Methods and devices for improving breathing in patients with pulmonary disease

Abstract

Methods, apparatus, and kits for enhancing breathing in patients suffering from chronic pulmonary obstructive disease are described. The methods and apparatus rely on increasing flow resistance to expiration in a manner which mimics “pursed lip” breathing which has been found to benefit patients suffering from this disease. In a first example, a device is implanted in a trachea or bronchial passage to increase flow resistance, preferably selectively increase resistance to expiration relative to inspiration. In a second embodiment, a mouthpiece is provided, again to increase resistance to expiration, preferably with a lesser increase in flow resistance to inspiration. In a third embodiment, the patient's trachea or bronchial passage is modified by the application of energy in order to partially close the lumen therethrough.

1 . A device for partially occluding an expiratory airway in a patient, the device comprising: a frame implantable within a trachea or bronchial passage; and means on the frame for increasing flow resistance to expiration.  
   
   
       2 . The device of  claim 1  wherein the means selectively increases flow resistance to expiration while increasing resistance to inspiration to a lesser extent.  
   
   
       3 . The device of  claim 2  wherein the means comprises a flow responsive element which opens to inspiration and closes to expiration.  
   
   
       4 . The device of  claim 1  wherein the means comprises a fixed element.  
   
   
       5 . A method for treating patients suffering from chronic obstructive pulmonary disease, the method comprising: creating a resistance to expiratory flow in a tracheal or bronchial passage.  
   
   
       6 . The method of  claim 5  wherein the step of creating includes the step of implanting a flow resistor in the trachea or bronchial passage.  
   
   
       7 . The method of  claim 6  wherein the flow resistor comprises an implantable frame and means on the frame for selectively increasing flow resistance to expiration.  
   
   
       8 . The method of  claim 5  wherein the step of creating includes the step of applying energy to the trachea or bronchial passage to partially occlude the lumen of the passage.  
   
   
       9 . A device that partially occludes an expiratory airway in a patient, the device including a flow resistance element implantable within one of the trachea and a bronchi of the patient.  
   
   
       10 . The device of  claim 9  wherein the flow resistance element provides a first flow resistance to inspiration and a second flow resistance to expiration, the second flow resistance being greater than the first flow resistance.  
   
   
       11 . The device of  claim 9  wherein the flow resistance element comprises a valve.  
   
   
       12 . The device of  claim 11  further including a frame that supports the valve.  
   
   
       13 . The device of  claim 9  wherein the flow resistance element provides a first flow resistance to air flow from proximal airways to distal airways, a second flow resistance to first air flow from distal airways to proximal airways, and a third flow resistance to second air flow from distal airways to proximal airways, wherein the second flow resistance is greater than the third flow resistance and the second airflow from distal airways to proximal airways is greater than the first airflow from distal airways to proximal airways.  
   
   
       14 . The device of  claim 13  wherein the third flow resistance is greater than the first flow resistance.