EP4065203A2 - Dispositifs à pression expiratoire positive à soupape flottante - Google Patents

Dispositifs à pression expiratoire positive à soupape flottante

Info

Publication number
EP4065203A2
EP4065203A2 EP20894104.7A EP20894104A EP4065203A2 EP 4065203 A2 EP4065203 A2 EP 4065203A2 EP 20894104 A EP20894104 A EP 20894104A EP 4065203 A2 EP4065203 A2 EP 4065203A2
Authority
EP
European Patent Office
Prior art keywords
passageway
air
stopper
patient
valve
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.)
Pending
Application number
EP20894104.7A
Other languages
German (de)
English (en)
Other versions
EP4065203A4 (fr
Inventor
Michael J. Rusher
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.)
Individual
Original Assignee
Individual
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
Priority claimed from US16/693,915 external-priority patent/US11452838B2/en
Application filed by Individual filed Critical Individual
Publication of EP4065203A2 publication Critical patent/EP4065203A2/fr
Publication of EP4065203A4 publication Critical patent/EP4065203A4/fr
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A61M16/208—Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M16/0006—Accessories therefor, e.g. sensors, vibrators, negative pressure with means for creating vibrations in patients' airways
    • 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
    • A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
    • A61M16/049—Mouthpieces
    • 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
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816—Joints or connectors
    • A61M16/0833—T- or Y-type connectors, e.g. Y-piece
    • 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
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0866—Passive resistors therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/1005—Preparation of respiratory gases or vapours with O2 features or with parameter measurement
    • 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
    • A61M16/12—Preparation of respiratory gases or vapours by mixing different gases
    • A61M16/122—Preparation of respiratory gases or vapours by mixing different gases with dilution
    • A61M16/125—Diluting primary gas with ambient air
    • 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
    • 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

Definitions

  • This application relates generally to airway pressure control devices, and more particularly to a positive expiratory pressure device with an oscillating pressure valve to control expiratory air flow.
  • PEP positive expiratory pressure
  • COPD Chronic Obstructive Pulmonary Disease
  • CHF Consgestive Heart Failure
  • Pulmonary Edema, atelectasis, and/or decreased lung capacity due to pain or inhibited abdominal diaphragm function may benefit from therapy such as positive expiratory pressure (PEP) therapy.
  • PEP therapy may not generally exhale with enough force to expand the alveoli.
  • pressures within the alveoli typically range from 4cmH20 to 6CIT1H2O, and when pulmonary capillary pressures (normal range 3cmH20) exceed the alveoli pressures, blood seeps into the alveoli. In this situation it is critical to add pressure greater than 6CIT1H2O to the space within the alveoli.
  • PEP devices that increase expiratory air pressure are known.
  • PEP positive expiratory pressure
  • PEP devices are typically small devices that a patient exhales into, optionally using a mask.
  • the PEP device creates pressure in the lungs and keeps the airways from closing.
  • the air flowing through the PEP device helps move the mucus into the larger airway.
  • known prior art devices use strictures or small orifices to produce positive expiratory pressures. This may compromise flow with increased friction, requiring more work to exhale.
  • some known PEP devices are useful only for allowing a patient to exhale, and may not be used for normal in-and-out breathing.
  • ventilators mechanically move breathable air into and out of the lungs, and assist patients who need help breathing or are physically unable to breathe.
  • Such ventilators may pump regular air or oxygen-enriched air to a patient, and are typically connected to a patient’s lungs through two tubes through which air may flow: an inspiration tube to provide air/oxygen to the patient’s lungs; and an expiration tube to receive exhaled air back from the patient.
  • the inspiration pathway provides air/oxygen that is pumped by the ventilator at a pressure of between 5 and 40 cm of water pressure, depending on the patient’s needs.
  • the expiration pathway is passive.
  • air which may be regular, atmospheric air or oxygen-enriched air or some other gas, as desired by medical personnel, all of which will be referred to generically as “air” in this disclosure) is typically controlled by one of two methods.
  • the flow of air is provided under a “pressure control” system in which the flow is provided until it faces a set pressure as detected by a pressure sensor.
  • the flow of air is provided under a “volume control” system in which the flow is provided until a predetermined volume of air has been delivered.
  • the ventilator delivers air at a breath rate (in breaths per minute) that is also set by the ventilator operator.
  • a problem may arise if the pressure in the inspiratory tube rises above a level that is safe for the patient. This is particularly a problem when the ventilator is operating in a volume control mode, although excessive pressure may arise even when the ventilator is operating in a pressure control mode.
  • the present invention addresses those needs.
  • a positive pressure airway device for providing resistance in an air pathway for a patient exhaling.
  • the positive pressure airway device comprises or consists essentially of: a) a central tube region; b) a first passageway for passing air into the central tube region when a patient breathing through the device inhales; c) a second passageway for passing air out of the central tube region when a patient breathing through the device exhales, wherein the second passageway has an upper portion defined by upper wall, a lower portion defined by a lower wall, and a transitional wall connecting the lower wall to the upper wall, and wherein the transitional wall is slanted at an angle a with respect to a line perpendicular to the vertical axis of the second passageway, thus providing a passageway having a valve seat angle a; d) a third passageway for passing air from the central tube region and into a patient when the patient breathing through the device inhales, and for passing air from the patient to the
  • valve seat angle a is greater than plug angle b, and the stopper-biasing spring tapers outward from its first end to its second end, thus facilitating an oscillating movement of the plug in the passageway.
  • plug angle b is less than the valve seat angle a, and the stopper-biasing spring tapers inward (i.e., gets more narrow) from its second/cap end to its first/plug end.
  • valve seat angle a is less than or equal to plug angle b, and the spring does not taper outward, and preferably tapers inward, from its first end to its second end, thus facilitating a laminar movement of the plug in the passageway.
  • plug angle b is greater than or equal to the valve seat angle a, and the stopper-biasing spring tapers outward (i.e., gets wider) from its second/cap end to its first/plug end.
  • the tapered spring may additionally act as a valve stabilizer eliminating the need for a plug stabilizer wall or rod.
  • the stopper is made of a first material having a first weight per unit volume, and includes a weighted portion made of a second material having a weight per unit volume that is greater than said first weight per unit volume.
  • the weighted portion may be positioned below the region at which the stopper contacts the second passageway when sealing the second passageway from air flow.
  • a method for requiring a patient to breathe out with a pre-determined expiratory air pressure comprises or consists essentially of: Applicants) providing a device for providing resistance in an air pathway for the patient exhaling, the device comprising:
  • a second passageway for passing air out of the central tube region when a patient breathing through the device exhales, wherein the second passageway has an upper portion defined by upper wall, a lower portion defined by a lower wall, and a transitional wall connecting the lower wall to the upper wall, and wherein the transitional wall is slanted at an angle a with respect to a line perpendicular to the vertical axis of the second passageway, thus providing a passageway having a valve seat angle a;
  • a third passageway for passing air from the central tube region and into a patient when the patient breathing through the device inhales, and for passing air from the patient to the central tube when the patient breathing through the device exhales;
  • valve in said second passageway includes: i) a stopper to close the passageway and to prevent air from flowing through the passageway when the stopper is biased to its closed position, and ii) a stopper-biasing spring to maintain the stopper in a fixed and closed position unless the expiratory air pressure in the passageway is greater than a selected pressure, wherein the valve in said second passageway includes: i) a stopper to close the passageway and to prevent air from flowing through the passageway when the stopper is biased to its closed position, and ii) a stopper-biasing spring to maintain the stopper in a fixed and closed position unless the expiratory air pressure in the passageway is greater than a selected pressure, wherein the valve in said second passageway includes: i) a stopper to close the passageway and to prevent air from flowing through the passageway when the stopper is biased to its closed position, and ii) a stopper-biasing spring to maintain the stopper in a fixed and closed position unless the expiratory air pressure in the
  • a spring housing cap to retain the stopper-biasing spring and to partially compress the spring to a length shorter than its free length, wherein the spring housing cap is movable with respect to the transitional portion of the second passageway wall so that movement of the spring housing is effective for varying the compression length of the spring, and thus is effective for varying the expiratory air pressure that will cause the valve to open, and wherein the stopper-biasing spring is attached at its first end to the spring housing cap, and at its second end to the stopper, with the center of the spring being free from any structure that would prevent or significantly inhibit the “side-to-side” movement of the spring within the housing, and thus prevent or significantly inhibit providing the desired oscillating flow of air through the device; wherein the stopper has an exterior surface defining a plug angle b with respect to a line perpendicular to the vertical axis of the plug; and b) breathing out through said device with sufficient expiratory air pressure to cause said expiratory air valve to open, allowing air to exit the device.
  • valve seat angle a is greater than plug angle b, and the stopper-biasing spring tapers outward from its first end to its second end, thus providing an oscillating movement of the plug in the passageway, and thereby providing an oscillating pressure of air flow through the device.
  • valve seat angle a is less than or equal to plug angle b, and the spring does not taper outward, and preferably tapers inward, from its first end to its second end, thus facilitating a laminar movement of the plug in the passageway, and thus providing a laminar flow of air flow through the device.
  • FIG. 1 shows a side view, in partial section, of one aspect of the present invention, particularly showing a device for increasing positive pressure within the patient's airways, as the illustrated device is being used to inhale.
  • FIG. 2 shows a side view, in partial section, of one aspect of the present invention, particularly showing a device for increasing positive pressure within the patient's airways, as the illustrated device is being used to exhale.
  • FIG. 3 shows an exploded section view of the device of FIGS. 1 and 2.
  • FIG. 4 shows an end view the device of FIGS. 1 and 2, showing the opening of the inhalation tube and the valve support therein.
  • FIG. 5 shows a top plan view the device of FIGS. 1 and 2, showing the opening of the exhalation tube and the spring-retaining housing thereon.
  • FIG. 6 shows a side view the device of FIGS. 1 and 2, with a nebulizer attached to the inhalation opening.
  • FIG. 7 shows a side view, in partial section, of the device of FIGS. 1 and 2 with the spring-retaining housing being in its compressed position.
  • FIG. 8 shows a side view, in partial section, of the device of FIGS. 1 and 2 with the spring-retaining housing being in its relaxed position.
  • FIG. 9 shows an exploded view of the device of FIGS. 1 and 2.
  • FIG. 10 shows a perspective view of the exhaust/exhalation tube of one aspect of the present invention, showing the threaded outer wall.
  • FIG. 11 shows a perspective view of the spring-retaining housing of one aspect of the present invention, showing the threaded inner wall.
  • FIGS. 12 and 13 show a side view, in partial section, of the device of FIG. 12 as the valve is fluttering from left to right while the device is being used to exhale.
  • FIG. 14 shows one embodiment of a valve in an exhalation passageway, according to one embodiment, illustrating the angle a formed by the transitional portion of the passageway.
  • FIG. 15 shows a plug/stopper that may be used in preferred embodiments of the present invention, showing the angle b that is defined by the plug/stopper surface.
  • FIG. 16 shows one embodiment of a valve effective for use in an exhalation passageway, according to one embodiment.
  • FIG. 17 shows a perspective view of one embodiment of the disclosed device.
  • FIG. 18 shows a perspective view, in partial section, of the embodiment of Fig. 17.
  • FIG. 19 shows an elevational view, in partial section, of the embodiment of Fig. 17.
  • FIG. 20 shows an elevational view, in partial section, of the embodiment of Fig. 17.
  • FIG. 21 shows a perspective view of one embodiment of the disclosed device.
  • FIG. 22 shows a side elevation view of one embodiment of the stopper used in the disclosed device.
  • FIG. 23 shows a side elevation view of one embodiment of the stopper used in the disclosed device.
  • FIG. 24 shows a perspective view of one embodiment of the housing cap used in the disclosed device.
  • FIG. 25 shows a side elevation view of one embodiment of the spring housing cap used in the disclosed device.
  • FIG. 26 shows a side elevation view of one embodiment of the spring housing cap used in the disclosed device.
  • FIG. 27 shows a graph of the desired oscillating air flow pressure that may be achieved by certain embodiments of the present invention.
  • FIG. 28 shows one embodiment of the present invention adapted for use to provide oscillating therapy in a BiPAP or Ventilator circuit.
  • FIG. 29 shows one embodiment of the present invention adapted for use to provide positive pressure oscillation therapy to open airways, and to expel lung secretions.
  • FIG. 30 shows one embodiment of the present invention adapted for use to provide positive pressure therapy to open airways and support recovery from respiratory distress. DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • the positive pressure airway device comprises: a) a central tube region; b) a first passageway for passing air into said central tube region when a patient breathing through the device inhales; c) a second passageway for passing air out of said central tube region when a patient breathing through the device exhales; d) a third passageway for passing air from said central tube region and into a patient when the patient breathing through the device inhales, and for passing air from said patient to said central tube when the patient breathing through the device exhales; e) a valve in the first passageway that allows air to flow in through the first passageway to the central tube when a patient using the device inhales, and that prevents air from flowing out through the first passageway when a patient using the device exhales; f) a valve in the second passageway that allows air to flow out from the second passageway when a patient using the device exhales
  • the device has the general shape of an upside-down “T” with one of the two horizontal arms of the “T” being the first passageway for passing air into the central tube region when a patient breathing through the device inhales, the other horizontal arm being the third passageway for passing air from the central tube region and into a patient when the patient breathing through the device inhales and for passing air from the patient to the central tube when the patient breathing through the device exhales, and the vertical arm of the “T” being the second passageway for passing air out of the central tube region when a patient breathing through the device exhales.
  • the device has the general shape of a “+” with one of the two horizontal arms of the “+” being the first passageway for passing air into the central tube region when a patient breathing through the device inhales, and the other horizontal arm being the third passageway for passing air from the central tube region and into a patient when the patient breathing through the device inhales and for passing air from the patient to the central tube when the patient breathing through the device exhales.
  • One of the verticals arm of the “+” is the second passageway for passing air out of the central tube region when a patient breathing through the device exhales, and the second vertical arm is a passageway for providing a flow of supplemental air to the central tube region while a first flow of air is entering the central tube region through the first passageway.
  • the second flow of air may be separate and distinct from the first flow of air at least until the two flows intermix in the central tube region.
  • the fourth passageway may be connected to auxiliary air and/or to a nebulizer for providing a drug to the patient when inhaling.
  • the passageways are preferably tube-shaped to facilitate air flow through the device.
  • the tubes are preferably made of plastic, and have an inner diameter of between 0.50 inches and 1.5 inches, and more preferably between 0.75 inches and 1.25 inches.
  • the expiratory air passageway preferably includes a lower portion with an inner diameter of between about 10 mm and 20 mm, more preferably between about 12 mm and 16 mm, most preferably about 14 mm, and an upper portion with an inner diameter of between about 15 mm and 30 mm, more preferably between about 20 mm and 25 mm, most preferably about 22.5 mm.
  • the sloped portion has a tubular shape with a diameter that transitions smoothly from the diameter of the lower passageway portion to the diameter of the upper passageway portion.
  • the diameter is the same as the diameter of the lower passageway portion, and it is this diameter that the diameter of the stopper should exceed to allow the stopper to close the passageway.
  • the diameter is the same as the diameter of the upper passageway portion, and it is this diameter that the diameter of the stopper should not exceed to allow free movement of the stopper in the passageway.
  • One or more of the passageways may be provided with surface features to cause air flow through the tube to be turbulent. Most preferably only the passageway for passing air out of the central tube region when a patient breathing through the device exhales provides turbulent air flow, and then only or primarily in the region where the air flows around the stopper.
  • the volume available for expiratory air to occupy remains fixed and constant as long as the valves in the first and second passageways are closed. Generally, that volume is defined by the volume of the central tube region, plus the volume of the third passageway, plus the volume of the first passageway between the central tube region and the valve in that passageway, plus the volume of the second passageway between the central tube region and the valve in that passageway. Accordingly, when a patient blows into the device the space available for expiratory air does not increase and the air resistance pressure faced by the patient increases until the pressure is sufficient to open the expiratory air valve.
  • the passageways are separate and distinct from each other.
  • the portion of the second passageway around the stopper is shaped or otherwise adapted to make air flow around the stopper turbulent.
  • Valves to control the flow of air are preferably included in at least the first and second passageways.
  • the valve in the first passageway is preferably a valve that allows air to flow in through the first passageway to the central tube when a patient using the device inhales, and that prevents air from flowing out through the first passageway when a patient using the device exhales.
  • a disc that bends away from a support to allow air to flow around the disc when blown from the direction of the support, yet is prevented from blowing away from the support and thus prevents air from flowing around the disc when blown toward the direction of the support, is one available option.
  • the valve in the second passageway is used adapted to allow air flow through the second passageway when a patient using the device exhales, while preventing air from through the second passageway when a patient using the device inhales.
  • the valve provides a selectively-variable resistance to the air flow through the passageway.
  • valve in the second/exhalation passageway comprises or consists essentially of a stopper to close the passageway and prevent air from flowing through the passageway when the stopper is biased to its closed position, and a stopper-biasing spring to bias the stopper to its closed position unless a pre-determined expiratory air pressure is provided in the passageway.
  • the stopper may comprise a seat portion that is sized and shaped to contact a portion of the expiratory air passageway so as to allow air flow through that passageway to be blocked.
  • the seat portion is generally wider that the diameter of the lower expiratory air passageway so that the seat may contact the passageway wall and prevent air flow through the passageway.
  • the seat will typically have a diameter of between 14 mm and 24 mm.
  • the seat will typically have a diameter of between 16 mm and 20 mm.
  • the seat will typically have a diameter of about 18 mm.
  • the seat portion of the stopper may have a shape that corresponds to the portion of the passageway in which the stopper resides. This may allow the stopper to contact the passageway over an extended distance of at least 2 mm, and preferably at least 5 mm, and optionally between 2 mm and 10 mm.
  • the seat portion of the stopper may have a shape that does not correspond to the portion of the passageway in which the stopper resides.
  • the stopper does not contact the passageway wall for an extended distance although some contact is necessary to allow the stopper to prevent air from flowing through the passageway.
  • the stopper is shaped or otherwise adapted to make air flow around the stopper turbulent. This may cause the forces acting on the stopper to be unbalanced as air flows around the stopper, causing the stopper to “flutter” and the pressure drop across the stopper to oscillate.
  • the flutter motion may be an upward and downward motion of the valve plug, or it may be a side-to-side motion of the valve plug, or it may be both an upward and downward motion and a side-to-side motion of the valve plug.
  • the plug or stopper in the expiratory air passageway is preferably held against the passageway by a biasing spring.
  • magnets or other structures may be used to apply a force against the valve stopper to move it toward the valve seat, and thus to aid in achieving correct Hz oscillation frequency as could otherwise be provided by a spring.
  • the stopper-biasing spring is preferably a compression coil spring.
  • the spring may be of a constant diameter or it may be tapered.
  • the constant diameter may be a wide diameter that is greater than half of the diameter of the passageway in which the spring resides, or it may be a narrow diameter that is less than half, and optionally less than one-third, and alternatively optionally less than one-quarter, of the diameter of the passageway in which the spring resides.
  • the upper portion of the spring may have a wide diameter that is greater than half of the diameter of the passageway in which the spring resides, and the lower portion of the spring may have a narrow diameter that is less than half, and optionally less than one-third, and alternatively optionally less than one-quarter, of the diameter of the passageway in which the spring resides.
  • stopper-biasing spring may be attached at its first end to a spring housing, and at its second end to the stopper, with the center of the spring being free from any structure that would prevent or significantly inhibit the “side-to-side” movement of the spring within the housing, and thus prevent or significantly inhibit providing a therapeutically-effective oscillating flow of air through the device.
  • the stopper may be provided with a ridge or knob or other structure for optionally-releasable attachment of the stopper to a stopper-biasing spring.
  • the spring holding the stopper is shaped or positioned or otherwise adapted to cause the forces acting on the stopper to be unbalanced as air flows around the stopper, causing the stopper to “flutter” and the pressure drop across the stopper to oscillate.
  • the device includes a spring-retaining housing to retain a stopper-biasing compression coil spring and to partially compress the spring to a length shorter than its free length.
  • the spring- retaining housing is movable with respect to the stopper so that the spring-retaining housing is effective for varying the compression length of the spring, and thus for varying the expiratory air pressure/force needed to open the resistance valve.
  • the stopper and/or the spring and/or the expiratory air passageway may be adapted to provide unbalanced forces that cause the valve to “flutter” in response to a patient’s exhalation air pressure.
  • the flutter motion may be an upward and downward motion of the valve plug, or it may be a side-to-side motion of the valve plug, or it may involve both an upward and downward motion and a side-to-side motion of the valve plug.
  • This fluttering motion of the valve plug may be caused, for example, by a stopper having a particular shape, and/or the use of a spring having a particular shape and/or connection with the stopper, and/or by having an air passageway with a shape and/or features that provide turbulent air flow.
  • the turbulent or fluttering air flow provides advantages when compared with the more constant air flow provided by alternative designs. It is known that flutter or oscillation at certain frequencies (Hz) promote mucus secretion mobilization within the airways of the lungs.
  • the passageway through which air leaves the device, and in which the stopper/plug is located includes a transitional wall that is slanted at an angle a with respect to a line perpendicular to the vertical axis of the second passageway, thus providing a passageway having a valve seat angle a.
  • the valve stopper/plug has an exterior surface defining a plug angle b with respect to a line perpendicular to the vertical axis of the plug.
  • valve seat angle a is greater than plug angle b, and the stopper-biasing spring tapers outward from its first end to its second end, thus facilitating an oscillating movement of the plug in the passageway.
  • plug angle b is less than the valve seat angle a, and the stopper-biasing spring tapers inward (i.e., gets more narrow) from its second/cap end to its first/plug end.
  • valve seat angle a is less than or equal to plug angle b, and the spring does not taper outward, and preferably tapers inward, from its first end to its second end, thus facilitating a laminar movement of the plug in the passageway.
  • plug angle b is greater than or equal to the valve seat angle a, and the stopper-biasing spring tapers outward (i.e., gets wider) from its second/cap end to its first/plug end.
  • the seat angle is between 20° and 40°, with 30° being most preferred.
  • the stopper angle is 5° to 15° less than the seat angle, with a stopper angle about 10° less than the seat angle being most preferred. Accordingly, when the seat angle is about 30°, the stopper angle is about 20°.
  • the spring preferably tapers outward as you move up from the stopper to the cap (i.e., spring tapers inward as you go down from the cap to the stopper). This oscillating valve and valve seat design, in combination with the appropriate spring, may provide a periodic disruption of gas flow by pushing the gas backward during valve/valve seat closing, and increases the resonance effect.
  • the stopper angle is equal to or greater than the seat angle, so when the seat angle is about 30°, the stopper angle is between 20° and about 30°.
  • the spring preferably tapers inward as you move up from the stopper to the cap (i.e., spring tapers outward as you go down from the cap to the stopper).
  • the valve in the exhalation passageway preferably allows air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 20cmH20.
  • the device includes a valve in the exhalation passageway to allow air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 30cmH20.
  • the force provided against the stopper by the spring is adjustable so that the expiratory air pressure needed to open the exhalation passageway may be varied and selected within the range of l OcmhteO to 30cm/H20.
  • a method for requiring a patient to breathe out with a pre-determined expiratory air pressure preferably comprises providing one of the devices herein disclosed and breathing out through said device with sufficient expiratory air pressure to cause said expiratory air valve to open, allowing air to exit the device.
  • the method may include the step of selecting a pre determined expiratory air pressure and moving the spring housing with respect to the stopper so that the pressure necessary to move the topper to its open position is the pre-determined expiratory air pressure.
  • the method requires a pre-determined expiratory air pressure of between lOcmh O and 30cm/H20.
  • some embodiments use a valve in the exhalation passageway that allows air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 10CIT1H2O.
  • the device uses a valve in the exhalation passageway that allows air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 20cmH20.
  • the device uses a valve in the exhalation passageway that allows air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 30cmH20.
  • the present invention provides a device that is designed to increase positive pressure within the patient's airways during exhalation. This expands the lungs within patients that have compromised lungs due to decreased lung capacity resulting from COPD (Chronic Obstructive Pulmonary Disease), CHF (Congestive Heart Failure), Pulmonary Edema, decreased lung capacity due to pain or inhibited abdominal diaphragm function, and particularly atelectasis (the collapse of the Alveoli within the lungs).
  • COPD Choronic Obstructive Pulmonary Disease
  • CHF Consgestive Heart Failure
  • Pulmonary Edema decreased lung capacity due to pain or inhibited abdominal diaphragm function
  • atelectasis the collapse of the Alveoli within the lungs.
  • PPEPD pneumatic positive expiratory pressure device
  • the PPAD is designed to function between 10cmH20 and 30cmH20.
  • the device uses a valve in the exhalation passageway that prevents the patient from exhaling through the device unless the expiratory air pressure is at least 10CIT1H2O.
  • the device includes a valve in the exhalation passageway to allow air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 15cmH20.
  • the device includes a valve in the exhalation passageway to allow air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 20cmH20.
  • the device includes a valve in the exhalation passageway to allow air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 25cmH20.
  • the device includes a valve in the exhalation passageway to allow air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 30cmH20. In yet other embodiments the device includes a valve in the exhalation passageway to allow air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 35cmH20. In still other embodiments the device includes a valve in the exhalation passageway to allow air to flow out through the device only when the patient exhales with an expiratory air pressure greater than 40cmH20.
  • the device includes a valve that is variable with respect to the necessary expiratory air pressure so that the necessary expiratory air pressure may be selected to be essentially anywhere within the range of 10cmH20 to 40cmH20, or most preferably within the range of l Ocmh O to 35cmH20
  • the device In use, the device is commonly used to provide up to about 20 liters per minute of air flow. However, it is to be appreciated that the device may also be used for flush-flow, in which substantially more (for example, 40 liters per minute or more) air (or other gas) may be passed through the device to prime the device.
  • substantially more air (for example, 40 liters per minute or more) air (or other gas) may be passed through the device to prime the device.
  • the inventive device may be adapted to provide unbalanced forces against the stopper plug. This may cause the plug to flutter and the pressure drop across the plug to oscillate.
  • the valve is closed.
  • the inlet pressure forces become greater than the spring elastic forces, the valve opens.
  • flow begins through the device and results in a pressure drop across the valve.
  • valve As the valve continues to open, the pressure drop across the valve rapidly decreases allowing flow to increase, the inlet pressure is reduced and the pressure forces on the upstream face (inlet) of the disc decrease below the force applied by the springl and the valve closes quickly.
  • This cycle repeats at a designated frequency and pressure amplitude that is determined by the valve’s geometry (valve shape or angles) which fixes the effective flow area, the effective force areas, and resulting valve flow characteristics (flow rate vs valve deflection).
  • the device can be attached to a continuous positive airway pressure (CPAP) mask to aid a patient in ventilation (blow off C02) and oxygenate.
  • CPAP continuous positive airway pressure
  • inventive devices described herein may be used to clear and open airways, strengthen the thoracic muscles, and improve the ability to swallow correctly by strengthening the muscles of the upper airway. Sickness weakens these muscles quickly, and frequent use of therapeutic devices like the rusher valves in combination with other respiratory therapies are essential to sustain a safe and efficient road to recovery.
  • FIGS. 1 -2 show a side view of one embodiment of a positive pressure airway device, in partial section.
  • the illustrated device includes a central tube portion 11 where a first passageway 12, a second passageway 13, and a third passageway 14 meet.
  • First passageway 12 is the “inhalation” passageway through which air may enter the device when a patient using the device inhales.
  • First passageway 12 may include an inhalation valve 21 that allows air to flow in through first passageway 12 to central tube portion 11 when a patient using the device inhales. Valve 21 may also prevent air from flowing out through first passageway 12 when a patient using the device exhales.
  • Second passageway 13 is the “exhalation” passageway through which air may leave the device when a patient using the device exhales.
  • Second passageway 13 may include a variable-pressure exhalation valve 22 that allows air to flow out through second passageway 13 when a patient using the device exhales.
  • Valve 22 may also prevent air from flowing in through second passageway 13 when a patient using the device inhales.
  • Third passageway 14 is the “patient breathing” passageway through which air passes into and out of the patient’s lungs. Third passageway 14 receives air from first passageway 11 through central tube portion 11 when the patient inhales, and passes air out to second passageway 13 through central tube portion 11 when the patient exhales.
  • valve 21 may be used to allow air to flow in through first passageway 12 to central tube portion 11 when a patient using the device inhales. Valve 21 may also prevent air from flowing out through first passageway 12 when a patient using the device exhales. Similarly, valve 22 may allow air to flow out through second passageway 13 when a patient using the device exhales. Valve 22 may also prevent air from flowing in through second passageway 13 when a patient using the device inhales.
  • Valve 22 is preferably variable with respect to the pressure needed to open the valve. Most preferably valve 22 is biased closed with a pressure of between lOcmF O and 30cm/Fl20.
  • the pressure needed to open the valve is selectable, so that when the patient selects an opening pressure of lOcmFbO to open the valve the valve will open when the patient exhales with an expiratory air pressure of at least lOcmFbO.
  • an opening pressure of 30cmFl20 to open the valve the valve will open when the patient exhales with an expiratory air pressure of at least 30cmFl20. Accordingly, it can be seen in FIG.
  • valve 21 opens when the patient inhales through the device, and it can be seen in FIG 2 that valve 21 closes on exhalation.
  • valve 22 remains biased closed when the patient inhales through the device, and it an be seen in FIG 2 that valve 22 opens when the expiratory air pressure exceeds the selected spring pressure. This combination of valves forces the patient's air to exit through the expiratory pressure exhaust port by forcing the expiratory pressure valve to push open against the pressure control spring.
  • valve 22 may comprise a stopper 22 that seats in a lower, sloped portion of sidewall 24 in passageway 13.
  • Spring 23 biases stopper 22 downward with a pressure equal to the expiratory air pressure that is desired.
  • valve 22 (or any stopper for oscillation) and seat 24 may contain magnets to aid in achieving a correct Hz oscillation frequency.
  • the pressure exerted by spring 23 may be variable.
  • a spring- retaining housing 25 may be used to vary the compression applied to spring 23, and thereby to vary the pressure needed to move stopper 22 to its open position.
  • Threaded outer sidewalls on exhalation tube 24 may cooperate with threaded inner sidewalls of spring-retaining housing 25 to vary the length of passageway 13, and thus the pressure exerted by spring 23.
  • FIG. 3 shows an exploded section view of the device of FIGS. 1 and 2.
  • Spring 23 is positioned above stopper 22 and presses down on stopper 22 when spring-retaining housing 25 is screwed onto tube 24.
  • FIG. 4 shows an end view the device of FIGS. 1 and 2, showing the opening of the inhalation tube and the valve support 31 therein.
  • FIG. 5 shows a top plan view the device of FIGS. 1 and 2, showing the opening of the exhalation tube and the spring-retaining housing 25 thereon.
  • Spring- retaining housing 25 includes openings 29 to allow expiratory air to exit the device, and retaining arms 32 to retain the spring in the housing.
  • FIG. 6 shows a side view the device of FIGS. 1 and 2, with a nebulizer 30 attached to the inhalation opening.
  • FIG. 7 shows a side view, in partial section, of the device of FIGS. 1 and 2 with the spring-retaining housing being in its compressed position.
  • spring-retaining housing 25 has been moved downward over second passage 13 by screwing the threaded housing toward the bottom of the passageway.
  • stopper 22 remains seated to seal exhalation tube 24 closed.
  • FIG. 8 shows a side view, in partial section, of the device of FIGS. 1 and 2 with the spring-retaining housing being in its relaxed position.
  • spring-retaining housing 25 has been moved upward away from the lower portion of second passage 13 by screwing the threaded housing away from the bottom of the passageway.
  • the patient is exhaling and air is leaving the device as stopper 22 is pushed upward by an expiratory air pressure that exceeds the downward pressure provided by spring 23.
  • FIG. 9 shows an exploded view of the device of FIGS. 1 and 2.
  • FIG. 10 shows a perspective view of the exhaust/exhalation tube of one aspect of the present invention, showing the threaded outer wall.
  • Threads 110 may include a cut-out 111 to receive a ramp 112.
  • Ramp 112 and cut-out 111 comprise a ramp-lock to lock housing 25 onto tube 24 and prevent the housing from being removed from the tube unless the ramp-lock is released.
  • FIG. 11 shows a perspective view of the spring-retaining housing of one aspect of the present invention, showing the threaded inner wall.
  • a ramp 112 may be included to lock the housing 25 onto tube 24 unless the user releases the ramp- lock assembly.
  • an O2 nipple adapter 27 may be used to facilitate the supply of supplemental oxygen (or other gas) to the patient if and when needed.
  • the nipple adaptor allows supplemental gas to be provided to the patient at any range from less than 1 liter per minute to at least about 15 liters per minute.
  • valve 21 may include a diaphragm that is deflected inward to allow air to enter during inhalation. When exhaling, that diaphragm presses against support 31 to prevent air from exiting through that opening. Instead, air is forced to exit through the exhalation control valve which provides a positive airway pressure against the patient. When the patient blows with sufficient force, the biasing force of the pressure control spring is overcome and air may exit through the exhalation ports.
  • the positive airway pressure may be controlled within limits by using the pressure control knob to shorten or lengthen the space in the upper housing, thus increasing or decreasing the pressure provided by the spring.
  • the present invention allows the patient to both inhale and exhale through the device.
  • the device may therefore be used as for normal breathing, without manipulating the device in any way and without requiring the patient to put the device aside to inhale.
  • a patient may achieve positive pressure exhalation without compromising expiratory air flow. This provides the benefit of requiring less work by the patient for breathing by (APPE) active positive pressure exhalation. Exhalation is normally passive.
  • the PPAD may be used for expiratory positive pressure ventilation (EPPV) or positive exhalation pressure (PEP).
  • EPPV expiratory positive pressure ventilation
  • PEP positive exhalation pressure
  • the device is designed to relieve difficulty of breathing at onset of respiratory distress by means of APPE or FPPE (forced positive pressure exhalation) with asthma attacks. This is comparable to the function of PEP with a broader explanation of uses of EPPV or PEP.
  • the PPAD may also be used for simple lung expansion exercises for patients who have compromised lung function due to restriction and or pain from thoracic and abdominal surgeries.
  • the PPAD may be used for early intervention of patients who are pending respiratory distress. These patients can benefit greatly from EPPV to prevent or recover from respiratory distress in a short period of time.
  • the PPAD may prevent air trapping by splinting the bronchiole tubes during
  • the PPAD may allow for better ventilation and oxygenation, and may act as an internal splint in the smaller bronchiole walls and alveoli to prevent respiratory distress with pulmonary edema resulting from atelectasis and/or CFIF causing tremendous negative pressures within the airways. Respiratory distress may be minimized by recruiting and hyper inflating alveoli during APPE. Similarly, the PPAD may help patients expand hypo inflated lungs due to lack of proper deep breathing.
  • the PPAD may help hold the normal shape of alveoli during exhalation with patients who suffer from obstructive lung disease by splinting the flaccid air sacs and damaged bronchiole tubes.
  • the result may be less stagnant lungs which will help mobilize secretions (increased expansion and contraction of the lungs).
  • the PPAD may achieve desired pressure without compromising flow. The result may be less energy expended during device use resulting in greater chances of recovery.
  • the PPAD may be adapted so as to be used with supplemental oxygen or an aerosol nebulizer if desired by patient or medical personnel.
  • FIGS. 12-13 show a side view, in partial section, of an alternative embodiment of one aspect of the present invention, particularly showing a device similar to the device shown in FIGS. 1 and 2.
  • the device is being used to inhale
  • FIGS. 13-15 the device is being used to exhale.
  • the tapered spring and the weighted plug causes the valve to flutter from side-to-side when the patient exhales. This may provide turbulent air flow when compared to the more constant air flow provided by other embodiments, and may advantageously be used to provide an oscillating pressure during exhalation.
  • FIG. 14 shows one embodiment of an exhalation passageway with an exhalation valve positioned therein, according to one embodiment.
  • the passageway has a lower portion defined by lower wall 310, and an upper portion defined by upper wall 311.
  • the lower portion defined by wall 310 has a passageway diameter W2 that is smaller than the passageway diameter Wi of the upper portion defined by wall 311.
  • a transitional/slanted area 317 connects lower wall 310 to upper wall 311. Transitional area 317 between the lower and upper portions is slanted at an angle with respect to a line perpendicular to the vertical axis “V” of the passageway, thus defining a valve seat angle a in the passageway.
  • Expiratory valve plug 312 is positioned in the passageway such that a portion of the plug contacts the slanted transitional sloped wall, thus closing the passageway when the plug is biased against and contacts the wall.
  • FIG. 15 shows one embodiment of a plug or stopper that may be used in the valve in an exhalation passageway.
  • Plug/stopper 312 has a width W3 that is larger than passageway diameter W2 but smaller than the passageway diameter W-i.
  • plug/stopper 312 has a slanted/sloped contact area 313 that adopts an angle b with respect to a line perpendicular to the vertical axis of the plug (i.e., angle b is the angle between the plug surface and a line perpendicular to the vertical axis of the passageway when the plug is pushed to its closed position).
  • Plug/stopper surface angle b (optionally referred to as valve angle b) may or may not be the same as valve seat angle a.
  • the lower portion 315 of plug/stopper 312 extends into lower passageway portion 310, and has a symmetrical shape to provide a desirable air flow around the plug when the plug does not contact the passageway wall.
  • FIG. 16 shows another embodiment of a plug that may be used in the valve in an exhalation passageway.
  • Plug 341 has a width that is larger than passageway diameter W2 but smaller than the passageway diameter Wi to allow the bottom of the plug to contact slanted/sloped transitional wall 317 when the plug is biased against that wall, and to allow air to flow around the plug when the plug is raised from and does not contact slanted/sloped transitional wall 317.
  • the bottom portion of plug 341 has a slanted/sloped contact area that adopts an angle b that may or may not be the same as passageway wall angle a.
  • the lower portion of plug 341 extends into lower passageway portion 310, and has a symmetrical shape to provide a desirable air flow around the plug when the plug does not contact the passageway wall.
  • the stopper of FIG. 22 may include a space 348 for a weight.
  • the stopper is made of a first material having a first weight per unit volume.
  • Space 348 for a weight may be filled with a second material having a weight per unit volume that is greater than said first weight per unit volume.
  • the main body of the stopper may be made of acrylonitrile butadiene styrene (ABS), and the weight may be made of stainless steel.
  • ABS acrylonitrile butadiene styrene
  • the weight may be made of stainless steel.
  • the weighted portion may be positioned below the region at which the stopper contacts the second passageway when sealing the second passageway from air flow.
  • the vertical rod on the stopper prevents tilt >45 degrees, holding the valves alignment to the valve seat.
  • FIG. 17 shows a perspective view of one embodiment of the disclosed device
  • FIG. 18 shows a perspective view, in partial section, of the embodiment of Fig. 17.
  • FIGS. 19 and 20 show elevation views, in partial section, of the embodiment of Fig. 17, and FIG. 21 shows a perspective view of one embodiment of the disclosed device.
  • FIGS. 22 and 23 show side elevation views of one embodiment of the stopper used in the disclosed device.
  • FIG. 24 shows a perspective view of one embodiment of the housing cap used in the disclosed device
  • FIGS. 25 and 26 show side elevation views of the spring housing cap of Fig. 24.
  • the housing cap serves as a ventilator circuit pressure control cap, and has an extended spring seat that seats on the oscillating valve in the fully closed position to hold the valve shut. This allows the device to stay inline on the circuit at all times.
  • the spring seat tube and/or the pressure control cap may be longer or shorter than the illustrated version.
  • the spring seat may be adapted to facilitate a desired function of the device.
  • the pressure control cap may be adapted to provide any or all of the following functions:
  • the spring seat may be adapted to help stabilize the floating valve when the laminar flow is desired
  • the spring seat may be adapted to help stabilize the oscillating valve by holding the valve in proper position
  • the spring seat may be adapted to act as an oscillating valve turn off and on when the device is used in a ventilator.
  • FIG. 27 shows a graph of the desired oscillating air flow pressure that may be achieved by certain embodiments of the present invention.
  • the valve seat angle a is greater than plug angle b
  • the stopper-biasing spring tapers outward from its proximal end to its distal end, are effective for providing an oscillating movement of the plug in the passageway, and a corresponding oscillating air flow pressure to the patient.
  • FIG. 28 shows one embodiment of the present invention adapted for use to provide oscillating therapy in a BiPAP or Ventilator circuit.
  • FIG. 29 shows one embodiment of the present invention adapted for use to provide positive pressure oscillation therapy to open airways, and to expel lung secretions.
  • FIG. 30 shows one embodiment of the present invention adapted for use to provide positive pressure therapy to open airways and support recovery from respiratory distress.
  • FIGS. 28-30 solve significant therapy access problems by: (1 ) producing therapeutic results without causing undue patient physical strain, since they create resistance with little restriction to flow and provide precise pressure control, and (2) providing a device that is portable, simple to use, easy to clean, and affordable enough to allow patients to use it anywhere.
  • the present invention may comprise or consist essentially of any or all of the illustrated or described embodiments, devices, and/or features.
  • the present invention includes devices comprising each of the embodiments and/or features illustrated in the Figures, and the present invention includes devices consisting essentially of any of the embodiments and/or features illustrated in the Figures.

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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)
  • Respiratory Apparatuses And Protective Means (AREA)
  • Check Valves (AREA)

Abstract

L'invention concerne un dispositif respiratoire à pression positive destiné à fournir une résistance dans une voie respiratoire pour l'expiration de patient. Le dispositif comprend une région de tube central, un passage d'air d'inspiration pour faire passer l'air dans la région de tube central lorsque de l'air respiré par le patient est inhalé par le biais du dispositif, et un passage d'air expiratoire pour faire passer l'air hors de la région de tube central lorsque de l'air respiré par le patient est expiré par le biais du dispositif. Une soupape dans le passage d'air expiratoire permet à l'air de circuler uniquement lorsqu'un patient utilisant le dispositif expire avec une pression d'air expiratoire supérieure à une pression sélectionnée, et comprend un bouchon et un ressort hélicoïdal doté d'une partie intérieure qui est exempte de toute structure susceptible d'empêcher ou d'inhiber de manière significative le mouvement « extrémité à extrémité » du ressort à l'intérieur du logement, et d'empêcher ou d'inhiber ainsi la fourniture d'une circulation d'air oscillante thérapeutiquement efficace à travers le dispositif. Le bouchon présente une surface bloquant l'air de forme conique fournissant un angle de soupape qui peut être différent de l'angle de siège de soupape, de sorte qu'un écoulement laminaire ou oscillant puisse être obtenu.
EP20894104.7A 2019-11-25 2020-11-25 Dispositifs à pression expiratoire positive à soupape flottante Pending EP4065203A4 (fr)

Applications Claiming Priority (2)

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US16/693,915 US11452838B2 (en) 2011-04-28 2019-11-25 Positive expiratory pressure devices with flutter valve
PCT/US2020/062193 WO2021108524A2 (fr) 2019-11-25 2020-11-25 Dispositifs à pression expiratoire positive à soupape flottante

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CN113648619A (zh) * 2021-09-26 2021-11-16 重庆上品益生电子商务有限公司 呼吸训练器

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US3511228A (en) * 1964-06-04 1970-05-12 Claes Erik Gunnar Lundgren Bronchial dilator for patients suffering from emphysema and asthma or the like
US5301667A (en) * 1992-08-03 1994-04-12 Vital Signs, Inc. Pressure limiting valve for ventilation breathing bag apparatus
WO2000078407A1 (fr) * 1999-06-18 2000-12-28 Powerlung Inc Dispositif d'exercices pulmonaires
CN101219249B (zh) * 2006-12-25 2010-06-23 北京谊安医疗系统股份有限公司 限压阀
US20170136205A1 (en) * 2011-04-28 2017-05-18 Rusher Medical LLC Positive expiratory pressure devices with flutter valve
US9233274B2 (en) * 2013-03-14 2016-01-12 D R Burton Healthcare, Llc Combination spirometer and PEP breathing exerciser

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