JP2011235123A - 換気安定化技術 - Google Patents
換気安定化技術 Download PDFInfo
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- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
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Abstract
【解決手段】睡眠サイクルの期間中での患者の再呼吸を増加させるある方法が使用されている。過呼吸の期間での再呼吸を増加させることで、一般的には過呼吸期間から生じる過酸化を減少させ、よって補償する減呼吸期間を減少させ、中枢性睡眠時無呼吸症に関連するループゲインを有効に減少させることが可能である。鼻の閉塞及び漏れ耐性を有する口腔インターフェース24は患者のインターフェースからの気体の漏れを制御する。
【選択図】図2
Description
VD=VED+VID (式1)
この容積は制御系に必然的に発生する非効率さを表す。その非効率さとは、肺内部の気体交換に関わる1回換気量を減少させることである。詳細には、1回換気量は2つの成分の和で表される。
VT=VD+VA (式2)
ここでVAは1回換気量における“肺胞”による換気、すなわち呼吸器の気体交換にかかわる容積、を表す。また、V E、V A及びV Dを積f・VT、f・VA及びf・VD(fは呼吸器の周波数を表す)とすると、V E=V A+V Dとなる。呼吸器制御システムの負のフィードバックループ(図1)では、V Eは呼吸器の中枢パターン発生装置の出力を表し、V Aは動脈血気体圧力に影響を与える変数である。V EとV Aとの関連は当然のことではあるが、ループゲインの動的制御を操作する基本変数V Dである。
↓V B→↑V ED→↓V A→↓L.G. (式3)
ここで重要なのは後述するように、VEDの増加は大きく呼吸する期間でのみ生じるということである。よって、通常呼吸では、システムにデッドスペースを加える必要はない。
VR=Vret−Vwash (式4)
図8で図示されている最初の5例では、VRは負の値又はゼロに等しい(図8A、図8B、図8C、図8D及び図8E)。それは、このような呼吸器パターンでは、付加されるデッドスペースが存在しないことを意味する。しかし、肺換気が増加すると仮定すると、Vretは増加し、VRは正の値になる。同様に、吐出期間(Te)が減少すると、Vwashは減少し、VRは正の値になる。動脈血PCO2の増加及び動脈血PO2の減少によって呼吸が促進されるとき、1階換気量は増加し、Teは減少する。従って、VBが比較的小さい場合(この例では0.35及び0.25)、化学的刺激は、より高レベルの肺換気がより大きなVRの値と連携するようにVRが正の値を取るようにする。
VED=VR−(V B)(t) (式5)
ここでtは図9で図示されているように、VRが患者インターフェース及び気体が通る管から排除されるのに必要な時間と定義される。VEDは吸入時間をゼロから徐々に増加させ、吸入容積VSUM及び吐出ポート容積を計算することで計算可能である。つまり、以下の式を使用するということである。
Claims (13)
- 呼吸障害の処置装置であって:
気体供給手段;
患者の気道に適合する、漏れ耐性を有する患者インターフェース;及び、
前記装置の能動的制御素子を調節することで、前記患者の睡眠障害を制御する再呼吸レベルを調節するプロセッサ;
を有し、
前記漏れ耐性患者インターフェースは、前記患者の鼻と口の開口部を覆う全面マスクを有し、かつ前記患者の口腔気道及び経鼻気道のうちの1つを閉塞する手段を組み込み、
前記漏れ耐性患者インターフェースは管を使用することで、前記気体供給手段と操作可能な状態で接続する、
ことを特徴とする装置。 - 前記漏れ耐性患者インターフェースは口腔漏れを減少させる歯科器具及び、経鼻漏れを排除する経鼻閉塞装置を有することを特徴とする、請求項1に記載の装置。
- 前記漏れ耐性患者インターフェースは出口を有し、
前記の漏れ耐性患者インターフェース出口と操作可能な状態で接続する可変空気抵抗手段をさらに有することを特徴とする、請求項1又は2に記載の装置。 - 前記制御装置は、発生する再呼吸レベルを調節する前記可変空気抵抗手段と操作可能な状態で接続することを特徴とする、請求項1、2又は3のいずれか1つに記載の装置。
- 前記制御装置は、漏れ耐性患者インターフェースの圧力を大きく変化させることなく、前記管内の暫定的可変空気流を保持することを特徴とする、請求項4に記載の装置。
- 前記制御装置は、
前記呼吸障害に関連して呼吸が増加する期間では、前記患者からの吐出気体は前記管へ入り込んで前記気体供給手段へ逆流し、前記出口から排出され、かつ、
前記呼吸障害に関連して呼吸が増加する期間における初期吐出期間に、前記患者からの吐出気体は前記管へ入り込んで前記気体供給手段へ逆流し、前記出口から排出され、次の吸入期間中に十分な量の再呼吸が生じることで呼吸障害を制御できるように前記管の外へ流れることで洗浄する、
ことを特徴とする、請求項4に記載の装置。 - 通常呼吸期間中にはほとんど再呼吸が生じないことを特徴とする、請求項6に記載の装置。
- 通常呼吸期間中には逆流が生じるが、次の吸入期間前に、洗浄流は十分吐出空気を除去することを特徴とする、請求項6に記載の装置。
- 前記呼吸障害に関連して呼吸が増加する期間中に、前記患者からの吐出気体は前記管へ入り込んで前記気体供給手段へ逆流し、前記出口から排出されるように備えられ、
前記気体供給手段からの気体圧力は、前記患者の呼吸器サイクルとは独立に4cmの水圧未満の制御されたレベルに設定される、
ことを特徴とする、請求項4に記載の装置。 - 前記制御装置は前記可変空気抵抗手段を調節することで、睡眠サイクルのある期間においてデッドスペースを提供することを特徴とする、請求項9に記載の装置。
- 呼吸障害の処置方法であって:
漏れ耐性患者インターフェースを患者の気道に適合させる手順;
前記患者の口腔気道及び経鼻気道のうちの1つを遮断する手順;及び、
前記漏れ耐性患者インターフェースと操作可能な状態で接続する再呼吸装置で前記患者を処置する手順;
を有する方法。 - 前記漏れ耐性患者インターフェースは口腔器具及び経鼻閉塞装置を有することを特徴とする、請求項11に記載の方法。
- 呼吸障害を処置する装置であって:
CPAP再呼吸装置;及び、
前記CPAP再呼吸装置と操作可能な状態で接続し、口腔器具及び経鼻閉塞装置を有する漏れ耐性患者インターフェース;
を有する装置。
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Application Number | Priority Date | Filing Date | Title |
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US10/762,979 | 2004-01-23 | ||
US10/762,979 US7073501B2 (en) | 1999-02-04 | 2004-01-23 | Ventilatory stabilization technology |
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JP2006549808A Division JP2007518497A (ja) | 2004-01-23 | 2005-01-21 | 換気安定化技術 |
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US (2) | US7073501B2 (ja) |
EP (1) | EP1706164A4 (ja) |
JP (2) | JP2007518497A (ja) |
AU (1) | AU2005205851B2 (ja) |
BR (1) | BRPI0507036A (ja) |
CA (1) | CA2554128C (ja) |
WO (1) | WO2005070487A1 (ja) |
Families Citing this family (67)
Publication number | Priority date | Publication date | Assignee | Title |
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US7073501B2 (en) * | 1999-02-04 | 2006-07-11 | Univerity Technologies International Inc. | Ventilatory stabilization technology |
CA2847786C (en) * | 2005-05-03 | 2017-07-04 | Ruth E. Martin | An oral device and kit for use in association therewith |
US7766829B2 (en) * | 2005-11-04 | 2010-08-03 | Abbott Diabetes Care Inc. | Method and system for providing basal profile modification in analyte monitoring and management systems |
US7810497B2 (en) * | 2006-03-20 | 2010-10-12 | Ric Investments, Llc | Ventilatory control system |
US8381732B2 (en) * | 2008-03-21 | 2013-02-26 | The Periodic Breathing Foundation, Llc | Nasal interface device |
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US7073501B2 (en) | 2006-07-11 |
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CA2554128A1 (en) | 2005-08-04 |
EP1706164A4 (en) | 2011-04-20 |
EP1706164A1 (en) | 2006-10-04 |
WO2005070487A1 (en) | 2005-08-04 |
AU2005205851A1 (en) | 2005-08-04 |
US20060201505A1 (en) | 2006-09-14 |
CA2554128C (en) | 2015-07-14 |
JP2007518497A (ja) | 2007-07-12 |
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