Methods for prevention, moderation, and/or treatment of cognitive injury

Abstract

This disclosure describes methods and systems for preventing, moderating, and/or treating brain injury. The methods herein may include obtaining a test result reflecting a condition of a brain in the subject, determining a stimulation parameter based on the test result, and stimulating a nerve based on the stimulation parameter, wherein stimulation of the nerve assists or causes contraction of a respiratory muscle in the subject. The systems herein may include a processor configured to: receive a test result reflecting a condition of a brain in a subject, and determine a stimulation parameter based on the test result; and a stimulator configured to stimulate a nerve based on the stimulation parameter, wherein stimulation of the nerve assists or causes contraction of a respiratory muscle in the subject.

1 - 46 . (canceled) 
     
     
         47 . A method for treating a subject, the method comprising:
 providing positive pressure ventilation to the subject via an external respiratory support device;   stimulating a nerve via a first pulsed electrical signal transmitted from at least one electrode, thereby generating negative pressure in a thoracic cavity of the subject; and   sending a signal to the at least one electrode via a remote controller, the signal inducing the at least one electrode to stimulate the nerve via a second electrical signal.   
     
     
         48 . The method of  claim 47 , wherein the first electrical signal and the second electrical signal each has an amplitude, a frequency, a pulse width, and a duration of stimulation, and at least one of the amplitude, the frequency, the pulse width, or the duration of stimulation of the first electrical signal is different than the amplitude, the frequency, the pulse width, or the duration of stimulation of the second electrical signal. 
     
     
         49 . The method of  claim 47 , further comprising activation of the hand-held remote controller to stop stimulation of the nerve by the at least one electrode. 
     
     
         50 . The method of  claim 47 , further comprising activation of the hand-held remote controller to initiate stimulation of the nerve by the at least one electrode. 
     
     
         51 . The method of  claim 47 , wherein stimulating the nerve via the second electrical signal creates a magnitude of negative pressure in the thoracic cavity greater than a magnitude of negative pressure in the thoracic cavity by the first electrical signal. 
     
     
         52 . The method of  claim 47 , wherein the remote controller comprises a hand switch, a voice-activated switch, a touch-activated switch, a pressure-activated switch, a wireless remote, or a combination thereof. 
     
     
         53 . The method of  claim 47 , wherein the signal is transmitted from the remote controller, through a control unit in communication with the external respiratory support device, to the at least one electrode. 
     
     
         54 . The method of  claim 47 , wherein the external respiratory support device includes mechanical ventilation, non-invasive ventilation, continuous positive airway pressure (CPAP), nasal cannula oxygenation, bilevel positive airway pressure (BiPAP), or extracorporeal membrane oxygenation (ECMO). 
     
     
         55 . The method of  claim 47 , further including detecting a respiratory event of the subject. 
     
     
         56 . The method of  claim 55 , wherein the respiratory event is detected by manual palpitation, a sensor in contact with the subject's skin, an electrode measuring an impedance, an airway pressure sensor in the external respiratory support device, or combinations thereof. 
     
     
         57 . The method of  claim 56 , wherein the signal is sent via the hand-held remote controller at the start of the detected respiratory event, the end of the detected respiratory event, or both. 
     
     
         58 . A method of treating a subject, the method comprising:
 providing positive pressure ventilation to the subject via an external respiratory support device;   stimulating a nerve via an electrical signal transmitted from at least one electrode, thereby generating negative pressure in a thoracic cavity of the subject;   determining a condition of the subject; and   based on the condition of the subject, adjusting a frequency, an amplitude, a pulse width, a duration of stimulation, or a combination thereof, of the electrical signal.   
     
     
         59 . The method of  claim 58 , further comprising, based on the condition of the subject, adjusting the positive pressure ventilation. 
     
     
         60 . The method of  claim 58 , wherein determining a condition of the subject comprises measuring a heart blood flow, measuring a peripheral blood flow, measuring a blood pressure, measuring a blood gas concentration, measuring a blood concentration of an inflammatory agent, imaging, determining a pressure, determining an airflow, determining a tidal volume, or a combination thereof. 
     
     
         61 . The method of  claim 58 , wherein the nerve is a phrenic nerve. 
     
     
         62 . The method of  claim 58 , wherein the nerve is stimulated  1  out of every x breaths of the subject, where x is 1 to 10,000. 
     
     
         63 . The method of  claim 58 , further comprising determining the start of a respiratory event, the end of a respiratory event, or both. 
     
     
         64 . A method for treating a subject, the method comprising:
 providing positive pressure ventilation to the subject via an external respiratory support device;   stimulating a nerve via a first pulsed electrical signal transmitted from at least one electrode, thereby generating negative pressure in a thoracic cavity of the subject;   determining the start of a respiratory event, the end of a respiratory event, or both;   determining a condition of the subject; and   based on the condition of the subject, determining a frequency, an amplitude, a pulse width, a duration of stimulation, or a combination thereof, of a second pulsed electrical signal; and   sending a signal to the at least one electrode via a remote controller, the signal inducing the at least one electrode to stimulate the nerve via the second pulsed electrical signal.   
     
     
         65 . The method of  claim 64 , wherein determining a condition of the subject comprises measuring a heart blood flow, measuring a peripheral blood flow, measuring a blood pressure, measuring a blood gas concentration, measuring a blood concentration of an inflammatory agent, imaging, determining a pressure, determining an airflow, determining a tidal volume, or a combination thereof. 
     
     
         66 . The method of  claim 64 , wherein the nerve is a phrenic nerve, and the method further comprises, based on the condition of the subject, adjusting the positive pressure ventilation.