WO2021203214A1 - System for providing breathing assistance to persons by means of a single ventilator and connection bodies for forming same - Google Patents

System for providing breathing assistance to persons by means of a single ventilator and connection bodies for forming same Download PDF

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Publication number
WO2021203214A1
WO2021203214A1 PCT/CL2021/050023 CL2021050023W WO2021203214A1 WO 2021203214 A1 WO2021203214 A1 WO 2021203214A1 CL 2021050023 W CL2021050023 W CL 2021050023W WO 2021203214 A1 WO2021203214 A1 WO 2021203214A1
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Prior art keywords
respirator
branches
people
connection
respiratory assistance
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PCT/CL2021/050023
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Spanish (es)
French (fr)
Inventor
Ignacio LUGONES
Original Assignee
FERNANDEZ ROJAS, Maite, Alejandra
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Publication of WO2021203214A1 publication Critical patent/WO2021203214A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • 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
    • A61M16/04—Tracheal tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/12—Preparation of respiratory gases or vapours by mixing different gases
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/20—Valves specially adapted to medical respiratory devices

Definitions

  • the present invention refers to a system and its connectors, for respiratory assistance to people through the use of a single respirator, in which a single respirator is used for more than one patient, preferably two, wherein said system comprises a set of elements that allow to adequately connect and ventilate these patients, guaranteeing the ventilation of two or more patients simultaneously, avoiding cross contamination and allowing to configure the most important variables of the “setting” of each one of the patients individually. Preferably, it allows feeding two patients.
  • respirators have a great capacity to move high tidal volumes.
  • Most respirators can deliver up to 2500 ml of tidal volume, a volume that would certainly be excessive for a single patient, thus having the capacity to handle up to five people at the same time.
  • the inspiratory unit of the ventilator regulating the tidal volume that is going to provide a single patient did not contemplate the possibility of needing to separate the tidal volume to distribute it in two or more territories.
  • Figure 1 illustrates an exploded view of the inspiratory limb accessory of the arrangement of the present invention
  • Figure 2 shows a side sectional view of the accessory of the inspiratory limb of Figure 1;
  • Figure 3 illustrates a top view of the accessory of Figure 1;
  • Figure 4 is a perspective view of the accessory of Figure 1;
  • Figure 5 illustrates an exploded view of the expiratory limb accessory of the arrangement of the present invention
  • Figure 6 shows a side sectional view of the accessory of the expiratory limb of Figure 5;
  • Figure 7 is a perspective view of the accessory of Figure 5;
  • Figure 8 illustrates a schematic view of the positioning and connection of the inspiration and expiration accessories in order to form the arrangement for respiratory assistance proposed here;
  • the application accessory in the inspiratory branch of the respirator, used to ventilate two patients with a single artificial respirator which comprises a tubular main body in the shape of a substantially "T", with an inlet route 1, a first outlet 2 for a first patient and a second outlet 3 for a second patient.
  • Said inlet port 1 will be connected to the inspiratory outlet of the artificial ventilator used, outlet port 2 will connect to the inspiratory limb of a first patient, and outlet port 3 will do the same to the inspiratory limb of the second patient.
  • outlet port 3 will do the same to the inspiratory limb of the second patient.
  • a diverter valve 4 with its rotating body 4a and closing surface 4b, is located at the confluence of said three ways 1, 2, and 3, in order to regulate the flow of the mixture.
  • a supplemental oxygen inlet nozzle 6, fitted with a one-way valve 6a, and a pressure gauge 7, are located sequentially from the diverter valve 4, towards the outlet ports 2 and 3.
  • the system will comprise a tubular main body in the shape of a substantially "Y", with a first inlet port 8, connected to the expiratory branch of a first patient. , a second inlet port 9 connected to the expiratory limb of a second patient, and an outlet port 10 that is connected to the expiratory mouth of an artificial respirator.
  • arrows "B" it is possible to clearly see the direction of air circulation inside the main tubular exhalation body.
  • Each inlet port has a one-way valve 5 of the duckbill type, made of a soft and flexible material of the silicone type, arranged in such a way as to allow the flow of the gaseous mixture in the direction from the respective inlet port towards the outlet port 10.
  • Corresponding pressure regulating valves 11, arranged in each inlet port and between the duckbill valve 5 and the point of confluence of said inlet ports of the substantially “Y” shaped body, will seek to adjust the pressure between 5 and 20 cm H20 in order to manage the positive pressure at the end of expiration, to be measured by the respective pressure gauges 7.
  • the inspiratory limb accessory with its main body in the shape of a substantially "T” is connected via its inlet port 1 to the inspiratory outlet of the artificial respirator "C".
  • the inspiratory branches of patient 1 and patient 2 are connected to its outlet routes 2 and 3. It is advisable to interpose a filter between the adapter and each inspiratory branch.
  • the inspiratory limb of each patient is connected to the endotracheal tube through a connector with a main body in the form of a substantially "Y" shape, provided in the commercial tubing set.
  • An expiratory branch is connected to it.
  • the expiratory limb of each patient connects to one of the inlets 8 and 9 of the expiratory limb accessory in a substantially "Y" shape.
  • the aforementioned filters both for the inspiratory and expiratory branches, are of the type that are discarded and are placed externally to add additional protection and extend the useful life of the filters that respirators have embedded inside to capture viruses. bacteria and other debris ..
  • viruses such as SARS-CoV2
  • the filter in the expiratory branch is important so that the air that comes from the patient is filtered even more before leaving the environment.
  • the air enters the inspiratory limb adapter substantially in the form of ”through the inlet port 1.
  • Diversion valve 4 regulates the flow of the gas mixture towards both patients.
  • the airway pressure of each patient can be monitored with the manometers 7 of each inspiratory path of the adapter. Air enters the lungs of both patients through the respective endotracheal tubes. During expiration, air returns through the endotracheal tube of each patient and enters the respective expiratory limb.
  • the expiratory limbs of both patients connect to the expiratory pathways of the expiratory limb adapter substantially in a "Y" shape. Through it, air enters the expiratory unit of the respirator.
  • tidal volume and peak inspiratory pressure can be regulated with the diverter valve 4 of the inspiratory limb adapter so that each one receives what they need, as well as the end-expiratory pressure, which can be regulated by establishing a minimum pressure value that will provide the ventilator, configuring it with the commands of the same, and adding what is necessary to each patient in particular through the pressure regulating valve of the expiratory limb adapter.
  • the exact end-expiration pressure for each patient will be reached with the aid of the respective pressure gauges 7.
  • the inspired fraction of basal oxygen will be the same for both patients, and can be increased in each individual patient by providing a supplemental oxygen flow through a one-way duckbill valve spout.
  • Cross contamination between patients will be avoided thanks to the sequence of one-way valves located on both adapters. In this way, the deviation of air flow from one patient to another will also be prevented in the event of occlusion of any of the branches.
  • embodiments may consist of diverter valves with many more routes, where it is allowed to regulate the inspiration volume for each of the patients, and of course the tubular bodies will have as many secondary branches as patients need to be fed.
  • the components or elements could also be used for a ventilation arrangement for five patients, and used in the case of one, two, three, four or five people.

Abstract

The present invention relates to a system and connectors thereof, for providing breathing assistance to persons by means of a single ventilator, a single ventilator being used for more than one patient, preferably two, wherein the system comprises a set of elements that allow the patients to be correctly connected and ventilated.

Description

MEMORIA DESCRIPTIVA DESCRIPTIVE MEMORY
CAMPO TECNICO TECHNICAL FIELD
La presente invención se refiere a un sistema y sus conectores, para asistencia respiratoria a personas mediante el uso de un solo respirador, en el cual se utiliza un solo respirador para más de un paciente, preferentemente dos, en donde dicho sistema comprende un conjunto de elementos que permiten conectar y ventilar adecuadamente a dichos pacientes, garantizando la ventilación de dos o más pacientes en forma simultánea, evitando la contaminación cruzada y permitiendo configurar las variables más importantes del “setting” de cada uno de los pacientes en forma individual. En forma preferente, el mismo permite alimentar a dos pacientes. The present invention refers to a system and its connectors, for respiratory assistance to people through the use of a single respirator, in which a single respirator is used for more than one patient, preferably two, wherein said system comprises a set of elements that allow to adequately connect and ventilate these patients, guaranteeing the ventilation of two or more patients simultaneously, avoiding cross contamination and allowing to configure the most important variables of the “setting” of each one of the patients individually. Preferably, it allows feeding two patients.
ESTADO DE LA TECNICA Y PROBLEMAS A RESOLVER STATE OF THE TECHNIQUE AND PROBLEMS TO BE SOLVED
Como consecuencia de catástrofes súbitas de gran envergadura tales como atentados, desastres naturales (maremotos, terremotos, huracanes), accidentes, epidemias y pandemias, el foco del sistema sanitario se ha centrado en la necesidad de atención médica simultánea para un gran número de víctimas. As a consequence of sudden catastrophes of great magnitude such as attacks, natural disasters (tsunamis, earthquakes, hurricanes), accidents, epidemics and pandemics, the focus of the health system has been on the need for simultaneous medical care for a large number of victims.
Sin embargo, dependiendo de la naturaleza del desastre, muchos suministros hospitalarios pueden resultar insuficientes desde los momentos iniciales posteriores al evento. En aquellos casos en que existe una gran exposición a una noxa respiratoria, por ejemplo, la cantidad de respiradores artificiales puede súbitamente volverse insuficiente para soportar la demanda However, depending on the nature of the disaster, many hospital supplies may be insufficient from the initial moments after the event. In those cases where there is a large exposure to a respiratory noxa, for example, the number of artificial respirators may suddenly become insufficient to support the demand.
Si bien los recursos gubernamentales podrían inmediatamente reorientarse a la provisión de estos equipos, existe un período de tiempo variable entre el momento en que se comienza a necesitarlos en grandes cantidades y el momento en el que son provistos. En este intervalo, de no existir capacidad para proporcionar soporte ventilatorio a los pacientes, muchos de ellos podrían morir. La alternativa de la ventilación manual a veces no resulta suficiente, ya que se necesita dedicación exclusiva de personal adicional, generalmente no disponible en situaciones de catástrofe. Por otro lado, el almacenamiento preventivo de respiradores mecánicos sería muy costoso y poco efectivo, por la imprevisibilidad de este tipo de eventos. Although government resources could immediately be redirected to the provision of this equipment, there is a variable period of time between the moment it begins to be needed in large quantities and the moment it is provided. In this interval, if there is no capacity to provide ventilatory support to patients, many of them could die. The alternative of manual ventilation is sometimes not sufficient, as it requires dedicated dedication of additional personnel, generally not available in catastrophic situations. On the other hand, the preventive storage of Mechanical respirators would be very expensive and ineffective, due to the unpredictability of this type of event.
Es conocido que los respiradores actuales disponen de una gran capacidad para mover volúmenes corrientes altos. El volumen corriente (la cantidad de aire que ingresa a los pulmones en cada inspiración) habitual que requiere un adulto ronda los 500 mi (mililitros). La mayoría de los respiradores pueden aportar hasta 2500 mi de volumen corriente, un volumen que por cierto sería excesivo para un único paciente, teniendo por lo tanto ese caso la capacidad de manejar hasta cinco personas al mismo tiempo. It is known that current respirators have a great capacity to move high tidal volumes. The usual tidal volume (the amount of air that enters the lungs with each inspiration) required by an adult is around 500 ml (milliliters). Most respirators can deliver up to 2500 ml of tidal volume, a volume that would certainly be excessive for a single patient, thus having the capacity to handle up to five people at the same time.
De esta manera, es factible considerar que, ante situaciones de catástrofe, lo que cuenta no es la cantidad de respiradores disponible sino el total de mililitros que dichos respiradores pueden aportar para ventilar pacientes. Ante una situación tan súbita, considerar métodos alterativos para sacar el mayor rédito posible de los respiradores disponibles puede salvar muchas vidas. In this way, it is feasible to consider that, in catastrophic situations, what counts is not the number of available respirators but the total milliliters that these respirators can provide to ventilate patients. Faced with such a sudden situation, considering alternative methods to get the most out of available respirators can save many lives.
Con respecto al estado de la técnica y de las soluciones allí propuestas, es conocido el ventilar múltiples pacientes con un solo respirador artificial, tal como se describe por Neyman e Irvin en el año 2006 en el artículo titulado "A single ventilator for múltiple simulated patients to meet disaster surge", en Academic Emergency Medicine 2006; 13(11): 1246-9. En esta simulación, cuatro simuladores de pulmón fueron ventilados con un solo respirador, utilizando conectores de tres vías para disponer de cuatro ramas inspiratorias y cuatro ramas espiratorias. Adicionalmente Branson y colaboradores publicaron en 2012 el artículo "Use of a single ventilator to support 4 patients: laboratory evaluation of a limited concept" en Respiratory Care 2012;57(3):399-403. La conclusión del estudio fue que el volumen corriente no podía ser controlado para cada paciente y que la disparidad en el volumen corriente se debía a la variabilidad en la complacencia de la vía aérea de cada paciente. Asimismo, el modo ventilatorio de presión-control exacerbaba la disparidad más que el modo volumen- control. Regarding the state of the art and the solutions proposed therein, it is known to ventilate multiple patients with a single artificial respirator, as described by Neyman and Irvin in 2006 in the article entitled "A single ventilator for multiple simulated patients. to meet disaster surge ", in Academic Emergency Medicine 2006; 13 (11): 1246-9. In this simulation, four lung simulators were ventilated with a single ventilator, using three-way connectors to provide four inspiratory limbs and four expiratory limbs. Additionally, Branson et al. Published in 2012 the article "Use of a single ventilator to support 4 patients: laboratory evaluation of a limited concept" in Respiratory Care 2012; 57 (3): 399-403. The conclusion of the study was that the tidal volume could not be controlled for each patient and that the disparity in the tidal volume was due to the variability in the compliance of the airway of each patient. Likewise, the ventilatory pressure-control mode exacerbated the disparity more than the volume-control mode.
Adicionalmente, Paladino y colaboradores, en 2008, testearon en modelo animal el método descrito por Neyman e Irvin, llegando a la conclusión de que era factible ventilar 4 ovejas de tamaño similar a humanos adultos simultáneamente con un solo respirador durante 12 horas, pero allí no se ha tenido en cuenta ni medido el flujo cruzado de aire entre los mismos, ni el dispositivo utilizado había sido pensado para contingencias tales como la oclusión parcial o total de una o más de las ramas inspiratorias y/o espiratorias. Additionally, Paladino et al., In 2008, tested the method described by Neyman and Irvin in an animal model, reaching the conclusion that it was feasible to ventilate 4 sheep of similar size to adult humans simultaneously with a single respirator for 12 hours, but not there. the cross flow of air between the The same, neither the device used had been designed for contingencies such as partial or total occlusion of one or more of the inspiratory and / or expiratory branches.
Si bien en el interior de sus unidades inspiratoria y espiratoria, estos respiradores tenían válvulas antiretorno o unidireccionales, que impiden el flujo de la mezcla gaseosa en el sentido incorrecto durante el ciclo respiratorio, dichas válvulas no podían impedir el desvío de aire de un simulador de pulmón o un paciente a otro. Although inside their inspiratory and expiratory units, these respirators had non-return or unidirectional valves, which prevent the flow of the gas mixture in the wrong direction during the respiratory cycle, these valves could not prevent the diversion of air from a respiratory simulator. lung or patient to patient.
Por otra parte, la unidad inspiratoria del respirador reguladora del volumen corriente que va a aportar a un único paciente no contemplaba la posibilidad de necesitar separar el volumen corriente para distribuirlo en dos o más territorios. On the other hand, the inspiratory unit of the ventilator regulating the tidal volume that is going to provide a single patient did not contemplate the possibility of needing to separate the tidal volume to distribute it in two or more territories.
Tampoco dichos equipos permiten regular la presión de final de espiración en forma independiente para dos o más pacientes con un mismo respirador dado que no tienen un control único de presión de fin de espiración dado que fueron concebidos para un solo paciente. Nor do these devices allow the end-expiration pressure to be regulated independently for two or more patients with the same respirator, since they do not have a single control of the end-expiration pressure since they were designed for a single patient.
En la presente invención, y a diferencia de los sistemas conocidos, se evita la contaminación cruzada entre pacientes usando válvulas unidireccionales, se permite regular el volumen corriente que se le aporta a cada paciente según sus necesidades, y se controla la presión de fin de espiración en forma individual, las cuales no son propiedades triviales en absoluto. In the present invention, and unlike known systems, cross-contamination between patients is avoided using unidirectional valves, the tidal volume supplied to each patient is allowed to be regulated according to their needs, and the end-expiration pressure is controlled in individually, which are not trivial properties at all.
BREVE DESCRIPCION DE LAS FIGURAS DE LA INVENCIÓN BRIEF DESCRIPTION OF THE FIGURES OF THE INVENTION
A fin de que la presente invención sea claramente comprendida y llevada a la práctica con facilidad ha sido presentada en una de sus modalidades preferentes de realización en las figuras de carácter ilustrativo y no limitativo que acompaña a esta memoria, en donde:In order for the present invention to be clearly understood and put into practice with ease, it has been presented in one of its preferred embodiments in the figures of an illustrative and non-limiting nature that accompany this specification, where:
La figura 1 ilustra un despiece del accesorio de la rama inspiratoria de la disposición de la presente invención; La figura 2 permite ver una vista en corte lateral del accesorio de la rama inspiratoria de la figura 1 ; Figure 1 illustrates an exploded view of the inspiratory limb accessory of the arrangement of the present invention; Figure 2 shows a side sectional view of the accessory of the inspiratory limb of Figure 1;
La figura 3 ilustra una vista superior del accesorio de la figura 1 ; Figure 3 illustrates a top view of the accessory of Figure 1;
La figura 4 es una vista en perspectiva del accesorio de la figura 1 ; Figure 4 is a perspective view of the accessory of Figure 1;
La figura 5 ilustra un despiece del accesorio de la rama espiratoria de la disposición de la presente invención; Figure 5 illustrates an exploded view of the expiratory limb accessory of the arrangement of the present invention;
La figura 6 permite ver una vista una vista en corte lateral del accesorio de la rama espiratoria de la figura 5; Figure 6 shows a side sectional view of the accessory of the expiratory limb of Figure 5;
La figura 7 es una vista en perspectiva del accesorio de la figura 5; Figure 7 is a perspective view of the accessory of Figure 5;
La figura 8 ilustra una vista esquemática del posicionamiento y conexionado de los accesorios de inspiración y espiración a fin de conformar la disposición para asistencia respiratoria aquí propuesta; Figure 8 illustrates a schematic view of the positioning and connection of the inspiration and expiration accessories in order to form the arrangement for respiratory assistance proposed here;
En todas las figuras, iguales referencias numéricas se corresponden con iguales elementos. In all the figures, the same numerical references correspond to the same elements.
DESCRIPCIÓN DETALLADA DE LA INVENCIÓN DETAILED DESCRIPTION OF THE INVENTION
Vemos en las figuras 1 a 5, el accesorio de aplicación en la rama inspiradora del respirador, utilizado para ventilar a dos pacientes con un único respirador artificial, el cual comprende cuerpo principal tubular en forma sustancialmente de “T”, con una vía de entrada 1 , una primera vía de salida 2 para un primer paciente y una segunda vía de salida 3 para un segundo paciente. Dicha vía de entrada 1 se conectará a la salida inspiratoria del respirador artificial que se utilice, la vía de salida 2 lo hará a la rama inspiratoria de un primer paciente, y la vía de salida 3 hará lo propio a la rama inspiratoria del segundo paciente. Con las flechas “A” es posible ver claramente el sentido de circulación del aire por el interior del cuerpo principal tubular de inspiración. We see in Figures 1 to 5, the application accessory in the inspiratory branch of the respirator, used to ventilate two patients with a single artificial respirator, which comprises a tubular main body in the shape of a substantially "T", with an inlet route 1, a first outlet 2 for a first patient and a second outlet 3 for a second patient. Said inlet port 1 will be connected to the inspiratory outlet of the artificial ventilator used, outlet port 2 will connect to the inspiratory limb of a first patient, and outlet port 3 will do the same to the inspiratory limb of the second patient. . With the arrows “A” it is possible to clearly see the direction of air circulation inside the main tubular inspiration body.
Asimismo, una válvula diversora 4, con su cuerpo giratorio 4a y superficie de cierre 4b, se ubica en la confluencia de dichas tres vías 1 , 2, y 3, a fin de regular el flujo de la mezcla gaseosa hacia cada una de las dos vías de salida 2 y 3, equipadas a su vez cada una con una válvula unidireccional o antirretorno 5, del tipo pico de pato, confeccionada con un material blando y flexible del tipo de la silicona dispuesta de manera tal que permite el flujo de la mezcla gaseosa en sentido desde la vía de entrada 1 hacia la respectiva vía de salida. Un pico de entrada de oxígeno suplementario 6, munido de una válvula unidireccional 6a, y un manómetro 7, se ubican secuencialmente desde la válvula diversora 4, hacia las vías de salida 2 y 3. Likewise, a diverter valve 4, with its rotating body 4a and closing surface 4b, is located at the confluence of said three ways 1, 2, and 3, in order to regulate the flow of the mixture. gas towards each of the two outlet ways 2 and 3, each equipped with a one-way or non-return valve 5, of the duckbill type, made of a soft and flexible material of the silicone type arranged in such a way that allows the flow of the gaseous mixture in the direction from the inlet route 1 towards the respective outlet route. A supplemental oxygen inlet nozzle 6, fitted with a one-way valve 6a, and a pressure gauge 7, are located sequentially from the diverter valve 4, towards the outlet ports 2 and 3.
Por el lado de la rama espiratoria, se pueden ver en las figuras 5 a 7, el sistema comprenderá un cuerpo principal tubular en forma sustancialmente de “Y”, con una primera vía de entrada 8, conectada a la rama espiratoria de un primer paciente, una segunda vía de entrada 9 conectada a la rama espiratoria de un segundo paciente, y una vía de salida 10 que se conecta a la boca espiratoria de un respirador artificial. Con las flechas “B” es posible ver claramente el sentido de circulación del aire por el interior del cuerpo principal tubular de espiración. On the side of the expiratory branch, can be seen in Figures 5 to 7, the system will comprise a tubular main body in the shape of a substantially "Y", with a first inlet port 8, connected to the expiratory branch of a first patient. , a second inlet port 9 connected to the expiratory limb of a second patient, and an outlet port 10 that is connected to the expiratory mouth of an artificial respirator. With the arrows "B" it is possible to clearly see the direction of air circulation inside the main tubular exhalation body.
Cada vía de entrada dispone de una válvula unidireccional 5 del tipo pico de pato, confeccionada con un material blando y flexible del tipo de la silicona dispuesta de manera tal que permite el flujo de la mezcla gaseosa en sentido desde la vía de entrada respectiva hacia la vía de salida 10. Correspondientes válvulas reguladora de presión 11, dispuestas en cada vía de entrada y entre la válvula pico de pato 5 y el punto de confluencia de dichas vías de entrada del cuerpo sustancialmente en forma de “Y", buscará ajustar la presión entre 5 y 20 cm H20 para así manejar la presión positiva de final de espiración, a ser medida por los respectivos manómetros 7. Each inlet port has a one-way valve 5 of the duckbill type, made of a soft and flexible material of the silicone type, arranged in such a way as to allow the flow of the gaseous mixture in the direction from the respective inlet port towards the outlet port 10. Corresponding pressure regulating valves 11, arranged in each inlet port and between the duckbill valve 5 and the point of confluence of said inlet ports of the substantially “Y” shaped body, will seek to adjust the pressure between 5 and 20 cm H20 in order to manage the positive pressure at the end of expiration, to be measured by the respective pressure gauges 7.
Como se observa en la figura 8, el accesorio de rama inspiratoria con su cuerpo principal en forma sustancialmente de “T” se conecta por su vía de entrada 1 a la salida inspiratoria del respirador artificial “C”. En sus vías de salida 2 y 3 se conectan las ramas inspiratorias del paciente 1 y del paciente 2. Es aconsejable interponer un filtro entre el adaptador y cada rama inspiratoria. La rama inspiratoria de cada paciente se conecta con el tubo endotraqueal a través de un conector con cuerpo principal en forma sustancialmente en forma de “Y”, provisto en el set de tubuladuras comercial. Al mismo se conecta una rama espiratoria. La rama espiratoria de cada paciente conecta a una de las vías de entrada 8 y 9 del accesorio de rama espiratoria en forma sustancialmente de “Y”. Este a su vez se conecta a la boca espiratoria del respirador artificial a través de su vía de salida 10. Es aconsejable en ciertos casos colocar un filtro entre la rama espiratoria y la vía de entrada del adaptador de rama espiratoria. Con las flechas “A” y “B” es posible ver claramente el sentido de circulación del aire hacia el respirador “C”. As can be seen in figure 8, the inspiratory limb accessory with its main body in the shape of a substantially "T" is connected via its inlet port 1 to the inspiratory outlet of the artificial respirator "C". The inspiratory branches of patient 1 and patient 2 are connected to its outlet routes 2 and 3. It is advisable to interpose a filter between the adapter and each inspiratory branch. The inspiratory limb of each patient is connected to the endotracheal tube through a connector with a main body in the form of a substantially "Y" shape, provided in the commercial tubing set. An expiratory branch is connected to it. The expiratory limb of each patient connects to one of the inlets 8 and 9 of the expiratory limb accessory in a substantially "Y" shape. This, in turn, is connected to the expiratory mouth of the artificial respirator through its outlet port 10. In certain cases, it is advisable to place a filter between the expiratory limb and the inlet port of the adapter. of expiratory branch. With the arrows “A” and “B” it is possible to clearly see the direction of air circulation towards the respirator “C”.
Los filtros antes mencionados, tanto para la rama inspiratoria como la espiratoria, son del tipo de los que son descartares y se colocan externamente para agregar protección adicional y prolongar la vida útil de los filtros que los respiradores tienen embutido en su interior para capturar virus, bacterias y demás desechos.. En casos de virus como el SARS- CoV2, el filtro en la rama espiratoria es importante para que el aire que venga del paciente se filtre más aún antes de salir al ambiente. The aforementioned filters, both for the inspiratory and expiratory branches, are of the type that are discarded and are placed externally to add additional protection and extend the useful life of the filters that respirators have embedded inside to capture viruses. bacteria and other debris .. In cases of viruses such as SARS-CoV2, the filter in the expiratory branch is important so that the air that comes from the patient is filtered even more before leaving the environment.
En modo de ventilación asistido-controlado, con volumen-control, con ambos pacientes sedados, durante la inspiración, el aire entra al adaptador de rama inspiratoria sustancialmente en forma de ” por la vía de entrada 1. La válvula diversora 4 regula el flujo de la mezcla gaseosa hacia ambos pacientes. La presión de la vía aérea de cada paciente puede monitorearse con los manómetros 7 de cada vía inspiratoria del adaptador. El aire penetra en los pulmones de ambos pacientes por los respectivos tubos endotraqueales. Durante la espiración, el aire retorna a través del tubo endotraqueal de cada paciente e ingresa a la rama espiratoria respectiva. Las ramas espiratorias de ambos pacientes se conectan a las vías espiratorias del adaptador de rama espiratoria sustancialmente en forma de “Y”. A través de él, el aire ingresa a la unidad espiratoria del respirador. In assisted-controlled ventilation mode, with volume-control, with both patients sedated, during inspiration, the air enters the inspiratory limb adapter substantially in the form of ”through the inlet port 1. Diversion valve 4 regulates the flow of the gas mixture towards both patients. The airway pressure of each patient can be monitored with the manometers 7 of each inspiratory path of the adapter. Air enters the lungs of both patients through the respective endotracheal tubes. During expiration, air returns through the endotracheal tube of each patient and enters the respective expiratory limb. The expiratory limbs of both patients connect to the expiratory pathways of the expiratory limb adapter substantially in a "Y" shape. Through it, air enters the expiratory unit of the respirator.
Es aconsejable que los pacientes tengan ramas inspiratorias de igual longitud, ramas espiratorias de igual longitud e igual calibre de tubo endotraqueal. El volumen corriente y la presión inspiratoria pico pueden regularse con la válvula diversora 4 del adaptador de rama inspiratoria para que cada uno reciba lo que necesite, al igual que la presión de final de espiración, que podrá ser regulada estableciendo un valor mínimo de presión que aportará el respirador, configurándola con los comandos del mismo, y agregando lo necesario a cada paciente en particular mediante la válvula reguladora de presión del adaptador de rama espiratoria. It is advisable for patients to have inspiratory branches of equal length, expiratory branches of equal length, and equal endotracheal tube caliber. The tidal volume and peak inspiratory pressure can be regulated with the diverter valve 4 of the inspiratory limb adapter so that each one receives what they need, as well as the end-expiratory pressure, which can be regulated by establishing a minimum pressure value that will provide the ventilator, configuring it with the commands of the same, and adding what is necessary to each patient in particular through the pressure regulating valve of the expiratory limb adapter.
La presión de fin de espiración exacta de cada paciente se alcanzará con la ayuda de los manómetros 7 respectivos. La fracción inspirada de oxígeno basal será igual para ambos pacientes, y podrá aumentársela en cada paciente en particular aportando un flujo de oxígeno suplementario a través de un pico con válvula unidireccional en pico de pato. La contaminación cruzada entre pacientes será evitada gracias a la secuencia de válvulas unidireccionales localizadas en ambos adaptadores. También será prevenido de esta manera el desvío de flujo de aire de un paciente a otro en caso de oclusión de alguna de las ramas. The exact end-expiration pressure for each patient will be reached with the aid of the respective pressure gauges 7. The inspired fraction of basal oxygen will be the same for both patients, and can be increased in each individual patient by providing a supplemental oxygen flow through a one-way duckbill valve spout. Cross contamination between patients will be avoided thanks to the sequence of one-way valves located on both adapters. In this way, the deviation of air flow from one patient to another will also be prevented in the event of occlusion of any of the branches.
Por supuesto que otras modalidades de realización podrán constar de válvulas derivadoras de muchas más vías, en donde se permita regular el volumen de inspiración para cada uno de los pacientes, y por supuesto los cuerpos tubulares tendrán tantas ramas secundarias como pacientes se necesite alimentar. También se podrían utilizar los componentes o elementos para una disposición de asistencia respiratoria para cinco pacientes, y usar las necesarias en el caso de que sea una, dos, tres, cuatro o cinco personas. Of course, other embodiments may consist of diverter valves with many more routes, where it is allowed to regulate the inspiration volume for each of the patients, and of course the tubular bodies will have as many secondary branches as patients need to be fed. The components or elements could also be used for a ventilation arrangement for five patients, and used in the case of one, two, three, four or five people.

Claims

REIVINDICACIONES
1. Sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, caracterizada por comprender: 1. System for respiratory assistance to people through the use of a single respirator, characterized by comprising:
- un primer cuerpo principal tubular (a), que posee una rama principal (1), con conexión a la boca de inspiración de un respirador (C), que se bifurca en al menos dos ramas secundarias de conexión (2, 3), ubicándose en el punto de bifurcación una válvula diversora (4), cuya superficie de cierra (4) distribuye el flujo de la rama principal (1) entre dichas al menos dos ramas secundarias (2, 3); estando posicionadas respectivas válvulas unidireccionales (5) entre dicha válvula diversora (4) y las tomas de presión de manómetros (7) de cada una de dichas al menos dos ramas secundarias de conexión (2, 3); - a first tubular main body (a), which has a main branch (1), with connection to the inspiration mouth of a respirator (C), which branches into at least two secondary connecting branches (2, 3), being located at the bifurcation point a diverter valve (4), whose closing surface (4) distributes the flow of the main branch (1) between said at least two secondary branches (2, 3); respective one-way valves (5) being positioned between said diverter valve (4) and the pressure taps of manometers (7) of each of said at least two secondary connection branches (2, 3);
- un segundo cuerpo principal tubular, que posee una rama principal (10), con conexión a la boca de espiración de un respirador (C), que se bifurca en al menos dos ramas secundarias de conexión (8, 9), ubicándose en los laterales de la bifurcación respectivas válvulas reguladoras (11); estando posicionadas respectivas válvulas unidireccionales (5) entre cada una de dichas válvulas reguladoras (11) y los extremos de cada una de dichas al menos dos ramas secundarias de conexión (8, 9); - a second tubular main body, which has a main branch (10), with connection to the exhalation mouth of a respirator (C), which bifurcates into at least two secondary connection branches (8, 9), being located in the sides of the bifurcation respective regulating valves (11); respective one-way valves (5) being positioned between each of said regulating valves (11) and the ends of each of said at least two secondary connection branches (8, 9);
- correspondientes manómetros (7) capaces de medir la presión del fluido de inspiración luego de pasar por las mencionadas válvulas unidireccionales (5). - Corresponding manometers (7) capable of measuring the pressure of the inspiration fluid after passing through the mentioned one-way valves (5).
2. Sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, de acuerdo a la reivindicación 1 , caracterizada porque dicho primer cuerpo principal con una bifurcación tiene forma sustancialmente de “T”. 2. System for respiratory assistance to people through the use of a single respirator, according to claim 1, characterized in that said first main body with a bifurcation has a substantially "T" shape.
3. Sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, de acuerdo a la reivindicación 1 , caracterizada porque dicho segundo cuerpo principal con una bifurcación tiene forma sustancialmente de “Y”. 3. System for respiratory assistance to people through the use of a single respirator, according to claim 1, characterized in that said second main body with a bifurcation has a substantially "Y" shape.
4. Sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, de acuerdo a la reivindicación 1 , caracterizada porque dichas válvulas unidireccionales o antirretorno (5) son del tipo pico de pato. 4. System for respiratory assistance to people through the use of a single respirator, according to claim 1, characterized in that said one-way or non-return valves (5) are of the duckbill type.
5. Sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, de acuerdo a la reivindicación 1 , caracterizada porque entre dichas válvulas unidireccionales o antirretomo (5) y el extremo de cada rama secundaria inspiratoria (2, 3) se ubica un pico (6) con su respectiva válvula unidireccional (6a) para incorporación de oxígeno suplementario. 5. System for respiratory assistance to people through the use of a single respirator, according to claim 1, characterized in that between said unidirectional or anti-return valves (5) and the end of each secondary inspiratory branch (2, 3) is located a spout (6) with its respective one-way valve (6a) for the incorporation of supplemental oxygen.
6. Sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, de acuerdo a la reivindicación 1 , caracterizada porque dispone de manómetros (7) capaces de medir la presión del fluido de espiración previo a pasar por las válvulas unidireccionales (5). 6. System for respiratory assistance to people by using a single respirator, according to claim 1, characterized in that it has manometers (7) capable of measuring the pressure of the expiratory fluid prior to passing through the one-way valves (5) .
7. Sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, de acuerdo a la reivindicación 1, caracterizada porque dichas al menos dos ramas secundarias del cuerpo principal de inspiración (1) y de espiración (10) son dos. 7. System for respiratory assistance to people through the use of a single respirator, according to claim 1, characterized in that said at least two secondary branches of the main body of inspiration (1) and expiration (10) are two.
8. Un cuerpo de conexión con la toma de inspiración de un respirador para uso en un sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, caracterizada porque comprende un primer cuerpo principal tubular (a), que posee una rama principal (1), con conexión a la boca de inspiración de un respirador (C), que se bifurca en al menos dos ramas secundarias de conexión (2, 3), ubicándose en el punto de bifurcación una válvula diversora (4), cuya superficie de cierra (4) distribuye el flujo de la rama principal (1) entre dichas al menos dos ramas secundarias (2, 3); estando posicionadas respectivas válvulas unidireccionales (5) entre dicha válvula diversora (4) y las tomas de presión de manómetros (7) de cada una de dichas al menos dos ramas secundarias de conexión (2, 3); y correspondientes manómetros (7) capaces de medir la presión del fluido de inspiración luego de pasar por las mencionadas válvulas unidireccionales (5). 8. A connection body with the inspiration intake of a respirator for use in a system for respiratory assistance to people through the use of a single respirator, characterized in that it comprises a first tubular main body (a), which has a main branch ( 1), with connection to the inspiration mouth of a respirator (C), which branches into at least two secondary connection branches (2, 3), with a diversion valve (4) being located at the branch point, whose surface of closes (4) distributes the flow of the main branch (1) between said at least two secondary branches (2, 3); respective one-way valves (5) being positioned between said diverter valve (4) and the pressure taps of manometers (7) of each of said at least two secondary connection branches (2, 3); and corresponding pressure gauges (7) capable of measuring the pressure of the inspiration fluid after passing through the mentioned one-way valves (5).
9. Un cuerpo de conexión con la toma de espiración de un respirador para uso en un sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, caracterizada porque comprende un segundo cuerpo principal tubular, que posee una rama principal (10), con conexión a la boca de espiración de un respirador (C), que se bifurca en al menos dos ramas secundarias de conexión (8, 9), ubicándose en los laterales de la bifurcación respectivas válvulas reguladoras (11); estando posicionadas respectivas válvulas unidireccionales (5) entre cada una de dichas válvulas reguladoras (11) y los extremos de cada una de dichas al menos dos ramas secundarias de conexión (8, 9). 9. A connection body with the exhalation intake of a respirator for use in a system for respiratory assistance to people through the use of a single respirator, characterized in that it comprises a second tubular main body, which has a main branch (10), with connection to the exhalation mouth of a respirator (C), which bifurcates into at least two secondary connection branches (8, 9), with respective regulating valves (11) being located on the sides of the bifurcation; respective one-way valves (5) being positioned between each of said regulating valves (11) and the ends of each of said at least two secondary connection branches (8, 9).
10. Un cuerpo de conexión con la toma de inspiración de un respirador para uso en un sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, caracterizada porque dicho cuerpo principal tubular tiene forma sustancialmente de “T”. 10. A connection body with the inspiration intake of a respirator for use in a system for respiratory assistance to people through the use of a single respirator, characterized in that said tubular main body has a substantially "T" shape.
11. Un cuerpo de conexión con la toma de espiración de un respirador para uso en un sistema para asistencia respiratoria a personas mediante el uso de un solo respirador, caracterizada porque dicho cuerpo principal tubular tiene forma sustancialmente de “Y”. 11. A connection body with the exhalation intake of a respirator for use in a system for respiratory assistance to people through the use of a single respirator, characterized in that said tubular main body has a substantially "Y" shape.
PCT/CL2021/050023 2020-04-05 2021-04-04 System for providing breathing assistance to persons by means of a single ventilator and connection bodies for forming same WO2021203214A1 (en)

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