WO1996022803A1 - Procede et appareil permettant d'administrer un traitement medical par les organes respiratoires - Google Patents

Procede et appareil permettant d'administrer un traitement medical par les organes respiratoires Download PDF

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Publication number
WO1996022803A1
WO1996022803A1 PCT/SE1996/000068 SE9600068W WO9622803A1 WO 1996022803 A1 WO1996022803 A1 WO 1996022803A1 SE 9600068 W SE9600068 W SE 9600068W WO 9622803 A1 WO9622803 A1 WO 9622803A1
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WO
WIPO (PCT)
Prior art keywords
gas
patient
treatment
supply
breathing
Prior art date
Application number
PCT/SE1996/000068
Other languages
English (en)
Inventor
Ola Stenquist
Original Assignee
Loflo Ab
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 Loflo Ab filed Critical Loflo Ab
Priority to AU45936/96A priority Critical patent/AU4593696A/en
Publication of WO1996022803A1 publication Critical patent/WO1996022803A1/fr

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Classifications

    • 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
    • A61M16/12—Preparation of respiratory gases or vapours by mixing different gases
    • 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
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/02—Gases
    • A61M2202/0266—Nitrogen (N)
    • A61M2202/0275—Nitric oxide [NO]

Definitions

  • the present invention relates to a method and an assembly for the preparation of a gas mixture for medical treatment by means of medically active compounds supplied via the respiratory system of a patient.
  • the supply of nitrogen monoxide is thereby especially referred to.
  • the oxygenation which the patient himself can bring about through his respiration is, in certain medical conditions, insufficient. In not too severe conditions, it may be sufficient to supply additional oxygen gas in the inhalation air and in other cases furthermore a compulsory pulmonary ventilation. In certain conditions, e.g. severe weakness conditions, or during the period of intensive care after a major operation, and also during cardiac or pulmonary operations, not even the use of respirator and raised oxygen level is sufficient in order to achieve a satisfactory oxygenation. A reason for this has turned out to be that a compound important for the uptake of oxygen from the pulmonary vesicles, namely nitrogen monoxide, which improves the adaptation between inhaled oxygen and the blood flow passing the lungs in order to be oxygenated, is produced by the patient to an extent which is too small.
  • An assembly of the described type will be very complicated and has to be provided with electronically controlled valves, which ensure that the correct amounts of said gases are supplied to the patient in a correctly tuned respiratory rhythm.
  • Such a supply apparatus is known from EP, Al, 0589 751.
  • a supply conduit for the treatment gas to the outlet from a ventilator, where said outlet is connected to a patient system consisting of a supply tube, the inhalator portion, and an outlet tube, the expiration portion, connected together next to the patient with an Y- coupling.
  • the normal respiratory gas is supplied to the patient in an even rhythm, meaning that the flow in the inhalator portion is at its maximum during inhalation and zero during expiration.
  • the NO-supply In order to be able to obtain an uniform concentration of the supplied NO-gas, the NO-supply must be synchronized with the ventilation by means of a valve controlling the supply, making it occur only during active inhalation, which leads to a uniform concentration of NO in the gas inhaled by the patient.
  • the supply conduit is provided with a valve, which is arranged to open when an over-pressure in a special conduit from the ventilator indicates that gas for inhalation is supplied. In this way, the gas supply is brought to occur rhythmically during the inhalation moments.
  • the non-uniform mixture leads to NO of a high concentration coming into close contact with oxygen gas of a high concentration, which leads to the formation of nitrogen dioxide, which is extremely poisonous and the amount of which must be minimized.
  • a non-uniform mixture also causes the lungs to receive different concentration of the treatment gas in different parts, which might cause a deteriorated treatment result.
  • the enclosed drawing is shows an embodiment of the invention in a block diagram.
  • the assembly may be said to comprise three main components: a ventilator 1, a device 2 for supply of the treatment gas and for proportioning of the same, and a patient system 3.
  • the ventilator 1 is arranged to rhythmically supply breathing gas to the patient system 2 and through this on to the patient in order to maintain the breathing of the same.
  • Such ventilators with control and checking devices are well known from the technique of intensive care and anaesthesia and need not to be closer described herein.
  • a supply conduit 4 for oxygen 0 2/ to the ventilator 1
  • a supply conduit 5 for air for air.
  • a conduit 6 leads from the ventilator for the supply of breathing gas, accordingly a tuned mixture of the gases from the supply conduits 4 and 5, to the patient, and a conduit 7 for the reception of gas from the patient.
  • the gas which is supplied to the patient system from the conduit 6 is, as understood, designed for the inhalation of the patient and the conduit 7 is designed for receiving gas from the expiration of the patient.
  • the conduits or the ventilator there are valves, which ensure that the gas flow only occurs in the specified direction. This direction of flow is shown with arrows in the drawing. Further, it is shown in the drawing that the ventilator may be provided with an additional connection 8. From this a measurement test result, specifying the volume of breathing gas received by the patient, can be emitted in the form of an electric signal or a gas pressure. Such connections for said measurement signal exist on most ventilators.
  • a collection conduit 19, via a Y-coupling 11, is connected to the conduits 6 and 7 from the ventilator 1.
  • the collection conduit 10 in turn is connected to the respiratory organs of the patient, preferably through a tube inserted into the windpipe of the patient.
  • connection between the patient system 3 and the ventilator 1 for the expiration gas, consequently the conduit 7, may, as shown in the drawing, be made directly without any other instruments than said valves.
  • the connection between the patient system and the conduit 6 is on the other hand made via the device for supply of the treatment gas.
  • the device 2 for supply of the treatment gas consists of the following main parts: a source for supply of the treatment gas.
  • a gas bottle 12 is shown here and since it is presumed here that the treatment gas is nitrogen monoxide, NO, in nitrogen gas, the gas bottle is accordingly filled with this gas under pressure.
  • a mixing chamber 13 to which is connected a conduit 14, connected to the gas bottle 12 and to the conduit 6 for the reception of inhalation gas from the ventilator 1.
  • Some type of flow-affecting member 15 for the intimate mixing of the breathing gas from the ventilator and the treatment gas from the gas source may be inserted in the mixing chamber 13. Further, the mixing chamber 13 has an outlet 16 to an absorption chamber 17.
  • the absorption chamber contains a compound which absorbs nitrogen dioxide, N0 2 , but on the whole not NO, 0 2 or N 2 .
  • a compound which absorbs nitrogen dioxide, N0 2 , but on the whole not NO, 0 2 or N 2 .
  • Such a compound may be soda-lime, the use of which is known from the technique of anaesthesia.
  • the gas purified from N0 2 may be emitted to the Y- coupling 11 of the patient system via a conduit 19.
  • NO is proportioned very accurately in proportion to the breathing gas from the ventilator and thereby in a minute proportion.
  • This is achieved by controlling the supply to the mixing chamber 13, via the conduit 14, very accurately.
  • a control valve 20 is arranged in the conduit 14 between the gas source 12 and the mixing chamber 13.
  • control valve 20 is to measure the proportion of NO directly before the patient system 3. This can be done by supplying gas samples to a gas analyzer 22, said gas samples being drawn off via a conduit 23 from the gas supply conduit for the inhalation gas with the treatment gas added, after the absorption chamber 17 and preferably as close as possible to the patient connection.
  • the gas analyzer 22 may be adjusted to a set point, adapted to the treatment case in question, for the proportion of treatment gas in the inhalation gas.
  • the gas analyzer is thereby set up to emit a preferably electrical signal, via a wire 24, to the thereby electrically controlled control valve 20.
  • the system is thereby adapted to, when the set point is exceeded, give a signal to the control valve, which causes the amount of NO supplied from the gas source to decrease, and vice versa if the set point is not reached.
  • a simplification may be achieved if the analyzer is only arranged for controlling a reduction of the treatment gas flow when a certain set point for NO and/or No 2 is exceeded.
  • Gas analyzers of this type adapted for the emission of a control signal when the set point for the content of a certain gas in a gas mixture is deviated from, are earlier known and several types are found on the market.
  • the previously mentioned signal connection 8 of the ventilator may be used. This is indicated with the dot-lined wire 25 from the output 8 to the control valve 20. Since the signal from the output 8 indicates the amount of breathing gas supplied to the patient, the amount of supplied treatment gas may be determined, on the basis of the desired proportion. If the signal from the output 8 shall be used as the only means of regulation, it is still necessary to arrange a gas analyzer for determining that a correct starting point for the proportioning is obtained. The flow through the valve is thereby tuned to the amount of breathing gas supplied during the measurement. If this amount thereafter fluctuates, these fluctuations, expressed as a fluctuating signal from the output 8, may be used for such a regulation of the valve 20 that the set proportion is maintained.
  • the mentioned advantages from an operational point of view are achieved by, after the mixing of the breathing gas and the treatment gas, bringing this mixture through an absorber for the removal of unsuitable and harmful reaction products before it is supplied to the patient.
  • the treatment gas is NO, but it should not be excluded that also other treatment gases may give harmful reaction products, which may be removed by an absorber adapted for this purpose.

Landscapes

  • Health & Medical Sciences (AREA)
  • Emergency Medicine (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Respiratory Apparatuses And Protective Means (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Materials For Medical Uses (AREA)

Abstract

Cette invention concerne un procédé ainsi qu'un dispositif de préparation d'un mélange gazeux, lequel mélange est destiné à effectuer un traitement médical par les voies respiratoires et comprend un gaz de traitement tel que du monoxyde d'azote. On obtient ce mélange gazeux en introduisant le gaz de traitement selon un débit régulier dans un autre gaz contenant de l'oxygène, avant de faire passer le mélange ainsi composé à travers un absorbeur (17), lequel va absorber les produits indésirables issus de la réaction entre l'oxygène et le gaz de traitement.
PCT/SE1996/000068 1995-01-25 1996-01-24 Procede et appareil permettant d'administrer un traitement medical par les organes respiratoires WO1996022803A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU45936/96A AU4593696A (en) 1995-01-25 1996-01-24 Method and assembly for preparation of a gas mixture intended for medical treatment via the respiratory system

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE9500251A SE503976C2 (sv) 1995-01-25 1995-01-25 Förfarande och aggregat för beredning av en gasblandning avsedd för medicinsk behandling via andningsvägarna
SE9500251-5 1995-01-25

Publications (1)

Publication Number Publication Date
WO1996022803A1 true WO1996022803A1 (fr) 1996-08-01

Family

ID=20396952

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/SE1996/000068 WO1996022803A1 (fr) 1995-01-25 1996-01-24 Procede et appareil permettant d'administrer un traitement medical par les organes respiratoires

Country Status (3)

Country Link
AU (1) AU4593696A (fr)
SE (1) SE503976C2 (fr)
WO (1) WO1996022803A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6432077B1 (en) * 2000-12-26 2002-08-13 Sensormedics Corporation Device and method for treatment of surface infections with nitric oxide
WO2013050907A1 (fr) * 2011-10-05 2013-04-11 Koninklijke Philips Electronics N.V. Systèmes et procédés de thérapie respiratoire utilisant un circuit de mélange du gaz
WO2020084994A1 (fr) * 2018-10-25 2020-04-30 帝人ファーマ株式会社 Dispositif d'administration d'oxyde nitrique
WO2020084993A1 (fr) * 2018-10-25 2020-04-30 帝人ファーマ株式会社 Dispositif d'administration d'oxyde nitrique

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0589751A1 (fr) * 1992-09-24 1994-03-30 L'air Liquide, Societe Anonyme Pour L'etude Et L'exploitation Des Procedes Georges Claude Installation et procédé de fourniture d'un mélange gazeux aux voies respiratoires d'un utilisateur
EP0640357A1 (fr) * 1993-07-22 1995-03-01 Siemens-Elema AB Mélange de gaz et un dispositif d'alimentation du mélange d'un patient
EP0659445A1 (fr) * 1993-11-22 1995-06-28 Ohmeda Inc. Système d'alimentation en oxyde nitrique

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0589751A1 (fr) * 1992-09-24 1994-03-30 L'air Liquide, Societe Anonyme Pour L'etude Et L'exploitation Des Procedes Georges Claude Installation et procédé de fourniture d'un mélange gazeux aux voies respiratoires d'un utilisateur
EP0640357A1 (fr) * 1993-07-22 1995-03-01 Siemens-Elema AB Mélange de gaz et un dispositif d'alimentation du mélange d'un patient
EP0659445A1 (fr) * 1993-11-22 1995-06-28 Ohmeda Inc. Système d'alimentation en oxyde nitrique

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6432077B1 (en) * 2000-12-26 2002-08-13 Sensormedics Corporation Device and method for treatment of surface infections with nitric oxide
US6793644B2 (en) 2000-12-26 2004-09-21 Sensormedics Corporation Device and method for treatment of surface infections with nitric oxide
WO2013050907A1 (fr) * 2011-10-05 2013-04-11 Koninklijke Philips Electronics N.V. Systèmes et procédés de thérapie respiratoire utilisant un circuit de mélange du gaz
US9662468B2 (en) 2011-10-05 2017-05-30 Koninklijke Philips N.V. Respiratory therapy systems and methods using a gas mixing circuit
WO2020084994A1 (fr) * 2018-10-25 2020-04-30 帝人ファーマ株式会社 Dispositif d'administration d'oxyde nitrique
WO2020084993A1 (fr) * 2018-10-25 2020-04-30 帝人ファーマ株式会社 Dispositif d'administration d'oxyde nitrique
KR20210059749A (ko) * 2018-10-25 2021-05-25 데이진 화-마 가부시키가이샤 일산화질소 투여 장치
KR20210059751A (ko) * 2018-10-25 2021-05-25 데이진 화-마 가부시키가이샤 일산화질소 투여 장치
JPWO2020084994A1 (ja) * 2018-10-25 2021-09-02 帝人ファーマ株式会社 一酸化窒素投与装置
JPWO2020084993A1 (ja) * 2018-10-25 2021-09-09 帝人ファーマ株式会社 一酸化窒素投与装置
JP7004841B2 (ja) 2018-10-25 2022-01-21 帝人ファーマ株式会社 一酸化窒素投与装置
KR102571301B1 (ko) 2018-10-25 2023-08-25 데이진 화-마 가부시키가이샤 일산화질소 투여 장치
KR102635008B1 (ko) * 2018-10-25 2024-02-07 데이진 화-마 가부시키가이샤 일산화질소 투여 장치

Also Published As

Publication number Publication date
AU4593696A (en) 1996-08-14
SE503976C2 (sv) 1996-10-07
SE9500251D0 (sv) 1995-01-25
SE9500251L (sv) 1996-07-26

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