US 3349766 A
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Description (OCR text may contain errors)
Filed June 2, 1964 FIG. 4
D. J. DONOFRIO ANESTHETI ZING, RESUSCITATING, AND RESPIRATORY APPARATUS 2 Sh etsSheet 2 FIGS INVENTOR.
DAVID J. DONOF'RIO ATTYS;
of a conduit United States Patent ()fitice 334M665 Patented Get. 31, 1967 3,349,766 ANESTHETIZHNG, RESUSCITATING, AND RESPIRATORY APPARATUS David .I. Donofrio, 1407 Herberich Ava, Akron, Ohio 44301 Filed June 2, 1964, Ser. No. 372,057 9 Claims. (Cl. 128-1456) This invention relates to an anesthetizing, resuscitating, and respiratory apparatus which is essentially automatic and easily convertible or interchangeable between any of these three systems necessary for most medical operations. The apparatus is particularly adaptable for veterinary operative usage.
Heretofore it has been known that there have been many and varied types of automatic anesthetizing, resuscitating, and respiratory apparatus. However, most of these machines have been adaptable to only one or two of these operative functions, and then only by utilizing extremely complex and involved apparatus with considerable manipulative changes as well as actual mechanical change requirements necessary to adequately shift from one system to another, or from one volume or respiratory rate to another. With known apparatus and techniques the time required to switch from one apparatus to another may mean the loss of life of the patient, as for example, should the patients lungs collapse when subjected to anesthetic. The very complexity of these prior art practices has resulted in great cost of equipment, and high operator skill requirements. Further, there has been an inadequacy in the art of combining these three medical functions in an apparatus adaptable for veterinary and human usage.
It is the general object of the present invention to avoid and overcome the foregoing and other objections to prior art practices by the provisions of an anesthetizing, resuscitating, and respiratory apparatus which is essentially automatic, extremely simple in operation, low in cost, free of maintenance, operative with relative few moving parts, having great flexibility between systems, and readily adaptable to changes in volume and pressure.
A further object of the invention is to provide a respiratory apparatus utilizing a double compensating valve to control volume and pressure of fluid flow Where any anesthetic agent and any volume of oxygen may be controllably introduced into the system.
A further object of the invention is to provide an automatic respirator and anesthesia machine in combination wherein the total amount of anesthetic used is minimum thereby facilitating the use of cyclopropane or trifluoroethyl vinyl ether.
which will become apparent as the description proceeds are achieved by providing in a respirator the combination piping system having one access opening thereto and two discharge openings therefrom, means to introduce a controllable rhythmic pulsating fluid pressure to the access opening,
a double compensating valve means to selectively determine the proportion of fluid pressure and volume introduced into the access opening which is "discharged from each of the discharge openings, eXpandable system means operatively connected to one of the gear 30 driving a chain 32 and not to cock or tilt the plate 22 discharge openings adapted to receive at least the total pressure and volume introduced into the access opening of the piping system, flexible conduit means operatively connected to the other of the discharge openings, means to controllably introduce oxygen under controlled pres sure into the piping system, and means to controllably introduce an anesthetizing agent under controlled pressure into the piping system.
The term gas respirator as employed herein is intended to cover the controlled passage or pumping of air, anesthetic vapor or gas, or oxygen or other gas, individually or in selected combinations, to and from, or to and from in changed condition the lungs of a human or animal.
For a better understanding of the invention reference should be had to the accompanying drawings, wherein:
FIGURE 1 is a schematic flow diagram of a piping system disclosing a preferred embodiment of the invention;
FIGURE 2 is a partially broken away enlarged vertical cross sectional view of the double compensating valve of FIGURE 1 which comprises an important feature of the invention.
FIGURE 3 is a partially broken away enlarged schematic view of a piping system showing a slight variation of the embodiment of the invention disclosed in FIG- URE 1;
FIGURE 4 is an enlarged broken away cross sectional schematic wiring diagram of the grounding system of the invention; and
FIGURE 5 is a front elevational view of an operating board which can be associated with the system of FIG- URE 1.
While it should be understood that the respirator is adaptable for human use, it has not been designedwith this purpose in mind. Rather, it is believed to be most adaptable for utilization with veterinary surgery on cats and dogs. Hence, the drawings are directed along that line, and will be so described.
Particularly, the apparatus was designed to help perform successful intra-thoracic surgery on a dog. To this end, maintenance of normal tidal volume exchange was necessary, as well as being able to maintain a constant percentage concentration of the anesthetic agents utilized. The machine was made readily adaptable for variable inspiration and expiration movements, thereby making the tidal volume flow variable in nature. Another important criteria during this type of surgery happens upon lung collapse, when the machine must also be able to act as an automatic respirator.
With reference to FIGURE 1 of the drawings, the numeral 10 indicated generally a respiratory apparatus which comprises a piping system 12 having generally an inlet access opening 14 and two discharge openings 16 and 18. In order to supply a rhythmic pulsating fluid pressure and flow to the access opening 14, a collapsible bellows 29 is provided. The bellows 20 has an actuation plate 22 mounted on the bottom thereof which is driven by a link 24 pivotally mounted thereto and eccentrically mounted to a rotating plate 26. The plate 26 is operatively driven by a motor 28 operating through a spur engaging a spur gear 34 which is affixed to the plate 26. It must be understood that the link 24 must ride in a perfectly vertical plane in order compressing the bellows 20. Likewise, any convenient gear ratio or drive means for the bellows 20 might be utilized.
In order to control the actual speed of reciprocating movernent to the bellows 20, the speed of the motor 28 in the gear train or drive apparatus preferably plastic coated or else made of plastic gears to eliminate any sparking hazards and render the drive apparatus for the bellows completely safe for use with gas mixtures subject to burning or exploding. The motor 28 and gear systems may be grounded by a line 40.
In order to properly determine the pressure in the piping system 12, a conventional mercury actuated pressure gage 42 may be provided. This gage 42 may also contain a maximum pressure relief valve to the atmosphere to limit the top pressure carried by the apparatus. The pressure relief valve may also be adapted to purge the system 12 when oxygen or anesthetizing gas are introduced so that this introduction will be quickly transferred to the patient, even when using a closed system without exhalation exhaust to the atmosphere, as described hereinafter. In order for a respirator operator to determine the pressure actually sent to the patient, a positive-negative gage 42a should be located in the line 56, as indicated in FIGURE 1.
As an important feature of the invention, the discharge openings 16 and 18 from the piping system 12 are preferably provided with a double compensating valve, indicated generally by numeral 50, which selectively controls the amount of pressure and volume discharged through each opening as a proportion of the pressure and volume introduced through the access opening 14. To this end, the valves 50 consist of a valve stem 52 passed through a discharge line 54 from the opening 18 and a discharge line 56 from the opening 16. The valve stem 52 is maintained in sealed relationship with the discharge pipes 54 and 56 by any convenient packing or sealing means. The valve stem 52 mounts a butterfly valve 58 in the discharge pipe 54 and a butterfly valve 60 in the discharge passage 56. The butterfly valves 58 and 60 are mounted at normal or 90 relative rotation from each other so that when the valve 58 closes the passage 54, as indicated in FIG- URE 1, the valve 60 is in the fully opened position in the passage 56. A handle 62 is mounted to the valve stem 52 and rotation of this handle will selectively open the valve 58 in the passage 54 and begin to selectively close the valve 60 in the passage 56. In other words, it is apparent that rotation of the handle 60 will selectively open or close the valves 58 and 60 so that as one valve is being opened, the other is being closed, and vice versa. It should be noted that there will always be some fluid flow through both valves 58 and 60 as long as neither valve is in fully closed position as indicated in FIGURE 1.
The passage 54 actually terminates in an expandable pressure resistant breathing bag 64, generally made from rubber, which is made of adequate volume to be equal or greater than the maximum gas volume displacement by the bellows 20. The passage 54 is also adapted to receive oxygen through a line 66 from an oxygen cylinder 68 as controlled by valve 70 with pressure indicated on a conventional mercury indicator 72. A pressure indicator 74 mounted to the cylinder 68 indicates the amount of oxygen pressure and volume remaining in the cylinder 68. Also, in order to introduce anesthetizing gases into the system, a plurality of access openings, indicated generally by numeral 7 6, may be provided on the passage 54. It is apparent that gaseous anesthetizing agents can be controllably introduced through these openings 76, in the same manner as that disclosed for the oxygen through passage 66. Although the oxygen and gas introduction is indicated as entering passage 54, the objects of the invention may still be achieved if the introduction of these gases is into the main piping system 12.
The passage 56 is usually made from some convenient flexible conduit means and can be considered as an open system. The passage 56 is directed to a substantially conventional vaporizer 80 which may be controllably cut into the line by valve means 82 to provide ether vaporization as an anesthetic, or any other suitable liquid anesthetic, as selectively desired. A flexible tubing 84 is connected to the output of the passage 56 and this connects a to and fro canister 86 which is simply utilized to absorb CO exhaled from the patient when the system is used in normal operation as a closed respirator or anesthetize machine. An output passage 88 from the canister 36 is operatively connected to an intratracheal catheter 90 or mask for normal anesthetizing procedures or in combination. According to the usual practice, the catheter 90 is provided of the largest size which is able to pass through the vocal chords of the animal with the catheter then inflated to provide an air tight fitting. A substantially conventional exhalation valve 01 may be incorporated with the catheter 90 to provide an open system for a non-rebreathing method of operation, where all gas exhaled from the patient is discharged through valve 91 to the atmosphere. Thus, with this method of operation the system is refilled for each cycle of the bellows 20 with oxygen or air, or anesthetizing gas as selectively desired. For use with anesthetic the double compensating valves 50 may be about /2 open so as to activate the rebreathing bag 64.
FIGURE 2 is an enlarged view of the double-compensating valve 50 of FIGURE 1, and more clearly shows its relationship to the passages 54 and 56. As clearly seen in the cross section, the valve 58 is operatively carried by the valve stem 52. Valve 60 is mounted to the stem 52 in the same manner. Sealing nuts 92 provide fluid tight seals around the stem 52. The invention contemplates that the handle 62 will be mounted adjacent a convenient scale 144, as seen in FIGURE 5, showing the positions of the valves 58 and 60 carried by the valve stem 52.
FIGURE 3 represents a slight modification of the apparatus of the invention. All components are essentially the same as illustrated in FIGURE 1 except that a bypass line is provided extending from a discharge line 54a to a discharge line 56a with the bypass line 100 terminating in the discharge line 56a in a one-way spring loaded pressure valve 102. The spring tension on the pressure valve 102 may be adjusted by a threaded handle 104. A helically coiled spring 106 provides a resilient bias against movement of a valve seat 108. The valve seat 108 may be displaced by gas pressure passing through line 100 from line 540 or by negative pressure from the ventilator through line 56a. This then provides a fresh supply of gas upon positive pressure from the ventilator. This structural relationship may be utilized for resuscitation or to provide an improved non-breathing method for the basic apparatus.
For another non-rebreathing method of operation, the apparatus will be used preferably to provide a high flow of oxygen through a line 66 or 66a or if desired, to provide a high flow of anesthetizing gas through a line 76a. A double compensating valve 50a will have a valve 58a in the closed position and a valve 60a in the opened position. Thus, it can be seen that there cannot be any reverse flow from incoming oxygen or anesthetizing gas through the line 54a and back through the line 56a. Therefore, the fluid pressure applied to a piping system 12a by a bellows (not shown) will immediately and directly pass through line 56a and to the patient. However, because of the use of the conventional exhalation valve 91 to discharge the exhaled fluid from the patient, on the negative stroke of the bellows the excess pressure of oxygen or anesthetizing gas introduced into line 54a will pass through line 100 and be sufficient to open the one-way valve 102, as assisted by the negative pressure of the bellows, causing the system to be filled with fresh oxygen or anesthetizing gas. In this manner, a patient can receive a fresh supply of oxygen or anesthetizing gas on every positive stroke of a bellows means. This avoids utilization of a C0 absorber, and is readily adaptable for immediate emergency use to provide 100% oxygen, preferably, or anesthetizing gas as desired. Of course, even with this method of operation, the double compensating valve 50a may have to be adjusted to control volume and pressure flow to conform to the lung capacity of the particular patient.
Although the valve 102 is normally only utilized in an emergency for a non-rebreathing method of operation, the valve may be permanently placed in the system With sufficient pressure applied by the spring 106 during other normal methods of operation that it will not operate.
FIGURE 4 discloses a block schematic diagram of a grounding system for the apparatus. Namely, a motor 110, a gear system 112, gas system 114 and front panel 116 are all connected to a metallic main coupling 120 through resistors, indicated generally by numeral 122. The main coupling 120 is firmly afiixed to a base plate 124 for the apparatus. The base plate 124 is movably mounted by electric conductive caster wheels 126 which are grounded to the main coupling 120 by Wires 128 and resistors 130. The caster wheels 126 may engage With grounded metal plate (not shown) lying on the floor. Most likely the wheels 126 will be engaged with conductive flooring, which is a normal safety precaution in modern hospital operating rooms. If a positive ground cannot be obtained through the casters 126, a ground wire 132 may be connected directly to the main coupling 120 for permanently grounding the entire machine. With this system of positive grounding manner, the possibility of the occurrence of any sparks or electrical discharge (i.e., static electricity) is greatly minimized, thereby making the apparatus inherently safe even when using gases of explosive or high burning qualities.
FIGURE 5 illustrates a proposed mounting of the main indicating components on a front panel 140 for the apparatus. Namely, the panel includes an on-otf switch 142 for the motor 28 of FIGURE 1, with the variable rheostat 36 mounted adjacent thereto. The system pressure gage 42 including the system adjustable relief valve is provided to operate in conjunction with a mercury gage 72a which indicate introductory pressures of oxygen, trifluoroethyl vinyl ether, cyclopropane (CYCLO-abbreviation) and other gases or gaseous agents. The positive negative prescompensating valve may be mounted so that it coincides with an adjacent scale 144. Similarly, the one-way variable pressure valve handle 104 can be mounted mined by the input flow and pressures through the bellows,
Thus it is seen that the objects of the invention have been achieved by providing an extremely simple, yet highly effective respiratory apparatus. The only moving parts are the mechanical movement to actuate the bellows and the selective adjustable movement of the doublecompensating valves 50 or the one-way pressure actuated valve 102 of the embodiment of FIGURE 3. The completely grounded system reduces explosion hazards to a minimum. It is obvious that utilizing the variable speed to the motor along with the variable tidal volume flow by the double-compensating valves means that pressure and volume flow to the patient may be readily and variably controlled. It is also obvious that any anesthetic agent may be administered either through the vaporizer 80 or through the gas access openings 76. A direct flow of oxygen may be controllably admitted to the apparatus. In case of failure to the bellows, the expandable breathing bag 64 may be manipulated by hand. The oxygen concentration may always be maintained in excess of metabolic require ments and because of the extreme flexibility of the ap paratus, it is excellent for respiratory depression and/o: respiratory complications during surgery, or normal pr or post-operative care. Further, it is apparent that the ap paratus can be utilized for deliberate hyper ventilation or apnea which some operations require. The apparatus has proven to be highly successful for intra-thoracic surgery on animals.
It should be clear that during the non-rebreathing method, all exhaled mixture from the patient is discharged to the atmosphere so that a new charge of oxygen or anesthetizing agent may be introduced. This could be considered a semi-closed method, Whereas the apparatus set forth in FIGURE 1 could be called a to and fro method as essentially the same gas is pressurized to and fro the lungs of the patient. In the to and fro operation of the apparatus a C0 absorber should be utilized. The simplicity, and highly effective operation provides an improvement in the art.
While in accordance with the patent statutes only one best known embodiment of the invention has been illustrated and described in detail, it is to be particularly understood that the invention is not limited thereto or thereby, but that the inventive scope is defined in the appended claims.
What is claimed is:
1. In a gas respirator the combination of a conduit piping system having one access opening thereto and two discharge openings therefrom,
closed bellows means having a single output connected to the access opening of said piping system,
motor means to mecahnically actuate said bellows with a reciprocating motion to introduce a fluid under a pulsating pressure into said piping system,
rheostat means to control the speed of said motor means,
a closed expandable rebreathing bag having a single access opening operatively connective to one of the discharge openings of said piping system,
an open system flexible conduit means connected to the other discharge opening of said piping system,
interconnected double-compensating valve means associated with said discharge openings from said piping system,
means to actuate said valve means so that as one discharge opening is regulated from fully opened to fully closed, the other discharge opening is simultaneously regulated from fully closed to fully opened, and
means to controllably introduce oxygen under controlled pressure into the piping system.
2. A gas respirator according to claim 1 Where the motor means, conduit piping system, and double-compensating valve means are all grounded to minimize explosive hazards.
3. In a gas respirator adapted to provide gaseous fluid flow to the lungs of a patient the combination of a closed piping system having one access opening and two discharge openings,
closed bellows means having a single output connected to the access opening of said piping system,
means to mechanically actuate said bellows with a reciprocating motion to provide a specific volume of input under a gaseous fluid rythmic pulsating pressure into the piping system,
means to control the reciprocating motion to said bellows means,
a closed expandable rebreathing bag having a single access opening operatively connected to one of the discharge openings of said piping system,
flexible conduit means connected to the other discharge opening of said piping system and providing a closed system to the lungs of said patient,
double-compensating valve means associated with said discharge openings from said piping system,
means to actuate said double-compensating valve means so that as said one discharge opening is regulated from fully opened to fully closed, the other discharge opening in coordinated movement is simultaneously regulated from fully closed to fully opened so as to selectively control the volume of tidal flow of gaseous fluid under pressure introduced by the bellows means into the piping system passed through the flexible conduit means to the lungs of the patient.
4. A gas respirator according to claim 3 which includes means to discharge fluid exhaled from lungs of the patient from the system and replace it with a selected concentration of oxygen.
5. A gas respirator according to claim 3 which includes means to discharge fluid exhaled from the lungs of the patient from the system and replace said discharged fluid with a selected concentration of an anesthetizing gas.
6. A gas respirator according to claim 3 which includes means to discharge fluid exhaled from the lungs of the patient from the system and replace said discharged fluid with a selected mixture of anesthetizing gas and oxygen.
7. A gas respirator according to claim 3 where an anesthetizing gas can be selectively introd-uced into the closed piping system to provide a tidal flow of a controlled concentration of anesthetizing gas to the lungs of the patient.
8. A respirator according to claim 3 where oxygen can be selectively introduced into the closed piping system to provide tidal flow of a controlled concentration of oxygen to the lungs of the patient.
9. A respirator according to claim 3 Where oxygen and an anesthetic gas can be selectively introduced into the closed piping system to provide a tidal flow of a controlled concentration of oxygen and an anesthetic gas to the lungs of the patient.
References (Iited UNITED STATES PATENTS 2,591,120 4/1952 Blease 128-29 2,924,215 2/1960 Goodner 128-29 3,045,668 7/1962 Lee 128-29 3,088,456 5/1963 Stanton 128-29 RICHARD A. GAUDET, Primary Examiner.
C. F. ROSENBAUM, Examiner.