US 20110209705 A1
A method and apparatus is described for supporting the respiration of a patient. The spontaneous respiration of a patient can be detected by sensors and during inhalation an additional amount of oxygen can be administered to the lungs via a jet gas current. If required, during exhalation a countercurrent can be administered to avoid collapse of the respiration paths. This therapy can be realized by an apparatus including a transtracheal catheter, an oxygen pump connected to an oxygen source, spontaneous respiration sensor(s) connected to a control unit for activating the oxygen pump and, if needed, a tracheal prosthesis. The tracheal prosthesis may include a connection for the catheter and the breath sensor(s). The tracheal prosthesis, if used, and the catheter can be dimensioned so the patient can freely breathe, cough, swallow and speak without restriction, and the system can be wearable to promote mobility.
1. A method for supporting the respiration of a patient comprising the steps of:
detecting the spontaneous respiration of the patient is by sensors;
identifying the end of the inhalation process; and
administering an additional amount of oxygen to the lungs.
2. The method of
3. The method of
4. The method of
5. The method of
6. The method of
7. An apparatus for supporting the respiration of a patient that comprises an oxygen pump operatively connected to an oxygen source, the apparatus further comprising sensors for detecting the spontaneous respiration of the patient, the sensors are connected to a control unit for activating the oxygen pump.
8. The apparatus of
9. The apparatus of
10. The apparatus of
11. The apparatus of
12. The apparatus of
13. The apparatus of
14. The apparatus of
15. The apparatus of
16. The apparatus of
17. The apparatus of
18. The apparatus of
19. A tracheal prosthesis comprising a tubular support body, a connection for a jet catheter and at least two sensors coupled with the support body.
20. The tracheal prosthesis of
21. The tracheal prosthesis of
22. The tracheal prosthesis of
23. A catheter having a first and second end, one end affixable by at least one sensor.
24. The catheter of
25. The catheter of
26. The catheter of
This application is a continuation of U.S. application Ser. No. 12/271,484, filed Nov. 14, 2008, which is a continuation of U.S. application Ser. No. 10/771,803, filed Feb. 4, 2004, which claims the benefit of priority under 35 U.S.C. §119 to co-pending German Patent Application Serial No. 10337138.9, filed Aug. 11, 2003, the contents of each of which is incorporated herein in its entirety.
The present invention relates generally to respiratory systems directed and more particularly to specialized mechanisms for enhanced ventilation of a patient.
In order that the body can take in oxygen and give off carbon dioxide, both components of the respiratory bronchial system must function—the lungs as a gas-exchanging organ and the respiratory pump as a ventilation organ that transports air into the lungs and back out again. The breathing center in the brain, central and peripheral nerves, the osseous thorax and the breathing musculature as well as free, stable respiratory paths are necessary for a correct functioning of the respiratory pump.
In certain diseases there is a constant overload on or exhaustion of the respiratory pump. A typical syndrome is pulmonary emphysema with flat-standing diaphragms without the ability to contract. In the case of pulmonary emphysema the respiratory paths are usually extremely slack and tend to collapse. As a consequence of the flattened, over-extended diaphragms the patient cannot inhale deep enough. In addition, the patient cannot exhale sufficiently on account of the collapsing respiratory paths. This results in an insufficient respiration with an undersupply of oxygen and a rise of carbon dioxide in the blood, the so-called ventilatory insufficiency.
The treatment for inhalation difficulty often makes use of a breathing device. The so-called home respiration is an artificial respiration for supporting or completely relieving the respiratory pump.
The respiration can take place non-invasively via a tube and a nose mask or mouth mask that the patient can put on and take off as needed. However, this prevents the patient from breathing freely and speaking freely. In addition, a blocked tracheal cannula can be inserted into the trachea. This also has the consequence that the patient can no longer speak.
In the case of invasive respiration this usually occurs via a tracheostomy. This involves an opening placed in the trachea by an operation. A catheter about the diameter of a finger with a blocking balloon is inserted via the opening into the trachea and connected to a breathing apparatus. This makes a sufficiently deep respiration possible but prevents the patient from speaking. In addition to the respiration there is the transtracheal administration of oxygen via thinner catheters. U.S. Pat. Nos. 5,181,509 or 5,279,288 disclose corresponding embodiments. In this manner a highly dosed administration of oxygen is administered to the patient in a continuous stream with a permanently adjusted frequency. The flow of oxygen is regulated manually by a throttle device. However, simulation of the natural breathing process of a patient is not achieved because breathing is not deep enough. Also, the catheter end introduced into the trachea can result in irritations and a local traumatizing of the surrounding tissue in that it strikes against the trachea as a consequence of the respiratory movement or in that the surrounding tissue is dried out by the jet stream.
Furthermore, so-called “Montgomery T-tubes” are known that are inserted into the trachea. The patient can obtain oxygen via the shank of the T-piece run to the outside. In addition, the patient can draw off secretions himself if needed. The patient can breathe freely and speak when the front shank is closed; however, respiration is not possible via the Montgomery T-tube since the introduced air escapes upward into the buccal cavity or the pharyngeal area. An additional limitation of the above-referenced therapies is the impaired mobility of the patient because of inadequate ventilation as well as the bulk of the apparatus.
Therefore, there is an existing need for a respiratory system that provides a more efficient method for supporting the respiration of a patient and of creating an apparatus to this end that can also be taken along by the patient and is reliable in its use. Moreover, the there is a need for a tracheal prosthesis and a catheter that make possible a respiratory support synchronized with the spontaneous respiration of the patient without adversely affecting the patient's ability to speak.
It is a principal objective of the present invention to provide an apparatus and method that improves the quality of life of patients that require respiratory support. In the furtherance of this and other objectives, the present inventor provides a respiratory system that provides a more efficient method of supporting the respiration of a patient by providing additional oxygen when needed.
I is an additional objective in accordance with the present invention to provide as system that is portable and reliable in its use.
Yet another objective in accordance with the present invention is to provide a tracheal prosthesis and a catheter that make possible a respiratory support synchronized with the spontaneous respiration of the patient without adversely affecting the patient's ability to speak.
Further objectives, features and advantages of the invention will be apparent from the following detailed description taken in conjunction with the accompanying drawings.
The present invention, in a preferred embodiment, provides an apparatus for supporting the respiration of a patient and to a tracheal prosthesis. According to the invention the spontaneous respiration of a patient is detected by sensors and at the end of an inhalation procedure an additional amount of oxygen is administered to the lungs via a jet gas current. This improves the absorption of oxygen during inhalation. If required, the exhalation procedure of the patient can be arrested or slowed by a countercurrent in order to avoid a collapse of the respiration paths in this manner. This procedure is realized by an apparatus comprising an oxygen pump that can be connected to an oxygen source and comprising a tracheal prosthesis that can be connected via a catheter. The spontaneous respiration of the patient is detected by sensors connected to a control unit for activating the oxygen pump. The tracheal prosthesis comprises a tubular support body with a connection for the catheter and two of the sensors are associated with the support body. The tracheal prosthesis and the jet catheter that is integrated or can be introduced are dimensioned in such a manner that the patient can freely breath and speak without restriction.
Referring specifically to
Such a respiration process with inhalation/inspiratory flow and exhalation (expiratory flow) without respiratory support is shown in
In order to support and relieve the strain on the respiratory pump the patient's spontaneous respiration is detected by sensor and at the end of an inhalation process of the lungs an additional amount of oxygen is administered. This respiratory flow is illustrated in the right half of
In addition, the exhalation process of the patient is braked by a countercurrent. As a consequence thereof, the respiratory flow shifts during exhalation along the curved designated by A2. This purposeful resistance acting opposite to the exhalation prevents a collapsing of the respiratory paths during exhalation. In this manner the exhalation volume is increased by the volume also shown darkened and designated by A3.
As a consequence, this method avoids an insufficient respiration with an undersupply of oxygen and an increase of carbon dioxide in the blood. Patient P is significantly less stressed and more mobile and in addition he perceives less or no shortage of air.
In order to carry out the respiration support of patient P, an apparatus is provided comprising oxygen pump 1 that can be connected to an oxygen source (see
In tracheal prosthesis 2 according to
Separate coupling 18 is provided on connection 7 in tracheal prosthesis 3 according to
Oxygen pump 1 is schematically shown in
The switching states of valves V1 to V4 and the supply lines and removal lines are designated by letters a to g.
Oxygen pump 1 functions in the apparatus during the support of respiration as follows: When valve V1 is open from c to a (b to c closed) and valve V2 open from b to e (e to d closed), piston 20 moves to the left in the plane of the figure and the oxygen flows via outlet 22 and jet catheter 5 to patient P. The additional amount of oxygen E3 is administered during the inhalation process of patient P.
When valve V1 is open from b to c (c to a closed) and valve V2 is open from e to d (b to e closed), piston 20 moves to the right in the plane of the figure in the flow of oxygen takes place in the direction of valve V3. Valve V3 is connected to the ambient air via outlet 23. In the instance in which valve V3 is open from d to g the oxygen flows off without expiration brake. That means that the exhalation process is not braked by a countercurrent.
If valve V3 is closed from d to g and open from d to f the oxygen flows via access path 24 in the direction of outlet 22 and catheter 5 in order to be administered to patient P during the exhalation process and in order to break the respiratory flow. The countercurrent prevents a collapsing of the respiratory paths and keeps them open. This makes a deeper exhalation possible.
Furthermore, valve V4 is located in access path 24 of the apparatus, via which the flowthrough (f to a) can be variably adjusted. This can advantageously be a proportional valve with pulse-width modulation.
It can also be seen that end 31 of catheter 28 is provided with jet nozzle 35. The cross section of the flow is reduced relative to the cross section of the catheter in jet nozzle 35 so that the discharge rate of the supplied oxygen is increased.
Catheter 28 can be introduced into support body 36, as
The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative, and not restrictive. The scope of the invention is, therefore, indicated by the appended claims, rather than by the foregoing description. All changes, which come within the meaning and range of equivalency of the claims, are to be embraced within their scope.