EP3302665A1 - Appareil de ventilation artificielle avec monitorage de massage cardiaque - Google Patents

Appareil de ventilation artificielle avec monitorage de massage cardiaque

Info

Publication number
EP3302665A1
EP3302665A1 EP16733158.6A EP16733158A EP3302665A1 EP 3302665 A1 EP3302665 A1 EP 3302665A1 EP 16733158 A EP16733158 A EP 16733158A EP 3302665 A1 EP3302665 A1 EP 3302665A1
Authority
EP
European Patent Office
Prior art keywords
gas
massage
cardiac massage
flow
information
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.)
Withdrawn
Application number
EP16733158.6A
Other languages
German (de)
English (en)
French (fr)
Inventor
Marius DERMEL
Eric Jacquot
Marceau RIGOLLOT
Jean-Christophe Richard
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.)
Air Liquide Medical Systems SA
Original Assignee
Air Liquide Medical Systems SA
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Air Liquide Medical Systems SA filed Critical Air Liquide Medical Systems SA
Publication of EP3302665A1 publication Critical patent/EP3302665A1/fr
Withdrawn legal-status Critical Current

Links

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
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
    • A61H31/007—Manual driven
    • 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
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/364—Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4848—Monitoring or testing the effects of treatment, e.g. of medication
    • 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
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
    • A61H31/005—Heart stimulation with feedback for the user
    • 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
    • A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2505/00—Evaluating, monitoring or diagnosing in the context of a particular type of medical care
    • A61B2505/01—Emergency care
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient ; user input means
    • A61B5/746—Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms
    • 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
    • A61H2201/01—Constructive details
    • A61H2201/0173—Means for preventing injuries
    • A61H2201/0184—Means for preventing injuries by raising an alarm
    • 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
    • A61H2201/10—Characteristics of apparatus not provided for in the preceding codes with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
    • A61H2201/105—Characteristics of apparatus not provided for in the preceding codes with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy with means for delivering media, e.g. drugs or cosmetics
    • A61H2201/107—Respiratory gas
    • 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
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1619—Thorax
    • 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5023—Interfaces to the user
    • A61H2201/5035—Several programs selectable
    • 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
    • A61H2201/5023—Interfaces to the user
    • A61H2201/5043—Displays
    • 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
    • A61H2201/5023—Interfaces to the user
    • A61H2201/5048—Audio interfaces, e.g. voice or music 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
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5071—Pressure sensors
    • 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
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/40—Respiratory characteristics
    • A61H2230/42—Rate
    • 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
    • A61M16/20—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
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
    • 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
    • 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
    • A61M2205/18—General characteristics of the apparatus with alarm
    • 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
    • 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
    • A61M2205/52—General characteristics of the apparatus with microprocessors or computers with memories providing a history of measured variating parameters of apparatus or patient
    • 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
    • A61M2209/00—Ancillary equipment
    • A61M2209/08—Supports for equipment

Definitions

  • the invention relates to an artificial ventilation device that can be used during a cardiac massage on a ventilated patient, to ensure monitoring, that is to say a follow-up, of the cardiac massage practiced by a rescuer, such as a doctor of the SAMU, a firefighter, a nurse or the like, and a monitoring method implemented by such a device.
  • Some respiratory assistance devices are fitted to first aid vehicles, such as ambulances, fire engines or ambulances, which respond to traffic accidents, life-threatening emergencies or other risky situations. These respiratory assistance devices are also called “ventilatory assistance devices”, “artificial ventilation devices” or, more simply, “medical ventilators”.
  • emergency interventions often require the combination of a mechanical ventilation of the patient to a cardiac massage thereof, particularly when the victim is in cardiac arrest, following a heart attack for example.
  • a major disadvantage of these devices is that they are added to all the equipment necessary for the rescuer during his intervention and that, moreover, their installation consumes valuable time especially in cardiopulmonary resuscitation situation, then that time is running out.
  • the problem that arises is therefore to propose a medical device for respiratory assistance and a monitoring method that makes it possible to solve all or some of the aforementioned problems and disadvantages, in particular a respiratory assistance device making it possible to assist a rescuer in him.
  • the solution of the invention thus relates to a respiratory assistance device capable of delivering a flow of gas to a patient comprising:
  • a gas conveying conduit for conveying a stream of gas, in particular air
  • measuring means designed to measure at least one representative parameter of the gas flow and to provide at least one signal corresponding to the least one parameter representative of said gas flow
  • signal processing means designed to process said at least one signal coming from the measurement means and to deduce therefrom at least one characteristic information of a cardiac massage performed on a patient
  • the respiratory assistance apparatus of the invention may comprise one or more of the following technical characteristics:
  • measuring means designed to measure at least one representative parameter of the gas flow chosen from the gas pressure and the gas flow rate, in particular the flow rate of gas injected into the patient and / or the flow rate of gas exhaled by the patient.
  • the gas conveying conduit is supplied with gas by a source of gas which may be internal to the apparatus, in particular a motorized or external micro-blower, in particular a gas tank, such as a gas cylinder, or a gas distribution wall outlet supplied by a gas supply duct.
  • a source of gas which may be internal to the apparatus, in particular a motorized or external micro-blower, in particular a gas tank, such as a gas cylinder, or a gas distribution wall outlet supplied by a gas supply duct.
  • the measuring means comprise at least one gas pressure sensor or a gas flow sensor.
  • the measuring means perform a measurement of at least one parameter representative of the gas flow within the gas conduit.
  • the apparatus comprises a micro-blower supplying the gas transport duct and the measuring means are designed to measure the speed of rotation of the motor of the micro-blower.
  • the signal processing means are able to determine information representative of the work (W v; WT) supplied by the massage or amplitudes of pressure and / or flow rate resulting from the massage.
  • the signal processing means are configured to determine the amplitude of the pressure or flow variations generated by a cardiac massage by determining the difference between the maximum pressure (Pmax) or the maximum flow rate (Qmax), respectively, and the pressure minimum (Pmin) or minimum flow rate (Qmin) achieved during the compression and relaxation phases of the patient's ribcage.
  • the signal processing means are configured to determine information representative of the work (Wv) supplied by the massage by calculating the integral of the ventilation pressure with respect to the volume of gas exchanged between the ventilator and the patient, during the compression phase of the cardiac massage and / or the relaxation phase of the cardiac massage. For example, the calculation is done using the following equation (I):
  • - dV is the derivative of the volume exchanged between the ventilator and the patient
  • the signal processing means are configured to determine a representative work information (WT) provided by the massage by calculating the integral of the ventilation pressure with respect to time, during the compression phase heart massage and / or relaxation phase of cardiac massage.
  • WT work information
  • the signal processing means comprise at least one electronic card, preferably an electronic card comprising at least one microprocessor implementing at least one algorithm.
  • It further comprises storage means for storing / storing information, data or other, for example store the characteristic information or massage determined by the signal processing means and their evolution over time.
  • the signal processing means are designed or configured to determine information characteristic of cardiac massage by applying one or more calculation algorithms to one or more signals representative of the gas flow, in particular pressure and / or flow rate signals, preferably, the calculation algorithm or algorithms are applied to a combination of signals representative of the gas flow.
  • calculation algorithm we mean an algorithm configured to operate any mathematical operation, in particular derived type calculations, integral, addition, subtraction, multiplication, division ....
  • the signal processing means are configured, ie capable of and designed to, average the characteristic information or information of the cardiac massage determined during one or more massage cycles, each cycle comprising a compression phase and a phase relaxation (ie decompression) of the patient's ribcage.
  • the signal processing means are configured to calculate an average from the information collected over several cycles, typically between one and several tens of cycles, for example an average made from at least 20 or 30 cycles, preferably from at least 40 to 50 cycles.
  • the display means enable the user, that is to say the rescuer, to visualize said at least one characteristic information of a cardiac massage in the form of values, curves, trends, etc.
  • the device can display a work value (Wv, W T ) provided by the massage or an evolution curve of this value updated instantly with the new values or to display the evolution history of this value for a given period of time selectable.
  • the display means comprise an information display screen, preferably a touch screen and / or color.
  • It further comprises alarm means for alerting the user when one (or more) characteristic information determined is out of a range of predefined values and / or stored by the user, for example if it exceeds a value- high or maximum threshold or, conversely, if it is below a low or minimum threshold value.
  • the signal processing means are configured to control a triggering of the alarm means.
  • the alarm means comprise a visual alarm device and / or an audible alarm device, for example one or fixed or flashing light alerts displayed on the information display screen and / or an emission an audible signal via a speaker or the like.
  • It further comprises at least one battery or an accumulator of electrical energy, preferably rechargeable, and / or a mains connection (110 / 230V).
  • the measuring means and the signal processing means are arranged in a cowling forming the outer shell or carcass of the apparatus, said cowling further carrying the display means.
  • connection connection to a gas outlet duct, in fluid communication with the gas delivery duct, for conveying the gas, such as air, to a patient interface, such as a mask respiratory tract or tracheal tube.
  • the apparatus of the invention thus makes it possible to monitor, that is to say, a follow-up, in real time (or near-real) of the cardiac massage operation that the rescuer (s) ) is practicing on a patient in cardiac arrest and, therefore, to be able to maintain a regularity in the delivered massage, including in case of change of rescuer performing the massage.
  • the invention also relates to a monitoring method that can be implemented by a respiratory assistance device delivering a flow of gas, such as air or air enriched with oxygen, in particular the apparatus according to the invention described above, wherein: a) at least one parameter representative of a gas flow is measured in a gas transport duct,
  • step b) treating said measurement signal obtained in step a) and deducing at least one characteristic information of a cardiac massage performed on a patient, typically a person in cardiac arrest, and
  • step b) displaying said at least one characteristic information of a cardiac massage obtained in step b), on display means.
  • the method of monitoring that is to say monitoring, of the invention may include one or more of the following technical characteristics: the representative parameter of the gas flow is chosen from the gas pressure and the gas flow rate.
  • the representative parameter of the gas flow is a flow rate of gas injected into the patient and / or a flow rate of gas exhaled by the patient.
  • step c) is performed as a value or curves.
  • the parameter representative of the gas flow measured in step a) is converted into at least one measurement signal representative of the gas flow, prior to step b).
  • the characteristic information of the cardiac massage is representative of the work (Wv, W T ) provided by the massage.
  • the characteristic information of the cardiac massage is representative of the amplitudes of pressures caused by the massage.
  • the characteristic information of the cardiac massage is representative of the amplitudes of flow rates caused by the massage.
  • the amplitude of the pressure variations generated by the cardiac massage is determined / evaluated by determining, for each compression and relaxation of the thoracic cavity, the difference between the maximum pressure (Pmax) reached and the pressure minimum (Pmin) reached.
  • step b) the amplitude of the flow variations generated by the cardiac massage is determined / evaluated by determining, for each cycle of compression and relaxation of the rib cage, the difference between the maximum flow rate (Qmax) attained and the minimum flow rate (Qmin) reached.
  • a characteristic information of the representative heart massage of the work (Wv) supplied by the massage is determined / evaluated by calculating the integral of the ventilation pressure with respect to the volume (V) exchanged between the apparatus and the patient, during the compression phase of the cardiac massage and / or during the relaxation phase of the cardiac massage.
  • a characteristic information of the representative massage of the work (W T ) provided by the massage is determined / evaluated by calculating during the release and / or compression phase the integral of the ventilation pressure by relation to time (T).
  • a cardiac massage characteristic information is determined / evaluated by applying one or more calculation algorithms to one or more signals representative of the gas flow, preferably to a combination of signals representative of the gas flow, in particular pressure (P) and flow (Q) signals.
  • the characteristic information or information of the cardiac massage determined during one or more massage cycles is averaged, the average being effected either from several cycles or over a given period of time.
  • the average is made from at least 10 cycles, preferably at least 20 cycles, preferably at least 30 cycles, preferably at least 40 cycles, preferably at least 50 cycles.
  • the average is carried out for example for a period of several seconds, preferably several tens of seconds, preferably for at least 40 seconds, more preferably at least 1 minute.
  • the information (or information) relating to one or more characteristics of the cardiac massage provided to the rescuer enables him to maintain a regularity in the delivered massage, including case of change of rescuer realizing the massage.
  • FIG. 1 represents an embodiment of a respiratory assistance apparatus according to the present invention
  • FIGS. 2A, 2B and 2C represent operations that can be performed by a respiratory assistance device according to the present invention, based on the parameters measured to estimate a characteristic information of the cardiac massage.
  • FIG. 3 is an embodiment of a screen for displaying the characteristic information of the cardiac massage fitted to a respiratory assistance device according to the present invention, such as the apparatus of FIG. 1.
  • Figure 1 shows schematically an embodiment of a ventilatory assistance apparatus or medical ventilator 1 according to the present invention.
  • a gas source 4 which is here a motorized micro-blower, also called turbine, delivering a flow of breathing assistance gas, typically a stream of air or air enriched in oxygen.
  • a flow of breathing assistance gas typically a stream of air or air enriched in oxygen.
  • the air is sucked by the micro-blower via one (or) inlet 4a arranged in the carcass 9 of the fan 1.
  • the gas source 4 comprises a pilot valve supplied with gas, via an internal duct, itself in fluid communication with a gas tank or a gas supply wall outlet connected to a network of gases.
  • gas ducts via a flexible duct connecting the gas tank or the wall socket to the internal duct.
  • the ventilatory circuit 2, 16 comprises at least one inspiratory branch 2 for conveying the respiratory gas to the patient 20. It may also comprise an expiratory branch 16 designed to collect the exhaled gases from the patient 20 which are rich in C0 2 .
  • the expiratory limb 16 comprises an expiratory flow sensor 17, for example a hot-wire sensor, electrically connected to the control means 5, such as an electronic card, as well as an expiratory valve 19 controlled by the control means 5.
  • the limb expiratory 16 communicates, at its downstream end, with the atmosphere via a gas outlet port 18, while its upstream end is connected to the inspiratory branch 2, via a Y-shaped part, or directly to the patient interface 3.
  • Measuring means 6 are provided, such as a sensor and / or flow, which are adapted to and designed to measure at least one parameter representative of the gas flow, in particular the gas pressure or the gas flow, whether the flow rate breathed by the ventilator and / or the flow rate of gas exhaled by the patient 20, and to deliver at least one signal representative of said at least one measured parameter.
  • the measurement is made in the inspiratory branch 2 of the ventilatory gas circuit 2, 16 so as to allow a measurement of the pressure or the gas flow in said inspiratory branch 2 serving as a gas conduit.
  • the measuring means 6 are arranged outside the fan; however, they may also be in the fan 1, according to another embodiment.
  • this measured parameter is converted into at least one signal representative of the gas flow, which is then transmitted to and analyzed by means for processing the gas flow.
  • signal 8 that is to say typically the electronic card acting as control means 5, to deduce at least information relating to a cardiac massage operated on a patient in cardiac arrest.
  • the signal processing means 8 are therefore part of the control means 5 of the fan 1 and comprise one or more microprocessor electronic cards (s) implementing one or more algorithms.
  • the fan 1 further comprises one or more control keys 11, which can be activated by the user, that is to say the nursing staff, such as a first-aid worker, for example, for example a stop / start button or other, and an information display screen 7, preferably a color display touch screen.
  • the signal processing means 8 When the signal processing means 8 have processed the signal (s) coming from the measurement means 6 and deduced therefrom a characteristic information of a cardiac massage performed on the patient 20, this information is sent to and displayed by the means display 7, typically a touch screen.
  • the characteristic information of a cardiac massage may be a work value (W V; W T ) provided by the massage or pressure and / or flow amplitudes resulting massage.
  • This information is displayed as a value, an evolution curve or an evolution trend for a given period of time.
  • Storage means 12 can store all the information, data, tables etc .... They include for example one or flash memories or others.
  • the transmission of signals between the different components of the fan 1 is via suitable connectors, that is to say, electrical connections 10, such as cables or other.
  • the fan 1 may also include a carrying handle 13 and / or a hooking system 14, such as a hook or the like, for hanging the apparatus on a support.
  • the transport of the fan 1 can also be done in a rigid case or a soft bag.
  • Figures 2A-2C provide a better understanding of how the measurements are processed and which characteristic information II, 12, 13 of a cardiac massage can be extracted.
  • FIG. 2A is a graphical representation of the ventilation gas pressure measured during the conduct of a cardiac massage by the measuring means 6, such as a pressure sensor, of the respiratory assistance apparatus or ventilator 1 according to FIG. 'invention.
  • the pressure sensor 6 makes it possible to measure gaseous pressures and to convert these measurements into signals which are transmitted to the information processing means 5, typically an electronic card, of the fan 1 which processes them.
  • the information processing means 5 of the fan 1 determine, on the basis of these measured signals, the maximum pressure Pmax reached by the ventilation pressure P1 during one or each compression phase and the minimum pressure Pmin reached by the ventilation pressure P1. during one or each phase of relaxation of the cardiac massage.
  • the fan 1 determines the characteristic information of the cardiac massage Il by calculating the difference between the maximum pressure Pmax and the minimum pressure Pmin during each compression / decompression cycle, a compression / decompression cycle comprising a compression phase followed by a relaxation phase, that is to say of decompression.
  • the fan of the invention is designed for and able to calculate this information II for all cycles of compression / decompression of the cardiac massage.
  • the information II is here an amplitude of the pressure variations P1 generated by the cardiac massage corresponding to the difference between the maximum pressure (Pmax) and the minimum pressure (Pmin).
  • the curve C1 of FIG. 2A represents, for its part, the evolution of the information II with respect to time, that is to say the evolution of the amplitude of the variations of pressure P1 during the cardiac massage.
  • the information II is then displayed on the screen of the fan 1 of the invention, preferably a color touch screen so as to allow the rescuer to follow, that is to say monitor, these pressure amplitude changes PI and, if necessary, to adapt the massage performed.
  • FIG. 2B is a graphical representation of the flow rate of gas Q1 exchanged between the ventilator 1 and the patient during the execution of a cardiac massage and measured by the measuring means, such as a flow sensor, of the respiratory assistance apparatus or ventilator 1 according to the invention.
  • the flow sensor here makes it possible to measure gas flows and to convert these flow measurements into corresponding signals which are transmitted to the information processing means, typically an electronic card, of the fan 1 which processes them.
  • the information processing means determine, from these signals, the maximum flow rate Qmax reached by the gas flow Ql exchanged between the fan 1 and the patient, during the release phase, and the minimum flow rate Qmin reached by the flow of gas exchanged Q1 during the compression phase of the cardiac massage.
  • the fan of the invention is adapted to and designed to calculate such information 12 for all cycles of compression and decompression of cardiac massage.
  • the information 12 is then displayed, as previously, on the screen of the fan 1 of the invention so as to allow the rescuer to follow these changes in flow amplitude and, if necessary, to adapt the massage performed.
  • FIG. 2C is a graphical representation of the ventilation pressure P2 measured during the execution of a cardiac massage by the measuring means, such as a pressure sensor, in a manner analogous to that explained above in relation to with Figure 2A.
  • the characteristic information 13 of the cardiac massage is obtained by integrating the ventilation pressure P2 with respect to time for a cycle of compression and relaxation and corresponds, in fact, to a work W provided by the massage.
  • the ventilator is capable of calculating this information 13, that is to say the work W, for all the compression and decompression cycles of the cardiac massage.
  • the fan's electronic card can calculate the integral of the ventilation pressure in relation to:
  • V the volume (V) of gas exchanged between the ventilator and the patient, during the compression phase of the cardiac massage and / or the relaxation phase of the cardiac massage, so as to determine the "volumic" work Wv provided by the massage .
  • the information 13 is then displayed on the screen 7 of the fan 1 of the invention so as to allow the rescuer to follow the changes in the work provided W and, if necessary, to adapt the massage performed.
  • the characteristic information II, 12, 13 of a cardiac massage can not only be displayed, as already explained, but also be used to edit one or several reports that can be displayed on the screen 15 or transferable by the ventilator for a consultation out of the fan by the user, for example a consultation on a computer, a smartphone, a touch pad or paper.
  • This report contains the characteristic information of the cardiac massage performed; it may also contain information relating to the characteristics of the ventilation delivered during the cardiac massage, for example the oxygen concentration of the gas supplied to the patient, the volume infused and exhaled by the patient ... This information can be displayed in the report as values or curves.
  • the respiratory assistance device 1 can generate visual and / or audible alarms. These alarms make it possible to alert the user that one or more characteristic information of a cardiac massage is outside a range of predefined values and / or stored by the user.
  • the range of predefined values associated with the information II contains a minimum value II min and a maximum value Il ma x.
  • Il mmi When the instantaneous or average value of the information II is lower than the value Il mmi, a visual and / or audible alarm is generated, by analogy when the instantaneous or average value of the information II is greater than the value Il max an alarm visual and / or sound is generated.
  • FIG. 3 represents an embodiment of an information display screen 7 equipping a respiratory assistance device 1, that is to say a medical ventilator, according to the present invention that can be used to administer a gas. respiratory, such as air, to a person in cardiac arrest, during a cardiac massage operation.
  • a respiratory assistance device 1 that is to say a medical ventilator, according to the present invention that can be used to administer a gas. respiratory, such as air, to a person in cardiac arrest, during a cardiac massage operation.
  • the screen 7 is of touch type and is in color.
  • the displayed information may be characteristic parameters of a cardiac massage or any other information determined by the respiratory assistance device.
  • the characteristic information of a cardiac massage II is displayed in the zone VI, while a piece of information representative of the volume of gas exchanged is displayed in the zone V2.
  • the areas C of the screen make it possible to display the evolution of an information over time in the form of a curve.
  • the information and its evolution, which points constitute the curve, are extracted from the memory means 12.
  • the displayed information may be characteristic parameters of a cardiac massage or any other information determined by the respiratory assistance device.
  • the duration of representation of the information is predefined or selected by the user, it is thus possible to display the evolution of the information over a shorter or longer period.
  • the screen 7 can also display the settings of the fan R and allow the user to modify them by pressing the Ri key of the setting to be modified.
  • the artificial ventilation apparatus and the monitoring method implemented by such an apparatus are perfectly adapted to use during a cardiac massage on a ventilated patient, to ensure monitoring, that is, that is to say a follow-up, of the cardiac massage practiced by the rescuers, such as doctor of the SAMU, fireman, nurse or other.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Emergency Medicine (AREA)
  • Hematology (AREA)
  • Anesthesiology (AREA)
  • Surgery (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Physiology (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Percussion Or Vibration Massage (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
EP16733158.6A 2015-06-08 2016-05-31 Appareil de ventilation artificielle avec monitorage de massage cardiaque Withdrawn EP3302665A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR1555189A FR3036970A1 (fr) 2015-06-08 2015-06-08 Appareil de ventilation artificielle avec monitorage de massage cardiaque
PCT/FR2016/051298 WO2016198764A1 (fr) 2015-06-08 2016-05-31 Appareil de ventilation artificielle avec monitorage de massage cardiaque

Publications (1)

Publication Number Publication Date
EP3302665A1 true EP3302665A1 (fr) 2018-04-11

Family

ID=54066034

Family Applications (1)

Application Number Title Priority Date Filing Date
EP16733158.6A Withdrawn EP3302665A1 (fr) 2015-06-08 2016-05-31 Appareil de ventilation artificielle avec monitorage de massage cardiaque

Country Status (7)

Country Link
US (1) US20170368281A1 (pt)
EP (1) EP3302665A1 (pt)
CN (1) CN107072871A (pt)
BR (1) BR112017007495A2 (pt)
CA (1) CA2965092A1 (pt)
FR (1) FR3036970A1 (pt)
WO (1) WO2016198764A1 (pt)

Family Cites Families (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4823828A (en) * 1987-05-28 1989-04-25 Mcginnis Gerald E Pressure relief valve
US5084060A (en) * 1989-02-15 1992-01-28 Freund Precision, Inc. Apparatus for enlarging a vessel or clearing obstructive tissue from a vessel according to vessel compliance
US6155257A (en) * 1998-10-07 2000-12-05 Cprx Llc Cardiopulmonary resuscitation ventilator and methods
US6280389B1 (en) * 1999-11-12 2001-08-28 Cardiac Pacemakers, Inc. Patient identification for the pacing therapy using LV-RV pressure loop
US6644311B1 (en) * 2001-02-21 2003-11-11 Respironics, Inc. Monitoring fluid flow in a pressure support system
US7263995B2 (en) * 2001-02-28 2007-09-04 Hyperbaric Technology, Inc. Hyperbaric oxygen therapy system controls
US8021310B2 (en) * 2006-04-21 2011-09-20 Nellcor Puritan Bennett Llc Work of breathing display for a ventilation system
US20080255482A1 (en) * 2007-04-16 2008-10-16 Advanced Circulatory Systems, Inc. Intrathoracic pressure limiter and cpr device for reducing intracranial pressure and methods of use
GB2462304B (en) * 2008-07-31 2010-12-01 Laerdal Medical As Device and method for detecting heart beats in a patient using the airway pressure
EP2198823A1 (en) * 2008-12-19 2010-06-23 Dräger Medical B.V. Ventilation device with CPR mode
DE102011007964A1 (de) * 2010-01-11 2011-07-14 Weinmann Geräte für Medizin GmbH + Co. KG, 22525 Vorrichtung und Verfahren zur Generierung eines Atemgashubes während der Herz-Druckmassage
US20110271960A1 (en) * 2010-05-07 2011-11-10 Nellcor Puritan Bennett Llc Ventilator-Initiated Prompt Regarding Auto-PEEP Detection During Volume Ventilation Of Triggering Patient
GB201009666D0 (en) * 2010-06-09 2010-07-21 Univ Gent Methods and systems for ventilating or compressing
DE102012024672A1 (de) * 2012-12-18 2014-06-18 Dräger Medical GmbH Beatmungsgerät und Verfahren zum Betrieb eines Beatmungsgerätes
FR3000893A1 (fr) * 2013-01-14 2014-07-18 Air Liquide Medical Systems Ventilateur d'assistance respiratoire avec prise en compte des massages cardiaques

Also Published As

Publication number Publication date
WO2016198764A1 (fr) 2016-12-15
FR3036970A1 (fr) 2016-12-09
US20170368281A1 (en) 2017-12-28
BR112017007495A2 (pt) 2018-01-30
CN107072871A (zh) 2017-08-18
CA2965092A1 (en) 2016-12-15

Similar Documents

Publication Publication Date Title
JP6808627B2 (ja) 呼吸の吸気相及び呼気相の両方で推定される患者肺コンプライアンスを使用してベンチレータと患者の分離を検出するためのシステム及び方法
JP2022058525A (ja) 患者の換気有効性を診断するための装置および患者の換気有効性を決定するための方法
EP3510924B1 (fr) Appareil de ventilation pour réanimation cardio-pulmonaire avec affichage de la tendance en co2
EP3218035B1 (fr) Appareil de ventilation artificielle apte à délivrer une ventilation et un monitorage spécifiques aux patients recevant un massage cardiaque
JP2022511091A (ja) 人工呼吸デバイス
FR3000893A1 (fr) Ventilateur d'assistance respiratoire avec prise en compte des massages cardiaques
CN107158531B (zh) 可在心肺复苏术中使用的呼吸辅助仪器
EP3218036B1 (fr) Appareil de ventilation artificielle avec monitorage d'une absence de contractions thoraciques
EP3299055B1 (fr) Appareil d'assistance respiratoire avec détection automatique du mode de massage cardiaque manuel ou automatique
CA3023591A1 (fr) Appareil de ventilation pour reanimation cardio-pulmonaire avec monitorage et affichage de la valeur maximale de co2 mesuree
JP2011030990A (ja) 携帯用人工呼吸器の人命救助ナビゲーション装置
CA2983717A1 (en) Artificial ventilation apparatus with ventilation modes suited to cardiac massage
EP3302665A1 (fr) Appareil de ventilation artificielle avec monitorage de massage cardiaque
KR20170055693A (ko) 수동식 인공호흡기용 공기공급량 측정장치
CN108403357A (zh) 一种民用高压氧疗器材
FR2987274A1 (fr) Dispositif et procede de ventilation de patient
WO2021242086A1 (fr) Dispositif pour la respiration artificielle automatique et communiquant : ventilateur mécanique.
FR3131698A1 (fr) Ventilateur médical avec monitorage d’une réanimation cardio-pulmonaire
CA3172635A1 (en) Ventilator adaptors

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 20180108

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

AX Request for extension of the european patent

Extension state: BA ME

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE APPLICATION HAS BEEN WITHDRAWN

18W Application withdrawn

Effective date: 20180607