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
  • A61M16/10—Preparation of respiratory gases or vapours
• • 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
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
  • A61M16/022—Control means therefor
  • A61M16/024—Control means therefor including calculation means, e.g. using a processor
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/04—Tracheal tubes
  • A61M16/0402—Special features for tracheal tubes not otherwise provided for
  • A61M16/0404—Special features for tracheal tubes not otherwise provided for with means for selective or partial lung respiration
• • 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
  • A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
  • A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
  • A61M2016/0021—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with a proportional output signal, e.g. from a thermistor
• • 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
  • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
  • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
  • A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit
• • 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
  • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
  • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
  • A61M2016/0042—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the expiratory circuit
• • 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
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
  • A61M2205/502—User interfaces, e.g. screens or keyboards

Definitions

• the present invention relates to an apparatus for the assisted ventilation .
• the apparatus can be used, in particular, associated to an automatic ventilator for allowing a ventilation separated for the two lungs .
• an automatic ventilator for allowing a ventilation separated for the two lungs .
• This kind of ventilation is indicated in several respiratory diseases .
• the main are : lobar bronchopneumonia, pulmonary fibrosis, thoracic trauma (pulmonary contusion) , atelectasis , thoracic surgery anaesthesia, etc .
• the main aim of the present invention is to eliminate the above drawbacks . These results have been achieved according to the invention thanks to the idea of producing an apparatus having the features described in independent claim. Other features relate to the dependant claims .
• Fig .2 is a detail view of the embodiment of Fig . l ;
• FIG. 7 is a schematic representation of another embodiment of the invention, in which it is possible separately ventilate and control also pulmonary lobes .
• an apparatus A for the assisted ventilation is of the type usable disposed between an automatic ventilator and the respiratory lines Ll, L2 destined to two lungs L ⁇ l, LU2.
• the apparatus is provided with measurement and regulation means V, SF, SP of the flows of inspiration and expiration, independent for the two lungs LUl, LU2 and connected to a single respirator
• the apparatus is provided with a first respiratory line Ll and with a second respiratory line L2 , said measurement and regulation means being provided at least on said first respiratory line Ll .
• the means of measurement and regulation comprise valvular means VI , VE, independent each other and disposed on the inspiration duct Il and expiration ducts El of said respiratory line Ll , and sensor means SF, SP of the flow and/or the pressure disposed on the ducts of inspiration Il and expiration El , said sensor means being disposed upstream and downstream of the valvular means VI , VE .
• the means of measurement and regulation can be connected to a control circuit with micro-processor C, M .
• Said control circuit C, M is programmable in order to - be ' -*able to operate said measurement and regulation means V, SF, SP .
• the apparatus can be provided with visualization means G for allowing the dynamic study of the mono-pulmonary function and/or the contralateral pulmonary function .
• the separation of the flows inspiratory and expiratory for the two lungs LUl and LU2 takes place directly at the outlet of the respirator R and this in order to avoid, with two separated rotatory circuits , one for each lung, the mixture of the inspired gases with the expired gases .
• a respiratory line (L2 ) relative to a lung (LU2 ) , is completely free, being able to distribute gas with the preset data of pressure of the respirator R; the other respiratory line L2 , relative to contra-lateral lung LUl is subj ect to the action of the apparatus A, which is provided with valves, one (VI ) disposed on the inspiratory line ( II ) and the other (VE) on the expiratory line (El ) , for modulating the relevant flows .
• the valves are marked with V, while in Fig . 2 with VI and VE .
• the operation of the valves is electromechanical and the control of the opening 'and closing of the same is determined by a micro-processor which elaborates the data coming from the flow sensors (disposed upstream and downstream of the valves ) and regulates the opening or the closing of the valves according to values of pressure, time and flow predetermined by the operator .
• the opening and the closing of the valves are thus regulated by pressure, flow and time values programmed by the operator .
• the two respiratory circuits for the two lungs end with an antibacterial filter and a "Mount" link, to an orotracheal bilumen tube that takes the gasses separately to both lungs .
• the system comprises a respiratory circuit which is separated in two parts at the outlet of the ventilator R.
• a circuit L2 is completely independent so it ventilates the lung with the modality programmed by the ventilator R. As it' s a ⁇ rotatory circuit, it' s impossible the mixture of inspired and expired gasses .
• the second circuit is rotatory too and is originated by the other line of the Y link; on its way to the orotracheal tube there is an apparatus A, provided with valve device with flow reducer .
• the apparatus of invention is provided with two valves VI , VE, one on the inspiratory line Il and the other one on the expiratory line El .
• the two valves have an electro-mechanic command that can modulate their closing : the valves can be completely closed without flow and can be absolutely opened, with a flow value equal to the one programmed on the ventilator that is the same for the other lung .
• the working of the valves is independent so that the interaction of the two can give all the possible pressure values from zero (no flow) to a static overdistension that corresponds to the peak pressure programmed on the ventilator .
• the lung will be excluded from ventilation; if the expiratory valve VE is totally closed and the inspiratory one VI is open, there will be a static overdistension of the lung .
• Modulating the valves by graduating the closing it' s possible to increase the end expiration pressure', ' " to ' reduce the end inspiration pressure ( PEEP) , to ventilate lung with high PEEPs and low tidals , for all pressure values between expired and inspired extremes . It' s possible to change the time that defines the inspiration-expiration ratio, giving to the expiratory valve a late or a slow opening so to create a kind of inspiration break, as soon as the expiratory valve of the main ventilator opens to let expiratory phase begin .
• the apparatus comprises a sensors system.
• flow and pressure sensors marked generically with S-F-P in Fig . l and with SF and SF in Fig .2.
• the downstream sensors are located as a control system.
• distal sensors have to recognize gas pressure and the flow coming out from the lung .
• the proximal sensors (going toward the ventilator) have to modulate exactly the time of the expiratory phase , recognizing the instant when the main ventilator expiratory valve opens .
• the apparatus comprises a control system M, C .
• This system provided with a microprocessor M, gathering sensors information, will modulate the opening and closing of the valves, sending signals to an electromechanical operating system.
• Unit C strictly connected with the microprocessor, will verify the precision of the parameters set at the exit of the two valves . ' ⁇ *
• a programming system P provided with visualization means G (display) .
• This system has to gather the ventilation data, required by the operating doctor, and send them to the control system so to occur in an active way, on valve system.
• the visualization or graphic means G allow the graphic visualization of flow and pressure waves .
• the respiratory circuit can be composed by two separated components : a disposable element , comprising the real circuit , the Y link and the valve device .
• the electronic components are part of the fixed equipment .
• "Compliance" curves (volume/pressure curves ) flow/time curves , volume/time curves, can be separately extrapolated for each lung .
• the curves can be extrapolated directly on the main ventilator, by closing inspiratory and expiratory valves of the controlled respiratory line, so to exclude in it the respiratory flux .
• Controlled lung functionality curves "can ' be directly extrapolated from the graphic system connected to the suggested respiratory circuit .
• test of mono pulmonary alveolar recruitment can be besides done, by setting , pptimal PEEP for each lung . It ' s possible, in point of fact, to study each lung separately and choose the best ventilation for each of them, either for PEEP, or peak pressure, or inspiration/expiration ratio .
• separated lung ventilation technique with a single ventilator can be also done by making different variants .
• Proposed circuit, with valve device is a totally independent flux and mono pulmonary pressure regulation system, able to detect and modify ventilation flows in a ventilator .
• Separated lung ventilation technique with one ventilator can be also done by arranging the main ventilator for this aim.
• FIG. 5 This possible embodiment is shown in Fig .5 , where A and A' indicate the two apparatus for the two lungs .
• FIG. 6 Another embodiment, shown in Fig .6, provides for making an interface system K between valve device A and the ventilator R, so to simplify on the external equipment, graphic and sensor systems, according to respiratpry power.
• the apparatus A is connected to the ventilator R by an interface device K, able to allow the adjustment of the ventilator R on the base of the signals received by the measurement and regulation means of the flows .
• the apparatus comprises second measurement and regulation means (A' ) , acting on the second respiratory line (L2 ) , and the apparatus (A) is disposed internal to an automatic ventilator (R) provided with , two flow sources (H, H' ) r connected to said first (Ll) and second (L2 ) respiratory lines .
• the apparatus A as in Fig.3 , can comprise second measurement and regulation means (indicated by A' ) acting on the second respiratory line L2.
• the apparatus A can comprise second measurement and regulation means ( indicated by A' ) acting on the second respiratory line L2 ; the apparatus is disposed internal to an automatic ventilator R provided with a flow source (H) with two inlet/outlet , connected to said first (Ll ) and second (L2 ) inspiratory lines (see Fig.5) .
• a supplementary respiratory line (LS ) is associated to a main respiratory line (L) , connected to a ventilator (R) .
• the supplementary respiratory line (LS ) comprises a bronchoscopical sound-probe (B) , which can be selectively connected to a lobular bronchus .
• the distal end of the bronchoscope (B) is inserted in the medium lobe (L02 ) of the right lung (LUl ) .
• This embodiment of the invention thus allows differentiate ventilations respectively for : inferior right lobe (LOl) , medium right lobe (L02 ) , superior right lobe (L03 ) , inferior and medium right lobes (LOl, L02 ) , inferior left lobe (L04 ) , sperior right lobe (L05 ) .
• the main respiratory line (L) is connected to a j oint of "Mount" type (MO) .
• MO j oint
• LS supplementary line
• LS which comprises the broncho-scope (B) and on which is acting the apparatus (A) .

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• Health & Medical Sciences (AREA)
• Pulmonology (AREA)
• Emergency Medicine (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)
• Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Applications Claiming Priority (2)

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• 2004
  • 2004-12-20 IT IT000072A patent/ITNA20040072A1/it unknown
• 2005
  • 2005-12-19 EP EP05823859A patent/EP1830913A1/en not_active Withdrawn
  • 2005-12-19 WO PCT/IT2005/000742 patent/WO2006067822A1/en active Application Filing

Non-Patent Citations (1)

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