WO1995020413A1 - Chambre et procede de prelevement pulmonaire - Google Patents

Chambre et procede de prelevement pulmonaire Download PDF

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Publication number
WO1995020413A1
WO1995020413A1 PCT/US1994/001632 US9401632W WO9520413A1 WO 1995020413 A1 WO1995020413 A1 WO 1995020413A1 US 9401632 W US9401632 W US 9401632W WO 9520413 A1 WO9520413 A1 WO 9520413A1
Authority
WO
WIPO (PCT)
Prior art keywords
chamber
air
patient
aerosol
enclosure
Prior art date
Application number
PCT/US1994/001632
Other languages
English (en)
Inventor
Anthony D. Blau
Original Assignee
Blau Anthony D
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Blau Anthony D filed Critical Blau Anthony D
Priority to PCT/US1994/001632 priority Critical patent/WO1995020413A1/fr
Publication of WO1995020413A1 publication Critical patent/WO1995020413A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/0045—Devices for taking samples of body liquids
    • A61B10/0051—Devices for taking samples of body liquids for taking saliva or sputum samples
    • 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
    • A61B5/0806—Detecting, measuring or recording devices for evaluating the respiratory organs by whole-body plethysmography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G10/00—Treatment rooms or enclosures for medical purposes
    • 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
    • A61M16/1065—Filters in a path in the expiratory path

Definitions

  • SI Sputum induction
  • the sputum can be examined in a variety of ways, according to the judgment of the clinician, for bacteria, fungi, viruses, parasites, or malignant cells.
  • patients undergo an invasive procedure known as fiber optic bronchoscopy in which a thin, flexible tube is guided into the patients lungs allowing for suctioning of material.
  • Bronchoscopy is somewhat uncomfortable, costly, occasionally hazardous, time consuming and usually requires a hospital environment to be accomplished safely.
  • Sputum induction is a long standing procedure traditionally used to obtain material to confirm the diagnoses of pulmonary tuberculosis, a bacterial infection of the lungs. It is also used to follow, in a serial manner, the effectiveness of therapy for this condition.
  • the technique of sputum induction essentially comprises having the subject breathe a nebulized mist or aerosol of a liquid which acts as a cough inducing agent, for example hypertonic saline solution.
  • a nebulized mist or aerosol of a liquid which acts as a cough inducing agent, for example hypertonic saline solution.
  • the inhaled saline aerosol or mist humidifies and also irritates the subject's airways, thus promoting and facilitating expectoration of a deep sputum sample.
  • SI Sputum induction
  • Therapeutic patient enclosures have been known for at least one hundred years. Such patient enclosures are frequently used, for example, to treat patients who must inhale aerosolized medication. Aerosol pentamidine treatment has been administered in this fashion to HIV infected patients to prevent or delay the occurrence of Pneumocystis pneumonia.
  • ST requires the delivery of a large volume of nebulized mist of externally generated aerosol particles.
  • an aerosol of hypertonic saline solution has been successfully used for the purpose.
  • Existing commercial enclosures provide some type of small-aperture nozzle mounted to the wall of the chamber. Through such a nozzle a quantity of air with aerosol mist must be generated and
  • the aerosol is thus diffused throughout the chamber, the concentration of the aerosol reaching the patient is
  • aerosolized medication may be administered with a small hand held nebulizer held by the patient within the chamber.
  • Sputum induction requires that the aerosol mist be provided in a copious and continuous supply to the patient. Accordingly, the patient's air supply must be heavily laden with nebulized aerosol. To be effective for sputum induction the necessary quantity of aerosol is most conveniently generated exterior to the chamber and delivered into the chamber and ultimately directly to the patient through a mouthpiece. A significantly large ventilator tubing specially connected for the purpose is required for delivering directly to the patient an adequate copious volume of externally generated aerosal mist for an effective sputum induction procedure.
  • the central purpose of my invention is to provide means whereby a patient may inhale an air and aerosol agent mixture generated externally of an airtight secure chamber having a controlled negative pressure therein with respect to the ambient atmospheric pressure.
  • the chamber must be
  • the disclosure does not address sputum induction, as by a breathable mist. Nor does it address the isolation of pathogens through maintenance of lower-than-ambient interior pressure.
  • U.S. Patent 3,565,072 issued to Gauthier is directed to an atmosphere-controlling device embodied by an enclosed chamber.
  • This invention has openings which are not sealed and has a hi gher-than-ambient interior pressure, thereby allowing the escape of infectious agents.
  • U.S. Patent 3,665,917 issued to Jensen provides a console with a hood in which a cough inducing spray or aerosol may be administered to a patient who places his head within the
  • the console is equipped with suction means provided to draw air and pathogens from the interior of the hood and the environment about the hood into a filter for safe removal.
  • the Jensen device discloses a
  • U.S. Patent 5,233,975 issued to Choate discloses respiratory filter apparatus comprised of a face mask through which the patient inhales and exhales. The patient is also partially enclosed within a disposable plastic enclosure designed to restrict spread of pathogens from the patients exhalations or coughing. The patients exhalations are conducted through the face mask into a filter system for safely disposing of
  • Choate does not enclose the patient in a negative pressure chamber to securely control spread of all pathogen material.
  • U.S. Patent 4,981,466 to Lumbert is directed to a medical ventilating and venting apparatus and methods in which a
  • catheter tube is used to evacuate lung secretions.
  • Lumbert teaches an invasive medical procedure for obtaining deep lung secretion samples.
  • the present invention is directed to an entirely noninvasive technique for diagnostic deep pulmonary sampling.
  • U.S. Patent No. 426,609 issued to Tucken is directed to a hand-held device to deliver an irritant through a patient mouthpiece.
  • there is no provision in the Tucken patent for trapping exhaled infectious particles.
  • U.S. Patent 310,568 issued to Emery is directed to a medical vapor generator, but discloses no means for entrapping infectious particles exhaled by a patient.
  • the present invention provides a disposable mouthpiece terminal tubing connection permitting introduction of an aerosol generated externally to the enclosure leading to the patient's airways, while permitting the patient to breath normally and confining all patient exhalations and airborne droplets from the patient's coughing to the interior of the chamber where any pathogenic particles may be safely filtered from the air within the chamber before it is returned to the environment in the medical office.
  • Figure 1 is a perspective view, partly cutaway, illustrating a preferred embodiment of my invention.
  • Figure 2 is a detailed view of tubing arrangement in the embodiment of my invention shown in Figure 1 for introducing a mixture of air and aerosol mist to a patient within an enclosure while confining the patients exhalations to the interior of the enclosure.
  • Figure 3 is a schematic view of the component parts of the embodiment of my invention illustrated in Figure 1 which further illustrates the control means for regulating a negative pressure within an enclosure, the flow of incoming air, the aerosol mist, the patients exhalation of cough induced particles, and the filtered air exhausted into the ambient atmosphere external of the enclosure.
  • the present invention provides for a sputum induction apparatus for safely and noninvasively collecting deep pulmonary samples from a patient without risk of spreading infectious microbes into the ambient air surrounding the apparatus.
  • the present invention combines the features of a conventionally ventilated chamber resembling a telephone booth in size and shape, the chamber being equipped with air inflow and forced air exhaust means to maintain a negative atmospheric pressure when in use.
  • An externally positioned compressor-driven nebulizer is connected to the interior of the chamber through flexible ventilator tubing which delivers aerosol mist from the nebulizer through a tubing arrangement directly to a patient enclosed within the chamber.
  • Figure 1 is a partly cutaway perspective view of my invention.
  • An enclosed airtight chamber 10 comprised of a rear panel, front panel 12; side panels 14, 16, top panel 18 and floor 20.
  • a door 22 is mounted in the front panel 12 to permit a patient entrance into and from the interior of the chamber 10.
  • the door 22 is equipped with an airtight sealing gasket 24 about its perimeter.
  • a sealed window 26 is mounted in the side panel 14.
  • Other transparent windows, such as window 28 mounted in door 22, are provided for the comfort and observation of a patient seated in the closed chamber.
  • the top panel 18 is fitted with an intake air filter 30 positioned within an aperture within the top panel 18.
  • the intake air filter 30 provides significant air flow resistance to the incoming air. Accordingly, a negative air pressure less than ambient atmospheric pressure may be maintained within the chamber when a forced exhaust air flow is maintained.
  • a seat 34 is situated upon which a patient may be comfortably seated. It is convenient to
  • the exhaust blower provides a flow rate of between 150 and 270 cubic feet of air per minute.
  • the exhaust air blower is capable of completely exchanging the air within the chamber between 250 and 460 times per hour. Thus a continuous supply of fresh air at a negative pressure is provided within the chamber. The exhaust air is cleared by the filters of pathogens and returned to the exterior of the chamber without temperature change.
  • a readily replaceable main exhaust filter 40 is shown mounted in the side panel 16, airtight ducting confines the exhaust air stream from the prefilter 36 through blower 38 and into the main filter 40.
  • the exhaust prefilter 36 and the main filter 40 entrap all particulate matter larger than 0.3 microns.
  • the negative air pressure within the chamber is achieved with selecting the filters 30, 36 and 40 with respect to size, resistance to passage of air therethrough and the relative positioning of the exhaust filters 36 and 40 with respect to the blower 38.
  • the intake air filter 30 is substantially smaller in area and has substantially greater resistance to passage of air therethrough than either, respectively, that of the prefilter 36 or the exhaust filter 40.
  • the prefilter 36 has an area smaller than that of the exhaust filter 40. Moreover the resistance of air passage through the prefilter 36 is greater than that through the exhaust filter 40.
  • the prefilter 36 is mounted at the intake port of the high volume blower 38.
  • the high volume blower 38 draws air through the prefilter 36 in part due to reduced pressure resulting from the action of the high volume exhaust blower 38 intake air stream.
  • a region of slightly lower air pressure than that inside the chamber proper is maintained in the exhaust ducting in the space between the exhaust side of the prefilter 36 and the intake port of blower 38.
  • flow of air in the exhaust direction is maintained through the prefilter 36.
  • the ducted space between the output port of the blower 38 and the inner surface of the exhaust filter 40 is maintained at a positive or greater than atmospheric pressure, thus providing the pressure differential to sustain volume flow of air through the filter 40 into the ambient atmosphere.
  • a negative differential of between 4 and 20 millibars of air pressure with respect to ambient atmosphere air pressure may be readily maintained within the sealed chamber when the high volume blower is in operation and the filters having the
  • a conventional compressor driven aerosol nebulizer 44 is positioned exteriorly to the chamber 10. Aerosol nebulizers are commercially available; a Ultra Neb 99 device manufactured by the DeVilbiss Company of Medford, Pennsylvania has been used successfully in my sputum induction system. The aerosol mist is generated by gravity feeding hypertonic saline or other
  • a hypertonic saline solution in the reservoir 46 when mixed with a rapidly moving air stream within the nebulizer produces an aerosolized air mixture well adapted to sputum induction.
  • the output port (not shown in the illustrations) of the aerosol nebulizer 44 feeds a mixture of aerosol and air
  • the tube of approximately one inch diameter provides sufficient flow and therefore volume of aerosol and air
  • the ventilator tube 50 is passed through an aperture 52 located in the chamber side panel 14.
  • Packing material 54 may be placed around the ventilator tube 50 at the aperture 52 to prevent leakage.
  • the ventilator tube 50 terminates within the chamber.
  • a connector section 60 is mounted to the end of the ventilator tube 50.
  • a replaceable mouthpiece 66 is inserted over the connector section 60.
  • the ventilator tube 50 carries aerosol mist at a slight positive pressure above ambient atmospheric pressure from the nebulizer 44 into the interior of the chamber 10.
  • the chamber 10 when in use is maintained at a negative pressure with respect the ambient atmospheric pressure.
  • the air and aerosol mixture entering the chamber through the ventilator tube 50 add only a small portion of the volume of air flowing into the chamber.
  • the sputum induction procedure may be commenced.
  • the patient places the mouth piece 66 within his mouth. Nebulized aerosol is then fed through the ventilator tube 50 into the connector 60. The patient then breathes by inhaling through the mouthpiece 66, and exhaling into the enclosure chamber 10.
  • An apparatus for safely conducting non-invasive sputum induction procedures comprising a hollow tubing means, a source of aerosol for inducing a patient to cough, a sealable enclosure adequate to fully enclose a patient, air intake and air exhaust means for retaining a negative atmospheric pressure within the enclosure while continuously changing the air within the

Abstract

L'invention concerne un appareil et un procédé pour faire des prélèvements pulmonaires. Cet appareil et ce procédé, dits égalements de déclenchement d'expectorations, permettent de collecter de manière hygiénique des échantillons d'expectorations pulmonaires sans laisser les microbes pathogènes infectieux s'échapper dans l'air ambiant. La présente invention peut être utilisée, de manière pratique et en toute sécurité dans les services ambulatoires tels que les cabinets des médecins et les laboratoires. L'appareil enveloppe entièrement le patient dans une chambre (10). Cette chambre est équipée d'une soufflante d'échange d'air (38) qui produit une pression d'air négative contrôlée dans la chambre fermée. La piège est pourvue d'un filtre extracteur remplaçable (36, 40) qui permet de piéger les pathogènes en suspension dans l'air et d'autres particules éventuellement toxiques. La chambre d'air interne négative assure la fermeture étanche de la chambre pour éviter toute fuite des particules infectieuses en suspension dans l'air hors de la chambre. La chambre est, en outre, pourvue d'un système de tube creux (50), dont une extrémité est raccordée à une source externe d'aérosols (44) par une ouverture ménagée dans la paroi de la chambre.
PCT/US1994/001632 1994-01-31 1994-01-31 Chambre et procede de prelevement pulmonaire WO1995020413A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/US1994/001632 WO1995020413A1 (fr) 1994-01-31 1994-01-31 Chambre et procede de prelevement pulmonaire

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US1994/001632 WO1995020413A1 (fr) 1994-01-31 1994-01-31 Chambre et procede de prelevement pulmonaire

Publications (1)

Publication Number Publication Date
WO1995020413A1 true WO1995020413A1 (fr) 1995-08-03

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1994/001632 WO1995020413A1 (fr) 1994-01-31 1994-01-31 Chambre et procede de prelevement pulmonaire

Country Status (1)

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WO (1) WO1995020413A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017079884A1 (fr) * 2015-11-10 2017-05-18 关开泮 Équipement cpap utilisé avec une cabine de thérapie cpap
CN107469247A (zh) * 2017-08-31 2017-12-15 合肥康东福双信息科技有限公司 一种高层建筑安防救生舱气压控制系统

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US310568A (en) * 1885-01-13 Medical still or vapor-generator
US360773A (en) * 1887-04-05 hosford
US859156A (en) * 1906-09-04 1907-07-02 Charles E Congdon Pneumomedical apparatus.
US3565072A (en) * 1968-04-08 1971-02-23 Champion Spark Plug Co Environmental control apparatus
US3665917A (en) * 1969-10-01 1972-05-30 Marcus M Jensen Environment contaminent control console
US3703173A (en) * 1970-12-31 1972-11-21 Ted A Dixon Nebulizer and tent assembly
US3745991A (en) * 1971-02-22 1973-07-17 Champion Spark Plug Co Environmental contamination control device
US3902488A (en) * 1970-02-25 1975-09-02 Hylton Frederick Grif Sheppard Apparatus for inducing hyperthermia
US4224936A (en) * 1978-05-31 1980-09-30 Vickers Limited Transit isolator
US5233975A (en) * 1989-12-01 1993-08-10 Choate Thomas V Respiratory filter apparatus with patient enclosure and method

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US310568A (en) * 1885-01-13 Medical still or vapor-generator
US360773A (en) * 1887-04-05 hosford
US859156A (en) * 1906-09-04 1907-07-02 Charles E Congdon Pneumomedical apparatus.
US3565072A (en) * 1968-04-08 1971-02-23 Champion Spark Plug Co Environmental control apparatus
US3665917A (en) * 1969-10-01 1972-05-30 Marcus M Jensen Environment contaminent control console
US3902488A (en) * 1970-02-25 1975-09-02 Hylton Frederick Grif Sheppard Apparatus for inducing hyperthermia
US3703173A (en) * 1970-12-31 1972-11-21 Ted A Dixon Nebulizer and tent assembly
US3745991A (en) * 1971-02-22 1973-07-17 Champion Spark Plug Co Environmental contamination control device
US4224936A (en) * 1978-05-31 1980-09-30 Vickers Limited Transit isolator
US5233975A (en) * 1989-12-01 1993-08-10 Choate Thomas V Respiratory filter apparatus with patient enclosure and method

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017079884A1 (fr) * 2015-11-10 2017-05-18 关开泮 Équipement cpap utilisé avec une cabine de thérapie cpap
CN107469247A (zh) * 2017-08-31 2017-12-15 合肥康东福双信息科技有限公司 一种高层建筑安防救生舱气压控制系统

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