WO2009011608A1 - Précédé et dispositif de ventilation artificielle des poumons - Google Patents

Précédé et dispositif de ventilation artificielle des poumons Download PDF

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Publication number
WO2009011608A1
WO2009011608A1 PCT/RU2007/000391 RU2007000391W WO2009011608A1 WO 2009011608 A1 WO2009011608 A1 WO 2009011608A1 RU 2007000391 W RU2007000391 W RU 2007000391W WO 2009011608 A1 WO2009011608 A1 WO 2009011608A1
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WO
WIPO (PCT)
Prior art keywords
pressure
respiratory
membrane
circuit
line
Prior art date
Application number
PCT/RU2007/000391
Other languages
English (en)
Russian (ru)
Inventor
Igor Victorovich Isaev
Original Assignee
Morozov, Vasiliy Jurievich
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 Morozov, Vasiliy Jurievich filed Critical Morozov, Vasiliy Jurievich
Priority to PCT/RU2007/000391 priority Critical patent/WO2009011608A1/fr
Publication of WO2009011608A1 publication Critical patent/WO2009011608A1/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
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A61M16/208—Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
    • A61M16/209—Relief valves
    • 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
    • A61M16/021—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
    • 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
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A61M16/208—Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
    • 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
    • A61M16/01—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes specially adapted for anaesthetising
    • 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
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • 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
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors

Definitions

  • the invention relates to the field of medical technology and relates to artificial ventilation of the lungs, and more specifically relates to a method and device for creating positive end-expiratory pressure (PEEP) and the implementation of assisted ventilation during mechanical ventilation.
  • PEEP positive end-expiratory pressure
  • a device for artificial ventilation of the lungs is known (RF Patent 2185196, 05.29.2000, MKI A61M 16/00), which contains a respiratory mixture input unit, a compressor, an electric motor, a control and indication unit, a remote control, a sealing control unit, a switch, a respiratory humidifier mixtures, a nasal mask and a positive pressure regulator at the end of the exit.
  • Known artificial ventilation apparatus (patent of the Russian Federation 2219892, 10.24.2002, MKI A61H 31/02), which for operation in artificial ventilation mode with positive pressure
  • the end of exhalation (PDKV) has a control unit that contains a program for controlling the inclusion of the pneumatic pulse generator when the lung reaches the set value of PDKV in the act of expiration.
  • a device is known for providing artificial ventilation with positive end-expiratory pressure (CTTTA Patent 6,932,084,23.08.2005, MKI A61M 16/00) containing a computer for counting leaks of the respiratory mixture and compensating for positive airway pressure. The device increases the flow rate of the respiratory mixture during inhalation and / or exhalation, depending on the increase in its flow rate during sleep or heart failure.
  • a known artificial lung ventilation apparatus (patent of the Russian Federation 2146913,23.08.1999, MKI A6Sh31 / 02) containing a controlled exhalation valve installed on the patient's expiration line for hermetically closing the expiration line in the act of inspiration and creating positive pressure in the patient's lungs at the end of the exhalation act.
  • the valve is implemented in the form of an adjustable spring-loaded diaphragm valve, the spring-loaded submembrane cavity of which is pneumatically connected to the outlet of the injector, which creates the necessary volumetric flow rate of the working gas with the atmosphere and the inlet of the pneumatic switch commuting the injector line and the inner space of the fur body, in which the respiratory mixture of a given volume for each a separate act of inspiration, and an inspiratory non-return valve in the breathing circuit for unidirectional delivery of the respiratory mixture into the lung e patient.
  • the spring force acting on the diaphragm valve overlaps the expiration line with a residual positive pressure in the patient's lungs, which immediately begins to fall due to due to leaks of the respiratory mixture from the respiratory circuit, due to its leaks, in particular at the places where the hoses enter the patient’s airways.
  • (assisted lung ventilation) is meant ventilation of the lungs with the supply of the respiratory mixture into the patient's lungs simultaneously with the occurrence of the patient's own breathing attempt, that is, with an uneven inhalation-exhalation rhythm.
  • auxiliary lung ventilation appears when the patient has the ability to carry out independent breathing, manifested in the form of respiratory attempts, the occurrence of which has a random, chaotic nature, i.e. arrhythmic.
  • it is still impossible to disconnect the patient from the artificial lung ventilation apparatus, and keeping him on forced ventilation without coordination with breathing attempts is already bad, since the patient's arrhythmic respiratory cycle begins to struggle with a certain respiratory rhythm of forced ventilation.
  • the occurrence of a patient’s respiratory attempt can only be judged by mild pressure drops that can be identified and identified as respiratory attempts (i.e., separated from the pressure drop associated, for example, with a gas leak from the respiratory circuit) when observing pressure fluctuations in the lungs the patient only against the background of stability of pressure in the respiratory circuit on the exhale.
  • Known methods and devices for creating positive end-expiratory pressure and artificial lung ventilation prevent dynamic compression of the airways, “constriction” of the alveoli of the lungs that occur when “pouring” into the area of negative pressure during the act of inspiration.
  • the basis of the present invention is the development of a method and device for creating positive end-expiratory pressure (PEEP) and mechanical ventilation, providing automatic stabilization of PEEP in the respiratory circuit on the exhale and the implementation of auxiliary lung ventilation.
  • PEEP positive end-expiratory pressure
  • the problem is solved in that in the method of creating a positive pressure of the end of expiration (PEEP) during mechanical ventilation by applying a pressure generating force to the respiratory mixture to create a pressure, to block the exhalation line of the respiratory circuit and forming PEEP, according to the invention, the PEEP setting force is applied, creating pressure of the respiratory mixture, on the inspiratory line of the respiratory circuit to the inspiratory check valve, part of this respiratory mixture is autonomously fed to the outlet of the respiratory circuit to block the line and exhalation and automatically injected but additional respiratory mixture in the breathing circuit through the reverse inhalation valve when the pressure value for this valve to below the pressure valve, the inhalation valve on the return inlet breathing gas always present.
  • PEEP positive pressure of the end of expiration
  • the problem is also solved by the fact that in the method of artificial ventilation of the lungs, which includes the sequential implementation of the act of inspiration and expiration during PEEP, a setting force is applied, creating pressure of the respiratory mixture, on the inspiratory line of the respiratory circuit to the inspiratory check valve, while breathing, the respiratory mixture is pumped in the respiratory circuit and block the exit by excess pressure at the inlet and outlet of the respiratory circuit, while exhaling, reduce the pressure at the inlet and outlet of the respiratory circuit to the MPC level
  • part of this respiratory mixture is independently supplied to the outlet of the respiratory circuit for overlapping the exhalation line and additionally automatically inject the respiratory mixture into the respiratory circuit through the inspiratory non-return valve, if the pressure behind the valve is lower than the pressure up to the valve, stabilizing the pressure in the respiratory circuit behind the inspiratory return valve, against the background of this stabilized pressure, the current PEEP value is compared with an acceptable value of pressure fluctuations and when a slight drop in pressure occurs, the patient's own respiratory attempt is identified, and a breath is taken at
  • the device for creating positive end-expiratory pressure (PEEP) in the respiratory circuit containing the inspiratory line connected through the inspiratory check valve to the patient's lungs, and the exhalation line including the PEEP control device containing a membrane pressure regulator additionally contains an autonomous circuit in the form of a pipeline, one end of which is connected to the inspiratory line and connected to the inlet of the inspiratory check valve, and an exhalation membrane regulator, to the supmembrane olosti which is connected the other end of the conduit, and submembrane cavity is connected with the expiratory line, the pressure regulator membrane is mounted on the inspiratory line entering the breathing circuit.
  • the membrane of the membrane expiratory regulator can be made flat or in the form of a bellows.
  • the membrane of the pressure regulator can also be made flat or in the form of a bellows.
  • the device for artificial ventilation of the lungs containing the injection unit of the respiratory mixture, the respiratory circuit including the inspiratory line connected through the inspiratory check valve to the patient's lungs, and the expiratory line
  • the PDKV control device contains a membrane pressure regulator, regulating the pressure of the respiratory mixture at the entrance to the breathing circuit, a setter for setting the preset force, which creates excess pressure during inhalation and PEEP during exhalation, associated with the membranes a pressure regulator, a respiratory attempt sensor connected by the inlet to the inspiratory line, an autonomous circuit in the form of a pipeline, one end of which is connected to the inspiratory line and connected to the inlet of the inspiratory check valve, an exhalation diaphragm regulator, to the supmembrane cavity of which the other end of the pipeline is connected, and the submembrane cavity is connected to the exhalation line
  • the membrane of the pressure regulator can also be made flat or in the form of a bellows.
  • the device would comprise a control circuit associated with a setpoint of a diaphragm pressure regulator. It is advisable that the respiratory attempt sensor be connected to the master of the membrane pressure regulator via a control circuit. It is also advisable that the respiratory attempt sensor would be implemented as a flow sensor or as a pressure sensor.
  • FIG. 1 illustrates the change in pressure P in the inspiratory line behind the inspiratory check valve during mechanical ventilation, according to the invention
  • FIG. 2 is a schematic diagram of an artificial lung ventilation device with a device for generating positive end expiratory pressure (MPE) according to the invention.
  • MPE positive end expiratory pressure
  • the term “breathing mixture” describes a suitable combination of gases for breathing, including atmospheric air
  • the term “respiratory contact” describes a set of lines of supply and removal of the respiratory mixture into the patient's lungs.
  • the supply line includes the inspiratory line with the inspiratory non-return valve and the patient's inspiratory hose
  • the exhaust line includes the exhalation line and the patient's expiratory hose.
  • Atmospheric pressure of the respiratory mixture is taken as zero level of mechanical ventilation.
  • PEEP positive end pressure expiration
  • An inspiratory act is carried out, in which the respiratory mixture is injected into the respiratory circuit during the time of the solid-state reaction at an excess pressure Pu, which is applied at the inlet and outlet of the respiratory circuit to block the exit of the respiratory mixture.
  • the pressure P in the inspiratory line behind the inspiratory check valve gradually increases during the time Tvd (Fig. 1) and reaches the level of excess pressure Pu at time Ti.
  • an exhalation act is carried out, for which at a time point Ti reduce the pressure to the level of PEEP.
  • the pressure P in the inspiratory line behind the inspiratory check valve gradually decreases during the time T outflow (Fig. 1) and reaches the PEEP level at the time Tg.
  • the achieved level of PEEP is stabilized (Fig. 1) and, against the background of a stable level of PEEP, on exhalation, an independent respiratory attempt of the patient is expected.
  • the permissible biological time for holding the patient in inspiration is T add.
  • the pressure fluctuation at time point Ts reached the threshold value ⁇ and was identified as a respiratory attempt, as a result of where at the time point T 5 the subsequent act of inspiration is started and then, at time Tb the act of exhalation as described above.
  • the dashed line in FIG. 1, for illustration, shows the line of decline in the level of PEEP due to natural leakage of the respiratory mixture. ⁇
  • Notearily As can be seen from the graph, with non-compensation of leaks, the pressure in the respiratory circuit in the exhalation cycle due to the natural leakage of the respiratory mixture is continuously reduced.
  • a false breathing attempt is identified and inspiration begins if there is no patient breathing attempt.
  • assisted ventilation with unstable PEEP is not feasible due to the presence of a false identification of the patient's respiratory attempt.
  • auxiliary ventilation of the lungs according to the invention, a positive pressure of the end of exhalation is created and stabilized as follows.
  • the 25th mixture is separated and autonomously directed towards the exit from the respiratory circuit towards the direction of the respiratory mixture leaving the respiratory circuit.
  • the pressure of the respiratory mixture leaving the respiratory circuit and autonomously coming to the exit from the entrance of the respiratory circuit is directed towards each other.
  • the PDKV master force is generated and the master force is applied to the respiratory mixture at the inlet of the respiratory circuit, in the inspiration line to the inlet of the non-return valve.
  • the resulting pressure of the respiratory ⁇ réelle mixture is pneumatically transmitted and is directly output to the respiratory circuit.
  • the output of the respiratory circuit the pressure of the respiratory mixture, enters through the patient's respiratory system.
  • Stabilization of the positive pressure of the end of exhalation is carried out as follows.
  • the inspiratory check valve opens and the breathing mixture is automatically additionally injected into the breathing circuit through the inspiratory check valve until the pressure on the check valve is equalized and pressure in the respiratory circuit of the specified PEEP.
  • FIG. 2 is a schematic diagram of an artificial lung ventilation device with a device for generating a positive 25th end expiratory pressure (MPD) according to the invention.
  • MPD positive 25th end expiratory pressure
  • the device for creating a positive pressure of the end of exhalation contains a membrane pressure regulator mounted on line 3 of the inspiration at the entrance to the idiomatic circuit, an autonomous circuit in the form of a pipe 14 and a membrane regulator 15 exhalation.
  • the membrane pressure regulator may be a membrane regulator 8.
  • the pipeline 14 is connected at one end to the inspiratory line 3 and connected to the inlet of the inspiratory non-return valve 4, and at the other end is connected to the supramembrane cavity 16.
  • the submembrane cavity 17 of the exhalation diaphragm regulator 15 is connected to the exhalation line 10, and the nozzle 18 is connected to the atmosphere.
  • the membrane of the membrane regulator 15 can be made flat or in the form of a bellows of any flexible material (rubber, plastics, including silicone, metal, etc.).
  • PEEP positive end-expiratory pressure
  • the artificial lung ventilation device includes a pressure unit 1, the input of which is a breathing mixture, a breathing circuit 2 containing an inhalation line 3 with a check valve 4, an inhalation hose 5 and an exhalation hose 6 connected to the patient's lungs 7, and an exhalation line 10, a membrane pressure regulator 8 with switch 9 and nozzle for communication with the inlet of the pressure unit (not numbered).
  • the membrane of the membrane regulator 8 can be made flat or in the form of a bellows of any flexible material (rubber, plastics, including silicone, metal, etc.).
  • the blower unit 1 contains a continuous-flow breathing air blower, which is made in the form of a blower 11, and a circulation loop 12, which is connected to the blower 11 and to the inhalation line 3 at the inlet of the respiratory circuit through the submembrane cavity 13 of the pressure regulator 8.
  • the device contains an autonomous circuit in the form of a pipe 14 and a membrane expiratory regulator 15.
  • the pipe 14 is connected at one end to the inspiratory line 3 and connected to the inlet of the inspiratory non-return valve 4, and at the other end is connected to the supramembrane cavity 16.
  • the submembrane cavity 17 of the exhalation diaphragm regulator 15 is connected to the exhalation line 10, and the nozzle 18 is connected to the atmosphere.
  • the membrane of the membrane regulator 15 can be made flat or in the form of a bellows of any flexible material (rubber, plastics, including silicone, metal, etc.).
  • the device also contains a respiratory attempt sensor 19, connected by an input to the inspiratory line 3, and by an output - with a setter 9 through the control circuit 20.
  • the sensor 19 can be performed as a flow sensor (flow rate or mass or volumetric flow rate).
  • the sensor 19 can also be implemented as a pressure sensor.
  • the circuit 20 with the function of controlling artificial ventilation of the lungs and respiratory attempt can be constructed according to the known principles of trigger systems responding to an inspiratory attempt by a patient, or various systems of response to an inspiratory attempt by a patient can be implemented - by pressure, flow rate, volume, etc. d.
  • An artificial lung ventilation device with a device for creating positive end-expiratory pressure works as follows. When you turn on the blower 11, the breathing mixture enters the submembrane cavity 13 of the membrane pressure regulator 8.
  • the respiratory mixture enters through the line of inspiration 3 to the inlet of the check valve 4 and the pipeline 14 into the supramembrane cavity 16 of the membrane regulator 15 exhalation.
  • the respiratory mixture enters the inlet of the non-return valve 4 of the inspiration and into the supramembrane cavity 16 with an excess pressure ⁇ rion.
  • the inspiratory check valve 4 opens and the respiratory mixture enters the patient’s lungs 7 and then, from the patient’s lungs, through the exhalation line 10, into the submembrane cavity 17 of the exhalation diaphragm valve 15.
  • the outlet of the respiratory mixture from the respiratory circuit is blocked by the same excess pressure created by the respiratory mixture in the supramembrane cavity 16, the nozzle 18 is closed.
  • the pressure in line 3 of the inspiration gradually rises to the level of overpressure. Then carry out the act of exhalation.
  • a positive pressure of the end expiratory pressure is applied to the respiratory mixture in the submembrane cavity 13 by the adjuster 9 and the respiratory mixture is withdrawn through the nozzle (not numbered) in the submembrane cavity 13 to lower the pressure of the respiratory mixture to the PEEP level.
  • PEEP end expiratory pressure
  • the pressure in the breathing circuit behind the check valve 4 of the inspiration drops and becomes lower than the pressure at the inlet to the check valve 4, where the breathing is constantly present mixture at the level of PDKV.
  • the non-return valve 4 opens and the respiratory mixture is automatically pumped in from the inhalation line 3 through the non-return valve 4 until the pressure at the non-return valve 4 is equalized and the pressure in the respiratory circuit reaches the PEEP level.
  • PDKV pressure a constant level of positive pressure of the end of expiration is automatically maintained, i.e. PDKV pressure is stabilized.
  • the respiratory attempt sensor 19 compares, against the background of stabilized PDKV pressure, the current PDKV value with an acceptable threshold value of pressure fluctuation. If the threshold value is exceeded, the sensor 19 and / or circuit 20 identifies the patient's respiratory attempt and gives a signal to the controller 9 to perform an auxiliary inspiration act.
  • the setter 9 of the membrane pressure regulator 8 can regulate for example, by means of a sensor 19 and / or circuit 20. Manual control of the task is also possible.
  • the invention can be used for ventilation of the patient’s lungs with a partial and / or complete absence of respiratory activity of the patient.

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  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Emergency Medicine (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)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

L'invention concerne les équipements médicaux et notamment la ventilation artificielle des poumons, avec création d'une pression positive à la fin de l'expiration et une ventilation auxiliaire. L'invention consiste en ce que la ventilation auxiliaire des poumons s'effectue sur un fond de stabilisation de pression positive à la fin de l'expiration stabilisée dans le circuit de respiration. A l'expiration lors de la pression positive à la fin de l'expiration on attend une tentative de respiration de la part du patient en comparant la valeur courante de pression positive à la fin de l'expiration avec une valeur de seuil admissible de fluctuation de pression pour identifier la tentative propre de respiration. On effectue un acte d'inspiration auxiliaire au moment de l'identification de la tentative propre de respiration ou un acte d'inspiration forcée si la durée de rétention de l'inspiration dépasse une valeur limite acceptable. La pression positive à la fin de l'expiration est crée en appliquant un effort de référence créant une pression du mélange respirable sur une ligne d'inspiration (3) du circuit de respiration (2) jusqu'à la soupape anti-retour (4) d'inspiration, une partie de ce mélange de respiration est envoyée vers la sortie du circuit de respiration (2) pour couper la ligne d'expiration (10), et le mélange respirable est injecté dans le circuit de respiration (2) à partir de la ligne d'inspiration (3) si la valeur de pression au-delà de la soupape anti-retour (4) d'inspiration est inférieure à la pression avant la soupape anti-retour (4) d'expiration. A l'entrée de la soupape anti-retour (4) d'inspiration le mélange respirable est présent en permanence.
PCT/RU2007/000391 2007-07-19 2007-07-19 Précédé et dispositif de ventilation artificielle des poumons WO2009011608A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/RU2007/000391 WO2009011608A1 (fr) 2007-07-19 2007-07-19 Précédé et dispositif de ventilation artificielle des poumons

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/RU2007/000391 WO2009011608A1 (fr) 2007-07-19 2007-07-19 Précédé et dispositif de ventilation artificielle des poumons

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WO2009011608A1 true WO2009011608A1 (fr) 2009-01-22

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5063925A (en) * 1988-07-07 1991-11-12 Dragerwerk Aktiengesellschaft Controllable expiration valve arrangement for a ventilating apparatus
RU2219892C1 (ru) * 2002-10-24 2003-12-27 Зао "Вниимп-Вита" Аппарат искусственной вентиляции легких
RU2240767C1 (ru) * 2003-12-29 2004-11-27 Зао "Вниимп-Вита" Аппарат искусственной вентиляции легких
US6932084B2 (en) * 1994-06-03 2005-08-23 Ric Investments, Inc. Method and apparatus for providing positive airway pressure to a patient
US20060032503A1 (en) * 1999-01-15 2006-02-16 Michael Berthon-Jones Method and apparatus to counterbalance intrinsic positive end expiratory pressure

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5063925A (en) * 1988-07-07 1991-11-12 Dragerwerk Aktiengesellschaft Controllable expiration valve arrangement for a ventilating apparatus
US6932084B2 (en) * 1994-06-03 2005-08-23 Ric Investments, Inc. Method and apparatus for providing positive airway pressure to a patient
US20060032503A1 (en) * 1999-01-15 2006-02-16 Michael Berthon-Jones Method and apparatus to counterbalance intrinsic positive end expiratory pressure
RU2219892C1 (ru) * 2002-10-24 2003-12-27 Зао "Вниимп-Вита" Аппарат искусственной вентиляции легких
RU2240767C1 (ru) * 2003-12-29 2004-11-27 Зао "Вниимп-Вита" Аппарат искусственной вентиляции легких

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