CA1302505C - Computer gated positive exporatory pressure system - Google Patents
Computer gated positive exporatory pressure systemInfo
- Publication number
- CA1302505C CA1302505C CA000533497A CA533497A CA1302505C CA 1302505 C CA1302505 C CA 1302505C CA 000533497 A CA000533497 A CA 000533497A CA 533497 A CA533497 A CA 533497A CA 1302505 C CA1302505 C CA 1302505C
- Authority
- CA
- Canada
- Prior art keywords
- pressure
- patient
- valve
- controlling
- computing
- 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.)
- Expired - Fee Related
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES 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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
- A61M16/022—Control means therefor
- A61M16/024—Control means therefor including calculation means, e.g. using a processor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES 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
- A61M2230/00—Measuring parameters of the user
- A61M2230/04—Heartbeat characteristics, e.g. ECG, blood pressure modulation
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Veterinary Medicine (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Pulmonology (AREA)
- Public Health (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Emergency Medicine (AREA)
- Cardiology (AREA)
- Physiology (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
- Medical Informatics (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Percussion Or Vibration Massage (AREA)
- Respiratory Apparatuses And Protective Means (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
- External Artificial Organs (AREA)
Abstract
ABSTRACT
A gating system is provided for controlling a ventilator means, which, in turn, generates a positive pressure breath. The systems including a sensing means for sensing sequential heart beats of a patient, together with a computing means, which is connected to the sensing means, for computing a period between the sequential heart beats. In addition to the above, a valve means is connected electrically to the computing means and pneumatically to the ventilator means for controlling the ventilator means, with the valve means being positioned to cease positive pressure breaths in response to the computed period.
A gating system is provided for controlling a ventilator means, which, in turn, generates a positive pressure breath. The systems including a sensing means for sensing sequential heart beats of a patient, together with a computing means, which is connected to the sensing means, for computing a period between the sequential heart beats. In addition to the above, a valve means is connected electrically to the computing means and pneumatically to the ventilator means for controlling the ventilator means, with the valve means being positioned to cease positive pressure breaths in response to the computed period.
Description
~L3~2~
TITLE OF TH IN~7~NTIO~
Computer ~ated Positive Exporatory Pressure System BACKGROUND
~hen breathing normally, one's diaphragm is dropped to increase one's thoracic cavity, thus creating a negative pressure in the thoracic cavity, relatiJe to atmospheric pressure. Air is driven by the atmospheric pressure into the negative-pressure thoracic ca~ity. Many patients, such as victims of accidents suffering from shock, trauma or heart attack, may require a respirator or ventilator to aid breathin~. Prior respirators used intermittent, positive pressure breaths to increase the pressure within a patient's lungs until filled. Air is expelled passively by the natural stiffness of the lungs.
Such respirators drive a positive pressure breath into the lungs which are already at atmospheric pressure. The pressure in the lungs is increased above atmospheric pressure, contrary to normal occurrence, which inhibits the heart's ability to pump blood. During normally respiration, negative thoracic pressure is developed upon inspiration of air, which aids in filling the heart with blood. The resultant pressure gradient (the relatively positive pressure in the periphery and ne~ative ,.1 ~3~
pressure in the thora~) helps to ill the heart as it opens, sub~equent to the heart~s squeezing or pumping motion. I f ho~ever, the pressure in the thoracic chamber is increase~, as with respirators, the amount of blood returning or entering the heart is decreased~ The heart also must squeeze against a higher pressure. A lo~er cardiac output results.
The common technique for improving arterial oxygen tension is the use of Positive-End-Expiratory Pressure (PEEP)~
where a low level of positive pressure is maintained in the airway between positive pressure breaths. PEEP uses a standard switch. A pressure signal applied to the valve controls the high or low pressure states of the valve. The low PEEP state is generated when the valve is fully open. A partial clo~ing of the valve creates high intrathoracic pressure hetween breaths, as some air from the tedal volume is not allowed to escape.
However, at 10 centimeters of water pressure of PEEP, cardiac output drops significantl~. Intravenous fluids are used to increase intravascular volume in an effort to minimize this fall in cardiac output. The patient may already have compromised cardiac function, minimizing or negating the advantages of the intravascular volùme increase. Additionally, patients requiring respirators typically lack adequate kidney function and cannot process the added fluids. If too much intravenous fluid is used, relative to the patientls ability (aided or not) to process the fluid, the fluid may enter the patient's lungs.
- . - .
Positive inotropic ag~nts are used to increase the squeeze of the heart to pump more blood. Obviously, the heart ~orks harder than normal resulting in possible heart attac~s or arrhythmias. Often, physicians will prescribe a com~ination of increased intravenous fluids and positi~Te inotropic agents with PEEP.
Several in~estigators have evaluated the effect of cardiac cycle-specified, increases in thoracic pressure on cardiac output. They synchronized high frequency jet ventilation to various phases of the R-R interval. Carlson and Pinsky found that the cardiac depressant effect of positive pressure ventilation is m~nimized if the positive pressure pulsations are synchronized with diastole. Otto and Tyson, however, found no significant changes in cardiac output while synchronizing positive pressure pulsations to various portions of the cardiac cycle.
Pinchak described the best frequency in high frequency jet ventilation. He also noticed rhythmic oscillations in pulmonary artery pressure ~PAP) and also rhythmic changes in systemic blood pressure. A possible explanation for these oscillations is that the jet pulsations move in and out of synchrony with the heart rate. In evaluating his data it appears that when jet airway pressure peak occurred during early systole there ~as a high pulmonary artery pressure, and a low systemic blood pressure. While Pinchak does not comment on this, his . ~
.. " '.~ .
, ~L3~}2~?S
recorded data show that pulmonary artery pressure ~a~ waxing and waning precisely opposite to the blood pressure. A plausi~le explanation is an increase in pulmonary artery pressure is simply a reflection of an increase in pulmonary vascular resistance which causes a decrement in left ventricular filling and thus decrease in systemic blood pressure secondary to a decrease in cardiac output. If the slight oscillations in the systemic blood pressure reflect oscillations in cardiac output, then Pinchak's study would support Pinsky and Carlson's work, suggesting that positive airway pressure is least detrimental during diastole.
SU~ARY OF THE I~VENTION
The inven~ion concerns a computer-gated, positive expiratory pressure system for supplementing positive end-expiratory pressure (PEEP) systems. The output of a cardiogram machine is amplified and squared, or an LED of a cardiogram machine is optically monitored, to determine an R-wave, or the beginning of electrical systole. A signal is fed to a multiplier where the R-R wave signal ~period) is multiplied representing the duration of the R-R wave with a variable interval set by a ph~sician. The resultant produce ~R-~ wave times variable interval) is used to trigger a solenoid operated 3-way valve. The 3-way valve is normally closed to pass a positive pressure to a standard PEEP valve which functions normally. When triggered, the 3-way valve opens to allow a ~3~ S
relatively low pressure to pass to the PEEP valve such that the PEEP valve creates a 1~ pressure to the patient.
Thus, PEEP is removed Eor a variable time ratio immediatel~ before a next heart beat. The PEEP valve is controlled by computer gating a 3-way valve to create pressure drops, allowing the heart to fill. Once the heart fills, PEEP is resumed without any detrimental effects~ Respiration of the patient is coordinated ~ith the patient's heart beat to maximize cardiac output. Additionally pressure can be replaced immediately after drop out in an effort to improve emptying of the heart.
BRIEF DESCRIPTION OF THE DRAI~INGS
Figure 1 is a schematic of the present invention in its environment.
Figure 2 is a block diagram of the Figure 1 microcomputer contents, as connected to a 3-way valve.
Figure 3 reveals a second embodiment for detecting a heart beat interval.
DETAILED DESCRIPTION OF THE INVENTION
The computer-gated, positive expiratory pressure system is shown in Figure 1 in its environment, connected to 2 therapeutic device such as a PEEP system. A patient 10 is shown usin~ a respirator or ventilator 12 via a standard expiratory ~3~
~PEEP3 valve 14. The PEEP valve 14 opens and closes to allow low and high pressures to the patient 10. In accordance with the present invention, the patient lO is also connected to a cardiogram machine ( ~) 16. Successive heart beats are detected b~ the EKG 16 and a signal representing each beat is output to a microcomputer 18, the details of which are discussed regarding Figures 2 and 3. A variable inter~al is generated ~y generator 20 as a second input to the microcomputer 18, the value of the interval being set by the attending physician. Th~ microcomputer 18 combines the variable interval signal from 20 and a value representing the period between successi~e heart beats from EKG
16 and generates a controlling output to a solenoid 22 of a 3-way valve 24. The 3-way valve 24 is connected by a first end to a positive pressure source 26. A second valve end is pneumatically connected to a lo~ relative pressure 28, while a third end is connected to the PEEP valve 14 via ~hich the patient lO received the positive pressure breaths.
Under normal operation of the ventilator 12, the PEEP
valve 14 is operated to allow alternate low and high positive pressure breaths (approximately .4 psi) from the ventilator 12 to pass directly to the patient 10. However, in response to the output of microcomputer 18, the solenoid 22 is energized to yield at output 30, a negative pressure from the low relati~e pressure source 28. The negative pressure output at 30 opens ~he PEEP
valve 14~ Because the PEEP valve 14 is fully opened, a low ', . .
;.
~3q~2S~
pressure is received by the patient 10 from the ventilator 12.
The resultant low pressure, in accordance with the present invention, occurs just prior to a predicted heart beat to insure the heart, when filling, does not ~ork against high pressuresO
PEEP systems per se too often generate high pressures when the heart beats, inhibiting heart filling and decreasing car~iac output.
In Figure 2, the details of microcomputer 18 are evident. The output of EKG 16 is run through an operational amplifier 32 to a timer 34 which squares the amplified EKG signal to develop a series of electrical pulses corresponding to successive heart beats. The electrical pulses of timer 34 are received by memory/calculator 36 which determines a period representing the interval between successive heart beats. This period is used to pred ct a next heart beat so a low pressure is delivered to the patient slightly before and during this next heart beat. The variable interval generator 20 is set by the attending physician between 15 and 400 microseconds, for instance, by typical anolog controls. The variable interval signal from 20 and the period signal from calculator 35 are used to generate a produce in multiplier 38. The resultant product is used as a signal to energize the solenoid 32, to control 3-way valve 24.
In a normal state, 3-way valve 24 connects the positive pressure 26 to the output 30, putting PEEP valve 14 in a ~3~
partially closed posltion. Thus, the ventilator 12 can genér~te a high, positive pressure breath to the patient 10. However, assume the E~G 16 detects a heart beat each second. The EKG
signal is amplified at 32, squared by ti~er 34, and the period of one second calculated in memory 36. If the variable interval generator is set by the physician for 0.8 second, multiplier 38 forms a product of the period and variable interval (1.0 x 0.8) equal to 0.8 seconds. Thus, 0.2 second before the next predicted, heart beat ~0.8 second ~rom the last heart beat) solenoid 22 is energized. The 3-wav valve 24 no~ opens output 30 to the vacuum 28. Accordingly, a resultant negative pressure fully opens the PEEP valve 14 and a low pressure reaches the patient. Should the heart rate vary, the difference bet~.~een predicted and actual heart beats will be detected and pulse timing corrected. The time duration of the pulse to the solenoid is controlled by a second timer (not sho~n).
Figure 3 reveals a second embodiment for determining or sensing heart beats. A photodetector 40 is used to detect the blinking LED 42 which is typically part of a cardioyram machine.
The photodetector ~0, turning on and off with the flash of the LED 42, requires no timer or wave s~uarer, and thus is input directly to the amplifier 32 for subsequent processing in the manner of the Figure 2 embodiment.
Other modifications are apparent to those s~illed ih ~3~IZ~
the art which do not depart from the spirit of the present invention, the scope being defined b~ the appended claims. For instance, rather than use a microcomputer, a microprocessor (e~g.
C 64 Commadore Computer~ may be adapted and soft~are developed to monitor and determine beat period, with a progra~mable variable . interval for use by the physician.
TITLE OF TH IN~7~NTIO~
Computer ~ated Positive Exporatory Pressure System BACKGROUND
~hen breathing normally, one's diaphragm is dropped to increase one's thoracic cavity, thus creating a negative pressure in the thoracic cavity, relatiJe to atmospheric pressure. Air is driven by the atmospheric pressure into the negative-pressure thoracic ca~ity. Many patients, such as victims of accidents suffering from shock, trauma or heart attack, may require a respirator or ventilator to aid breathin~. Prior respirators used intermittent, positive pressure breaths to increase the pressure within a patient's lungs until filled. Air is expelled passively by the natural stiffness of the lungs.
Such respirators drive a positive pressure breath into the lungs which are already at atmospheric pressure. The pressure in the lungs is increased above atmospheric pressure, contrary to normal occurrence, which inhibits the heart's ability to pump blood. During normally respiration, negative thoracic pressure is developed upon inspiration of air, which aids in filling the heart with blood. The resultant pressure gradient (the relatively positive pressure in the periphery and ne~ative ,.1 ~3~
pressure in the thora~) helps to ill the heart as it opens, sub~equent to the heart~s squeezing or pumping motion. I f ho~ever, the pressure in the thoracic chamber is increase~, as with respirators, the amount of blood returning or entering the heart is decreased~ The heart also must squeeze against a higher pressure. A lo~er cardiac output results.
The common technique for improving arterial oxygen tension is the use of Positive-End-Expiratory Pressure (PEEP)~
where a low level of positive pressure is maintained in the airway between positive pressure breaths. PEEP uses a standard switch. A pressure signal applied to the valve controls the high or low pressure states of the valve. The low PEEP state is generated when the valve is fully open. A partial clo~ing of the valve creates high intrathoracic pressure hetween breaths, as some air from the tedal volume is not allowed to escape.
However, at 10 centimeters of water pressure of PEEP, cardiac output drops significantl~. Intravenous fluids are used to increase intravascular volume in an effort to minimize this fall in cardiac output. The patient may already have compromised cardiac function, minimizing or negating the advantages of the intravascular volùme increase. Additionally, patients requiring respirators typically lack adequate kidney function and cannot process the added fluids. If too much intravenous fluid is used, relative to the patientls ability (aided or not) to process the fluid, the fluid may enter the patient's lungs.
- . - .
Positive inotropic ag~nts are used to increase the squeeze of the heart to pump more blood. Obviously, the heart ~orks harder than normal resulting in possible heart attac~s or arrhythmias. Often, physicians will prescribe a com~ination of increased intravenous fluids and positi~Te inotropic agents with PEEP.
Several in~estigators have evaluated the effect of cardiac cycle-specified, increases in thoracic pressure on cardiac output. They synchronized high frequency jet ventilation to various phases of the R-R interval. Carlson and Pinsky found that the cardiac depressant effect of positive pressure ventilation is m~nimized if the positive pressure pulsations are synchronized with diastole. Otto and Tyson, however, found no significant changes in cardiac output while synchronizing positive pressure pulsations to various portions of the cardiac cycle.
Pinchak described the best frequency in high frequency jet ventilation. He also noticed rhythmic oscillations in pulmonary artery pressure ~PAP) and also rhythmic changes in systemic blood pressure. A possible explanation for these oscillations is that the jet pulsations move in and out of synchrony with the heart rate. In evaluating his data it appears that when jet airway pressure peak occurred during early systole there ~as a high pulmonary artery pressure, and a low systemic blood pressure. While Pinchak does not comment on this, his . ~
.. " '.~ .
, ~L3~}2~?S
recorded data show that pulmonary artery pressure ~a~ waxing and waning precisely opposite to the blood pressure. A plausi~le explanation is an increase in pulmonary artery pressure is simply a reflection of an increase in pulmonary vascular resistance which causes a decrement in left ventricular filling and thus decrease in systemic blood pressure secondary to a decrease in cardiac output. If the slight oscillations in the systemic blood pressure reflect oscillations in cardiac output, then Pinchak's study would support Pinsky and Carlson's work, suggesting that positive airway pressure is least detrimental during diastole.
SU~ARY OF THE I~VENTION
The inven~ion concerns a computer-gated, positive expiratory pressure system for supplementing positive end-expiratory pressure (PEEP) systems. The output of a cardiogram machine is amplified and squared, or an LED of a cardiogram machine is optically monitored, to determine an R-wave, or the beginning of electrical systole. A signal is fed to a multiplier where the R-R wave signal ~period) is multiplied representing the duration of the R-R wave with a variable interval set by a ph~sician. The resultant produce ~R-~ wave times variable interval) is used to trigger a solenoid operated 3-way valve. The 3-way valve is normally closed to pass a positive pressure to a standard PEEP valve which functions normally. When triggered, the 3-way valve opens to allow a ~3~ S
relatively low pressure to pass to the PEEP valve such that the PEEP valve creates a 1~ pressure to the patient.
Thus, PEEP is removed Eor a variable time ratio immediatel~ before a next heart beat. The PEEP valve is controlled by computer gating a 3-way valve to create pressure drops, allowing the heart to fill. Once the heart fills, PEEP is resumed without any detrimental effects~ Respiration of the patient is coordinated ~ith the patient's heart beat to maximize cardiac output. Additionally pressure can be replaced immediately after drop out in an effort to improve emptying of the heart.
BRIEF DESCRIPTION OF THE DRAI~INGS
Figure 1 is a schematic of the present invention in its environment.
Figure 2 is a block diagram of the Figure 1 microcomputer contents, as connected to a 3-way valve.
Figure 3 reveals a second embodiment for detecting a heart beat interval.
DETAILED DESCRIPTION OF THE INVENTION
The computer-gated, positive expiratory pressure system is shown in Figure 1 in its environment, connected to 2 therapeutic device such as a PEEP system. A patient 10 is shown usin~ a respirator or ventilator 12 via a standard expiratory ~3~
~PEEP3 valve 14. The PEEP valve 14 opens and closes to allow low and high pressures to the patient 10. In accordance with the present invention, the patient lO is also connected to a cardiogram machine ( ~) 16. Successive heart beats are detected b~ the EKG 16 and a signal representing each beat is output to a microcomputer 18, the details of which are discussed regarding Figures 2 and 3. A variable inter~al is generated ~y generator 20 as a second input to the microcomputer 18, the value of the interval being set by the attending physician. Th~ microcomputer 18 combines the variable interval signal from 20 and a value representing the period between successi~e heart beats from EKG
16 and generates a controlling output to a solenoid 22 of a 3-way valve 24. The 3-way valve 24 is connected by a first end to a positive pressure source 26. A second valve end is pneumatically connected to a lo~ relative pressure 28, while a third end is connected to the PEEP valve 14 via ~hich the patient lO received the positive pressure breaths.
Under normal operation of the ventilator 12, the PEEP
valve 14 is operated to allow alternate low and high positive pressure breaths (approximately .4 psi) from the ventilator 12 to pass directly to the patient 10. However, in response to the output of microcomputer 18, the solenoid 22 is energized to yield at output 30, a negative pressure from the low relati~e pressure source 28. The negative pressure output at 30 opens ~he PEEP
valve 14~ Because the PEEP valve 14 is fully opened, a low ', . .
;.
~3q~2S~
pressure is received by the patient 10 from the ventilator 12.
The resultant low pressure, in accordance with the present invention, occurs just prior to a predicted heart beat to insure the heart, when filling, does not ~ork against high pressuresO
PEEP systems per se too often generate high pressures when the heart beats, inhibiting heart filling and decreasing car~iac output.
In Figure 2, the details of microcomputer 18 are evident. The output of EKG 16 is run through an operational amplifier 32 to a timer 34 which squares the amplified EKG signal to develop a series of electrical pulses corresponding to successive heart beats. The electrical pulses of timer 34 are received by memory/calculator 36 which determines a period representing the interval between successive heart beats. This period is used to pred ct a next heart beat so a low pressure is delivered to the patient slightly before and during this next heart beat. The variable interval generator 20 is set by the attending physician between 15 and 400 microseconds, for instance, by typical anolog controls. The variable interval signal from 20 and the period signal from calculator 35 are used to generate a produce in multiplier 38. The resultant product is used as a signal to energize the solenoid 32, to control 3-way valve 24.
In a normal state, 3-way valve 24 connects the positive pressure 26 to the output 30, putting PEEP valve 14 in a ~3~
partially closed posltion. Thus, the ventilator 12 can genér~te a high, positive pressure breath to the patient 10. However, assume the E~G 16 detects a heart beat each second. The EKG
signal is amplified at 32, squared by ti~er 34, and the period of one second calculated in memory 36. If the variable interval generator is set by the physician for 0.8 second, multiplier 38 forms a product of the period and variable interval (1.0 x 0.8) equal to 0.8 seconds. Thus, 0.2 second before the next predicted, heart beat ~0.8 second ~rom the last heart beat) solenoid 22 is energized. The 3-wav valve 24 no~ opens output 30 to the vacuum 28. Accordingly, a resultant negative pressure fully opens the PEEP valve 14 and a low pressure reaches the patient. Should the heart rate vary, the difference bet~.~een predicted and actual heart beats will be detected and pulse timing corrected. The time duration of the pulse to the solenoid is controlled by a second timer (not sho~n).
Figure 3 reveals a second embodiment for determining or sensing heart beats. A photodetector 40 is used to detect the blinking LED 42 which is typically part of a cardioyram machine.
The photodetector ~0, turning on and off with the flash of the LED 42, requires no timer or wave s~uarer, and thus is input directly to the amplifier 32 for subsequent processing in the manner of the Figure 2 embodiment.
Other modifications are apparent to those s~illed ih ~3~IZ~
the art which do not depart from the spirit of the present invention, the scope being defined b~ the appended claims. For instance, rather than use a microcomputer, a microprocessor (e~g.
C 64 Commadore Computer~ may be adapted and soft~are developed to monitor and determine beat period, with a progra~mable variable . interval for use by the physician.
Claims (20)
1. A computer-gated positive expiratory pressure system for controlling a pressure breath of a patient, comprising, a sensing means for sensing sequential heart beats of a patient;
a computing means connected to said sensing means for computing a period of the sequential heart beats of said patient;
a ventilator means, a first valve means connected electronically to said computing means, a second valve means connected pneumatically to said ventilator means for controlling the pressure in said ventilator means, with said second valve means being positioned by said first valve means to cut off pressure breaths in response to the computed period.
a computing means connected to said sensing means for computing a period of the sequential heart beats of said patient;
a ventilator means, a first valve means connected electronically to said computing means, a second valve means connected pneumatically to said ventilator means for controlling the pressure in said ventilator means, with said second valve means being positioned by said first valve means to cut off pressure breaths in response to the computed period.
2. A computer-gated positive expiratory pressure system for controlling a pressure breath of a patient recited as in claim 1 and additionally a vacuum means pneumatically connected to said first valve means for generating a low pressure to the ventilator means through said second valve means.
3. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 2, including a pressure means, said first valve means comprising a 3-way valve having first, second and third ends, with said first end being connected pneumatically to said ventilator means, the second end being connected to said vacuum means, and the third end being connected to said pressure means.
4. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 3, with said 3-way valve means having a solenoid electrically connected to said computing means, with said computing means positioning said 3-way valve means.
5. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 2, including a variable interval means connected to said computing means for generating a variable interval signal to said computing means.
6. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 5, said computing means having a multiplier connected to said sensing means and said variable interval means for generating a product signal based on the computed period times the variable interval signal.
7. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 6, said ventilator means having a gated valve means pneumatically connected to the first end of said second valve means, said gated valve means being opened by a drop in pneumatic pressure controlled by said second valve means being pneumatically connected to said relative low pressure source means to said ventilator means, said gated valve means being closed by the positive pneumatic pressure controlled connection of said second valve means pneumatic connection to said positive pressure means to said ventilator means.
8. A computer gated pressure system for controlling a pressure breath of a patient, comprising, a pneumatic means through which a fluid may flow;
a sensing means for sensing sequential heart beats of a patient and generating beat signals;
a computing means connected to said sensing means to receive said sensed heart beat signals and for computing a period between said sequential heart beat signals and generating a period signal;
a means for generating a variable interval signal;
a therapeutic means;
a first valve means connected to said therapeutic means through said pneumatic means;
a second valve means connected to said computing means and connected pneumatically to said first valve means;
said computing means being connected to receive and combine said period signal and said variable interval signal, said computing means also being connected to said second valve means for controlling said second valve means in response to the combined period signal and variable interval signal; and a low pressure source means pneumatically connected to said second valve means for creating a negative pressure relative to atmospheric pressure when said computing means is opened.
a sensing means for sensing sequential heart beats of a patient and generating beat signals;
a computing means connected to said sensing means to receive said sensed heart beat signals and for computing a period between said sequential heart beat signals and generating a period signal;
a means for generating a variable interval signal;
a therapeutic means;
a first valve means connected to said therapeutic means through said pneumatic means;
a second valve means connected to said computing means and connected pneumatically to said first valve means;
said computing means being connected to receive and combine said period signal and said variable interval signal, said computing means also being connected to said second valve means for controlling said second valve means in response to the combined period signal and variable interval signal; and a low pressure source means pneumatically connected to said second valve means for creating a negative pressure relative to atmospheric pressure when said computing means is opened.
9. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 8, and additionally a positive pressure means, with said combining means comprising a 3-way valve, said valve having a first end means for connection to said therapeutic device, a second end means for connection to said low pressure source means, and a third end means for connection to said positive pressure means.
10. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 9 wherein said 3-way valve means is provided with solenoid means electronically connected to said computing means for positioning of said 3-way valve means.
11. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 10, said computing means including a multiplying means connected to said sensing means and said variable interval means for generating a product signal based on said computed period times said variable interval signal.
12. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 11, an amplifying means connected to said sensing means for amplifying said heart beat signal.
13. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 12, said computing means including a timing mechanism connected to said amplifying means for squaring said heart beat signal and for generating pulses to said multiplying means.
14 14. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 12, wherein said sensing means includes a photodetector means for detecting light signals in response to said heart beat of a patient, with said photodetector means generating an output to said amplifying means.
15. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient, comprising, a means for sensing sequential heart beats of said patient, a means connected to said sensing means for computing a period of the sequential heart beats of said patient, a ventilator means, a first means connected electronically to said computing means, a second means connected to said ventilator means for controlling the pressure in said ventilator means, with said second means being positioned by said first means to cut off pressure breaths in a patient in response to said computed period.
16. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 15, and additionally a means connected through said computer controlled first means to said second means for generating a low pressure to open said second means in order to allow a drop in pressure in said ventilator means through said second means.
17. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 15, and additionally a positive pressure means pneumatically connected through said computer controlled first valve means to said second valve means for generating a high pressure to close said second valve means in order to allow a return in pressure in said ventilator means through said second valve means.
18. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient, comprising, a sensing means for sensing sequential heart beats of said patient, a computing means connected to said sensing means for computing a period of the sequential heart beats of said patient, a ventilator means, a first valve means connected electronically to said computing means, a second valve means connected pneumatically to said ventilator means for controlling the pressure in said ventilator means, with said second valve means being positioned by said first valve means to cut off positive pressure breaths in a patient in response to said computed period.
19. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 12, and additionally a means connected through said computer controlled first valve means to said second valve means for generating a low pressure to open said second valve means in order to allow a drop in pressure in said ventilator means through said valve second means.
20. A computer gated positive expiratory pressure system for controlling a pressure breath of a patient as recited in claim 19, and additionally a pressure means pneumatically connected through said computer controlled first valve means to said second valve means for generating a high pressure to close said second valve means in order to allow a return in pressure in said ventilator means through said second valve means.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US84594286A | 1986-03-31 | 1986-03-31 | |
| US845,942 | 1986-03-31 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1302505C true CA1302505C (en) | 1992-06-02 |
Family
ID=25296488
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000533497A Expired - Fee Related CA1302505C (en) | 1986-03-31 | 1987-03-31 | Computer gated positive exporatory pressure system |
Country Status (11)
| Country | Link |
|---|---|
| EP (1) | EP0273041A4 (en) |
| JP (2) | JPS63503207A (en) |
| AU (1) | AU598255B2 (en) |
| CA (1) | CA1302505C (en) |
| CH (1) | CH672991A5 (en) |
| DE (1) | DE3790137T1 (en) |
| DK (1) | DK162257C (en) |
| GB (1) | GB2194892B (en) |
| NL (1) | NL8720165A (en) |
| SE (1) | SE459214B (en) |
| WO (1) | WO1987006040A1 (en) |
Families Citing this family (34)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE69421375T2 (en) * | 1994-02-07 | 2000-07-06 | Azriel Perel | Procedure for determining cardiovascular function |
| DE9406407U1 (en) * | 1994-04-18 | 1995-08-17 | Schneider Peter | Oxygen therapy device |
| US8346337B2 (en) | 1998-04-30 | 2013-01-01 | Abbott Diabetes Care Inc. | Analyte monitoring device and methods of use |
| US9066695B2 (en) | 1998-04-30 | 2015-06-30 | Abbott Diabetes Care Inc. | Analyte monitoring device and methods of use |
| US8465425B2 (en) | 1998-04-30 | 2013-06-18 | Abbott Diabetes Care Inc. | Analyte monitoring device and methods of use |
| US6175752B1 (en) | 1998-04-30 | 2001-01-16 | Therasense, Inc. | Analyte monitoring device and methods of use |
| US8480580B2 (en) | 1998-04-30 | 2013-07-09 | Abbott Diabetes Care Inc. | Analyte monitoring device and methods of use |
| US8688188B2 (en) | 1998-04-30 | 2014-04-01 | Abbott Diabetes Care Inc. | Analyte monitoring device and methods of use |
| US8974386B2 (en) | 1998-04-30 | 2015-03-10 | Abbott Diabetes Care Inc. | Analyte monitoring device and methods of use |
| US6949816B2 (en) | 2003-04-21 | 2005-09-27 | Motorola, Inc. | Semiconductor component having first surface area for electrically coupling to a semiconductor chip and second surface area for electrically coupling to a substrate, and method of manufacturing same |
| US6560471B1 (en) | 2001-01-02 | 2003-05-06 | Therasense, Inc. | Analyte monitoring device and methods of use |
| US7041468B2 (en) | 2001-04-02 | 2006-05-09 | Therasense, Inc. | Blood glucose tracking apparatus and methods |
| US8771183B2 (en) | 2004-02-17 | 2014-07-08 | Abbott Diabetes Care Inc. | Method and system for providing data communication in continuous glucose monitoring and management system |
| US7811231B2 (en) | 2002-12-31 | 2010-10-12 | Abbott Diabetes Care Inc. | Continuous glucose monitoring system and methods of use |
| US8066639B2 (en) | 2003-06-10 | 2011-11-29 | Abbott Diabetes Care Inc. | Glucose measuring device for use in personal area network |
| US8112240B2 (en) | 2005-04-29 | 2012-02-07 | Abbott Diabetes Care Inc. | Method and apparatus for providing leak detection in data monitoring and management systems |
| US7766829B2 (en) | 2005-11-04 | 2010-08-03 | Abbott Diabetes Care Inc. | Method and system for providing basal profile modification in analyte monitoring and management systems |
| US7620438B2 (en) | 2006-03-31 | 2009-11-17 | Abbott Diabetes Care Inc. | Method and system for powering an electronic device |
| US8226891B2 (en) | 2006-03-31 | 2012-07-24 | Abbott Diabetes Care Inc. | Analyte monitoring devices and methods therefor |
| US8732188B2 (en) | 2007-02-18 | 2014-05-20 | Abbott Diabetes Care Inc. | Method and system for providing contextual based medication dosage determination |
| US8930203B2 (en) | 2007-02-18 | 2015-01-06 | Abbott Diabetes Care Inc. | Multi-function analyte test device and methods therefor |
| US8123686B2 (en) | 2007-03-01 | 2012-02-28 | Abbott Diabetes Care Inc. | Method and apparatus for providing rolling data in communication systems |
| US8665091B2 (en) | 2007-05-08 | 2014-03-04 | Abbott Diabetes Care Inc. | Method and device for determining elapsed sensor life |
| US8461985B2 (en) | 2007-05-08 | 2013-06-11 | Abbott Diabetes Care Inc. | Analyte monitoring system and methods |
| US7928850B2 (en) | 2007-05-08 | 2011-04-19 | Abbott Diabetes Care Inc. | Analyte monitoring system and methods |
| US8456301B2 (en) | 2007-05-08 | 2013-06-04 | Abbott Diabetes Care Inc. | Analyte monitoring system and methods |
| US8103456B2 (en) | 2009-01-29 | 2012-01-24 | Abbott Diabetes Care Inc. | Method and device for early signal attenuation detection using blood glucose measurements |
| WO2010127050A1 (en) | 2009-04-28 | 2010-11-04 | Abbott Diabetes Care Inc. | Error detection in critical repeating data in a wireless sensor system |
| US9184490B2 (en) | 2009-05-29 | 2015-11-10 | Abbott Diabetes Care Inc. | Medical device antenna systems having external antenna configurations |
| EP2473098A4 (en) | 2009-08-31 | 2014-04-09 | Abbott Diabetes Care Inc | Analyte signal processing device and methods |
| US8993331B2 (en) | 2009-08-31 | 2015-03-31 | Abbott Diabetes Care Inc. | Analyte monitoring system and methods for managing power and noise |
| EP2482720A4 (en) | 2009-09-29 | 2014-04-23 | Abbott Diabetes Care Inc | Method and apparatus for providing notification function in analyte monitoring systems |
| US9980669B2 (en) | 2011-11-07 | 2018-05-29 | Abbott Diabetes Care Inc. | Analyte monitoring device and methods |
| US9968306B2 (en) | 2012-09-17 | 2018-05-15 | Abbott Diabetes Care Inc. | Methods and apparatuses for providing adverse condition notification with enhanced wireless communication range in analyte monitoring systems |
Family Cites Families (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CH571868A5 (en) * | 1973-11-21 | 1976-01-30 | Hoffmann La Roche | |
| US4182366A (en) * | 1976-01-08 | 1980-01-08 | Boehringer John R | Positive end expiratory pressure device |
| DE2746924C2 (en) * | 1977-10-19 | 1982-09-16 | Drägerwerk AG, 2400 Lübeck | Ventilator |
| SE425595B (en) * | 1978-11-29 | 1982-10-18 | Siemens Elema Ab | DEVICE OF A RESPIRATORY DEVICE |
| FR2483785A1 (en) * | 1980-06-10 | 1981-12-11 | Air Liquide | AUTOMATIC VENTILATION CORRECTION RESPIRATOR |
| JPS5822221A (en) * | 1981-08-04 | 1983-02-09 | Sumitomo Heavy Ind Ltd | Retractor for counterweight supporting frame for continuous unloader |
| DE3242814A1 (en) * | 1982-11-19 | 1984-05-24 | Siemens AG, 1000 Berlin und 8000 München | METHOD AND RESPIRATOR FOR BREATHING A PATIENT IN THE HEART RHYMUS AND FOR SUPPORTING THE BLOOD CIRCULATION |
| FR2557253B1 (en) * | 1983-12-22 | 1986-04-11 | Cit Alcatel | VALVE WITH OPENING OPERATING AT DEPRESSION |
| DE3401841A1 (en) * | 1984-01-20 | 1985-07-25 | Drägerwerk AG, 2400 Lübeck | VENTILATION SYSTEM AND OPERATING METHOD THEREFOR |
| DE3422066A1 (en) * | 1984-06-14 | 1985-12-19 | Drägerwerk AG, 2400 Lübeck | VENTILATION SYSTEM AND CONTROLLABLE VALVE UNIT TO |
-
1987
- 1987-03-27 NL NL8720165A patent/NL8720165A/en not_active Application Discontinuation
- 1987-03-27 GB GB8722069A patent/GB2194892B/en not_active Expired - Lifetime
- 1987-03-27 WO PCT/US1987/000644 patent/WO1987006040A1/en not_active Application Discontinuation
- 1987-03-27 DE DE19873790137 patent/DE3790137T1/de not_active Ceased
- 1987-03-27 AU AU72316/87A patent/AU598255B2/en not_active Ceased
- 1987-03-27 CH CH4700/87A patent/CH672991A5/fr not_active IP Right Cessation
- 1987-03-27 JP JP62502279A patent/JPS63503207A/en active Pending
- 1987-03-27 EP EP19870902943 patent/EP0273041A4/en not_active Withdrawn
- 1987-03-31 CA CA000533497A patent/CA1302505C/en not_active Expired - Fee Related
- 1987-09-25 DK DK504687A patent/DK162257C/en not_active IP Right Cessation
- 1987-09-28 SE SE8703727A patent/SE459214B/en not_active IP Right Cessation
-
1991
- 1991-07-26 JP JP1991066000U patent/JPH06125Y2/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| AU598255B2 (en) | 1990-06-21 |
| DK162257B (en) | 1991-10-07 |
| EP0273041A1 (en) | 1988-07-06 |
| AU7231687A (en) | 1987-10-20 |
| SE8703727L (en) | 1987-10-01 |
| NL8720165A (en) | 1988-01-04 |
| JPH0488952U (en) | 1992-08-03 |
| DK504687D0 (en) | 1987-09-25 |
| DE3790137T1 (en) | 1988-03-31 |
| GB2194892A (en) | 1988-03-23 |
| CH672991A5 (en) | 1990-01-31 |
| DK504687A (en) | 1987-09-25 |
| JPH06125Y2 (en) | 1994-01-05 |
| SE8703727D0 (en) | 1987-09-28 |
| SE459214B (en) | 1989-06-12 |
| EP0273041A4 (en) | 1990-01-11 |
| WO1987006040A1 (en) | 1987-10-08 |
| GB8722069D0 (en) | 1987-10-28 |
| JPS63503207A (en) | 1988-11-24 |
| GB2194892B (en) | 1990-05-09 |
| DK162257C (en) | 1992-03-02 |
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