CN1826151A - Method and system of individually controlling airway pressure of a patient's nares - Google Patents
Method and system of individually controlling airway pressure of a patient's nares Download PDFInfo
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- CN1826151A CN1826151A CN 200480020719 CN200480020719A CN1826151A CN 1826151 A CN1826151 A CN 1826151A CN 200480020719 CN200480020719 CN 200480020719 CN 200480020719 A CN200480020719 A CN 200480020719A CN 1826151 A CN1826151 A CN 1826151A
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Abstract
A method and system of individually controlling positive airway pressure of a patient's nares. Some exemplary embodiments may be a method comprising applying therapeutic gas pressure within a first naris of a patient during respiration, and applying therapeutic gas pressure within a second naris of the patient during the respiration. The therapeutic gas pressures applied to each naris are different.
Description
Technical field
Embodiments of the invention relate to positive airway pressure device and method, for example continuous positive airway (CPAP) equipment.Particularly, embodiments of the invention relate to positive airway pressure device and method, by this equipment and method, can control flow and/or pressure by each nostril of patient and mouth respectively.
Background technology
Sleep disordered breathing is human common phenomena.Some disordered breathings may cause owing to the respiratory tract disorder.Sleep apnea may be a kind of patient temporary transient breathless disorderly phenomenon in sleep.Hypopnea may be that patient respiratory becomes unusual slow or shallow for some time.In some cases, hypopnea appears at before the apnea.
Although hypopnea and asphyxia have multiple reason, a reason that triggers this type of incident generation may be all or part of obstruction of respiratory tract.Particularly, in the middle of some patients, owing to the influence of gravity and/or owing to the external low influence of pressure ratio in the larynx, larynx may wither.Withering of pharynx in the respiratory tract, larynx, last air flue or other soft tissues can cause all or part of obstruction of respiratory tract, finally may cause hypopnea or asphyxia phenomenon.
A kind of to deal with the method that larynx withers can be the application of Positive Airway Pressure, can use the CPAP machine.In the prior art, this can be by covering breathing mask patient's nose at least, in face shield, provide to pharynx, larynx or on the pressure of air flue be achieved.Pharynx, larynx or the pressure of going up in the air flue may be bigger than external pressure, thereby get through air flue.
The CPAP machine only focuses on the gas pressure of patient nostril supply.But the gas that flow to the area of low pressure from the high-pressure area can be by the passage of resistance minimum.Therefore, offer in the prior art respirable gas of patient may be only or main nostril by ventilation flow.Because the sensation of the drying the when flow of gas and gas pass through the nostril forces or allows all gas to flow through the single nostril of patient to make the patient uncomfortable.When using the CPAP machine, if patient's attempt is breathed with mouth, then allowing gas pass through the mobile problem in nostril can worsen more.
Summary of the invention
A kind of method and system of controlling patient's two nostril Positive Airway Pressures respectively can address the above problem to a great extent.Some example embodiment can be a kind of methods, and this method is included in the respiratory, apply therapeutic gas pressure in patient's first nostril; And in respiratory, in patient's second nostril, apply therapeutic gas pressure.The therapeutic gas pressure difference that each nostril is applied.
Other embodiment can be a kind of system, and this system comprises first aerator, and it has the outlet (wherein, first aerator may be operably coupled to patient's first nostril) that is connected to first pressure transducer communicatively; And second aerator, it has the outlet (wherein, second aerator may be operably coupled to patient's second nostril) that is connected to second pressure transducer communicatively.
And further example embodiment can be a kind of method, and this method is included in the breathing process, the treatment air-flow is applied to patient's first nostril (the treatment air-flow is included in all gas basically that sucks by first nostril in the breathing process); And in breathing process, the treatment air-flow is applied to patient's second nostril (the treatment air-flow is included in all gas basically that sucks by second nostril in the breathing process).By in each nostril, applying different pressures the treatment air-flow is applied to each nostril.
Other embodiment can be a kind of system, this system comprises first aerator, it is connected to outlet (wherein communicatively by the first flow pick off, first aerator and first flow pick off may be operably coupled to patient's first nostril, and are provided at all gas basically that sucks by first nostril in the breathing process); And second aerator, it is connected to outlet (wherein communicatively by second flow transducer, second aerator and second flow transducer may be operably coupled to patient's second nostril, and are provided at all gas basically that sucks by second nostril in the breathing process).By first aerator impose on first nostril with the pressure of the gas flow that reaches expectation with imposed on second nostril by second aerator different with the pressure of the gas flow that reaches expectation.
And further example embodiment can be a kind of method, and this method comprises: in breathing process, one or two nostril to the patient applies Positive Airway Pressure selectively, and in breathing process, will apply Positive Airway Pressure to patient's mouth.
Other embodiment can be a kind of system, this system comprises first aerator, it is connected to outlet (wherein, first aerator may be operably coupled to patient's first nostril, and is provided at all gas basically that sucks by first nostril in the breathing process) communicatively; And second aerator, it is connected to outlet (wherein, second aerator may be operably coupled to patient's mouth, and is provided at all gas basically that sucks by mouth in the breathing process) communicatively.
And further embodiment can be a kind of method, the equipment end that this method is included in positive airway pressure mask provides treatment gas with first pressure, first pressure ratio is big for the pressure of patient regulation, and the therapeutic gas pressure at the patient end of face shield is just basic identical with the pressure of stipulating like this.
Other embodiment can be a kind of system, and this system comprises the treatment gas source of pressurization; And the positive airway pressure mask with equipment end and patient end, equipment end is connected to the treatment gas source, and patient end is connected to patient's air flue.This system is increased to the gas-flow resistance of the titration pressure of patient's regulation with the complementary area cover that comes up by the therapeutic gas pressure with the equipment end of face shield.
And further embodiment can be a kind of breathing mask, and this breathing mask comprises first naris interface, and it operationally seals patient's first nostril substantially; Second naris interface, it operationally seals patient's second nostril substantially; Mask, it operationally seals patient's mouth substantially; First supply pipe, it passes mask and is connected to first naris interface (first supply pipe operationally is connected to the first supply port of positive airway pressure device communicatively) communicatively; Second supply pipe, it passes mask and is connected to second naris interface (second supply pipe operationally is connected to the second supply port of positive airway pressure device communicatively) communicatively; And the 3rd supply pipe, it is connected to mask (the 3rd supply pipe operationally is connected to the 3rd supply port of positive airway pressure device communicatively) communicatively.
Other embodiment can be a kind of breathing mask, and this breathing mask comprises first naris interface, and it operationally seals patient's first nostril substantially; Second naris interface, it operationally seals patient's second nostril substantially; First supply pipe that links to each other with first naris interface, it is connected to the first supply port of positive airway pressure device communicatively; And second supply pipe that links to each other with second nostril, it operationally is connected to the second supply port of positive airway pressure device communicatively.
Disclosed equipment and method comprise the combination of feature and advantage, make it can overcome the shortcoming of prior art equipment.By the reading following detailed description and with reference to accompanying drawing, above-mentioned various characteristics and other features will be readily apparent to persons skilled in the art.
Description of drawings
Explain the preferred embodiments of the present invention below with reference to accompanying drawings, wherein:
Fig. 1 shows and is used to illustrate the demonstration system that concerns between pressure, flow and the gas-flow resistance;
Fig. 2 shows the positive airway pressure device according at least some embodiment structures of the present invention;
Fig. 3 shows the control system according at least some embodiment of the present invention;
Fig. 4 shows demonstration methods according to an embodiment of the invention;
Fig. 5 shows the breathing mask according at least some embodiment of the present invention;
Fig. 6 shows the breathing mask according at least some embodiment of the present invention, and this breathing mask can use with positive airway pressure device according to an embodiment of the invention;
Fig. 7 shows the sealing surfaces according to a pipe of the breathing mask of at least some embodiment of the present invention;
Fig. 8 shows the replacement convergent point of breathing mask among Fig. 6;
Fig. 9 shows breathing mask according to an alternative embodiment of the invention;
Figure 10 shows the partially cut-away side view according to the breathing mask among embodiments of the invention, Fig. 9; And
Figure 11 shows according to an alternative embodiment of the invention, the partially cut-away side view of breathing mask among Fig. 9.
Symbol and term
In description and claims, use some term to represent specific system component in the whole text.The application does not distinguish the title difference and the identical assembly of function.
In the following description and in claims, term " comprises " to open mode and using, thus it should be interpreted as " includeing but not limited to ... "Equally, term " connection " expression is connected directly or indirectly.Therefore, if first equipment is connected to second equipment, this connection may be the indirect connection that directly connects or pass through other equipment or connection.
And, herein and term that uses in claims " pressure ", " exerting pressure " etc. refer to relative pressure (gauge pressure) rather than absolute pressure.Therefore, apply negative pressure and refer to pressure below atmospheric pressure.
The specific embodiment
For the relation between pressure and the gas flow is described, referring now to system shown in Figure 1.Fig. 1 shows first fan or aerator 10 and second fan or aerator 12.Aerator 10,12 can provide controllable flow and/or controllable pressure in its outlet respectively.The outlet 14 of aerator 10 can be connected to pipe 18 communicatively, and pipe 18 can be connected to common chamber 20 communicatively.Equally, aerator 12 can be connected to pipe 22 communicatively, and pipe 22 can be connected to common chamber 20 communicatively.As shown in Figure 1, pipe 18 can be connected to chamber 20 communicatively by orifice plate 24, and pipe 22 can be not be connected to common chamber 20 communicatively by the orifice plate orifice plate of the obvious gas channel bigger than the gas channel of orifice plate 24 (or have).Therefore, when each pipe 18 and 22 can be connected to common chamber 20 communicatively, because the existence of orifice plate 24, to producing restriction or resistance from the air-flow of managing 18 inlet chambers 20.
Further consider that pipe 18,22 is connected to pressure transducer 26,28 respectively.Pressure transducer is for convenience of description, can not need in some embodiment of invention.Each pressure transducer 26,28 can read the pressure in each pipe 18,22.Aerator can move under pressure control mode.The pressure of each pipe inner control can be different, for convenience of explanation, consider that the pressure in each pipe 18,22 is controlled so as to identical.Further consider that common chamber 20 is in low-pressure state, as be disposed to atmosphere.Therefore, owing to have pressure reduction between pipe 18,22 and common chamber 20, air-flow can enter common chamber 20 (shown in the arrow Fig. 1) from managing 18,22.But in this example, although the pressure of managing in 18,22 can be identical, gas flow can be different.That is to say that orifice plate 24 can be to providing resistance from managing 18 air-flows that enter common chamber 20, and just do not have resistance by managing 22 airflow flowing.Particularly, because the restriction of orifice plate 24, can be by managing 18 gas flow than little by the gas flow of pipe 22.Therefore, even the pressure of managing in 18,22 is identical, can be also different by the gas flow of these pipes.
Consider now that aerator 10,12 moves under flow control mode, each aerator attempts to keep the gas flow that equates, with desired pressure independent.For the flow that keeps expecting, aerator 10 may need to be used for the restriction that the higher pressure of the required pressure of same traffic overcomes orifice plate 24 than aerator 12.Remember these principles, the following describes book discussion is used for providing the method for Positive Airway Pressure and relevant system to the patient.
Fig. 2 shows machine or the equipment 30 that is used to provide Positive Airway Pressure according to some embodiments of the present invention.Equipment 30 according to the some embodiments of the present invention structure preferably can be controlled to the pressure and/or the however, therapeutic gas flow in each nostril of patient respectively, and in certain embodiments, is controlled to the pressure and/or the however, therapeutic gas flow of patient mouth.The CPAP equipment of this and prior art forms sharp contrast, and the CPAP equipment of prior art can not make the flow that enters each nostril create a difference.Therefore, first gas channel can comprise the aerator 32 that is connected to flow transducer 34 and pressure transducer 36 communicatively.Aerator 32 can be any suitable device, as is connected to the blade type aerator of motor.In optional embodiment, except aerator 32, can also use treatment gas source such as oxygen, or treatment gas source and aerator 32 are used in combination.Therefore, the therapeutic gas pressure and the flow that are produced by aerator 32 can flow through flow transducer 34 (pick off of any adequate types), and can arrive patient's first nostril by pipe 38.Positive airway pressure device 30 can comprise second aerator 40 that is connected to second flow transducer 42 and second pressure transducer 44 according to an embodiment of the invention.The design of aerator 40 and structure can be similar with aerator 32.In optional embodiment, aerator 40 can be used in combination with compression treatment gas source such as oxygen, or is replaced by the compression treatment gas source.The therapeutic gas pressure and the flow that are produced by aerator 40 can pass through flow transducer 42 (pick off of any adequate types), and can arrive patient's second nostril by pipe 46.Below continuing, before the operation, in each bar gas channel, have pressure transducer and flow transducer simultaneously, might not require to have simultaneously this two kinds of equipment although should understand the example embodiment shown in Fig. 2.Some embodiment can only have flow transducer or pressure transducer is only arranged in each gas channel.
According to embodiments of the invention, positive airway pressure device 30 is controlled to the pressure and/or the flow in each nostril of patient respectively.In certain embodiments, can between two nostrils, separate the treatment air-flow that provides to the patient, so just needn't force arbitrary nostril by all treatment air-flows.In order to guarantee each nostril by treating air-flow to small part, the gas channel in each nostril can need independently pressure and/or flow-control.In optional embodiment, thereby can be controlled different respectively by the treatment air-flow in each nostril.
Pressure control and consequent treatment air-flow can adopt various ways.In one embodiment, can come controlled pressure, as by the rotating speed of motor of control connection to aerator by the rotating speed of controlling aerator selectively.In optional embodiment, aerator 32,40 can constant-speed operation, and the pressure that offers the patient can be respectively by pressure-control valve 48,50 controls that are used for aerator 32,40.Yet in other embodiments, can be used in combination control blower speed and these two means of pressure-control valve and come controlled pressure.
Fig. 3 shows and can be used for the control system 60 of the positive airway pressure device shown in the control figure 2.What particularly, be connected to each aerator 32,40 can be respectively motor 62,64.The rotating speed of each motor 62,64 output shaft (blower speed then) can be respectively by motor speed control unit 66 and 68 controls.In at least some embodiment, motor 62,64 can be the DC motor, and these rotating speed of motor can be regulated by the dc voltage that change applies.In optional embodiment, the voltage that is applied to each motor 62,64 can be constant, but can modulate, as controlling by pulse width modulation.And in other embodiments of the invention, motor 62,64 can be the AC motor, and in these embodiments, thereby motor speed control circuit 66,68 can provide the motor speed of the control voltage control with different voltages and frequency to motor.
According to some embodiments of the present invention, the mode (not shown) that microcontroller 70 can be by regulation control plate (dial-type) input or other form (not shown)s of some user interfaces provide the titration pressure of regulation.Pressure according to the rules, microcontroller can make speed controling signal pass through each motor speed control circuit 66 and 68 to realize the pressure of expectation.If serious hyperemia in nostril or obstruction (as because tumor or polyp), however, therapeutic gas flow only can be with the nostril of titration pressure by ventilating of regulation.And convection current quantitative limitation and resistance can change in whole evening in each nostril, as changing along with the situation of each intranarial congested situation or each intranarial soft tissue enlargement.Therefore, even treat gas with the pressure supply of regulation, the treatment gas that the patient receives also may be not enough.According to embodiments of the invention, positive airway pressure device can be measured however, therapeutic gas flow by each nostril by read signal from pressure transducer 34 and 42.If to the however, therapeutic gas flow in nostril at least partially in mean allocation between the nostril, then except controlled pressure, need not other action.But if the flow of measuring is not partial balanced at least, some embodiment of equipment 30 can come balanced flow by the pressure that change imposes on certain nostril.
According to embodiments of the invention, positive airway pressure device can produce air-flow to the nostril pressurize that stops up or part is stopped up at least momently.In case generation air-flow, the treatment air-flow by the nostril can equally move to air operated clamp (air-flow is clamped larynx to reduce hypopnea and apnea in very similar mode), therefore, after the ventilation of nostril, applied pressure can reduce.
The embodiment that replaces can relate to the titration pressure of regulation.Particularly, the doctor can authorized pressure to realize to patient's desired effects.But the present inventor finds, is used to provide the face shield of continuous positive airway pressure with relevant pipe treatment gas (as air or oxygen-enriched air) to be produced resistance in the prior art.Resistance to air-flow causes the pressure in face shield and the pipe to descend, and making can not provide desired titration pressure to the patient in face shield.Fig. 4 shows a kind of method that at least some embodiment according to the present invention realize, this method has solved this defective that exists in the prior art.Particularly, can begin (square frame 100) and carry out this process and determine face shield and the resistance (square frame 102) of relevant pipe air-flow.According to some embodiments of the present invention, before the patient is placed on face shield the patient airway use, make this and determine.According at least some embodiment of the present invention, can apply known pressure by positive airway pressure device end, and determine the gas-flow resistance of face shield and relevant pipe by the flow of pipe measurement gas at face shield and pipe.Use these parameters, and consider to leak (below will describe in detail), can calculate the Resistance Value of face shield and pipe near the control at patient airway place.In case determine the gas-flow resistance of face shield and pipe, the patient can be connected to respiratory tract with face shield, begins to exert pressure.But, according to these embodiment, can be bigger by the positive airway pressure device applied pressure than the titration pressure of doctor's regulation, the pressure that is higher than authorized pressure can compensate at face shield and the pressure drop (square frame 104) in managing, thereby the pressure of experiencing near the patient airway place is basic identical with authorized pressure.After this, this process finishes (square frame 106).
Although before exerting pressure, calculated gas-flow resistance, of the present inventionly also can be adjusted in the variation that the equipment end applied pressure compensates gas-flow resistance in use to small part embodiment to patient airway.Particularly, understand by the relative humidity (with respect to dew point) of the pipe and the treatment gas of breathing mask and influence the suffered resistance of air-flow.Relative humidity is high more, and the suffered resistance of air-flow is big more.Therefore, the relative humidity of the treatment gas of embodiments of the invention monitoring supply when relative humidity variations, is also and then changed by equipment 30 applied pressures, thereby guarantees that the pressure that provides in the patient airway in breathing process is the titration pressure of regulation basically.Fig. 3 shows the dew point monitor 47 that is connected to microcontroller 70.Microcontroller 70 can be read dew point monitor 47 termly, and adjusts applied pressure at equipment 30, compensates the resistance of convection current by pipe and breathing mask.Although can use any dew point or relative humidity sensor, preferred sensor is the solid-state relative humidity sensor of No.HIH-3602-C by Honeywell Inc.'s manufacturing, part number.
And in further optional embodiment, except titration pressure, the doctor can stipulate total however, therapeutic gas flow.In these cases, positive airway pressure device 30 can be used control system shown in Figure 3, and mean allocation can realize total however, therapeutic gas flow of stipulating like this by the flow in each nostril substantially.In these optional embodiment, control system 60 can only be monitored the flow signal that is produced by flow transducer 34,42.In these cases, when producing air-flow in the nostril, applied pressure can be equal substantially, still, can require to make each intranarial pressure difference to control flow.And in further optional embodiment, the however, therapeutic gas flow that the doctor can each nostril of separate provision, in these cases, positive airway pressure device 30 can be distributed the flow by each nostril according to the rules.In order to reach these different flows, positive airway pressure device 30 can apply different substantially pressure to each nostril.
Basic mean allocation gas flow may be more comfortable concerning the patient between the nostril.Although the gas-flow resistance by the nostril can change significantly in whole evening, can adjust its pressure the air-flow that needs still can be provided more accurately with the equipment of guaranteeing air-flow.And basic mean allocation however, therapeutic gas flow can reduce owing to air communication is crossed the discomfort (comparing by single nostril with forced draft) that the nostril causes dry nasal cavity between two nostrils.
But, in an embodiment of the present invention, for mean allocation not necessarily can increase pressure by the air-flow in nostril.Particularly, microcontroller 70 can have upper pressure limit, as 20cm H2O, can be applied to specific nostril so that nostril ventilation or the air-flow of expectation is provided.If also do not produce the also not ventilation of treatment air-flow or nostril after the arrival upper pressure limit, microcontroller 70 can be taked to provide necessary treatment air-flow to the nostril of ventilation, and can report by the user interface (not shown) and stop up.And in a further embodiment, as described below, pressure and/or the flow that only provides to the nostril of patient's ventilation can be provided by the mouth delivering therapeutic gas to the patient microcontroller 70.If (as a whole night) previous nostril of stopping up is to the resistance force diminishes of treatment gas in therapeutic process, microcontroller can be from begin to provide air-flow this moment.
And in other optional embodiment, positive airway pressure device 60 can be connected to patient's nasal openings, provides pressure and/or flow but can be under an embargo at first.Therefore, in original state, positive airway pressure device 60 can be only by nostril monitoring flow, and and if only if when flow interrupt occurring, just become and can operate.For example, if the patient changes the sleep posture, may produce obstacle, in the case, equipment 60 can start one or more aerators to apply airway pressure and/or to guarantee the treatment air-flow.And for example, a nostril or two nostrils of patient may be congested, and when detecting the obstruction of congested form, equipment 60 can start one or more aerators to apply airway pressure and/or to guarantee the treatment air-flow.And for example, equipment 60 can be monitored the flow by two nostrils, when patient's sneeze in the testing process (detecting rapid fluctuation as measuring in the flow) can start one or more aerators to apply airway pressure and/or to guarantee the treatment air-flow.And in other embodiment, equipment 60 can be provided as hypo-allergenic and filtered air to the patient at first, and if desired, can be in that the time provides treatment gas after a while.
Referring again to Fig. 2, only focus on pressure and/or the however, therapeutic gas flow that is controlled to the patient nostril respectively about the discussion of this point.But,,, also can provide Positive Airway Pressure to patient's mouth except providing Positive Airway Pressure to the nostril according at least some embodiment of the present invention.Therefore, Fig. 2 shows the aerator 41 that can be connected to patient mouth by flow transducer 43.Closely similar with aerator 32 and 40, the rotating speed that can control aerator 41 imposes on the pressure of patient mouth or imposes on the pressure of patient mouth and the flow by mouth by the flow of mouth or control simultaneously with control selectively.In optional embodiment, when with the aerator 41 of constant rotational speed operation, can use valve 51 to come controlled pressure and/or flow.Fig. 2 also shows also can working pressure pick off 45 to the flow circuit of patient mouth.Equally, Fig. 3 shows the motor 65 that is connected to motor speed control circuit 69 and microcontroller 70.Therefore, the explanation for the rotating speed of controlling aerator 32 and 40 is applicable to aerator 41 too.
According to an alternative embodiment of the invention, can be controlled to the however, therapeutic gas flow and/or the pressure of each nostril of patient and mouth respectively.In these embodiments, according to patient's special status, can be only to nostril or only lip-syncing or the combination of one or more nostrils and mouth applied Positive Airway Pressure.For example, consider in breathing process, only to provide Positive Airway Pressure to patient's nasal openings.When a nostril becomes congested, positive airway pressure device 30 possibly can't provide enough flows to prevent hypopnea or apnea by remaining nostril.In the case, according to embodiments of the invention, can provide extra Positive Airway Pressure to the patient by mouth.Relatively, unusual, the tumor of health or polyp may for good and all stop the air-flow by the patient nostril, therefore, can provide Positive Airway Pressure to the patient by the nostril and the mouth of ventilation.
The hypothesis patient breathes without mouth when applying Positive Airway Pressure respectively by the nostril.In some cases, patient's (especially in sleeping soundly) may carry out the transition to nose from only breathing through the nostrils and mouth is breathed simultaneously.For those patients who operates under titration pressure, even in breathing process, because portion gas is run out of from mouth, opening mouth has increased the flow that passes through one or more nostrils.The increase of this flow may increase the nasal irritation relevant with this flow.And, may mean the treatment gas deficiency (advantage that has deviated from Positive Airway Pressure) that arrives lung from mouth effusion treatment gas.According to an alternative embodiment of the invention, just begin, aerator 41 can be switched off, and flow transducer 43 can be connected to patient's mouth.In the patient mouth down periods, positive airway pressure device 30 can use aerator 32,40 and relevant equipment to control therapeutic gas pressure and/or flow selectively.When the patient opened mouth and begin to breathe with mouth, positive airway pressure device 30 can take to correct action.In certain embodiments, positive airway pressure device 30 can start aerator 41 with specific pressure to mouth supply treatment gas.In these embodiments, positive airway pressure device 30 can provide pneumatic obstruction to the air-flow by mouth.And in further embodiment, when detecting the mouth breathing, positive airway pressure device can provide treatment gas and/or pressure by the mouth of opening to the patient to small part.
The embodiment that discuss the front has related in breathing process provides Positive Airway Pressure to the patient.Even in exhalation process, lasting airway pressure ventilation (CPAP) equipment of prior art still provides Positive Airway Pressure.But, at least some embodiment according to the present invention, the pressure that positive airway pressure device 30 reduces in the patient airway, the effort that the reduction of patient expiration is required.Can reduce airway pressure with multiple mode.In certain embodiments, airway pressure may reduce, and the pressure in the air flue may still be higher than atmospheric pressure or ambient pressure.And in other embodiments, can be fully without pressure, in exhalation process, what air flue was experienced is atmospheric pressure substantially like this.And in other embodiments, can apply negative pressure (vacuum) and help the patient to exhale.Referring again to Fig. 2, in an embodiment, when pressure reduces and when still being higher than atmospheric pressure, one or more aerators 32,40,41 slow down, like this patient on one's body the therapeutic gas pressure reduction and still be higher than atmospheric pressure.According to embodiment, when stopping to apply airway pressure, in exhalation process, one or more aerators 32,40,41 can be out of service fully.According to embodiment, when applying negative pressure to patient airway, one or more aerators 32,40,41 can turn to and the opposite direction of exerting pressure, thereby help the patient to exhale by additional air flue.Because patient's nasal openings can have different pressure and flow control circuit respectively with mouth, therefore can control each nostril and mouth respectively, one or more like this respiratory tracts have the pressure or the negative pressure of the reduction that applies, and the pressure of other respiratory tract is constant or with the control of different pressure.
Briefly with reference to Fig. 2, pipe 38,46 is connected to patient's nasal openings once more.Fig. 5 shows the embodiment of breathing mask, and this breathing mask is used for pipe 38,46 is connected to two nostrils of patient respectively.Particularly, face shield can comprise nose part 72, and this part is connected to carrier pipe 38 first nostril (being left nostril herein) communicatively, and communicatively carrier pipe 46 is connected to second nostril (being right nostril herein).Nose part 72 can be fixing by belt 74, and belt 76 is fixed on relative position with carrier pipe 38 and 46, stretches out from forehead.Nose part 72 can be sealed each nostril by sealing with the outside surface that contacts, each nostril.In optional embodiment, nose part can comprise tube element, and this element puts in each nostril certain distance, thereby forms sealing with the inside in nostril.As shown in Figure 5, each pipe 38,46 preferably has the outlet 39,45 of control respectively.The gas evolution that outlet 39,45 can allow to breathe out in exhalation process enters atmosphere.In an embodiment of the present invention, when positive airway pressure device was controlled the flow of the treatment gas that enters each nostril, it can be considered from each outlet 39 and the 40 treatment gas flows of overflowing.
Fig. 6 shows the optional embodiment of breathing mask, and this breathing mask can use according to embodiments of the invention.Particularly, face shield 78 can comprise first supply pipe 80 (it can be identical with supply pipe 38 or 46) and second supply pipe 82 (it can be identical with supply pipe 38 or 46).According to embodiments of the invention, supply pipe 80 and 82 is not communicated with each other.The tip 84 of pipe 80 can be connected to first gas channel of positive airway pressure device, as equipment 30.Equally, the tip 86 of pipe 82 can be connected to second gas channel of positive airway pressure device, as press device 60 (not showing among Fig. 6).To second end in patient nostril, each pipe 80 and 82 can seal or sealing substantially, and same, each pipe can have outlet 81,83 respectively.Can seal the outer surface in each nostril, but preferably, pipe is in the inner surface sealing in each nostril.Fig. 7 shows exemplary end 88, and it can be a pipe 80 and/or 82, comprises sealing ring 90, and sealing ring is designed to be close to the internal diameter in nostril.Referring again to Fig. 6, in certain embodiments, pipe 80,82 can converge below patient's chin.In optional embodiment, pipe 80,82 can converge behind patient's brain, as shown in Figure 8.The patient that offside is slept, pipe converges behind brain can be more comfortable.
It is exercisable that breathing mask among Fig. 5,6 and 8 enters among the embodiment of the therapeutic gas pressure in nostril and/or flow in control only.Fig. 9 shows can be according to the breathing mask of embodiments of the invention use, and it controls therapeutic gas pressure and/or the flow that enters nostril and mouth respectively.Particularly, Fig. 9 shows breathing mask 120, and it comprises the mask part 122 that covers nose and mouth.Supply pipe 124 and 126 is connected to patient's nasal openings communicatively.Supply pipe 128 passes mask 122, and is connected to the space in the mask 122 communicatively.Mask 122 can be fixing by belt 130, and supply pipe 124,126 and 128 can be fixing by belt 132.
Figure 10 shows the sectional view of breathing mask 120.In the embodiment shown in fig. 10, show that mask is below patient's nose place, chin and along dotted line 134 sealings.In the embodiment shown in fig. 10, detector tube 124 is connected to patient's right nostril hermetically by sealing gasket.Similarly, patient's left nostril does not show among Figure 10, uses sealing gasket between detector tube 126 and left nostril.Figure 11 shows optional embodiment of the present invention, and except supply pipe 124 puts in the inner surface sealing in nostril certain distance and nostril, other and Figure 10 are similar.
Although the face shield shown in the accompanying drawing can be preferred, under the prerequisite that does not exceed scope and spirit of the present invention, can use any mechanism, by this mechanism, carrier pipe is connected to nostril separately communicatively.
Above-mentioned discussion only is used to illustrate principle of the present invention and various embodiment.After understanding foregoing fully, to one skilled in the art, many changes and modification all are conspicuous.Claims comprise all of these changes and modifications.
Claims (64)
1. method comprises:
In respiratory, in patient's first nostril, apply therapeutic gas pressure; And
In respiratory, in patient's second nostril, apply therapeutic gas pressure;
Wherein, impose on the therapeutic gas pressure difference in each nostril.
2. the method for claim 1 further comprises:
In breathing process, in described first nostril, apply treatment gas malleation; And
In breathing process, in described second nostril, apply treatment gas malleation.
3. method as claimed in claim 2 further comprises each intranarial therapeutic gas pressure of control, makes by the however, therapeutic gas flow in each nostril basic identical.
4. method as claimed in claim 2 further comprises each intranarial therapeutic gas pressure of control, makes the however, therapeutic gas flow difference by each nostril.
5. method as claimed in claim 2 further is included in the exhalation process, reduces by the first intranarial therapeutic gas pressure.
6. method as claimed in claim 5 further is included in the described exhalation process, reduces by the second intranarial therapeutic gas pressure.
7. method as claimed in claim 5 wherein, reduces by the first intranarial therapeutic gas pressure and further is included in the described exhalation process in described exhalation process, eliminate described treatment gas malleation.
8. method as claimed in claim 5, wherein, reduction by the first intranarial therapeutic gas pressure further is included in described first nostril and applies negative pressure in described exhalation process.
9. the method for claim 1 further comprises:
In exhalation process, reduce by the first intranarial pressure, described reduction is with respect to the therapeutic gas pressure that applies in the breathing process; And
In exhalation process, reduce by the second intranarial pressure, described reduction is with respect to the therapeutic gas pressure that applies in the breathing process.
10. method as claimed in claim 9, wherein, described reduction by the first nostril internal pressure further comprises the treatment gas malleation that elimination applies in breathing process.
11. method as claimed in claim 9 further comprises described first nostril is applied negative pressure.
12. a system comprises:
First aerator, it has the outlet that is connected to first pressure transducer communicatively, and wherein said first aerator may be operably coupled to patient's first nostril; And
Second aerator, it has the outlet that is connected to second pressure transducer communicatively, and wherein said second aerator may be operably coupled to patient's second nostril.
13. system as claimed in claim 12 further comprises:
Wherein, in patient's breathing process, described first aerator is controlled the first intranarial therapeutic gas pressure; And
Wherein, in patient's breathing process, described second aerator is controlled the second intranarial therapeutic gas pressure.
14. system as claimed in claim 13, wherein, in check pressure is different with in check pressure in described second nostril in described first nostril.
15. system as claimed in claim 13, wherein, in described first nostril in check pressure and described second nostril in check pressure basic identical.
16. system as claimed in claim 13 further comprises:
Wherein, described first aerator applies treatment gas malleation to reach the however, therapeutic gas flow by first nostril in first nostril;
Wherein, described second aerator applies treatment gas malleation to reach the however, therapeutic gas flow by second nostril in second nostril; And
Wherein, basic identical by the described however, therapeutic gas flow in first and second nostrils.
17. system as claimed in claim 13 further comprises:
Wherein, described first aerator applies treatment gas malleation to reach the however, therapeutic gas flow by first nostril in first nostril;
Wherein, described second aerator applies treatment gas malleation to reach the however, therapeutic gas flow by second nostril in second nostril; And
Wherein, the described however, therapeutic gas flow difference by first and second nostrils.
18. system as claimed in claim 13, wherein, in patient's exhalation process, described first aerator reduces by the first intranarial therapeutic gas pressure.
19. system as claimed in claim 18, wherein, in described exhalation process, described first aerator is eliminated therapeutic gas pressure.
20. system as claimed in claim 18, wherein, in described exhalation process, described first aerator applies negative pressure in first nostril.
21. system as claimed in claim 12, wherein, in exhalation process, described first aerator reduces by the first intranarial pressure, and described blood pressure lowering is with respect to the first intranarial pressure in the breathing process.
22. system as claimed in claim 21, wherein, in exhalation process, described second aerator reduces by the second intranarial pressure, and described blood pressure lowering is with respect to the second intranarial pressure in the breathing process.
23. system as claimed in claim 21, wherein, in described exhalation process, described first aerator applies negative pressure in first nostril.
24. a method comprises:
In breathing process, the treatment air-flow is applied to patient's first nostril, described treatment air-flow is included in all gas basically that first nostril described in the breathing process sucks;
In described breathing process, add patient's second nostril with treating air-flow, described treatment air-flow is included in all gas basically that second nostril described in the breathing process sucks;
Wherein, applied pressure is different in each nostril is applied to each nostril to described treatment air-flow by making.
25. method as claimed in claim 24, wherein, the described however, therapeutic gas flow that enters first nostril is different with the described however, therapeutic gas flow that enters second nostril.
26. method as claimed in claim 24 wherein, enters the described however, therapeutic gas flow in first nostril and enters with the described however, therapeutic gas flow in second nostril basic identical.
27. method as claimed in claim 24 further comprises:
In exhalation process, force gas to flow out from first nostril; And
In described exhalation process, force gas to flow out from second nostril.
28. method as claimed in claim 27, wherein, the described however, therapeutic gas flow of coming out from first nostril in described exhalation process is different with the described however, therapeutic gas flow of coming out from second nostril described exhalation process.
29. method as claimed in claim 27, wherein, the described however, therapeutic gas flow of coming out from second nostril in described exhalation process is basic identical with the described however, therapeutic gas flow of coming out from second nostril described exhalation process.
30. method as claimed in claim 24 further is included in the exhalation process, stops to control the first intranarial gas flow.
31. a system comprises:
First aerator, it is communicatively connected to outlet by the first flow pick off, wherein said first aerator and described first flow pick off may be operably coupled to patient's first nostril, and are provided at all gas basically that sucks by first nostril in the breathing process; And
Second aerator, it is connected to outlet communicatively by the two or two flow transducer, wherein said second aerator and described second flow transducer may be operably coupled to patient's second nostril, and are provided at all gas basically that sucks by second nostril in the breathing process;
Wherein, by described first aerator impose on first nostril with the pressure of the gas flow that reaches expectation with imposed on second nostril by described second aerator different with the pressure of the gas flow that reaches expectation.
32. system as claimed in claim 31 wherein, enters the gas flow in first nostril and enters with the gas flow in second nostril basic identical in breathing process in breathing process.
33. system as claimed in claim 31, wherein, it is different with the gas flow that enters in breathing process with second nostril to enter the gas flow in first nostril in breathing process.
34. a method comprises:
In breathing process, supply Positive Airway Pressure selectively to one or two nostril of patient; And
In described breathing process, to patient's mouth supply Positive Airway Pressure.
35. method as claimed in claim 34 further is included in the described breathing process, supplies Positive Airway Pressure so that small part stops the air-flow by mouth to patient's mouth.
36. method as claimed in claim 34 further is included in the described breathing process, to patient's the treatment gas of mouth supply Positive Airway Pressure to suck to the small part supply to the patient.
37. a system comprises:
First aerator, it is connected to outlet communicatively, and wherein said first aerator may be operably coupled to patient's first nostril, and is provided at all gas basically that sucks by first nostril in the breathing process; And
Second aerator, it is connected to outlet communicatively, and wherein said second aerator may be operably coupled to patient's mouth, and is provided at all gas basically that sucks by mouth in the breathing process.
38. system as claimed in claim 37, wherein, in patient's breathing process, the described second aerator lip-syncing provides gas pressure as offering first nostril with minimizing and from mouth escaping gas amount to the pneumatic obstruction of small part.
39. system as claimed in claim 37 further comprises:
The 3rd aerator, it is connected to outlet communicatively, and wherein said the 3rd aerator may be operably coupled to patient's second nostril, and is provided at all gas basically that sucks by second nostril in the breathing process; And
Wherein, by described first aerator impose on first nostril with the pressure of the gas flow that reaches expectation with imposed on second nostril by described the 3rd aerator different with the pressure of the gas flow that reaches expectation.
40. system as claimed in claim 39, wherein, in described patient's breathing process, the described second aerator lip-syncing provides gas pressure as offering first and second nostrils with minimizing and from mouth escaping gas amount to the pneumatic obstruction of small part.
41. a method, the equipment end that is included in positive airway pressure mask provides treatment gas with first pressure, and described first pressure ratio is big for the pressure of patient regulation, and is basic identical at the pressure of the therapeutic gas pressure of the patient end of face shield and regulation like this.
42. method as claimed in claim 41, further being included in provides before the treatment gas, measure the gas-flow resistance of positive airway pressure mask, wherein provide the step of treatment gas further to comprise and gas-flow resistance according to described measurement provide treatment gas with described first pressure.
43. method as claimed in claim 42 further comprises along with the described equipment end of described positive airway pressure mask and the increase of the gas-flow resistance between the described patient end, increases described first pressure.
44. method as claimed in claim 43 further comprises the increase along with the length of pipeline between described equipment end and the described patient end, increases described first pressure.
45. method as claimed in claim 41 further comprises according to the humidity of treatment gas, and described first pressure is provided selectively.
46. method as claimed in claim 45 comprises that further the humidity along with treatment gas increases, and increases described first pressure.
47. a positive airway pressure system comprises:
The treatment gas source of pressurization; And
Positive airway pressure mask, it has equipment end and patient end, and described equipment end is connected to described treatment gas source, and described patient end is connected to patient's air flue;
Wherein, described system is increased to the gas-flow resistance of the titration pressure of patient's regulation with the complementary area cover that comes up by the therapeutic gas pressure with the equipment end of face shield.
48. positive airway pressure as claimed in claim 47 system, wherein, before described face shield is connected to patient airway, the gas-flow resistance of the described face shield of described systematic survey, and wherein, the described pressure of treatment gas is arranged to be higher than the titration pressure of described regulation, and is basic identical in the titration pressure of the described therapeutic gas pressure at patient airway place and described regulation like this.
49. positive airway pressure as claimed in claim 47 system further comprises:
Be used to measure the device of described treatment gas humidity;
Wherein, described system increases therapeutic gas pressure by along with the increase of humidity, makes the titration pressure of the therapeutic gas pressure of patient end and described regulation basic identical.
50. positive airway pressure as claimed in claim 47 system, wherein, described treatment gas source is an aerator.
51. positive airway pressure as claimed in claim 47 system, wherein, described treatment gas is air.
52. a breathing mask that is used to carry Positive Airway Pressure comprises:
First naris interface, it operationally seals patient's first nostril substantially;
Second naris interface, it operationally seals patient's second nostril substantially;
Mask, it operationally seals patient's mouth substantially;
First supply pipe, it passes described mask, and is connected to described first naris interface communicatively, and described first supply pipe operationally is connected to first supply opening of positive airway pressure device communicatively;
Second supply pipe, it passes described mask, and is connected to described second naris interface communicatively, and described second supply pipe operationally is connected to second supply opening of positive airway pressure device communicatively;
The 3rd supply pipe, it is connected to described mask communicatively, and described the 3rd supply pipe operationally is connected to the 3rd supply opening of positive airway pressure device communicatively.
53. breathing mask as claimed in claim 52, wherein, when described breathing mask was put on, described first, second operationally stretched out from patient's forehead with the 3rd supply pipe.
54. breathing mask as claimed in claim 52, wherein, described the 3rd supply pipe is mechanically connected to described first supply pipe, and in parallel.
55. breathing mask as claimed in claim 52, wherein, described first naris interface puts in patient's first nostril, and the tight obedient first nostril internal diameter sealing.
56. breathing mask as claimed in claim 52, wherein, described first naris interface further comprises sealing gasket, and near its outer surface of being close to patient first nostril first nostril seals first nostril substantially.
57. breathing mask as claimed in claim 52, wherein said mask is sealed patient's nose, and wherein said first and second naris interface are positioned at the space that is limited by described mask.
58. a breathing mask that is used to carry Positive Airway Pressure comprises:
First naris interface, it operationally seals patient's first nostril substantially;
Second naris interface, it operationally seals patient's second nostril substantially;
First supply pipe, it is connected to described first naris interface communicatively, and described first supply pipe operationally is connected to first supply opening of positive airway pressure device communicatively;
Second supply pipe, it is connected to described second naris interface communicatively, and described second supply pipe operationally is connected to second supply opening of described positive airway pressure device communicatively.
59. breathing mask as claimed in claim 58, wherein, when described breathing mask was put on, described first and second supply pipes operationally stretched out from patient's forehead.
60. breathing mask as claimed in claim 58, wherein, each operationally extends to described first and second supply pipes on patient's ear.
61. breathing mask as claimed in claim 60, wherein, described first and second supply pipes converge below patient's chin.
62. breathing mask as claimed in claim 60, wherein, described first and second supply pipes converge behind patient's brain.
63. breathing mask as claimed in claim 58, wherein, described first naris interface puts in patient's first nostril, and the tight obedient first nostril internal diameter sealing.
64. breathing mask as claimed in claim 58, wherein, described first naris interface further comprises sealing gasket, and near its outer surface of being close to patient first nostril first nostril seals first nostril substantially.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US48861503P | 2003-07-18 | 2003-07-18 | |
| US60/488,615 | 2003-07-18 | ||
| US10/851,952 | 2004-05-21 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN1826151A true CN1826151A (en) | 2006-08-30 |
Family
ID=36936413
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 200480020719 Pending CN1826151A (en) | 2003-07-18 | 2004-07-01 | Method and system of individually controlling airway pressure of a patient's nares |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN1826151A (en) |
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