CA1037805A

CA1037805A - Apparatus for mechanical stimulation of the heart

Info

Publication number: CA1037805A
Application number: CA197,152A
Authority: CA
Inventors: Ionel Bucur
Original assignee: Individual
Current assignee: Individual
Priority date: 1973-04-10
Filing date: 1974-04-09
Publication date: 1978-09-05
Also published as: FR2286641B1; DE2417624C2; DE2417624A1; AU483402B2; GB1449959A; FR2286641A1; US3896797A; JPS6033509B2; JPS5030389A; AU6788374A; SE371743B

Abstract

ABSTRACT OF THE DISCLOSURE

A resuscinator of the type having a base for supporting human body and including a mechanical, reciprocating plunger for heart stimulation, the apparatus being also provided with a pressure applicator adapted to compress, during the action of the plunger, the abdomen of the body to restrict the passage of aorta abdominalis, whereby the heart stimulating action forces the blood stream predominantly to the brain to reduce the possibility of brain damage due to a temporary heart failure.

Description

~037805 Apparatus for Mechanical Stimulating of the Heart The present invention relates to an apparatus for mechanical stimulating of the heart of the type comprising heart stimulating means arranged to mechanically treat the chest of a ~;
human body in a rhythmical sequence, the apparatus also comprising a girdle provided to be stretched over the chest of a human body i~
and carrying power means arranged to mechanically treat said chest in a rhythmical sequence thereby stimulating the heart in said body.
From the U.S. Patent Specification No. 3,307,541 an apparatus for mechanical stimulating of the heart is known. The apparatus comprises a girdle intended to be tightened around the -~
human body in the level of the heart and carrying a pneumatic piston means arranged to be connected to a pressure tank, by means of which piston means the heart can be treated by means of rhyth-mical massage of the chest. An apparatus of the kind mentioned has, ho~wever, very restricted effectiveness when it is used in an attempt to bring a person back to life.
The object of the present invention is to provide an apparatus for mechanical stimulating of the heart which in a more efficient way than what is possible to obtain by means of apparatuses according to the prior art will provide an increase ~
of the blood stream to the brain which among the human organs `
will first be injured when the heart function is not satisfactory. ~;i - According to the present invention, an apparatus ~ -is provided for external mechanical stimulation of the heart, said apparatus comprising, in combination: heart stimulator means for mechanically compressing a portion of a human body in a rhythmical, pulsating fashion; compressing means for exerting a thrust against the abdomen of the human body; a base for supporting said body in a generally horizontal position;
and connector means for securing the stimulator means and the compressing means to the base. Preferably, the base is generally .::

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~037B05 convex to give to the chesttabdominal portion of the body a ~-generally convex posture when the body is supported by the base.
According to a still further feature of the present invention, the base is formed of two parts arranged for a selectively alternative mutual position to render the base either extended -for use, or contracted for storage. In one preferred embodiment, ;
the two parts of the base are connected to each other by hinge means for folding and unfolding of the base. In the folding and unfolding arrangement, the base is so shaped that, on folding Of the two parts, the respective portions of the surface of the base are generally complementary and generally coincident with each other.
The present invention will now be described by way of one embodiment, with reference to the accompanying ~ -drawings. - ;
In the drawings:
Fig. 1 shows the apparatus in a perspective view;
Fig. 2 shows the apparatus in a side view; ~`
Fig. 3 is a transversal section through the apparatus along the line III-III in Fig. 2;
Fig. 4 is a transversal section along the line IV-IV
in Fig. 2;
Fig. 5 shows in a schematical way a pneumatic system of the apparatus. ;
According to Figs. 1-4 the apparatus comprises a part 1 with the ~ntendedj function of a bed and provided with two tunnels 2 and 3 through which two girdles 4 and 5 respectively are stretching. The girdle 4 is provided with a power cylinder 6, the piston rod of which at the inside of the girdle 4 is provided with a thrust plate 7 (Fig. 4). The girdle 5 is provided with a cylinder 8 which at the inside of the girdle 5 is provided with an inflatable balloon 9 (Fig. 3).
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~037805 The tunnels 2, 3 are provided with manoeuvre organs 10 by means of which locking means 15 for the girdles 4, 5 can be manoeuvred. The manoeuvre organ 10 and the locking means 15 form together a lever at each of the mouths of the tunnels, which lever is pivotable by means of a shaft 16. A spring 17 is provided to press the locking means 15 against that in the tunnel 2, 3 inserted girdle 4, 5 respectively. Thereby the locking means 15 can lock the girdle by cooperation with one of theholes in the same. By means of a thrust against the 10 manoeuvre organ 10 the lever can be pivoted against the force of the spring 17 and by means of this the locking means 15 can be forced out of engagement with the girdle. At least the one end of each of the girdles 4, 5 can be entirely drawn out of the tunnel so that the girdle can be laid around the body on a person resting on the bed part 1. Preferably the girdles are - ~
provided to be displaced in the tunnels 2, 3 not only in the ~ ;
direction for stretching of the girdle but also in the longitu-dinal direction of the bed part 1 in order to suit the positions of the girdles to different persons.
As shown in Fig. 5 the pneumatic organs, the cylinders 6, 8 are provided to be connected to a pneumatic ,~
pressure source by means of hoses 11. In Fig. 5 this pressure ~;
source is shown as a pressure tank 18 with closing- and reducing valves and a pressure gauge. From the pressure tank 8 a forked !, ' , ,, conduit is leading to the two pneumatic organs 6, 8 via closing valves 19 and the hoses 11.
The pneumatic organ 6 comprises a cylinder 21 with a ~ ~ -piston 22 objected to the force from a thrust spring 23 and provided with a piston rod 24, which is terminating in said thrust plate 7, which is intended to move in a reciprocal move~

ment. To obtain this function a pneumatic pulse generator is provided in that conduit, which leads to the organ 6.

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-2-1037~05 The pulse generator 20 comprises a house 25 w~th a main channel 26 by means of which the organ 6 is connected to the pressure tank 18 via the hose 11. From the main channels 26 a branched channel 27 is leading to a cylinder space 28 via a regulating valve 29. The branched channel 27 can be vented by means of a second regulating valve 30. In the cylinder space 28 a piston 31 is arranged to move to and fro and is there- -by objected to the force from a spring 32. The piston 31 is provided with a piston rod 33 which is arranged as a closing valve in the main channel 26. The valve body on the piston rod 33 shows a seat in the channel 26 and the piston 31 shows a seat adjacent to the inlet in the cylinder 28 for the branched channel 27.
The part 1 intended to have the function of a bed ~
is provided with an upper surface curve which will give the -body of a person laying on the bed part 1 a convex posture seen -~
from the front whereby the head is leaning backwards (see Fig. 2).
In order to facilitate the transportation the part 1 is divided into two sections connected by means of a hinge 12 whereby said surface curve is so shaped that the two sections suit each other and are forming a parallelepipedic body 13 when folded together as is evident from Fig. 2. The one of the sections is provided with an extensible box 14 suitable for storing of said pressure tank 18.
By use of the apparatus the bed part 1 is placed in unfolded position on a substantially horizontal ground and ; the girdles 4, 5 are open. Hereinafter the body of the patient is laid on the bed part 1 in the position shown in Fig. 2. The girdles are tightened around the body, the girdle 4 so that the pneumatic organ 6 will be placed in the front of the heart and ;, the girdle 5 so that the pneumatic organ 8 will be placed in , the level of the abdomen to the left.
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-3-~037805 The pneumatic organs 6, 8 are by means of the hoses 11 connected to the pressure tank 18. After that the main valve is opened the balloon 9 is filled with gas under pressure by opening the respective valve 19. The balloon 9 is inflated and presses as is evident from Fig. 3 the wall of the abdomen inwards and if the balloon is in the right position, aorta abdominalis will be pressed against the vertebral column.
Thereby the bloodstream to the lower extremeties will be restricted and when the heart is stimulated the bloodstream will 10 substantially be directed towards the brain, which is very ' ~ -sensitive to restrictions in the supply of blood. ~ - -For starting of the heart stimulating operation the second one of the valves 19 is opened. During a first period of time the piston rod 33 is forced by the spring 32 to be in the - ~ -position shown in Fig. 5 and the pressure gas has an unrestricted way through the main channel 26 to the organ 6. By means of the pressure gas the piston 22 of the organ 6 will be displaced ~ ;
against the force from the spring 23 so that the thrust plate 7 will press against the heart via the chest as shown in Fig. 4.
However, the pressure gas will escape via the branch channel 27 and the regulating valve 29 to the piston 31. When the pressure at the piston 31 has reached a certain level the force from the spring 32 is overcome and the piston 31 begins to move towards the main channel 26. When the piston lifts from its seat a larger surface of the piston is exposed to the gas pressure.
Thereby the piston is momentarily moved to its second extreme position in which the valve body formed by the piston rod 28 closes the main channel 26. The gas entrapped between the valve -body 33 and the piston 22 of the organ 26 escapes relatively ~, slowly out through the two regulating valves 29, 30. Thereby the thrust plate 7 returns to its inner position under the force from the spring 23 against the piston 22. At the same time the . " .
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~.037805 pressure in the cylinder room 28 decreases and the pressure against the valve body 33 together with the force from the spring 32 after a while will overcome the decreasing pressure in the cylinder 28 whereby the valve body 33 lifts from its seat so that the surface of the same, exposed to the pressure in the main channel 26 increases. Consequently, the piston 31 with the piston rod 33 momentarily will return to its original position shown in Fig. 5 and the pressure gas again can flow unrestricted through the main channel 26 and the hose ll to the organ 6 so that the piston 22 with the thrust plate 7 will make a new stroke. In this way the cycle is repeated so that the heart is mechanically stimulated by means ;
of a rythmical treatment. The frequence of the same can be regulated by means of the regulating valves 29, 30.
By means of the shape of the bed part 1 the body of the patient will be supported in such position that the heart will be well exposed to external massage and aorta -abdominalis in position to be efficiently compressed. Further-more, the bed part can be provided to give the head a position which will free the air passage and facilitate the using of artificial respiration.
In spite of its complex and advanced function the apparatus according to the invention is very easy to handle and it is suited to be brought in function very rapidly according to its transportability as well as to its ' easy preparation for use.

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SUPPLEMENTARY DISCLOSURE
In a further development of the present invention, it was found of advantage to produce an arrangement wherein the connector means is a generally rigid frame secured to the base.
Preferably, the generally rigid frame is a generally U-shaped frame whose free ends are provided with bracket means for -- -pivotally securing the frame to the base for pivotal movement about an axis generally coincident with the surface of~the base and extending transversely thereof.
An embodiment of the improved device will now be -~
described with reference to Figures 6-10, wherein:
Fig. 6 is a perspective view of the resuscinator according to the invention ready for use;
Fig. 7 is a perspective view of the resuscinator folded for transportation;
Fig. 8 is a part of a support of the resuscinator;
Fig. 9 is a sectional view of the resuscinato~ and Fig. 10 is a block diagram of the power system for the resuscinator.
According to Fig. 6 the resuscinator according to the `
invention comprises a base 101 intended to be used as a bed and shaped to give the person who has to be treated a suitable position i.e. the base is provided with a portion 102 intended to give the abdomen a raised position and a portion 103 giving the head a backleaning position. Two control panels 102 are provided with a control means of the power system which will be described in the following. The base 101 is further provided with an extension part 105 which by the shown embodiment is shaped as a ladder made for example of metal profiles. The ~!, extension part is in its free end provided with lifting handles 106. A support plate 107 is provided for the lower part of the treated person's body. ', ~

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la37~0s The resuscinator according to the invention further comprises a device 108 for the stimulation of the heart includ-ing first power means e.g. a piston-cylinder unit of the single or double acting type provided at the lower portion with pushing means 109 intended to push against the person's chest for -rhythmical mechanical treatment of the same. -The resuscinator further comprises a device 110 for the compression of the aorta abdominalis formed by a second power means, e.g. a single acting piston-cylinder unit and at - ~ -its lower part provided with a pushing organ 112 intended to ~ -push against the person's abdomen substantially by the aorta.
For the support of the two power means 108, 110 a support 113 is provided attached to the base 101 at the both opposite sides of the same. The support 113 substantially consists of a bridge shaped frame 114 at the centre provided with a sleeve 115 in which the power means 108 is displaceably supported. The lower parts of the frame 114 at the opposite sides of the base 111 are shaped as attachments 116 for the frame which are displaceable in longitudinal direction relative to the base 101 in a chute 108 along each one of the sides 117 of the base 101. ~ ' -A preferred embodiment of the attachment 116 is shown in Figg. 8 and 9 according to which figures each one of the attachments 116 substantially consists of a plate shaped element 119. The frame 114 is pivotably connected to the element 119 by means of a pivoting means 120 and a locking means 121 is provided at at least one of the attachments 116. The locking means 121 for example in the known way is designed as a spring loaded pin which in the locking position extends into an opening in the element 119. A further opening 122 is provided in the element 119 making the locking of the frame 114 in a folded down position possible as shown with dashed and dotted lines -6- ,4 . .
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1037&05 in Figs. 6 and 7. The attachment 116 comprises further two relatively to the element 119 rotatable rolls 123, which extend into the chute on both sides of the base 101 to make it possible to displace the support 113 in different positions relative to - the base 101 by displacing the rolls in the chute. The support -113 can be locked relative to the base 101 in a desired position in the chute 108 by means of locking means 124. The locking means 124 is in the shown embodiment connected to at least one ~ ~
of the rolls 123 and includes an eccentric element 125 which is ~ -rotatable between a releasing position and a locking position by means of turning means 126. Thus, the attachment-116 is ~ -locked in the chute 118 by friction. -The power means 110 for the compression of aorta is, as mentioned, supported by the support 113. For this purpose a supporting arm 127 extends from the frame 114 and, in the shown embodiment, the arm is extendable in a telescopic way and the power means 110 is carried at the outer end of the arm. -`
The supporting arm 124 is attached to the frame 114 to the one leg 128 of the-same by means of a sleeve 129 which is partly displaceable in vertical direction along the leg 128 and partly s pivotable relative to the same. By means of this arrangement ~;
the power means 110 with the pushing plate 112 can be adjusted to the right position in a horizontal plane and in vertical ~ -; direction for the treatment of the person and it can also be pivoted to a position at the side of the base 101 and the person resting on the same. The sleeve 129 preferably has an automatic locking on the leg 128 by means of the friction which will be `~
the effect of the turning moment on the arm 127 when the power means 111 is activated. In Fig. 10 is shown a power system for the two power means 108 and 110. The power means are driven .; : .
by a pressurized medium, preferably air, delivered from a source 130 of pressure preferably a movable pressure air -~

~ , . ' : ~ ' -: : : , . . , , . - . , ,. . ~. . ,,, ;~ .,, -: , , container or alternatively the resuscinator can be connected to a conduit for pressure medium. Such conduits are commonly installed in most hospitals. The power system is divided in two branches, the first branch 131 leading to the power means 108 for the stimulation of the heart and a second branch 132 leading to the power means 110 for the compression of aorta.
Each branch is provided with a valve 133, 134, pressure regulator 135, 136 and a pressure gauge 137, 138 by means of which the two power means 108, 110 can be separately activated and oper-ated at a suitable pressure. In the branch 131 to the heartstimulating device is further a pulse generating means 139 pro-vided which is arranged to transform the continuous pressure -to a series of pressure pulses in the conduit 140 to the power means 108 for the heart stimulation device by means of which the pulse plate 109 is brought to a rhythmical vibration the frequence of which can be adjusted by means of adjusting means -141.
The treatment can be varied according to medical requirements as choice of the activating of the power means 108 ~ -or 110 or both of the pressure and frequenc~ for the powermeans 108.
The support 113 according to the invention can be pivoted around the pivoting means 120 and can be locked in raised as well as in laid down position. When the person intended for treatment shall be placed on the base 111 or removed from the same the support 111 is preferably displaced in a direction -~
towards the end of the chute 118 which is adjacent to the manoeuvre panel 104 while the frame 114 is laid down to the position shown in Fig. 6 with dashed-dotted lines. The support arm 127 has to be pivoted in a position sidewise to the base.
Thus there are no obstacles for the placing of the person on the base 101. When the person is resting on the base the sup-port 113 has to be raised to its raised position and locked in -- : ~ ., ::- , la37~0s : , this position and the attachment 113 is locked in the chute by means of the locking means 124 in a suitable position in the centre of the chest of the person. The power means 108 for the -;~
heart stimulating device will thereafter be moved to a suitable vertical position in the sleeve 115 and the power means 110 for -the compression of aorta is adjusted to a correct position at the abdomen by means of an adjustment to a correct vertical position and to a correct pivoting angle of the arm 124 with the same extended in a suitable position. The resuscinator is now ready for use.
In Fig. 10 it is shown how the resuscinator according to the invention can be folded to a less space consuming form for transport or storing. Thereby the extendable part 155 is -retracted in the base 101 and the frame 114 is laid down against -~
the base 101 and locked in this position by means of the locking means 121 cooperating with the opening 122 in the attachment 119 ;
which in turn is locked by the locking means 124 in a suitable position in the chute 118. The support arm 127 is pivoted so .,' , .
that the power means 110 is pivoted in over the base 101. It 2Q is also possible to give the resuscinator according to the invention other forms than the described embodiment. For example it is possible to design the support 113 in another way than the shown, e.g. with only one leg attached to the one side of the base. It is also possible to arrange a separate support `'hi or frame for the support arm 127.
Those skilled in the art will readily appreciate from both the original and supplementary disclosure that many other embodiments of the present invention may be produced deferring to a greater or lesser degree from the embodiments shown above.
Many such deviations, however, still fall within the scope of ` -the present invention as defined in the accompanying claims, both original and supplementary.

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Claims

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:

1. Apparatus for external mechanical stimulation of the heart, said apparatus comprising, in combination:
(a) heart stimulator means for mechanically compressing a portion of human body in a rhythmical, pulsating fashion;
(b) compressing means for exerting a thrust against the abdomen of the body;
(c) a base for supporting said body in a generally horizontal position; and (d) connector means for securing said stimulator means and said compressing means to said base.

2. Apparatus as claimed in claim 1, wherein the surface of said base is generally convex to give to the chest/
abdominal portion of the body a generally convex posture, when the body is supported by said base.

3. Apparatus as claimed in claim 2, wherein said base is formed of two parts arranged for a selectively alternative mutual position to render said base either extended for use, or contracted for storage.

4. Apparatus as claimed in claim 3, wherein said two parts are connected to each other by transverse hinge means for folding and unfolding of said base.

5. Apparatus as claimed in claim 4 , wherein the surface of said base is so shaped that on folding of said two parts, the respective portions of the surface of the base are generally complementary and generally coincident with each other.

6. Apparatus as claimed in claim 1, wherein said connector means is formed by two girdles, one arranged to be stretched generally transversely over the chest of the body, the other girdle being arranged to be stretched generally transversely over the abdomen of the body;

7. Apparatus as claimed in claim 1, further comprising adjustment means for selectively adjusting the location of said heart stimulator means and of said compressing means in a direction generally longitudinally of said base.

8. Apparatus as claimed in claim 1, wherein said connector means is formed by two girdles, one arranged to be stretched generally transversely over the chest of the body, the other girdle being arranged to be stretched generally transversely over the abdomen of the body, said apparatus further comprising adjustment means for selectively adjusting the location of said heart stimulator means and of said compressing means in a direction generally longitudinally of said base, said adjustment means comprising channel means secured to said base, said channel means providing a passage for an end portion of the respective girdle.

9. Apparatus as claimed in claim 8 wherein said passage is a narrow slot elongated in a direction generally parallel with the surface of said base, the width of said slot being in excess of the width of the respective girdle, whereby the location of the respective girdle relative to said slot and thus relative to the base, is selectively adjustable said slot thus forming said adjustment means.

CLAIMS SUPPORTED BY SUPPLEMENTARY DISCLOSURE

10. Apparatus as claimed in claims 1, 2 or 3, wherein said connector means is a generally rigid frame means secured to said base.

11. Apparatus as claimed in claims 1, 2 or 3, wherein said connector means is a generally rigid frame means secured to said base, said generally rigid frame means being a generally U-shaped frame whose free ends are provided with bracket means for securing the frame to said base for pivotal movement about an axis generally coincident with the surface of said base and extending transversely thereof.

12. Apparatus as claimed in claims 1, 2 or 3, wherein said connector means is a generally rigid frame means secured to said base, said generally rigid frame means being a generally U-shaped frame whose free ends are provided with bracket means for securing the frame to said base for pivotal movement about an axis generally coincident with the surface of said base and extending transversely thereof, said bracket means further comprising lock means for releasably maintaining said frame in a generally upright position relative to the surface of said base, whereby the frame can be selectively positioned in said generally upright position or in a folded position in which said generally U-shaped frame is generally coincident with the surface of said base.

13. Apparatus as claimed in claims 1, 2 or 3, wherein said connector means is a generally rigid frame means secured to said base, said generally rigid frame means being a generally U-shaped frame whose free ends are provided with bracket means for securing the frame to said base for pivotal movement about an axis generally coincident with the surface of said base and extending transversely thereof, said bracket means being slidable along the respective side of said base, whereby the location of said axis relative to the base is selectively adjustable.

14. Apparatus as claimed in claims 1, 2 or 3, wherein said connector means is a generally rigid frame means secured to said base, said frame being a generally U-shaped frame having a generally horizontal bar section and two leg sections, each leg section having a free end remote from the horizontal bar section; said heart stimulator means being secured to said generally horizontal bar section, said com-pressing means being secured to one of said leg sections.

15. Apparatus as claimed in claims 1, 2 or 3, wherein said connector means is a generally rigid frame means secured to said base, said frame being a generally U-shaped frame having a generally horizontal bar section and two leg sections, each leg section having a free end remote from the horizontal bar section; said heart stimulator means being secured to said generally horizontal bar section, said com-pressing means being secured to one of said leg sections, by securing means, said securing means being of the type allowing for selective displacement of said stimulator means:
(a) in a direction generally parallel to the elongation of the respective leg section;
(b) in a direction generally radially of the elongation of the respective leg section;
whereby the position of the compressing means is selectively adjustable to place same to a selected point above the surface of said base.

16. Apparatus as claimed in claims 1, 2 or 3, wherein said connector means is a generally rigid frame means secured to said base, said frame being a generally U-shaped frame having a generally horizontal bar section and two leg sections, each leg section having a free end remote from the horizontal bar section; said heart stimulator means being secured to said generally horizontal bar section, said com-pressing means being secured to one of said leg sections, by securing means, said securing means being of the type allowing for selective displacement of said stimulator means:
(a) in a direction generally parallel to the elongation of the respective leg section;
(b) in a direction generally radially of the elongation of the respective leg section;
(c) in a direction pivotally about said generally radial direction;
whereby the position of the compressing means is selectively adjustable to place same to a selected point above the surface of said base.

17. Resuscinator comprising power means for the stimulation of the heart by rhythmical mechanical treatment of the chest of a person and power means for the compression of aorta abdominalis provided with a second power device with a pressure organ arranged to push against the abdomen of the person and a base provided to support the person and a support provided to support the first and the second power means CHARACTERIZED in that the support is provided with a first generally rigid portion attachable at the base and provided to stretch in the direction away from the base and at least one second portion extending from said first portion and pro-vided to extend over the base and to carry the power means substantially in a fixedly secured state relative to each other such that the location of said power means is selectively adjustable to a suitable working position or to a non-working, folded position.