WO2015155494A1 - Appareil de ventilation - Google Patents

Appareil de ventilation Download PDF

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Publication number
WO2015155494A1
WO2015155494A1 PCT/GB2015/000072 GB2015000072W WO2015155494A1 WO 2015155494 A1 WO2015155494 A1 WO 2015155494A1 GB 2015000072 W GB2015000072 W GB 2015000072W WO 2015155494 A1 WO2015155494 A1 WO 2015155494A1
Authority
WO
WIPO (PCT)
Prior art keywords
gas
breathing
cpap
outlet
ventilator
Prior art date
Application number
PCT/GB2015/000072
Other languages
English (en)
Inventor
Mohammad Qassim Mohammad KHASAWNEH
Mark Charles Oliver
Mark Sinclair Varney
Original Assignee
Smiths Medical International Limited
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 Smiths Medical International Limited filed Critical Smiths Medical International Limited
Publication of WO2015155494A1 publication Critical patent/WO2015155494A1/fr

Links

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
    • 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
    • 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
    • A61M16/201—Controlled valves
    • A61M16/202—Controlled valves electrically actuated
    • A61M16/203—Proportional
    • A61M16/204—Proportional used for inhalation control
    • 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
    • A61M16/201—Controlled valves
    • A61M16/202—Controlled valves electrically actuated
    • A61M16/203—Proportional
    • A61M16/205—Proportional used for exhalation control
    • 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
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/02—Gases
    • A61M2202/0208—Oxygen
    • 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
    • A61M2209/00—Ancillary equipment
    • A61M2209/08—Supports for equipment
    • A61M2209/088—Supports for equipment on the body
    • 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
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/20—Blood composition characteristics
    • A61M2230/205—Blood composition characteristics partial oxygen pressure (P-O2)

Definitions

  • This invention relates to ventilator apparatus of the kind including a source of breathing gas having an outlet connected with a breathing device, such as a mask, via a CPAP device.
  • PEEP positive end expiratory pressure
  • CPAP continuous positive airway pressure
  • CPAP devices are available, for example, from Smiths Medical under the EzPAP name. However, for some patients the work required to breathe out with a CPAP may be arduous. In these cases a bi-level positive airway pressure ventilator may be used. Such ventilators can be described as pressure controlled ventilation in both the inspiratory and expiratory phases during spontaneous breathing providing two distinct pressure levels. These systems use variable levels of air pressure instead of continuous steady pressure. The pressure rises when inhaling and drops when exhaling, making breathing easier. It can also be described as a continuous positive airway pressure (CPAP) system with a time-cycled change of the applied CPAP level. As with a pressure-controlled, time-cycled mode, the duration of each phase as well as the corresponding high and low pressure levels can be adjusted independently.
  • CPAP continuous positive airway pressure
  • Bi-level positive pressure therapy may be prescribed for patients with sleep apnoea (a sleep disorder characterized by failure of the brain to signal the chest muscles to breathe) if CPAP therapy is too uncomfortable. It is also helpful in cases of ventilatory muscle fatigue, congestive heart failure and different types of lung disorders, particularly patients who have above-normal carbon dioxide levels. It has also been applied in situations where the more invasive procedures of intubation or tracheostomy are considered too detrimental or inappropriate.
  • a bi-level positive pressure ventilator can be spontaneously timed. Such a ventilator is arranged to initiate a breath for the patient automatically if the patient does not take a breath spontaneously. Depending on the spontaneous breathing activity, bi-level positive pressure systems can be subdivided into: no spontaneous breathing; spontaneous breathing at the lower pressure level; spontaneous breathing at the upper pressure level; and spontaneous breathing at both CPAP levels, that is, genuine bi-level PAP.
  • Bi-level PAP ventilation enables a progressive, controlled transition from all levels of augmented mechanical ventilation, so may be a suitable mode for the entire period of mechanical ventilation of the patient. There are no difficulties choosing the correct moment for switching or the further respiratory management of the ventilated patient under bi-level PAP.
  • the necessary adaptation can be tailored to the individual on the basis of blood gas analyses which may be accomplished by the inclusion of pulse oximetry within the setup as-described.
  • With bi-level PAP an increase or reduction of the invasive extent of ventilation can be attained without any problems.
  • spontaneous breathing of the patient does not necessitate any switching of the mode of ventilation.
  • the transition from controlled to augmented ventilation is smooth.
  • Bi-level PAP enables the therapist to let the patient breathe freely even under the most invasive of ventilation conditions.
  • ventilator apparatus characterised in that the apparatus includes a PEEP device connected with the breathing device, and that the apparatus is arranged such that the expiratory path from the breathing device is preferentially via the PEEP device and bypasses the CPAP device on exhalation.
  • the apparatus preferably includes a non-return valve connected between the CPAP device and the breathing device.
  • the source of breathing gas may include a cylinder of oxygen.
  • the PEEP device is preferably arranged to provide an impedance to gas flow to maintain a pressure at an outlet of the breathing device during expiration in the range 5 mmHg to 10 mmHg.
  • the apparatus may further include a blood gas sensor arranged to provide an output to the gas supply to control flow of gas from the supply in accordance with the patient's sensed blood gas levels.
  • the apparatus may include a support by which the gas source is mounted on the patient's body.
  • the support may be in the form of a vest with a front panel supported by two shoulder straps, the gas source being mounted on the front panel.
  • FIG 1 shows the ventilator apparatus schematically
  • FIGS 2A and 2B show the front and rear respectively of ventilator apparatus
  • the apparatus includes a gas source 1 the outlet 10 of which is connected to the inlet of a CPAP device 2.
  • the outlet 20 of the CPAP device 2 is connected to the inlet 30 of a patient's breathing device 3.
  • the outlet 31 of the breathing device 3 is connected with the inlet 40 a PEEP device 4, the outlet 41 of which opens to atmosphere.
  • the gas source 1 may be provided by various different arrangements such as by a cylinder 11 of compressed oxygen connected to the outlet 10 via a regulator 12.
  • the gas source could be provided by other means, such as, for example, an air pump or compressor or by a hospital oxygen wall supply.
  • the CPAP device 2 may be of any conventional kind that provides a continuous flow of breathing gas at a pressure sufficient to keep the airways open.
  • the CPAP device 2 incorporates a demand valve that allows the patient to breath spontaneously.
  • One example of a CPAP arrangement is described in WO2014/162107.
  • the outlet 20 of the CPAP device 2 may be connected to the inlet 30 of the breathing device 3 via a one- way or non-return valve 5.
  • the purpose of the non-return valve 5 is to ensure that all, or most, of the exhaled gas from the patient is prevented from flowing back through the CPAP device 2 and instead bypasses the CPAP device and flows to the PEEP device 4.
  • the non-return valve 5 may not be necessary if the CPAP device 2 itself provides a greater impedance to flow than the PEEP device 4 so that most of the exhaled gas flows out via the PEEP device.
  • the non-return valve 5 could be incorporated into the breathing device 3 so that gas flows into the breathing device via the inlet 30 and flows out via the outlet 31.
  • the breathing device 3 is typically a breathing mask but could alternatively be an airway or breathing tube, such as an endotracheal or tracheostomy tube, or a laryngeal mask.
  • the PEEP device 4 is arranged to provide an impedance to gas flow so as to maintain a pressure of about 5 mmHg to 10 mmHg at the outlet 31 of the breathing device 3, to maintain alveolar inflation sufficient to prevent the lungs from collapse during expiration.
  • the PEEP device 4 may be of conventional construction.
  • the apparatus could also include a blood gas sensor such as in the form of a pulse oximeter 6 externally connected to the patient such as on his finger, earlobe or any other suitable part of the anatomy.
  • the gas sensor 6 would provide an output to the gas supply 1 to control the flow of gas at its outlet. For example, if the sensor 6 were to detect a fall in Sp0 2 this could be arranged to cause the gas supply to increase flow to the outlet 10, and hence to the patient.
  • the ventilation apparatus described may be contained in a single desk-top unit or it may be incorporated into an ambulatory support of the kind shown in Figures 2 A and 2B.
  • the support takes the form of a vest 60 having a front panel 61 with two side straps 62 and 63 extending laterally from the lower end of the panel.
  • the side straps 62 and 63 are terminated by a buckle 64 or other fastener and are long enough to extend around the waist of the user and to fasten at his back.
  • the vest 60 also has two wide shoulder straps 65 and 66 that extend upwardly from the upper end of the front panel 61 and over the shoulders of the user.
  • the ends of the wide shoulder straps 65 and 66 continue as narrow fastening straps 67 and 68 that are fastened to respective lower straps 69 and 70 extending upwardly from the rear of the side straps 62 and 63 by means of buckles 71 and 72 or other fasteners on the lower straps.
  • the gas source, in the form of a small oxygen cylinder 1 is supported on the front panel 61 by retaining straps 80 or by other means, such as a small pocket.
  • Gas tubing 81 extends from the cylinder W along a part of one of the shoulder straps 66.
  • Figure 2A shows the tubing 81 supporting a CPAP device 2' in line with a face mask 3'.
  • the CPAP device could be supported on the front panel 61 of the vest 60 such as in a pocket.
  • the mask 3' has a separate inlet 30' and outlet 3 , the tubing 81 being connected to the inlet.
  • the outlet 3 is connected to a PEEP device 4' supported by tubing 82, although this could also be supported on the front panel 61 of the vest 60.
  • the outlet 41 ' of the PEEP device 4' opens to air.
  • the face mask could have a single opening that functions as both an inlet and outlet. In such an arrangement a single length of tubing would extend from the mask and would divide at some point along its length into two parallel channels for the inlet supply from the CPAP and the outlet path via the PEEP device.
  • a non-return valve would be connected at the outlet of the CPAP device so that exhaled gas flows only to the PEEP device.
  • This ambulatory apparatus could also include a pulse oximeter.

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)
  • Respiratory Apparatuses And Protective Means (AREA)

Abstract

La présente invention concerne un ventilateur qui comprend une source (1) de gaz respiratoire de nature à comprendre un cylindre (11, 11') d'oxygène comprimé monté sur le panneau avant (61) d'un gilet (60) porté par le patient au moyen de deux bretelles (65) et (66). L'orifice (10, 10') de sortie de la source de gaz est relié à un masque (3, 3') par l'intermédiaire d'un dispositif CPAP (2, 2'). Un dispositif PEEP (4, 4') est relié à l'orifice (31, 31') de sortie du masque (3, 3'). Une soupape antiretour (5) est reliée pour garantir que le gaz expiré provenant du masque (3, 3') s'écoule à travers le dispositif PEEP (4, 4') et contourne le dispositif CPAP (2, 2').
PCT/GB2015/000072 2014-04-07 2015-02-28 Appareil de ventilation WO2015155494A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB1406298.8 2014-04-07
GB201406298A GB201406298D0 (en) 2014-04-07 2014-04-07 Ventilator apparatus and systems

Publications (1)

Publication Number Publication Date
WO2015155494A1 true WO2015155494A1 (fr) 2015-10-15

Family

ID=50776994

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2015/000072 WO2015155494A1 (fr) 2014-04-07 2015-02-28 Appareil de ventilation

Country Status (2)

Country Link
GB (1) GB201406298D0 (fr)
WO (1) WO2015155494A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPWO2017002826A1 (ja) * 2015-06-29 2018-02-22 帝人ファーマ株式会社 心不全治療装置

Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3266489A (en) * 1963-05-17 1966-08-16 Vickers Res Ltd Breathing apparatus
DE4309923A1 (de) * 1993-03-26 1994-09-29 Boesch Wilhelm Vorrichtungsanordnung zur Zufuhr von Atemgas zu einem Patienten
US5370113A (en) * 1991-03-20 1994-12-06 Racal Panorama Limited Breathing apparatus held in a convertible case and garment assembly
US5676135A (en) * 1996-06-25 1997-10-14 Mcclean; Leon Breath saver
US5868133A (en) * 1994-10-14 1999-02-09 Bird Products Corporation Portable drag compressor powered mechanical ventilator
US6675798B1 (en) * 2001-01-18 2004-01-13 Automed - Automatic Dosage Systems, Ltd. Automatically regulating oxygen flow to a patient
US20060180149A1 (en) * 2003-07-22 2006-08-17 Hasdi Matarasso A respiratory aid system and method
US20070144516A1 (en) * 2005-12-08 2007-06-28 Ric Investments, Llc. Ventilator adaptable for use with either a dual-limb circuit or a single-limb circuit
US20120325209A1 (en) * 2011-06-24 2012-12-27 Quintin Luc Method for treating early severe diffuse acute respiratory distress syndrome
US20130087146A1 (en) * 2009-11-11 2013-04-11 Matthew John Callaghan Ventilation systems and methods
WO2014162107A1 (fr) 2013-04-04 2014-10-09 Smiths Medical International Limited Agencements de réanimateur et surveillance de flux

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3266489A (en) * 1963-05-17 1966-08-16 Vickers Res Ltd Breathing apparatus
US5370113A (en) * 1991-03-20 1994-12-06 Racal Panorama Limited Breathing apparatus held in a convertible case and garment assembly
DE4309923A1 (de) * 1993-03-26 1994-09-29 Boesch Wilhelm Vorrichtungsanordnung zur Zufuhr von Atemgas zu einem Patienten
US5868133A (en) * 1994-10-14 1999-02-09 Bird Products Corporation Portable drag compressor powered mechanical ventilator
US5676135A (en) * 1996-06-25 1997-10-14 Mcclean; Leon Breath saver
US6675798B1 (en) * 2001-01-18 2004-01-13 Automed - Automatic Dosage Systems, Ltd. Automatically regulating oxygen flow to a patient
US20060180149A1 (en) * 2003-07-22 2006-08-17 Hasdi Matarasso A respiratory aid system and method
US20070144516A1 (en) * 2005-12-08 2007-06-28 Ric Investments, Llc. Ventilator adaptable for use with either a dual-limb circuit or a single-limb circuit
US20130087146A1 (en) * 2009-11-11 2013-04-11 Matthew John Callaghan Ventilation systems and methods
US20120325209A1 (en) * 2011-06-24 2012-12-27 Quintin Luc Method for treating early severe diffuse acute respiratory distress syndrome
WO2014162107A1 (fr) 2013-04-04 2014-10-09 Smiths Medical International Limited Agencements de réanimateur et surveillance de flux

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPWO2017002826A1 (ja) * 2015-06-29 2018-02-22 帝人ファーマ株式会社 心不全治療装置

Also Published As

Publication number Publication date
GB201406298D0 (en) 2014-05-21

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