EP3934602B1 - Vorrichtung zur selektiven regionalisierung der lungenbeatmung auf den posteriolateralen teil der lungen - Google Patents

Vorrichtung zur selektiven regionalisierung der lungenbeatmung auf den posteriolateralen teil der lungen Download PDF

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Publication number
EP3934602B1
EP3934602B1 EP20725812.0A EP20725812A EP3934602B1 EP 3934602 B1 EP3934602 B1 EP 3934602B1 EP 20725812 A EP20725812 A EP 20725812A EP 3934602 B1 EP3934602 B1 EP 3934602B1
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EP
European Patent Office
Prior art keywords
cuirass
patient
intended
shell
negative pressure
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EP20725812.0A
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English (en)
French (fr)
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EP3934602A1 (de
EP3934602C0 (de
Inventor
Guillaume CARTEAUX
Armand MEKONTSO DESSAP
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Assistance Publique Hopitaux de Paris APHP
Institut National de la Sante et de la Recherche Medicale INSERM
Universite Paris Est Creteil Paris 12
Original Assignee
Assistance Publique Hopitaux de Paris APHP
Institut National de la Sante et de la Recherche Medicale INSERM
Universite Paris Est Creteil Paris 12
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Publication of EP3934602B1 publication Critical patent/EP3934602B1/de
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    • 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
    • A61H31/02—"Iron-lungs", i.e. involving chest expansion by applying underpressure thereon, whether or not combined with gas breathing means
    • 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
    • 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
    • A61H31/006—Power driven
    • 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
    • A61H31/008—Supine patient supports or bases, e.g. improving air-way access to the lungs
    • 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
    • A61H2031/001—Artificial respiration or heart stimulation, e.g. heart massage fixed on the chest by suction
    • 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
    • A61H2031/003—Artificial respiration or heart stimulation, e.g. heart massage with alternated thorax decompression due to lateral compression
    • 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
    • A61H2201/12—Driving means
    • A61H2201/1238—Driving means with hydraulic or pneumatic drive
    • 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
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/165—Wearable interfaces
    • 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
    • A61H2201/1683—Surface of interface
    • A61H2201/169—Physical characteristics of the surface, e.g. material, relief, texture or indicia
    • 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
    • A61H2205/08—Trunk
    • 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
    • A61H2205/08—Trunk
    • A61H2205/084—Chest

Definitions

  • the invention relates to a device for the selective regionalization of the pulmonary aeration, intended to selectively surround the posterior part of the thoracic cage of a patient, in order to create a depression there by means of a negative pressure generator.
  • the invention finds applications in the medical field, and in particular in the field of ventilatory assistance for patients having a respiratory pathology associated with inhomogeneous pulmonary lesions.
  • the invention is particularly suitable for the treatment or prevention of acute or chronic respiratory failure.
  • Acute or chronic respiratory failure is a condition affecting millions of people around the world. In some cases, the inability of the respiratory system to ensure sufficient oxygenation of the body must be compensated by ventilatory assistance.
  • Current devices for treating acute or chronic respiratory failure globally deliver gas throughout the entire lung volume of the patient.
  • ventilatory assistance by positive intrathoracic pressure is delivered via an invasive interface (intubation tube or tracheostomy cannula) or non-invasive (nasal mask, face mask, or helmet), connected to a positive pressure generator.
  • ventilatory assistance by extrathoracic negative pressure is delivered globally via a shell or cuirass (placed on the front part of the trunk), a cage or tight clothing (containing in particular the entire trunk), connected to a negative pressure generator.
  • ARDS Acute Respiratory Distress Syndrome
  • VILI ventilatory assistance
  • the document US2853 998 describes a portable respirator housing consisting essentially of two parts: a lightweight trough-shaped cage adapted to be placed on the patient's trunk, its edges resting against a support, and a sheet of flexible air-impermeable material to be placed on the cage, with the front and rear sides resting against the patient's body and the other placed between the patient and the support.
  • the device is so flexible that the edges can be easily shaped by hand to conform well enough to the contours of patients' bodies having a variety of shapes to form the aforementioned substantially airtight contact therewith. and, therefore, the room substantially airtight mentioned above, but which is however rigid enough to maintain any shape in which it is formed.
  • the present invention makes it possible to redistribute more evenly the ventilation delivered by ventilatory assistance and/or naturally by the respiratory muscles, so as to preferentially solicit the damaged areas, rather than the healthy areas of one or more lungs, in a patient with respiratory failure most often requiring ventilatory assistance, in case of inability of their respiratory muscles to ensure sufficient ventilation of the lungs.
  • the object of the invention is to at least partially solve the problem associated with overventilation of healthy areas to the detriment of damaged areas in one or both lungs of a patient in need of artificial respiratory assistance.
  • the invention proposes a device allowing the selective regionalization of the distribution of pulmonary aeration, so as to preferentially recruit the damaged zones of a lung during ventilatory assistance or during spontaneous ventilation.
  • the damaged areas of a lung are most often located in the posterolateral part.
  • the invention proposes to locally create a depression likely to favor the opening and the aeration of the damaged postero-lateral zones of the lung to make them available to the ventilation delivered by the ventilatory assistance (in positive pressure) and/or naturally by the respiratory muscles.
  • the device according to the invention selectively surrounds the dorsal part of the patient's thoracic cage, hermetically.
  • the space between the patient's body and the device is advantageously filled with a material capable of following the contours of the patient's body and which makes it possible to keep, like a spacer, a distance between the negative pressure orifice and the skin of the dorsal wall. (in order to avoid a point of contact between the skin of the dorsal wall and the shell at the level of the negative pressure orifice which would generate too focal and too strong a depression at this point of contact). A depression is created in this space and in the posterolateral part of the patient's lungs.
  • the device according to the invention is non-invasive and can be used in a hospital or non-hospital setting.
  • the device is molded to the dimensions of the patient, in order to ensure optimum sealing.
  • the device according to the invention can be used alone or in combination with a conventional, invasive or non-invasive ventilatory assistance system.
  • the invention therefore relates to a device for the selective regionalization of pulmonary aeration, intended to apply a depression on a postero-lateral part of the chest wall of a patient, said device comprising a rigid or semi-rigid shell, intended to selectively surround a posterior part of the patient's chest wall, and a layer of cellular material covering an internal wall of the rigid shell, intended to be in contact with the patient's chest wall, said shell comprising at least one through orifice, intended to be connected to a negative pressure generator.
  • the invention relates to a device for the selective regionalization of pulmonary ventilation, intended to apply a depression on a posterolateral part of the chest wall of a patient, said device comprising a rigid or semi-rigid shell , intended to surround a posterior part of the patient's chest wall, and a layer of cellular material covering an internal wall of the rigid shell, intended to be in contact with the patient's chest wall, said shell comprising at least one through hole, intended to be connected to a negative pressure generator.
  • the invention also relates to a system for applying localized transpulmonary pressure, said system comprising at least one device for the selective regionalization of pulmonary aeration according to the invention, at least one negative pressure generator connected to the device by the through hole on the shell, so as to communicate a negative pressure from the generator to the shell and create a depression between the posterior chest wall of a patient on which the device is applied and said shell.
  • the invention also relates to a ventilatory assistance kit comprising a system for applying localized transpulmonary pressure according to the invention and an invasive or non-invasive artificial ventilation system (operating in positive pressure).
  • the negative pressure generator is able to deliver constant or variable negative pressures.
  • an invasive or non-invasive artificial ventilation system is coupled with the negative pressure generator(s)
  • the invasive or non-invasive artificial ventilation system is capable of delivering constant or variable positive pressures
  • the present invention proposes a device intended to selectively surround the posterior (dorsal) part of the rib cage of a patient and able to apply a vacuum to all or part of the posterior part of said rib cage.
  • the term “patient” designates a mammal, and preferentially a human, including an adult, a child or an infant.
  • the term “patient” can also designate a non-human animal, in particular a non-human primate.
  • the device according to the invention comprises a shell of rigid or semi-rigid material, forming the structure which will receive the patient's body.
  • the shell is for example made of plastic such as polypropylene, polyethylene, polyamide, of composite material such as glass, carbon or aramid fibers, or of resin. It can be modeled for example by thermoforming or three-dimensional printing.
  • the shell preferably has an elliptical shape having a concave curvature to match a contour of the posterior part of the patient's chest wall.
  • the dimensions of the shell are such that the shell covers the posterior and lateral part of the thorax, from the lower costal edge at the bottom to the inter-scapular region at the top at the height of the axillary hollows, and transversely of a line middle axillary to side.
  • the shell is obtained by molding, taking into account the dimensions of the patient.
  • the hull is obtained by means of a 3D printing scan.
  • the general shape of the shell is such that it hermetically conforms to the contour of the dorsal part of the patient's chest wall, when the patient is lying on said shell.
  • the shape of the shell is such that it makes it possible to receive the dorsal part of a patient's thorax, from the lower costal edge at the bottom to the interscapular region at the height of the axillary hollows at the top and from a middle axillary line to the other on the sides.
  • There shell thus delimits a volume intended to receive a dorsal and lateral part of the rib cage of a patient.
  • a layer of alveolar (or porous) material lines the inner wall of the shell, facing the patient's body.
  • the dorso-lateral part of the patient's body is therefore in contact with the layer of alveolar material.
  • the layer of cellular material has a structure that makes it possible, when a depression is created in the shell, to distribute the depression evenly over the entire contact surface of the dorsal part of the patient's chest wall.
  • the layer of cellular material is made of polymer, preferably chosen from polyurethane, polyethylene, polyether.
  • the layer of alveolar or cellular material is, for example, a homogenizing foam, preferably with open porosity, thus allowing the pores of the foam to be connected to each other and to distribute the vacuum evenly.
  • the foam used has a low density and a low rigidity, in particular in order to match the contours of the dorsal part of the patient.
  • the foam may in particular be a polymeric foam, in particular polypropylene or polystyrene.
  • the sealing between the hermetic shell and the patient's body is obtained by means of sealing means, extending over a peripheral part of the shell, intended to be brought into sealing contact against the chest wall. of the patient.
  • the sealing means comprise a gasket.
  • the connection between the seal and the hull can also be reinforced by an adhesive.
  • the seal comprises two sealing lips, intended to come into contact with the patient's skin, on either side of the peripheral part of the shell.
  • the shell may have one or more reinforcing grooves, extending over the internal and external wall of the shell.
  • the cross section of each groove draws a concavity at the level of the internal wall and a convexity at the level of the external wall.
  • at least one reinforcing groove opens into a through hole in the shell.
  • the groove or grooves can also be used to suck up and evacuate any serosities.
  • the device comprises a central support means, extending longitudinally on the internal wall of the shell, and intended to come into contact with the patient's body opposite the spinal column.
  • the support means is made of a material that is dense and/or strong enough not to collapse under the patient's weight and to support the patient's spine.
  • the central support means is made of impermeable material, capable of hermetically separating the parts of the shell arranged on either side of said central support means when the shell is held around the part posterior to the patient's rib cage.
  • the central support means makes it possible to divide the internal volume of the shell into two parts, in which it is possible to independently create the vacuum.
  • the support means is made of viscoelastic material, in particular a viscoelastic gel.
  • the device for the selective regionalization of the distribution of pulmonary aeration comprises a hermetic rigid or semi-rigid shell, intended to selectively surround a posterior part of the patient's thoracic wall, a gasket sealing extending over a peripheral part of said shell and intended to be brought into sealed contact against the chest wall of the patient, a central support means extending transversely on the internal wall of the shell and dividing the shell into two parts, each of the two parts of the shell being lined with a layer of cellular material, the wall of the shell being traversed at each of these parts by an orifice intended to be connected to a negative pressure generator, so that it is possible to create a depression in one and/or the other of the parts of the shell when it is applied to the posterior part of the patient's rib cage.
  • the invention also relates to a system for applying localized transpulmonary pressure, said system comprising at least one device for selective regionalization of the distribution of pulmonary aeration as described above and at least one negative pressure generator connected to the device through the through hole on the shell, so as to communicate a negative pressure from the generator to the shell and create a depression between the posterior chest wall of a patient on which the device is applied and said shell.
  • the device for the selective regionalization of the distribution of pulmonary aeration as described above in combination with an invasive or non-invasive artificial ventilation system (which operates under positive pressure) .
  • the device aims to better distribute the pulmonary aeration resulting from the ventilation delivered by ventilatory assistance with an invasive or non-invasive artificial ventilation system in positive pressure, and/or naturally by the respiratory muscles, to preferentially distribute the aeration in the postero-lateral areas of the lungs, by selectively favoring the opening of the alveoli of these usually injured areas, the latter remaining otherwise (in the known state of the art) occluded to the ventilation generated by an artificial ventilation system and /or naturally by the respiratory muscles.
  • FIG. 1 depicts a cross-section of a human patient's rib cage, lying supine (in the supine position), vertebrae 6 down in the figure.
  • the 3 posterior parts of the lungs are condensed and poorly ventilated (horizontal hatching), which can undergo opening/closing cycles causing additional lung damage, while the relatively healthy anterior 4 parts (vertical hatching) are overdistended by ventilatory assistance overall.
  • the device 10 makes it possible to overcome this problem by promoting targeted re-aeration of the posterior part of one or both lungs 1, 2 ( picture 3 ). More specifically, the dorsal part of the patient's rib cage is housed in the sealed shell 11, and rests on a homogenizing foam 12 lining an internal wall 13 of said shell 11.
  • a vacuum pump (not shown) is connected to the sealed shell 11 by at least one through hole 14 provided in the shell 11 ( figure 2A &2B) to create a depression capable of lowering the pleural pressure around the posterior part 3 of the lung and thus increasing the transpulmonary pressure in a localized manner, promoting its re-aeration.
  • a pressure sensor can be connected to the vacuum pump to monitor the pressure inside the hull.
  • the damaged area of the lung can be defined beforehand on the basis of a clinical examination or complementary imaging examinations.
  • the figure 2A And 2B schematically show an embodiment of a device for the selective regionalization of pulmonary aeration 10 towards the posterolateral zones according to the invention.
  • the shell 11 has a general shape and a curvature, and is made of rigid or semi-rigid material, making it possible to match the contours of the dorsal part of the patient's rib cage.
  • the shell 11 extends longitudinally from the lower edge of the ribs to the armpit, and transversely to the mid-axillary line.
  • Two through holes 14 are provided on the wall of the hermetic shell 11, on either side of a central longitudinal axis (extending substantially along the spine of the patient housed in the shell) dividing said shell 11 into two side parts 15, 16 substantially equal.
  • a central support means 17 extends longitudinally along the internal wall 13 of the shell 11, so as to physically separate the two lateral parts 15, 16.
  • the homogenizing foam 12 lines each of the lateral parts 15, 16 from a peripheral contour 18 to the central support means 17.
  • the foam 12 can extend over the entire internal wall 13 of the shell 12, and the central support means 17 covers said foam 12 or is covered by said foam 12.
  • the presence of the central support means 17 makes it possible to potentially hermetically divide the internal volume of the shell 11 into two parts.
  • each part of the shell 11 is provided with a through hole 14 adapted to be connected to a negative pressure generator, it is possible to generate depressions individually in each part or in combination and thus promote the ventilation of one or more two lungs.
  • the peripheral contour 18 of the shell 11 when the latter is in position around the dorsal part of the patient, sticks hermetically to the skin of the patient, so as to create a hermetically closed volume.
  • the seal 20 comprises two contact lips 21, 22 made of deformable material making it possible to guarantee the tightness of the connection between the shell 11 and the dorsal part of the chest wall, during depression.
  • the shell 11 is further provided with reinforcing grooves 2, extending longitudinally or transversely on said shell 11.
  • longitudinal grooves extend between the two through orifices 14.

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  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Rehabilitation Therapy (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Emergency Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Percussion Or Vibration Massage (AREA)
  • Prostheses (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Claims (15)

  1. Vorrichtung (10) zur selektiven Regionalisierung der Lungenbeatmung, die aus der Ventilation resultiert, die durch eine Atemunterstützung mit einem invasiven oder nicht-invasiven künstlichen Beatmungssystem und/oder natürlicherweise durch die Atmungsmuskulatur bereitgestellt ist, für einen Patienten mit einer Atmungserkrankung, die mit inhomogenen Lungenläsionen verbunden ist, zur Verwendung mit wenigstens einem Unterdruckgenerator, um einen Unterdruck auf dem posterolateralen Teil der Thoraxwand zu erzeugen, wobei die Vorrichtung eine starre oder halbstarre Schale (11) umfasst, umfassend
    • eine Form, die ein Volumen definiert, das die Konturen des Rückens des Patienten aufnimmt und sich ihnen anpasst, wenn der Patient auf der Schale (11) liegt,
    • wenigstens eine Durchgangsöffnung (14), die zum Anschluss an einen Unterdruckgenerator dient,
    • eine hermetische Umfangskontur (18), die zur hermetischen Auflage auf der Haut des Patientenrückens dient,
    • eine Innenwand (13), die durch die hermetische Umfangskontur (18) begrenzt ist und das Volumen bildet, das den dorsalen Teil der Thoraxwand des Patienten aufnimmt und in dem der Unterdruck aufrechterhalten wird,
    • und eine Schaumstoffschicht, die die Innenwand (13) der starren Schale (11) bedeckt, um die Konturen des Körpers des Patienten anzupassen und die mit der Haut des Rückens in Kontakt ist,
    wobei der in dem dorsalen Teil, der in der Vorrichtung hermetisch untergebracht ist, erzeugte Unterdruck erlaubt, durch die lokale Erhöhung des transpulmonaren Drucks, die Beatmung der verletzten Regionen der Lunge oder Lungen in dem posterolateralen Bereich zu fördern und folglich eine homogenere Umverteilung der Lungenbeatmung zu erhalten, die aus der Ventilation resultiert.
  2. Vorrichtung gemäß Anspruch 1, dadurch gekennzeichnet, dass die Schaumstoffschicht eine Struktur aufweist, die erlaubt, wenn ein Unterdruck in der Schale (11) erzeugt wird, den Unterdruck über die gesamte Oberfläche homogen zu verteilen.
  3. Vorrichtung gemäß einem der Ansprüche 1 bis 2, dadurch gekennzeichnet, dass die Schaumstoffschicht aus einem offenporigen homogenisierten Schaum besteht.
  4. Vorrichtung gemäß einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, dass die Schaumstoffschicht aus einem Polymer, vorzugsweise ausgewählt aus Polyurethan, Polyethylen, Polyether, besteht.
  5. Vorrichtung gemäß einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Schale (11) eine elliptische Form mit einer konkaven Krümmung besitzt, um sich einer Kontur des hinteren Teils der Thoraxwand des Patienten anzupassen.
  6. Vorrichtung gemäß einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Schaumstoffschicht die gesamte Innenschale (11) bedeckt und durch die Innenschale (11) und die Umfangskontur (18) begrenzt ist.
  7. Vorrichtung gemäß einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Umfangskontur (18) Dichtungsmittel (20) umfasst, die sich über die Kontur des peripheren Teils (18) der Schale erstrecken und auf der Haut des Rückens des Patienten in der posterolateralen Region der Thoraxwand dicht aufliegen und gegebenenfalls dass die Dichtungsmittel eine Abdichtung (20) umfassen, wobei die Abdichtung vorteilhafterweise mit zwei Dichtungslippen (21, 22) versehen ist, die mit der Haut des Patienten auf beiden Seiten des peripheren Teils (18) der Schale in Kontakt kommen sollen.
  8. Vorrichtung gemäß einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Schale (11) mehrere angeordnete Durchgangsöffnungen (14) aufweist, um den Unterdruck in der Schale (11) gleichmäßig zu verteilen.
  9. Vorrichtung gemäß einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Schale (11) mit wenigstens einer Verstärkungsnut (23) versehen ist, deren Querschnitt auf Höhe der Innenwand (13) eine Konkavität und eine Konvexität auf Höhe der Außenwand der Schale (11) beschreibt und gegebenenfalls dass die Verstärkungsnut in eine Durchgangsöffnung (14) der Schale (11) mündet.
  10. Vorrichtung gemäß einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass sie ein zentrales Stützmittel (17) umfasst, das quer auf der Innenwand (13) der Schale (11) angeordnet ist und in Kontakt mit dem Körper des Patienten kommen soll und in Längsrichtung der Wirbelsäule verläuft, und gegebenenfalls dass das zentrale Stützmittel (17) aus Dichtungsmaterial besteht und besagte Schale (11) in zwei laterale Teile (15, 16) hermetisch teilt, die folglich geeignet sind, die lateralen Teile (15, 16) der Schale hermetisch zu trennen, die auf beiden Seiten des zentralen Stützmittels (17) angeordnet sind, wenn die Schale um den dorsalen Teil der Thoraxwand des Patienten gehalten ist, wobei der Schaum (12) beide lateralen Teile (15, 16) von der Umfangskontur (18) bis zum zentralen Stützmittel (17) bedeckt, wobei jeder Teil der Schale (11) mit wenigstens einer Durchgangsöffnung (14) versehen ist, die zum Anschluss an einen Unterdruckgenerator geeignet ist, um individuelle Unterdrücke in jedem Teil oder in Kombinationen zu erzeugen und folglich die Beatmung des posterolateralen Teils einer oder beider Lungen zu erlauben.
  11. Vorrichtung gemäß einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass sich die Schale (11) in Längsrichtung vom unteren Rippenrand bis zur Achselhöhle und quer bis zur Medioaxillarlinie erstreckt.
  12. System zur Anwendung eines lokalen transpulmonaren Drucks, wobei das System wenigstens umfasst
    • eine Vorrichtung zur selektiven Regionalisierung der Verteilung der Lungenbeatmung im posterolateralen Teil der Lungen gemäß einem der Ansprüche 1 bis 11,
    • wenigstens einen Unterdruckgenerator, der mit der Vorrichtung über die Durchgangsöffnung (14) auf der Schale (11) verbunden ist, um auf diese Weise einen Unterdruck des Generators auf die Schale zu übertragen und einen Unterdruck zwischen der hinteren Thoraxwand eines Patienten, auf der die Vorrichtung angebracht ist, und der Schale zu erzeugen.
  13. System gemäß Anspruch 12, dadurch gekennzeichnet, dass der Unterdruckgenerator geeignet ist, konstante oder variable Unterdrücke zu liefern.
  14. Kit zur Atemunterstützung umfassend
    • ein System zur Anwendung eines lokalen transpulmonalen Drucks gemäß einem der Ansprüche 12 bis 13, und
    • ein System zur invasiven oder nicht-invasiven künstlichen Beatmung.
  15. Kit zur Atemunterstützung gemäß Anspruch 14, wobei ein invasives oder nicht-invasives künstliches Beatmungssystem mit dem oder den Unterdruckgeneratoren gekoppelt ist und/oder wobei das invasive oder nicht-invasive künstliche Beatmungssystem geeignet ist, konstante oder variable Überdrücke zu liefern.
EP20725812.0A 2019-03-04 2020-03-03 Vorrichtung zur selektiven regionalisierung der lungenbeatmung auf den posteriolateralen teil der lungen Active EP3934602B1 (de)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR1902190A FR3093433B1 (fr) 2019-03-04 2019-03-04 Dispositif de regionalisation selective de la ventilation pulmonaire
PCT/FR2020/050421 WO2020178521A1 (fr) 2019-03-04 2020-03-03 Dispositif de regionalisation selective de l'aeration pulmonaire vers la partie postero laterale des poumons

Publications (3)

Publication Number Publication Date
EP3934602A1 EP3934602A1 (de) 2022-01-12
EP3934602B1 true EP3934602B1 (de) 2023-08-23
EP3934602C0 EP3934602C0 (de) 2023-08-23

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EP20725812.0A Active EP3934602B1 (de) 2019-03-04 2020-03-03 Vorrichtung zur selektiven regionalisierung der lungenbeatmung auf den posteriolateralen teil der lungen

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US (1) US20220054354A1 (de)
EP (1) EP3934602B1 (de)
FR (1) FR3093433B1 (de)
WO (1) WO2020178521A1 (de)

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB470611A (en) * 1936-12-23 1937-08-18 Rudolf Eisenmenger Improvements relating to apparatus for promoting respiration
US2648331A (en) * 1950-02-01 1953-08-11 Bennett Vivian Ray Means for applying artificial respiration
US2707948A (en) * 1953-12-18 1955-05-10 John H Emerson Chest respirator
US2853998A (en) * 1955-02-28 1958-09-30 John H Emerson Respirator casing and methods of producing the same
EP3128987A4 (de) * 2014-04-07 2017-11-22 The Penn State Research Foundation Neonatale brustschiene zur anwendung von sich ausdehnendem unterdruck
US10478375B2 (en) * 2015-09-25 2019-11-19 Peter Antros Pulmonary expansion therapy devices
TWI678198B (zh) * 2017-11-28 2019-12-01 財團法人工業技術研究院 可調式胸甲

Also Published As

Publication number Publication date
FR3093433B1 (fr) 2023-06-23
WO2020178521A4 (fr) 2020-11-12
WO2020178521A1 (fr) 2020-09-10
US20220054354A1 (en) 2022-02-24
EP3934602A1 (de) 2022-01-12
EP3934602C0 (de) 2023-08-23
FR3093433A1 (fr) 2020-09-11

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