US2924215A - Double bellows controlled respiration unit - Google Patents

Description

Feb. 9, 1960 M. H. GOODNER DOUBLE BELLOWS CONTROLLED RESPIRATION UNIT Filed Jan. 22, 1958 ATTO N EY United States Patent 2,924,215 DOUBLE BELLOWS CQJDlLI'IiROLLED RESPIRATION Monroe H. Goodner, Red Bank, N.J., assignor to Stephenson Corporation, Red Bank, N .J., a corporation of New Jersey Application January 22, 1958, Serial No. 710,501

5 Claims. (Cl. 128-29) This invention relates to a Controlled breathing device and is a modification of the device disclosed in my copending application Serial No. 633,163, filed lanuary 8, i957.

The device disclosed in said co-pending application comprises a single main bellows communicating through valve means directly with a patient or indirectly, as through anesthesia equipment, and alternately collapsed and expanded to supply gas or gases under controlled pressure into a patients lungs and to exhaust gas from a patients lungs under controlled negative pressure. A storage chamber is provided in the form of a smaller bellows communicating with the main bellows through two sep arate, weighted valves through which gas may be removed from the main bellows to the storage bellows if the pressure in the main bellows exceeds a predetermined maximum, and through which gas may be returned to the main bellows from the storage bellows if the pressure in the main bellows falls below a predetermined minimum. Since the said storage bellows and weighted valves form no part of this invention, they are not described herein and are shown in the drawing only to illustrate that the device of the said co-pending application may be incorporated as a unit in the apparatus disclosed herein.

The'device which is the subject of this application can be used wherever the device of said co-pending application is used, and, in addition, is particularly applicable in the case of patients, such as some convalescent patients,

for example those convalescing from polio, where the device must be kept in'use to control breathing for periods of several hours. In such cases it is especially desirable to avoid the possibility of contamination of the gases supplied to the patient due to passing through container, storage, or conduit means through which pass the gases Withdrawn from the patients lungs.

It is accordingly an object of this invention to provide a controlled breathing device for controlling the volume of gas supplied to and removed from a patients lungs per unit of time characterized by separation of the path of gas supplied to the patient from the path of gas exhausted from the patient.

Another object of this invention is to provide a device of the above mentioned kind in which a controlled breathing unit such as is disclosed in my said co -pending application may be included as part of the device.

The invention will best be understood if the following description is read in connection with the drawings in which i Figure 1 is a schematic view of a device embodying my invention. The numeral 10a indicates a first collapsible gas container illustrated herein or a bellows, interconnected as by rods 13 with a second main collapsible gas container, illustrated herein as bellows 10b, thus pro- .viding for simultaneous collapsing and expanding movements of said members when either 10a or 10b is collapsed or expanded, and p Figure 2 is a detail view in vertical section showing 2,924,215 Patented Feb. 9, 1960 the connection and relation between conduits 75, a and 78.

Gas is supplied to a patient through the first main bellows 10a and conduit 12a, and is exhausted from the patient through conduit 12b and second main bellows 10b. Behows 19a has the gas intake port 54 to which a source of gas supply may be coupled and in which the one-way check valve 56 is provided, and bellows 1012 has the exhaust port 76 in which the one-way check valve 77 is provided. The upper end of bellows 10b is connected to the lower surface of valve chest 30 as by the ring bracket 20. The lower end of bellows 10b is connected,

as by ring 17, to the base plate 14b which is connected to the lower ends of rods 13.

Bellows 10a is attached at the bottom, as by ring 15,,v

to the base plate 14a which is fixed to the rods 13 by the coupling means 16. Bellows 10a is attached at the bellows 10a and have telescopically disposed within them the pistons 28 which are connected at their closed upper ends to the upper ends of the rods 13, respectively, by the brackets 25. It will be understood that the valve chest 30 is provided with bores 32. and the cross member 22 is provided with the bores 24 to permit the rods 13 to reciprocate freely through them; that rods 13 rise and fall with the pistons 27, and that as the rods 13 move up and down the bellows 10a and 10b are simultaneously collapsed and expanded.

In the upper portion of the upper bellows 10a, a valve chamber 34 is provided and in the upper end ofbellows 10b 2. similarvalve chamber 36 is provided. As shown, these valve chambers are circular. Chamber 34 is defined by a top plate 35 depending from cross support 22 and as shown it fits within and is supported by the annular bracket member 18. In the top plate 35 is the port 38 anddepending from plate 35 and surrounding port 38 is the cup-shaped member 40 which defines the bottom and side walls of chamber 34. Stretched'horizontally across chamber 34 and supported at its periphery by the attachment means 42 is a flexible diaphragm 44 which carries the valve member 46 which is urged by the spring 48 in a direction away from the port 38 to leave the said port open. In the sidewall of chamber 34, above the diaphragm 44, the apertures 50 are provided to pass into the upper portion of chamber 34 gas which is re ceived into bellows loathrough the conduit 52, the inlet end 54 of which may be coupled directly to a source of gas supply such, for example, as a tank of oxygen under pressure and has in it a one-way check valve 56 of.

known kind.

Leading from the space 39 above port 38, between the top plate 35 of chamber 34 and the cross support member 22, is the nipple or coupling 37a to which is connected the conduit 12a leading to the patient or the patients face mask (not shown) through the branch conduit 58 which, in the drawing, is shown broken away. When the position of diaphragm 44 causes valve 46 to be open gas fl'ows from bellows 10a through apertures50 into the upperpart of chamber 34 and through port 38 and space 39 to conduit 12a.

Chamber 36 inbellows 10b is similar to chamber 34 and Conduit 12b communicates between the patient or the patients face mask and the space 74 between the bottom of the valve chest 30 and plate 60. In the side wall of ha e 6 e pert res q er v t pass x? halation' gases from the space 74 'into bellows 1012 when 79, which; communicates 'with conduit 78 1 throughbranch conduit 80, ,and fed back into said systemtwheneverpressure therein falls below. predetermined" amount Ill @011; duit 78 is thetwo-wayvalve '82 which, in pnegpositi'on assass n permits flow of gas in conduit '78, to inlet port 54, and; tothebag 79, and in anothert'position dischargesithe jgasto atmosphere. x

Compressed air is supplied to,;and exhaustedfrom, each of the valve chambers 34 and 36 through thegcbnduit8l aswill be explained. Duringthe expanding movement. of

bellows 10a and -10bthis pressure is suppliedftdthevalve chambers and serves to counter-balance the springsw48 and 70, respectively,' and therefore to hold valvetmembers 46 closed and valve member 68openv during the expansion. of said bellows thus preventing'supply of gas to the pa- 'tients lungsand causing gas to be .withdtafvtnQfrom ,the

patients lungs. Upon the upward, collapsingmovement of the bellows10a and 10b the pressureis released'from under the valve diaphragms through conduit 81, permitting them tomove downward, and spring 48 then serves to hold valve 68 open and spring 70 serves to hold valve 68 closed, thus causing gas to be supplied totthe patient from bellows 10a. and causing gasp previously exhaustedfrom the patient tobe dischargedfrom bellows 10b.

' Except for, the addition of compressed air conduiti 81/81a, the structure of valvechest and thesmeans provided;forcollapsing and expanding the bellows 10a and 10b; and ft'or regulating the duration ofeach of'these movements, and for providing a dwellfi orflattening of t the inhalation'or exhalation curve near its end (flattening of the texhalation curve being illustratedhereinl ma'y be. thesame as those illustrated and fully describedtinmy co pendinglapplication Serial No. 633,163 These means in: clude the three needle valves 82, 84'and 86'gwhich are controlledrespectively by knobs 83), 85 and 87 each of which is surrounded bya calibrated ring. These valves control the flow of compressed air within passages schematically illustratedin Figure l. The compressed air or equivalent means used in'thesaid passages is employed for collapsing containers 1041 and 10b simultaneously and is entirely separate from the gas or gases contained within thecontainer means and exchanged between said means and the 4 patient directly, or indirectly as through anesthesiajequip ment.

Valve-82. controls the admission of compressed air from supply couduit 88 to passage 9 0 from which it flows to passage'92' when valve member 94'of valve assembly-v is unseated. Passage 92 communicates with both hollow mns 2 h u h b a h s aend. b .ands sup-l plied and x u t d th qus Pa a 92' erv o raise d lowerithe cylindrical pistons28'which'move up and down within said columns and in turn raise and lower the' base plates or platform members 14aand 14b-thereby collapsingeorr expanding the bellows- 10a and-10b;

a v is unseated and valvemember 94 is seated, which is the position shown in Figure 1. Conduit 81 through branch 81a communicates with passage 96 between valve assembly v and valve member 84, and consequently supplies compressed air to chambers 34 and 36, under the diaphragms .44 and 64, respectively, during the time valve ring 98 is unseated and the compressed air is flowing out of columns- 26 :andl the bellows slfial and 10B are conse quently expanding, causingvalve 46 to closeand valve 68 to open Tho-pressure under the diaphragms 44v and t 64 is released when valve ring 98 istclosed du'ringfwhich time conduit 81 is able to exhaust gas throughpassages 81a, 96' and 97, thus causingvalve 46 to open and valve 68 to close: At this time compressed airsupplied through passage 90, past valve 'hfifid94 andgthrough passage 92, is raising the pistons 28, thus collapsing the bellows 10a and 10b and gas is being supplied to the patient while exhalationg gases; areztbeing separately exhausted from bellows 10hr: V i t r i Valve 86 controls thewexhaustingaof,fairs from an air chamber100 in valve chest 30'through passage 102 The outer end portions of passages; 96 and 102. are shown merging infa common dischargepassage 104.

Air chamben100uis ,notsupplied with compressed air but, isgconnected tomatmosphere through passage 102. Piston-r108 is vurged. in a direction away from the outlet. to passage; 102 by coil.spring,109;andt has the plunger 110 extending through the; top oftthe chamber in which n the small port 106 is provided. Whenthe descending base plate orplatform14a strikes plunger 110 its downwards movement is resisted and slowedin proportion to the rate atwhich the. adjustmentof valve86allows air to escape 1 V fromtchamberillw throughpassagedlflz" Valve 86 may be adjusted tol slow thedownward movement; of piston 108 so that dnringthefinal portion of the expansion of bellows 10aLand-10b the negative pressure exerted 'on the patients lungs from container. 10/bellows 10b, as for example through anesthesia equipment and'a face mask, issubstantially level thus providing in effect a pause between the exhalation and inhalation phases of a breathing cycle.

As is explained in my co-pendirigapplication, this levelling Qfi, off the pressure curve approaching zero' provides a pause.in the breathing cycle enabling the operator to make the cycle of the device correspondrwithtthe breathing cycle of the patient; The, duration of the interval dur-' ing which thejpressure curveis thus substantially flattened is determinedtbyfthe} position 10f, baseplate 14a when it strike'splunger llot and} in thef illustrated embodiment of r theQinVention this {depends ,upon the distance, to which val durin'glwhich the pressure remains substantially constant can beobtained substantiallybetween the inhalation and exhalation phases. 1 t

Theposition of valve assembly v is controlled by toggle mechanisms comprising the toggle arms 112 and 113, the

knifeedge inner ends of which are received in the V-shaped 1 indentations a. and b providedin the opposite faces of the Valve 84controls theexhausting of airfrom columns t 26 Land passage, 92 and 92arand 91b through 5 passage 96 ,t when the ring 98 on the head portion 92 0f; yal vezaSSfim W enlarged lower end.114a ofthe control rod 114 extending upwa dlyjromfthe top of valve chest 30. Rod 114? is supported by said toggle'arms and is movableup and down to actuate the toggle mechanism, being guided by the downwardly extending guide pin 115 which extends'into a guiding-vertical-borei provided in the valve chest 30.1

Toggle arm- 112 is "supported, at its outer end on the re du'ced-portien IIS of a post 116*pi'ojecting up t'rom valve' arm 113is=connected tothe reduced portion 119 of valve stem 120 of the valve assembly v. p The outer'ends .of the t ss azar sareicinedztenement-by"coilrspringimeansnzz.

Projectingfrom the moving base plate 14a is a lip 124, shown schematically in Figure 1 asanangle extension member, having a slot 126 through which the control rod 114 extends. On rod 114 below the outer end of extension 124 is a lower fixed stop '128', and above the outer end of extension 124 is an upper adjustable stop 130, rod 114 being preferably calibrated to facilitate setting of the position ofadjustabl'estop 130 as may be desired to determine the volume of bellows a and 10b, i.e., the extent to .which they can be expanded which of course determines the volume of gas 10b can receive from the patients lungs, and the volume of gas 10a can transfer to the patients lungs when it is collapsed. 1

When expansion of bellows 10a moves its lower end to the end of its downward stroke lip 124 contacts fixed stop 128 and moves control rod 114 downwardly enough to actuate said toggle arms downwardly, thus raising valve stem 120 and ending the negative or exhalation phase of the breathing cycle and starting the succeeding positive phase. When the collapsing of container 10a causes the lip 124 to strike the upper adjustable stop member 130 control arm 114 is elevated just enough to trip the toggle mechanism and lower valve stem 120 causing valve 94 to close and unseating ring 98, thus ending the positive phase of the breathing cycle and starting the negative phase.

Control rod 114 may be raised or lowered and locked in either of said positions to stop automatic operation of the device, by means of a control dial 132 on the upper end of control rod 114. Since the means for raising and lowering the control rod forms no part of this invention and is fully described in my said co-pending application, it is not described here except to say that the dial 132' may be turned from a middle running position in one direction for locking it in raised position and in the other direction for locking it in lowered position. When the dial 132 is in raised position, the valve assembly v is lowered and valve 98 in passage 92 is open so that when the dial is turned to the middle position auto matic operation will be resumed at the start of the downward movement of the containers 10a and 10b which corresponds with the exhalation phase of the breathing cycle.

When the dial is in lowered position, the valve assembly v is raised and valve 98 is closed, and valve 94 in passage 92 is open so that when the dial is turned to middle or running position automatic operation will be resumed at the start of the upward movement of the containers 10a and 10b which corresponds with the inhalation phase of the breathing cycle. The dial 132 is shown provided with the finger piece 132a.

The structure shown herein above cross member 22 between intake conduit 52 and the nipple 56 forms no part of this invention and is illustrated herein merely to indicate that the complete device as disclosed in my co-pending application may be bodily incorporated in a device of the kind disclosed herein.

There has thus been provided a device in which the objects stated above have been achieved in a practical way.

What I claim is:

1. Apparatus for controlling breathing comprising two expansible and collapsible gas containers and means in- .tercorinecting the containers for operation in unison, an inlet port in one of said containers for connection to a source of gas supply, conduit means for providing communication between said container and a patient, conduit means for providing communication between the patient :and the other container, exhaust port means for exhausting gas from said other container, means for alternately expanding and collapsing said containers simultaneously, valve means, for closing the conduit between said one container and the patient while said containers are expanding and gas is consequently being drawn into said one container from isaid source and gas is being drawninto the other container from the patients lungsrodsfor alternately'collapsing and expanding said gas containers.

2. Apparatus for controlling breathing comprising two expansible and collapsible gas containers and means interconnecting the containers for operation in unison, an inlet port in one of said containers for connection to a source of gas supply, conduit means for providing communication between said container and a patient, conduit means for providing communication between the patient and the other container, exhaust port means for exhausting gas from said other container, means for alternately expanding and collapsing said containers simultaneously, valve means, for closing the conduit between said one container and the patient while said containers are expanding and gas is consequently being drawn into said one container from said source and gas is being drawn into the other container from the patients lungs and for opening the conduit between said one container and the patient while said containers are collapsing and gas is consequently being supplied to the patient from said one container and gas is being exhausted from said second container through said exhaust port means, other valve means for controlling flow of gas from the patient into said other container, pressure responsive means tending to hold the first-mentioned valve means closed and the second mentioned valve means open, and means for alternately exerting pressure and relieving pressure to control the operation of said valve means.

3. Apparatus for controlling breathing comprising two expansible and collapsible gas containers and means interconnecting the containers for operation in unison, an inlet port in one of said containers for connection to a source of gas supply, conduit means for providing communication between said container and a patient, conduit means for providing communication between the patient and the other container, exhaust port means for I exhausting gas from said other container, means for alternately expanding and collapsing said containers simultaneously, valve means, for closing the conduit between said one container and the patient while said containers are expanding and gas is consequently being drawn into said one container from said source and gas is being drawn into the other container from the patients lungs and for opening the conduit between said one container and the patient while said containers are collapsing and gas is consequently being supplied to the patient from said one container and gas is being exhausted from said second container through said exhaust port means, and means for connecting said inlet and outlet ports to provide a closed circuit.

4. The apparatus claimed in claim 3 including a 2-way valve means in the connecting means for controlling the proportion of exhaled gas recirculated to said inlet and the proportion discharged to atmosphere.

5. Apparatus for controlling breathing comprising two expansible and collapsible gas containers and means in I terconnecting the containers for operation in unison, an inlet port in one of said containers for connection to a source of gas supply, conduit means for providing communication between said container and a'patient, conduit means for providing communication between the patient and the other container, exhaust port means for exhausting gas from said other container, means for alternately expanding and collapsing said containers simultaneously, valve means, for closing the conduit between for connecting saidinlet and outlet ports to provide; a

closed I circuity a "gas storage member; means communi eating between said storage; member. 'andasaid xzdnncting

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