CA2230622A1 - Respiratory support apparatus equipped with a device for creating an underpressure in the expiration circuit - Google Patents
Respiratory support apparatus equipped with a device for creating an underpressure in the expiration circuit Download PDFInfo
- Publication number
- CA2230622A1 CA2230622A1 CA002230622A CA2230622A CA2230622A1 CA 2230622 A1 CA2230622 A1 CA 2230622A1 CA 002230622 A CA002230622 A CA 002230622A CA 2230622 A CA2230622 A CA 2230622A CA 2230622 A1 CA2230622 A1 CA 2230622A1
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- Prior art keywords
- expiration
- inspiration
- support apparatus
- valve
- respiratory support
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- Abandoned
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- 230000000241 respiratory effect Effects 0.000 title claims abstract description 27
- 238000009826 distribution Methods 0.000 claims description 28
- 230000002093 peripheral effect Effects 0.000 claims description 16
- 239000012528 membrane Substances 0.000 claims description 15
- 239000007789 gas Substances 0.000 claims description 13
- 238000007789 sealing Methods 0.000 claims description 10
- 238000009530 blood pressure measurement Methods 0.000 claims description 2
- 238000003825 pressing Methods 0.000 claims description 2
- 238000011144 upstream manufacturing Methods 0.000 description 6
- 238000004458 analytical method Methods 0.000 description 2
- 238000004140 cleaning Methods 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 230000001105 regulatory effect Effects 0.000 description 2
- 230000029058 respiratory gaseous exchange Effects 0.000 description 2
- 235000010627 Phaseolus vulgaris Nutrition 0.000 description 1
- 244000046052 Phaseolus vulgaris Species 0.000 description 1
- 208000004756 Respiratory Insufficiency Diseases 0.000 description 1
- 230000000295 complement effect Effects 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 230000000977 initiatory effect Effects 0.000 description 1
- 230000010354 integration Effects 0.000 description 1
- 239000004973 liquid crystal related substance Substances 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 201000004193 respiratory failure Diseases 0.000 description 1
- 230000003068 static effect Effects 0.000 description 1
- 230000001954 sterilising effect Effects 0.000 description 1
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
- A61M16/20—Valves specially adapted to medical respiratory devices
- A61M16/201—Controlled valves
- A61M16/206—Capsule valves, e.g. mushroom, membrane valves
-
- 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
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M16/0009—Accessories therefor, e.g. sensors, vibrators, negative pressure with sub-atmospheric pressure, e.g. during expiration
-
- 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
- A61M16/0057—Pumps therefor
- A61M16/0066—Blowers or centrifugal pumps
- A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
-
- 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
-
- 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
- A61M16/20—Valves specially adapted to medical respiratory devices
- A61M16/201—Controlled valves
- A61M16/202—Controlled valves electrically actuated
- A61M16/203—Proportional
- A61M16/204—Proportional used for inhalation control
-
- 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
- A61M16/20—Valves specially adapted to medical respiratory devices
- A61M16/201—Controlled valves
- A61M16/202—Controlled valves electrically actuated
- A61M16/203—Proportional
- A61M16/205—Proportional used for exhalation control
-
- 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
- A61M16/20—Valves specially adapted to medical respiratory devices
- A61M16/208—Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
- A61M16/209—Relief valves
Landscapes
- Health & Medical Sciences (AREA)
- Emergency Medicine (AREA)
- Pulmonology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Respiratory Apparatuses And Protective Means (AREA)
Abstract
The invention provides a respiratory support apparatus of the type including a compressed air source (16) which supplies compressed air intended to be conveyed, during an inspiration phase, towards a patient by way of an inspiration circuit (12), and of the type in which air expired by the patient during an expiration phase is collected via an expiration circuit (14), characterized in that the apparatus (10) includes means (58) for connecting the expiration circuit (14) to an underpressure source (56) during at least part of the expiration phase.
Description
CA 02230622 l998-02-26 Respiratory support apparatus equipped with a device for creating an underpressure in the expiration circuit The invention relates to a respiratory support apparatus equipped with a device for creating an underpressure in the expiration circuit.
The invention relates more particularly to a respiratory support apparatus of the type including a cornpressed air source which supplies compressed air intended to be conveyed, during an inspiration phase, towards a patient by way of an inspiration circuit, and of the type in which air expired by the patient during an expiration phase is collected 10 via an expiration circuit.
There are many types of respiratory support apparatuses, also called respirators, with which it is possible to overcome breathing difficulties by providing the patient in particular with insufflation assistance during the inspiration phases.
The patient generally has on his face a mask which covers the nose and mouth and to which the inspiration circuit is c:onnected in such a way as to force the patient's inspiration.
However, in an apparatus of this type, the patient's expiration must necessarily be performed by way of the mask, and in some cases this is an inconvenience to the patient, particularly at the start of the expiration phase when the expiration flow rate is at its maximum.
This inconvenience is more particularly noticeable when the expiration valve, by way of which the patient expires to the atmosphere, is arranged not directly on the mask, but instead at a certain distance therefrom.
Indeed, the expiration valve is sometimes remote from the patient's face so that the expiration does not take place directly alongside his face. In some apparatuses, the CA 02230622 l998-02-26 expiration valve is even arranged at the respiratory support apparatus.
This is because the expiration gases are then returned towards the apparatus via an expiration conduit, separate from the inspiration conduit, in such a way that it is possible to carry out analyses of the flow rate and pressure of the expiration stream, or even to carry out an analysis of the cornposition of the expired gases via sensors which are in this case fitted directly in the apparatus and no longer at a 10 distance, a fact which considerably simplifies the integration of these sensors in a respirator control circuit.
The disadvantage of this type of embodiment, referred to as a double circuit, is that the losses of pressure in the expiration circuit are relatively high and further increase the effort the patient needs to make to expire, especially at the start of expiration when the expiration flow rate is at its maximum.
The object of the invention is therefore to provide a respiratory support apparatus which includes means by which it is possible to reduce the effort the patient needs to make during the expiration phase in order to expel the expired gases, especially when using a double circuit.
To this end, the invention provides a respiratory support apparatus of the type described above, characterized in that the apparatus includes means for connecting the expiration circuit to an underpressure source during at least part of the expiration phase.
According to other characteristics of the invention:
- the expiration circuit is connected to the underpressure source at the start of the expiration phase;
- the expiration circuit includes an expiration chamber which is arranged in the apparatus, and an expiration conduit CA 02230622 l998-02-26 which connects the expiration chamber to the patient, and the expiration chamber is connected, on the one hand, to an outlet for the expired gases via an expiration valve, and, on the other hand, to the underpressure source via an underpressure valve;
- a flow rate sensor is interposed in the expiration circuit between the expiration conduit and the expiration chamber;
- the inspiration circuit includes an inspiration chamber which is arranged in the apparatus and into which the 10 cornpressed air source opens, and an inspiration conduit which connects the inspiration chamber to the patient, and the inspiration chamber is connected, on the one hand, to the inspiration conduit by way of an inspiration valve, and, on the other hand, to an exhaust outlet via an exhaust valve;
- the inspiration, expiration, exhaust and underpressure valves are designed in the form of pneumatically controlled membrane valves, and they are arranged in a distribution block in which the inspiration and expiration chambers are formed;
- at least one of the pneumatically controlled valves is provided in the form of a recess hollowed out in the distribution block, the recess opens outwards in a side face of the block and includes, at the back, an internal enclosure and a peripheral enclosure which is formed around the internal 25 enclosure, the two enclosures are delimited from one another by a wall, one end of which extends outwards in the form of a tubular portion which terminates in a transverse annular face directed outwards and forming a sealing seat, a flexible transverse membrane is connected in a sealed manner, via its 30 peripheral edge, to a wall of the recess of the block, towards the outside in relation to the sealing seat, in order to separate the two enclosures from a control compartment, and an CA 02230622 l998-02-26 overpressure in the control compartment is capable of pressing the membrane flat against the sealing seat in order to isolate the internal enclosure in a sealed manner from the peripheral enclosure and thus to close the valve by interrupting the cornmunication between the two enclosures;
- the control compartment is delimited towards the outside by an internal face of a distributor cap, a supply conduit of the control compartment is formed in the distribution block and opens out in a peripheral surface of the recess, 10 opposite a groove which is formed in a peripheral surface of the distributor cap, and the cap includes a channel which opens out, on the one hand, in the groove and, on the other hand, in the front face in order to connect the supply conduit to the control compartment;
- the distribution block is mounted in a removable manner in the apparatus;
- the pressure source is a motor ventilator, and the underpressure source is formed by a suction inlet of the motor ventilator;
- the pressure source is a motor ventilator of the centrifugal type;
- the flow rate sensor includes an external body in which there is engaged a tubular bushing which delimits an air flow channel, the bushing includes two series of radial bores 25 which open out, on the one hand, towards the inside, axially on either side, respectively, of a porous body interposed in the flow channel, and, on the other hand, towards the outside in two annular grooves, respectively, formed in an external cylindrical surface of the bushing, and the external body 30 includes two orifices which each open out opposite one of the grooves and which are connected to pressure sensors;
CA 02230622 l998-02-26 - the pressure measurement orifices of the external body do not open out opposite a radial bore of the bushing.
Other characteristics and advantages of the invention will become evident from reading the following detailed description, which will be understood by referring to the attached drawings, in which:
- Figures 1 to 3 are diagrams illustrating the operating principle of one embodiment of the invention, respectively in the inspiration phase, in the phase with an 10 underpressure in the expiration circuit, and in the expiration phase;
- Figure 4 is an exploded perspective view illustrating an embodiment of the distribution block of a respiratory support apparatus according to the invention;
- Figure 5 is an enlarged view of a detail from Figure 1, illustrating more particularly the pneumatic control valves of the distribution block;
- Figure 6 is a diagrammatic perspective view, with cutaway, illustrating the internal geometry of a pneumatically 20 controlled valve;
- Figure 7 is a side view illustrating the arrangement of the pneumatic valve in the distribution block;
- Figure 8 is a sectional view illustrating the pneumatically controlled valve;
- Figures 9, 10 and 11 are sectional views, along the line 9-9 in Figure 7, of the distribution block of the apparatus according to the invention, represented, respectively, in the inspiration phase, the underpressure phase, and the expiration phase;
- Figures 9A, 10A. 11A are sectional views along the line A-A in Figures 9, 10, 11, respectively;
CA 02230622 l998-02-26 - Figures 9B, 10B, 11B are sectional views along the line B-B in Figures 9, 10, 11, respectively;
- Figure 12 is an axial sectional view of a sensor of the respiratory support apparatus according to the invention;
- Figure 13 is a perspective view illustrating the general structure of an apparatus according to the invention;
and - Figure 14 is a view similar to that in Figure 1, illustrating a second embodiment of the invention.
A diagram illustrating in a simplified manner the structure of a respiratory support apparatus 10, or respirator, according to the invention is represented in Figures 1 to 3.
The apparatus 10 includes an inspiration circuit 12 which is intended to convey compressed air to a patient during 15 respiration phases. During expiration phases, the supply of compressed air is interrupted and the gases expired by the patient are collected in an expiration circuit 14 before being discarded to the atmosphere.
In the illustrative embodiment which is described 20 hereinafter, the apparatus 10 is a self-contained apparatus, more particularly intended to be used in the patient's home, for which reason it includes its own source of production of compressed air. Here, the apparatus 10 thus includes a motor ventilator 16 which is advantageously in the form of a 25 centrifugal compressor and which can be powered, for example, by way of the mains current or by way of accumulator batteries (not shown).
Such a respiratory support apparatus 10 must therefore be particularly compact. An illustrative embodiment 30 of the apparatus 10 is represented in a diagrammatic form in Figure 13, in which it can be seen that the accumulator batteries 18, a distribution block 20 and a centrifugal CA 02230622 l998-02-26 compressor 16, with its drive means, are stacked vertically.
The apparatus according to the invention is furthermore intended to be able to function independently for a long period by means of the energy of its batteries 18 alone.
The apparatus 10 is represented here without its covering bodywork in order to reveal a vertical bracket 24 which bears, at its upper end 26 forming a grab handle, a liquid crystal display 28 intended to facilitate the programing of the respirator 10, and more particularly that of a control circuit 10 (not shown) which is carried by a printed circuit board which can be arranged behind the display 28.
The control circuit is intended to control the functioning of the motor ventilator 16, the distribution block 20 and, generally, the whole of the respirator 10.
During the functioning of the respirator 10, the patient generally has on his face a mask (not shown) which covers the mouth and nose and which is connected to the distribution block 20 via an inspiration conduit 30.
Furthermore, the respiratory support apparatus 10 according to the invention is more particularly intended to be used advantageously with a mask which includes an expiration conduit 32, independent of the inspiration conduit 30, in order to collect the gases expired by the patient and to return these to the apparatus 10.
As can be seen from Figure 13, the inspiration 30 and expiration 32 conduits are intended to be connected to a front face 34 of the distribution block 20.
The inspiration 30 and expiration 32 conduits are advantageously designed in the form of flexible tubes, and it is possible to design them, at least along part of their length, in the form of two coaxial tubes, one of which is arranged entirely inside the other.
CA 02230622 l998-02-26 As can be seen more particularly from Figures 1 to 3 and 9 to 11, the inspiration circuit 12 includes an inspiration chamber 36 which is formed in the distribution block 20. An upstream longitudinal end 38 of the inspiration chamber 36 is connected to an air outlet of the motor ventilator 16, while a downstream longitudinal end 39 opens into the inspiration conduit 30.
The inspiration chamber 36 is equipped with a pneumatically controlled inspiration valve 40 which is arranged 0 in such a way as to permit the interruption of the circulation of air in the inspiration chamber 36 between upstream 38 and downstream 39. However, a calibrated branch conduit 42 bypasses the inspiration valve 40 in such a way as to permit circulation of a stream of air at a minimal flow rate, called the 15 leak rate, in the inspiration circuit 12 even when the inspiration valve 40 is closed.
Upstream of the inspiration valve 40, the inspiration chamber 36 is connected to an air exhaust outlet 44 by way of an exhaust valve 46, which is also pneumatically controlled.
The expiration circuit 14 includes, in a symmetrical manner, an expiration chamber 48 which extends longitudinally and parallel to the inspiration chamber 36 in the distribution block 20, and which is connected upstream 50 to the expiration conduit 32 and opens downstream 52, by way of a 25 pneumatically controlled expiration valve 54, into an outlet for the expired gases.
In accordance with the teaching of the invention, the respiratory support apparatus 10 includes means which allow the expiration circuit 14 to be connected to an underpressure 30 source during at least part of the expiration phase.
To this end, the expiration chamber 48 is connected, between its upstream end 50 and the expiration valve 54, to an CA 02230622 l998-02-26 air suction inlet 56 of the motor ventilator 16 by way of a pneumatically controlled underpressure valve 58.
The four exhaust 46, inspiration 40, expiration 54 and underpressure 58 valves are advantageously grouped in the 5 distribution block 20 which, as can be seen from Figures 4 and 9 to 11, is particularly compact and has the advantage that it can be easily dismantled from the apparatus with a view to cleaning and sterilizing it.
All four pneumatically controlled valves are designed according to the same principle of deformation of a flexible membrane which forms the sealing element. Like the inspiration 36 and expiration 48 chambers, they are designed integrally in the material of the distribution block 20 and they are thus similar to the exhaust valve 46 which will be described in greater detail with reference to Figures 5 to 8.
The exhaust valve 46 is designed in the form of a recess 60 which is hollowed out in the distribution block 20 in an axial direction A1 perpendicular to the general longitudinal direction of the inspiration 36 and expiration 48 chambers, and 20 which opens out to the outside in a longitudinal side face 62 of the block 20.
The recess 60 delimits, axially at the back towards the inside of the block 20, an axial cylindrical internal enclosure 64 which opens inwards into the inspiration chamber 36. Formed around the internal enclosure 64 there is an annular peripheral enclosure 66. Tunnels 68 extend axially towards the inside from the back of the annular peripheral enclosure 66 and open into the exhaust outlet 44 which is designed in the form of a cylindrical bore which extends parallel to the inspiration chamber 36 and which opens longitudinally to the rear in a rear face 72 of the distribution block 20.
CA 02230622 l998-02-26 As can be seen more particularly from Figures 6 and 7, the tunnels 68 have a bean shape in cross-section on a plane perpendicular to the axial direction A1 of the exhaust valve 46, and they are diametrally opposite, on either side of the axis A1 of the valve 46, in order, respectively, to pass over and below the inspiration chamber 36.
Viewed from above, the intersection 71 of the tunnels 68 and the exhaust outlet 44 has substantially the shape of an hourglass, as can be seen more particularly from Figures 9 to 10 11.
In the recess 60, the internal 64 and peripheral 66 enclosures are separated by an axial tubular wall 74, of which an annular end face 76, directed towards the outside of the block 20, is intended to form a sealing seat for the valve 46.
A deformable membrane 78 is arranged across the recess 60, axially towards the outside thereof in relation to the tubular wall 74. The membrane 78 includes a peripheral edge 77 which bears sealingly against a shoulder 79 formed in a cylindrical surface 94 of the recess 60.
The membrane 78 separates the two enclosures 64, 66 from a control compartment 80 which extends on the outer side of the membrane 78 and which is delimited axially towards the outside by the front face 82 of a distributor cap 84 engaged sealingly in an external part of the recess 60. As can 25 be seen from Figure 8, the distributor cap 84 is held in place inside the recess 60 by a threaded obturator 86 which is screwed into the open end of the recess 60 in such a way as to lie substantially flush with the outer face 62 of the distribution block 20.
The control compartment 80 is intended to be supplied with compressed air in such a way as to force the membrane 78 to bear inwards, via a central part, against the annular surface 76 of the tubular wall 74 which forms a sealing seat. In this position, the membrane 78 prohibits any communication between the two enclosures, internal 64 and peripheral 66, in such a way that no communication is possible 5 between the inspiration chamber 36 and the exhaust outlet 44.
By contrast, when the supply of compressed air to the control compartment 80 is cut, there is sufficient clearance between the membrane 78 and the sealing seat 76 to permit a stream of air to circulate from the internal enclosure 64 to the 0 peripheral enclosure 66, or vice versa, thereby bringing the inspiration chamber 36 and the exhaust outlet 44 into communication.
The distributor cap 84 is designed in the form of a cylindrical roller of axis A1 in which there is formed, on an 15 external cylindrical surface 88, a collecting annular groove 90 which is interposed axially between two grooves 92 which are intended to receive O-ring seals capable of cooperating with the internal cylindrical wall 94 of the recess 60.
A compressed control air distribution network, which 20 is formed in the distribution block 20, includes a conduit 96 which opens out in the internal cylindrical wall 94 of the recess 60 opposite the collecting groove 90 of the distributor cap 84.
The distributor cap 84 also includes an internal channel 98 which has a substantially radial portion and a substantially 25 axial portion which run together and which open out in the collecting groove 90 and, respectively, in the front face 82 of the distributor cap 84.
Thus, compressed air delivered via the conduit 96 is conducted as far as the control compartment 80 in order to 30 control the opening or closure of the valve 46.
As can be seen from Figures 1 to 3, the pneumatically controlled valves 40, 46, 54, 58 are controlled CA 02230622 l998-02-26 by solenoid valves 102, 104, 106 with three inlets 1, 2 and 3 (referred to hereinafter as 102-1, 102-2, ..., 106-3) and with two positions referred to as 2-1 and 2-3 depending on which inlets are brought into communication.
The solenoid valve 102 which controls the inspiration valve 40 is connected via one inlet 102-2 to the control compartment of the valve 40 and via one inlet 102-1 to a presure tap 108 arranged at the air outlet of the motor ventilator 16 in such a way that when the solenoid valve 102 is in position 2-1, the pressure supplied by the motor ventilator 16 is supplied to the control compartment 80 of the pneumatically controlled valve 40 and causes the latter to close .
The solenoid valve 102 is also connected via its inlet 102-3 to a pressure tap 110 which opens out in the inspiration chamber 36 downstream of the inspiration valve 40.
When the solenoid valve 102 is in position 2-3, the inspiration valve 40 is open and a phenomenon of self-regulation of the stream of air passing through the inspiration valve 40 takes place. This is because a drop in pressure downstream of the valve 40 causes a reduction in the pressure in the control compartment 80 of the valve 40, in such a way that its degree of opening increases and the flow rate of air through the valve 40 increases and tends to cause an increase in the pressure downstream of the valve 40. By contrast, if the pressure downstream of the inspiration valve 40 increases, the pressure in the control compartment 80 also increases, which reduces the flow rate through the valve 40, which thus tends to diminish the pressure downstream of the valve 40.
As can be seen from Figures 1 to 3, the exhaust valve 46 and the expiration valve 54 are controlled by the same solenoid valve 104, of which one inlet 104-2 is CA 02230622 l998-02-26 connected to the control compartment 80 of the two valves 46, 54. This solenoid valve 104 is connected via its inlet 104-1 to the pressure tap 108 at the outlet of the motor ventilator 16, in such a way that when the solenoid valve 104 is in position 2-1, the exhaust 46 and expiration 54 valves are closed.
The inlet 104-3 of the solenoid valve 104 for control of the exhaust 46 and expiration 54 valves is connected to the outlet of a proportional solenoid valve 11 2 whose inlet is connected to the pressure tap 108 at the outlet of the motor ventilator 1 6. A calibrated leakage 11 4 is arranged between the proportional solenoid valve 112 and the inlet 104-3 of the solenoid valve 104. By modulating the degree of opening of the proportional valve 112, it is thus possible to modulate the control air pressure which is supplied at the inlet 104-3, and thereby to control with precision the pressure prevailing in the control compartment 80 of the valves 46, 54 when the solenoid valve 104 is in position 2-3.
With this device it is possible in particular to finely regulate the flow rate which may pass through the exhaust 46 20 and expiration 54 valves. However, in an alternative, the proportional solenoid valve can be replaced by an additional compressor controlled for supplying a suitable pressure.
Finally, the inlets 106-1, 106-2 and 106-3 of the solenoid valve 106 for control of the underpressure valve 58 are connected, in a similar manner to those of the solenoid valve 102 for control of the inspiration valve 40, in such a way that when the solenoid valve 106 is in position l-2, the underpressure valve 58 is closed, whereas it is open when the solenoid valve is in position 2-3. When the underpressure valve 58 is open, self-regulation of the flow rate through the underpressure valve 58 takes place by virtue of a branch CA 02230622 l998-02-26 conduit 1 16 which connects the inlet 106-3 of the solenoid valve 106 to downstream 117 of the underpressure valve 58.
The functioning of the respirator 10 according to the invention will now be more particularly described with reference to diagrammatic Figures 1 to 3, and to Figures 9 to 1 1, 9A to 1 1 A, a nd 9B to 1 1 B i n wh ich the d istribution b lock 20 is represented more precisely but in which the pneumatically controlled valves 40, 46, 54, 58 are represented in a diagrammatic manner for the sake of greater clarity.
When the patient is in the inspiration phase, the respirator 10, and in particular the distribution block 20, is in the state represented in Figures 1, 9A and 9B.
In this state, only the inspiration valve 40 is open, while the exhaust 46, expiration 54 and underpressure 58 valves are closed. In this way, the air supplied by the motor ventilator 16 flows through the inspiration chamber 36, through the inspiration valve 40, and is supplied to the patient by way of l:he inspiration conduit 30.
A pressure sensor 118, interposed between the inspiration chamber 36 and the inspiration conduit 30, and a pre!ssure sensor 120, arranged in the inspiration conduit 30, are connected to a control circuit of the respirator 20 which makes it possible in particular to control the speed of rotation of the motor ventilator 16 in order to deliver to the patient a known volume of air at a known pressure.
As can be seen from Figures 3, 11, 11A and 11 B, when the patient is in the expiration phase, the inspiration 40 and underpressure 58 valves are closed, while the exhaust 46 and expiration 54 valves are open.
Thus, the compressed air supplied by the motor ventilator 16 is directly evacuated through the exhaust valve 46 in the direction of the exhaust outlet 44.
The inspiration circuit 12 is closed off by the inspiration valve 40. A nonreturn shutter 124, arranged in the inspiration circuit 12 between the flow meter 1 18 and the pre!ssure sensor 120, prevents the expired gases from 5 returning to the inspiration chamber 36. However, it is possible to choose not to install the shutter given the fact that the inspiration valve 40, if arranged near the downstream end of the chamber 36, in any event prevents the expired gases from returning too far upstream.
1C By contrast, the gases expired by the patient are collected via the expiration circuit 14 and are evacuated to the expired gases outlet 52 through a flow meter 122, arranged bel:ween the expiration conduit 32 and the expiration chamber 48, and through the expiration valve 54.
The solenoid valve 104 of the expiration valve 54 is the!n in position 2-3 in such a way that it is possible to modulate the pressure in the control compartment 80 of the expiration valve 54 by acting on the proportional valve 112, by which means it is possible to create, in the expiration circuit 14, a positive end-expiratory pressure (PEP) of a defined level which is favourable in the treatment of certain forms of respiratory insufficiency. In this case, a low leak rate, flowing via the branch conduit 42, makes it possible to compensate for any leaks at the patient's mask.
However, the respirator 10 according to the invention includes means for facilitating the patient's expiration at the stalrt of the expiration phase, especially at the moment when the patient has to expire a maximum amount of gas at a large flouv rate.
For this purpose, as can be seen from Figures 2, 10, 10A and 10B, the underpressure valve 58 is open, for a length of time which may vary, for example, between an eighth and a CA 02230622 l998-02-26 quarter of the total duration of the expiration phase, in order to connect the expiration chamber 48 to the underpressure source formed by the air suction inlet 56 of the motor ventilator 16.
In this way, the pressure in the expiration circuit 14 drops and the volume of air contained in the expiration circuit 14 is set in motion by an action other than the simple expiration of the patient, a fact which greatly facilitates the expiration work of the said patient.
Once the expiration phase has thus been started, the underpressure valve 58 is closed again in order to allow expiration to continue by way of the expiration valve 54, as has been seen above.
The invention can also be used in a case where the expiration valve is not arranged in the respirator but, for example, on the mask which the patient is wearing. In this case, the enclosure delimited by the mask forms an expiration chamber, and it suffices to connect the enclosure of the mask to an underpressure valve, controlled by the respirator, in 20 ordler to create, within the mask, a drop in pressure favouring the initiation of expiration.
Figure 14 shows an alternative embodiment of a res,piratory support apparatus according to the invention. In this figure, the elements which are identical or similar to those 25 described above are designated by the same reference nurnerals.
In this second embodiment of the invention, the control compartments 80 of the exhaust 46, expiration 54 and underpressure 58 valves are all controlled simultaneously in 30 an identical manner. This is because they are each connected to the inlet 154-2 of a first solenoid valve or selector 154 which CA 02230622 l998-02-26 thus controls the opening or closure of the corresponding valves .
The inlet 154-3 of the selector 154 is in fact connected via the branch conduit 116 to downstream 117 of the underpressure valve 58, that is to say to an underpressure source. Thus, when the selector 154 is in position 2-3, a positive opening action is produced on each of the membranes 78 of the corresponding valves due to the underpressure which then prevails in their control compartment 80.
With this device it is possible in particular to accelerate the opening of the exhaust valve 46 and of the expiration valve 54 with the purpose of facilitating still further the patient's expiration.
By contrast, the inlet 154-1 of the selector 154 is connected to the inlet 152-2 of a second solenoid valve whose inlets 152-1 and 152-3 are connected, respectively, to the pre!ssure tap 108 at the outlet of the motor ventilator 16 and to the regulated pressure tap formed by the proportional solenoid valve 112 and the calibrated leakage 114.
In this way, when the solenoid valve forming the selector 154 is in position 2-1, the control compartments 80 of the three valves 46, 54, 58 connected to the selector 154 are subjected to a pressure which can be either the pressure at the turbine outlet, which causes closure of these valves, or the pre!ssure regulated by the proportional solenoid valve 112, in which case it is possible to govern the degree of opening of these three valves by acting on the setting of the proportional solenoid valve 112.
It should be noted that in this embodiment of the invention the underpressure valve 58 is necessarily open throughout the duration of the expiration phase.
CA 02230622 l998-02-26 As has been indicated above, the distribution block 20 can be easily dismantled from the apparatus to permit easy cleaning thereof.
For this purpose, as can be seen from Figure 4, the respirator 10 according to the invention includes a rear panel 126 which is intended to be arranged opposite the rear face 72 of the block 20 when the latter is mounted in the apparatus 10.
Thiis rear panel 126, which is fixed in the apparatus, includes, on a rear face 128, means allowing it to be connected to, for example, the motor ventilator 16 and the solenoid valves 102, 104, 106 for control of the valves. On a front face 130, the rear panel 126 includes corresponding connection means which are able to cooperate with complementary means arranged on the rear face of the block 20 and which allow the block 20 to be released by simply sliding the block 20 forwards in the longitudinal direction.
As is represented in Figure 4, the flow rate sensors 118, 122, interposed respectively in the inspiration 12 and expiration 14 circuits, are mounted at the front of the distribution block 20. The two sensors 118, 122 are of an identical design, which is represented diagrammatically in Figure 12.
Each sensor 118, 122 thus includes a substantially tubular external body 132 and a tubular bushing 134 which is engaged in the longitudinal direction in a corresponding cylindrical bore of the external body 132, and of which an internal cylindrical surface 136 delimits a longitudinal internal ch,annel for the passage of the air which is intended to be inspired or which has been expired by the patient.
An external cylindrical surface 138 of the bushing 134 includes two external annular grooves 140 which are spaced Iongitudinally from one another. For its part, the internal CA 02230622 l998-02-26 cylindrical surface 136 of the bushing 134 also includes two internal annular grooves 142 which are arranged to be longitudinally in line, respectively, with the external grooves 140.
The corresponding external 140 and internal 142 grooves are connected via radial bores 144 which are distributed on the circumference of the grooves 140,142.
The external body 132 includes two parallel orifices 146 of radial orientation which each open towards the inside 10 opposite one of the two external grooves 140. Connectors 148 are intended to be introduced into the orifices 146 so as to be connected to transducers of the control circuit of the respirator 10 which are sensitive to pressure.
Furthermore, the bushing 134 is indexed angularly so 15 that the orifices 146 of the external body 132 do not open directly opposite a bore 144 of the bushing.
A porous body is interposed in the internal channel delimited by the bushing 134, longitudinally between the series of corresponding grooves. This porous body 150 is 20 advantageously designed in the form of a honeycombed structure including cells which extend longitudinally and are open in this direction.
Thus, when a stream of air is flowing through the internal channel of the bushing 134, the transducers are each 25 subjected to the static pressure prevailing on the corresponding side of the porous body 150. From the diflerence of these two pressures it is possible to determine by calculation, after a calibrating operation, the flow rate passing thnough the flow meter.
The invention relates more particularly to a respiratory support apparatus of the type including a cornpressed air source which supplies compressed air intended to be conveyed, during an inspiration phase, towards a patient by way of an inspiration circuit, and of the type in which air expired by the patient during an expiration phase is collected 10 via an expiration circuit.
There are many types of respiratory support apparatuses, also called respirators, with which it is possible to overcome breathing difficulties by providing the patient in particular with insufflation assistance during the inspiration phases.
The patient generally has on his face a mask which covers the nose and mouth and to which the inspiration circuit is c:onnected in such a way as to force the patient's inspiration.
However, in an apparatus of this type, the patient's expiration must necessarily be performed by way of the mask, and in some cases this is an inconvenience to the patient, particularly at the start of the expiration phase when the expiration flow rate is at its maximum.
This inconvenience is more particularly noticeable when the expiration valve, by way of which the patient expires to the atmosphere, is arranged not directly on the mask, but instead at a certain distance therefrom.
Indeed, the expiration valve is sometimes remote from the patient's face so that the expiration does not take place directly alongside his face. In some apparatuses, the CA 02230622 l998-02-26 expiration valve is even arranged at the respiratory support apparatus.
This is because the expiration gases are then returned towards the apparatus via an expiration conduit, separate from the inspiration conduit, in such a way that it is possible to carry out analyses of the flow rate and pressure of the expiration stream, or even to carry out an analysis of the cornposition of the expired gases via sensors which are in this case fitted directly in the apparatus and no longer at a 10 distance, a fact which considerably simplifies the integration of these sensors in a respirator control circuit.
The disadvantage of this type of embodiment, referred to as a double circuit, is that the losses of pressure in the expiration circuit are relatively high and further increase the effort the patient needs to make to expire, especially at the start of expiration when the expiration flow rate is at its maximum.
The object of the invention is therefore to provide a respiratory support apparatus which includes means by which it is possible to reduce the effort the patient needs to make during the expiration phase in order to expel the expired gases, especially when using a double circuit.
To this end, the invention provides a respiratory support apparatus of the type described above, characterized in that the apparatus includes means for connecting the expiration circuit to an underpressure source during at least part of the expiration phase.
According to other characteristics of the invention:
- the expiration circuit is connected to the underpressure source at the start of the expiration phase;
- the expiration circuit includes an expiration chamber which is arranged in the apparatus, and an expiration conduit CA 02230622 l998-02-26 which connects the expiration chamber to the patient, and the expiration chamber is connected, on the one hand, to an outlet for the expired gases via an expiration valve, and, on the other hand, to the underpressure source via an underpressure valve;
- a flow rate sensor is interposed in the expiration circuit between the expiration conduit and the expiration chamber;
- the inspiration circuit includes an inspiration chamber which is arranged in the apparatus and into which the 10 cornpressed air source opens, and an inspiration conduit which connects the inspiration chamber to the patient, and the inspiration chamber is connected, on the one hand, to the inspiration conduit by way of an inspiration valve, and, on the other hand, to an exhaust outlet via an exhaust valve;
- the inspiration, expiration, exhaust and underpressure valves are designed in the form of pneumatically controlled membrane valves, and they are arranged in a distribution block in which the inspiration and expiration chambers are formed;
- at least one of the pneumatically controlled valves is provided in the form of a recess hollowed out in the distribution block, the recess opens outwards in a side face of the block and includes, at the back, an internal enclosure and a peripheral enclosure which is formed around the internal 25 enclosure, the two enclosures are delimited from one another by a wall, one end of which extends outwards in the form of a tubular portion which terminates in a transverse annular face directed outwards and forming a sealing seat, a flexible transverse membrane is connected in a sealed manner, via its 30 peripheral edge, to a wall of the recess of the block, towards the outside in relation to the sealing seat, in order to separate the two enclosures from a control compartment, and an CA 02230622 l998-02-26 overpressure in the control compartment is capable of pressing the membrane flat against the sealing seat in order to isolate the internal enclosure in a sealed manner from the peripheral enclosure and thus to close the valve by interrupting the cornmunication between the two enclosures;
- the control compartment is delimited towards the outside by an internal face of a distributor cap, a supply conduit of the control compartment is formed in the distribution block and opens out in a peripheral surface of the recess, 10 opposite a groove which is formed in a peripheral surface of the distributor cap, and the cap includes a channel which opens out, on the one hand, in the groove and, on the other hand, in the front face in order to connect the supply conduit to the control compartment;
- the distribution block is mounted in a removable manner in the apparatus;
- the pressure source is a motor ventilator, and the underpressure source is formed by a suction inlet of the motor ventilator;
- the pressure source is a motor ventilator of the centrifugal type;
- the flow rate sensor includes an external body in which there is engaged a tubular bushing which delimits an air flow channel, the bushing includes two series of radial bores 25 which open out, on the one hand, towards the inside, axially on either side, respectively, of a porous body interposed in the flow channel, and, on the other hand, towards the outside in two annular grooves, respectively, formed in an external cylindrical surface of the bushing, and the external body 30 includes two orifices which each open out opposite one of the grooves and which are connected to pressure sensors;
CA 02230622 l998-02-26 - the pressure measurement orifices of the external body do not open out opposite a radial bore of the bushing.
Other characteristics and advantages of the invention will become evident from reading the following detailed description, which will be understood by referring to the attached drawings, in which:
- Figures 1 to 3 are diagrams illustrating the operating principle of one embodiment of the invention, respectively in the inspiration phase, in the phase with an 10 underpressure in the expiration circuit, and in the expiration phase;
- Figure 4 is an exploded perspective view illustrating an embodiment of the distribution block of a respiratory support apparatus according to the invention;
- Figure 5 is an enlarged view of a detail from Figure 1, illustrating more particularly the pneumatic control valves of the distribution block;
- Figure 6 is a diagrammatic perspective view, with cutaway, illustrating the internal geometry of a pneumatically 20 controlled valve;
- Figure 7 is a side view illustrating the arrangement of the pneumatic valve in the distribution block;
- Figure 8 is a sectional view illustrating the pneumatically controlled valve;
- Figures 9, 10 and 11 are sectional views, along the line 9-9 in Figure 7, of the distribution block of the apparatus according to the invention, represented, respectively, in the inspiration phase, the underpressure phase, and the expiration phase;
- Figures 9A, 10A. 11A are sectional views along the line A-A in Figures 9, 10, 11, respectively;
CA 02230622 l998-02-26 - Figures 9B, 10B, 11B are sectional views along the line B-B in Figures 9, 10, 11, respectively;
- Figure 12 is an axial sectional view of a sensor of the respiratory support apparatus according to the invention;
- Figure 13 is a perspective view illustrating the general structure of an apparatus according to the invention;
and - Figure 14 is a view similar to that in Figure 1, illustrating a second embodiment of the invention.
A diagram illustrating in a simplified manner the structure of a respiratory support apparatus 10, or respirator, according to the invention is represented in Figures 1 to 3.
The apparatus 10 includes an inspiration circuit 12 which is intended to convey compressed air to a patient during 15 respiration phases. During expiration phases, the supply of compressed air is interrupted and the gases expired by the patient are collected in an expiration circuit 14 before being discarded to the atmosphere.
In the illustrative embodiment which is described 20 hereinafter, the apparatus 10 is a self-contained apparatus, more particularly intended to be used in the patient's home, for which reason it includes its own source of production of compressed air. Here, the apparatus 10 thus includes a motor ventilator 16 which is advantageously in the form of a 25 centrifugal compressor and which can be powered, for example, by way of the mains current or by way of accumulator batteries (not shown).
Such a respiratory support apparatus 10 must therefore be particularly compact. An illustrative embodiment 30 of the apparatus 10 is represented in a diagrammatic form in Figure 13, in which it can be seen that the accumulator batteries 18, a distribution block 20 and a centrifugal CA 02230622 l998-02-26 compressor 16, with its drive means, are stacked vertically.
The apparatus according to the invention is furthermore intended to be able to function independently for a long period by means of the energy of its batteries 18 alone.
The apparatus 10 is represented here without its covering bodywork in order to reveal a vertical bracket 24 which bears, at its upper end 26 forming a grab handle, a liquid crystal display 28 intended to facilitate the programing of the respirator 10, and more particularly that of a control circuit 10 (not shown) which is carried by a printed circuit board which can be arranged behind the display 28.
The control circuit is intended to control the functioning of the motor ventilator 16, the distribution block 20 and, generally, the whole of the respirator 10.
During the functioning of the respirator 10, the patient generally has on his face a mask (not shown) which covers the mouth and nose and which is connected to the distribution block 20 via an inspiration conduit 30.
Furthermore, the respiratory support apparatus 10 according to the invention is more particularly intended to be used advantageously with a mask which includes an expiration conduit 32, independent of the inspiration conduit 30, in order to collect the gases expired by the patient and to return these to the apparatus 10.
As can be seen from Figure 13, the inspiration 30 and expiration 32 conduits are intended to be connected to a front face 34 of the distribution block 20.
The inspiration 30 and expiration 32 conduits are advantageously designed in the form of flexible tubes, and it is possible to design them, at least along part of their length, in the form of two coaxial tubes, one of which is arranged entirely inside the other.
CA 02230622 l998-02-26 As can be seen more particularly from Figures 1 to 3 and 9 to 11, the inspiration circuit 12 includes an inspiration chamber 36 which is formed in the distribution block 20. An upstream longitudinal end 38 of the inspiration chamber 36 is connected to an air outlet of the motor ventilator 16, while a downstream longitudinal end 39 opens into the inspiration conduit 30.
The inspiration chamber 36 is equipped with a pneumatically controlled inspiration valve 40 which is arranged 0 in such a way as to permit the interruption of the circulation of air in the inspiration chamber 36 between upstream 38 and downstream 39. However, a calibrated branch conduit 42 bypasses the inspiration valve 40 in such a way as to permit circulation of a stream of air at a minimal flow rate, called the 15 leak rate, in the inspiration circuit 12 even when the inspiration valve 40 is closed.
Upstream of the inspiration valve 40, the inspiration chamber 36 is connected to an air exhaust outlet 44 by way of an exhaust valve 46, which is also pneumatically controlled.
The expiration circuit 14 includes, in a symmetrical manner, an expiration chamber 48 which extends longitudinally and parallel to the inspiration chamber 36 in the distribution block 20, and which is connected upstream 50 to the expiration conduit 32 and opens downstream 52, by way of a 25 pneumatically controlled expiration valve 54, into an outlet for the expired gases.
In accordance with the teaching of the invention, the respiratory support apparatus 10 includes means which allow the expiration circuit 14 to be connected to an underpressure 30 source during at least part of the expiration phase.
To this end, the expiration chamber 48 is connected, between its upstream end 50 and the expiration valve 54, to an CA 02230622 l998-02-26 air suction inlet 56 of the motor ventilator 16 by way of a pneumatically controlled underpressure valve 58.
The four exhaust 46, inspiration 40, expiration 54 and underpressure 58 valves are advantageously grouped in the 5 distribution block 20 which, as can be seen from Figures 4 and 9 to 11, is particularly compact and has the advantage that it can be easily dismantled from the apparatus with a view to cleaning and sterilizing it.
All four pneumatically controlled valves are designed according to the same principle of deformation of a flexible membrane which forms the sealing element. Like the inspiration 36 and expiration 48 chambers, they are designed integrally in the material of the distribution block 20 and they are thus similar to the exhaust valve 46 which will be described in greater detail with reference to Figures 5 to 8.
The exhaust valve 46 is designed in the form of a recess 60 which is hollowed out in the distribution block 20 in an axial direction A1 perpendicular to the general longitudinal direction of the inspiration 36 and expiration 48 chambers, and 20 which opens out to the outside in a longitudinal side face 62 of the block 20.
The recess 60 delimits, axially at the back towards the inside of the block 20, an axial cylindrical internal enclosure 64 which opens inwards into the inspiration chamber 36. Formed around the internal enclosure 64 there is an annular peripheral enclosure 66. Tunnels 68 extend axially towards the inside from the back of the annular peripheral enclosure 66 and open into the exhaust outlet 44 which is designed in the form of a cylindrical bore which extends parallel to the inspiration chamber 36 and which opens longitudinally to the rear in a rear face 72 of the distribution block 20.
CA 02230622 l998-02-26 As can be seen more particularly from Figures 6 and 7, the tunnels 68 have a bean shape in cross-section on a plane perpendicular to the axial direction A1 of the exhaust valve 46, and they are diametrally opposite, on either side of the axis A1 of the valve 46, in order, respectively, to pass over and below the inspiration chamber 36.
Viewed from above, the intersection 71 of the tunnels 68 and the exhaust outlet 44 has substantially the shape of an hourglass, as can be seen more particularly from Figures 9 to 10 11.
In the recess 60, the internal 64 and peripheral 66 enclosures are separated by an axial tubular wall 74, of which an annular end face 76, directed towards the outside of the block 20, is intended to form a sealing seat for the valve 46.
A deformable membrane 78 is arranged across the recess 60, axially towards the outside thereof in relation to the tubular wall 74. The membrane 78 includes a peripheral edge 77 which bears sealingly against a shoulder 79 formed in a cylindrical surface 94 of the recess 60.
The membrane 78 separates the two enclosures 64, 66 from a control compartment 80 which extends on the outer side of the membrane 78 and which is delimited axially towards the outside by the front face 82 of a distributor cap 84 engaged sealingly in an external part of the recess 60. As can 25 be seen from Figure 8, the distributor cap 84 is held in place inside the recess 60 by a threaded obturator 86 which is screwed into the open end of the recess 60 in such a way as to lie substantially flush with the outer face 62 of the distribution block 20.
The control compartment 80 is intended to be supplied with compressed air in such a way as to force the membrane 78 to bear inwards, via a central part, against the annular surface 76 of the tubular wall 74 which forms a sealing seat. In this position, the membrane 78 prohibits any communication between the two enclosures, internal 64 and peripheral 66, in such a way that no communication is possible 5 between the inspiration chamber 36 and the exhaust outlet 44.
By contrast, when the supply of compressed air to the control compartment 80 is cut, there is sufficient clearance between the membrane 78 and the sealing seat 76 to permit a stream of air to circulate from the internal enclosure 64 to the 0 peripheral enclosure 66, or vice versa, thereby bringing the inspiration chamber 36 and the exhaust outlet 44 into communication.
The distributor cap 84 is designed in the form of a cylindrical roller of axis A1 in which there is formed, on an 15 external cylindrical surface 88, a collecting annular groove 90 which is interposed axially between two grooves 92 which are intended to receive O-ring seals capable of cooperating with the internal cylindrical wall 94 of the recess 60.
A compressed control air distribution network, which 20 is formed in the distribution block 20, includes a conduit 96 which opens out in the internal cylindrical wall 94 of the recess 60 opposite the collecting groove 90 of the distributor cap 84.
The distributor cap 84 also includes an internal channel 98 which has a substantially radial portion and a substantially 25 axial portion which run together and which open out in the collecting groove 90 and, respectively, in the front face 82 of the distributor cap 84.
Thus, compressed air delivered via the conduit 96 is conducted as far as the control compartment 80 in order to 30 control the opening or closure of the valve 46.
As can be seen from Figures 1 to 3, the pneumatically controlled valves 40, 46, 54, 58 are controlled CA 02230622 l998-02-26 by solenoid valves 102, 104, 106 with three inlets 1, 2 and 3 (referred to hereinafter as 102-1, 102-2, ..., 106-3) and with two positions referred to as 2-1 and 2-3 depending on which inlets are brought into communication.
The solenoid valve 102 which controls the inspiration valve 40 is connected via one inlet 102-2 to the control compartment of the valve 40 and via one inlet 102-1 to a presure tap 108 arranged at the air outlet of the motor ventilator 16 in such a way that when the solenoid valve 102 is in position 2-1, the pressure supplied by the motor ventilator 16 is supplied to the control compartment 80 of the pneumatically controlled valve 40 and causes the latter to close .
The solenoid valve 102 is also connected via its inlet 102-3 to a pressure tap 110 which opens out in the inspiration chamber 36 downstream of the inspiration valve 40.
When the solenoid valve 102 is in position 2-3, the inspiration valve 40 is open and a phenomenon of self-regulation of the stream of air passing through the inspiration valve 40 takes place. This is because a drop in pressure downstream of the valve 40 causes a reduction in the pressure in the control compartment 80 of the valve 40, in such a way that its degree of opening increases and the flow rate of air through the valve 40 increases and tends to cause an increase in the pressure downstream of the valve 40. By contrast, if the pressure downstream of the inspiration valve 40 increases, the pressure in the control compartment 80 also increases, which reduces the flow rate through the valve 40, which thus tends to diminish the pressure downstream of the valve 40.
As can be seen from Figures 1 to 3, the exhaust valve 46 and the expiration valve 54 are controlled by the same solenoid valve 104, of which one inlet 104-2 is CA 02230622 l998-02-26 connected to the control compartment 80 of the two valves 46, 54. This solenoid valve 104 is connected via its inlet 104-1 to the pressure tap 108 at the outlet of the motor ventilator 16, in such a way that when the solenoid valve 104 is in position 2-1, the exhaust 46 and expiration 54 valves are closed.
The inlet 104-3 of the solenoid valve 104 for control of the exhaust 46 and expiration 54 valves is connected to the outlet of a proportional solenoid valve 11 2 whose inlet is connected to the pressure tap 108 at the outlet of the motor ventilator 1 6. A calibrated leakage 11 4 is arranged between the proportional solenoid valve 112 and the inlet 104-3 of the solenoid valve 104. By modulating the degree of opening of the proportional valve 112, it is thus possible to modulate the control air pressure which is supplied at the inlet 104-3, and thereby to control with precision the pressure prevailing in the control compartment 80 of the valves 46, 54 when the solenoid valve 104 is in position 2-3.
With this device it is possible in particular to finely regulate the flow rate which may pass through the exhaust 46 20 and expiration 54 valves. However, in an alternative, the proportional solenoid valve can be replaced by an additional compressor controlled for supplying a suitable pressure.
Finally, the inlets 106-1, 106-2 and 106-3 of the solenoid valve 106 for control of the underpressure valve 58 are connected, in a similar manner to those of the solenoid valve 102 for control of the inspiration valve 40, in such a way that when the solenoid valve 106 is in position l-2, the underpressure valve 58 is closed, whereas it is open when the solenoid valve is in position 2-3. When the underpressure valve 58 is open, self-regulation of the flow rate through the underpressure valve 58 takes place by virtue of a branch CA 02230622 l998-02-26 conduit 1 16 which connects the inlet 106-3 of the solenoid valve 106 to downstream 117 of the underpressure valve 58.
The functioning of the respirator 10 according to the invention will now be more particularly described with reference to diagrammatic Figures 1 to 3, and to Figures 9 to 1 1, 9A to 1 1 A, a nd 9B to 1 1 B i n wh ich the d istribution b lock 20 is represented more precisely but in which the pneumatically controlled valves 40, 46, 54, 58 are represented in a diagrammatic manner for the sake of greater clarity.
When the patient is in the inspiration phase, the respirator 10, and in particular the distribution block 20, is in the state represented in Figures 1, 9A and 9B.
In this state, only the inspiration valve 40 is open, while the exhaust 46, expiration 54 and underpressure 58 valves are closed. In this way, the air supplied by the motor ventilator 16 flows through the inspiration chamber 36, through the inspiration valve 40, and is supplied to the patient by way of l:he inspiration conduit 30.
A pressure sensor 118, interposed between the inspiration chamber 36 and the inspiration conduit 30, and a pre!ssure sensor 120, arranged in the inspiration conduit 30, are connected to a control circuit of the respirator 20 which makes it possible in particular to control the speed of rotation of the motor ventilator 16 in order to deliver to the patient a known volume of air at a known pressure.
As can be seen from Figures 3, 11, 11A and 11 B, when the patient is in the expiration phase, the inspiration 40 and underpressure 58 valves are closed, while the exhaust 46 and expiration 54 valves are open.
Thus, the compressed air supplied by the motor ventilator 16 is directly evacuated through the exhaust valve 46 in the direction of the exhaust outlet 44.
The inspiration circuit 12 is closed off by the inspiration valve 40. A nonreturn shutter 124, arranged in the inspiration circuit 12 between the flow meter 1 18 and the pre!ssure sensor 120, prevents the expired gases from 5 returning to the inspiration chamber 36. However, it is possible to choose not to install the shutter given the fact that the inspiration valve 40, if arranged near the downstream end of the chamber 36, in any event prevents the expired gases from returning too far upstream.
1C By contrast, the gases expired by the patient are collected via the expiration circuit 14 and are evacuated to the expired gases outlet 52 through a flow meter 122, arranged bel:ween the expiration conduit 32 and the expiration chamber 48, and through the expiration valve 54.
The solenoid valve 104 of the expiration valve 54 is the!n in position 2-3 in such a way that it is possible to modulate the pressure in the control compartment 80 of the expiration valve 54 by acting on the proportional valve 112, by which means it is possible to create, in the expiration circuit 14, a positive end-expiratory pressure (PEP) of a defined level which is favourable in the treatment of certain forms of respiratory insufficiency. In this case, a low leak rate, flowing via the branch conduit 42, makes it possible to compensate for any leaks at the patient's mask.
However, the respirator 10 according to the invention includes means for facilitating the patient's expiration at the stalrt of the expiration phase, especially at the moment when the patient has to expire a maximum amount of gas at a large flouv rate.
For this purpose, as can be seen from Figures 2, 10, 10A and 10B, the underpressure valve 58 is open, for a length of time which may vary, for example, between an eighth and a CA 02230622 l998-02-26 quarter of the total duration of the expiration phase, in order to connect the expiration chamber 48 to the underpressure source formed by the air suction inlet 56 of the motor ventilator 16.
In this way, the pressure in the expiration circuit 14 drops and the volume of air contained in the expiration circuit 14 is set in motion by an action other than the simple expiration of the patient, a fact which greatly facilitates the expiration work of the said patient.
Once the expiration phase has thus been started, the underpressure valve 58 is closed again in order to allow expiration to continue by way of the expiration valve 54, as has been seen above.
The invention can also be used in a case where the expiration valve is not arranged in the respirator but, for example, on the mask which the patient is wearing. In this case, the enclosure delimited by the mask forms an expiration chamber, and it suffices to connect the enclosure of the mask to an underpressure valve, controlled by the respirator, in 20 ordler to create, within the mask, a drop in pressure favouring the initiation of expiration.
Figure 14 shows an alternative embodiment of a res,piratory support apparatus according to the invention. In this figure, the elements which are identical or similar to those 25 described above are designated by the same reference nurnerals.
In this second embodiment of the invention, the control compartments 80 of the exhaust 46, expiration 54 and underpressure 58 valves are all controlled simultaneously in 30 an identical manner. This is because they are each connected to the inlet 154-2 of a first solenoid valve or selector 154 which CA 02230622 l998-02-26 thus controls the opening or closure of the corresponding valves .
The inlet 154-3 of the selector 154 is in fact connected via the branch conduit 116 to downstream 117 of the underpressure valve 58, that is to say to an underpressure source. Thus, when the selector 154 is in position 2-3, a positive opening action is produced on each of the membranes 78 of the corresponding valves due to the underpressure which then prevails in their control compartment 80.
With this device it is possible in particular to accelerate the opening of the exhaust valve 46 and of the expiration valve 54 with the purpose of facilitating still further the patient's expiration.
By contrast, the inlet 154-1 of the selector 154 is connected to the inlet 152-2 of a second solenoid valve whose inlets 152-1 and 152-3 are connected, respectively, to the pre!ssure tap 108 at the outlet of the motor ventilator 16 and to the regulated pressure tap formed by the proportional solenoid valve 112 and the calibrated leakage 114.
In this way, when the solenoid valve forming the selector 154 is in position 2-1, the control compartments 80 of the three valves 46, 54, 58 connected to the selector 154 are subjected to a pressure which can be either the pressure at the turbine outlet, which causes closure of these valves, or the pre!ssure regulated by the proportional solenoid valve 112, in which case it is possible to govern the degree of opening of these three valves by acting on the setting of the proportional solenoid valve 112.
It should be noted that in this embodiment of the invention the underpressure valve 58 is necessarily open throughout the duration of the expiration phase.
CA 02230622 l998-02-26 As has been indicated above, the distribution block 20 can be easily dismantled from the apparatus to permit easy cleaning thereof.
For this purpose, as can be seen from Figure 4, the respirator 10 according to the invention includes a rear panel 126 which is intended to be arranged opposite the rear face 72 of the block 20 when the latter is mounted in the apparatus 10.
Thiis rear panel 126, which is fixed in the apparatus, includes, on a rear face 128, means allowing it to be connected to, for example, the motor ventilator 16 and the solenoid valves 102, 104, 106 for control of the valves. On a front face 130, the rear panel 126 includes corresponding connection means which are able to cooperate with complementary means arranged on the rear face of the block 20 and which allow the block 20 to be released by simply sliding the block 20 forwards in the longitudinal direction.
As is represented in Figure 4, the flow rate sensors 118, 122, interposed respectively in the inspiration 12 and expiration 14 circuits, are mounted at the front of the distribution block 20. The two sensors 118, 122 are of an identical design, which is represented diagrammatically in Figure 12.
Each sensor 118, 122 thus includes a substantially tubular external body 132 and a tubular bushing 134 which is engaged in the longitudinal direction in a corresponding cylindrical bore of the external body 132, and of which an internal cylindrical surface 136 delimits a longitudinal internal ch,annel for the passage of the air which is intended to be inspired or which has been expired by the patient.
An external cylindrical surface 138 of the bushing 134 includes two external annular grooves 140 which are spaced Iongitudinally from one another. For its part, the internal CA 02230622 l998-02-26 cylindrical surface 136 of the bushing 134 also includes two internal annular grooves 142 which are arranged to be longitudinally in line, respectively, with the external grooves 140.
The corresponding external 140 and internal 142 grooves are connected via radial bores 144 which are distributed on the circumference of the grooves 140,142.
The external body 132 includes two parallel orifices 146 of radial orientation which each open towards the inside 10 opposite one of the two external grooves 140. Connectors 148 are intended to be introduced into the orifices 146 so as to be connected to transducers of the control circuit of the respirator 10 which are sensitive to pressure.
Furthermore, the bushing 134 is indexed angularly so 15 that the orifices 146 of the external body 132 do not open directly opposite a bore 144 of the bushing.
A porous body is interposed in the internal channel delimited by the bushing 134, longitudinally between the series of corresponding grooves. This porous body 150 is 20 advantageously designed in the form of a honeycombed structure including cells which extend longitudinally and are open in this direction.
Thus, when a stream of air is flowing through the internal channel of the bushing 134, the transducers are each 25 subjected to the static pressure prevailing on the corresponding side of the porous body 150. From the diflerence of these two pressures it is possible to determine by calculation, after a calibrating operation, the flow rate passing thnough the flow meter.
Claims (12)
1. Respiratory support apparatus of the type including a compressed air source (16) which supplies compressed air intended to be conveyed, during an inspiration phase, towards a patient by way of an inspiration circuit (12), and of the type in which air expired by the patient during an expiration phase is collected via an expiration circuit (14), characterized in that the apparatus (10) includes means (58) for connecting the expiration circuit (14) to an underpressure source (56) at the start of the expiration phase.
2. Respiratory support apparatus according to Claim 1, characterized in that the expiration circuit (14) includes an expiration chamber (48) which is arranged in the apparatus, and an expiration conduit (32) which connects the expiration chamber (48) to the patient, and in that the expiration chamber (48) is connected, on the one hand, to an outlet (52) for the expired gases via an expiration valve (54), and, on the other hand, to the underpressure source (56) via an underpressure valve (58).
3. Respiratory support apparatus according to Claim 2, characterized in that a flow rate sensor (122) is interposed in the expiration circuit (14) between the expiration conduit (32) and the expiration chamber (48).
4. Respiratory support apparatus according to any one of the preceding claims, characterized in that the inspiration circuit (12) includes an inspiration chamber (36) which is arranged in the apparatus (10) and into which the compressed air source (16) opens, and an inspiration conduit (30) which connects the inspiration chamber (36) to the patient, and in that the inspiration chamber (36) is connected, on the one hand, to the inspiration conduit (30) by way of an inspiration valve (40), and, on the other hand, to an exhaust outlet (44) via an exhaust valve (46).
5. Respiratory support apparatus according to Claim 4, taken in combination with any one of Claims 2 or 3, characterized in that the inspiration (40), expiration (54), exhaust (46) and underpressure (58) valves are designed in the form of pneumatically controlled membrane valves, and in that they are arranged in a distribution block (20) in which the inspiration (36) and expiration (48) chambers are formed.
6. Respiratory support apparatus according to Claim 5, characterized in that at least one of the pneumatically controlled valves (40, 46, 54, 58) is provided in the form of a recess (60) hollowed out in the distribution block (20), in that the recess (60) opens outwards in a side face (62) of the block (20) and includes, at the back, an internal enclosure (64) and a peripheral enclosure (66) which is formed around the internal enclosure (64), in that the two enclosures (64, 66) are delimited from one another by a wall (74), one end of which extends outwards in the form of a tubular portion which terminates in a transverse annular face (76) directed outwards and forming a sealing seat, in that a flexible transverse membrane (78) is connected in a sealed manner, via its peripheral edge (77), to a wall (94) of the recess (60) of the block (20), towards the outside in relation to the sealing seat (76), in order to separate the two enclosures (64, 66) from a control compartment (80), and in that an overpressure in the control compartment (80) is capable of pressing the membrane (78) flat against the sealing seat (76) in order to isolate the internal enclosure (64) in a sealed manner from the peripheral enclosure (66) and thus to close the valve by interrupting the communication between the two enclosures (64, 66).
7. Respiratory support apparatus according to Claim 6, characterized in that the control compartment (80) is delimited towards the outside by an internal face (82) of a distributor cap (84), in that a supply conduit (96) of the control compartment (80) is formed in the distribution block (20) and opens out in a peripheral surface (94) of the recess (60), opposite a groove (90) which is formed in a peripheral surface (88) of the distributor cap (84), and in that the cap (84) includes a channel (98) which opens out, on the one hand, in the groove (90) and, on the other hand, in the front face (82) in order to connect the supply conduit (96) to the control compartment (80).
8. Respiratory support apparatus according to any one of the preceding claims, characterized in that the distribution block (20) is mounted in a removable manner in the apparatus (10).
9. Respiratory support apparatus according to any one of the preceding claims, characterized in that the pressure source is a motor ventilator (16), and in that the underpressure source is formed by a suction inlet (56) of the motor ventilator (16).
10. Respiratory support apparatus according to Claim 9, characterized in that the pressure source (16) is a motor ventilator of the centrifugal type.
11. Respiratory support apparatus according to any one of the preceding claims, characterized in that the flow rate sensor (118, 122) includes an external body (132) in which there is engaged a tubular bushing (134) which delimits an air flow channel, in that the bushing (134) includes two series of radial bores (144) which open out, on the one hand, towards the! inside, axially on either side, respectively, of a porous body (150) interposed in the flow channel, and, on the other hand, towards the outside in two annular grooves (140), respectively, formed in an external cylindrical surface (138) of the bushing (134), and in that the external body (132) includes two orifices (146) which each open out opposite one of the grooves (140) and which are connected to pressure sensors.
12. Respiratory support apparatus according to Claim 11, characterized in that the pressure measurement orifices (146) of the external body (132) do not open out opposite a radial bore (144) of the bushing (134).
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR9702502A FR2760196B1 (en) | 1997-03-03 | 1997-03-03 | RESPIRATORY ASSISTANCE APPARATUS PROVIDED WITH A DEVICE FOR CREATING A DEPRESSION IN THE EXPIRATORY CIRCUIT |
| FR9702502 | 1997-03-03 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2230622A1 true CA2230622A1 (en) | 1998-09-03 |
Family
ID=9504358
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002230622A Abandoned CA2230622A1 (en) | 1997-03-03 | 1998-02-26 | Respiratory support apparatus equipped with a device for creating an underpressure in the expiration circuit |
Country Status (5)
| Country | Link |
|---|---|
| EP (1) | EP0862922A1 (en) |
| CA (1) | CA2230622A1 (en) |
| FR (1) | FR2760196B1 (en) |
| MA (1) | MA24482A1 (en) |
| TR (1) | TR199800378A2 (en) |
Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2007054829A2 (en) * | 2005-09-26 | 2007-05-18 | Innovent Medical Solutions, Inc. | Combined ventilator inexsufflator |
| US8651107B2 (en) | 2006-10-20 | 2014-02-18 | The Metrohealth System | Manual lung ventilation device |
| US8844530B2 (en) | 2008-11-17 | 2014-09-30 | Hill-Rom Services Pte. Ltd. | Combination lung ventilation and mucus clearance apparatus and method |
| CN104203321A (en) * | 2012-03-21 | 2014-12-10 | 皇家飞利浦有限公司 | Bi-directional flow generation in an in-exsufflation system |
| US9795752B2 (en) | 2012-12-03 | 2017-10-24 | Mhs Care-Innovation, Llc | Combination respiratory therapy device, system, and method |
| AU2016339393B2 (en) * | 2015-10-12 | 2019-05-30 | Ruxin (Beijing) Medical Systems Co. Ltd. | Inexsufflation system |
| WO2022079477A1 (en) * | 2020-10-16 | 2022-04-21 | Arcelormittal | Mechanical ventilator |
Families Citing this family (17)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR2784587B1 (en) * | 1998-10-19 | 2001-02-02 | Saime Sarl | RESPIRATORY ASSISTANCE APPARATUS COMPRISING IMPROVED MEANS FOR CONTROLLING AN EXPIRATION VALVE |
| SE9803684D0 (en) * | 1998-10-27 | 1998-10-27 | Siemens Elema Ab | Anesthesia apparatus |
| FR2822384B1 (en) * | 2001-03-21 | 2003-12-19 | Airox | MIXED PULMONARY FAN |
| DE10131653C2 (en) * | 2001-06-29 | 2003-07-03 | Map Medizin Technologie Gmbh | Method and device for supplying a breathing gas |
| SE0102400D0 (en) | 2001-07-04 | 2001-07-04 | Siemens Elema Ab | Fluid flow regulation system |
| FR2858236B1 (en) | 2003-07-29 | 2006-04-28 | Airox | DEVICE AND METHOD FOR SUPPLYING RESPIRATORY GAS IN PRESSURE OR VOLUME |
| US8302602B2 (en) | 2008-09-30 | 2012-11-06 | Nellcor Puritan Bennett Llc | Breathing assistance system with multiple pressure sensors |
| EP2654868A2 (en) * | 2010-12-21 | 2013-10-30 | Koninklijke Philips N.V. | Ventilator with integrated blower |
| FR3009966B1 (en) | 2013-08-27 | 2017-02-17 | Fabien Cotteaux | RESPIRATORY ASSISTANCE APPARATUS FOR PERSONS WITH RESPIRATORY DISORDERS AND VENTILATION METHOD USED BY SAID APPARATUS |
| FR3031447B1 (en) * | 2015-01-08 | 2017-01-27 | Air Liquide Medical Systems | MEDICAL VENTILATOR WITH PROPORTIONAL EXHAUST VALVE ASSOCIATED WITH A BI-DIRECTIONAL FLOW SENSOR |
| FR3040886A1 (en) * | 2015-09-10 | 2017-03-17 | Air Liquide Medical Systems | SAFETY SYSTEM FOR MEDICAL FAN |
| FR3085852B1 (en) | 2018-09-14 | 2022-07-15 | Eove | COUGH ASSISTANT DEVICE WITH PNEUMATIC CONTROLLED VALVES |
| CN111569222B (en) * | 2020-05-14 | 2022-12-23 | 浙江省科技宣传教育中心 | Breather valve assembly structure for breathing machine |
| FR3110690B1 (en) * | 2020-05-20 | 2022-09-02 | Renault Sas | Flow meter comprising at least one tube with an internal grid |
| FR3122097B1 (en) | 2021-04-23 | 2023-08-11 | Air Liquide Medical Systems | Cough device implementing video animation to help the patient perform their treatment, especially in INEX mode |
| FR3122096B1 (en) | 2021-04-23 | 2023-06-23 | Air Liquide Medical Systems | Cough device implementing video animation to help the patient perform his treatment, especially in IPPB mode |
| FR3125969B1 (en) | 2021-08-04 | 2023-07-21 | Eove | Cough device with display of insufflated and target gas volumes |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR1160627A (en) * | 1956-11-24 | 1958-07-22 | Jules Richard Sa Des Ets | Method of intermittent pulsation of a gaseous fluid and apparatus for implementing this method, in particular for resuscitation |
| US3741208A (en) * | 1971-02-23 | 1973-06-26 | B Jonsson | Lung ventilator |
| EP0298367B1 (en) * | 1987-07-09 | 1993-10-13 | Carmeli Adahan | Portable ventilator apparatus |
| FR2682042B1 (en) * | 1991-10-04 | 1998-04-30 | Masson Yves Le | DEVICE FOR VENTILATION OF THE RESPIRATORY TRACKS IN PULSED AIR AND FILTER AND ITS APPLICATIONS. |
| WO1994006499A1 (en) * | 1992-09-18 | 1994-03-31 | Pierre Medical S.A. | Breathing aid device |
| FR2714837B1 (en) * | 1994-01-12 | 1996-09-06 | Saime | Device for assisting the ventilation of a patient, comprising in particular a volumetric inspiratory assistance mode. |
| FR2732607B1 (en) * | 1995-04-04 | 1997-08-29 | Saime Sarl | VOLUMETRIC RESPIRATORY ASSISTANCE APPARATUS WITH AN IMPROVED VALVE BLOCK |
-
1997
- 1997-03-03 FR FR9702502A patent/FR2760196B1/en not_active Expired - Fee Related
-
1998
- 1998-02-20 EP EP98400413A patent/EP0862922A1/en not_active Withdrawn
- 1998-02-23 MA MA24974A patent/MA24482A1/en unknown
- 1998-02-26 CA CA002230622A patent/CA2230622A1/en not_active Abandoned
- 1998-03-03 TR TR1998/00378A patent/TR199800378A2/en unknown
Cited By (12)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2007054829A2 (en) * | 2005-09-26 | 2007-05-18 | Innovent Medical Solutions, Inc. | Combined ventilator inexsufflator |
| WO2007054829A3 (en) * | 2005-09-26 | 2007-10-18 | Innovent Medical Solutions Inc | Combined ventilator inexsufflator |
| US8651107B2 (en) | 2006-10-20 | 2014-02-18 | The Metrohealth System | Manual lung ventilation device |
| US8844530B2 (en) | 2008-11-17 | 2014-09-30 | Hill-Rom Services Pte. Ltd. | Combination lung ventilation and mucus clearance apparatus and method |
| CN104203321A (en) * | 2012-03-21 | 2014-12-10 | 皇家飞利浦有限公司 | Bi-directional flow generation in an in-exsufflation system |
| US20150027444A1 (en) * | 2012-03-21 | 2015-01-29 | Koninklijke Philips N.V. | Bi-directional flow generation in an in-exsufflation system |
| CN104203321B (en) * | 2012-03-21 | 2017-07-18 | 皇家飞利浦有限公司 | Two-way airflow is produced in gas extraction system is blown |
| US10328220B2 (en) * | 2012-03-21 | 2019-06-25 | Koninklijke Philips N.V. | Bi-directional flow generation in an in-exsufflation system |
| US9795752B2 (en) | 2012-12-03 | 2017-10-24 | Mhs Care-Innovation, Llc | Combination respiratory therapy device, system, and method |
| US10814082B2 (en) | 2012-12-03 | 2020-10-27 | Mhs Care-Innovation, Llc | Combination respiratory therapy device, system and method |
| AU2016339393B2 (en) * | 2015-10-12 | 2019-05-30 | Ruxin (Beijing) Medical Systems Co. Ltd. | Inexsufflation system |
| WO2022079477A1 (en) * | 2020-10-16 | 2022-04-21 | Arcelormittal | Mechanical ventilator |
Also Published As
| Publication number | Publication date |
|---|---|
| MA24482A1 (en) | 1998-10-01 |
| TR199800378A2 (en) | 1998-09-21 |
| FR2760196B1 (en) | 1999-07-16 |
| EP0862922A1 (en) | 1998-09-09 |
| FR2760196A1 (en) | 1998-09-04 |
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