JP5758799B2 - 呼吸作用を感知し、人工呼吸器の機能を制御するための方法およびデバイス - Google Patents
呼吸作用を感知し、人工呼吸器の機能を制御するための方法およびデバイス Download PDFInfo
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- JSMRMEYFZHIPJV-UHFFFAOYSA-N C1C2CCC1C2 Chemical compound C1C2CCC1C2 JSMRMEYFZHIPJV-UHFFFAOYSA-N 0.000 description 1
- GDOPTJXRTPNYNR-UHFFFAOYSA-N CC1CCCC1 Chemical compound CC1CCCC1 GDOPTJXRTPNYNR-UHFFFAOYSA-N 0.000 description 1
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- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/03—Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/087—Measuring breath flow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
- A61M16/022—Control means therefor
- A61M16/024—Control means therefor including calculation means, e.g. using a processor
- A61M16/026—Control means therefor including calculation means, e.g. using a processor specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
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- 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
- A61M16/0402—Special features for tracheal tubes not otherwise provided for
- A61M16/0427—Special features for tracheal tubes not otherwise provided for with removable and re-insertable liner tubes, e.g. for cleaning
-
- 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
- A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
-
- 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
- A61M16/0475—Tracheal tubes having openings in the tube
-
- 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
- A61M16/0841—Joints or connectors for sampling
- A61M16/0858—Pressure sampling ports
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/085—Measuring impedance of respiratory organs or lung elasticity
-
- 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
- A61M16/1045—Devices for humidifying or heating the inspired gas by using recovered moisture or heat from the expired gas
-
- 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
- A61M16/105—Filters
- A61M16/1055—Filters bacterial
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- 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
- A61M16/105—Filters
- A61M16/106—Filters in a path
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
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- 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
- A61M16/0402—Special features for tracheal tubes not otherwise provided for
- A61M16/0411—Special features for tracheal tubes not otherwise provided for with means for differentiating between oesophageal and tracheal intubation
- A61M2016/0413—Special features for tracheal tubes not otherwise provided for with means for differentiating between oesophageal and tracheal intubation with detectors of CO2 in exhaled gases
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/17—General characteristics of the apparatus with redundant control systems
Description
本出願は、その内容の全体が参照によって組み込まれる、2008年4月18日出願の表題「Methods and Devices for Sensing Respiration and Controlling Ventilator Functions」の米国特許仮出願第61/071,252号に対する優先権を主張するものとする。
1.換気チューブまたはカテーテル:OD2mmからOD12mm、好ましくは3〜5mm、ID0.5〜6mm、好ましくはID1〜3mm。挿入長さ10mmから150mm、好ましくは30〜100mm。遠位の直線セクションが気管の管腔と整列されるように湾曲される。デュロメータ40〜80シューD。
2.一重リム換気回路:OD4mmからOD12mm、好ましくはOD5〜8mm、および長さ24〜48インチ。
3.外側スリーブ(気管切開チューブ):ID4〜10mm、好ましくはID5〜8mmおよび壁厚1〜2mm。
4.外側スリーブ(薄壁最小プロファイルの気管切開チューブ):ID4〜8mm、好ましくはID5.5〜6.5mm、および壁厚0.75〜1.25mm。長さ40mm〜120mm、好ましくは60〜90mm。
5.外側スリーブ(瘻孔ガイド):ID4〜10mm、好ましくはID5〜8mm、および壁厚1〜2mm。長さ20〜50mm、好ましくは長さ25〜35mm。
6.ガス送出管腔:ID0.5〜6mm、好ましくはID1〜3mm。
7.感知管腔:ID0.25〜3mm、好ましくは0.5〜1.75mm、最も好ましくは0.75〜1.5mm.
8.マイクロ圧力変換器:長さおよび幅寸法1mm〜8mm、厚さ1〜5mm。
9.光ファイバ圧力変換器:感知要素における断面寸法0.5〜3mm、好ましくは1〜2mm。
10.流導管:ID0.5〜2.0mm、好ましくはID1〜1.5mm。
11.フラッシュ・ポート:幅または長さまたは直径0.25〜2mm
12.フラッシュ管腔:0.2mm〜1.0mm、好ましくは0.25〜0.5mm。
B 基線
E 呼気
I 吸気
L 肺(複数可)
P1、P2、P3 圧力変換器1、2および3
Pp 近位圧力センサポート
Pd 遠位圧力センサポート
Pt 患者
Pf フラッシュ圧力レベル
Q 気管の空気流トレース
Q’ 気道の総空気流量の推定
S1、S2、S3 感知要素
TA 気管気道
T、t1、t2、t3 時間
T1 熱感知要素1
T2 熱感知要素2
V 人工呼吸器
V1、V2、V3、V4 弁1、2、3および4
WOB 呼吸の仕事量
WOB’ 呼吸の仕事量
X 定数
10 プロセッサ
20 人工呼吸器の制御ユニット
21 換気ガス送出回路、二重リム
23 圧力タップ
24 換気ガス送出回路、一重リム
25 換気チューブ
28 気管切開チューブの外側カニューレ
28’ 薄壁小径気管切開チューブ
29 瘻孔スリーブ
30 瘻孔スペーサ
52 人工呼吸器のガス送出圧力のトレーシング
58 患者の自発呼吸曲線
60 胸部インピーダンスのワイヤ
62 胸部インピーダンスのバンド
63 患者吸気努力
66 患者呼息の気管の流れ/圧力曲線
77 胸部インピーダンスのトレーシング
92 呼吸センサ配線
100 外側カニューレの開窓部(複数可)
110 換気カテーテルと気管切開チューブの連結器
111 気管切開チューブ換気回路の連結器
115 換気カテーテルのフランジ
116 換気カテーテル−外側カニューレの呼吸流ポート
118 換気カテーテル−外側カニューレの熱水交換
120 換気カテーテル−外側カニューレのフィルタ
122 吸気弁
136 センサ保護シールド
200 吸気流
202 呼気流
206 センサ流導管
208 感知管腔
208’ 感知管腔
209 感知ポート
210 人工呼吸器のガス流管腔
214 センサの物理的障壁
216 圧力センサの感知ポート
218 圧力感知拡張チューブ
219 感知管腔の圧力タップ、近位
220 センサのフラッシュ・ポート
221 感知管腔の圧力タップ、機械側端部
222 マイクロ変換器
224 フラッシュ管腔
226 圧力感知管腔の連結器、雄型
227 フラッシュ管腔の連結器
228 圧力感知管腔の連結器、雌型
230 ガス送出管腔の連結器
232 流導管スクリーン
240 光ファイバ圧力変換器
242 光ファイバの信号伝導ファイバ/有線
244 流体充填された感知管腔
260 低プロファイルカフ
262 開口部
264 ガス送出の連結器
266 感知管腔の連結器
270 歪みゲージセンサ
Claims (7)
- 換気ガス送出回路と、
前記換気ガス送出回路に結合された換気チューブと、
複数の圧力感知ポートと
を備える換気および呼吸感知装置であって、
前記複数の圧力感知ポートが、前記複数の圧力感知ポート間の圧力差を検出するために、ある距離だけ分離され、独立した信号を生成し、
気管、鼻または口の気道内へと延びる、前記換気チューブとは別個の圧力感知管腔をさらに備え、前記圧力感知管腔が、複数の圧力感知ポート間の圧力降下を測定するための前記複数の圧力感知ポートを備える、
換気および呼吸感知装置。 - 前記換気チューブが、前記換気ガス送出回路に取り外し式に結合される、請求項1に記載の換気および呼吸感知装置。
- 外側スリーブをさらに備え、前記換気チューブが、前記外側スリーブ内に配設される、請求項1に記載の換気および呼吸感知装置。
- 前記換気チューブが、患者インターフェースを含む、請求項1に記載の換気および呼吸感知装置。
- 前記複数の圧力感知ポートの少なくとも2つの間の物理的障壁をさらに備える、請求項1に記載の換気および呼吸感知装置。
- 前記物理的障壁が、圧力降下を生み出し、空気流の方向に応じて前記複数の圧力感知要素の少なくとも2つの圧力感知ポートの各々の応答時間を偏倚させる、請求項5に記載の換気および呼吸感知装置。
- 気道の入口近傍またはその中に配設された少なくとも1つの熱センサをさらに備え、前記少なくとも1つの熱センサが、自発呼吸空気流を決定するために使用され、前記複数の圧力感知ポートの少なくとも1つが、呼吸圧力を決定するために使用され、前記自発呼吸の空気流および前記呼吸圧力の組合せが、人工呼吸器の同期化および治療の滴定を最適化するために使用される、請求項1に記載の換気および呼吸感知装置。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US7125208P | 2008-04-18 | 2008-04-18 | |
US61/071,252 | 2008-04-18 | ||
PCT/US2009/041027 WO2009151791A2 (en) | 2008-04-18 | 2009-04-17 | Methods and devices for sensing respiration and controlling ventilator functions |
Publications (2)
Publication Number | Publication Date |
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JP2011518004A JP2011518004A (ja) | 2011-06-23 |
JP5758799B2 true JP5758799B2 (ja) | 2015-08-05 |
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Application Number | Title | Priority Date | Filing Date |
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JP2011505241A Expired - Fee Related JP5758799B2 (ja) | 2008-04-18 | 2009-04-17 | 呼吸作用を感知し、人工呼吸器の機能を制御するための方法およびデバイス |
Country Status (4)
Country | Link |
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US (1) | US8776793B2 (ja) |
EP (1) | EP2276535B1 (ja) |
JP (1) | JP5758799B2 (ja) |
WO (1) | WO2009151791A2 (ja) |
Cited By (1)
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JP7241376B2 (ja) | 2017-10-04 | 2023-03-17 | フルタ電機株式会社 | 主板とボスとの組立て方法 |
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WO2009151791A2 (en) | 2009-12-17 |
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EP2276535A4 (en) | 2015-07-01 |
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