JP4606655B2 - Breathing gas supply device - Google Patents
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Description
【０００１】
【発明の属する技術分野】
本発明は、医療用の気体を供給する呼吸用気体供給装置に関する。さらに詳細には、空気中から酸素を分離供給する医療用酸素濃縮装置、および加圧された空気を供給する医療用陽圧式人工呼吸補助装置に関する。
【０００２】
【従来の技術】
近年、喘息、肺気腫症、慢性気管支炎等の呼吸器系疾患に苦しむ患者が増加する傾向にあるが、その最も効果的な治療法の一つとして酸素吸入療法があり、空気中から酸素濃縮気体を直接分離する酸素濃縮装置が開発され、使用時の利便性、保守管理の容易さから酸素吸入療法のための治療装置として次第に普及するようになって来ている。
【０００３】
かかる医療用酸素濃縮装置としては、酸素選択透過膜を用いた膜分離型酸素濃縮装置と、窒素又は酸素を選択的に吸着し得る吸着剤を用いた吸着型酸素濃縮装置が知られている。更には、酸素イオンを選択的に透過する固体電解質膜を利用し、電気化学的に酸素を生成する装置なども有る。吸着型酸素濃縮装置としては、気体圧縮機、または気体吸引機を用いた圧力変動吸着型酸素濃縮装置があり、通常、窒素を選択的に吸着し得る吸着剤を充填した吸着床にコンプレッサーで圧縮空気を導入して加圧状態で窒素を吸着させることにより酸素濃縮気体を得る吸着工程と、吸着床の内圧を減少させて窒素を脱着させ吸着剤の再生を行なう脱着工程を交互に行なうことにより酸素濃縮気体を患者に供給する呼吸用気体供給装置である。また、酸素濃縮気体を患者に供給するためのインターフェースとしては、酸素濃縮気体をチューブによって鼻腔へと導く鼻カニューラが一般的である。
【０００４】
一方、医療用陽圧式人工呼吸補助装置は、肺結核後遺症や慢性閉塞性肺疾患（COPD）、肺気腫など自発呼吸だけでは十分な換気が得られない換気不全患者の呼吸をサポートするために使用される間欠的陽圧式人工呼吸補助装置、および睡眠時無呼吸症候群など睡眠時に気道閉塞を呈する患者に対して、気道を常に陽圧に保つことのできる持続陽圧式人工呼吸補助装置が普及しつつある。
【０００５】
また、心不全のように循環障害を持つ疾患においては、過換気と低換気が繰り返し現れるチェーンストークス呼吸を呈することで知られている。このような睡眠呼吸障害に対する治療法として、高濃度酸素療法や間欠的陽圧式人工呼吸補助療法、および持続陽圧式人工呼吸療法の有用性が認められつつある。
【０００６】
間欠的陽圧式人工呼吸補助装置の中でも最も一般的な鼻マスクを用いるタイプを、図１を用いて説明する。本体１は２〜３０cmH2O程度の陽圧空気を間欠的に発生し、導管２に送る。中でも、使用者７の吸気と呼気に合わせて２レベルの圧力、例えば図２に示すように、吸気時陽圧（IPAP：Inspiration Positive Airway Pressure）：１２〜１５cmH2O、呼気時陽圧（EPAP：Expiration Positive Airway Pressure）：２〜４cmH2Oの設定圧力で陽圧空気を使用者に供給するタイプが主流である。導管２は、マスククッション６を固定するマスクフレーム５に繋がり、マスククッション６を通して、陽圧空気を使用者７の鼻腔へ送る。呼気排出孔３は使用者７の呼気ガスを呼吸回路外へ排出するために設けてあり、治療用ガス混入ポート４は、陽圧空気以外に酸素など治療用ガスの混入を必要とする患者に対して治療用ガスの投入口として使用される。
【０００７】
持続陽圧式人工呼吸補助装置は間欠的陽圧式人工呼吸補助装置と構成は殆ど同じであるが、使用者の吸気/呼気によらず常に一定の陽圧空気を気道に供給するものである。
【０００８】
【発明が解決しようとする課題】
陽圧式人工呼吸補助装置の中でも、鼻マスクを用いる非侵襲的タイプの陽圧式人工呼吸補助装置は、医師による管理が比較的簡単であり、在宅において治療を実施するケースが急激に増加している。また、そのような患者の殆どは高濃度酸素ガスの混入治療を必要としており、患者は陽圧式人工呼吸補助装置のみならず酸素濃縮装置も所有し、医師の指導の基に両装置をチューブ等で繋ぎ合わせ、高濃度酸素の混ざった陽圧空気を吸入する。
【０００９】
しかしながら、このような患者は昼間と睡眠時で処方が異なることが多く、状況に応じて各装置の設定変更やチューブの繋ぎ替えを頻回に行なわなければならない。例えば、昼間は高濃度酸素吸入療法のみを実施し、睡眠時は高濃度酸素ガスを混入した間欠的陽圧式人工呼吸療法を実施する場合が多い。このような場合は、患者は、昼間は酸素濃縮装置に直接繋いだ鼻カニューラから高濃度酸素を吸入し、夜間は鼻カニューラを酸素濃縮装置から外して、チューブによって酸素濃縮装置と鼻マスクを繋ぎ、更に夜間の設定流量となるように酸素流量を設定し直す必要がある。当然ながら、翌日の昼間は再び鼻カニューラに接続し直して高濃度酸素流量を調整する必要があり、これらの作業は患者にとって大きな負担となってしまうことに加え、チューブ接続ミスや設定変更ミス等によって必要な量の高濃度酸素を吸入することができないといった危険性が増えることは言うまでもない。
【００１０】
本発明は、陽圧式人工呼吸補助装置と酸素濃縮装置を併用して用いる場合に、設定変更やチューブの繋ぎ替え作業を簡便に行い、且つ、必要な量の高濃度酸素を吸入することができない等の危険性を無くすような呼吸用気体供給装置を提供することを課題とする。
【００１１】
【課題を解決するための手段】
かかる課題を達成するため、本発明者は鋭意検討した結果、酸素濃縮装置と陽圧式人工呼吸補助装置を連結させた新しい呼吸用気体供給装置を提供することによって課題を解決できることを見出した。
【００１２】
即ち本発明は、呼吸用陽圧空気を発生する陽圧空気発生手段、使用者に該陽圧空気を供給するための陽圧空気供給用呼吸インターフェース、および該陽圧空気発生手段と該陽圧空気供給用呼吸インターフェースを繋ぐ導管手段を備えた陽圧式人工呼吸補助手段と、空気中から酸素を分離し高濃度酸素を発生する酸素濃縮手段、該高濃度酸素を使用者に送るための酸素供給用呼吸インターフェースを備えた酸素供給手段を備えた呼吸用気体供給装置において、該高濃度酸素を該酸素供給用呼吸インターフェース、又は該導管もしくは該陽圧空気供給用呼吸インターフェースに供給する酸素供給切り換え手段を備え、該酸素供給切り換え手段は、操作に応じて、以下の（Ａ）、（Ｂ）及び（Ｃ）から選択されるいずれか１つの接続状態により、酸素濃縮手段の酸素供給口と各供給先とを接続することを特徴とする呼吸用気体供給装置を提供するものである。
接続状態（Ａ）：該高濃度酸素の供給先を、該陽圧空気供給用呼吸インターフェース又は該導管に、先端を配置した接続用チューブに接続する。
接続状態（Ｂ）：該高濃度酸素の供給先を、該酸素供給用呼吸インターフェースに接続する。
接続状態（Ｃ）：該酸素供給口から該接続用チューブ間の流路を閉とする。
また本発明は、使用者の入力に応じて、該（Ａ）、（Ｂ）及び（Ｃ）のうちいずれか１つの接続状態を選択しうる入力操作手段を備えた、呼吸用気体供給装置を提供するものである。
【００１３】
また本発明は、かかる切り換え手段が電磁弁であり、かつ該陽圧式人工呼吸補助手段及び該酸素供給手段が其々別の電源を備え、両電源のON/OFFの状態を検知して、
（ｉ）該陽圧式人工呼吸補助手段と該酸素濃縮手段の両方の電源をONにした場合に、該電磁弁が作動して接続状態（Ａ）へ、
（ii）該陽圧式人工呼吸補助手段の電源をOFF、且つ該酸素濃縮手段の電源をONにした場合に、該電磁弁が作動して接続状態（Ｂ）へ、
（iii）該陽圧式人工呼吸補助手段の電源をON、且つ該酸素濃縮手段の電源をOFFにした場合に、該電磁弁が作動して接続状態（Ｃ）へ、
自動的に切り換える制御手段を備えることを特徴とする呼吸用気体供給装置を提供するものである。
【００１４】
また本発明は、呼吸用陽圧空気を発生する陽圧空気発生手段、使用者に該陽圧空気を供給するための陽圧空気供給用呼吸インターフェース、および該陽圧空気発生手段と該陽圧空気供給用呼吸インターフェースを繋ぐ導管手段を備えた陽圧式人工呼吸補助手段と、空気中から酸素を分離し高濃度酸素を発生する酸素濃縮手段、該高濃度酸素を使用者に送るための酸素供給用呼吸インターフェースを備えた酸素供給手段を備えた呼吸用気体供給装置において、該高濃度酸素を該酸素供給用呼吸インターフェース、又は該導管もしくは該陽圧空気供給用呼吸インターフェースに供給する酸素供給切り換え手段を備え、かかる陽圧式人工呼吸補助手段及び該酸素供給手段が其々別の電源を備え、両電源のON/OFFの状態を検知して、
（ｉ）該陽圧式人工呼吸補助手段及び該酸素供給手段の両方の電源が両方ともONの場合には、陽圧空気に酸素を混入して吸入する場合の設定酸素流量になるように、
（ii）該陽圧式人工呼吸補助手段の電源がOFF、且つ該酸素供給手段の電源がONの場合には、酸素のみを吸入する場合の設定酸素流量になるように、
該高濃度酸素の供給流量を自動的に変更する制御手段を備えることを特徴とする呼吸用気体供給装置を提供するものである。
また本発明は、呼吸用陽圧空気を発生する陽圧空気発生手段、使用者に該陽圧空気を供給するための陽圧空気供給用呼吸インターフェース、および該陽圧空気発生手段と該陽圧空気供給用呼吸インターフェースを繋ぐ導管手段を備えた陽圧式人工呼吸補助手段と、空気中から酸素を分離し高濃度酸素を発生する酸素濃縮手段、該高濃度酸素を使用者に送るための酸素供給用呼吸インターフェースを備えた酸素供給手段を備えた呼吸用気体供給装置において、該高濃度酸素を該酸素供給用呼吸インターフェース、又は該導管もしくは該陽圧空気供給用呼吸インターフェースに供給する酸素供給切り換え手段を備え、使用者の入力操作に応じて、以下の（１）又は（２）の設定状態となるように制御を行う、入力及び制御手段を備えた、呼吸用気体供給装置を提供するものである。
設定状態（１）：陽圧空気に酸素を混入して吸入する場合の設定酸素流量になるように、該高濃度酸素の供給流量を自動的に変更する。
設定状態（２）：酸素のみを吸入する場合の設定酸素流量になるように該高濃度酸素の供給流量を自動的に変更する。
また本発明は、前記酸素濃縮手段と前記陽圧式呼吸手段は、それぞれを分離することができる呼吸用気体供給装置を提供するものである。
【００１５】
更に本発明は、特にかかる陽圧式人工呼吸補助手段が、使用者の呼吸に対応し、吸気時に吸気時設定圧力、呼気時に該吸気時圧力よりも低い呼気時設定圧力で陽圧空気を供給することを特徴とする間欠的陽圧式人工呼吸補助手段であることを特徴とする呼吸用気体供給装置を提供するものである。
【００１６】
【発明の実施の形態】
本発明の呼吸用気体供給装置は、呼吸用陽圧空気を発生する陽圧空気発生手段、使用者に該陽圧空気を供給するための陽圧空気供給用呼吸インターフェース、および該陽圧空気発生手段と該陽圧空気供給用呼吸インターフェースを繋ぐ導管手段を備えた陽圧式人工呼吸補助手段と、空気中から酸素を分離し高濃度酸素を発生する酸素濃縮手段、および該高濃度酸素を使用者に送るための酸素供給用呼吸インターフェースを備えた酸素供給手段を有する呼吸用気体供給装置であり、該酸素供給用呼吸インターフェース、又は該導管内もしくは該陽圧空気供給用呼吸インターフェース内に該高濃度酸素を供給するように流路を切り換えるための酸素供給切り換え手段から構成される。
【００１７】
かかる陽圧空気発生手段は、空気を加圧して陽圧空気を発生する手段であり、ブロアが用いられる。陽圧空気供給の制御は、使用者の医師の処方圧力に合わせて吸気時間に吸気時陽圧（IPAP）、呼気時に呼気時陽圧（EPAP）のガスを供給するように、陽圧空気発生手段の発生を制御するものであり、陽圧空気発生手段出口から導管手段、陽圧空気供給用呼吸インターフェース内の呼吸回路に圧力センサー、流量センサー等を設けることにより患者の吸気開始点、呼気開始点を検出し、これに応じて陽圧空気発生手段の供給圧力を切り換え制御する装置や、吸気時間、呼気時間を予め設定しておき、それに従って陽圧空気発生手段の供給圧力を切り換え制御し、使用者がそれに呼吸を合わせるものが使用される。
【００１８】
陽圧空気供給用呼吸インターフェースは、使用者の鼻に陽圧空気を供給する鼻マスクや、鼻および口を覆うフェイスマスクなどの呼吸用マスクが用いられる。これらには、使用者の呼気をマスク外に排出する呼気排出孔が設けられている。
【００１９】
また、酸素濃縮手段には吸着型の酸素濃縮手段、電解質を用いた電気化学型の酸素濃縮手段を用いることが出来る。吸着型の酸素濃縮手段とは、窒素を選択的に吸着しうる吸着剤を充填した吸着床に空気圧縮手段で圧縮空気を導入して加圧状態で窒素を吸着させることにより酸素濃縮気体を得る吸着工程と、吸着床の内圧を減少させて窒素を脱着させ吸着剤の再生を行なう脱着工程を交互に行なうことにより酸素を濃縮する加圧型手段、あるいは常圧空気を導入し常圧で窒素を吸着する工程と、気体吸引により吸着床の内圧を常圧より減圧して窒素を脱着させ吸着剤の再生を行なう脱着工程を交互に行なうことにより酸素を濃縮する減圧型手段、またこれら加圧型手段、減圧型手段をくみあわせたものである。
【００２０】
かかる吸着剤としては、窒素に対して選択的吸着性を有する結晶性ゼオライトモレキュラーシーブがある。このようなゼオライトにはカチオンとして金属元素を有するゼオライトが好ましい。空気圧縮手段における電気駆動式機械手段としてはコンプレッサー、ポンプなどが挙げられる。気体吸引手段における電気駆動式機械手段としてもコンプレッサーが使用される。また、濃縮された酸素を使用者に供給するための酸素供給用呼吸インターフェースとしては、使用者の鼻腔に管を挿入するタイプの鼻カニューラが使用される。
【００２１】
また、本発明における呼吸用気体供給装置は、該酸素供給手段によって生成された高濃度酸素を鼻カニューラ、または呼吸用マスク内もしくは該導管内に供給するよう切り換える手段を備える。
【００２２】
該酸素供給切り換え手段としては手動の切り換え弁や電磁弁等の弁手段を用いるのが好ましい。これらの弁手段は、１次側はチューブ等を介して酸素濃縮手段における酸素供給口に接続し、２次側を鼻カニューラおよび呼吸用マスク内に先端を配置した接続用チューブに接続する。または、マスク内に先端を配置したチューブの代わりに導管内に酸素を供給するような位置に２次側を接続したチューブを用いても良い。すなわち、導管内にチューブ先端を配置させたり、Ｔ字管等にチューブを接続しＴ字管を導管内に配置させれば良い。
【００２３】
また、該弁手段として電磁弁を用いれば、患者が手で弁手段を切り換える手間を無くすことができる。例えば、電磁弁の駆動を装置の電源と連動させることによって自動的に弁の切り換えが可能となる。
【００２４】
即ち、該陽圧式人工呼吸補助手段と該酸素供給手段（或は該酸素濃縮手段）がそれぞれ別の電源を備え、（１）該陽圧式人工呼吸補助手段と該酸素濃縮手段の両方の電源をＯＮにした場合に、電磁弁が作動して該高濃度酸素の供給先を該接続用チューブに接続し、（２）該陽圧式人工呼吸補助手段の電源をＯＦＦ、且つ該酸素濃縮手段の電源をＯＮにした場合に、電磁弁が作動して該高濃度酸素の供給先を該酸素供給用呼吸インターフェースに接続する。
【００２５】
更に、該酸素濃縮手段を使用せず該陽圧式人工呼吸補助手段のみで治療を行なう場合には、陽圧空気が接続用チューブを通って酸素濃縮手段内に逆流し、患者に十分な陽圧空気の供給ができないことを防ぐため、（３）該電磁弁によって、該陽圧式人工呼吸補助手段の電源をＯＮ、且つ該酸素濃縮手段の電源をＯＦＦにした場合に、該高濃度酸素の供給口から該接続用チューブ間の流路を閉とすることにより、該高濃度酸素の供給口から該接続用チューブ間の流路を遮断するのが望ましい。
【００２６】
また、本発明の呼吸用気体供給装置は該酸素供給手段を単独で使うか、もしくは該陽圧式人工呼吸補助手段と組み合わせて使うかによって、自動的に酸素供給流量を切り換える手段を持つ。
【００２７】
酸素供給手段単独で使用する場合と、該陽圧式人工呼吸補助手段と組み合わせて使う場合の酸素流量は、予め医師によって処方された値を装置に入力しておき、其々の電源に連動させて酸素流量を自動切り換えするのが好ましい。
【００２８】
即ち、該酸素供給手段および該陽圧式人工呼吸補助装置の電源が両方ともＯＮの場合には、陽圧空気に酸素を混入して吸入する場合の設定酸素流量になるように、該高濃度酸素流量を自動的に変更するよう制御し、該酸素供給手段の電源がＯＮ、且つ該陽圧式人工呼吸補助装置の電源がＯＦＦの場合には、酸素のみを吸入する場合の設定酸素流量になるように該高濃度酸素流量を自動的に変更するよう制御する。もしくは、電源のＯＮ/ＯＦＦによって電磁弁の動作や自動設定変更を行なう代わりに、あるボタンを押すなど、使用者が特定の入力を行った場合に、電磁弁の動作や自動設定変更を行なうようにすることも可能である。
【００２９】
また、呼吸状態のモニタ手段を備え、呼吸状態に応じて該高濃度酸素流量を自動的に変化させても良い。例えば、血中酸素飽和度をモニタするパルスオキシメーターを該モニタ手段として備え、酸素飽和度が低い場合に該高濃度酸素流量を増やし、酸素飽和度が高い場合に該酸素流量を減らすことによって、患者の時々刻々と変化する病態に応じて最適な治療を施すことができ、過剰な酸素吸入を避けることもできる。
【００３０】
また、呼吸状態が良い場合には該陽圧式人工呼吸補助手段を自動的にＯＦＦとし、高濃度酸素吸入療法のみとし、呼吸状態が悪い場合には高濃度酸素を混入した陽圧式人工呼吸補助療法に自動的に切り換える方法も考えられる。更に、呼吸状態の程度に応じて、陽圧式人工呼吸補助手段によって発生する陽圧空気の圧力を自動調整することによって、より効果的な治療を提供できる。この場合、該モニタ手段として、呼吸に関連した胸腹の動きを測定するレスピバンド、吸気と呼気を測定する鼻および口サーミスタまたは鼻および口の微圧計、更に脳波計などを用いることができる。
【００３１】
【実施例】
本発明の呼吸用気体供給装置を、図３の好適な実施例を用いて更に詳細に説明する。
コンプレッサーで加圧された空気は、吸着剤を充填した吸着床に送られ、吸着床内を間欠的に加減圧して濃縮酸素を発生し、濃縮酸素は製品タンクへ運ばれる。製品タンクの下流には流量設定器が設けられており、予め処方されていた設定流量および制御手段aからの信号に応じて流量を決定する。流量設定器の更に下流には電磁弁が備えられており、制御手段aからの信号に応じて、酸素の供給を鼻カニューラ１０、または鼻マスク内に先端を配置された接続用チューブ１１に切り換える。なお、接続用チューブ１１の先端は導管２内でも構わない。また、電磁弁は酸素濃縮手段８の電源aがＯＦＦの場合には接続用チューブ１１への流路を閉じ、陽圧式人工呼吸補助手段９からの陽圧空気の逆流を防ぐ。加湿器は、高濃度酸素を加湿するために設けられており、酸素濃縮手段８の内部に設けられても良いし、外部に設けられていても良い。
【００３２】
陽圧式人工呼吸補助手段９は、制御手段bによってブロアを制御し、ブロアは吸気時圧力とこれ以下の呼気時圧力を発生し導管２に送る。圧力計は陽圧空気の圧力値を制御手段bに送り、制御手段bはこの値を基に予め設定された圧力となるようブロアの回転数を制御する。また、流量計は患者の呼吸を検知して制御手段bに送り、制御手段bは患者の呼吸が吸気であるか呼気であるかを判断し、所定の圧力を発生するようブロアの回転数を制御する。
【００３３】
酸素濃縮手段８の電源a、および陽圧式人工呼吸補助手段９の電源bのＯＮ/ＯＦＦ信号は、それぞれ制御手段aに送られ、制御手段aは、ＯＮ/ＯＦＦ信号に応じて電磁弁の切り換え、および設定酸素流量の自動変更を行なう。
【００３４】
また、酸素濃縮手段８と陽圧式人工呼吸手段９はそれぞれを分離することができ、組み合わせて用いる場合には台座式のドッキングステーション等によって両手段が接続され、両手段をドッキングさせることによって、両手段間で接続用チューブ１１および電源ＯＮ/ＯＦＦ信号が自動的に接続されるのが好ましい。
【００３５】
【発明の効果】
本発明により、陽圧式人工呼吸補助装置と酸素濃縮装置を併用して用いる場合に、設定変更やチューブの繋ぎ替え作業の手間を軽減し、更に、設定変更のミスやチューブの繋ぎ替えミスが原因となって処方された量の酸素を吸入できない等の危険性を無くし、簡単且つ安全な治療器を提供することができる。
【図面の簡単な説明】
【図１】鼻マスク式の間欠的陽圧式人工呼吸補助装置。
【図２】一般的な間欠的陽圧式人工呼吸補助装置における供給圧力パターン。
【図３】本発明の好適な呼吸用気体供給装置。
【符号の説明】
１．陽圧空気発生手段
２．導管
３．呼気排出孔
４．治療用ガス混入ポート
５．マスクフレーム
６．鼻マスク
７．使用者
８．酸素濃縮手段
９．陽圧式人工呼吸補助手段
１０．鼻カニューラ
１１．接続用チューブ[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a breathing gas supply device that supplies medical gas. More specifically, the present invention relates to a medical oxygen concentrator that supplies oxygen separately from the air, and a medical positive pressure artificial respiration assist device that supplies pressurized air.
[0002]
[Prior art]
In recent years, there has been an increase in the number of patients suffering from respiratory diseases such as asthma, emphysema, and chronic bronchitis. One of the most effective treatments is oxygen inhalation therapy. Oxygen concentrators that directly separate the gas have been developed, and are becoming increasingly popular as therapeutic devices for oxygen inhalation therapy because of convenience during use and ease of maintenance.
[0003]
As such a medical oxygen concentrator, a membrane separation type oxygen concentrator using an oxygen selective permeable membrane and an adsorption type oxygen concentrator using an adsorbent capable of selectively adsorbing nitrogen or oxygen are known. Furthermore, there is an apparatus that electrochemically generates oxygen using a solid electrolyte membrane that selectively permeates oxygen ions. As the adsorption type oxygen concentrator, there is a pressure fluctuation adsorption type oxygen concentrator using a gas compressor or a gas suction machine. Usually, the adsorption bed is packed with an adsorbent capable of selectively adsorbing nitrogen, and compressed by a compressor. By alternately performing an adsorption process for obtaining oxygen-enriched gas by introducing nitrogen in a pressurized state by introducing air and a desorption process for desorbing nitrogen by reducing the internal pressure of the adsorption bed and regenerating the adsorbent A breathing gas supply device that supplies oxygen-enriched gas to a patient. As an interface for supplying oxygen-enriched gas to a patient, a nasal cannula for guiding the oxygen-enriched gas to the nasal cavity by a tube is common.
[0004]
On the other hand, the positive pressure artificial respiration support device for medical use is used to support the respiration of patients with ventilatory insufficiency where spontaneous respiration alone cannot provide sufficient ventilation such as pulmonary tuberculosis sequelae, chronic obstructive pulmonary disease (COPD), and emphysema. An intermittent positive pressure artificial respiration assist device and a continuous positive pressure artificial respiration assist device capable of always maintaining a positive air pressure for a patient exhibiting airway obstruction during sleep such as sleep apnea syndrome are becoming widespread.
[0005]
Moreover, in diseases having a circulatory disorder such as heart failure, it is known to exhibit Chain Stokes respiration in which hyperventilation and hypoventilation repeatedly appear. As treatments for such sleep disordered breathing, the usefulness of high-concentration oxygen therapy, intermittent positive-pressure artificial respiration therapy, and continuous positive-pressure artificial respiration therapy is being recognized.
[0006]
The most common type using a nasal mask among intermittent positive pressure artificial respiration assist devices will be described with reference to FIG. The main body 1 intermittently generates positive pressure air of about 2 to 30 cmH 2 O and sends it to the
[0007]
The continuous positive pressure artificial respiration assist device has almost the same configuration as the intermittent positive pressure artificial respiration assist device, but always supplies a constant positive pressure air to the airway regardless of the user's inspiration / expiration.
[0008]
[Problems to be solved by the invention]
Among positive pressure artificial respiration assist devices, non-invasive type positive pressure artificial respiration assist devices using nasal masks are relatively easy to manage by doctors, and the number of cases where treatment is performed at home is increasing rapidly. . In addition, most of these patients require treatment with high-concentration oxygen gas, and patients have not only a positive pressure artificial respiration assist device but also an oxygen concentrator. Connect together and inhale positive pressure air mixed with high concentration oxygen.
[0009]
However, such patients often have different prescriptions in the daytime and during sleep, and it is necessary to frequently change the settings of each device and change the tube depending on the situation. For example, only high-concentration oxygen inhalation therapy is performed during the daytime, and intermittent positive pressure artificial respiration therapy mixed with high-concentration oxygen gas is often performed during sleep. In such cases, the patient inhales high-concentration oxygen from the nasal cannula directly connected to the oxygen concentrator during the day, and removes the nasal cannula from the oxygen concentrator at night and connects the oxygen concentrator and nasal mask with a tube. Furthermore, it is necessary to reset the oxygen flow rate so that it becomes the set flow rate at night. Of course, it is necessary to reconnect to the nasal cannula again in the daytime of the next day to adjust the high-concentration oxygen flow rate, and these operations will be a heavy burden on the patient, as well as tube connection mistakes and setting change mistakes, etc. Needless to say, this increases the risk that the required amount of high-concentration oxygen cannot be inhaled.
[0010]
When the present invention is used in combination with a positive pressure type artificial respiration assisting device and an oxygen concentrating device, the setting change and tube reconnecting work can be easily performed and a necessary amount of high concentration oxygen cannot be inhaled. It is an object of the present invention to provide a breathing gas supply device that eliminates such a risk.
[0011]
[Means for Solving the Problems]
In order to achieve this problem, the present inventor has intensively studied and found that the problem can be solved by providing a new breathing gas supply device in which an oxygen concentrator and a positive pressure artificial respiration assist device are connected.
[0012]
That is, the present invention provides a positive pressure air generating means for generating positive pressure air for breathing, a positive pressure air supply breathing interface for supplying the positive pressure air to a user, and the positive pressure air generating means and the positive pressure. A positive pressure artificial respiration assisting means having a conduit means for connecting a breathing interface for supplying air, an oxygen concentrating means for separating oxygen from the air and generating high concentration oxygen, and oxygen supply for sending the high concentration oxygen to the user In a breathing gas supply device having an oxygen supply means having a breathing interface for oxygen, the oxygen supply switching means for supplying the high-concentration oxygen to the breathing interface for supplying oxygen or the conduit or the breathing interface for supplying positive pressure air with a oxygen supply switching means, in response to the operation, the following (a), by any one connection condition selected from (B) and (C), acid There is provided a breathing gas supply apparatus characterized by connecting the oxygen supply port of the enrichment means and the respective supply destinations.
Connection state (A): The high-concentration oxygen supply destination is connected to the positive pressure air supply breathing interface or the conduit to a connection tube having a tip.
Connection state (B): The high-concentration oxygen supply destination is connected to the oxygen supply breathing interface.
Connection state (C): The flow path between the oxygen supply port and the connection tube is closed.
In addition, the present invention provides a breathing gas supply device including input operation means that can select any one of the connection states (A), (B), and (C) according to a user input. It is to provide.
[0013]
In the present invention, the switching means is a solenoid valve, and the positive pressure artificial respiration assisting means and the oxygen supply means are provided with separate power sources, respectively, detecting the ON / OFF state of both power sources,
(I) When both the positive-pressure artificial respiration assisting means and the oxygen concentrating means are turned on, the solenoid valve is activated to enter the connected state (A).
(Ii) When the positive pressure artificial respiration assisting means is turned off and the oxygen concentrating means is turned on, the solenoid valve is activated to enter the connected state (B).
(Iii) When the positive pressure artificial respiration assisting means is turned on and the oxygen concentrating means is turned off, the solenoid valve is actuated to the connected state (C).
The present invention provides a breathing gas supply device including a control means for automatically switching.
[0014]
The present invention also provides positive pressure air generating means for generating positive pressure air for breathing, a breathing interface for supplying positive pressure air to a user, and the positive pressure air generating means and the positive pressure. A positive pressure artificial respiration assisting means having a conduit means for connecting a breathing interface for supplying air, an oxygen concentrating means for separating oxygen from the air and generating high concentration oxygen, and oxygen supply for sending the high concentration oxygen to the user In a breathing gas supply device having an oxygen supply means having a breathing interface for oxygen, the oxygen supply switching means for supplying the high-concentration oxygen to the breathing interface for supplying oxygen or the conduit or the breathing interface for supplying positive pressure air The positive pressure artificial respiration assisting means and the oxygen supply means are each provided with a separate power source, detecting the ON / OFF state of both power sources,
(I) When both the power sources of the positive pressure artificial respiration assisting means and the oxygen supply means are both ON, the set oxygen flow rate when inhaling oxygen mixed in positive pressure air is set to
(Ii) When the positive pressure artificial respiration assisting means is turned off and the oxygen supplying means is turned on, the set oxygen flow rate when inhaling only oxygen is set.
The present invention provides a breathing gas supply device comprising a control means for automatically changing the supply flow rate of the high-concentration oxygen.
The present invention also provides positive pressure air generating means for generating positive pressure air for breathing, a breathing interface for supplying positive pressure air to a user, and the positive pressure air generating means and the positive pressure. A positive pressure artificial respiration assisting means having a conduit means for connecting a breathing interface for supplying air, an oxygen concentrating means for separating oxygen from the air and generating high concentration oxygen, and oxygen supply for sending the high concentration oxygen to the user In a breathing gas supply device having an oxygen supply means having a breathing interface for oxygen, the oxygen supply switching means for supplying the high-concentration oxygen to the breathing interface for supplying oxygen or the conduit or the breathing interface for supplying positive pressure air And breathing air equipped with an input and control means for performing control so as to be in the following setting state (1) or (2) according to the input operation of the user There is provided a supply device.
Setting state (1): The supply flow rate of the high-concentration oxygen is automatically changed so as to obtain a set oxygen flow rate when oxygen is mixed with positive pressure air and inhaled.
Setting state (2): The supply flow rate of the high-concentration oxygen is automatically changed so as to be a set oxygen flow rate when inhaling only oxygen.
The present invention also provides a breathing gas supply device capable of separating the oxygen concentrating means and the positive pressure breathing means from each other.
[0015]
Further, in the present invention, in particular, such a positive pressure type artificial respiration assisting means corresponds to the breathing of the user, and supplies positive pressure air at a set pressure at the time of inspiration during inspiration and a set pressure at the time of expiration lower than the pressure at the time of inspiration. It is an object of the present invention to provide a breathing gas supply device, characterized in that it is an intermittent positive pressure artificial respiration assisting means.
[0016]
DETAILED DESCRIPTION OF THE INVENTION
The breathing gas supply device of the present invention includes a positive pressure air generating means for generating positive pressure air for breathing, a positive pressure air supply breathing interface for supplying the positive pressure air to a user, and the positive pressure air generation. A positive pressure artificial respiration assist means having a conduit means connecting the breathing interface for supplying the positive pressure air and the positive pressure air supply, an oxygen concentrating means for separating oxygen from the air and generating high concentration oxygen, and a user using the high concentration oxygen A breathing gas supply device having oxygen supply means with an oxygen supply breathing interface for delivering to the high concentration in the oxygen supply breathing interface, or in the conduit or in the positive pressure air supply breathing interface It comprises oxygen supply switching means for switching the flow path so as to supply oxygen.
[0017]
Such positive pressure air generating means is means for generating positive pressure air by pressurizing air, and a blower is used. The control of the positive pressure air supply generates positive pressure air so as to supply positive inspiratory pressure (IPAP) during inspiration time and positive expiratory pressure (EPAP) during expiration according to the prescription pressure of the user's doctor It controls the generation of the means. From the outlet of the positive pressure air generation means, the pressure means, the flow rate sensor, etc. are provided in the breathing circuit in the conduit means and the positive pressure air supply breathing interface. A device for detecting the point and switching the supply pressure of the positive pressure air generating means according to this, and setting the inspiration time and expiration time in advance and switching the supply pressure of the positive pressure air generating means accordingly. , What the user adjusts to breathe is used.
[0018]
As a respiration interface for supplying positive pressure air, a respiration mask such as a nasal mask for supplying positive pressure air to the user's nose or a face mask covering the nose and mouth is used. These are provided with an exhalation exhaust hole for exhausting the exhalation of the user out of the mask.
[0019]
The oxygen concentrating means may be an adsorption type oxygen concentrating means or an electrochemical type oxygen concentrating means using an electrolyte. Adsorption-type oxygen concentrating means is an oxygen-concentrated gas obtained by introducing compressed air into an adsorbent bed filled with an adsorbent capable of selectively adsorbing nitrogen and adsorbing nitrogen in a pressurized state. The pressure-type means for concentrating oxygen by alternately performing the adsorption step and the desorption step of desorbing nitrogen by desorbing the internal pressure of the adsorption bed and regenerating the adsorbent, or introducing atmospheric pressure nitrogen to introduce nitrogen at normal pressure A depressurization type means for concentrating oxygen by alternately performing an adsorption step and a desorption step of desorbing nitrogen by desorbing the internal pressure of the adsorption bed from atmospheric pressure by gas suction, and these pressure type means A combination of decompression type means.
[0020]
Such adsorbents include crystalline zeolite molecular sieves that have selective adsorptivity to nitrogen. Such a zeolite is preferably a zeolite having a metal element as a cation. Examples of the electrically driven mechanical means in the air compressing means include a compressor and a pump. A compressor is also used as an electrically driven mechanical means in the gas suction means. A nasal cannula of a type in which a tube is inserted into the nasal cavity of the user is used as a breathing interface for supplying oxygen to the user.
[0021]
The breathing gas supply device according to the present invention further comprises means for switching so as to supply the high-concentration oxygen generated by the oxygen supply means into the nasal cannula, the breathing mask or the conduit.
[0022]
As the oxygen supply switching means, it is preferable to use a valve means such as a manual switching valve or a solenoid valve. In these valve means, the primary side is connected to an oxygen supply port in the oxygen concentrating means via a tube or the like, and the secondary side is connected to a connection tube having a tip disposed in the nasal cannula and the respiratory mask. Or you may use the tube which connected the secondary side to the position which supplies oxygen in a conduit | pipe instead of the tube which has arrange | positioned the front-end | tip in a mask. That is, the tip of the tube may be disposed in the conduit, or the tube may be connected to a T-shaped tube or the like and the T-shaped tube may be disposed in the conduit.
[0023]
Further, if an electromagnetic valve is used as the valve means, it is possible to eliminate the trouble for the patient to manually switch the valve means. For example, the valve can be automatically switched by interlocking the driving of the electromagnetic valve with the power source of the apparatus.
[0024]
That is, the positive pressure type artificial respiration assisting means and the oxygen supply means (or the oxygen concentrating means) are provided with separate power sources, respectively. (1) Both the positive pressure type artificial respiration assisting means and the oxygen concentrating means are powered When turned on, the solenoid valve is activated to connect the supply destination of the high concentration oxygen to the connecting tube; (2) the positive pressure artificial respiration assisting means is turned off, and the oxygen concentrating means is powered Is turned ON, the solenoid valve is activated to connect the high-concentration oxygen supply destination to the oxygen supply breathing interface.
[0025]
Furthermore, when the treatment is performed only by the positive pressure type artificial respiration assisting means without using the oxygen concentrating means, the positive pressure air flows back into the oxygen concentrating means through the connecting tube, and the positive pressure sufficient for the patient is obtained. In order to prevent the supply of air, (3) supply of the high concentration oxygen when the positive pressure artificial respiration assisting means is turned on and the oxygen concentrating means is turned off by the solenoid valve. It is desirable to close the flow path between the connection tubes from the high concentration oxygen supply port by closing the flow path between the connection tubes from the opening.
[0026]
The breathing gas supply apparatus of the present invention has means for automatically switching the oxygen supply flow rate depending on whether the oxygen supply means is used alone or in combination with the positive pressure artificial respiration assisting means.
[0027]
When using the oxygen supply means alone and in combination with the positive pressure artificial respiration assist means, the oxygen flow rate is input to the device in advance as a prescription by a doctor, and linked to each power source. It is preferable to automatically switch the oxygen flow rate.
[0028]
That is, when both the oxygen supply means and the positive-pressure artificial respiration assist device are turned on, the high-concentration oxygen is set so that the set oxygen flow rate is obtained when oxygen is mixed into the positive-pressure air and inhaled. When the oxygen supply means is turned on and the positive pressure artificial respiration assist device is turned off, the flow rate is automatically changed so that the set oxygen flow rate for inhaling only oxygen is obtained. The high concentration oxygen flow rate is controlled to be automatically changed. Or, instead of performing solenoid valve operation or automatic setting change by turning the power ON / OFF, the solenoid valve operation or automatic setting change is performed when the user performs a specific input, such as pressing a certain button. It is also possible to make it.
[0029]
Further, a breathing state monitoring unit may be provided, and the high concentration oxygen flow rate may be automatically changed according to the breathing state. For example, a pulse oximeter for monitoring blood oxygen saturation is provided as the monitoring means, and the high concentration oxygen flow rate is increased when the oxygen saturation level is low, and the oxygen flow rate is decreased when the oxygen saturation level is high, Optimal treatment can be performed according to the patient's ever-changing pathology, and excessive oxygen inhalation can be avoided.
[0030]
Also, when the respiratory condition is good, the positive pressure artificial respiration assisting means is automatically turned off, and only high concentration oxygen inhalation therapy is used. When the respiratory condition is poor, the positive pressure artificial respiration assist therapy is mixed with high concentration oxygen. A method of automatically switching to is also conceivable. Furthermore, more effective treatment can be provided by automatically adjusting the pressure of the positive pressure air generated by the positive pressure artificial respiration assisting means according to the degree of the respiratory state. In this case, as the monitoring means, a response band for measuring the movement of the chest and abdomen related to breathing, a nose and mouth thermistor for measuring inspiration and expiration, or a micrometer for the nose and mouth, and an electroencephalograph can be used.
[0031]
【Example】
The breathing gas supply device of the present invention will be described in more detail using the preferred embodiment of FIG.
The air pressurized by the compressor is sent to an adsorption bed filled with an adsorbent, and the inside of the adsorption bed is intermittently pressurized and decompressed to generate concentrated oxygen, and the concentrated oxygen is carried to a product tank. A flow rate setting device is provided downstream of the product tank, and the flow rate is determined in accordance with a pre-set flow rate and a signal from the control means a. An electromagnetic valve is provided further downstream of the flow rate setting device, and according to a signal from the control means a, the supply of oxygen is switched to the
[0032]
The positive pressure artificial respiration assisting means 9 controls the blower by the control means b, and the blower generates an inspiratory pressure and an expiratory pressure lower than this and sends them to the
[0033]
The ON / OFF signals of the power source a of the oxygen concentrating means 8 and the power source b of the positive pressure artificial respiration assisting means 9 are respectively sent to the control means a, and the control means a switches the solenoid valve according to the ON / OFF signal. , And automatically change the set oxygen flow rate.
[0034]
In addition, the oxygen concentrating means 8 and the positive pressure artificial respiration means 9 can be separated from each other. When used in combination, both means are connected by a pedestal-type docking station or the like, and both means are docked, It is preferable that the connecting tube 11 and the power ON / OFF signal are automatically connected between the means.
[0035]
【The invention's effect】
According to the present invention, when a positive pressure artificial respiration assist device and an oxygen concentrator are used in combination, the trouble of setting change and tube reconnecting work is reduced, and further, setting change error and tube reconnecting error are caused. Thus, there is no danger that the prescribed amount of oxygen cannot be inhaled, and a simple and safe treatment device can be provided.
[Brief description of the drawings]
FIG. 1 is a nasal mask type intermittent positive pressure artificial respiration assist device.
FIG. 2 shows a supply pressure pattern in a general intermittent positive pressure artificial respiration assist device.
FIG. 3 is a preferred breathing gas supply device of the present invention.
[Explanation of symbols]
1. 1. Positive pressure air generating means 2. Conduit 3. Exhalation discharge hole 4. Gas mixture port for treatment 5. Mask frame 6. Nasal mask User 8. Oxygen concentrating means 9. Positive pressure artificial respiration assist means10. Nose cannula11. Tube for connection
Claims (7)
接続状態（Ａ）：該高濃度酸素の供給先を、該陽圧空気供給用呼吸インターフェース又は該導管に、先端を配置した接続用チューブに接続する。
接続状態（Ｂ）：該高濃度酸素の供給先を、該酸素供給用呼吸インターフェースに接続する。
接続状態（Ｃ）：該酸素供給口から該接続用チューブ間の流路を閉とする。 Positive pressure air generating means for generating positive pressure air for breathing, a positive pressure air supply breathing interface for supplying the positive pressure air to a user, and the positive pressure air generation means and the positive pressure air supply breathing interface A positive pressure artificial respiration assisting means having a conduit means for connecting the oxygen, an oxygen concentrating means for separating oxygen from the air and generating high concentration oxygen, and an oxygen supply breathing interface for sending the high concentration oxygen to the user and the breathing gas supply apparatus provided with oxygen supply means includes oxygen supply switching means for supplying the high-concentration oxygen oxygen supply breathing interface or conduit or said positive air supply breathing interface, oxygen Depending on the operation, the supply switching means may be selected from the following (A), (B), and (C) in accordance with any one connection state, so Breathing gas supply apparatus characterized by connecting the supply port and the respective supply destinations.
Connection state (A): The high-concentration oxygen supply destination is connected to the positive pressure air supply breathing interface or the conduit to a connection tube having a tip.
Connection state (B): The high-concentration oxygen supply destination is connected to the oxygen supply breathing interface.
Connection state (C): The flow path between the oxygen supply port and the connection tube is closed.
（ｉ）該陽圧式人工呼吸補助手段と該酸素濃縮手段の両方の電源をONにした場合に、該電磁弁が作動して接続状態（Ａ）へ、
（ii）該陽圧式人工呼吸補助手段の電源をOFF、且つ該酸素濃縮手段の電源をONにした場合に、該電磁弁が作動して接続状態（Ｂ）へ、
（iii）該陽圧式人工呼吸補助手段の電源をON、且つ該酸素濃縮手段の電源をOFFにした場合に、該電磁弁が作動して接続状態（Ｃ）へ、
自動的に切り換える制御手段を備えることを特徴とする請求項１記載の呼吸用気体供給装置。The switching means is a solenoid valve, and the positive pressure artificial respiration assisting means and the oxygen supply means are provided with separate power sources, respectively, detecting the ON / OFF state of both power sources,
(I) When both the positive-pressure artificial respiration assisting means and the oxygen concentrating means are turned on, the solenoid valve is activated to enter the connected state (A).
(Ii) When the positive pressure artificial respiration assisting means is turned off and the oxygen concentrating means is turned on, the solenoid valve is activated to enter the connected state (B).
(Iii) When the positive pressure artificial respiration assisting means is turned on and the oxygen concentrating means is turned off, the solenoid valve is actuated to the connected state (C).
2. The breathing gas supply apparatus according to claim 1, further comprising control means for automatically switching.
（ｉ）該陽圧式人工呼吸補助手段及び該酸素供給手段の両方の電源が両方ともONの場合には、陽圧空気に酸素を混入して吸入する場合の設定酸素流量になるように、
（ii）該陽圧式人工呼吸補助手段の電源がOFF、且つ該酸素供給手段の電源がONの場合には、酸素のみを吸入する場合の設定酸素流量になるように、
該高濃度酸素の供給流量を自動的に変更する制御手段を備えることを特徴とする呼吸用気体供給装置。 Positive pressure air generating means for generating positive pressure air for breathing, a positive pressure air supply breathing interface for supplying the positive pressure air to a user, and the positive pressure air generation means and the positive pressure air supply breathing interface A positive pressure artificial respiration assisting means having a conduit means for connecting the oxygen, an oxygen concentrating means for separating oxygen from the air and generating high concentration oxygen, and an oxygen supply breathing interface for sending the high concentration oxygen to the user A breathing gas supply device comprising oxygen supply means, comprising oxygen supply switching means for supplying the high concentration oxygen to the oxygen supply breathing interface, or to the conduit or the positive pressure air supply breathing interface, The pressure-type artificial respiration assisting means and the oxygen supply means are provided with separate power sources, respectively, detecting the ON / OFF state of both power sources,
(I) When both the power sources of the positive pressure artificial respiration assisting means and the oxygen supply means are both ON, the set oxygen flow rate when inhaling oxygen mixed in positive pressure air is set to
(Ii) When the positive pressure artificial respiration assisting means is turned off and the oxygen supplying means is turned on, the set oxygen flow rate when inhaling only oxygen is set.
Call吸用gas delivery system you further comprising a control means for automatically changing the supply flow rate of the high concentration of oxygen.
設定状態（１）：陽圧空気に酸素を混入して吸入する場合の設定酸素流量になるように、該高濃度酸素の供給流量を自動的に変更する。
設定状態（２）：酸素のみを吸入する場合の設定酸素流量になるように該高濃度酸素の供給流量を自動的に変更する。 Positive pressure air generating means for generating positive pressure air for breathing, a positive pressure air supply breathing interface for supplying the positive pressure air to a user, and the positive pressure air generation means and the positive pressure air supply breathing interface A positive pressure artificial respiration assisting means having a conduit means for connecting the oxygen, an oxygen concentrating means for separating oxygen from the air and generating high concentration oxygen, and an oxygen supply breathing interface for sending the high concentration oxygen to the user A breathing gas supply device comprising oxygen supply means, comprising oxygen supply switching means for supplying the high concentration oxygen to the oxygen supply breathing interface or the conduit or the positive pressure air supply breathing interface; A breathing gas supply device comprising an input and control means for performing control so as to be in the following setting state (1) or (2) in accordance with the input operation.
Setting state (1): The supply flow rate of the high-concentration oxygen is automatically changed so as to obtain a set oxygen flow rate when oxygen is mixed with positive pressure air and inhaled .
Setting state (2): The supply flow rate of the high-concentration oxygen is automatically changed so as to be the set oxygen flow rate when inhaling only oxygen .
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| JP6211253B2 (en) * | 2012-08-22 | 2017-10-11 | 国立大学法人鳥取大学 | Oxygen supply equipment |
| JP7352964B2 (en) * | 2020-04-13 | 2023-09-29 | 日本気圧バルク工業株式会社 | ventilator system |
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| JPH01321508A (en) * | 1988-06-23 | 1989-12-27 | Kojima Seisakusho:Kk | Oxygen density controller |
| JPH0370147U (en) * | 1989-11-09 | 1991-07-12 | ||
| JPH0626894U (en) * | 1992-09-08 | 1994-04-12 | 山陽電子工業株式会社 | Medical oxygen enriched gas supply device |
| JP2000051359A (en) * | 1998-08-05 | 2000-02-22 | Teijin Ltd | Positive pressure artificial respiration assisting device |
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- 2001-07-02 JP JP2001200595A patent/JP4606655B2/en not_active Expired - Fee Related
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH01321508A (en) * | 1988-06-23 | 1989-12-27 | Kojima Seisakusho:Kk | Oxygen density controller |
| JPH0370147U (en) * | 1989-11-09 | 1991-07-12 | ||
| JPH0626894U (en) * | 1992-09-08 | 1994-04-12 | 山陽電子工業株式会社 | Medical oxygen enriched gas supply device |
| JP2000051359A (en) * | 1998-08-05 | 2000-02-22 | Teijin Ltd | Positive pressure artificial respiration assisting device |
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