JPH0464359A - Rib cage external negative pressure type artificial respiratory apparatus with auxiliary exhaling function - Google Patents

Abstract

PURPOSE:To achieve inhaling and exhaling as aid to a patient by arranging a pressurizing band which contains a flexible tube having an air inlet/outlet and is wound on a half of a human body to be tied at both ends thereof, an airtight jacket adapted to wrap the body on a highly rigid shell surrounding a chest part and an air pressure controller which lets a positive pressure be applied into and released from the pressurizing band and lets a negative pressure be done into the shell and therefrom alternately. CONSTITUTION:A pressurizing band 1, a shell 2 and an airtight jacket 3 are mounted on a patient A sequentially and an air pressure controller 6 is operated to perform an automatic control so that an inhaling phase and an exhaling phase are generated alternately. In the exhaling phase, air is sent to a rubber tube 11 at a lower stage to press a belly cavity by a positive pressure and after t1sec. air is sent to a rubber tube 12 at a medium stage to press an intermediate part of a chest cavity. In the subsequent inhaling phase, a negative pressure is given outside the rib cage and a belly to expand the rib cage and the belly so that atmospheric air is taken into a lung.

Description

DETAILED DESCRIPTION OF THE INVENTION (Field of Industrial Application) The present invention relates to a ventilator that is provided with auxiliary functions for inhalation and exhalation for a patient.

(Prior Art) Traditionally, mechanical ventilation methods for patients with respiratory failure involve inserting a tube into the trachea through the nostrils, etc.
A positive airway pressure artificial respiration method, in which positive pressure is forcibly applied intermittently through the tube, is generally employed. However, this method may be superior for unconscious patients, as it allows for the opening of the airway and suction of intratracheal secretions, or for conscious patients, the presence of a tube in the airway is extremely painful, and therefore it is sometimes analgesic. There are problems such as the need for drugs, muscle relaxants, or the inability to ingest or talk.

In order to relieve patients from such pain and inconvenience, an extrathoracic negative pressure artificial respiration method has recently been developed and is now in clinical use. This artificial respiration method involves surrounding the chest and cage with a highly rigid shell, then covering the human body including the shell with an airtight jacket, reducing the pressure by suctioning air through the intake holes leading to the inside of the shell, and restoring the pressure to normal pressure by inflowing air. By repeating this, positive pressure is applied intermittently to the outside of the thorax, which expands the thorax intermittently, allowing the patient to inhale in the same way as natural breathing.

(Problems to be Solved by the Invention) The above-mentioned extrathoracic negative pressure artificial respiration method has been recognized for its effectiveness and has been used clinically, but there are some cases in which the effect is not significant.

Among these, an example of hypoventilation that cannot be improved is due to failure of chest reduction function caused by exhaustion of muscle contractility, as seen in patients with end-stage muscular dystrophy. In this example, even if positive pressure is applied outside the thorax to expand the thorax and allow air into the lungs, the pressure is returned to normal and expiration is performed using the elasticity of the respiratory muscles, there is no muscle contraction force, so sufficient exhalation is not possible. In this case, it is not possible to obtain

Therefore, it is an object of the present invention to solve such problems.

(Means for Solving the Problems) The problem of the present invention is to solve the above problems by using a pressure band which includes a flexible tube having an air inlet and outlet and wraps around the upper body and ties both ends together. , a highly rigid shell surrounding the chest, an airtight jacket wrapping the human body from above the shell, applying and releasing positive pressure within the pressure band, and applying and releasing positive pressure within the shell. A first means characterized by comprising a pneumatic pressure control device that performs alternating air pressure, or a first means according to claim 2, wherein the pressurizing band is divided into a plurality of upper and lower stages extending from the chest to the abdomen, and the pressure band is divided into upper and lower stages extending sequentially from the lower stage. 2. Adding means characterized by pressurization to 1.
solved by means of

(Function) According to the first means, compressed air is supplied to the pressurizing tube to apply positive pressure to the outer surface of the upper body, thereby compressing the upper body to assist exhalation, and then applying the positive pressure. After release, positive pressure is applied inside the shell to expand the thorax and assist in breathing. Furthermore, according to the second means, the area from the abdominal cavity to the thoracic cavity is compressed in stages during exhalation, so exhalation can be easily performed.

Inhalation assistance is performed in the same manner as in the first method.

(Example) Hereinafter, the present invention will be described in detail with reference to the drawings. In FIG. 1, A is a patient, 1 is a pressure band wrapped around the patient's upper body, that is, from the abdomen to the chest, 2 is a shell that surrounds the patient A's thorax from the outside of the pressure band 1, and 3 is the shell 2. 4 is a positive pressure hose group consisting of three sets of hoses that supply positive pressure into the pressure band, and 5 is a positive pressure hose group inside the shell 2. A decompression hose 6 is a pneumatic pressure control device that alternately applies the positive pressure to the air.

As shown in FIG. 2, the pressure band 1 is in the shape of a manchette, and surface-bonded velvet-type fasteners (for example, Velcro tape) 8. It is divided into stages, each with a rubber tube 11.
12 and 13 are inserted and held, and each tube is provided with an air inlet/outlet 11a, 12a, 513a extending outside the cloth bag 2.

This pressurizing hand 1 has an air inlet/outlet H as shown in FIG.
a, lower rubber tube 1 with 12a... facing forward
1 is placed on the abdomen, the upper rubber tube 13 is placed on the chest and wrapped around the upper body of the patient A, and the fasteners 8 and 9 are connected on the dorsal side and wrapped.
2a, 13a are connected to positive pressure hoses llb, 12b, 13b constituting the positive pressure port group 4 through airtight holes 14 of the airtight jacket 3. The shell 2 is shaped like kendo armor as shown in Fig. 4, and is made of a highly rigid hard plastic front shell 15 and rear shell 1.
It is divided into two parts (6) and can be connected and disassembled with buckles I7 and I7 on both sides.The inner surface is lined with urethane sponge 18 that softens the contact with the human body, and the edges are lined with soft rubber tubes. A pair of shoulder straps 21 are attached to the upper edge of the shell 19.2o, which are connected and separated by a buckle 22, and a stopper band 23 is attached to the inside of the rear shell 16. At the front of the front shell 15, there is a joint 24 that passes through the jacket 3 and connects to the decompression hose 5.
is provided in a protruding manner, and a nut 25 is screwed into the joint 24 to airtightly connect the airtight jacket 3 at the jacket penetration portion.

The airtight jacket 3 may be sufficient if it airtightly surrounds the pressure band 1 and shell 2 from the outside, or it may have a structure that can also surround part of the arms and legs for ease of wearing, as shown in FIG. One airtight sheet is folded at the upper side 2B and cut into a shape that can wrap the entire torso and part of the four limbs as the front cloth 27 and back cloth 28, and the upper side 26 is made with elastic cord. Connect the neck cover 29, which has many types, and connect the sides and inseam with zippers 30 and 31. Bands 3 are attached to the arms and legs.
2.33 are provided to make it easy to put on and take off and maintain and release the airtightness, and the band 34 on the torso allows it to fit the body.
The band 34 is not critical. Both ends of each band 32-34 are provided with velvet fasteners for connection. A hole 35 is made in the chest of the front cloth 27, into which the shell 2 is inserted.
The joint 24 is inserted from the inside, the nut 25 is screwed together from the outside, and the front cloth is compressed to seal.

The air pressure control device 6 controls the pressure in the exhalation phase and the inspiratory phase, and includes an extrathoracic positive pressure generator 31 during expiration and an extrathoracic negative pressure generator 31 during inspiration. The positive pressure generating section 30 includes a filter 3 in a high pressure circuit 32 connected to a high pressure air source through a joint 33.
4. Three air supply solenoid valves SVI, SV:, and SV3 are connected in parallel via a regulator 35 and a throttle valve 36, and exhalation valves EV+, EV2, and EV3 are connected in series with each air supply solenoid valve. The valves EV1, Ev2, and EV3 each have an inflow port 37 and an outflow port 38, and both ports 37.3
8 is the positive pressure hose llb, 1 of the positive pressure hose group 4;
2b and 13b, and each outflow port 38 is connected to an air vent circuit 39 on the outflow side at the exhaust position.

The opening/closing timing of the air supply solenoid valves SV+, SV2, and SV3 is as follows.
The timers T1, 2, and 3 of the controller C2 are controlled to delay the opening time little by little. In addition, each exhalation valve EV+,
E■2... is a pneumatic circuit 4 branched from the high pressure circuit 32
The air pressure is controlled by the circuit 41 in the control panel C1.
It is switched by the exhalation valve driving solenoid valve SV4 which is controlled via the exhalation valve drive solenoid valve SV4.

Next, the inspiratory extrathoracic negative pressure generating section 31 is provided in a negative pressure pipe 45 that joins the decompression hose 5 and the air vent circuit 39, which communicate with the inside of the shell 2 via the joint 25. A large blower 46 as a negative pressure source is connected to the terminal of the negative pressure pipe 43, and a flow rate control valve 47, an intake reverse relief valve 48, and a negative pressure release reverse relief valve 49 are connected to the middle. The negative pressure release reverse relief valve 49 is also controlled by the control panel C2, and the portion communicating with the negative pressure pipe 45 is opened and closed by the inhalation/exhalation switching solenoid valve S5 controlled by the control panel C2.

The method of using this device is as follows. Patient A wears the pressure band 1, shell 2, and airtight jacket 3 in sequence as described above, and operates the air pressure control device 6 to automatically control the exhalation phase and the inhalation phase to occur alternately. In the exhalation phase, first, the control panel C2 opens the inhalation/exhalation switching valve SV5, and the pressure inside the negative pressure pipe 45 becomes the pressure set by the negative pressure release reverse relief valve 49. Next, the control panel C1 opens the exhalation valve driving solenoid valve SL. is opened and the inflow port 37 of the exhalation valve EV, ~EV3
Switch to the communication state, then switch the air supply solenoid valve SV+
-3V3 is opened sequentially by valve opening timers T1 to T3,
First, air is sent to the lower rubber tube 11 to compress the abdominal cavity with positive pressure, after t1 seconds, air is sent to the middle rubber tube 12 to compress the middle part between the abdominal cavity and the thoracic cavity, and after 12 seconds, the upper rubber tube Air is supplied to the tube 13 to compress the chest cavity for 13 seconds, and 1. +12+
Allow to exhale for 13-1 seconds. During this exhalation, the control panel C2 opens the exhalation switching solenoid valve SV5 to connect the negative pressure release reverse relief valve 49 to the negative pressure pipe 45, and the pressure inside the airtight jacket 3 and shell 2 reaches the set pressure of the reverse relief valve 49. Decrease positive pressure.

After seconds have elapsed, when the exhalation valve driving solenoid valve SL closes and the pressure in the circuit 40 is reduced, the exhalation valves EV, ~EV, return to the illustrated state, and the air in the rubber tubes 11~13 is
The outflow port 38 and the air vent circuit 39 are closed, and the air is sucked and discharged at the set pressure of the negative pressure release reverse relief valve 49, resulting in a pressure close to normal pressure.

In the next inspiratory phase, when the inhalation/exhalation switching valve SV5 is closed, positive pressure is generated in the shell 2 up to the suction flow rate set by the flow rate control valve 47 and the maximum suction pressure set by the reverse relief valve 48, and at the same time, the rubber tube 11.12.13 Also exhalation valve EV
, ~EV3 are connected to the negative pressure pipe 45 through the respective outflow ports 38, so that the pressure is the same as the positive pressure inside the shell 2.

This results in positive pressure outside the patient's thorax and abdomen, causing the thorax and abdomen to expand and draw air into the lungs.

Next, when moving to the exhalation phase, the positive pressure release reverse relief valve 49 is opened as described above, and the negative pressure inside the shell 2 is released via the negative pressure pipe 45 and the pressure reduction hose 5, and then the pressure is transferred to the pressure band 1. Positive pressure is applied.

Artificial respiration may be performed by repeating the above exhalation phase and inhalation phase, or timers 1 and -T3 may be set to operate simultaneously during the exhalation phase to pressurize the rubber tubes 11 to 13 at the same time. In addition, instead of a pressure band made of three rubber tubes, a pressure band with one or two wide rubber tubes or a large number of rubber tubes may be used, and the high pressure circuit 33 and negative pressure tube 45 may be replaced with a pressure booster with supply. It is also possible to make changes such as connecting via the pump 2, pressure accumulator, etc. to form a closed circuit.

(Effects of the Invention) The present invention can support both exhalation and inhalation for patients, so it can be used for patients with weak muscle contraction force and impaired thoracic reduction function, such as patients with end-stage muscular dystrophy. It can be effective in assisting breathing. Moreover, it has the effect of causing almost no pain or inconvenience to the patient during the treatment, and also has the effect of helping to reduce labor because the treatment does not require human power.

[Brief explanation of the drawing]

Fig. 1 is a perspective view showing how the device of the present invention is used, Fig. 2 is a front view of the pressure band, Fig. 3 is a view of the pressure band being installed, and Figs. FIG. 5 is a front view, side view, and plan view of the shell, FIG. 5 is a perspective view of the airtight jacket, and FIG. 6 is a circuit diagram of the air pressure control device. 1. Pressure band 2. Shell 3. Airtight shell 5. G11. 12. 6... Pneumatic control device 13... Rubber tube Figure 2 Patent patent applicant Kintoshi Kikita and 3 other people Figure 3

Claims (2)

[Claims] (1) Built-in flexible tube with air inlet and outlet,
A pressure band wrapped around the upper body and tied at both ends, a highly rigid shell surrounding the chest, an airtight jacket that wraps the human body from above the shell, applying positive pressure to the pressure band, and 1. An extrathoracic negative pressure artificial respirator with an exhalation assist function, characterized in that it is equipped with an air pressure control device that alternately applies and releases negative pressure within the shell. (2) Extrathoracic negative pressure artificial respiration with exhalation assist function according to claim (1), wherein the pressure band is divided into upper and lower stages extending from the chest to the abdomen, and pressurization is applied sequentially from the lower stage. vessel.