New ventilation method for COPD patients, reducing auto-peep and shear stress in the lung and thereby preventing hyperinflation and inflammation
Chronic obstructive pulmonary disease (COPD) is a major public health problem with currently about 600 million people suffering from this disease, with the trend rising. According to WHO, COPD has become the forth leading cause of death, and the economic burden only in the U.S. in 2007 amounted to $43 billion.
Besides medication, non-invasive ventilation is considered as a treatment option, especially for patients having hypercapnic respiratory insufficiency. Current ventilation devices aim at supporting respiration by supplying an inspirational pressure during inhalation and a lower expirational pressure during exhalation.
The prevailing opinion is to adjust the pressure amplitude as high as possible in the scope of acceptance of the patient, in order to ensure the best possible respiration support. However, studies have shown that an enlargement of the pressure amplitude does not result in the desired relief of the respiratory musculature, but rather causes an increased hyperinflation of the lungs. Hence, a better ventilation method is needed to avoid undesired hyperinflation and to improve respiration support of COPD patients.
The inventors have developed an optimized ventilation method based on the insight that undesired hyperinflation of the lungs is caused by the overly added air being pumped in during inhalation. Due to the damaged small airways, excess air cannot be sufficiently exhaled in the exhalation phase, eventually causing shortness of breath (SOB; dyspnoea).
The new therapy is based on real-time measurements of various patient's parameters regarding air flow dynamics. During inhalation and exhalation phase, supplied air pressure is continuously regulated somewhat asymmetrically to the patient's breathing, thus mimics 'pursed lip breathing' and targets at a modulation of the patients breathing regulation reflexes. This dynamic adaption of air pressure head prevents additional hyperinflation during inhalation and keeps airways open during exhalation. By this means, the invention facilitates efficient gas exchange and relief of the respiratory musculature, slows down breathing rate, increases tidal volume, mitigate dyspnoea perception and likely reduces intrapulmonal shear stress and thereby airway inflammation.
The technology is offered for in-licensing and/or co-development.
The beneficial effects of the new ventilation method have been confirmed by treating COPD patients with an adapted, manually controlled ventilation device. It is anticipated that the innovative method can be easily implemented into existing instruments, simply by adapting the control software.
A PCT international application has been filed in 2011, claiming priority of a prior German and US provisonal application. National and regional phases have been entered in EP, US, AU and CN.