JP7174745B2 - 呼吸ガス加湿システム - Google Patents
呼吸ガス加湿システム Download PDFInfo
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- G01K13/00—Thermometers specially adapted for specific purposes
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- 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
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
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- 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
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- A61M16/1095—Preparation of respiratory gases or vapours by influencing the temperature in the connecting tubes
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- 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
- A61M16/14—Preparation of respiratory gases or vapours by mixing different fluids, one of them being in a liquid phase
- A61M16/16—Devices to humidify the respiration air
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- A—HUMAN NECESSITIES
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- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/14—Preparation of respiratory gases or vapours by mixing different fluids, one of them being in a liquid phase
- A61M16/16—Devices to humidify the respiration air
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- A—HUMAN NECESSITIES
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- 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
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/08—Tubes; Storage means specially adapted therefor
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- G01F—MEASURING VOLUME, VOLUME FLOW, MASS FLOW OR LIQUID LEVEL; METERING BY VOLUME
- G01F1/00—Measuring the volume flow or mass flow of fluid or fluent solid material wherein the fluid passes through a meter in a continuous flow
- G01F1/68—Measuring the volume flow or mass flow of fluid or fluent solid material wherein the fluid passes through a meter in a continuous flow by using thermal effects
- G01F1/684—Structural arrangements; Mounting of elements, e.g. in relation to fluid flow
- G01F1/688—Structural arrangements; Mounting of elements, e.g. in relation to fluid flow using a particular type of heating, cooling or sensing element
- G01F1/69—Structural arrangements; Mounting of elements, e.g. in relation to fluid flow using a particular type of heating, cooling or sensing element of resistive type
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01F—MEASURING VOLUME, VOLUME FLOW, MASS FLOW OR LIQUID LEVEL; METERING BY VOLUME
- G01F23/00—Indicating or measuring liquid level or level of fluent solid material, e.g. indicating in terms of volume or indicating by means of an alarm
- G01F23/22—Indicating or measuring liquid level or level of fluent solid material, e.g. indicating in terms of volume or indicating by means of an alarm by measuring physical variables, other than linear dimensions, pressure or weight, dependent on the level to be measured, e.g. by difference of heat transfer of steam or water
- G01F23/26—Indicating or measuring liquid level or level of fluent solid material, e.g. indicating in terms of volume or indicating by means of an alarm by measuring physical variables, other than linear dimensions, pressure or weight, dependent on the level to be measured, e.g. by difference of heat transfer of steam or water by measuring variations of capacity or inductance of capacitors or inductors arising from the presence of liquid or fluent solid material in the electric or electromagnetic fields
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- G01K1/00—Details of thermometers not specially adapted for particular types of thermometer
- G01K1/14—Supports; Fastening devices; Arrangements for mounting thermometers in particular locations
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- G01—MEASURING; TESTING
- G01K—MEASURING TEMPERATURE; MEASURING QUANTITY OF HEAT; THERMALLY-SENSITIVE ELEMENTS NOT OTHERWISE PROVIDED FOR
- G01K13/00—Thermometers specially adapted for specific purposes
- G01K13/02—Thermometers specially adapted for specific purposes for measuring temperature of moving fluids or granular materials capable of flow
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/16—Details of sensor housings or probes; Details of structural supports for sensors
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- 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
- A61M16/0057—Pumps therefor
- A61M16/0066—Blowers or centrifugal pumps
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- 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
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
- A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit
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- A61M2205/3379—Masses, volumes, levels of fluids in reservoirs, flow rates
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Description
本願は、2012年3月13日に出願された米国仮特許出願第61/610,109号明細書;2012年12月4日に出願された同第61/733,360号明細書;2012年12月4日に出願された同第61/733,359号明細書;2012年3月15日に出願された同第61/611,331号明細書;及び2012年11月5日に出願された同第61/722,659号明細書の優先権利益を主張し、これらの各仮特許出願の全体は、本明細書によって参照により本明細書に援用される。
図1及び図1Aは、検知装置22、液位検知システム222、複合管、及び/又は本開示の特定の特徴、態様及び利点に従い配置及び構成された他の特徴を含み得る呼吸加湿システム20を示す。検知装置22、検知システム222、複合管、及び他の特徴は、本明細書では、呼吸加湿システム20と関連して例示及び説明されるが、限定はされないが腹腔鏡検査、換気等を含めた、使用者又は患者への加熱加湿ガス流の供給が関わる他の用途に適用性が見出され得る。
加湿ユニット40の制御器56は、呼吸加湿システム20の様々な構成部品の動作を制御することができる。例示される構成は単一の制御器56で示されるが、他の構成では複数の制御器が用いられ得る。複数の制御器は交信してもよく、又は別個の機能が提供され、従って制御器は交信する必要がない。構成によっては、制御器56は、コンピュータプログラム用のソフトウェアコードを含む関連するメモリ又はストレージを有するマイクロプロセッサ、プロセッサ又は論理回路を含み得る。このような構成では、制御器56は、コンピュータプログラム内に含まれるなどする命令に従い、また外部入力に応答して、加湿システム20の動作を制御することができる。
制御器56はまた、液位検知システム222からも入力を受け取る。液位検知システム222は、チャンバ46又はベース52に、又はその近傍に位置決めされた1つ以上のセンサを含み得る。液位検知システム222は、本明細書に記載されるとおりチャンバ46の液位を決定するための電圧源及び検出システムを含み得る。制御器56は液位検知システム222から液位情報を受け取り、その液位情報に応答して制御特性を調節することができる。一部の実施形態では、制御器56は、液位状態に関してユーザインターフェース部品82を用いて使用者に通知することができる。
図1に関連して、制御器56はまた、流れセンサ84及び少なくとも1つの温度センサ86からも入力を受け取る。任意の好適な流れセンサ84を使用することができ、任意の好適な温度センサ86を使用することができる。構成によっては、流れセンサ84が温度センサ86を含み得る。
上記に記載したとおり、呼吸加湿システム20は、ガス源30を加湿ユニット40、吸気導管70、及び/又は呼気導管と接続する導管44を含み得る。一部の実施形態では、これらの導管のいずれか又は全ての一部又は全体が複合管であってもよく、複合管は、2つ以上の部分又は構成部品を有する管であり得る。本明細書に記載されるとおりの複合管はまた、他の用途、例えば限定されないが腹腔鏡手術にも用いられ得る。例えば、図1Bに示される例示的な吹送システム701において導管713として複合管を使用することにより、熱損失を最小限に抑えた患者705の手術部位への加湿ガスの送気が促進され得る。これは、熱損失を補償するのに必要な熱入力が少なくなるため、吹送システムにおける全エネルギー消費を有利に低減し得る。
次に、複合管の例示的製造方法を示す図41A~図41Fを参照する。
図42A~図42Fは、第1の長尺部材又は部分203と第2の長尺部材又は部分205とを有する単一の管形状要素を含む管の例示的実施形態の横方向断面を示す。図示されるとおり、第2の長尺部分205は第1の長尺部分203と一体化され、この単一の管形状要素の全長に沿って延在する。例示される実施形態では、単一の管形状要素は長尺中空本体であり、横方向断面において、中空部分501を一部画定する比較的薄い壁を有し、その比較的薄い壁に隣接する長尺中空本体の対向する両側に、比較的厚い又は比較的硬い2つの補強部分205を備えている。これらの補強部分は、長尺中空本体が螺旋状に巻回された後、ルーメン207の内壁の一部をなし、従ってこれらの補強部分もまた、長尺中空体の隣接する巻きの間に螺旋状に位置決めされる。
次に、使用中に加湿器に接続するように構成される管の端部にコネクタを取り付けるための例示的なフローチャートを示す図43Aを参照する。例えば、上記に図1に関連して記載したとおり、吸気導管70は入口42を介して加湿ユニット40に接続する。図43Aの例示的なフローチャートは、吸気導管70を加湿ユニット40と物理的及び電気的に接続可能にすることができる。
次に、管201の一方の端部を患者インターフェース(図示せず)に接続する例示的なコネクタ1600を示す図44A~図44Hを参照する。コネクタ1600のうち患者インターフェースと接続する部分が、参照符号1601によって示される。図44Aはコネクタ1600の側面斜視図を示す。図44B~図44Eに示すとおり、コネクタ1600は、管201、PCB1603、インサート1605(一体に組み付けられたとき、まとめて計算流体力学(CFD)アセンブリ1607と称される)、及びカバー1609を含む。図44B~図44Eの各々は、図44Aの図と略対応する側面斜視図を示す。
次に、PCBとの電気的接続性を有しないコネクタを示す図45A~図45Eを参照する。しかしながら、構成によってはコネクタは、PCBと電気的接続性を有するように等しく適合され得る。このコネクタは患者インターフェース又は加湿器との接続に好適である。これは特に、閉塞性睡眠時無呼吸環境における患者端コネクタ及び/又は装置端コネクタとしての使用に適している。
次に、電気ワイヤが中を通る医療用回路に使用することのできるコネクタを示す図46A~図46Fを参照する。コネクタ1801はカットアウト1802を含み、これは特定の実施形態では30mm(又は約30mm)の横幅である。特定の実施形態において、カットアウト1802の一方の端部にL字型アーム1803があり、これは一部がコネクタ1801から外側に延在し、一部がコネクタ1801の長手方向軸と平行に延在する。
同軸呼吸管もまた、上記に記載したとおりの複合管に含まれ得る。同軸呼吸管では、第1のガス空間が吸気リム又は呼気リムであり、第2のガス空間が吸気リム又は呼気リムの他方である。前記吸気リムの入口と前記吸気リムの出口との間に1つのガス通路が提供され、且つ前記呼気リムの入口と前記呼気リムの出口との間に1つのガス通路が提供される。一実施形態では、第1のガス空間が前記吸気リムであり、且つ第2のガス空間が前記呼気リムである。或いは、第1のガス空間が呼気リムであってもよく、且つ第2のガス空間が吸気リムであってもよい。
加熱フィラメント215を組み込む複合管201の実施形態では、第1の長尺部材203の壁を通じて熱が失われ、加熱が不均一となり得る。上記に説明したとおり、この熱損失を補償する一つの方法は、第1の長尺部材203の壁に外部加熱源を適用することであり、これは温度の調節及び熱損失の相殺に役立つ。しかしながら、熱特性を最適化する他の方法が用いられてもよい。
少なくとも1つの実施形態において、複合管の材料は、様々なクリーニング方法を取り扱えるように選択され得る。一部の実施形態では、高度消毒(約20分間のクリーニングサイクル)を使用して複合管201を清浄にし得る。高度消毒では、複合管201を約75℃で約30分間の低温殺菌に供する。次に、複合管201を2%グルタルアルデヒド浴で約20分間処理する。複合管201をグルタルアルデヒドから取り出し、6%過酸化水素に約30分間浸漬する。最後に、複合管201を過酸化水素から取り出し、0.55%オルトフタルアルデヒド(OPA)浴で約10分間処理する。
Claims (15)
- 加湿装置とともに使用するためのカートリッジであって、
1つ以上のセンサと、
前記1つ以上のセンサを前記カートリッジに結合するように構成された対応する付勢手段であって、前記1つ以上のセンサと前記カートリッジとの間に配置され、前記1つ以上のセンサを前記加湿装置のポートの開口部に挿入する際に、前記1つ以上のセンサの端部と前記開口部内に配置されたバリアとの間に反復可能な力を提供するように適合された付勢手段と、
を備えたカートリッジ。 - 前記カートリッジは、
前記カートリッジの第1の端部またはその近傍で前記カートリッジに結合された1つの前記センサと、
前記カートリッジの第2の端部またはその近傍で前記カートリッジに結合された2つの前記センサと
を備える、請求項1記載のカートリッジ。 - 前記カートリッジは、シャーシを備え、前記第1の端部および前記第2の端部は、前記シャーシの横方向に関して反対側にある両端部に位置している、請求項2に記載のカートリッジ。
- 前記シャーシは、中央のコネクタ部分と、前記中央のコネクタ部分から外側に延びる一対のウィングとを備え、前記ウィングは前記コネクタ部分に対して垂直である、請求項3に記載のカートリッジ。
- 前記ウィングは、前記第1の端部および前記第2の端部を含み、前記ウィングは前記センサおよび/または前記付勢手段を受け入れるためのソケットを画定する、請求項4に記載のカートリッジ。
- 前記付勢手段は、前記センサが前記ポートに挿入されたときに圧縮され、前記カートリッジから外側に向けられた反復可能な力を提供して、前記1つ以上のセンサを前記シャーシに対して外側に押し出すように適合されている、請求項3または4に記載のカートリッジ。
- 前記付勢手段はばねを含む、請求項6に記載のカートリッジ。
- 前記センサは前記付勢手段を介して前記シャーシに取り付けられており、前記付勢手段は前記センサと前記シャーシの間に配置されている、請求項3から7のうちのいずれか一項に記載のカートリッジ。
- 前記加湿装置は2つのポートを備え、前記2つのポートのうち第1のポートは、1つの前記センサを受け入れるように構成された1つの開口部を備え、前記2つのポートのうち第2のポートは、2つの前記センサを受け入れるように構成された開口部を備える、請求項8に記載のカートリッジ。
- 加湿装置と共に使用するための加湿ユニットであって、前記加湿ユニットは加湿チャンバを含み、前記加湿チャンバは2つのポートを含み、前記各ポートは1つ以上のセンサを受け入れるように適合された開口部をその中に有し、前記加湿ユニットは請求項1に記載のカートリッジをさらに含む、加湿ユニット。
- 前記カートリッジが、前記加湿チャンバに解放可能に取り付けられるように構成されているという特徴、および/または、
前記カートリッジが、1つのセンサが結合された第1の端部と、2つのセンサが結合された第2の端部とを備えているという特徴、および/または、
前記付勢手段が,前記センサが前記ポートに挿入されたときに圧縮され,前記カートリッジの外側に向けられた反復可能な力を提供して,前記センサを前記カートリッジに対して外側に押し出すように適合されているという特徴、
を具備している、請求項10に記載の加湿ユニット。 - 前記付勢手段はばねを備えている、請求項11に記載の加湿ユニット。
- 可撓性の膜をさらに備え、前記膜は、前記カートリッジから外側に向けられた反復可能な力に対する前記センサの挿入に伴って伸張するように適合されている、請求項11または12に記載の加湿ユニット。
- 前記可撓性の膜は、前記開口部の1つ以上に取り付けられている、請求項13に記載の加湿ユニット。
- 前記センサは前記付勢手段を介して前記カートリッジに取り付けられており、前記付勢手段は前記センサと前記加湿ユニットとの間に配置されているという特徴、および/または、
前記カートリッジは、1つのセンサが結合された第1の端部と、2つのセンサが結合された第2の端部とを有し、前記第1のポートは前記1つのセンサを受け入れるように構成された開口部を有し、前記第2のポートは前記2つのセンサを受け入れるように構成された開口部を有するという特徴、
を具備している、請求項11から14のうちのいずれか一項に記載の加湿ユニット。
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