EP0542383B1 - Kompressionsvorrichtung - Google Patents

Kompressionsvorrichtung Download PDF

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Publication number
EP0542383B1
EP0542383B1 EP19920250157 EP92250157A EP0542383B1 EP 0542383 B1 EP0542383 B1 EP 0542383B1 EP 19920250157 EP19920250157 EP 19920250157 EP 92250157 A EP92250157 A EP 92250157A EP 0542383 B1 EP0542383 B1 EP 0542383B1
Authority
EP
European Patent Office
Prior art keywords
pressure
chamber
controller
electrical signal
sleeve
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP19920250157
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English (en)
French (fr)
Other versions
EP0542383A3 (de
EP0542383A2 (de
Inventor
John F. Dye
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Tyco International US Inc
Original Assignee
Tyco International US Inc
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Filing date
Publication date
Application filed by Tyco International US Inc filed Critical Tyco International US Inc
Publication of EP0542383A2 publication Critical patent/EP0542383A2/de
Publication of EP0542383A3 publication Critical patent/EP0542383A3/de
Application granted granted Critical
Publication of EP0542383B1 publication Critical patent/EP0542383B1/de
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H9/00—Pneumatic or hydraulic massage
    • A61H9/005—Pneumatic massage
    • A61H9/0078—Pneumatic massage with intermittent or alternately inflated bladders or cuffs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5007—Control means thereof computer controlled
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2205/00—Devices for specific parts of the body
    • A61H2205/10—Leg

Definitions

  • the present invention relates to a device for applying compressive pressures against a patient's limb through means of a compression sleeve enclosing the limb, and mare particularly, to a means for automatically adjusting the pressure within the sleeve to maintain a preselected pressure.
  • Flexible compressive sleeves having a plurality of pressure compartments/chambers are wrapped around the limb of a patient and are then pressurized to apply compressive pressure at different parts of the limb.
  • the sleeves are connected to a source of pressurized fluid which is regulated by a controller.
  • the controllers generally operate to form pressure cycles which propel the blood upwards from the ankle towards the thigh.
  • Such devices can be misadjusted or drift from proper adjustment so that safe and effective pressure may not be applied to the limbs.
  • Applicant is not aware of any prior art that discloses or suggests that pressure applied to a patient's limb may be controlled by an automatic means.
  • the present invention provides such an automatic control means to control pressure exerted on a patient's limb.
  • the abject of the present invention is to provide a pressure generating device for applying compressive forces against a patient's limb through a flexible pressurizable sleeve which encloses the limb having a means for automataally adjusting pressure supplied to the pressurized sleeve to maintain a preselected pressure value.
  • the present invention is a pressure controller as defined in Claim 1.
  • the dependent claims relate to advantageous versions thereof and to a pressure generating device which comprises the pressure controller.
  • the device has a pressure transducer and a controller which generates electrical signals in response to signals from the transducer which operate a flow control valve that controls the flow of fluid to a solenoid controlled valve to automatically adjust the pressure in the sleeve.
  • Another object is to provide automatic pressure adjustment to eliminate the need for a nurse or similar person from having to continuously monitor the pressure selection to insure it remains at a preselected pressure value.
  • Another object of the present invention is to provide automatic pressure adjustment in response to changes in the effective volumes of the pressure chambers of the sleeve caused by changes in a patient's position.
  • the compression device 10 is seen as supplying sequential compressive pressures and cooling to legs 12 of a patient 14.
  • the device 10 includes a pressure controller 16 mounted in a case 18.
  • the controller 16 generates controlled pressures timed as illustrated in FIG. 3, at output ports 20A, 20B, 20C and 20D, respectively as will be described in detail hereinafter.
  • the output ports 20A-20D are connected through flexible tubes 22A, 22B, 22C and 22D and are in fluid communication with input ports 24A, 24B, 24C and 24D of a manifold 26.
  • Two sets of input ports are connected to a pair of compression sleeves 28 by a pair of flexible sets of tubes 30.
  • each sleeve has an ankle chamber 32A, a calf chamber 32B and a thigh chamber 32C.
  • each sleeve has one or more ventilation chambers 32D for ventilating the patient's legs 12.
  • the pressure generator 16 functions to repetitively generate pressure pulses to its output ports 20A-20D in the time sequence shown by wave-forms of FIG. 3.
  • the pressure cycles commence at time TA when pressure pulse A is applied to port 20A and the ankle chambers 32A are pressurized.
  • pressure pulse B is applied to port 20B and the calf chambers 32B are pressurized.
  • pressure pulse C is applied to port 20C and the thigh chambers 32C are pressurized.
  • pressure pulses A, B and C are terminated, chambers 32A, 32B and 32C are vented to the atmosphere, and cooling pulse D is applied to port 20D and ventilation chambers 32D.
  • the entire sequence is repeated commencing with pressure pulse A.
  • the pressure controller 16 has a compressor 74 as a generating source of pressurized fluid.
  • the pressurized fluid is air generated by an air compressor 74.
  • the compressor 74 is connected through a conduit 70 to fluid junction 90 which is connected to solenoid valve 46D and the inlet opening 110 of flow control valve 44 through conduit 61.
  • the discharge opening 120 of flow control valve 44 is connected through conduit 64 to the solenoid valve manifold 94.
  • the solenoid valves 46A, 46B, 46C and 46D control the input of pressure through conduits 66A, 66B, 66C and 66D to a manifold 62 which has output ports 20A, 20D, 20B and 20C.
  • the pressure transducer 34 of a commercially available type, is in fluid communication with the solenoid manifold 94 through pneumatic connection 68 and fluid junction 96.
  • the pressure transducer 34 senses the pressure at output port 20A through conduits 66A and 68; and then converts the pressure sensed into a first electrical signal.
  • the first electrical signal is an analog electrical signal and is communicated to a signal converter 36 through lead 78.
  • This first electrical signal is received by the signal converter 36, of a per se known and commercially available type, which converts the analog electrical signal to a digital electrical signal.
  • the digital electrical signal generated by the signal converter 36 is then communicated to a microprocessor 38 through lead 76.
  • the digital signal is received by the microprocessor 38, also of a per se known and commercially available type, which is programmed to monitor and to compare the digital signal to a preselected pressure value.
  • the microprocessor 38 then sends a second electrical signal to a driver circuit 40, of a commercially available type, through lead 76 which in turn sends pulses of current through lead 72 to a motor 42.
  • the motor 42 preferably is a linear stepper motor that is commercially available, and operates the flow control valve 44 which controls the flow of fluid to solenoid valves 46A, 46B and 46C.
  • the pressure applied to outlet ports 20A-C through solenoid valves 46A-C is dynamically regulated by automatic adjustment of the flow of pressurized fluid through flow control valve 44.
  • a flow control valve 44 for controlling and automatically adjusting pressure in pressure sleeves is depicted.
  • the valve has a hollow body member 100 which has an inlet opening 110 within which a precision orifice 112 is situated and a discharge opening 120.
  • the body member 100 also has a chamber 130 in communication with the inlet and discharge openings.
  • the chamber 130 has a cylindrical central portion 132.
  • the body member 100 may be made from any type of material such as aluminum, steel, brass, etc., although the preferred material is plastic.
  • the flow valve also has a means for sealing against fluid flow entering the chamber 130, the means including a plunger member 140 having a tapered pin 141 at is leading or distal end for releasably seating into the precision orifice 112 situated within inlet opening 110.
  • the plunger 140 may be made of various materials, such as brass, steel, aluminum, other metals or composites, brass being preferred.
  • Plunger 140 has a trailing or proximal sealing portion 142 in slideable fluid-tight contact with the walls of chamber 130 defining cylindrical portion 132.
  • the taper of the tapered pin 141 preferably is a compound taper which permits plunger 140 to precisely control the flow of fluid through orifice 112.
  • Attached to the hollow body 100 is a means for moving plunger 140. This means is a linear stepper motor 42.
  • the plunger 140 is connected to a shaft 152 of the motor 42 which extends into the hollow body 100. The motor moves the plunger 140 in a linear motion in and out of the orifice 112.
  • the stepper motor 42 provides linear motion in increments of 0.0508 mm (2 thousandths of an inch.)
  • the motor 42 has a predetermined internal stop (not shown) to prevent the plunger 140 from jamming into the body of the motor.
  • a predetermined internal stop (not shown) to prevent the tapered pin 141 from jamming into the orifice 112. Because the stepper motor 42 is calibrated to move in increments of 2 thousandths of an inch it can move pin 141 precisely into and out of the orifice 112 without causing it to jam.
  • the pin 141 has a compound taper, the flow of fluid through orifice 112 can be precisely controlled, thereby providing finite adjustments in the flow of fluid to the solenoid valves and therefore to the compression chambers.
  • the flow is precisely controlled due to the combination of the incremental movement of plunger 140 and the compound taper of pin 141.
  • the compound tapered member reduces the area around the inlet opening 110 incrementally until it eventually seats in the orifice 112. This combination permits the finite pressure adjustments.
  • the tapered member is moved in and out of the inlet opening the area between the taper and the inlet opening diminishes or expands, thus, exact control over the pressure is had, which is necessary to maintain a preselected pressure.
  • This control is illustrated in FIG. 5 wherein a comparison is made of the described compound taper and a standard plunger commonly used within flow control valves. The difference in the slopes of pressure is quite obvious.
  • the slope of the pressure when using the standard plunger dips downward showing a drop in fluid flow has occurred.
  • the pressure slope of the present valve is stable and has no substantial pressure drops in its slope. This is important when providing pressure to a pressure sleeve that is being used on the limb's of a patient because any drop in pressure may cause the compressor supplying the pressure to over compensate and provide to much pressure which may possibly cause injury to the patient.
  • This new valve there are no pressure drops, thus when automatically adjusting the pressure in the sleeves, an even flow of pressure will be assured and the compressor will not provide unneeded pressure to the sleeves.
  • a Setting LED (light emitting diode) 48 is shown to be provided to indicate the preselected pressure that is to be applied to the chambers 32A, 32C and 32D, of the sleeves.
  • a cycle monitor 50 is also preferably provided to continuously display the status of the controller's compression sequence.
  • the cycle monitor 50 consists of four back lit panels, which when lighted read: ANKLE, CALF, THIGH and VENT. These represent the four major divisions of one complete cycle. During operation, the ANKLE, CALF, THIGH and VENT lights will light, one at a time, to indicate each of the major cycle divisions in turn.
  • a ten-segment bar graph 52 is also shown to be provided.
  • Each of the ten segments of the bar represents ten percent of a major cycle division and will light in sequence to indicate how much of a major cycle division is complete.
  • the preferred embodiment of this invention will further include a Run LED 54 which indicates that the actual pressure is within 2mmHg of the set pressure.
  • the setting LED 48 After start-up, the setting LED 48 will set itself at 45mmHg and display as the set pressure. The setting LED 48 will light indicate that the microprocessor 38 is in the process of adjusting the actual pressure being supplied by the compressor 16. Within four cycles, the setting LED 48 will turn off and the Run LED 54 will come on, indicating that the actual pressure is within 3mmHg of the set pressure. The microprocessor 38 will continue to operate to make small adjustments in order to more perfectly match the set pressure.
  • the pressure generating device microprocessor 38 controls pressure to the sleeves by automatic pressure adjustment and not only sets the pressure automatically, but maintains the set pressure no matter how the patient moves or changes position.
  • the automatic adjustment feature of the present invention provides a significant advancement and a tremendous achievement over the prior art, therefore an advantage over all prior art. Because the present invention automatically adjusts the pressure to pressure chambers in a sleeve, the requirement to have someone constantly watch over a pressure monitor to see the rise in pressure, and then to have them continue to monitor the pressure to make sure the pressure does not exceed a preselected pressure or to make sure that the chambers have not been depressurized during the pressure cycle because of over pressurizing the chambers, has been eliminated.
  • the nurse can start the pressure generating device, which has a preselected pressure and go on to other duties.
  • the controller will monitor the pressure being supplied to the pressure chambers in the sleeve and will automatically adjust the pressure until the required pressure is arrived at. The controller will then continue to monitor the pressure provided throughout a pressure cycle and maintain the preselected pressure without having to manually make adjustments. The time saved by not requiring constant monitoring is substantial and makes it economically sound for use in hospitals or other health care facilities.
  • the present invention even though automatically adjusting the pressure delivered to pressure chambers, also has a means, as does prior art, to depressurize the pressure chambers in the sleeves, either when the last pressure cycle has terminated, as suggested in an earlier paragraph, or in case of an involuntary shut down or overload of the pressure system.

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  • Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Massaging Devices (AREA)
  • Prostheses (AREA)
  • Percussion Or Vibration Massage (AREA)

Claims (15)

  1. Drucksteuerung (16) zum automatischen Regeln des Kompressionsdrucks von einer Erzeugungsquelle (74) für Druckfluid zu einer flexiblen Hülle (28), die dazu eingerichtet ist, das Glied eines Patienten zu umschließen, wobei die Hülle (28) wenigstens eine Druckkammer (32A, 32B, 32C) hat, in die das Druckfluid einzuführen ist, um einen Kompressionsdruck an das Glied anzulegen, wobei die Drucksteuerung (16) aufweist:
    mit Leitungseinrichtungen (70, 61, 64, 66A, 66B, 66C) verknüpfte Ventileinrichtungen (46A, 46B, 46C), die dazu eingerichtet sind, die Drucksteuerung (16) in Fluidverbindung mit der Quelle (74) für Druckfluid und in Fluidverbindung mit der Druckkammer (32A, 32B, 32C) der Hülle zu setzen,
    ein Flußsteuerventil (44) in Fluidverbindung zwischen der Quelle (74) für Druckfluid und den Ventileinrichtungen (46A, 46B, 46C),
    Einrichtungen (34) zum Erfassen des Druckes in der Kammer (32A), wobei die Druckerfassungseinrichtungen (34) einen Druck-Meßwandler zum Erzeugen eines ersten elektrischen Signals in Antwort auf den Kammerdruck aufweisen;
    wobei die Drucksteuerung (16) gekennzeichnet ist durch auf das erste elektrische Signal reagierende Einrichtungen, um den Druck in der Druckkammer (32A, 32B, 32C) der Hülle (28) automatisch einzustellen, um im wesentlichen einen vorgewählten Druck zu halten, mit:
    Einrichtungen (36, 38) zum Vergleichen des ersten elektrischen Signals mit einem vorgewählten Wert, wobei die Vergleichseinrichtungen (36, 38) eine Einrichtung (38) zum Erzeugen eines zweiten elektrischen Signals aufweisen,
    auf das zweite elektrische Signal reagierenden Einrichtungen (40) zum Erzeugen von elektrischen Stromimpulsen,
    auf die Stromimpulse von der Erzeugungseinrichtung (40) zum Steuern des Flußsteuerventils (44) für das Fluid reagierenden Einrichtungen (42);
    wobei das Flußsteuerventil (44) dazu eingerichtet ist, durch die auf die Stromimpulse reagierenden Einrichtungen (42) gesteuert zu werden, um den Kammerdruck durch Regulieren des Fluidflusses durch das Flußsteuerventil (44) zu den mit den Leitungseinrichtungen (70, 61, 64, 66A, 66B, 66C) verknüpften Ventileinrichtungen (46A, 46B, 46C) für den Austritt des Druckfluids von der Drucksteuerung (16) zu der Hüllenkammer (32A, 32B, 32C) im wesentlichen auf einen vorgewählten Druck automatisch einzustellen.
  2. Drucksteuerung (16) nach Anspruch 1, mit Einrichtungen zum Setzen des gewünschten, an die Kammer (32A, 32B, 32C) anzulegenden Druckes.
  3. Drucksteuerung (16) nach Anspruch 1, wobei die Ventileinrichtungen (46A, 46B, 46C) ein Magnetventil aufweisen.
  4. Drucksteuerung (16) nach Anspruch 1, wobei die auf die Stromimpulse reagierenden Einrichtungen (42) ein linearer Schrittmotor (42) sind.
  5. Drucksteuerung (16) nach Anspruch 2, wobei die Vergleichseinrichtungen (36, 38) einen Signalwandler (36) zum Konvertieren des ersten elektrischen Signals in ein digitales elektrisches Signal und einen Mikroprozessor (38) zum Erfassen des digitalen Signals und zum Vergleichen des digitalen Signals mit dem vorgewählten, von den Setzeinrichtungen bereitgestellten Wert aufweisen.
  6. Drucksteuerung (16) nach Anspruch 1, wobei das Flußsteuerventil (44) aufweist:
    ein hohles Körperelement (100) mit einer Einlaßöffnung (110) und einer Auslaßöffnung (120) darin und eine Kammer (130) in Verbindung mit der Einlaßöffnung (110) und der Auslaßöffnung (120);
    eine Einrichtung (140, 141) zum Abdichten gegen Fluidfluß, der in die Kammer (130) eintritt, wobei die Einrichtung (140, 141) ein verjüngtes Kolbenelement (140, 141) zum lösbaren Setzen in die Einlaßöffnung (110) aufweist; und
    Einrichtungen (42) zum Bewegen des verjüngten Elements (140, 141), wobei die Bewegungseinrichtungen (42) einen linearen Schrittmotor (42) zum Bewegen des verjüngten Elements (140, 141) in einer linearen Bewegung aufweisen.
  7. Drucksteuerung (16) nach Anspruch 6, wobei der lineare Schrittmotor (42) dazu kalibriert ist, sich in einer linearen Bewegung in Schritten von der Größenordnung von etwa 0,0508 mm (0,002 Zoll) zu bewegen.
  8. Drucksteuerung (16) nach Anspruch 7, wobei der Konus (141) des verjüngten Elements (140, 141) ein Verbundkonus (141) ist.
  9. Druckerzeugungsvorrichtung (10) mit, in Kombination, einer flexiblen, mit Druck beaufschlagbaren Hülle (28) mit wenigstens einer Kammer (32A, 32B, 32C) zum Anlegen von Kompressionsdruck an ein Glied eines Patienten, wobei die Kammer (32A, 32B, 32C) in Fluidverbindung mit einer Drucksteuerung (16), wie in Anspruch 1 oder Anspruch 6 definiert, ist, wodurch Druckfluid von der Steuerung (16) erhalten wird.
  10. Druckerzeugungsvorrichtung (10) nach Anspruch 9, wobei die Hülle (28) eine Kammer (32A) zum Anlegen von Kompressionsdruck an den Knöchel, eine Kammer (32B) zum Anlegen von Kompressionsdruck an den Unterschenkel und eine Kammer (32C) zum Anlegen von Kompressionsdruck an den Oberschenkel eines Patienten enthält, wobei jede der Kammern (32A, 32B, 32C) in Fluidverbindung mit der Drucksteuerung (16) ist.
  11. Druckerzeugungsvorrichtung (10) mit einer Quelle (74) für Druckfluid zum Aufbringen von Kompressionskräften gegen ein Glied eines Patienten mittels einer flexiblen Hülle (28), die das Glied umschließt und wenigstens eine mit der Quelle (74) verbindbare Druckkammer (32A, 32B, 32C) hat, und einer Drucksteuerung (16), wie in Anspruch 1 oder Anspruch 6 definiert, die Ventileinrichtungen (46A, 46B, 46C), die mit der Quelle (74) verbunden und mit der Druckkammer (32A, 32B, 32C) verbindbar sind, zum Steuern des Druckes an die Druckkammer (32A, 32B, 32C) aufweist.
  12. Druckerzeugungsvorrichtung (10) nach Anspruch 11, wobei die auf die Stromimpulse reagierenden Einrichtungen (42) ein linearer Schrittmotor (42) sind.
  13. Druckerzeugungsvorrichtung (10) nach Anspruch 11, wobei die Vergleichseinrichtungen (36, 38) einen Signalwandler (36) zum Konvertieren des ersten elektrischen Signals in ein digitales elektrisches Signal und einen Mikroprozessor (38) zum Erfassen des digitalen Signals und zum Vergleichen des digitalen Signals mit dem vorgewählten Wert aufweisen.
  14. Druckerzeugungsvorrichtung (10) nach Anspruch 13, wobei der Mikroprozessor (38) dazu programmiert ist, den Druck auf einen vorgewählten Druck zu überwachen und einzustellen.
  15. Druckerzeugungsvorrichtung (10) nach Anspruch 11, wobei die Ventileinrichtungen (46A, 46B, 46C) wenigstens ein Magnetventil aufweisen.
EP19920250157 1991-11-12 1992-06-18 Kompressionsvorrichtung Expired - Lifetime EP0542383B1 (de)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US79080991A 1991-11-12 1991-11-12
US790809 2001-02-23

Publications (3)

Publication Number Publication Date
EP0542383A2 EP0542383A2 (de) 1993-05-19
EP0542383A3 EP0542383A3 (de) 1994-10-12
EP0542383B1 true EP0542383B1 (de) 1998-05-13

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EP19920250157 Expired - Lifetime EP0542383B1 (de) 1991-11-12 1992-06-18 Kompressionsvorrichtung

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EP (1) EP0542383B1 (de)
JP (1) JP3431935B2 (de)
AU (1) AU654571B2 (de)
CA (1) CA2071379C (de)
DE (1) DE69225459T2 (de)
ES (1) ES2115639T3 (de)

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AU2090392A (en) 1993-05-13
EP0542383A3 (de) 1994-10-12
CA2071379A1 (en) 1993-05-13
DE69225459D1 (de) 1998-06-18
DE69225459T2 (de) 1998-09-17
JPH05269163A (ja) 1993-10-19
AU654571B2 (en) 1994-11-10
CA2071379C (en) 1998-11-10
JP3431935B2 (ja) 2003-07-28
EP0542383A2 (de) 1993-05-19
ES2115639T3 (es) 1998-07-01

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