WO2015200879A1 - Système de ventilateur - Google Patents

Système de ventilateur Download PDF

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Publication number
WO2015200879A1
WO2015200879A1 PCT/US2015/038159 US2015038159W WO2015200879A1 WO 2015200879 A1 WO2015200879 A1 WO 2015200879A1 US 2015038159 W US2015038159 W US 2015038159W WO 2015200879 A1 WO2015200879 A1 WO 2015200879A1
Authority
WO
WIPO (PCT)
Prior art keywords
flow
ventilator
fluid
valve
gas
Prior art date
Application number
PCT/US2015/038159
Other languages
English (en)
Inventor
Steven Duquette
Adrian D. DESILVA
Richard LE
Jeffrey Harold MILLER
Hector Gonzalez
Raul Valdez
Chiun Wang
Malcolm R. Williams
Huy Thanh VU
Original Assignee
Carefusion 303, Inc.
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
Priority claimed from US14/318,504 external-priority patent/US20150007815A1/en
Application filed by Carefusion 303, Inc. filed Critical Carefusion 303, Inc.
Priority to MX2016016198A priority Critical patent/MX2016016198A/es
Priority to CN201580034923.1A priority patent/CN106794326A/zh
Priority to EP15742422.7A priority patent/EP3160562A1/fr
Priority to JP2017520765A priority patent/JP2017524100A/ja
Priority to AU2015279627A priority patent/AU2015279627A1/en
Priority to CA2952626A priority patent/CA2952626A1/fr
Publication of WO2015200879A1 publication Critical patent/WO2015200879A1/fr

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    • 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
    • A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
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    • 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
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    • G01F15/00—Details of, or accessories for, apparatus of groups G01F1/00 - G01F13/00 insofar as such details or appliances are not adapted to particular types of such apparatus
    • G01F15/02—Compensating or correcting for variations in pressure, density or temperature
    • G01F15/04—Compensating or correcting for variations in pressure, density or temperature of gases to be measured
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    • G—PHYSICS
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    • G01F—MEASURING VOLUME, VOLUME FLOW, MASS FLOW OR LIQUID LEVEL; METERING BY VOLUME
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    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F05—INDEXING SCHEMES RELATING TO ENGINES OR PUMPS IN VARIOUS SUBCLASSES OF CLASSES F01-F04
    • F05D—INDEXING SCHEME FOR ASPECTS RELATING TO NON-POSITIVE-DISPLACEMENT MACHINES OR ENGINES, GAS-TURBINES OR JET-PROPULSION PLANTS
    • F05D2240/00—Components
    • F05D2240/20—Rotors
    • F05D2240/30—Characteristics of rotor blades, i.e. of any element transforming dynamic fluid energy to or from rotational energy and being attached to a rotor
    • F05D2240/304—Characteristics of rotor blades, i.e. of any element transforming dynamic fluid energy to or from rotational energy and being attached to a rotor related to the trailing edge of a rotor blade
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F05—INDEXING SCHEMES RELATING TO ENGINES OR PUMPS IN VARIOUS SUBCLASSES OF CLASSES F01-F04
    • F05D—INDEXING SCHEME FOR ASPECTS RELATING TO NON-POSITIVE-DISPLACEMENT MACHINES OR ENGINES, GAS-TURBINES OR JET-PROPULSION PLANTS
    • F05D2250/00—Geometry
    • F05D2250/50—Inlet or outlet
    • F05D2250/52—Outlet

Definitions

  • the present disclosure generally relates to ventilation systems and, in particular, to a modular ventilation system.
  • Ventilators typically provide a flow of air, or other breathing gases, at an elevated pressure during an inhalation interval, followed by an exhalation interval where the pressurized air is diverted so that the air within the patient's lungs can be naturally expelled.
  • the inhalation interval may be initiated upon detection of a patient's natural inhalation or by the ventilator.
  • Ventilators are available in a variety of sizes with different ranges of air flows and pressures that can be provided. For example, a neonatal patient will require a much lower pressure and volume of air per breath than an adult.
  • the blowers that are used are loud and the noise level in the patient's room is commonly 65 dB or more. This level of noise may disrupt the patient's rest and sleep as well as cause fatigue for the caregiver and may further obstruct diagnosis and monitoring of the patient by masking the natural breathing noises that provide an indication of the patient's condition.
  • Some respirators may be configured to accept one or more breathing gases, for example "pure oxygen” or “heliox 80/20” (a mixture of 80% helium with 20% oxygen) from external sources.
  • the exact gas mixture delivered to the patient may be a mixture of various breathing gases since the specific percentage required for a particular patient may not be commercially available and must be custom mixed in the respirator. It is important to provide precisely the specified flow rate of gas to the patient, particularly for neonatal patients whose lungs are small and very susceptible to damage from overinflation.
  • ventilators and ventilator components may be modular such that ventilators may comprise various combinations of ventilator components described herein.
  • the modular ventilator components may be removable or otherwise interchangeable.
  • a ventilator comprising a blower and a flow control device, wherein the blower is in fluid communication with the flow control device.
  • the blower comprises a housing defining an impeller cavity, an impeller plate disposed within the impeller cavity and comprising an outside edge and one or more vanes disposed on the impeller plate and comprising a leading surface and a trailing surface connecting at a tip, wherein the leading surface comprises a first portion abutting a second portion, the first portion extends from the tip with a first radius, the second portion extends from the tip with a second radius, the first radius is smaller than the second radius.
  • the flow control device comprises a fixed magnetic field, a drive coil configured to move within the fixed magnetic field in response to a low frequency signal and configured to receive a high frequency signal, a detection coil adjacent the drive coil and configured to detect the high frequency signal in the drive coil, the detected high frequency signal corresponding to a position of the drive coil, a processor coupled to the high frequency source and the low frequency source and configured to receive the detected high frequency signal form the detection coil, a seal configured to move based on the position of the drive coil, and a valve orifice defining a valve seat and a variable opening, the variable opening being adjustable based on a position of the seal relative to the valve seat.
  • a ventilator comprising a flow cassette and a fluid inlet adapter.
  • the flow cassette comprises a fluid passage terminating at an inlet and an outlet, a temperature sensor disposed within the fluid passage and configured to detect a temperature, a flow rate sensor disposed within the fluid passage and configured to detect a flow rate, and a processor configured to determine a compensated flow rate based on the temperature and the flow rate.
  • the fluid inlet adapter comprises a first inlet end configured to connect to a fluid source, a second inlet end configured to removably connect to the inlet of the flow cassette, a latching component configured to secure the fluid inlet adapter to the flow cassette, and a machine-readable indicator for identifying the fluid source.
  • a ventilator comprising a flow sensor comprising a fluid passage, a flow restriction disposed within the fluid passage such that a fluid passing through the fluid passage must pass through the flow restriction, a first pressure sensor coupled to a first end of the fluid passage and configured to detect a first pressure, a second pressure sensor coupled to a second end of the fluid passage and configured to detect a second pressure, such that the flow restriction is between the first and second pressure sensors, a temperature sensor coupled to the fluid passage and configured to detect a temperature, and a flow sensor processor configured to determine a compensated flow rate based at least on the first pressure, the second pressure, and the temperature.
  • a blower has an impeller comprising an impeller plate and a plurality of blades each attached to the impeller plate.
  • Each blade has a tip and a leading surface that comprises a first portion proximate to the tip.
  • the first portion has a first radius that is within a range of 0.03-0.20 inch.
  • an impeller has an impeller plate having an outside edge with a first radius and a plurality of blades attached to the impeller plate.
  • Each of the plurality of blades comprises a tip at the outside edge and a leading surface with a first portion extending from the tip and a second portion that extends from the first portion with a second radius that is within the range of 0.14-0.16 inch.
  • Described herein are ventilators having a valve that is a software-controlled valve used to adjust the flow of gas passing through a port of the ventilator.
  • the valve is controlled by a software control signal and works in conjunction with a ventilator's gas delivery subsystems to maintain user set pressure control levels.
  • CPAP continuous positive airway pressure
  • the valve preferably helps maintain a set pressure.
  • Described herein are ventilators having an exhalation valve that is a software-controlled valve used to adjust the flow of gas passing through an expiratory port of the ventilator to the outside environment.
  • the exhalation valve is controlled by a software control signal and works in conjunction with a ventilator's gas delivery subsystems to maintain user set pressure control levels.
  • the exhalation valve preferably maintains a set pressure, and outlet flow is controlled at a specified target bias flow rate. Additional (demand) flow is provided to maintain the pressure in the event of patient inspiratory flow exceeding the bias flow.
  • Some implementations described herein relate to a flow control device comprising a high frequency source configured to generate a high frequency signal, a low frequency source configured to generate a low frequency signal, and a fixed magnetic field.
  • the flow control device further comprises a drive coil configured to move within the fixed magnetic field in response to the low frequency signal and configured to receive the high frequency signal, and a detection coil adjacent the drive coil and configured to detect the high frequency signal in the drive coil.
  • the detected high frequency signal corresponds to a position of the drive coil.
  • the flow control device further comprises a processor coupled to the high frequency source and the low frequency source and configured to receive the detected high frequency signal from the detection coil.
  • the flow control device further comprises a seal configured to move based on the position of the drive coil, and a valve orifice defining a valve seat and a variable opening. The variable opening is adjustable based on a position of the seal relative to the valve seat.
  • Described herein are ventilator systems that include, for example, a first valve connected to a supply channel.
  • the first valve comprises a first high frequency source configured to generate a first high frequency signal, a first low frequency source configured to generate a first low frequency signal, and a first fixed magnetic field.
  • the first valve further comprises a first drive coil configured to move within the first fixed magnetic field in response to the first low frequency signal and configured to receive the first high frequency signal, and a first detection coil adjacent the first drive coil and configured to detect the first high frequency signal in the drive coil.
  • the detected first high frequency signal corresponds to a position of the first drive coil.
  • the first valve further comprises a first processor coupled to the first high frequency source and the first low frequency source and configured to receive the detected first high frequency signal from the first detection coil.
  • the first valve further comprises a first seal configured to move based on the position of the first drive coil, and a variable first valve orifice defining a first valve seat.
  • the first valve orifice is adjustable based on a position of the first seal relative to the first valve seat.
  • Some methods include sending a high frequency signal and a low frequency signal to a drive coil.
  • the low frequency signal causes the drive coil to move within a fixed magnetic field, and the drive coil causes a seal to adjust a variable valve orifice of the valve.
  • the methods also include detecting the high frequency signal in the drive coil, determining a velocity of the drive coil based on the detected high frequency signal, and modifying the low frequency signal based on the determined velocity of the drive coil.
  • Some embodiments described herein relate to a valve that includes a valve orifice with an adjustable opening; a fixed magnetic field; a force coil configured to be moved within the fixed magnetic field in response to a low frequency current; a current amplifier configured to direct a summed low frequency current and a high frequency current into the force coil; a feedback coil configured to detect the high frequency current in the force coil, the detected high frequency current having a magnitude that is proportional to a force coil position within the fixed magnetic field.
  • the valve can also include a processor configured (i) to receive data relating to the position of the force coil and (ii) to send instructions to the current amplifier; and a diaphragm configured to adjust the valve orifice opening based on the position of the force coil.
  • ventilator systems that include, for example, a gas source configured to provide a gas to a patient via a supply channel; an exhaust channel configured to direct exhaust gas from the patient; and an exhaust valve.
  • the exhaust valve may include a force coil configured to be moved within a fixed magnetic field in response to a low frequency current; a current amplifier configured to direct a summed low frequency current and a high frequency current into the force coil; a feedback coil configured to detect the high frequency current in the force coil; a processor configured (i) to receive data relating to the position of the force coil, (ii) to receive data relating to pressure within the exhaust channel, and (iii) to send instructions to the current amplifier based on the position of the coil and the pressure; and a diaphragm configured to adjust opening of a valve orifice based on the instructions from the processor.
  • Some methods include the following steps: directing a summed low frequency current and a high frequency current from a current amplifier into a force coil that is configured (i) to be moved within a fixed magnetic field in response to the low frequency current and (ii) to control a diaphragm to adjust opening of a valve orifice; detecting the high frequency current in the force coil, the detected high frequency current having a magnitude that is proportional to a position of the force coil within the fixed magnetic field; detecting the pressure in the ventilator line; and changing the low frequency current to move the force coil within the fixed magnetic field, thereby adjusting the opening of a valve orifice, in response to the detected pressure.
  • the disclosed fluid inlet adapter provides a fluid inlet that can be configured to accept only one of two possible fluids at a time and provide a machine-readable indication as to which fluid is currently being accepted.
  • an adapter for providing fluid from a fluid source to a device comprises a housing and an inlet extending through the housing for connecting the fluid source to the device.
  • the inlet comprises a first end for connecting to the fluid source and a second end for connecting to the device.
  • the adapter further comprises a latching component configured to secure the adapter to the device, and a machine-readable indicator for identifying the fluid source.
  • the machine-readable indicator extends away from the first end of the inlet and beyond the second end of the inlet.
  • a flow sensor comprises a flow restriction disposed within a passage such that a fluid passing through the passage must pass through the flow restriction, an upstream pressure sensor coupled to the passage at a point upstream of the flow restriction and configured to measure and provide an upstream pressure of the fluid within the passage, a downstream pressure sensor coupled to the passage at a point downstream of the flow restriction and configured to measure and provide a downstream pressure of the fluid within the passage, a temperature sensor coupled to the passage and configured to measure and provide a temperature of the fluid within the passage, and a flow sensor processor coupled to the upstream and downstream pressure sensors and the temperature sensor and configured to accept measurements therefrom and calculate a compensated flow rate based at least in part on the measured pressures and temperature.
  • a flow cassette in certain embodiments, has a housing with an inlet and an outlet and a passage therebetween.
  • the flow cassette also has a temperature sensor disposed within the passage and configured to measure the temperature of a fluid flowing through the passage, a flow rate sensor disposed within the passage and configured to measure a flow rate of the fluid flowing through the passage, and a processor coupled to the temperature sensor and flow rate sensor.
  • the processor is configured to accept measurements of temperature and flow rate from the temperature sensor and flow rate sensor, respectively, and provide a compensated flow rate.
  • FIGS. 1 -2 are top and bottom perspective views of an exemplary blower according to certain aspects of the present disclosure.
  • FIG. 3 is an exploded view of the blower of FIG. 1 according to certain aspects of the present disclosure.
  • FIG. 4 is a perspective view of an exemplary impeller according to certain aspects of the present disclosure.
  • FIG. 5 is a perspective view of an exemplary impeller according to certain aspects of the present disclosure.
  • FIG. 6 is a close-up plan view of a vane tip of the impeller according to certain aspects of the present disclosure.
  • FIG. 7 is a cross-section of a blower according to certain aspects of the present disclosure.
  • FIG. 8 is an enlarged view of a portion of FIG. 7 according to certain aspects of the present disclosure.
  • FIGS. 9A-9C are perspective views of the overmolded top housing according to certain aspects of the present disclosure.
  • FIG. 10 depicts a patient using an exemplary ventilation system according to certain aspects of the present disclosure.
  • FIGS. 1 1 A and 1 IB are front and rear views of an exemplary ventilator according to certain aspects of the present disclosure.
  • FIG. 12 is a schematic representation of a ventilator according to certain aspects of the present disclosure.
  • FIGS. 13A-13B are schematic depictions of feedback systems according to certain aspects of the present disclosure.
  • FIG. 14 illustrates an exemplary schematic arrangement of a control system according to certain aspects of the present disclosure.
  • FIG. 15A is a cross sectional view of a flow valve according to certain aspects of the present disclosure.
  • FIG. 15B is a cross sectional view of a flow valve according to certain aspects of the present disclosure.
  • FIG. 16 is a schematic representation of a ventilator according to certain aspects of the present disclosure.
  • FIG. 1 7 shows a flowchart of a process for controlling a flow valve according to certain aspects of the present disclosure.
  • FIG. 18 illustrates high frequency signals according to certain aspects of the present disclosure.
  • FIGS. 19-20 are front and back perspective views of exemplary fluid inlet adapters according to certain aspects of the present disclosure.
  • FIG. 21 A is a cross-sectional side view of an exemplary fluid inlet adapter and a device according to certain aspects of the present disclosure.
  • FIG. 21 B is a cross-sectional side view of the exemplary fluid inlet adapter mated with the docking location of the housing according to certain aspects of the present disclosure.
  • FIGS. 22A-22B depict the position of the handle in exemplary unlatched and latched positions according to certain aspects of the present disclosure.
  • FIGS. 23 and 24 depict an exemplary inlet adapter configured to accept fluid from two different sources according to certain aspects of the present disclosure.
  • FIGS. 25-28 depict example connector configurations according to certain aspects of the present disclosure.
  • FIG. 29 depicts an adapter with one inlet according to certain aspects of the present disclosure.
  • FIG. 30 depicts adapters with different machine-readable indicators and a flow control device according to certain aspects of the present disclosure.
  • FIG. 31 depicts an adapter coupled to a flow control device according to certain aspects of the present disclosure.
  • FIG. 32 depicts frontal views of an adapter and a connector according to certain aspects of the present disclosure.
  • FIG. 33 depicts front views of an adapter and a flow control device according to certain aspects of the present disclosure.
  • FIG. 34 is a block diagram of an exemplary flow sensor according to certain aspects of the present disclosure.
  • FIG. 35A depicts an exemplary flow cassette according to certain aspects of the present disclosure.
  • FIG. 35B is a cross-section of the flow cassette of FIG. 35A according to certain aspects of the present disclosure.
  • FIG. 35C is an enlarged view of a portion of FIG. 35B showing an exemplary flow sensor according to certain aspects of the present disclosure.
  • FIG. 36 is a flow chart of an exemplary flow measurement process according to certain aspects of the present disclosure.
  • FIG. 37 is a block diagram of an exemplary flow cassette according to certain aspects of the present disclosure.
  • FIGS. 38A-38B depict an exemplary flow cassette according to certain aspects of the present disclosure.
  • FIG. 39A is a cross-section of the flow cassette of FIGS. 38A-38B according to certain aspects of the present disclosure.
  • FIG. 39B is an enlarged view of a portion of FIG. 39A according to certain aspects of the present disclosure.
  • FIG. 40 is a flow chart of an exemplary configuration process according to certain aspects of the present disclosure.
  • FIG. 41 is an illustration of a ventilator according to certain aspects of the present disclosure.
  • gas shall be interpreted to mean both a single material in gaseous form, for example oxygen, and a mixture of two or more gases, for example air or heliox (a mixture of oxygen and helium).
  • a gas may include water or other liquids in the form of vapor or suspended droplets.
  • a gas may also include solid particulates suspended in the gas.
  • pure when used with reference to a gas, means that the gas meets commonly accepted medical standards for purity and content.
  • temperature sensor means a device configured to measure temperature and to provide a signal that is related to the measured temperature.
  • a temperature sensor may include electronics to provide a drive current or voltage and/or measure a current or voltage.
  • the electronics may further include conditioning and conversion circuitry and/or a processor to convert the measured value to a signal that may be in analog or digital form.
  • pressure sensor means a device configured to measure a gas pressure and provide a signal that is related to the measured pressure.
  • a pressure sensor may include electronics to provide a drive current or voltage and/or measure a current or voltage.
  • the electronics may further include conditioning and conversion circuitry and/or a processor to convert the measured value to a signal that may be in analog or digital form.
  • the pressure may be provided in absolute terms or "gauge" pressure, i.e., relative to ambient atmospheric pressure.
  • valves having one or more valves that are software-controlled valves. These valves may be used to adjust the flow of gas passing through a port of the ventilator and can be configured to be positioned on the exhalation side of a ventilation system (meaning in connection with system components that receive exhaled air from a patient) or on an inhalation side of a ventilation system (meaning in connection with system components that provide air to a patient).
  • the valves can be controlled by a software control signal and work in conjunction with a ventilator's gas delivery subsystems to maintain user set pressure control levels.
  • an exhalation valve preferably maintains a set pressure, and outlet flow is controlled at a specified target bias flow rate. Additional (demand) flow may be provided through an inhalation valve to control the pressure.
  • An exhalation subsystem of a ventilator comprises an exhalation valve, an exhalation flow sensor, and a heated filter and water trap.
  • the exhalation valve is a software-controlled valve that is used to adjust the flow of gas passing through the expiratory port of the ventilator to the outside environment.
  • the exhalation valve is controlled by a software control signal and works in conjunction with a ventilator's gas delivery subsystems to maintain user set pressure control levels.
  • the exhalation valve operates on the principle of a force balance across a control diaphragm, which may be a disposable valve membrane.
  • a linear magneto-mechanical actuator controls a force on the diaphragm, which in turn controls the circuit or ventilator line pressure.
  • the force generated by the actuator is based on a command from the software closed-loop controller.
  • FIGS. 1 -2 are top and bottom perspective views of an exemplary blower 100 according to certain aspects of the present disclosure.
  • the blower 100 draws in ambient air, or other gases if connected to a source of gas, through inlet 1 19 of housing 1 12.
  • Impeller 160 may rotate at a variable speed up to 30,000 rotations per minute (rpm), for example, to centrifugally accelerate the air and provide a flow of pressurized air at outlet 1 18.
  • the housing 1 12 comprises two parts, 1 12T and 1 12B (see FIG. 3) held together with multiple clips 1 14.
  • the section line A-A indicates the cross-sectional view of FIG. 7.
  • FIG. 2 is a perspective view of the blower 100 of FIG. 1 with the blower 100 rotated so as to make the bottom housing portion 1 12B visible.
  • a motor 120 is attached to the housing 1 12 and the shaft of the motor (not visible in FIG. 2) passes through the housing 1 12 and connects to the impeller 160.
  • FIG. 3 is an exploded view of the blower 100 of FIG. 1 according to certain aspects of the present disclosure.
  • the top housing portion 1 12T has an impeller cavity 1 19.
  • the impeller 160 is at least partially disposed within the impeller cavity 1 19 when the blower 1 00 is assembled.
  • the housing 1 12 comprises a collector 1 16 formed when the top and bottom housing portions 1 12T, 1 12B are mated.
  • the collector 1 16 is shaped as a volute having a circular cross-sectional profile along a radial plane of the housing 1 12, wherein the area of the profile monotonically increases as the distance around the volute from the outlet 1 18 decreases.
  • the volute may have a non-circular profile.
  • the area of the profile may be constant over a portion of the volute.
  • the top and bottom housing portions 1 12T, 1 12B also respectively include edges 124U, 124L that are proximate to each other when the blower 100 is assembled and surround the impeller cavity so as to cooperatively define a slot (not visible in FIG. 3) that connects the impeller cavity 1 19 to the collector 1 16.
  • the lower housing portion 1 12B also includes a wall 120 and a shelf 122 adjacent to the edge 124L. This region of the blower 100 is described in greater detail with respect to FIG. 7.
  • FIG. 4 is a perspective view of a conventional impeller 10.
  • This impeller 10 has a plurality of vanes 12, 20 each having a leading edge 14 and a trailing edge 16, although vanes 20 are shorter than vanes 12 and are commonly referred to as "splitters.”
  • Conventional vanes 12, 20 have a three-dimensional curvature with a generally uniform thickness from leading edge 14 to trailing edge 16, with some rounding of the outside corners and filleting of the inside corners.
  • FIG. 5 is a perspective view of an exemplary impeller 160 according to certain aspects of the present disclosure.
  • the impeller 160 comprises an impeller plate 162 having a shaped surface 166 and a circular outside edge 164 that are centered about an axis of rotation 161 .
  • the portion of the long vanes 1 70 that is not present in the splitter vanes 171 is referred to as the "inducer" 173.
  • Each vane 170, 171 has an inlet edge 172, a tip 174 that is proximate to the outside edge 164, and a top surface 176 that is, in this example, flat in a generally circumferential direction about axis 161 while being curved in a generally radial direction.
  • the region indicated by the dashed-line oval labeled "B" is shown in FIG. 6.
  • FIG. 6 is a close-up plan view of a vane tip 174 of the impeller 160 of FIG. 5 according to certain aspects of the present disclosure.
  • the example vane 170 has a leading surface 180 and a trailing surface 182 that meet at the tip 174.
  • the leading surface 180 comprises a first portion 177 and a second portion 175.
  • the second portion 175 extends from the tip 174 with a radius R2 that is the same radius as the outside edge 164.
  • the first portion 177 abuts the second portion 175 and continues with a radius Rl that is smaller than R2 and larger than the radii conventionally used to round outside edges.
  • the radius Rl may be within the range of 0.03-0.20 inch.
  • the radius R l may be within the range of 0.12-0.18 inch.
  • the radius Rl may be within the range of 0. 14- 0.16 inch.
  • the radius Rl may be approximately 0.1 5 inch.
  • the effect of the radius Rl may be to control the turbulence of the air at the tip 174 and reduce the velocity gradient in the air flow as the air leaves the impeller 160, compared to a conventional vane that abruptly ends at the outside edge with a sizable angle between the leading surface and the outside edge, as is visible in the impeller 10 of FIG. 4.
  • the velocity gradient is reduced and the air flow may be less turbulent as the air leaves the impeller 160 and passes through the slot 126.
  • Each vane 170, 171 has a centerline 179 that is coincident with and bisects the top surface 1 76 between the leading and trailing surfaces 1 80, 182.
  • the vanes 170, 171 have a common width W taken perpendicular to the centerline 179, wherein W varies along the centerline 179.
  • the width W of each vane 170, 171 will be the same, for at least the length of the splitter vanes 171 .
  • the shape and width of the vanes 170, 171 proximate to the second portion 177 may be selected to simply enable the radius to be as large as Rl , compared to the constant-thickness vanes of a conventional impeller.
  • the trailing surface 1 82 has a minimum radius that is greater than the radius of the first portion of the leading surface 180.
  • the shape and location of the trailing surface 182 may be chosen to cooperate with the leading surface of the adjacent vane 170, 171 to control the pressure and/or velocity of the air flowing between the leading and trailing surfaces 1 80, 182.
  • the height of the vanes 170, 171 i.e. the distance from the shaped surface 166 to the top surface 176, varies from the inlet edge 172 and tip 1 74. In certain embodiments, the height is constant from the tip 174 over the first and second portions 177, 175 of the leading surface 1 80.
  • the shaped surface 166 has an outside portion 163 that is proximate to the first and second portions 177, 175 of the leading surface 1 80. In certain embodiments, the shaped surface 166 is flat and perpendicular to the axis 16 in the outside portion 163.
  • FIG. 7 is a cross-section taken along section line A-A of the blower 100 of FIG. 1 according to certain aspects of the present disclosure.
  • the arrows 101 and 102 respectively indicate how air is drawn in through the inlet 1 19 and directed by the impeller 160 into the collector 1 1 6.
  • the motor 120 is shown in schematic form and, in this embodiment, the rotor (not shown in FIG. 7) of the motor 120 is directly connected to the impeller 160.
  • the area indicated by the dashed-line box "C" is discussed in greater detail with respect to FIG. 8.
  • FIG. 8 is an enlarged view of the area C of FIG. 7 according to certain aspects of the present disclosure.
  • the cross-section of impeller 160 shows the top surface 166, a bottom surface 1 67, and the outside edge 162.
  • the upper edge 124U of the top housing portion 1 12T and the lower edge 124L of the bottom housing portion 1 12B are proximate to each other and separated by a slot 126.
  • the edges 124U and 124L both have a radius R4 on an inside corner nearest to the impeller 160, with angled surfaces that extend outward at an included angle 1 74 toward the collector 1 16.
  • the radius R4 improves the efficiency of the nozzle formed by slot 126.
  • R4 may be within the range of 0.01 -0.30 inch. In certain embodiments, R4 may be approximately 0.020 inch.
  • the reference line 170 is aligned with the peak of the radius R4 of lower edge 124L and the reference line 172 is aligned with the peak of the radius R4 of upper edge 124U.
  • the slot 126 is defined by the reference lines 170, 172.
  • the shaped surface 166 at the outside edge 162 is aligned with reference line 1 70, i.e. the lower edge 124L of the slot 1 26, and the top surfaces 176 of the plurality of blades 1 70, 171 are each aligned with the reference line 172, i. e. the upper edge 124U of the slot 126.
  • the gap between the top surface 176 and the upper inner surface 123 of the upper housing 1 12T is a path of potential backflow from the edge 162 of the impeller 160 toward the center. Minimizing the gap 1 83 between top surface 176 and the upper inner surface 123 reduces this backflow and thereby improves the pressure recovery of the blower 1 00.
  • the gap 1 83 may be in the range of 0.002-0.150 inch when the impeller 160 is stationary relative to the housing 1 12.
  • the gap 183 may be in the range of 0.005-0.050 inch.
  • the gap 180 may be approximately 0.010 inch.
  • the lower edge 124L has an adjacent wall 120 with a gap 180 between the outside edge 162 and the wall 120.
  • the gap 180 may be in the range of
  • the gap 1 80 may be in the range of 0.005-0.050 inch. In certain embodiments, the gap 180 may be approximately 0.0073 inch. In certain embodiments, the radius R2 of the outside edge 162 of the impeller 160 may increase as the rotational velocity of the impeller 160 increases and, therefore, the gap 1 80 may be reduced when the impeller 160 is rotating relative to the housing 1 12. In certain embodiments, the impeller 160 may rotate at a rotational velocity of up to 60,000 rotations per minute (rpm) relative to the housing 1 12 and the gap may be reduced to as little as 0.003 inch. As there will be a boundary layer (not visible in FIG.
  • reducing this gap may decrease the portion of the gap wherein airflow may go turbulent, e.g. the portion between the two boundary layers, thereby reducing the acoustic energy generated by the turbulent air.
  • the wall 120 connects to a shelf 122. There is a gap 182 between the bottom surface 167 of the impeller 160 and the shelf 122 of the bottom housing portion 1 12B.
  • the gap 1 82 may be less than or equal to 0.020 inch when the impeller 160 is stationary or moving relative to the housing 1 12B. In certain embodiments, the gap 1 82 may be less than or equal to 0.050 inch. In certain embodiments, the gap 182 may be less than or equal to 0.020 inch.
  • FIGS. 9A-9C are perspective views of the overmolded top housing 1 12T according to certain aspects of the present disclosure.
  • FIG. 9A depicts a translucent view of a layer 200 of a sound-damping material formed so as to match the external profile of a housing shell 210 shown in FIG. 9B.
  • the sound-damping layer 200 covers most of the external surface of the housing shell 210 with the exception of the attachment points 212 for the clips 1 14 (not shown in FIGS. 9A-9C).
  • FIG. 9C shows combined top housing portion 1 12T with the sound- damping layer 200 on the external surface of the housing shell 210.
  • the sound-damping layer 200 comprises an elastomer, e.g. a silicone or rubber, having poor acoustic transmissibility.
  • the sound-damping layer 200 may be overmolded on the housing shell 210.
  • the sound-damping layer 200 may be applied to the housing shell 21 0 by one or more of the processes of transfer molding, spraying, dipping, brushing, curtain coating, or other manual or automated coating application process.
  • the sound-damping layer 200 may comprise high-density particles, e.g. steel, that may further reduce the transmissibility of the sound-damping layer 200.
  • the disclosed embodiments of the blower may provide advantages in size, cost, performance, and reduced noise during operation.
  • the shaping of the leading and trailing surfaces of the vanes near the outside edge of the impeller may reduce the turbulence and velocity gradient in the air flow around the tip of the vanes, thereby reducing the acoustic noise generated by the air flow.
  • the small clearances between portions of the impeller and portions of the housing may further reduce the acoustic noise by decreasing the gaps compared to the depth of the boundary layers, thereby reducing the portion of the gap susceptible to noisy, turbulent flow.
  • FIG. 10 depicts a patient 1010 using an exemplary ventilation system with a
  • the ventilator 1 100 may include a blower, such as the blower 100 described herein.
  • the ventilator 1 100 operates as a gas source for providing gas to a patient (e.g., for respiration).
  • the ventilator system includes a supply channel, tube, or "limb" 1 104, a return or exhaust channel, tube, or limb 1 106, a conditioning module 1 108 that may, for example, warm or humidify the air passing through the supply limb 1 104.
  • the supply and exhaust limbs 1 104, 1 106 are both coupled to a patient interface device 1 102 that, in this example, is a mask that fits over the mouth of the patient 1010. In other embodiments (not shown in FIG.
  • FIGS. 1 1 A and 1 1 1 B are front and rear views of the ventilator 1 100 according to certain aspects of the present disclosure.
  • the ventilator 1 100 has a housing 1 1 10 with an attached user interface 1 1 15 that, in certain embodiments, comprises a display and a touchscreen.
  • the front of the housing 1 1 10 includes a supply port 1 155 for a supply limb, such as supply limb 1 104 in FIG. 10, and a return port 1 150 for an exhaust, such as exhaust limb 1 106 in FIG. 10.
  • the return port 1 1 50 may be mounted over an access door 1 1 52 that provides access to a filter (not visible in FIG. 1 1 A) that filters and absorbs moisture from the exhaled breath of the patient 1010.
  • a filter not visible in FIG. 1 1 A
  • FIG. 1 1 B shows a rear view of the ventilator 1 100 with a gas inlet adapter 1 120, an air intake port 1 140, and a power interface 1 130 that may include a power plug connector and a circuit breaker reset switch. There may also be a rear interface panel 1 165 for connection to external instruments or a network interface cable.
  • a flow control device such as a flow cassette described herein or a flow control valve described herein, may be installed within the housing 1 1 10 behind the gas inlet adapter 1 120 and in fluid communication between an inlet connector 1 126 shown in FIG. 1 I B and the supply port 1 1 55 shown in FIG. 1 1 A.
  • FIG. 12 illustrates a schematic depiction of the ventilator 1 100 having a control system 305, system hardware 3 10, user input 3 15, output 320, and feedback 325.
  • the control system 305 includes a ventilation control system 330 that receives user input 315.
  • the control system 305 includes hardware control systems that control respective hardware components of the ventilator 1 100.
  • the hardware control systems may include a blower control system 335, a flow cassette control system 340, and an exhalation valve control system 345.
  • the blower control system 335 controls a respective blower 350
  • the flow cassette control system 340 controls a respective flow cassette 355,
  • the exhalation valve control system 345 controls a respective exhalation valve 360.
  • the blower 350 may correspond to the blower 100 described herein, and may be in fluid communication with the flow cassette 355 and/or the exhalation valve 360.
  • the blower 350 may be before or after the flow cassette 355 or the exhalation valve 360 in a fluid path of the ventilator 1 100.
  • the system hardware 310 includes sensors 365 that detect information from the system hardware 310, for example, the blower 350, the flow cassette 355, and the exhalation valve 360.
  • the sensors 365 produce one or more feedback signals 325 that are received by the ventilation control system 330.
  • the ventilation control system 330 receives the feedback control signals 325 and the user input 315 and sends information to an output 320.
  • the output 320 can include, for example, monitoring information and alarms.
  • the feedback control signals 325 may also be used to provide inputs to the blower control system 335, the flow cassette control system 340, and the exhalation valve control system 345.
  • FIG. 13 A illustrates a schematic depiction of an exhalation control feedback system 400 that determines an amount of gas flow 405 that is permitted to pass through an exhalation valve 410.
  • the illustrated embodiment of the feedback system 400 is based on a target pressure 420 and an actual circuit pressure 425 (or a pressure within a line of the ventilator 1 100).
  • a processor 430 receives an input signal relating to the actual circuit pressure 425 and compares the actual circuit pressure 425 to the target pressure 420. Based on this comparison, the processor 430 sends a command signal 435 to an exhalation valve driver 440.
  • the exhalation valve driver 440 is configured to control a position of the exhalation valve 410 to regulate the gas flow 405 through the exhalation valve 410.
  • the exhalation valve driver 440 sends a control current 445 to the exhalation valve 410 to maintain or adjust the exhalation valve 410 to modify or adjust the pressure within the ventilator line.
  • the processor 430 sends a command 435 to the exhalation valve driver 440 to open the exhalation valve 410 to reduce pressure within the ventilator line.
  • the exhalation valve driver 440 upon receiving the command 435 to relieve pressure, adjusts the control current 445 to the exhalation valve 410 to increase the opening of the exhalation valve 410 and relieve pressure within the ventilator line.
  • the processor 430 receives position feedback 450 of the exhalation valve 410 via the exhalation valve driver 440, such that the processor 430 is able to determine the degree to which the exhalation valve 410 is open.
  • the processor 430 directs the driver 440 to adjust the control current 445 to the exhalation valve 410 to decrease the opening of the exhalation valve 410 such that pressure within the ventilator line is increased. If the actual circuit pressure 425 input to the processor 430 was found to be at an acceptable level or within an acceptable range, the processor 430 directs the driver 440 to maintain the control current 445 to the exhalation valve 410 to maintain the position of the exhalation valve 410.
  • FIG. 13B which illustrates a schematic depiction of an inhalation control feedback system 401 that determines an amount of gas flow 406 that is permitted to pass through an inhalation valve 41 1 .
  • the illustrated embodiment of the feedback system 401 is based on a target flow 421 and an actual flow 426 (or a flow within a line of the ventilator 1 100).
  • the position feedback may be used to determine flow, using the orifice characteristics of the valve and generally understood principles of fluid flow.
  • Multiple gas types may be controlled based on the identified gas type (or gas id).
  • the primary advantage of this flow measurement method is that the need for a separate flow sensor is eliminated and the resulting package provides for a compact flow delivery system.
  • a processor 431 receives an input signal relating to the actual flow 426 and compares the actual flow 426 to the target flow 421. Based on this comparison, the processor 43 1 sends a command signal 436 to an inhalation valve driver 441.
  • the inhalation valve driver 441 is configured to control a position of the inhalation valve 41 1 to regulate the gas flow 406 through the inhalation valve 41 1 .
  • the inhalation valve driver 441 sends a control current 446 to the inhalation valve 41 1 to maintain or adjust the inhalation valve 41 1 to modify or adjust the flow rate through the ventilator line.
  • the processor 43 1 sends a command 436 to the inhalation valve driver 441 to close the inhalation valve 41 1 to reduce the flow rate through the ventilator line.
  • the inhalation valve driver 441 upon receiving the command 436 to reduce the flow rate, adjusts the control current 446 to the inhalation valve 41 1 to decrease the opening of the inhalation valve 41 1 and reduce the flow rate within the ventilator line.
  • the processor 431 receives position feedback 451 of the inhalation valve 41 1 via the inhalation valve driver 441 , such that the processor 431 is able to determine the degree to which the inhalation valve 41 1 is open.
  • the processor 431 directs the inhalation driver 441 to adjust the control current 446 to the inhalation valve 41 1 to increase the opening of the inhalation valve 41 1 such that the flow rate through the ventilator line is increased. If the actual flow 426 input to the processor 431 was found to be at an acceptable level or within an acceptable range, the processor 431 directs the driver 441 to maintain the control current 446 to the inhalation valve 41 1 to maintain the position of the inhalation valve 41 1 .
  • FIG. 14 illustrates an exemplary schematic arrangement of a current control system 500 that illustrates some embodiments of a driver (e.g., the exhalation valve driver 440 of FIG. 13A or the inhalation valve driver 441 of FIG. 13B) operating to adjust a valve 503 (e.g., the exhalation valve 410 or the inhalation valve 41 1).
  • a driver e.g., the exhalation valve driver 440 of FIG. 13A or the inhalation valve driver 441 of FIG. 13B
  • a valve 503 e.g., the exhalation valve 410 or the inhalation valve 41 1).
  • a high frequency source 505 generates a signal having a high frequency
  • a low frequency source 510 generates a signal having a low frequency.
  • the high frequency signal and the low frequency signal are summed together, and the signal is amplified by a current amplifier 515.
  • the current amplifier 515 is a linear current output amplifier.
  • the signal is then directed to a coil 520 (e.g., a force coil) that is configured to move at least partly within a fixed magnetic field 525.
  • the fixed magnetic field 525 is produced by a magnetic field generator, e.g., at least one permanent magnet 530 or a separate coil (not shown).
  • the natural frequency of the coil 520 is such that the coil 520 responds to the low frequency component of the combined signal by movement within or in relation to the magnetic field, as illustrated by arrows 535.
  • the low frequency component is less than about 90% of the natural frequency of the coil 520.
  • the low frequency component is less than about 80% of the natural frequency of the coil 520, and in yet further embodiments, the low frequency component is less than about 50% of the natural frequency of the coil 520.
  • the high frequency component of the combined signal preferably has a negligible effect on the position of the coil 520 such that the position of the coil 520 within the magnetic field is controlled substantially by the low frequency component.
  • the high frequency component is more than 50% greater than the natural frequency of the coil 520.
  • the high frequency component can be between 50% and about 200% greater than the natural frequency of the coil 520.
  • the high frequency can be more than 200% greater than the natural frequency of the coil 520.
  • a detection coil 540 detects the high frequency component of the signal passing through the coil 520, and the detection coil 540 sends a signal to a high frequency feedback processor 545 that determines, based on the detection coil 540 signal, a position of the coil 520 within the magnetic field 525. In some embodiments, a magnitude of the high frequency signal detected by the detection coil 540 is used to determine the position of the coil 520 within the magnetic field 525. In some instances, the high frequency feedback processor 545 also detennines a velocity of the coil 520 within the magnetic field 525 and the high frequency feedback processor 545 sends a signal to the low frequency source 5 10 for providing feedback on the position and/or velocity of the coil 520. In some embodiments, the high frequency feedback processor 545 includes a position circuit 547 and a velocity circuit 548.
  • the low frequency source 5 10 also receives input from a sensor (not shown) within a ventilator line relating to how an actual condition 550 (e.g., pressure or flow rate) within the ventilator line compares to a target condition 555 of the ventilator line. Based on (i) the input relating to the comparison of actual condition 550 and the target condition 555 and (ii) the input from the high frequency feedback processor 545 relating to the position of the coil 520 in relation to the magnetic field 525, the low frequency source 510 determines whether the low frequency signal should be modified to change the position of the coil 520 in relation to the magnetic field 525.
  • a sensor not shown
  • an actual condition 550 e.g., pressure or flow rate
  • the low frequency source 510 changes the low frequency signal to move the coil 520 within the magnetic field 525.
  • the coil 520 is preferably coupled, directly (e.g., mechanically) or indirectly (e.g., magnetically), to a portion of the valve 503 that regulates flow through the valve 503. Accordingly, movement of the coil 520 moves the portion of the valve 503 and changes an amount of gas passing through the valve 503. As the amount of gas passing through the valve 503 changes, the detected condition within the ventilator line changes, and the actual condition 550 is detected and compared with the target condition 555.
  • the target condition 555 may include a minimum threshold pressure.
  • the low frequency source 510 may be configured to close the valve 503, such that substantially no gas from the exhalation line passes through the valve 503.
  • the low frequency source 5 10 may produce a signal that maintains position of the coil 520, and therefore the valve 503, to further increase the actual pressure within the exhalation line.
  • the target condition 555 may include a threshold time of flow rate.
  • the low frequency source 510 may be configured to close the valve 503, such that substantially no gas from the inhalation line passes through the valve 503.
  • the low frequency source 510 may produce a signal that maintains position of the coil 520, and therefore the valve 503, to maintain the flow rate through the inhalation line.
  • FIG. 15 A is an exemplary cross sectional view of the a valve 600A, which may be the exhalation valve 410 or the inhalation valve 41 1 , and operates under the same or similar principles described above with respect to valve 503 depicted in FIG. 14.
  • the illustrated valve 600A includes a housing 605 that defines an internal chamber 610. Disposed within the internal chamber 610 is a coil 615 that is positioned and axially movable within or in relation to a fixed magnetic field generator 620.
  • An armature 650 has a pole piece and may include or be attached to the coil 615.
  • a sensor 625 Positioned about at least a portion of the magnetic field generator 620.
  • the senor 625 is a detection coil that is configured to detect high frequency signals passing through the coil 615.
  • the high frequency signals detected by the sensor 625 are used to determine a position of the coil 61 5 within or in relation to the magnetic field generator 620.
  • a signal is communicated from the sensor 625 regarding a position of the coil
  • the coil 615 and signals are directed to the coil 615 via a flexible communication cable 630.
  • signals directed to the coil 615 cause the coil 615 to move within the internal chamber 610 in relation to the magnetic field, movement of the coil 615 affects positioning of a convoluted diaphragm 635 and poppet 647 or seal.
  • the poppet 647 operates as a variable orifice of the valve 600. Positioning of the poppet 647 with respect to the seat 645 affects the amount of fluid that passes through a valve having an opening 640.
  • Movement of the coil 615 can change a position of the sensor 625 by being directly coupled to the poppet 647 and moving the poppet 647 toward or away from a seat 645, which defines the valve orifice as the gap between the poppet 647 and seat 645.
  • the armature 650 may be directly connected to the diaphragm 635 and/or the poppet 647.
  • movement of the coil 615 can change a position of the poppet 647 by being indirectly coupled to the poppet 647.
  • a portion of the coil 615 and a portion of the poppet 647 may be magnetically opposed or attracted to each other.
  • this indirect coupling can affect positioning of the poppet 647 in connection with the seat 645 of the valve without contact between the coil 615 and the poppet 647.
  • valves that can be used include, but are not limited to, a flap valve, a rotating disk valve, a duck-billed valve, etc.
  • the valve 600A can also provide increased stability by damping the moving components of the valve 600A.
  • a velocity of the coil 615 can be determined by a processor (e.g., processor 430 or 43 1 or high frequency feedback processor 545), which can include a velocity circuit that calculates a change of position with respect to time. The velocity can then be used to determine the desired damping.
  • the damped frequency response is greater than or equal to about 40 Hz, and the damping coefficient that yields an under-damped or critically damped valve assembly.
  • additional damping such as pneumatic viscous damping can be incorporated into the valve 600A to further tune the valve 600 to the specific application.
  • the valve 600A can include a "fail-safe" open feature in case of loss of electrical power, software control, or loss of all inlet gases.
  • the valve 600A can also be configured to switch to the "fail-safe" open configuration when the ventilator 1 100 is turned off.
  • the ventilator 1 100 will close the valve 600A and normal ventilation can commence.
  • the valve 600A, and other valves or ports will work in conjunction to (i) relieve pressure from the circuit down to ambient pressure conditions, (ii) allow ambient air to be available to the patient for breathing, and (iii) minimize re-breathing of gases.
  • FIG. 1 5B illustrates a valve 600B, which may be another implementation of the valve 600A.
  • the valve 600B may comprise similar components as the valve 600A.
  • the valve 600B comprises a front flat spring 652, and a rear flat spring 654.
  • the front flat spring 652 and the rear flat spring 654 provide mechanical or structural support for the armature 650.
  • the armature 650 may be supported by other structures, such as bearings.
  • FIG. 16 illustrates a schematic depiction of another implementation of the ventilator 1 100 having a control system 705, system hardware 710, user input 715, output 720, and feedback 725.
  • the control system 705 includes a ventilation control system 730 that receives user input 715.
  • the control system 705 includes hardware control systems that control respective hardware components of the ventilator 100.
  • the hardware control systems may include a blower control system 735, an inflow valve control system 740, and an exhalation valve control system 745.
  • the blower control system 735 controls a respective blower 750
  • the inflow valve control system 740 controls a respective inflow valve 755,
  • the exhalation valve control system 745 controls a respective exhalation valve 760.
  • the blower 750 may correspond to the blower 100 described herein and may be in fluid communication with the inflow valve 755 and/or the exhalation valve 760.
  • the blower 750 may be before or after the inflow valve 755 or the exhalation valve 760 in a fluid path of the ventilator 1 100.
  • the system hardware 710 includes sensors 765 that detect information from the system hardware 710, for example, the blower 750, the inflow valve 755, and the exhalation valve 760.
  • the sensors 765 produce one or more feedback signals 725 that are received by the ventilation control system 730.
  • the ventilation control system 730 receives the feedback control signals 725 and the user input 715 and sends information to an output 720.
  • the output 720 can include, for example, monitoring information and alarms.
  • the feedback control signals 725 may also be used to provide inputs to the blower control system 735, the flow cassette control system 740, and the exhalation valve control system 745.
  • the inflow valve control system 740 may be similar to and operate similarly to the exhalation valve control system 745, which may correspond to the feedback system 400 in FIG. 13 or the current control system 500 in FIG. 14.
  • the inflow valve 755 may also be similar to and operate similarly to the exhalation valve 760, which may correspond to the exhalation valve 410 in FIGS. 13 and 1 5, or the valve 503 in FIG. 14.
  • the inflow valve 755 may be any front end valve before the patient in a gas flow.
  • the exhalation valve 760 may be any back end valve behind the patient in a gas flow.
  • a flow cassette may include a pressure measurement device for an inlet gas, which measures pressure differential to determine flow measurement.
  • the flow cassette may also include another valve tracker that drives the flow control valve of the flow cassette.
  • a flow cassette provides flow measurement and flow control.
  • valve control systems described herein provide flow control through the variable valve opening, but also provide flow measurement.
  • the flow measurement can be derived from the position of the force coil or drive coil.
  • the valve control systems also provide flow measurement and flow control, similar to flow cassettes.
  • flow cassettes may be cost prohibitive for certain applications.
  • a ventilator system with valve control systems may be less expensive to produce than a ventilator system with one or more flow cassettes.
  • the valve control systems may be different sizes, for example one quarter of the size of the other, as needed.
  • the two valve control systems can work together, with one for inspiration and one for exhalation.
  • the inflow valve 755 may be open and regulated until an appropriate volume of gas has flowed to the patient.
  • the inflow valve 755 will then close, and the exhalation valve 760 will open, and regulated until an appropriate volume of gas has been exhaled by the patient.
  • gas is connected to the inflow valve 755 which starts closed, building up high pressure.
  • the inflow valve control system 740 commands the inflow valve 755 to open, allowing the flow through to the patient.
  • inspiration starts, the exhalation valve 760 is closed.
  • the inflow valve control system 740 determines when to close the inflow valve 755 based on a flow control or a pressure control.
  • the exhalation valve control system 745 commands the exhalation valve 760 to open, allowing the patient to breathe out.
  • the inflow valve 755 is directed to open, and the cycle repeats.
  • Flow control may be calculated by sampling, for instance, the pressure every millisecond to make adjustments. Based on the position of the drive coil, the pressure can be calculated.
  • the pressure is continuously monitored to adjust the position of the drive coil until a target flow is reached.
  • the calculations may factor in ambient pressure, gas composition, gas temperature changes, downstream pressure changes, inlet pressure changes, etc. The calculations may further correct for standard conditions.
  • the exhalation valve 760 allows the patient to exhale without difficulty.
  • CPAP therapy other embodiments, particularly embodiments used on the front end of the ventilator, are not limited to CPAP therapy.
  • the flow control devices described herein may be utilized at any point along a flow path of a ventilator, respirator, or other similar device.
  • the flow control devices may be used in other fluid devices, particularly fluid devices which measure and/or regulate fluid flow, and are not limited to respiration.
  • FIG. 17 shows a flowchart 800 of controlling a flow valve, such as the valve 503.
  • a high frequency signal and a low frequency signal is sent to a drive coil, such as the coil 615.
  • the low frequency signal causes the drive coil to move within a fixed magnetic field, such as the fixed magnetic field generator 620.
  • the moved drive coil causes a movable part, such as the poppet 647 or seal, to adjust a valve orifice of the valve, such as the opening 640.
  • the high frequency signal in the moved drive coil is detected.
  • a velocity of the drive coil is determined based on the detected high frequency signal.
  • the low frequency signal is modified based on the determined velocity of the drive coil. For example, the velocity signal may be injected into the low frequency source for the purpose of dampening.
  • the block 830 may be expanded into several operations, denoted by the dotted lines in FIG. 17.
  • a delay between the high frequency signal and the detected high frequency signal may be determined.
  • FIG. 18 shows a sample space 900.
  • a high frequency signal 910 which may be a high frequency current from the high frequency source 505
  • a detected high frequency signal 920 which may be a high frequency current detected in the drive coil after the drive coil moves.
  • a delay 930 between the signals may be proportional to the position of the drive coil.
  • the position of the drive coil is determined based on the delay.
  • the velocity of the drive coil is determined based on the position of the drive coil.
  • the low frequency signal may be modified based on the determined velocity of the drive coil to, for example, control dampening of the drive coil.
  • a ventilator such as the ventilator 1 100 may utilize an adapter described herein to facilitate connections.
  • FIGS. 19-20 are front and back perspective views of an exemplary fluid inlet adapter 2100 according to certain aspects of the present disclosure.
  • the fluid inlet adapter 2100 also referred to herein as "the adapter 2100," comprises a body 21 10 with two inlets 2120, 21 30 that are configured to respectively mate with connectors 2020, 2030 that are connected to two different fluid sources.
  • the two connectors 2020 and 2030 may comprise different configurations comprising attributes such as shape, the presence or absence of thread, keys, etc.
  • Example connector configurations are shown in FIGS. 25-28.
  • a handle 2140 is movably coupled to the body 21 10 and comprising an access control
  • the access control element 2142 is a paddle extending from a shaft 2141 that is, in this example, perpendicular to the body 21 10.
  • the handle 2140 is shown in FIG. 19 in a latched position, wherein the access control element 2142 is positioned in front of inlet 2130, thereby preventing a user from connecting a connector 2030 to the inlet 2130.
  • the access control element 2142 is disposed in front of the inlet 2130.
  • the access control element 2142 is disposed proximate to the inlet 2130, e.g. adjacent to the side of the inlet 2130, so as to interfere with the attachment of a
  • the body 21 10 may include one or more keying holes 21 1 1 that engage pins, posts, or other keying features (not shown in FIG. 19) of the connectors 2020, 2030.
  • FIG. 20 depicts the back of the adapter 2100.
  • a center plane 2101 is defined relative to the body 21 10 and bisects the body 21 10.
  • the adapter 2100 has a first position, as shown in FIG. 20, and a second position that is rotated 180°from the first position with respect to the plane of symmetry. Positions of the adapter 2100 are discussed in greater detail with respect to FIGS. 23 and 24.
  • the adapter 2100 also comprises first and second coupling ports 21 16 that are symmetrically located on opposite sides of the center plane 2101 on a back side of the body 21 10.
  • the first and second coupling ports 21 16 are in respective fluid communication with the first and second inlets 2120, 2130.
  • the coupling ports 21 16 may be respectively aligned with the first and second inlets 2120, 2130.
  • the coupling ports 21 16 may be respectively offset from the first and second inlets 2120, 2130.
  • the handle 2140 comprises a latching pin 2144 that is disposed within a securing feature, for example slot 21 14 formed in the alignment feature 21 12.
  • the latching pin 2144 in this example, extends outward from the portion of the shaft 2141 that extends beyond the bottom of the body 21 10.
  • the function of the pin latching 2144 and the method by which the handle 2140 secures the adapter 2100 to a device, for example a ventilator (not shown), is discussed in greater detail with respect to FIGS. 22A-22B.
  • FIG. 21 A is a cross-sectional side view of the exemplary fluid inlet adapter 2100 and a device 2010 according to certain aspects of the present disclosure.
  • the device 2010 has a housing 2052 with, in this example, a docking station 2050 having an alignment slot 2066 that is configured to accept the alignment feature 21 12.
  • a recess 2062 adjacent to the alignment slot 2066 that is configured to accept an end of the handle 2140.
  • a latching slot 2064 extends laterally from the recess 2062 and is configured to engage the pin 2144 when the handle 2140 is rotated such that the pin extends from the alignment feature 21 12, as is discussed in greater detail with respect to FIGS. 22A-22B.
  • the housing 2052 comprises a fluid passage 2080 is configured to accept a flow of a fluid.
  • the device 2010 is a ventilator and the fluid passage 2080 connects to a blower (not shown) that pumps the fluid from fluid passage 2080 to a patient as is generally known to those of skill in the art and not repeated herein.
  • the fluid passage 2080 is positioned relative to the alignment slot 2066 such that one of the coupling ports 21 16 will be at least partially disposed within the fluid passage 2080 when the adapter 2100 is secured to the device 2010 in either a first or second position.
  • FIG. 21 A depicts the example adapter 2100 secured to the docking station 2050 in the first position, wherein the coupling port 21 16 that is in fluid communication with inlet 2120 is also at least partially disposed within and in fluid communication with the fluid passage 2080.
  • the adapter 2100 In the second position (not shown in FIG. 21 A), the adapter 2100 is upside down from the position shown in FIG. 21 A such that the coupling port 21 16 that is in fluid communication with inlet 2130 is also at least partially disposed within and in fluid communication with the fluid passage 2080.
  • the coupling ports 21 16 may have a sealing feature 21 18, for example an O-ring, which is configured to detachably and sealingly mate with the fluid passage 2080.
  • the housing also comprises a blind recess 2054 that accepts the un-used coupling port 21 16.
  • the docking location 2050 may have a recess 2056 configured to accept the body 21 10 such that the front of the body 21 10 is flush with the surface of the housing 2052.
  • the docking location 2050 may also have a recess 2070 position under a keying hole 21 1 1 .
  • the recess 2070 may provide clearance for a keying feature of a mating connector or may provide a retention function.
  • FIG. 21 B is a cross-sectional side view of the exemplary adapter 2100 of FIG.
  • FIGS. 22A-22B depict the position of the handle 2140 in exemplary unlatched and latched positions according to certain aspects of the present disclosure.
  • FIG. 22A depicts the position of the handle 2140 while in an "unlatched" position suitable for insertion of the alignment feature 21 12 into the alignment slot 2066 of the docking station 2050.
  • the pin 2144 is positioned completely within the slot 21 14 so as not to interfere with the alignment slot 2066.
  • FIG. 22B depicts a "latched" position with handle 2140 rotated so as to engage pin 2144 in latching slot 2064.
  • the access control element 2142 is disposed in front of the inlet 2130 thereby obstructing access to the inlet 2130 so as to discourage connection of a connector 2030 to the inlet 2130 while the adapter 2100 is secured to the device 2010 in this position.
  • FIGS. 23 and 24 depict an exemplary inlet adapter 2100 configured to accept fluid from two different sources 2020, 2030 according to certain aspects of the present disclosure.
  • FIG. 23 depicts the adapter 2100 configured to enable inlet 2120 to allow a connector 2020 (not shown in FIG. 23) while blocking connection to the inlet 2130. It can be seen that the machine- detectable indicator 2150 is positioned in a first position, e.g. on the near side of alignment feature 21 12.
  • FIG. 24 depicts the adapter 2100 reversed in orientation and configured to allow inlet 2130 to accept a connector 2030 (not shown in FIG. 24) while blocking connection to the inlet 2120. It can be seen that when the adapter 2100 is disposed in this position, which is the reverse of the position of FIG. 23, that the machine-detectable indicator 2150 is positioned in a second position, e.g. on the far side of alignment feature 21 12, that is also the reverse of FIG. 23.
  • the device 2050 may have a first sensor (not shown in FIG. 23) positioned so as to detect the presence of the sensor in the position of FIG. 23 and a second sensor positioned so as to detect the presence of the sensor in the position of FIG. 24.
  • the use of two sensors may provide a positive indication of the position of the adapter 2100 and, therefore, a positive indication of which gas is being provided.
  • FIGS. 25-28 depict example connector configurations according to certain aspects of the present disclosure.
  • the adapter 2100 may comprise inlets that are configured to accept one of these types of connectors.
  • FIG. 25 depicts an "Ohmeda style" gas connection 2200 wherein the gas-specific configuration of the connector is accomplished by one or more notches 2220 on the outlet face 2210 and a pin 2230 on the adaptor.
  • the notches 2220 and pins 2230 may vary in position and/or size based on the gas required.
  • FIG. 26 depicts a "Chemetron style" gas connection 2300 wherein the
  • gas-specific configuration of the connector is accomplished by the position and shape of the latching hole 2320 on the outlet face and alignment tabs 2330 that mate with recesses 2340.
  • the latching hole 2320 will vary in position and shape based on the gas required.
  • FIG. 27 depicts a "Diameter Index Safety System (DISS) style" gas connection
  • FIG. 28 depicts a "Schrader style" gas connection 2500 wherein the gas-specific configuration of the connector is accomplished by geometric indexing, i.e. each gas has a unique shape and size of the barrel 2510.
  • the disclosed embodiments of the inlet adapter provide a reliable means of configuring a device, such as a ventilator, to accept only one of a possible variety of gases. While the disclosed embodiment of the adapter has two inlets and accepts gas through one inlet while blocking the other inlet, other embodiments of the adapter may have three or more inlets and may be configured to accept gas through more than one of the three or more inlets.
  • the machine-detectable indicator that is disclosed as a magnet herein may be any machine-readable element, for example a barcode or 2D matrix positioned to be read by a camera or scanner when the adapter is configured in a certain position.
  • FIGS. 29-33 show implementations of adapters having one inlet.
  • FIG. 29 shows an adapter 3100.
  • the adapter 3100 has a housing 3 105, an inlet 3 101 extending through the housing 3 105, a machine-detectable or machine-readable indicator 3120, and a latching component 31 10.
  • the inlet 3101 has a first end 3 102 for connecting to a particular fluid source, and a connector 3103 for connecting to a flow control device 3200 (see in FIG. 30), which may be a flow cassette or other valve system.
  • the latching component 31 10 which may be a threaded nut that can be screwed by hand, is configured to interface with a threaded connector 3210 of the flow control device 3200.
  • the latching component 31 10 includes a groove 31 12.
  • the machine-readable indicator 3 120 may be a tab which includes magnet positions 3 122 A, 3122B, 3122C, and 3122D, which may hold one or more magnets in a magnet configuration 3125. In some embodiments, one or more magnet positions 3122A, 3 122B, 3122C, and 3122D may not hold any magnet. Although the magnet positions 3122A-D may be in a linear arrangement, in other implementations, other arrangements may be used.
  • FIG. 30 shows another adapter 3300.
  • the adapter 3 101 has a magnet configuration 3126, which may have magnets in magnet positions 3122B and 3122C.
  • the magnets may be embedded within the machine-readable indicator 3120.
  • an adapter 3400 has a magnet configuration 3127, which may have magnets in magnet positions 3122B and 3122D.
  • the magnet configurations may be detected by a sensor 3220 of the flow control device 3200.
  • the sensor 3220 may include magnet sensors 3222A, 3222B, 3222C, and 3222D, which may correspond to the magnet positions 3122A-D.
  • FIG. 31 shows the adapter 3 100 connected to the flow control device 3200, which may be secured by tightening the latching component 31 10.
  • the sensor 3220 aligns with the machine-readable indicator 3120.
  • the sensor 3220 is configured to detect the magnet configurations of adapters.
  • the magnet configurations correspond to specific fluid sources.
  • the magnet configuration 3126 may correspond to heliox
  • the magnet configuration 3127 may correspond to oxygen.
  • the inlet 3101 may be configured for connection to the corresponding fluid source.
  • the flow control device 3200 can identify the fluid passing through the flow control device 3200.
  • the various processors of the ventilator 1 100 may use parameters corresponding to the identified fluid for further calculations as described herein.
  • FIG. 32 shows the adapter 3100 without the latching component 31 10.
  • the housing 3105 includes a first protrusion 3106, and a second protrusion 3107.
  • the housing 3105 also includes a first pin 31 1 6, and a second pin 31 1 8.
  • the first and second pins 31 16 and 31 1 8 are configured to interface with the groove 31 12 of the latching component 31 10, allowing the latching component 3 1 10 to rotate freely without being separated from the housing 3105.
  • the threaded connector 3210 includes a first notch 3212 and a second notch 3214.
  • FIG. 33 further shows the adapter 3100 and the flow control device 3200.
  • a first width 3108 of the first protrusion 3106 corresponds to a first width 3213 of the first notch 3212.
  • a second width 3109 of the second protrusion 3107 corresponds to a second width 3215 of the second notch 3214.
  • the first protrusion 3106 is configured to fit into the first notch 3212, and the second protrusion 3107 is configured to fit into the second notch 3214. Because the first and second widths are different, the adapter 3100 can only fit into the threaded connector 3210 in one orientation, to mitigate incorrect insertions.
  • a distance 3104 between the inlet 3101 and the machine-readable indicator 3 120 corresponds to a distance 3221 between the threaded connector 3210 and the sensor 3220 such that the sensor 3220 can detect the machine-readable indicator 3120.
  • the machine-readable indicator 3120 may be properly aligned with the sensor 3220 when the latching component 31 10 is fully tightened.
  • the magnet configuration is unknown (e.g., a magnet is missing or in the wrong magnet position)
  • an alarm condition may occur.
  • pressurized gas may leak, causing an audible notification to the operator.
  • the connector 3103 may be configured to have a length such that the connector 3103 provides fluid communication with the flow control device 3200 at an intermediate portion along the threaded connector 3210's path when being connected.
  • the length of the connector 3 103 extends such that there may be fluid communication even when the latching component 31 10 is not fully engaged.
  • an audible hissing sound may inform the operator that the supply must be turned off and/or that the adapter 3100 should be fully removed from the source to limit complications associated with improper removal procedures.
  • multiple adapters 3100 allow a single flow control device 3200 to connect to various fluid sources, rather than having a flow control device for each possible fluid source. Reducing the number of flow control devices may reduce the size of the ventilator.
  • the multiple adapters may be tethered to the ventilator in order to prevent misplacement of the adapters.
  • a flow cassette 4200 may be installed within the housing 1 1 10 behind the gas inlet adapter 1 120 and in fluid communication between the inlet connector 1 126 shown in FIG. 1 I B and the supply port 1 155 shown in FIG. 1 1 A.
  • FIG. 34 is a block diagram of an exemplary flow cassette 4200 according to certain aspects of the present disclosure.
  • the flow cassette 4200 may correspond to the flow cassette control system 340 described above.
  • the flow cassette 4200 includes an inlet 4222 that is configured to sealingly mate with an input flow channel, for example a coupler 4122 of the gas inlet adapter 4120.
  • the gas inlet adapter 4120 also has an inlet connector (not shown in FIG. 34) that is fluidly connected to the coupler 4122.
  • Various breathing gases and gas mixtures are associated with individually unique connector types, sizes, and configurations, wherein the association is generally recognized in the medical industry.
  • Each gas inlet adapter 4120 has one or more inlet connectors that are adapted to respectively accept a connector that is unique to a certain type of gas or gas mixture.
  • the number and placement of magnets 4124 are uniquely associated with the inlet connector that will be coupled to the inlet of the flow cassette 4200 when that gas inlet adapter 4120 is installed in a ventilator and thereby mated with the flow cassette 4200.
  • the gas inlet adapter 4120 may be configured to accept one or more of a standard composition of ambient air, a pure oxygen, and a heliox gas mixture.
  • the inlet 4222 is fluidly connected to a passage 4223 that runs through the flow cassette 4200 to an outlet 4232 that is configured to sealingly mate with an output flow channel of the ventilator 4100 that, for example, leads to the supply limb 4104.
  • a check valve 4260 a filter 4264
  • a porous disk 4410 a porous disk 4410
  • a valve 4300 a valve 4300. In certain embodiments, some of these elements may be omitted or arranged in a different order along the passage 4223.
  • the flow cassette 4200 also includes a Hall effect sensor 4258 configured to detect the number and placement of the magnets 4124 of the gas inlet adapter 4120.
  • the processor 4252 can automatically determine what gas will be provided through the gas inlet adapter 4120 as installed in the ventilator 4100.
  • the gas inlet adapter 4120 may include another type of indicator, for example a machine-readable element, that is associated with the configuration of the gas inlet adapter 4120 and the flow cassette 4200 may include a sensor that is capable of reading the machine-readable element and thereby automatically detecting the configuration of the gas inlet adapter 4120.
  • the flow cassette 4200 includes a flow sensor 4400 that has a flow restriction 4410 that, in this example, is a porous disk disposed in passage 4223 such that all gas flowing through the passage 4223 must pass through the porous disk 4410.
  • the flow sensor 4400 also includes an upstream pressure sensor 4420A and downstream pressure sensor 4420B with gas passages 4424 from the sensors to sensing ports 4421 A and 442 I B disposed in the passage 4223 on upstream and downstream sides, respectively, of the porous disk 4410.
  • the pressure drop can be used to determine the true flow rate, sometimes referred to as "the compensated flow rate,” of the gas that is passing through the porous disk 4410.
  • the pressure drop across the porous disk 4410 is related in a monotonic way to the rate of gas passing through the porous disk 4410.
  • the porous disk 4410 is characterized as to its flow resistance characteristics with a selection of gases and gas mixtures at a standard temperature.
  • gases such as helium
  • certain gases have a smaller molecular size and pass more easily through the thickness of the porous disk 4410 compared to a gas, such as nitrogen, with a larger molecule.
  • a certain pressure drop will indicate a first flow rate for a small-molecule gas and a second, lower flow rate for a large-molecule gas.
  • Gas mixtures will tend to have flow rates that reflect the percentage composition of the gases that make up the gas mixture.
  • the pressure drops of certain predetermined medical gases and gas mixtures are specifically characterized for the porous disk 4410 and stored in a look-up table contained in the memory 4254 of the electronics module 4250.
  • the temperature of a gas also affects the pressure drop for a given flow rate of that gas flowing through the porous disk 4410.
  • the effect of the gas temperature is also characterized for the porous disk 4410 and stored in the memory 4254.
  • the characterization of the flow characteristics of the porous disk 4410 also referred to herein as "compensation parameters," are combined for gas type and temperature in a single look-up table.
  • compensation parameters may be stored in other forms, for example equations that include scaling parameters, to enable conversion of a raw pressure drop measurement into an accurate flow rate.
  • the flow cassette 4200 includes an electronics module 4250.
  • the conversion of the raw pressure measurements by pressure sensors 4420A, 4420B into a pressure drop measurement is accomplished in a separate pressure sensing electronics 4422 and provided to a flow sensor processor 4252.
  • the pressure sensing electronics 4422 may provide the processor 4252 with individual pressure signals for pressures that are upstream and downstream of the porous disk 4410.
  • the pressure sensors 4420A, 4420B may provide the raw signals directly to the processor 4252.
  • the pressure sensors 4420A, 4420B may include conversion circuitry such that each sensor 4420A, 4420B provides a pressure signal directly to the processor 4252.
  • the temperature sensor 4270 provides a signal that includes a temperature to the pressure sensing electronics 4422. In certain embodiments, the temperature sensor 4270 provides this temperature signal directly to the processor 4252. In certain embodiments, the temperature sensing element 4271 may be connected directly to the pressure sensing electronics 4422 or to the processor 4252. In certain embodiments, the temperature sensor 4270 may be configured to sense the gas temperature over a range of temperatures of at least 5-50° C. In certain embodiments, the temperature sensor 4270 may be configured to sense the gas temperature over a range of temperatures of at least 5-50° C.
  • the processor 4252 is connected to the memory 4254 and an interface module 4256 as well as the sensors 4270, 4420A, and 4420B.
  • the various drive, sensing, and processing functions of these sensors 4270, 4420A, and 4420B may be accomplished in various different modules, such as the processor 4252 and pressure sensing electronics 4422, depending on the particular design and layout of the flow cassette 4250 without departing from the scope of this disclosure.
  • a processor 4252 may be configured to provide a supply an electrical current directly to the temperature sensing element 4271 and to directly measure a voltage drop across the temperature sensing element 4271 without the need for intervening electronics. All functions disclosed herein may be accomplished in the block elements of FIG. 34 as described or in alternate blocks and the blocks depicted in Fig. 34 may be combined or divided without departing from the scope of this disclosure.
  • the memory 4254 is configured to store operating instructions for the processor 4252 and data that may include calibration data for the sensors 4258, 4270, 4420A, and 4420B.
  • the data may also include information, as discussed above, such as equations or look-up tables to use the two pressure measurements from pressure sensors 4420A and 4420B and the temperature measurement from the temperature sensor 4270 to determine a flow rate through the porous disk 4410.
  • the memory comprises non-volatile memory such as magnetic disk, a solid-state memory, a flash memory, or other non-transient, non-volatile storage device as known to those of skill in the art.
  • the processor 4252 is also operatively coupled to the valve 4300 and is capable of actuating the valve 4300.
  • the interconnection of the processor 4252 with the other elements as shown in FIG. 34 may be accomplished by direct connection via any technology known to those of skill in the art, for example twisted-pair wires or fiber-optic cables, or via a network connection with microprocessors embedded in the other elements.
  • the interface module 4256 may include signal transceivers for wired or wireless communication with other devices within the ventilator 4100 or may connector to an external interface, such as the rear interface panel 1 165 shown in FIG. 1 I B, to communicate with devices external to the ventilator 1 100.
  • FIG. 35A depicts an exemplary flow cassette 4200 according to certain aspects of the present disclosure.
  • the flow cassette 4200 has a body 4210 with an inlet end 4220 and an outlet end 4230.
  • At the inlet end 4220 there is the inlet 4222 that is configured to sealingly mate with a coupler 4122 (not shown in FIG. 35A) of a gas inlet adapter 4120.
  • the inlet end 4220 may also include locating features 4226, for example protruding pins, that align the gas inlet adapter 4120 to the inlet 4222 and a mating face 4224 that provides a reference surface for the mated gas inlet adapter 4120.
  • a solenoid 4240 is attached to the body proximate to the outlet end 4230 to drive a pressure control valve (not visible in FIG. 35A) disposed within the body 4210.
  • the electronics module 4250 is attached, in this embodiment, to the top of the body 4210. The details of the electronics module are discussed in greater detail with respect to FIG. 34.
  • FIG. 35B is a cross-section of the flow cassette of FIG. 35 A according to certain aspects of the present disclosure.
  • the dashed-line box 4400 indicates the elements that make up the flow sensor 4400, which is discussed in greater detail with respect to FIGS 34 and 35C.
  • the passage 4223 that connects the inlet 4222 and outlet 4232 is visible in the cross-section of FIG. 35B, with the porous disk 4410 disposed within the passage 4223.
  • FIG. 35C is an enlarged view of a portion of FIG. 35B showing the exemplary flow sensor 4400 according to certain aspects of the present disclosure.
  • the pressure sensors 4420A, 4420B are disposed within the package of the pressure sensing electronics 4422 and connected to the passage 4223 by gas passages 4424 leading to sensing ports 4421 A and 4421 B.
  • the temperature sensing element 4271 is exposed to the interior of the passage 4223 and therefore in contact with the gas within the passage 4223.
  • Seals 4426 in this example a pair of O-rings, provide a gas-tight seal between the housing 4210 and the tube extensions 4428 for the gas passages 4424 and a feed-through 4429 for the temperature sensing element 4271.
  • FIG. 36 is a flow chart of an exemplary flow measurement process 4500 according to certain aspects of the present disclosure.
  • the process 4500 starts in step 4510 by determining which gas or gas mixture, for example oxygen or heliox 70/30, will be flowing through the flow sensor 4400.
  • step 4515 the gas pressures upstream and downstream of the flow restriction 4410 are measured and a pressure drop across the flow restriction 4410 is calculated in step 4520.
  • step 4525 the processor 4252 calculates an uncompensated flow rate based at least partially on the pressure drop.
  • the temperature of the gas flowing through the flow sensor 4400 is measured in step 4530 and in step 4535 the processor 4252 loads information from the memory 4254 that may include compensation parameters related to the flow sensor 4400.
  • the processor 4252 calculates a compensated flow rate using the retrieved compensation parameters in step 4540 and provides this compensated flow rate, for example to a processor of the ventilator 1 100, in step 4545.
  • Step 4550 is a decision point that checks whether a "stop" command has been received, in which case the process 4500 branches along the "yes" path to the end and terminates. If a "stop" command has not been received, the process 4500 branches along the "no" path back to step 4515 and measures the pressures and temperature. The process 4500 will loop through the steps 451 5-4550 until a "stop" command is received.
  • the disclosed embodiments of the flow sensor provide an accurate measurement of a gas flow rate in a compact and modular form.
  • the accuracy of the flow rate may be improved by compensating for one or more of the gas temperature and the gas composition. This compensation may be accomplished through prior experimental calibration of the particular flow restriction, e.g. porous disk, or calculations based on gas flow theory.
  • the modular form enables this subsystem to be independently tested and calibrated as well as simplifying assembly and replacement.
  • flow cassette 5200 similar to flow cassette 4200, may be installed within the housing 1 1 10 behind the gas inlet adapter 1 120 and in fluid
  • FIG. 37 is a block diagram of an exemplary flow cassette 5200 according to certain aspects of the present disclosure.
  • the flow cassette 5200 includes an inlet 5222 that is configured to sealingly mate with an input flow channel, for example a coupler 5122 of the gas inlet adapter 5120.
  • the gas inlet adapter 5120 also has an inlet connector 5126 that is fluidly connected to the coupler 5122.
  • Various breathing gases and gas mixtures are associated with individually unique connector types, sizes, and configurations, wherein the association is generally recognized in the medical industry.
  • Each gas inlet adapter 5120 has one or more inlet connectors 5126 that are adapted to respectively accept a connector that is unique to a certain type of gas or gas mixture.
  • the gas inlet adapter 5120 may include one or more magnets 5124 wherein the number and placement of magnets 5124 are uniquely associated with the inlet connector 5126 that will be coupled to the inlet 5222 of the flow cassette 5200 when that gas inlet adapter 5120 is installed in a ventilator 1 100 and thereby mated with the flow cassette 5200.
  • the gas inlet adapter 5120 may be configured to accept one or more of a standard composition of ambient air, a pure oxygen, and a heliox gas mixture.
  • the inlet 5222 is fluidly connected to a passage 5223 that runs through the flow cassette 5200 to an outlet 5232 that is configured to sealingly mate with an output flow channel of the ventilator 1 100 that, for example, leads to the supply limb 1 104 in FIG. 10.
  • a check valve 5260 a filter 5264
  • a porous disk 5410 a valve 5300.
  • some of these elements may be omitted or arranged in a different order along the passage 5223. These elements are discussed in greater detail with respect to FIGS. 39A and 39B.
  • the flow cassette 5200 also includes a Hall Effect sensor 5258 configured to detect the number and placement of the magnets 5124 of the gas inlet adapter 5120. By comparing the detected number and placement of the magnets 5124 to stored information associating the number and placement of the magnets 5124 with gases that will be accepted by the inlet connector that is coupled to the inlet of the flow cassette 5200, the processor 5252 can automatically determine what gas will be provided through the gas inlet adapter 5120 as installed in the ventilator 1 100.
  • the gas inlet adapter 5120 may include another type of indicator, for example a machine-readable element, that is associated with the configuration of the gas inlet adapter 5 120 and the flow cassette 5200 may include a sensor that is capable of reading the machine-readable element and thereby automatically detecting the configuration of the gas inlet adapter 5 120.
  • another type of indicator for example a machine-readable element, that is associated with the configuration of the gas inlet adapter 5 120 and the flow cassette 5200 may include a sensor that is capable of reading the machine-readable element and thereby automatically detecting the configuration of the gas inlet adapter 5 120.
  • the flow cassette 5200 includes an electronics module 5250.
  • the electronics module 5250 includes a temperature sensor 5270 that has a temperature sensing element 5271 disposed in the passage 5223.
  • the electronics module 5250 also includes pressure sensors 5420A and 5420B that are respectively connected through passages to ports 5421 A and 542 I B in the passage 5223 that are disposed on opposite sides of the porous disk 5410.
  • the electronics module 5250 also includes a flow cassette processor 5252 that is connected to a memory 5254 and an interface module 5256.
  • the processor 5252 is also coupled to the sensors 5258, 5270, 5420A and 5420B and is configured to receive signals from each sensor that are associated with the measured parameter of each respective sensor.
  • the memory 5254 is configured to store operating instructions for the processor 5252 and data that may include calibration data for the sensors 5258, 5270, 5420A, and 5420B.
  • the data may also include information such as equations or look-up tables to use the two pressure measurements from pressure sensors 5420A and 5420B to determine a flow rate through the porous disk 5410.
  • additional sensors e.g.
  • the processor 5252 is also operatively coupled to the proportional valve 5300 and is capable of actuating the valve 5300.
  • the interconnection of the processor 5252 with the other elements as shown in FIG. 37 may be accomplished by direct connection via any technology known to those of skill in the art, for example twisted-pair wires or fiber-optic cables, or via a network connection with microprocessors embedded in the other elements.
  • the interface module 5256 may include signal transceivers for wired or wireless communication with other devices within the ventilator 1 100, for example a central processor (not shown in FIG. 37), or may connect to an external interface, such as the rear interface panel 5165 shown in FIG. 1 I B, to communicate with devices external to the ventilator 1 100.
  • Interface 5256 may be configured to accept both power and communication signals and, in certain embodiments, may include one or more voltage converters to provide power to the module.
  • FIGS. 38A-38B depict an exemplary flow cassette 5200 according to certain aspects of the present disclosure.
  • the flow cassette 5200 has a body 5210 with an inlet end 5220 and an outlet end 5230.
  • the inlet end 5220 includes an inlet 5222 that is configured to sealingly mate with a coupler 5122 (not shown in FIG. 38A) of the gas inlet adapter 5 120.
  • the inlet end 5220 may also include locating features 5226, for example protruding pins, that align the gas inlet adapter 5120 to the inlet 5222 and a mating face 5224 that provides a reference surface for the mated gas inlet adapter 5120.
  • a solenoid 5240 is attached to the body proximate to the outlet end 5230 and is discussed in greater detail with respect to FIG. 39A.
  • the electronics is attached to the body proximate to the outlet end 5230 and is discussed in greater detail with respect to FIG. 39A.
  • module 5250 is attached, in this embodiment, to the top of the body 5210. The details of the electronics module are discussed in greater detail with respect to FIG. 37.
  • FIG. 38B is a reverse-angle view of the flow cassette 5200 that shows the outlet 5232 and the seal 5234, in this example two O-rings, that are arranged at the outlet end 5230.
  • the outlet end 5230 is configured to sealingly mate with other gas passages (not shown in FIG. 38B) within the ventilator 1 100.
  • FIG. 39A is a cross-section of the flow cassette 5200 of FIGS. 38A-38B according to certain aspects of the present disclosure. An enlarged view of the region indicated by the dashed-line box labeled "A" is shown in FIG. 39B.
  • the dashed-line box 5400 indicates elements of the flow sensor 5400, including the pressure sensors 5420A, 5420B and a flow restriction 5410 that, in this example, is a porous disk.
  • the porous disk 5410 provides a known flow resistance that creates a pressure drop across the porous disk 5410 that varies with flow rate and may be calibrated for one or more gases or gas mixtures.
  • An actual pressure drop can be determined by measuring the pressures upstream and downstream of the porous disk 5410 with the pressure sensors 5420A and 5420B and determining the pressure difference between the pressure measurements.
  • the pressure drop can be used to determine the true flow rate, sometimes referred to as "the compensated flow rate," of the gas that is passing through the porous disk 5410.
  • the flow sensor 5400 may also include pressure sensing electronics 5422 that filter and condition the signals from the pressure sensors 5420A, 5420B and may convert the signals to digital form.
  • the dashed-line box 5300 indicates elements of the proportional valve 5300, including the solenoid 5240 and a plug 5320 that fits into a bore 5310 of the passage 5223.
  • the plug 5320 and bore 53 10 form an on-off fluid valve and the solenoid 5240 is configured to either fully retract or fully extend the plug 5320 so as to open or close the valve 5300.
  • the plug 5320 and bore 5310 form a variable-flow orifice and the solenoid 5240 is configured to adjustably position the plug 5320 with respect to the bore 5310 through a feedback control loop operative within the flow cassette processor 5252 that is operatively coupled to the solenoid 5240.
  • the flow cassette processor 5252 may actuate the solenoid 5240 so as to provide a determined flow rate, as sensed by the flow sensor 5400, or a determined pressure at the outlet 5232, as sensed by pressure sensor 5420B.
  • FIG. 39B is an enlarged view of a portion of FIG. 39A according to certain aspects of the present disclosure.
  • Gas entering the inlet 5222 passes to a check valve 5260 that is configured to allow flow through the passage 5223 toward the outlet 5232 while resisting flow in the opposite direction.
  • the check valve 5260 includes, in this embodiment, a rigid structure 5261 having a plurality of through holes 5263 with a flexible disk 5262 attached to the rigid structure
  • a filter 5264 that, in this embodiment, is formed as a hollow cylinder that is held in place by a cap 5266 having legs 5267 that contact the rigid structure 5261 of the check valve 5260 so as to retain the cap 5266 and filter 5264 in place. Gas passes around the outside of the cylinder and then passes inward through the filter 5264 to the hollow center and then flows out of the filter 5264.
  • the filter 5264 comprises a mechanical filter configured to trap particulates above a determined size.
  • the filter 5264 comprises one or more chemical filters, for example an activated charcoal or a desiccant, that are configured to absorb certain materials such as water or odors.
  • the temperature sensing element 5271 is disposed proximate to the filter 5264 and flush with the wall of the passage 5223.
  • FIG. 40 is a flow chart of an exemplary configuration process 5500 according to certain aspects of the present disclosure.
  • the process 5500 starts in step 5510 by installing a flow cassette 5200 in a ventilator 1 100.
  • the user determines which gas or gas mixture, for example oxygen or heliox 70/30, will be provided to the patient, selects the proper gas inlet adapter 5120, and attaches the gas inlet adapter 5120 to the ventilator 1 100 in the proper configuration such that the correct connector of the gas inlet adapter 5120 for the determined gas or gas mixture is coupled to the flow cassette 5200.
  • gas or gas mixture for example oxygen or heliox 70/30
  • the processor 5252 of the flow cassette 5200 can automatically determine in step 5520 which gas or gas mixture is being provided by sensing the magnet 5124 through the Hall Effect sensor 5258, as discussed with respect to FIG. 37.
  • the processor 5252 loads information from the memory 5254 that may include calibration and/or compensation parameters related to the flow sensor 5400.
  • the ventilator 1 100 is now configured for use. After the user connects a breathing circuit with a patient, generally as shown in FIG. 10, the user starts the ventilator 1 100 in step 5530.
  • the flow cassette 5200 measures the pressures on both sides of the porous disk 5410 and the temperature of the gas passing through the flow cassette 5200 in step 5535 using the flow sensor 5400 and temperature sensor 5270, respectively, as described with respect to FIGS. 37 and 39A.
  • the processor 5252 applies the compensation and calibration information downloaded in step 5525 to calculate the actual flow rate of the gas and provides this flow rate information in step 5545, for example to a processor in the ventilator 1 100.
  • Step 5550 is a decision point that branches depending on whether a "stop" command has been received. If the user has provided a "stop” command, the process 5500 branches along the "yes" path to the end and terminates. IF the user has not provided a "stop” command, the process 5500 branches along the "no" path back to step 5535 and measures the pressures and temperature. The process 5500 will loop through the
  • the disclosed embodiments of the flow cassette consolidate certain mechanical functions, such as backflow prevention and filtration, and the sensing of certain parameters, such as flow rate, in a compact and modular form.
  • the flow cassette includes electronics that process the raw measurements using internally stored compensation and calibration data and provide more accurate values of the sensed parameters.
  • the flow cassette may be configured to provide either a determined pressure or a determined flow rate of the supply gas at the outlet. The modular form enables this subsystem to be independently tested and calibrated as well as simplifying assembly and replacement.
  • FIG. 41 illustrates a ventilator 6000, which may correspond to the ventilator 1 100.
  • the ventilator 600 comprises various component parts, which may each be removed with a common tool, such as a Philips screwdriver.
  • the ventilator 600 comprises a blower 6050, a first flow valve 6055, a second flow valve 6060, a filter chamber 6070, and insulated flow path 6075, and a flow combiner 6080.
  • the component parts may be designed to fit within specific interior dimensions of the ventilator 6000.
  • Each of the component parts may be removed and replaced with alternative component parts, which may have similar dimensions as the part being replaced.
  • the blower 6050 which may correspond to the blower 350 and/or the blower
  • the blower 6050 may include a HEPA filter.
  • the first flow valve 6055 which may correspond to the 0 2 flow cassette 355 and/or the inflow valve 755, receives another gas, such as pressurized oxygen from a gas supply.
  • the flow combiner 6080 may combine the gases from the blower 6050 and the first flow valve 6055.
  • the flow combiner 6080 may connect to the patient for an inspiration phase.
  • the flow combiner 6080 may include a flow sensor for detecting flow to the patient, a safety valve which may open to protect the patient during an overpressure condition, and an occluder valve which blocks inflow to allow a clinician to measure inspiratory effort by the patient.
  • the patient's expiration flow may be connected to the filter chamber 6070.
  • the filter chamber 6070 may include a chamber, and may also be configured to accumulate condensation from expiration.
  • the filter chamber 6070 may include or be connected to a heater for warming the expiration and reducing condensation.
  • the expiration flow may continue through the insulated flow path 6075, which includes insulation to prevent the expiration from cooling down and causing condensation.
  • the expiration flow continues to the second flow valve 6060, which may correspond to the exhalation valve 360 and/or the exhalation valve 760.
  • top, bottom, front, and rear may extend upwardly, downwardly, diagonally, or horizontally in a gravitational frame of reference.
  • a phrase such as an "aspect” does not imply that such aspect is essential to the subject technology or that such aspect applies to all configurations of the subject technology.
  • a disclosure relating to an aspect may apply to all configurations, or one or more configurations.
  • a phrase such as an aspect may refer to one or more aspects and vice versa.
  • a phrase such as an “embodiment” does not imply that such embodiment is essential to the subject technology or that such embodiment applies to all configurations of the subject technology.
  • a disclosure relating to an embodiment may apply to all embodiments, or one or more embodiments.
  • a phrase such an embodiment may refer to one or more embodiments and vice versa.
  • a ventilator comprising: a blower comprising: a housing defining an impeller cavity; an impeller plate disposed within the impeller cavity and comprising an outside edge; and one or more vanes disposed on the impeller plate and comprising a leading surface and a trailing surface connecting at a tip; and a flow control device comprising: a fixed magnetic field; a drive coil configured to move within the fixed magnetic field in response to a low frequency signal and configured to receive a high frequency signal; a detection coil adjacent the drive coil and configured to detect the high frequency signal in the drive coil, the detected high frequency signal corresponding to a position of the drive coil; and a processor coupled to the high frequency source and the low frequency source and configured (i) to receive the detected high frequency signal form the detection coil and (ii) to adjust the low frequency signal to move the drive coil, wherein the blower is in fluid communication with the flow control device.
  • Concept 1 may or may not provide that the leading surface comprises a first portion abutting a second portion, the first portion extends from the tip with a first radius, the second portion extends from the tip with a second radius, the first radius is smaller than the second radius.
  • a ventilator comprising: a flow cassette comprising: a fluid passage terminating at an inlet and an outlet; a temperature sensor disposed within the fluid passage and configured to detect a temperature; a flow rate sensor disposed within the fluid passage and configured to detect a flow rate; and a processor configured to determine a compensated flow rate based on the temperature and the flow rate; and a fluid inlet adapter comprising: a first inlet end configured to connect to a fluid source; a second inlet end configured to removably connect to the inlet of the flow cassette; a latching component configured to secure the fluid inlet adapter to the flow cassette; and a machine-readable indicator for identifying the fluid source.
  • Concept 9 may or may not provide that the temperature sensor is disposed within the fluid passage, that the flow rate sense is disposed within the fluid passage, or that the cassette includes a processor configured to determine a compensated flow rate based on the temperature and the flow rate.
  • a flow control device comprising: a drive coil configured to move in response to a low frequency signal; a detection coil configured to detect a position of the drive coil based on a high frequency signal; a flow control device processor configured to receive the high frequency signal and modify the low frequency signal; and a valve orifice defining a variable opening, the variable opening adjustable based on the position of the drive coil.
  • a ventilator comprising: a flow sensor comprising: a fluid passage; a flow restriction disposed within the fluid passage such that a fluid passing through the fluid passage must pass through the flow restriction; a first pressure sensor coupled to a first end of the fluid passage and configured to detect a first pressure; a second pressure sensor coupled to a second end of the fluid passage and configured to detect a second pressure, such that the flow restriction is between the first and second pressure sensors; a temperature sensor coupled to the fluid passage and configured to detect a temperature; and a flow sensor processor configured to determine a compensated flow rate based at least on the first pressure, the second pressure, and the temperature.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Emergency Medicine (AREA)
  • Pulmonology (AREA)
  • Veterinary Medicine (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Physics & Mathematics (AREA)
  • Physics & Mathematics (AREA)
  • Fluid Mechanics (AREA)
  • Mechanical Engineering (AREA)
  • General Engineering & Computer Science (AREA)
  • Structures Of Non-Positive Displacement Pumps (AREA)
  • Control Of Positive-Displacement Air Blowers (AREA)

Abstract

La présente invention se rapporte à un ventilateur modulaire. Ce ventilateur possède des dispositifs de régulation d'écoulement modulaires (4200) qui sont reliés à des adaptateurs d'entrée de fluide (4120). Les dispositifs de régulation d'écoulement modulaires possèdent des capteurs (4400) destinés à réguler l'écoulement de fluide dans les dispositifs de régulation d'écoulement modulaires. Les adaptateurs d'entrée de fluide sont amovibles, et peuvent comprendre des indicateurs magnétiques (4124), et le ventilateur peut identifier le fluide provenant de l'indicateur magnétique. Le ventilateur peut également contenir un dispositif possédant un ventilateur soufflant à faible bruit (100) ou être relié à ce dispositif.
PCT/US2015/038159 2014-06-27 2015-06-26 Système de ventilateur WO2015200879A1 (fr)

Priority Applications (6)

Application Number Priority Date Filing Date Title
MX2016016198A MX2016016198A (es) 2014-06-27 2015-06-26 Sistema ventilador.
CN201580034923.1A CN106794326A (zh) 2014-06-27 2015-06-26 通气机系统
EP15742422.7A EP3160562A1 (fr) 2014-06-27 2015-06-26 Système de ventilateur
JP2017520765A JP2017524100A (ja) 2014-06-27 2015-06-26 ベンチレータ・システム
AU2015279627A AU2015279627A1 (en) 2014-06-27 2015-06-26 Ventilator system
CA2952626A CA2952626A1 (fr) 2014-06-27 2015-06-26 Systeme de ventilateur

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US14/318,504 US20150007815A1 (en) 2013-06-28 2014-06-27 Ventilator system
US14/318,504 2014-06-27

Publications (1)

Publication Number Publication Date
WO2015200879A1 true WO2015200879A1 (fr) 2015-12-30

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PCT/US2015/038159 WO2015200879A1 (fr) 2014-06-27 2015-06-26 Système de ventilateur

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EP (1) EP3160562A1 (fr)
JP (1) JP2017524100A (fr)
CN (1) CN106794326A (fr)
AU (1) AU2015279627A1 (fr)
CA (1) CA2952626A1 (fr)
MX (1) MX2016016198A (fr)
WO (1) WO2015200879A1 (fr)

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CN109798256A (zh) * 2019-01-04 2019-05-24 东莞市旭恒电子有限公司 一种换气风机及其使用方式
CN110461394A (zh) * 2016-12-06 2019-11-15 诺顿（沃特福特）有限公司 具有集成电子模块的吸入装置
CN111441983A (zh) * 2020-05-12 2020-07-24 南京海精电子技术有限公司 风机晃度监测系统及监测方法
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WO2024044662A1 (fr) * 2022-08-24 2024-02-29 Ventis Medical, Inc. Ventilateur mécanique
US12029858B2 (en) * 2016-01-18 2024-07-09 Fisher & Paykel Healthcare Limited Humidification of respiratory gases

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US11401974B2 (en) 2017-04-23 2022-08-02 Fisher & Paykel Healthcare Limited Breathing assistance apparatus
WO2019040233A1 (fr) * 2017-08-24 2019-02-28 Fastest, Inc. Raccords de fluide dotés de capteurs d'état de raccordement modulaire

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US4825904A (en) * 1988-04-18 1989-05-02 Pneumo Abex Corporation Two position flow control valve assembly with position sensing
US5265594A (en) * 1990-10-30 1993-11-30 Siemens Aktiengesellschaft Apparatus for regulating the flow-through amount of a flowing medium
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Cited By (8)

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US11278700B2 (en) 2015-06-24 2022-03-22 Fisher & Paykel Healthcare Limited Breathing assistance apparatus
US12029858B2 (en) * 2016-01-18 2024-07-09 Fisher & Paykel Healthcare Limited Humidification of respiratory gases
CN110461394A (zh) * 2016-12-06 2019-11-15 诺顿（沃特福特）有限公司 具有集成电子模块的吸入装置
CN109798256A (zh) * 2019-01-04 2019-05-24 东莞市旭恒电子有限公司 一种换气风机及其使用方式
CN109798256B (zh) * 2019-01-04 2024-01-12 东莞市旭恒电子有限公司 一种换气风机及其使用方式
CN111441983A (zh) * 2020-05-12 2020-07-24 南京海精电子技术有限公司 风机晃度监测系统及监测方法
CN111441983B (zh) * 2020-05-12 2024-04-12 海南水声技术有限公司 风机晃度监测系统及监测方法
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Also Published As

Publication number Publication date
JP2017524100A (ja) 2017-08-24
AU2015279627A1 (en) 2017-01-12
EP3160562A1 (fr) 2017-05-03
MX2016016198A (es) 2017-07-05
CA2952626A1 (fr) 2015-12-30
CN106794326A (zh) 2017-05-31

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