EP1009281A1 - Determination du flux respiratoire nasal et/ou buccal - Google Patents

Determination du flux respiratoire nasal et/ou buccal

Info

Publication number
EP1009281A1
EP1009281A1 EP98942776A EP98942776A EP1009281A1 EP 1009281 A1 EP1009281 A1 EP 1009281A1 EP 98942776 A EP98942776 A EP 98942776A EP 98942776 A EP98942776 A EP 98942776A EP 1009281 A1 EP1009281 A1 EP 1009281A1
Authority
EP
European Patent Office
Prior art keywords
image
respiratory
nasal
flow
respiratory flow
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP98942776A
Other languages
German (de)
English (en)
French (fr)
Inventor
Stéphane Ruton
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Taema SA
Original Assignee
Taema SA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Taema SA filed Critical Taema SA
Publication of EP1009281A1 publication Critical patent/EP1009281A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057Pumps therefor
    • A61M16/0066Blowers or centrifugal pumps
    • A61M16/0069Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/08Detecting, measuring or recording devices for evaluating the respiratory organs
    • A61B5/087Measuring breath flow
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022Control means therefor
    • A61M16/024Control means therefor including calculation means, e.g. using a processor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0015Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
    • A61M2016/0018Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
    • A61M2016/0021Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with a proportional output signal, e.g. from a thermistor

Definitions

  • the invention relates to a method and a device making it possible to determine an image of the respiratory flow or flow rate of a user liable to be subject to respiratory sleep disorders, with a view in particular to diagnosing and / or treating said respiratory disorders, from this image of nasal and / or oral respiratory flow or flow.
  • Respiratory sleep disorders such as Sleep Apnea Syndrome (SAS) are generally characterized by dysfunction of the respiratory function during sleep.
  • SAS Sleep Apnea Syndrome
  • Respiratory disorders can be obstructive or central. In the first case, we observe a total obstruction (obstructive apnea) or partial (obstructive hypopnea) of the upper airways while the muscular effort is maintained. This type of disorder is often associated with significant snoring.
  • muscle control is absent (central apnea) or reduced (central hypopnea), the upper airways being open.
  • Obstructive disorders represent the vast majority of nocturnal respiratory disorders.
  • the diagnosis of respiratory sleep disorders is carried out in a sleep laboratory thanks to the recording and study of many parameters related: - either to sleep: electroencephalogram, electroocculogram, electro-myogram, or cardio-respiratory function : EKG, respiratory rate, nasal and / or buccal flow, chest and abdominal movements, arterial oxygen saturation, snoring.
  • the treatment of sleep-disordered breathing usually involves an apparatus which keeps the upper airways open.
  • This apparatus most often includes a positive mask pressure device (CPAP), in which a means of compressing the ambient air, controlled by a control device, delivers in a conduit then in a mask placed on the nose of the patient. air tightly.
  • CPAP positive mask pressure device
  • the control device compares the pressure value in the mask with a set pressure setpoint and, depending on the difference measured, adjusts a control signal which it delivers by means of compression of the ambient air.
  • the pressure setpoint to be applied in the patient's mask is empirically determined in the sleep laboratory by gradually increasing an initial setpoint and observing the consequences on respiratory disorders, the value chosen being the first value for which we observe normal non-fragmented sleep.
  • the object of the present invention is therefore to propose a method and an apparatus for diagnosing and / or treating respiratory sleep disorders:
  • the present invention therefore relates to a method for determining the image of the nasal and / or oral respiratory flow of a user, to whom a respiratory gas is administered at at least one pressure level by means of at least one turbine driven by a motor. , in which :
  • the consumed current signal is processed, - an image of the nasal and / or oral respiratory flow of the user is determined from the processed current signal.
  • the method of the invention may include one or more of the following characteristics:
  • the processing of the current signal consumed is carried out by filtering, integration and / or amplification of said signal,
  • - ⁇ _ is equal to at least approximately 5 seconds and, preferably, to at least approximately 15 seconds and / or t 2 is equal to at most approximately 1 second and, preferably, to at most approximately 0.125 seconds,
  • the invention also relates to a device capable of implementing such a method and, in particular, a device for determining the image of the nasal and / or buccal respiratory flow of a user comprising:
  • a respiratory gas at at least one pressure level comprising at least one turbine driven by a motor
  • - supply means comprising at least one conduit for conveying said respiratory gas connecting the turbine to the nasal and / or oral respiratory tracts of the user
  • means for processing said consumed current signal means for memorizing an image of the nasal and / or buccal respiratory flow of the user,
  • the device of the invention may include one or more of the following characteristics: the processing means comprise a filter, an integrator and / or a signal amplifier,
  • the invention further relates to the use of such a device and / or of such a method for implementing a method of treatment or diagnosis of respiratory sleep disorders in a user and, in particular , for the treatment or diagnosis of obstructive sleep apnea, hypopnea and / or increased upper airway resistance syndrome.
  • the present invention is described in more detail below using an embodiment of such a device and with reference to Figures 1 to 6 given by way of illustration, but in no way limitative of the invention.
  • FIG. 1 represents the diagram of a device implementing the method of the invention. More specifically, a user or patient 2 is supplied with a breathing gas containing oxygen, such as air, by a turbine 6 actuated by an electric motor (not detailed), via a breathing duct 10 allowing the gas to be conveyed under pressure to the respiratory tract of said patient 2.
  • the respiratory gas is distributed at a constant positive pressure over time, that is to say at a single pressure level (device of the CPAP type) , or at a pressure varying between at least one low pressure level and at least one higher pressure level, that is to say at several pressure levels (BPAP type device).
  • BPAP type device a pressure varying between at least one low pressure level and at least one higher pressure level
  • connection between the respiratory tract 10 and the patient 2 is done, conventionally, by means of an oral and / or nasal piece 5, such as a mask and / or respiratory glasses.
  • an oral and / or nasal piece 5 such as a mask and / or respiratory glasses.
  • a nasal piece 5 of the respiratory mask type it is preferable to maintain a clear gas overpressure in said mask; generally between 5 and 20 mbar, for example 12 mbar.
  • a slight gas overpressure (0.20 mbar) is sufficient.
  • a pressure sensor 7 whose pressure tap point is arranged on the downstream end of the respiratory tract 10 or on the nasal and / or buccal part 5, that is to say in the immediate vicinity of the patient's respiratory tract 2 , makes it possible to detect pressure variations due to the patient's breathing, therefore the alternation of the inspiratory and expiratory phases.
  • This pressure sensor 7 then preferably transmits pressure value information continuously to control means 8 of the respiratory flow source, here the turbine 6.
  • control means 8 and the turbine 6 are inserted into the same box 4.
  • This pressure value information is then processed by said control means 8, which then supply a control signal to the turbine 6 as a function of a determined overpressure set value, such as as described in particular in document EP-A-505232 or US-A-5, 443, 061, so as to modulate the overpressure provided by said turbine 6 to patient 2.
  • This consumed current signal is then processed by said means 9 for processing the consumed current signal, so as to deduce therefrom at least one image 11 representative of the user's respiratory flow: inspiratory and expiratory phases and possible respiratory disorders: apneas, hypopneas, increased resistance ...
  • the processing of the current signal consumed by the turbine 6 comprises steps of filtering, amplification and / or integration of said signal.
  • This signal processing notably makes it possible to eliminate the major part of the parasitic noises which are there.
  • This signal processing can be carried out by means of a short-circuit resistor 23 or shunt resistor of low resistance at the terminals of which the current voltage is measured, that is to say a resistance at least about 0.05 Ohm, preferably around 0.1 Ohm, a low-pass filter 24, an integrator 25 and a signal amplifier 26.
  • a nasal part such as respiratory glasses
  • buccal respiratory flow detection means for example a thermistor 1, arranged near the mouth of patient 2.
  • the thermistor 1 can detect any possible oral flow, by the temperature variations that it generates in the immediate vicinity of the mouth. More specifically, the thermistor 1 sees its electrical resistance vary as a function of said temperature variations, thus creating a buccal breathing signal. This buccal breathing signal is then sent to means 3 of buccal breathing signal processing which processes this signal and make it possible to obtain an image 12 thereof. This buccal breathing image 12 can then be used by the practitioner to diagnose existence of an oral flow in the patient and then adapt the treatment of the patient taking into account this oral breathing flow.
  • FIGS. 3 to 6 represent recordings of the flow and of the image of the flow of a respiratory flow, here a nasal flow, obtained by the method of the invention; the flow being measured by means of a pneumotachograph of the conventional type. More specifically: - Figure 3 corresponds to the recording of normal breathing, that is to say of a patient suffering from no respiratory sleep disorder;
  • FIG. 4 corresponds to the recording of a limited rate breathing in a patient suffering from the syndrome of increased resistance of the upper airways (square shape of the image);

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Anesthesiology (AREA)
  • Emergency Medicine (AREA)
  • Hematology (AREA)
  • Biophysics (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Physics & Mathematics (AREA)
  • Physiology (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
EP98942776A 1997-08-25 1998-08-24 Determination du flux respiratoire nasal et/ou buccal Withdrawn EP1009281A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
FR9710605 1997-08-25
FR9710605A FR2767466B1 (fr) 1997-08-25 1997-08-25 Procede pour determiner l'image du flux respiratoire nasal et/ou buccal d'un utilisateur
PCT/FR1998/001843 WO1999009886A1 (fr) 1997-08-25 1998-08-24 Determination du flux respiratoire nasal et/ou buccal

Publications (1)

Publication Number Publication Date
EP1009281A1 true EP1009281A1 (fr) 2000-06-21

Family

ID=9510462

Family Applications (1)

Application Number Title Priority Date Filing Date
EP98942776A Withdrawn EP1009281A1 (fr) 1997-08-25 1998-08-24 Determination du flux respiratoire nasal et/ou buccal

Country Status (8)

Country Link
US (1) US6155985A (es)
EP (1) EP1009281A1 (es)
JP (1) JP2001513387A (es)
AR (1) AR013434A1 (es)
AU (1) AU9078498A (es)
CA (1) CA2295525A1 (es)
FR (1) FR2767466B1 (es)
WO (1) WO1999009886A1 (es)

Families Citing this family (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2794635B1 (fr) * 1999-06-14 2001-08-03 Taema Appareil de diagnostic ou de traitement des troubles respiratoires du sommeil et procede de fonctionnement
NO20002538L (no) * 2000-05-16 2001-11-19 Medisinsk Registrering Og Anal Deteksjon av pusteforstyrrelser
WO2005096729A2 (en) * 2004-03-31 2005-10-20 Resmed Limited Methods and apparatus for monitoring the cardiovascular condition of patients with sleep disordered breathing
US7878198B2 (en) 2004-03-31 2011-02-01 Michael Farrell Methods and apparatus for monitoring the cardiovascular condition of patients with sleep disordered breathing
WO2005104944A1 (en) 2004-05-04 2005-11-10 Dalhousie University Method of assessment of airway variability in airway hyperresponsiveness
US7734350B2 (en) * 2006-06-14 2010-06-08 Zmed Technologies, Inc. Respiration apparatus
US7748493B2 (en) * 2006-06-14 2010-07-06 Zmed Technologies, Inc. Respiration stimulation
NZ607004A (en) 2006-08-30 2014-08-29 Resmed Ltd Distinguishing closed and open respiratory airway apneas by complex admittance values
NZ599799A (en) 2007-05-11 2013-10-25 Resmed Ltd Automated Control for Detection of Flow Limitation
FR2899484B1 (fr) * 2007-06-11 2010-07-30 Saime Dispositif d'aide a la respiration a turbine et ventilateur axial
AU2008203812B2 (en) 2007-08-17 2014-10-02 ResMed Pty Ltd Methods and Apparatus for Pressure Therapy in the Treatment of Sleep Disordered Breathing
CN104486994B (zh) 2012-05-14 2017-06-20 瑞思迈发动机及马达技术股份有限公司 用于呼吸舒适度的压力控制
CN105496413B (zh) * 2015-12-15 2018-10-09 康泰医学系统(秦皇岛)股份有限公司 一种肺活量计肺活量获取方法

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5522382A (en) * 1987-06-26 1996-06-04 Rescare Limited Device and method for treating obstructed breathing having a delay/ramp feature
FI80606C (fi) * 1987-10-05 1990-07-10 Kemira Oy Foerfarande foer reglering av luftmaongden som matas in i en gasmask samt en gasmask som genomfoer denna foerfarande.
US5239995A (en) 1989-09-22 1993-08-31 Respironics, Inc. Sleep apnea treatment apparatus
FR2663547B1 (fr) 1990-06-25 1997-10-10 Taema Installation de fourniture en continu de surpression de gaz respiratoire.
US5069222A (en) * 1990-08-31 1991-12-03 Mcdonald Jr Lewis D Respiration sensor set
FR2674133B1 (fr) 1991-03-21 1993-06-11 Taema Installation de fourniture de surpression de gaz respiratoire et procede de commande d'une telle installation.
FR2692152B1 (fr) * 1992-06-15 1997-06-27 Pierre Medical Sa Appareil d'aide a la respiration, notamment pour traiter l'apnee du sommeil.
US5353788A (en) * 1992-09-21 1994-10-11 Miles Laughton E Cardio-respiratory control and monitoring system for determining CPAP pressure for apnea treatment
EP0661071B1 (en) * 1993-12-01 2000-02-02 Resmed Limited Device for continuous positive airway pressure breathing (CPAP)
AUPM279393A0 (en) 1993-12-03 1994-01-06 Rescare Limited Estimation of flow and detection of breathing in cpap treatment
US5792067A (en) * 1995-11-21 1998-08-11 Karell; Manuel L. Apparatus and method for mitigating sleep and other disorders through electromuscular stimulation

Non-Patent Citations (1)

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Title
See references of WO9909886A1 *

Also Published As

Publication number Publication date
FR2767466B1 (fr) 1999-10-15
FR2767466A1 (fr) 1999-02-26
AR013434A1 (es) 2000-12-27
AU9078498A (en) 1999-03-16
US6155985A (en) 2000-12-05
JP2001513387A (ja) 2001-09-04
CA2295525A1 (fr) 1999-03-04
WO1999009886A1 (fr) 1999-03-04

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