System for CO2 removal
A system for carbon dioxide (CO2) removal from a circulatory system of a patient includes a medical device providing extracorporeal lung assist (ECLA) treatment to the patient through extracorporeal removal of CO2 from the patient's blood; at least one control unit controlling the operation of the medical device so as to control a degree of CO2 removal obtained by the ECLA treatment; and a bioelectric sensor detecting a bioelectric signal indicative of the patient's efforts to breathe. The at least one control unit is configured to control the operation of the medical device based on the detected bioelectric signal.
1. A system for carbon dioxide (CO2) removal from a circulatory system of a patient, comprising:
an extracorporeal lung assist (ECLA) device providing an ECLA treatment to the patient through extracorporeal removal of CO2 from the patient's blood, the ECLA device being configured to generate an extracorporeal flow of blood from the patient, oxygenating the blood through extracorporeal gas exchange in which CO2 is removed from, and oxygen added to, the extracorporeal blood flow;
at least one control unit controlling an operation of the ECLA device so as to control a degree of CO2 removal obtained by the ECLA treatment; and
a bioelectric sensor detecting an electromyographic (EMG) signal representing an electrical activity of a diaphragm or muscles in an upper airway of the patient and indicative of efforts of a respiratory drive of the patient,
wherein the at least one control unit is configured to control the operation of the ECLA device to adjust the degree of CO2 removal obtained by the ECLA treatment based on the detected EMG signal, wherein the at least one control unit is configured to increase the degree of CO2 removal obtained by the ECLA treatment when one of an amplitude and a frequency of the EMG signal exceeds a predetermined threshold value or increases over time.
2. The system according to claim 1 , further comprising:
a ventilator providing respiratory treatment to the patient through a supply of breathing gas to lungs of the patient,
wherein the at least one control unit is configured to control the operation of the ECLA device based on the EMG signal and a current level of ventilation of the patient provided by the ventilator.
3. The system according to claim 2 , wherein the at least one control unit is configured to determine the current level of ventilation of the patient from (a) a tidal volume and/or a peak pressure currently being delivered to the patient by the ventilator and/or (b) a bodyweight of the patient.
4. The system according to claim 2 , wherein the at least one control unit is configured to control the ECLA device so as to increase the degree of CO2 removal obtained by the ECLA treatment when one of the amplitude and the frequency of the EMG signal exceeds the predetermined threshold value or increases over time, and the current level of ventilation substantially corresponds to, or exceeds, one of (a) a predetermined threshold level of ventilation of the patient and (b) a maximum level of ventilation of the patient.
5. The system according to claim 2 , wherein the at least one control unit is further configured to control the operation of the ventilator so as to control a degree of CO 2 removal obtained by the respiratory treatment based on the EMG signal.
6. The system according to claim 5 , wherein the at least one control unit is configured to control the ventilator so as to increase the degree of CO2 removal obtained by the respiratory treatment when one of the amplitude and the frequency of the EMG signal exceeds the predetermined threshold value or increases over time, and the current level of ventilation is below one of (a) a predetermined threshold level of ventilation of the patient and (b) a maximum level of ventilation of the patient.
7. The system according to claim 1 , wherein the bioelectric sensor includes an oesophageal catheter carrying a number of electrodes configured to capture the EMG signal from the diaphragm and/or the upper airway muscles of the patient.
8. The system according to claim 1 , wherein the at least one control unit is configured to control the operation of the ECLA device by controlling the extracorporeal blood flow generated by the ECLA device, a flow of fresh gas for extracorporeal blood oxygenation, and/or a composition of the fresh gas for extracorporeal blood oxygenation, based on the EMG signal.
9. An extracorporeal lung assist (ECLA) device for providing ECLA treatment to a patient through an extracorporeal removal of carbon dioxide (CO2) from blood of a patient, the ECLA device being configured to generate an extracorporeal flow of blood from the patient, oxygenating the blood through extracorporeal gas exchange in which CO2 is removed from, and oxygen added to, the extracorporeal blood flow, the ECLA device comprising:
a control unit controlling an operation of the ECLA device so as to control a degree of CO2 removal obtained by the ECLA treatment,
wherein the control unit is configured to control the operation of the ECLA device to adjust a degree of CO2 removal obtained by the ECLA treatment based on an electromyographic (EMG) signal representing an electrical activity of a diaphragm or muscles in an upper airway of the patient and indicative of a respiratory drive of the patient, wherein the at least one control unit is configured to increase the degree of CO2 removal obtained by the ECLA treatment when one of an amplitude and a frequency of the EMG signal exceeds a predetermined threshold value or increases over time.
10. A method for carbon dioxide (CO2) removal from a circulatory system of a patient, comprising the step of:
controlling an operation of an extracorporeal lung assist (ECLA) device providing an ECLA treatment to the patient through an extracorporeal removal of CO2 from blood of the patient so as to control a degree of CO2 removal obtained by the ECLA treatment, wherein the ECLA device is configured to generate an extracorporeal flow of blood from patient, oxygenating the blood through extracorporeal gas exchange in which CO2 is removed from, and oxygen added to, the extracorporeal blood flow;
registering an electromyographic (EMG) signal representing an electrical activity of a diaphragm or muscles in an upper airway of the patient and indicative of the respiratory drive of the patient; and
automatically controlling the operation of the ECLA device to adjust the degree of CO2 removal obtained by the ECLA treatment based on the registered EMG signal, wherein automatically controlling the operation of the ECLA device includes increasing the degree of CO2 removal obtained by the ECLA device when one of an amplitude and a frequency of the EMG signal exceeds a predetermined threshold value or increases over time.
11. The method according to claim 10 , further comprising the step of:
automatically controlling the operation of the ECLA device based on the EMG signal and a current level of ventilation of the patient, provided by a ventilator providing respiratory treatment to the patient through the supply of breathing gas to the patient's lungs.
12. The method according to claim 11 , wherein the current level of ventilation is determined from (a) a tidal volume and/or a peak pressure currently being delivered to the patient by the ventilator and/or (b) a bodyweight of the patient.
13. (Withdrawn, Currently Amended) The method according to claim 11 , further comprising the step of:
automatically controlling the ECLA device so as to increase the degree of CO2 removal obtained by the ECLA treatment when one of the amplitude and the frequency of the EMG signal exceeds the predetermined threshold value or increases over time, and the current level of ventilation substantially corresponds to, or exceeds, one of (a) a predetermined threshold level of ventilation of the patient and (b) a maximum level of ventilation of the patient.
14. The method according to claims 11 , further comprising the step of:
automatically controlling the operation of the ventilator so as to control a degree of CO2 removal obtained by the respiratory treatment based on the EMG signal.
15. The method according to claim 14 , further comprising the step of:
automatically controlling the ventilator so as to increase the degree of CO2 removal obtained by the respiratory treatment when one of the amplitude and the frequency of the EMG signal exceeds the predetermined threshold value or increases over time, and the current level of ventilation is below one of (a) a predetermined threshold level of ventilation of the patient and (b) a maximum level of ventilation of the patient.
16. The method according to claim 10 , wherein the operation of the ECLA device is controlled by controlling the extracorporeal blood flow generated by the ECLA device, a flow of fresh gas for extracorporeal blood oxygenation, and/or a composition of the fresh gas for extracorporeal blood oxygenation based on the EMG signal.