über computerlesbare Anweisungen weiter konfiguriert sind, um:

    als Reaktion auf das Druckniveau, das während des Hustensegments der ersten Ausatmung von dem Probanden bestimmt wurde, der die erhaltene Ziel-Ausatmungsdruckschwelle (210-214) nicht erreicht hat, Stellen der erhaltenen einen oder beiden einer Zielfrequenz und eines Ziel-Arbeitszyklus; und

    anschließend Steuern des Ventils (12) mindestens während eines anderen Hustensegments der ersten Ausatmung basierend auf der eingestellten einen oder beiden einer Zielfrequenzen und eines Ziel-Arbeitszyklus.


     
    2. System nach Anspruch 1, wobei die Einstellung der erhaltenen einen oder beiden einer Zielfrequenz und eines Ziel-Arbeitszyklus eine Verringerung der erhaltenen Zielfrequenz und eine Verringerung der ersten Dauer des Öffnens des Ventils (12) umfasst.
     
    3. System nach Anspruch 1, wobei die erhaltene Ziel-Ausatmungsdruckschwelle mindestens 25 cm-H2O beträgt.
     
    4. System nach Anspruch 1, wobei der eine oder die mehreren physikalischen Prozessoren (20) konfiguriert sind, um sowohl eine Zielfrequenz zum Steuern des Ventils (12) als auch einen Ziel-Arbeitszyklus zum Steuern des Ventils (12) zu erhalten, wobei der eine oder die mehreren physikalischen Prozessoren (20) konfiguriert sind, um den erhaltenen Zielarbeitszyklus einzustellen, und das Ventil (12) basierend auf dem eingestellten Ziel-Arbeitszyklus zu steuern, wobei der eine oder die mehreren physikalischen Prozessoren (20) ferner konfiguriert sind, zum:

    Vergleichen des Druckniveaus, das während eines nachfolgenden Hustensegments der ersten Ausatmung durch das Subjekt (106) bestimmt wurde, mit der erhaltenen Ziel-Ausatmungsdruckschwelle nach Einstellung des erhaltenen Ziel-Arbeitszyklus;

    in Reaktion auf das Druckniveau, das während des nachfolgenden Hustensegments der ersten Ausatmung durch das Subjekt (106) bestimmt wurde, das die erhaltene Ziel-Ausatmungsdruckschwelle nicht erreicht, die erhaltene Zielfrequenz einstellen;
    und

    anschließend das Ventil (12) zumindest während eines anderen Hustensegments der ersten Ausatmung basierend auf der eingestellten Zielfrequenz steuern.


     


    Revendications

    1. Système (100) configuré pour maîtriser la segmentation de la toux, le système (100) comprenant:

    une structure de délivrance de la toux (11) configurée pour communiquer fluidiquement avec une voie aérienne d'un sujet (106), où la structure de délivrance de la toux comprend une soupape (12), où la soupape (12) est configurée pour commander sélectivement une communication fluidique entre la structure de délivrance de la toux (11) et l'atmosphère;

    un ou plusieurs capteurs (142) configurés pour générer des signaux de sortie véhiculant des informations relatives à un niveau de pression à l'intérieur de la structure de délivrance de la toux (11) et/ou des voies aériennes du sujet (106); et

    un ou plusieurs processeurs physiques (20) configurés via instructions lisibles par ordinateur pour:

    déterminer le niveau de la pression sur la base des signaux de sortie générés;

    obtenir un seuil de la pression d'exhalation cible (210-214) ;

    obtenir un ou les deux entre une fréquence cible pour commander la soupape (12), la fréquence cible correspondant à une vitesse d'ouverture et de fermeture de la soupape (12), et un cycle de service cible pour commander la soupape (12), le cycle de service cible reflétant une première durée d'ouverture de la soupape (12) et une seconde durée de fermeture de la soupape (12) ;

    commander la soupape (12) sur la base de l'un ou des deux obtenus entre une fréquence cible et un cycle de service cible tel que, pendant une première exhalation par le sujet (106) au cours de laquelle la segmentation de la toux est maîtrisée par le système, la soupape est ouverte et fermée plusieurs fois selon l'un ou les deux obtenus entre une fréquence cible et un cycle de service cible pour définir une pluralité de segments de toux; et

    comparer le niveau de la pression déterminé pendant un segment de toux de la première exhalation avec le seuil de pression d'exhalation cible obtenu (210-214) ;

    caractérisé en ce que le ou les processeurs physiques (20) sont en outre configurés via des instructions lisibles par ordinateur pour:

    en réponse au niveau de la pression déterminé pendant le segment de toux de la première exhalation par le sujet n'atteignant pas le seuil de la pression d'exhalation cible obtenu (210-214), ajuster l'un ou les deux obtenus entre une fréquence cible et un cycle de service cible; et

    commander ensuite la soupape (12) au moins pendant un autre segment de toux de la première exhalation sur la base de l'un ou des deux ajustés entre une fréquence cible et un cycle de service cible.


     
    2. Système selon la revendication 1, dans lequel l'ajustement de l'un ou des deux obtenus entre une fréquence cible et un cycle de service cible comprend une réduction de la fréquence cible obtenue et une réduction de la première durée d'ouverture de la soupape (12).
     
    3. Système selon la revendication 1, dans lequel le seuil de la pression d'exhalation cible obtenu est d'au moins 25 cm-H2O.
     
    4. Système selon la revendication 1, dans lequel l'un ou les plusieurs processeurs physiques (20) sont configurés pour obtenir à la fois une fréquence cible pour commander la soupape (12) et un cycle de service cible pour commander la soupape (12), dans lequel l'un ou les plusieurs processeurs physiques (20) sont configurés pour ajuster le cycle de service cible obtenu et commander la soupape (12) sur la base du cycle de service cible ajusté, dans lequel l'un ou les plusieurs processeurs physiques (20) sont en outre configurés pour:

    comparer le niveau de la pression déterminé pendant un segment de toux ultérieur de la première exhalation par le sujet (106) avec le seuil de la pression de exhalation cible obtenu après l'ajustement du cycle de service cible obtenu;

    en réponse au niveau de la pression déterminé pendant le segment de toux suivant de la première exhalation par le sujet (106) n'atteignant pas le seuil de la pression d'exhalation cible obtenu, ajuster la fréquence cible obtenue;
    et

    commander ensuite la soupape (12) au moins pendant un autre segment de toux de la première exhalation sur la base de la fréquence cible ajustée.


     




    Drawing












    REFERENCES CITED IN THE DESCRIPTION



    This list of references cited by the applicant is for the reader's convenience only. It does not form part of the European patent document. Even though great care has been taken in compiling the references, errors or omissions cannot be excluded and the EPO disclaims all liability in this regard.

    Patent documents cited in the description