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. ventilators; Tracheal tubes
  • A61M16/01—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; 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. ventilators; Tracheal tubes
  • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
  • A61M16/0816—Joints or connectors
  • A61M16/0841—Joints or connectors for sampling
  • A61M16/085—Gas sampling
• • 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. ventilators; Tracheal tubes
  • A61M16/22—Carbon dioxide-absorbing devices ; Other means for removing carbon dioxide

Definitions

• the present invention relates to a method for respirating of patients, whereby use is made of an apparatus which is provided with means for circulating a gas in one direction in a closed line or conduit system, with means for varying the pressure in the line system in accordance with a certain respirating pattern, with means for measuring the flow of the gas and the composition of the gas, whilst the line system is provided with connecting means for the patient and with one or more supplies for the various components of the respiratory gas, whereby the line system further is provided with a connecting means to a discharge line that is provided with a closing device for the discharge out of the line system of gas, whilst in the line system, as seen in the direction of the circulation of the gas, behind the connecting means to the discharge line a second closing means is provided.
• a method is known.
• the known method in the closed system has the drawback , that the "washing in” of the patient, that is to say the intake of anesthetic gas by the patient, takes a relatively long time.
• the patient among other things has nitrogen in his lungs, which has to be removed before the anesthetic can be started. To that end the patient is administered 100% oxygen until practically all nitrogen has been ventilated out of the lungs (the "washing" of the lungs with oxygen). In the closed system this takes much time, because each time the oxygen is inhaled together with a part of the gas that is already present.
• an anesthetic gas here the carrier gas, such as xenon, is supplied, of which the patient takes in and exhales again a part.
• the amount of oxygen and xenon that is taken in is each time compensated with only xenon until the desired concentration of oxygen and the desired concentration of xenon is obtained in the breathing gas, which is the case only after a long time.
• the anesthetic or sedation here has to take place by other means.
• the method according to the invention to that end is characterized in that, as seen in the direction of circulation of the breathing gas, behind the second closing means and at a distance therefrom a third closing means is provided, in which the method comprises the following steps:
• the first gas consists of oxygen or a mixture of oxygen and another gas.
• the second gas consists of an elementary gas, such as for instance xenon, helium, argon or a composite gas, for instance laughing gas, or a mixture of a gas or gases with a vapour anesthetic.
• the gas is circulated in the line system in such a way, that the duration of one circulation of the gas is 10 seconds at the most, more in particular 5 seconds at the most, more in particular 3 seconds a the most, and even more in particular 2,5 seconds at the most.
• the invention further relates to an apparatus for the application of the method, which apparatus is provided with means for the circulating in one direction in a closed line or conduit system of a breathing gas, an anesthetic gas or a therapeutic gas, with means for varying the pressure in the line system in accordance with a certain respirating pattern, with means for measuring the flow of the gas and the
• the line system is provided with connecting means for the patient and with one or more supply lines for the various components of the respiratory gas and with means for withdrawing of the carbon dioxide exhaled by the patient in the line system, whereby the line system further is provided with a connecting means to a discharge line that is provided with a first closing device for the discharge out of the line system of breathing gas, whilst in the line system, as seen in the direction of the circulation of the gas, behind the connecting means to the discharge line a second closing means is provided, characterized in that, as seen in the direction of circulation of the breathing gas, behind the second closing means a third closing means is provided, whilst means are provided by means of which the second and third closing means can be controlled in such a way, that the section of the line system situated between the second closing means and the third closing means can be closed off, whilst the line system further is provided with means for the generating of a gas flow.
• the capacity of the means for the generating of a gas flow is adapted to the volume of the line system in such a way, that the duration of one circulation of the gas is 10 seconds at the most, more in particular 5 seconds at the most, more in particular 3 seconds at the most, and even more in particular 2,5 seconds at the most.
• the means for the generating in the line system of a gas flow consist of a circulation blower.
• the means for the generating in the line system of a gas flow are provided in the part of the line system that, as seen in the direction of the flow of the breathing gas, is situated behind the second closing means, and these are more in particular provided in the part of the line system that is situated between the second closing means and the third closing means.
• the apparatus 1 is provided with means, among which the device 1 1 for the supplying of the various components of the respiratory gas, anesthetic gas or therapeutic gas, with means for circulating in one direction 5 in a closed line or conduit system 4 of respiratory gas, anesthetic gas or therapeutic gas, and with means 6 for varying the pressure in the line system 4 in accordance with a certain respirating pattern to allow the ventilation of the patient 7. Further in the line system 4 at the connecting means for the patient 7 means are provided, such as the apparatus 8, for the determination of the composition of the gas breathed in and the gas breathed out 9 by the patient.
• the principle of sampling removal If so desired the gas that has been removed can be fed back into the system. It is also possible to make use of a measuring system directly in the gas breathed in and the gas breathed out 9.
• the volume or the flow of the respiration by the patient can be measured, during spontaneous ventilation as well as during breathing upon the patient or in a given case supportive breathing upon the patient.
• the sensor 10 is provided in the part of the line system 4 that, as seen in the direction of circulation of the breathing gas, is situated behind the means 6 for varying the pressure in the line system.
• the apparatus 11 provides the supply of the gases and the vaporous anesthetics into the system.
• the line system 4 is provided with a connection 13 to a discharge line 15 provided with a first closing means, such as a first valve 14, for the discharge out of the line system 4 of respiratory gas.
• a second closing means or second valve 16 is provided in the line system 4, as seen in the direction of the circulation 5 of the gas, behind the connecting means 13 to the discharge line 15, a second closing means or second valve 16 is provided. Behind the second valve 16 in this example of an embodiment a circulation blower 18 and a carbon dioxide absorber 2 are provided. Behind this, as seen in the direction of circulation 5 of the breathing gas, a third closing means or third valve 17 is provided. The second valve 16 and the third valve 17 can be controlled in such a way, that the part 19 of the line system 4 situated therein between can be closed off from the circulation of the respiratory gas, and in this manner forms a closed off section in which a particular gas can be stored.
• valve 16 and 17 are opened.
• the system functions as a half closed system.
• the composition of the gas is measured (not shown in the drawing) while the flow of the gas evacuated through the outlet 22 of the discharge line 15 is measured by the sensor 20.
• the system When the valve 14 is opened and the valves 16 and 17 are closed the system functions as an open system without rebreathing.
• the system is prepared by blowing into the system a first gas, in this example of an embodiment pure oxygen, by means of the apparatus 11.
• the apparatus 11 is provided in the part of the line system that is situated behind the third valve 17.
• the second valve 16 and the third valve 17 are open. Further the first valve 14 is open.
• Through the discharge 15 and the outlet 22 of the discharge 15 the gas is discharged out of the system. After this by means of the apparatus 11 the system is flushed with 100% oxygen. In the complete line system 95-100% oxygen now is present.
• the second valve 16 and the third valve 17 are closed.
• the system now functions as an open system. In the part 19 of the line system that is closed off more than 95% oxygen is present.
• the patient is now connected to the line system and the lungs subsequently are "washed clean" with 100% oxygen.
• an anesthetic gas such as for instance xenon, or a second mixture of gases
• xenon a second mixture of gases
• the line system 4 By feeding into the line system 4 a mixture of oxygen and xenon the line system will be filled from the position of the apparatus 1 1 up to the patient 7 with oxygen and xenon. In the closed off section 9 only oxygen or substantially only oxygen will be present.
• the apparatus 8 In the part of the line system situated at the connection to the patient 7 the apparatus 8 is provided, by means of which at the mouth of the patient 7 the concentration of xenon is measured.
• the circulation blower 18 quickly mixes the gases in the closed off section 19 and the other part of the line system 4 with each other, through which the desired mixture is quickly obtained.
• the circulation blower 18 is provided with a capacity that is such that by means of it a very fast mixing of the gases can take place.
• the circulation blower 18 has to circulate sufficiently so that the fastness of the mixing process is greater than the fastness of the processes within the human.
• the fast circulation by the circulation blower is of importance.
• the control of the composition of the respiratory gas by means thereof can be quicker than the processes in the human. Also because of this the intake of oxygen by the patient can be measured in an accurate manner.
• the apparatus 1 1 provides the supply of oxygen in the system and the supply of laughing gas.
• the pressure in the line system 4 is controlled by the means for the varying of the pressure.
• the flow through the discharge line 15 and the outlet 22 to outside is, in the half closed system, determined by the flow of fresh gas coming out of the apparatus 1 1 , the movement of the means for the varying of the pressure and the position of the regulating valve 20 in de discharge line 15.
• the regulating valve 20 in the discharge line 15 is intended to narrow or in the given case close at the moment the patient breathes in, so that the gas flow 5 does not become negative and the patient therefore only breathes in fresh gas.
• the sensor 21 the volume or the flow of the gas flowing through the regulating valve 20 is measured.

Landscapes

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

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• 2009
  • 2009-10-07 NL NL1037372A patent/NL1037372C2/nl active
• 2010
  • 2010-10-06 EP EP10798847.9A patent/EP2490740B1/en active Active
  • 2010-10-06 US US13/500,233 patent/US10155095B2/en active Active
  • 2010-10-06 WO PCT/NL2010/000142 patent/WO2011043650A1/en not_active Ceased
  • 2010-10-06 CN CN201080050998.6A patent/CN102695539B/zh active Active
  • 2010-10-06 IN IN3270DEN2012 patent/IN2012DN03270A/en unknown
  • 2010-10-06 CA CA2776939A patent/CA2776939C/en active Active

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