WO2002032489A2 - Ventilator with dual gas supply - Google Patents

Ventilator with dual gas supply Download PDF

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Publication number
WO2002032489A2
WO2002032489A2 PCT/US2001/032419 US0132419W WO0232489A2 WO 2002032489 A2 WO2002032489 A2 WO 2002032489A2 US 0132419 W US0132419 W US 0132419W WO 0232489 A2 WO0232489 A2 WO 0232489A2
Authority
WO
WIPO (PCT)
Prior art keywords
gas supply
relative pressure
ventilator
pressure gas
diverter valve
Prior art date
Application number
PCT/US2001/032419
Other languages
French (fr)
Other versions
WO2002032489A3 (en
Inventor
Gary L. Hansen
Original Assignee
Mallinckrodt 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
Application filed by Mallinckrodt Inc. filed Critical Mallinckrodt Inc.
Priority to JP2002535725A priority Critical patent/JP2004511311A/en
Priority to CA002424358A priority patent/CA2424358A1/en
Priority to EP01981709A priority patent/EP1326671B1/en
Priority to DE60137605T priority patent/DE60137605D1/en
Publication of WO2002032489A2 publication Critical patent/WO2002032489A2/en
Publication of WO2002032489A3 publication Critical patent/WO2002032489A3/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
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M16/0009—Accessories therefor, e.g. sensors, vibrators, negative pressure with sub-atmospheric pressure, e.g. during expiration
    • 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
    • A61M16/021—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
    • A61M16/026—Control means therefor including calculation means, e.g. using a processor specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
    • 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
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • 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
    • A61M16/06—Respiratory or anaesthetic masks
    • 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
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit

Definitions

  • the present invention relates generally to the field of medical ventilators.
  • a medical ventilator is a device used to deliver a gas or gases to a patient. This may include air or oxygen, and may also include a variety of additive medicines or treatments.
  • the gas is supplied to a patient via a gas delivery device such as a mask, a nasal cannula, or a tracheostomy tube.
  • the ventilator may be used in cases where it merely assists a patient ' s breathing (respiratory insufficiency) , or may be used in cases where the ventilator must perform breathing for the patient (respiratory failure or when the patient is under the influence of anesthesia) .
  • the ventilator may provide a constant pressure airflow, may provide a cyclic airflow, or may provide other pressure patterns.
  • a ventilator may need to be capable of providing a gas or gas mixture at either a steady pressure or may need to be capable of providing an output that follows a predetermined pressure or flow volume profile that corresponds to a predetermined breathing profile.
  • the pressure profile may be a cyclic inhalation/exhalation pattern having a varying gas pressure and flow volume profiles.
  • the pressure profile may need to be varied according to a patient's age, health, medical condition, etc.
  • FIG. 1 shows a prior art ventilator 100 connected to a gas delivery device 101 in the form of a mask.
  • the prior art ventilator 100 includes a blower 105, and a pressure sensor 108.
  • the blower may be used to achieve a gas supply pressure, and may be an electric motor turning an impeller.
  • a target gas supply pressure has typically been achieved by controlling the blower motor speed. If the pressure of the gas supply is below a predetermined pressure, the motor speed may be increased, and vice versa.
  • a variable blower speed ventilator 100 of the prior art has drawbacks. In order to keep the ventilator air circuit as light and unobtrusive as possible in order to improve wearability, the prior art ventilator 100 generally employs tubing of a small diameter. As a result, airflow resistance is increased, yielding a lower than expected pressure to the patient .
  • Airflow resistance is usually measured by a constant-flow pressure drop. This is the drop in pressure (usually expressed in units of centimeters of water, or cm H 2 0) between the entrance and the exit of the tube under conditions of unvarying flow.
  • the standard ventilator hose is typically about 22 millimeters in diameter and about 6 feet long. This creates a constant-flow pressure drop of less than 1-2 cm H 2 0 for reasonable values of flow (such as a breathing airflow of less than 60 liters per minute) . Higher peak airflow values for patients suffering from respiratory insufficiency are possible but are rare.
  • Recent prior art masks include short lengths of a smaller-diameter tubing (generally about 15 millimeters in diameter and about 6-18 inches long) acting as a strain relief between the bulkier air supply hose and the mask. These smaller diameter tubing segments can add 1-2 cm H 2 0 to the pressure drop.
  • a CPAP (continuous positive airway pressure) system may be used for nocturnal treatment of obstructive sleep apnea.
  • a CPAP system the patient's airway is partially inflated by the positive pressure in order to aid breathing and sleep. Therefore, it is desirable in a CPAP system to hold the target pressure to a tolerance of about plus or minus 2 cm H 2 0.
  • the acceptable pressure range for other ventilator modes may extend up to plus or minus 5 cm H 2 0.
  • a more resistive patient airflow circuit i.e., a mask and hose combined
  • the increased air circuit resistance may be somewhat compensated for by increasing the blower output.
  • a blower may not be able to adjust its speed and output quickly enough to correct for pressure changes.
  • the blower direction may need to be reversed in devices of the prior art. These quick changes in motor speed and direction may cause unacceptable levels of motor heating, may require more electrical power to achieve a desired pressure, may cause much higher levels of motor wear, and still do not provide a satisfactorily fast pressure response.
  • a ventilator is provided according to an embodiment of the invention.
  • the ventilator comprises a positive relative pressure gas supply, a negative relative pressure gas supply, and a diverter valve.
  • the diverter valve includes a positive pressure port connected to the positive relative pressure gas supply, a negative pressure port connected to the negative relative pressure gas supply, and a gas supply port communicating with a gas delivery device.
  • the ventilator preferably further includes a feedback sensor that detects a gas supply difference between a gas supply and a predetermined gas supply and generates a feedback signal that is substantially related to the gas supply difference.
  • the ventilator preferably further includes a diverter valve actuator communicating with the diverter valve and operating the diverter valve to communicate the positive relative pressure gas supply and the negative relative pressure gas supply to the gas supply port of the diverter valve based upon the feedback signal .
  • a method of pressure regulation for a ventilator comprises the steps of providing a positive relative pressure gas supply, providing a negative relative pressure gas supply, and detecting a gas supply difference between a gas supply provided to a gas delivery device of the ventilator and a predetermined gas supply.
  • the method further comprises the steps of generating a feedback signal that is substantially related to the gas supply difference, and actuating a diverter valve to communicate the positive relative pressure gas supply and the negative relative pressure gas supply to the gas delivery device in order to substantially minimize the gas supply difference.
  • FIG. 1 shows a prior art ventilator
  • FIG. 2 shows an embodiment of a ventilator according to the invention
  • FIG. 3 shows an embodiment of a diverter valve for use with a ventilator according to the present invention
  • FIG. 4 is a pressure graph of a representative pressure profile during a typical breathing cycle
  • FIG. 5 is a flow volume graph of a representative flow volume during a typical breathing cycle
  • FIG. 6 is a motor speed graph of a representative positive gas supply motor speed
  • FIG. 7 is a motor speed graph of a representative negative gas supply motor speed
  • FIG. 8 is a flowchart of a ventilator pressure regulation method embodiment according to the invention.
  • FIG. 2 shows an embodiment of a ventilator 200 according to the invention.
  • the ventilator 200 includes a positive relative pressure gas supply 204, a negative relative pressure gas supply 206, and a diverter valve 211 communicating with the positive relative pressure gas supply 204 and the negative relative pressure gas supply 206.
  • a gas delivery device 222 in the form of a mask is also shown communicating with the diverter valve 211.
  • the positive relative pressure gas supply 204 and the negative relative pressure gas supply 206 may be motors turning associated impellers or fans (e.g., blowers).
  • the gas supplies may be any form of bellows, piston, pump, fan, impeller or other device that is capable of providing a gas at an elevated relative pressure.
  • Each blower may need to provide at least positive and negative pressures of about 35 cm H 2 0 at the gas delivery device 220 in order to achieve a peak gas flow rate of 60 liters per minute. In a majority of patients, this will be a satisfactory flow volume.
  • the ventilator 200 may preferably be capable of providing positive and negative pressures of at least 40 to 60 cm H 2 0, or even greater. The greater the gas supply output, the greater the ability of the ventilator 200 to correct for sudden peaks in respiratory flow.
  • FIG. 3 shows an embodiment of the diverter valve 211.
  • the diverter valve 211 includes a positive pressure port 303, a negative pressure port 305, and a gas supply port 309. It should be understood that the diverter valve 211, although shown as a common tee type valve, could be a valve of any other configuration.
  • the diverter valve 211 may be actuated to select the positive pressure port 303, the negative pressure port 305, or a ratio of both, to communicate with the gas supply port 309.
  • valve member of diverter valve 211 is constructed of a material having a relatively low mass, such as plastic, it will be capable of being rapidly actuated. Therefore, the diverter valve 211 may have a small response time, and the pressure and/or flow volume at the gas supply port 309 may be carefully regulated.
  • the diverter valve 211 may be directly coupled to the two gas supplies 204 and 206 and to the gas delivery device 222. Alternatively, the various components may be connected by conduits 214 as shown in FIG. 1.
  • the ventilator 200 is especially suited for use with smaller diameter tubing 21 ' connecting the ventilator to the gas delivery device 222 as a strain relief. Therefore, the gas supplies 204 and 206 and the diverter valve 211 may be placed at a variety of locations relative to the patient, such as formed on the gas delivery device 222, or in a backpack, belt, or chest configuration, or on a cart or table remote from the patient, etc.
  • Ventilator 200 include one or more vent ports 218 that function to vent excess supplied gas (or exhaled carbon dioxide) . The vent port 218 may be located on any of the ventilator components, such as conduit 214, or on the gas delivery device 222.
  • the ventilator 200 may be used to maintain a predetermined gas supply to a patient.
  • the positive relative pressure gas supply 204 creates a positive relative gas pressure for the diverter valve 211
  • the negative relative pressure gas supply 206 creates a negative relative gas pressure for the diverter valve 211.
  • the diverter valve 211 may be used to communicate the positive relative pressure gas supply 204 and the negative relative pressure gas supply 206 to the gas delivery device 222.
  • the predetermined gas supply pressure achieved through use of the diverter valve 211 may therefore be a predetermined pressure and/or flow volume profile that substantially corresponds to a patient's breathing.
  • the resulting gas pressure at the gas delivery device 222 may therefore be any pressure in the negative-positive relative pressure range. This enables a quick and accurate control of the gas pressure supplied to the gas delivery device 222. In this manner, using the two gas supplies 204 and 206, pressure regulation is achieved and the patient may be aided in breathing without having to change the speed of an associated blower. This extends motor life, creates less noise, and allows lower motor running temperatures.
  • the two gas supplies 204 and 206 may be used to achieve a predetermined flow volume, instead of a predetermined pressure. The end result in both cases is a delivery to the patient of a predetermined gas supply to aid in breathing.
  • the pressure is commonly referred to in this description, it should be understood that the two gas supplies 204 and 206 and the diverter valve 211 may be operated according to either the pressure or the flow volume in the ventilator.
  • the diverter valve 211 may be capable of a continuous range of movement. Therefore, gas supply regulation may be achieved by positioning the diverter valve 211 anywhere in between the two selections and the two pressure extremes. In this manner, for example, the pressure at the gas supply port 309 may be the positive relative pressure, the negative relative pressure, or some level in between. At a time period between inhalations and exhalations, for example, the diverter valve 211 may be halfway open, and as a result there may be airflow only from the positive relative pressure gas supply to the negative relative pressure gas supply, and essentially no airflow into the gas delivery device 222. At the start of inhalation or exhalation, however, the diverter valve 211 may be near one of the extremes of travel in order to provide a desired pressure or flow volume.
  • the diverter valve 211 may be an either-or valve, where either the positive pressure port 303 is selected or the negative pressure port 305 is selected, but not both.
  • a predetermined pressure may be maintained in this embodiment by periodically actuating the diverter valve 211 between either pressure supply port.
  • the actuation duty cycle may be varied to achieve a predetermined pressure (or pressure profile) at any level between the positive pressure gas supply 204 or the negative relative pressure gas supply 206 (e.g., by fluttering the diverter valve 211) .
  • the ventilator 200 therefore includes a control system 250 and a feedback sensor of some type.
  • the control system 250 is capable of actuating the diverter valve 211 by sending an appropriate control signal to the actuator 212.
  • the control system 250 In order to actuate the diverter valve 211, the control system 250 must be able to determine a switching time. The actuation may be done in response to a feedback signal generated by one or more feedback sensors.
  • the feedback sensor may be a pressure or flow volume sensor 229 positioned on or between the diverter valve 211 and the mask 222.
  • the control system 250 may be any type of analog or digital electronic feedback control, such as a proportional controller, a proportional integral derivative (PID) controller, or a computer processor programmed to implement one or more predetermined breathing profiles.
  • the control system 250 may function to assist patients with respiratory insufficiency or may perform ventilation for patients with respiratory failure. Depending on the type of ventilation required, different breathing patterns and pressure levels may be needed.
  • the ventilator 200 may accommodate patients of different ages and in various states of health. Various ventilation pressure or flow volume profiles may be programmed into the control system 250 and recalled.
  • the ventilator 200 may provide adequate ventilation but yet accommodate different lung capacities, without the need for calibration.
  • the ventilator 200 includes a sensor 229 in the form of a pressure sensor positioned on or between the diverter valve 211 and the gas delivery device 222.
  • the pressure sensor 229 may generate a feedback signal that is substantially related to the gas supply pressure.
  • the feedback signal may be compared to a predetermined or desired pressure or pressure profile in order to generate a pressure difference.
  • the pressure difference may be used to actuate the diverter valve 211 according to any known feedback and control algorithm.
  • FIG. 4 is a pressure graph of a representative pressure profile during a typical breathing cycle. This may be the pressure at the gas delivery device 222.
  • the feedback sensor 229 is a flow volume sensor positioned on or between the diverter valve 211 and the gas delivery device 222.
  • the flow volume sensor 229 measures a flow volume of gas.
  • the flow volume may be used to signify pressure changes and determine when the patient is inhaling or exhaling (see FIG. 5 and accompanying discussion below) .
  • the flow volume sensor 229 may generate a feedback signal that is substantially related to the gas supply flow volume.
  • the feedback signal may be compared to a predetermined or desired flow volume or flow volume profile in order to generate a flow volume difference.
  • the flow volume difference may be used to actuate the diverter valve 211 according to any known feedback and control algorithm.
  • FIG. 5 is a flow volume graph of a representative flow volume during a typical breathing cycle. This may be the flow volume at the gas delivery device 222. As can be seen from the graph, the gas flow volume varies regularly with the patient's breathing. This figure shows that the changes in flow volume correspond to the changes in pressure, and illustrates why the flow volume measurement is substantially analogous to the pressure measurement. Therefore, the flow volume measurement may be used to control the diverter valve 211.
  • one or more motor speed sensors 234 and 236 are used to control the diverter valve 211.
  • the point in time when the motor speed of the positive relative pressure gas supply 204 drops patient inhalation has stopped and exhalation has begun.
  • the pressure in the ventilator increases when the patient stops inhaling (i.e., an airflow backup occurs). This increase in pressure will cause the motor of the positive relative pressure gas supply 204 to slow down. Therefore, the control system 250 may now control the actuator 212 and move the diverter valve 211 to select the negative pressure port 305 and the negative relative pressure gas supply 206, or select a greater opening percentage for the negative pressure port 305.
  • control system 250 may now control the actuator 212 and move the diverter valve 211 to select the positive pressure port 303 and the positive relative pressure gas supply 204, or select a greater opening percentage for the positive pressure port 303.
  • FIG. 6 is a motor speed graph of a representative positive gas supply motor speed. The graph shows how the motor speed may be affected by inspiration and expiration and shows how the motor speed may therefore be detected and used to control the diverter valve 211.
  • FIG. 7 is a motor speed graph of a representative negative gas supply motor speed.
  • the diverter valve 211 may be actuated using the speed of one or both motors.
  • a motor speed sensor at the positive relative pressure gas supply 204 would see a substantial increase in pressure at the start of a patient exhalation cycle, and would see a substantial drop in pressure at the start of a patient inhalation cycle.
  • FIG. 8 is a flowchart 800 of a ventilator pressure regulation method embodiment according to the invention.
  • a positive relative pressure gas supply is provided.
  • the positive relative pressure gas supply may be any form of bellows, piston, pump, fan, impeller or other device that is capable of providing a gas at a positive relative pressure (i.e., a gas at a pressure greater than the ambient air pressure) .
  • a negative relative pressure gas supply is provided.
  • the negative relative pressure gas supply may likewise be any form of bellows, piston, pump, fan, impeller or other device that is capable of providing a gas at a negative relative pressure.
  • a pressure difference between a gas supply and a predetermined or desired gas supply is detected.
  • the gas supply may be detected using the pressure, flow volume, or motor speed, and is a determination of the gas being supplied to a gas delivery device of the ventilator.
  • the pressure difference may be detected by measuring the gas supply pressure, by measuring a gas supply flow volume, blower motor speeds, etc., as previously discussed.
  • the positive relative pressure gas supply 204 and the negative relative pressure gas supply 206 are selected to be communicated to the gas delivery device 222.
  • the selection may be selecting one of the two gas supplies, or the selection device may be at some position in between wherein both the positive supply 204 and the negative supply 206 are partially communicating with the gas delivery device 222. In this manner, a predetermined gas supply pressure to the gas delivery device 222 may be substantially achieved.
  • ventilator 200 as described above is discussed in the context of a pressure regulator for respiratory therapy, it should be understood that the invention may enjoy other uses. This may include use as a breathing simulator, for example, that could be used to develop and test further ventilators of associated ventilation devices and control or monitoring routines.

Abstract

A method of pressure regulation and a ventilator are provided. The ventilator (200) includes a positive relative pressure gas supply (204), a negative relative pressure gas supply (206), and a diverter valve (211). The diverter valve (211) includes a positive pressure port (303) connected to the positive relative pressure gas supply (204), a negative pressure port (305) connected to the negative relative pressure gas supply (206), and a gas supply port (309) communicating with a gas delivery device (220, 222). The ventilator (200) preferably further includes a feedback sensor (229) that detects a gas supply difference between a gas supply and a predetermined gas supply and generates a feedback signal that is substantially related to the gas supply difference. The ventilator (200) preferably further includes a diverter valve actuator (212) communicating with the diverter valve (211) and operating the diverter valve (211) to communicate the positive relative pressure gas supply (204) and the negative relative pressure gas (206) supply to the gas supply port (309) of the diverter valve (211) based upon the feedback signal.

Description

VENTILATOR WITH DUAL GAS SUPPLY
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates generally to the field of medical ventilators.
2. Description of the Background Art
A medical ventilator is a device used to deliver a gas or gases to a patient. This may include air or oxygen, and may also include a variety of additive medicines or treatments. The gas is supplied to a patient via a gas delivery device such as a mask, a nasal cannula, or a tracheostomy tube. The ventilator may be used in cases where it merely assists a patient ' s breathing (respiratory insufficiency) , or may be used in cases where the ventilator must perform breathing for the patient (respiratory failure or when the patient is under the influence of anesthesia) . The ventilator may provide a constant pressure airflow, may provide a cyclic airflow, or may provide other pressure patterns. Therefore, a ventilator may need to be capable of providing a gas or gas mixture at either a steady pressure or may need to be capable of providing an output that follows a predetermined pressure or flow volume profile that corresponds to a predetermined breathing profile. The pressure profile may be a cyclic inhalation/exhalation pattern having a varying gas pressure and flow volume profiles. The pressure profile may need to be varied according to a patient's age, health, medical condition, etc. FIG. 1 shows a prior art ventilator 100 connected to a gas delivery device 101 in the form of a mask. The prior art ventilator 100 includes a blower 105, and a pressure sensor 108. The blower may be used to achieve a gas supply pressure, and may be an electric motor turning an impeller.
In the prior art, a target gas supply pressure has typically been achieved by controlling the blower motor speed. If the pressure of the gas supply is below a predetermined pressure, the motor speed may be increased, and vice versa. However, a variable blower speed ventilator 100 of the prior art has drawbacks. In order to keep the ventilator air circuit as light and unobtrusive as possible in order to improve wearability, the prior art ventilator 100 generally employs tubing of a small diameter. As a result, airflow resistance is increased, yielding a lower than expected pressure to the patient .
Airflow resistance is usually measured by a constant-flow pressure drop. This is the drop in pressure (usually expressed in units of centimeters of water, or cm H20) between the entrance and the exit of the tube under conditions of unvarying flow. The standard ventilator hose is typically about 22 millimeters in diameter and about 6 feet long. This creates a constant-flow pressure drop of less than 1-2 cm H20 for reasonable values of flow (such as a breathing airflow of less than 60 liters per minute) . Higher peak airflow values for patients suffering from respiratory insufficiency are possible but are rare. Recent prior art masks include short lengths of a smaller-diameter tubing (generally about 15 millimeters in diameter and about 6-18 inches long) acting as a strain relief between the bulkier air supply hose and the mask. These smaller diameter tubing segments can add 1-2 cm H20 to the pressure drop.
Clinical guidelines for regulating the air pressure to the patient vary depending on the medical use. A CPAP (continuous positive airway pressure) system may be used for nocturnal treatment of obstructive sleep apnea. In a CPAP system, the patient's airway is partially inflated by the positive pressure in order to aid breathing and sleep. Therefore, it is desirable in a CPAP system to hold the target pressure to a tolerance of about plus or minus 2 cm H20. The acceptable pressure range for other ventilator modes may extend up to plus or minus 5 cm H20. Particularly for CPAP ventilators, a more resistive patient airflow circuit (i.e., a mask and hose combined) can cause pressure regulation to the patient to vary outside an acceptable range. This creates a need for a ventilator that can more quickly compensate for rapid changes in the airflow rate .
The increased air circuit resistance may be somewhat compensated for by increasing the blower output. However, if the ventilator circuit resistance becomes too great, a blower may not be able to adjust its speed and output quickly enough to correct for pressure changes. In addition, if the blower is trying to quickly go from one pressure extreme to another, the blower direction may need to be reversed in devices of the prior art. These quick changes in motor speed and direction may cause unacceptable levels of motor heating, may require more electrical power to achieve a desired pressure, may cause much higher levels of motor wear, and still do not provide a satisfactorily fast pressure response.
There remains a need in the art for improved ventilator pressure regulation.
SUMMARY OF THE INVENTION A ventilator is provided according to an embodiment of the invention. The ventilator comprises a positive relative pressure gas supply, a negative relative pressure gas supply, and a diverter valve. The diverter valve includes a positive pressure port connected to the positive relative pressure gas supply, a negative pressure port connected to the negative relative pressure gas supply, and a gas supply port communicating with a gas delivery device. The ventilator preferably further includes a feedback sensor that detects a gas supply difference between a gas supply and a predetermined gas supply and generates a feedback signal that is substantially related to the gas supply difference. The ventilator preferably further includes a diverter valve actuator communicating with the diverter valve and operating the diverter valve to communicate the positive relative pressure gas supply and the negative relative pressure gas supply to the gas supply port of the diverter valve based upon the feedback signal .
A method of pressure regulation for a ventilator is provided according to an embodiment of the invention. The method comprises the steps of providing a positive relative pressure gas supply, providing a negative relative pressure gas supply, and detecting a gas supply difference between a gas supply provided to a gas delivery device of the ventilator and a predetermined gas supply. The method further comprises the steps of generating a feedback signal that is substantially related to the gas supply difference, and actuating a diverter valve to communicate the positive relative pressure gas supply and the negative relative pressure gas supply to the gas delivery device in order to substantially minimize the gas supply difference.
The above and other features and advantages of the present invention will be further understood from the following description of the preferred embodiments thereof, taken in conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 shows a prior art ventilator;
FIG. 2 shows an embodiment of a ventilator according to the invention; FIG. 3 shows an embodiment of a diverter valve for use with a ventilator according to the present invention;
FIG. 4 is a pressure graph of a representative pressure profile during a typical breathing cycle;
FIG. 5 is a flow volume graph of a representative flow volume during a typical breathing cycle;
FIG. 6 is a motor speed graph of a representative positive gas supply motor speed; FIG. 7 is a motor speed graph of a representative negative gas supply motor speed; and
FIG. 8 is a flowchart of a ventilator pressure regulation method embodiment according to the invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
FIG. 2 shows an embodiment of a ventilator 200 according to the invention. The ventilator 200 includes a positive relative pressure gas supply 204, a negative relative pressure gas supply 206, and a diverter valve 211 communicating with the positive relative pressure gas supply 204 and the negative relative pressure gas supply 206. A gas delivery device 222 in the form of a mask is also shown communicating with the diverter valve 211. By actuating the diverter valve 211 in substantial synchronization with the breathing of the patient, breathing is aided and the work required by the patient is decreased.
The positive relative pressure gas supply 204 and the negative relative pressure gas supply 206 may be motors turning associated impellers or fans (e.g., blowers). Alternatively, the gas supplies may be any form of bellows, piston, pump, fan, impeller or other device that is capable of providing a gas at an elevated relative pressure. Each blower may need to provide at least positive and negative pressures of about 35 cm H20 at the gas delivery device 220 in order to achieve a peak gas flow rate of 60 liters per minute. In a majority of patients, this will be a satisfactory flow volume. However, the ventilator 200 may preferably be capable of providing positive and negative pressures of at least 40 to 60 cm H20, or even greater. The greater the gas supply output, the greater the ability of the ventilator 200 to correct for sudden peaks in respiratory flow.
FIG. 3 shows an embodiment of the diverter valve 211. The diverter valve 211 includes a positive pressure port 303, a negative pressure port 305, and a gas supply port 309. It should be understood that the diverter valve 211, although shown as a common tee type valve, could be a valve of any other configuration. The diverter valve 211 may be actuated to select the positive pressure port 303, the negative pressure port 305, or a ratio of both, to communicate with the gas supply port 309.
If the valve member of diverter valve 211 is constructed of a material having a relatively low mass, such as plastic, it will be capable of being rapidly actuated. Therefore, the diverter valve 211 may have a small response time, and the pressure and/or flow volume at the gas supply port 309 may be carefully regulated.
The diverter valve 211 may be directly coupled to the two gas supplies 204 and 206 and to the gas delivery device 222. Alternatively, the various components may be connected by conduits 214 as shown in FIG. 1. The ventilator 200 is especially suited for use with smaller diameter tubing 21 ' connecting the ventilator to the gas delivery device 222 as a strain relief. Therefore, the gas supplies 204 and 206 and the diverter valve 211 may be placed at a variety of locations relative to the patient, such as formed on the gas delivery device 222, or in a backpack, belt, or chest configuration, or on a cart or table remote from the patient, etc. Ventilator 200 include one or more vent ports 218 that function to vent excess supplied gas (or exhaled carbon dioxide) . The vent port 218 may be located on any of the ventilator components, such as conduit 214, or on the gas delivery device 222.
In use, the ventilator 200 may be used to maintain a predetermined gas supply to a patient. The positive relative pressure gas supply 204 creates a positive relative gas pressure for the diverter valve 211, while the negative relative pressure gas supply 206 creates a negative relative gas pressure for the diverter valve 211. The diverter valve 211 may be used to communicate the positive relative pressure gas supply 204 and the negative relative pressure gas supply 206 to the gas delivery device 222. The predetermined gas supply pressure achieved through use of the diverter valve 211 may therefore be a predetermined pressure and/or flow volume profile that substantially corresponds to a patient's breathing.
The resulting gas pressure at the gas delivery device 222 may therefore be any pressure in the negative-positive relative pressure range. This enables a quick and accurate control of the gas pressure supplied to the gas delivery device 222. In this manner, using the two gas supplies 204 and 206, pressure regulation is achieved and the patient may be aided in breathing without having to change the speed of an associated blower. This extends motor life, creates less noise, and allows lower motor running temperatures. Alternatively, the two gas supplies 204 and 206 may be used to achieve a predetermined flow volume, instead of a predetermined pressure. The end result in both cases is a delivery to the patient of a predetermined gas supply to aid in breathing. Although the pressure is commonly referred to in this description, it should be understood that the two gas supplies 204 and 206 and the diverter valve 211 may be operated according to either the pressure or the flow volume in the ventilator.
In a first diverter valve embodiment, the diverter valve 211 may be capable of a continuous range of movement. Therefore, gas supply regulation may be achieved by positioning the diverter valve 211 anywhere in between the two selections and the two pressure extremes. In this manner, for example, the pressure at the gas supply port 309 may be the positive relative pressure, the negative relative pressure, or some level in between. At a time period between inhalations and exhalations, for example, the diverter valve 211 may be halfway open, and as a result there may be airflow only from the positive relative pressure gas supply to the negative relative pressure gas supply, and essentially no airflow into the gas delivery device 222. At the start of inhalation or exhalation, however, the diverter valve 211 may be near one of the extremes of travel in order to provide a desired pressure or flow volume.
In another embodiment, the diverter valve 211 may be an either-or valve, where either the positive pressure port 303 is selected or the negative pressure port 305 is selected, but not both. A predetermined pressure may be maintained in this embodiment by periodically actuating the diverter valve 211 between either pressure supply port. The actuation duty cycle may be varied to achieve a predetermined pressure (or pressure profile) at any level between the positive pressure gas supply 204 or the negative relative pressure gas supply 206 (e.g., by fluttering the diverter valve 211) .
Also shown in FIG. 2 are the feedback and control components that determine the pressure in the ventilator and actuate the diverter valve 211 in response. The ventilator 200 therefore includes a control system 250 and a feedback sensor of some type. The control system 250 is capable of actuating the diverter valve 211 by sending an appropriate control signal to the actuator 212. In order to actuate the diverter valve 211, the control system 250 must be able to determine a switching time. The actuation may be done in response to a feedback signal generated by one or more feedback sensors. The feedback sensor may be a pressure or flow volume sensor 229 positioned on or between the diverter valve 211 and the mask 222. Alternatively, or in addition to sensor 229, one or more motor speed sensors 234 and 236 may be associated with corresponding gas supplies 204 and 206. The control system 250 may be any type of analog or digital electronic feedback control, such as a proportional controller, a proportional integral derivative (PID) controller, or a computer processor programmed to implement one or more predetermined breathing profiles. The control system 250 may function to assist patients with respiratory insufficiency or may perform ventilation for patients with respiratory failure. Depending on the type of ventilation required, different breathing patterns and pressure levels may be needed. In addition, the ventilator 200 may accommodate patients of different ages and in various states of health. Various ventilation pressure or flow volume profiles may be programmed into the control system 250 and recalled.
By varying the gas supply at the gas delivery device 222 based on a detected gas supply level, the ventilator 200 may provide adequate ventilation but yet accommodate different lung capacities, without the need for calibration.
In a first feedback sensor embodiment, the ventilator 200 includes a sensor 229 in the form of a pressure sensor positioned on or between the diverter valve 211 and the gas delivery device 222. The pressure sensor 229 may generate a feedback signal that is substantially related to the gas supply pressure. The feedback signal may be compared to a predetermined or desired pressure or pressure profile in order to generate a pressure difference. The pressure difference may be used to actuate the diverter valve 211 according to any known feedback and control algorithm.
FIG. 4 is a pressure graph of a representative pressure profile during a typical breathing cycle. This may be the pressure at the gas delivery device 222.
In a second embodiment, the feedback sensor 229 is a flow volume sensor positioned on or between the diverter valve 211 and the gas delivery device 222. The flow volume sensor 229 measures a flow volume of gas. The flow volume may be used to signify pressure changes and determine when the patient is inhaling or exhaling (see FIG. 5 and accompanying discussion below) . The flow volume sensor 229 may generate a feedback signal that is substantially related to the gas supply flow volume. The feedback signal may be compared to a predetermined or desired flow volume or flow volume profile in order to generate a flow volume difference. The flow volume difference may be used to actuate the diverter valve 211 according to any known feedback and control algorithm.
FIG. 5 is a flow volume graph of a representative flow volume during a typical breathing cycle. This may be the flow volume at the gas delivery device 222. As can be seen from the graph, the gas flow volume varies regularly with the patient's breathing. This figure shows that the changes in flow volume correspond to the changes in pressure, and illustrates why the flow volume measurement is substantially analogous to the pressure measurement. Therefore, the flow volume measurement may be used to control the diverter valve 211.
In a third embodiment, one or more motor speed sensors 234 and 236 are used to control the diverter valve 211. In the two motor speed sensors embodiment, for example, the point in time when the motor speed of the positive relative pressure gas supply 204 drops, patient inhalation has stopped and exhalation has begun. As the positive pressure continues to be supplied, the pressure in the ventilator increases when the patient stops inhaling (i.e., an airflow backup occurs). This increase in pressure will cause the motor of the positive relative pressure gas supply 204 to slow down. Therefore, the control system 250 may now control the actuator 212 and move the diverter valve 211 to select the negative pressure port 305 and the negative relative pressure gas supply 206, or select a greater opening percentage for the negative pressure port 305.
Conversely, when the motor speed of the negative relative pressure gas supply 206 drops, as detected by the motor speed sensor 236, exhalation has stopped and inhalation has begun. The control system 250 may now control the actuator 212 and move the diverter valve 211 to select the positive pressure port 303 and the positive relative pressure gas supply 204, or select a greater opening percentage for the positive pressure port 303.
FIG. 6 is a motor speed graph of a representative positive gas supply motor speed. The graph shows how the motor speed may be affected by inspiration and expiration and shows how the motor speed may therefore be detected and used to control the diverter valve 211.
FIG. 7 is a motor speed graph of a representative negative gas supply motor speed. The diverter valve 211 may be actuated using the speed of one or both motors. In a one motor speed sensor embodiment, a motor speed sensor at the positive relative pressure gas supply 204 would see a substantial increase in pressure at the start of a patient exhalation cycle, and would see a substantial drop in pressure at the start of a patient inhalation cycle.
In comparison, in a two speed sensor embodiment, the positive motor speed sensor 234 may be used to determine the end of inhalation and the start of exhalation, while the negative motor speed sensor 236 may be used to determine the end of exhalation and the start of inhalation. By using the speed of both motors, the inspiration and expiration cycles may be detected with more precision. In addition, the redundancy of two speed sensors may provide the ventilator pressure regulator 200 with an extra level of reliability. FIG. 8 is a flowchart 800 of a ventilator pressure regulation method embodiment according to the invention. In step 806, a positive relative pressure gas supply is provided. The positive relative pressure gas supply may be any form of bellows, piston, pump, fan, impeller or other device that is capable of providing a gas at a positive relative pressure (i.e., a gas at a pressure greater than the ambient air pressure) .
In step 812, a negative relative pressure gas supply is provided. The negative relative pressure gas supply may likewise be any form of bellows, piston, pump, fan, impeller or other device that is capable of providing a gas at a negative relative pressure.
In step 816, a pressure difference between a gas supply and a predetermined or desired gas supply is detected. The gas supply may be detected using the pressure, flow volume, or motor speed, and is a determination of the gas being supplied to a gas delivery device of the ventilator. The pressure difference may be detected by measuring the gas supply pressure, by measuring a gas supply flow volume, blower motor speeds, etc., as previously discussed. In step 825, the positive relative pressure gas supply 204 and the negative relative pressure gas supply 206 are selected to be communicated to the gas delivery device 222. As previously described, the selection may be selecting one of the two gas supplies, or the selection device may be at some position in between wherein both the positive supply 204 and the negative supply 206 are partially communicating with the gas delivery device 222. In this manner, a predetermined gas supply pressure to the gas delivery device 222 may be substantially achieved.
Although the ventilator 200 as described above is discussed in the context of a pressure regulator for respiratory therapy, it should be understood that the invention may enjoy other uses. This may include use as a breathing simulator, for example, that could be used to develop and test further ventilators of associated ventilation devices and control or monitoring routines.
While the invention has been described in detail above, the invention is not intended to be limited to the specific embodiments as described. It is evident that those skilled in the art may now make numerous uses and modifications of and departures from the specific embodiments described herein without departing from the inventive concepts.

Claims

What is claimed is : 1. A ventilator, comprising: a positive relative pressure gas supply; a negative relative pressure gas supply; and a diverter valve including a positive pressure port connected to said positive relative pressure gas supply, a negative pressure port connected to said negative relative pressure gas supply, and a gas supply port for communicating with a gas delivery device.
2. The ventilator of claim 1, further comprising: a feedback sensor that detects a gas supply difference between a gas supply and a predetermined gas supply and generates a feedback signal that is substantially related to said gas supply difference; and a diverter valve actuator communicating with said diverter valve and operating said diverter valve to communicate said positive relative pressure gas supply and said negative relative pressure gas supply to said gas supply port of said diverter valve based upon said feedback signal.
3. The ventilator of claim 2, further comprising a control system that receives said feedback signal and commands said diverter valve actuator.
4. The ventilator of claim 2, further comprising a control system that receives said feedback signal and commands said diverter valve actuator and wherein said control system commands said diverter valve actuator to substantially achieve a predetermined breathing profile.
5. The ventilator of claim 2, wherein said ventilator pressure regulator further comprises a vent port .
6. The ventilator of claim 2, wherein said diverter valve actuator is a linear actuator capable of positioning said diverter valve.
7. The ventilator of claim 2, wherein said feedback sensor comprises a pressure sensor that measures a pressure of gas being supplied to said gas delivery device.
8. The ventilator of claim 2, wherein said feedback sensor comprises a flow volume sensor that measures a volume of gas being supplied to said gas delivery device.
9. The ventilator of claim 2, wherein said positive relative pressure gas supply and said negative relative pressure gas supply comprise blowers and motors and wherein said motors run at a substantially constant speed.
10. The ventilator of claim 2, wherein said positive relative pressure gas supply and said negative relative pressure gas supply comprise blowers and motors and wherein said feedback sensor is an electrical load sensor that measures an electrical load of said blowers and motors .
11. The ventilator of claim 2, wherein said positive relative pressure gas supply and said negative relative pressure gas supply comprise blowers and motors and wherein said feedback sensor is an optical rotational speed sensor that measures a motor speed.
12. The ventilator of claim 2, wherein said positive relative pressure gas supply and said negative relative pressure gas supply comprise blowers and motors and wherein said feedback sensor is a magnetic rotational speed sensor that measures a motor speed.
13. The ventilator of claim 2, wherein said positive relative pressure gas supply and said negative relative pressure gas supply comprise blowers and motors and wherein said feedback sensor is mechanical rotational speed sensor that measures a motor speed.
14. A method of pressure regulation for a ventilator, comprising the steps of: providing a positive relative pressure gas supply; providing a negative relative pressure gas supply; detecting a gas supply difference between a gas supply provided to a gas delivery device of said ventilator and a predetermined gas supply; generating a feedback signal that is substantially related to said gas supply difference; and actuating a diverter valve to communicate said positive relative pressure gas supply and said negative relative pressure gas supply to said gas delivery device in order to substantially minimize said gas supply difference.
15. The method of claim 14, wherein said detecting step comprises measuring a pressure of said gas supply.
16. The method of claim 14, wherein said detecting step comprises measuring a flow volume of said gas supply.
17. The method of claim 14, wherein said detecting step comprises measuring motor speeds of motors and impellers used to generate said positive relative pressure gas supply and said negative relative pressure gas supply.
18. The method of claim 14, wherein said detecting step comprises measuring electrical loads on motors and impellers used to generate said positive relative pressure gas supply and said negative relative pressure gas supply.
19. The method of claim 14, wherein said actuating step further comprises actuating a valve to select a mixture ratio of said positive relative pressure gas supply to said negative relative pressure gas supply.
20. The method of claim 14, wherein said method cycles said diverter valve to achieve a substantially predetermined flow volume .
21. The method of claim 14, wherein said method cycles said diverter valve to achieve a substantially predetermined pressure.
PCT/US2001/032419 2000-10-19 2001-10-18 Ventilator with dual gas supply WO2002032489A2 (en)

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EP01981709A EP1326671B1 (en) 2000-10-19 2001-10-18 Ventilator with dual gas supply
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Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003002176A2 (en) * 2001-06-29 2003-01-09 Map Medizin-Technologie Gmbh Method and device for supplying a breathing gas
WO2005070488A1 (en) * 2004-01-09 2005-08-04 Sensormedics Corporation Sensorless proportional positive airway pressure apparatus and method
EP1663361A2 (en) * 2003-09-08 2006-06-07 J.H. Emerson Company Insufflation-exsufflation system for removal of broncho-pulmonary secretions with automatic triggering of inhalation phase
WO2007045017A3 (en) * 2005-10-21 2007-07-12 Compumedics Ltd Apparatus for delivery of pressurised gas
AU2005301097B2 (en) * 2004-11-04 2012-03-15 ResMed Pty Ltd Using motor speed in a PAP device to estimate flow
WO2012042255A1 (en) * 2010-09-28 2012-04-05 Noel Martin Davis Treatment device and method of use

Families Citing this family (134)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6024089A (en) 1997-03-14 2000-02-15 Nelcor Puritan Bennett Incorporated System and method for setting and displaying ventilator alarms
CA2424358A1 (en) * 2000-10-19 2002-04-25 Mallinckrodt Inc. Ventilator with dual gas supply
IL145461A (en) * 2001-09-16 2006-09-05 Alyn Woldenberg Family Hospita Inexsufflator
DE10253947C1 (en) * 2002-11-19 2003-12-04 Seleon Gmbh Pressure loss compensation method for respiration device with calculation of pressure loss from measured air flow
FR2850284B1 (en) 2003-01-27 2012-11-30 Saime Sarl BREATHING DEVICE AND REGULATION METHOD
US20040244807A1 (en) * 2003-06-04 2004-12-09 Jianguo Sun Sleep-lab systems and methods
US7717112B2 (en) * 2003-06-04 2010-05-18 Jianguo Sun Positive airway pressure therapy management module
FR2858236B1 (en) 2003-07-29 2006-04-28 Airox DEVICE AND METHOD FOR SUPPLYING RESPIRATORY GAS IN PRESSURE OR VOLUME
US20050098179A1 (en) * 2003-11-06 2005-05-12 Steve Burton Multi-level positive air pressure method and delivery apparatus
AU2004317545A1 (en) * 2004-02-26 2005-10-06 Sekos, Inc. Self-contained micromechanical ventilator
FR2875138B1 (en) 2004-09-15 2008-07-11 Mallinckrodt Dev France Sa CONTROL METHOD FOR A HEATING HUMIDIFIER
US20060174885A1 (en) * 2005-02-08 2006-08-10 Acoba, Llc Method and related system to control applied pressure in CPAP systems
WO2006102707A1 (en) 2005-04-01 2006-10-05 Resmed Limited Ventless mask cpap system
US20060272643A1 (en) * 2005-06-07 2006-12-07 Acoba, Llc Methods and related systems to selectively control operational modes of positive airway pressure systems
US20070186928A1 (en) * 2005-09-26 2007-08-16 Be Eri Eliezer Combined ventilator inexsufflator
WO2007062400A2 (en) 2005-11-23 2007-05-31 Jianguo Sun Method and apparatus for providing positive airway pressure to a patient
US8021310B2 (en) 2006-04-21 2011-09-20 Nellcor Puritan Bennett Llc Work of breathing display for a ventilation system
US7369757B2 (en) * 2006-05-24 2008-05-06 Nellcor Puritan Bennett Incorporated Systems and methods for regulating power in a medical device
US7784461B2 (en) 2006-09-26 2010-08-31 Nellcor Puritan Bennett Llc Three-dimensional waveform display for a breathing assistance system
US8902568B2 (en) 2006-09-27 2014-12-02 Covidien Lp Power supply interface system for a breathing assistance system
US20080078390A1 (en) * 2006-09-29 2008-04-03 Nellcor Puritan Bennett Incorporated Providing predetermined groups of trending parameters for display in a breathing assistance system
GB0712710D0 (en) * 2007-06-29 2007-08-08 Laerdal Medical As Method and instrument to provide ventilation and perfusion
US20090133695A1 (en) * 2007-11-27 2009-05-28 Rao Chamkurkishtiah P Mechanical ventilator system
US20090205663A1 (en) * 2008-02-19 2009-08-20 Nellcor Puritan Bennett Llc Configuring the operation of an alternating pressure ventilation mode
EP2257328A2 (en) 2008-03-27 2010-12-08 Nellcor Puritan Bennett LLC Breathing assistance systems with lung recruitment maneuvers
US8425428B2 (en) 2008-03-31 2013-04-23 Covidien Lp Nitric oxide measurements in patients using flowfeedback
US8272379B2 (en) 2008-03-31 2012-09-25 Nellcor Puritan Bennett, Llc Leak-compensated flow triggering and cycling in medical ventilators
US8267085B2 (en) 2009-03-20 2012-09-18 Nellcor Puritan Bennett Llc Leak-compensated proportional assist ventilation
EP2313138B1 (en) 2008-03-31 2018-09-12 Covidien LP System and method for determining ventilator leakage during stable periods within a breath
US8792949B2 (en) * 2008-03-31 2014-07-29 Covidien Lp Reducing nuisance alarms
US8746248B2 (en) 2008-03-31 2014-06-10 Covidien Lp Determination of patient circuit disconnect in leak-compensated ventilatory support
NZ742900A (en) * 2008-06-05 2020-02-28 ResMed Pty Ltd Treatment of respiratory conditions by automatic control of flow and/or temperature and/or humidity independently to nares via separate flow paths
CN102056539B (en) 2008-06-06 2015-10-07 柯惠有限合伙公司 For making great efforts with patient the system and method that carries out pro rata taking a breath
US8528554B2 (en) 2008-09-04 2013-09-10 Covidien Lp Inverse sawtooth pressure wave train purging in medical ventilators
US8551006B2 (en) 2008-09-17 2013-10-08 Covidien Lp Method for determining hemodynamic effects
US8424520B2 (en) 2008-09-23 2013-04-23 Covidien Lp Safe standby mode for ventilator
US8794234B2 (en) 2008-09-25 2014-08-05 Covidien Lp Inversion-based feed-forward compensation of inspiratory trigger dynamics in medical ventilators
US8181648B2 (en) 2008-09-26 2012-05-22 Nellcor Puritan Bennett Llc Systems and methods for managing pressure in a breathing assistance system
US8393323B2 (en) 2008-09-30 2013-03-12 Covidien Lp Supplemental gas safety system for a breathing assistance system
US8302600B2 (en) 2008-09-30 2012-11-06 Nellcor Puritan Bennett Llc Battery management for a breathing assistance system
US8439032B2 (en) * 2008-09-30 2013-05-14 Covidien Lp Wireless communications for a breathing assistance system
US8302602B2 (en) 2008-09-30 2012-11-06 Nellcor Puritan Bennett Llc Breathing assistance system with multiple pressure sensors
US8585412B2 (en) * 2008-09-30 2013-11-19 Covidien Lp Configurable respiratory muscle pressure generator
US8652064B2 (en) 2008-09-30 2014-02-18 Covidien Lp Sampling circuit for measuring analytes
US8082312B2 (en) * 2008-12-12 2011-12-20 Event Medical, Inc. System and method for communicating over a network with a medical device
US8424521B2 (en) 2009-02-27 2013-04-23 Covidien Lp Leak-compensated respiratory mechanics estimation in medical ventilators
US8434479B2 (en) 2009-02-27 2013-05-07 Covidien Lp Flow rate compensation for transient thermal response of hot-wire anemometers
US8418691B2 (en) 2009-03-20 2013-04-16 Covidien Lp Leak-compensated pressure regulated volume control ventilation
US9186075B2 (en) * 2009-03-24 2015-11-17 Covidien Lp Indicating the accuracy of a physiological parameter
US20100288283A1 (en) * 2009-05-15 2010-11-18 Nellcor Puritan Bennett Llc Dynamic adjustment of tube compensation factor based on internal changes in breathing tube
US8776790B2 (en) 2009-07-16 2014-07-15 Covidien Lp Wireless, gas flow-powered sensor system for a breathing assistance system
CN105749394B (en) * 2009-08-11 2018-12-04 瑞思迈发动机及马达技术股份有限公司 Single-stage axial symmetry air blower and Portable Fan
US8789529B2 (en) 2009-08-20 2014-07-29 Covidien Lp Method for ventilation
US8439037B2 (en) 2009-12-01 2013-05-14 Covidien Lp Exhalation valve assembly with integrated filter and flow sensor
US8439036B2 (en) 2009-12-01 2013-05-14 Covidien Lp Exhalation valve assembly with integral flow sensor
US8469030B2 (en) 2009-12-01 2013-06-25 Covidien Lp Exhalation valve assembly with selectable contagious/non-contagious latch
US8469031B2 (en) 2009-12-01 2013-06-25 Covidien Lp Exhalation valve assembly with integrated filter
US8547062B2 (en) 2009-12-02 2013-10-01 Covidien Lp Apparatus and system for a battery pack assembly used during mechanical ventilation
US8434484B2 (en) 2009-12-03 2013-05-07 Covidien Lp Ventilator Respiratory Variable-Sized Gas Accumulator
US20110132369A1 (en) 2009-12-04 2011-06-09 Nellcor Puritan Bennett Llc Ventilation System With System Status Display
US8924878B2 (en) 2009-12-04 2014-12-30 Covidien Lp Display and access to settings on a ventilator graphical user interface
US20110132368A1 (en) 2009-12-04 2011-06-09 Nellcor Puritan Bennett Llc Display Of Historical Alarm Status
US9119925B2 (en) 2009-12-04 2015-09-01 Covidien Lp Quick initiation of respiratory support via a ventilator user interface
US9262588B2 (en) 2009-12-18 2016-02-16 Covidien Lp Display of respiratory data graphs on a ventilator graphical user interface
US8499252B2 (en) 2009-12-18 2013-07-30 Covidien Lp Display of respiratory data graphs on a ventilator graphical user interface
US8400290B2 (en) 2010-01-19 2013-03-19 Covidien Lp Nuisance alarm reduction method for therapeutic parameters
US8171094B2 (en) * 2010-01-19 2012-05-01 Event Medical, Inc. System and method for communicating over a network with a medical device
US8707952B2 (en) 2010-02-10 2014-04-29 Covidien Lp Leak determination in a breathing assistance system
US9302061B2 (en) 2010-02-26 2016-04-05 Covidien Lp Event-based delay detection and control of networked systems in medical ventilation
US8539949B2 (en) 2010-04-27 2013-09-24 Covidien Lp Ventilation system with a two-point perspective view
US8511306B2 (en) 2010-04-27 2013-08-20 Covidien Lp Ventilation system with system status display for maintenance and service information
US8453643B2 (en) 2010-04-27 2013-06-04 Covidien Lp Ventilation system with system status display for configuration and program information
US8638200B2 (en) 2010-05-07 2014-01-28 Covidien Lp Ventilator-initiated prompt regarding Auto-PEEP detection during volume ventilation of non-triggering patient
CN102892449B (en) * 2010-05-11 2016-04-20 皇家飞利浦电子股份有限公司 Inductance in pressure support system compensates
US8607790B2 (en) 2010-06-30 2013-12-17 Covidien Lp Ventilator-initiated prompt regarding auto-PEEP detection during pressure ventilation of patient exhibiting obstructive component
US8607789B2 (en) 2010-06-30 2013-12-17 Covidien Lp Ventilator-initiated prompt regarding auto-PEEP detection during volume ventilation of non-triggering patient exhibiting obstructive component
US8607791B2 (en) 2010-06-30 2013-12-17 Covidien Lp Ventilator-initiated prompt regarding auto-PEEP detection during pressure ventilation
US8607788B2 (en) 2010-06-30 2013-12-17 Covidien Lp Ventilator-initiated prompt regarding auto-PEEP detection during volume ventilation of triggering patient exhibiting obstructive component
US8676285B2 (en) 2010-07-28 2014-03-18 Covidien Lp Methods for validating patient identity
US8554298B2 (en) 2010-09-21 2013-10-08 Cividien LP Medical ventilator with integrated oximeter data
US8757152B2 (en) 2010-11-29 2014-06-24 Covidien Lp Ventilator-initiated prompt regarding detection of double triggering during a volume-control breath type
US8595639B2 (en) 2010-11-29 2013-11-26 Covidien Lp Ventilator-initiated prompt regarding detection of fluctuations in resistance
US8757153B2 (en) 2010-11-29 2014-06-24 Covidien Lp Ventilator-initiated prompt regarding detection of double triggering during ventilation
CN103384541B (en) * 2010-12-21 2016-01-20 皇家飞利浦电子股份有限公司 There is the ventilator of integrated aerator
US8676529B2 (en) 2011-01-31 2014-03-18 Covidien Lp Systems and methods for simulation and software testing
US8788236B2 (en) 2011-01-31 2014-07-22 Covidien Lp Systems and methods for medical device testing
US8783250B2 (en) 2011-02-27 2014-07-22 Covidien Lp Methods and systems for transitory ventilation support
US9038633B2 (en) 2011-03-02 2015-05-26 Covidien Lp Ventilator-initiated prompt regarding high delivered tidal volume
US8714154B2 (en) 2011-03-30 2014-05-06 Covidien Lp Systems and methods for automatic adjustment of ventilator settings
US8776792B2 (en) 2011-04-29 2014-07-15 Covidien Lp Methods and systems for volume-targeted minimum pressure-control ventilation
US9629971B2 (en) 2011-04-29 2017-04-25 Covidien Lp Methods and systems for exhalation control and trajectory optimization
JP5417561B2 (en) * 2011-09-12 2014-02-19 株式会社メトラン Expiratory valve and respiratory assistance device
US9089657B2 (en) 2011-10-31 2015-07-28 Covidien Lp Methods and systems for gating user initiated increases in oxygen concentration during ventilation
US9364624B2 (en) 2011-12-07 2016-06-14 Covidien Lp Methods and systems for adaptive base flow
US9238115B2 (en) 2011-12-19 2016-01-19 ResQSystems, Inc. Systems and methods for therapeutic intrathoracic pressure regulation
US9498589B2 (en) 2011-12-31 2016-11-22 Covidien Lp Methods and systems for adaptive base flow and leak compensation
US9022031B2 (en) 2012-01-31 2015-05-05 Covidien Lp Using estimated carinal pressure for feedback control of carinal pressure during ventilation
DE102012003549A1 (en) * 2012-02-23 2013-08-29 Dräger Medical GmbH Device for mechanical ventilation of patient, has gas-carrying bypass unit, by which gas outlet and gas inlet are coupled with each other for bypassing gas delivery device, where plasma generator is coupled in bypassed gas delivery device
CN104203321B (en) * 2012-03-21 2017-07-18 皇家飞利浦有限公司 Two-way airflow is produced in gas extraction system is blown
US8844526B2 (en) 2012-03-30 2014-09-30 Covidien Lp Methods and systems for triggering with unknown base flow
US9327089B2 (en) 2012-03-30 2016-05-03 Covidien Lp Methods and systems for compensation of tubing related loss effects
US9993604B2 (en) 2012-04-27 2018-06-12 Covidien Lp Methods and systems for an optimized proportional assist ventilation
US9144658B2 (en) 2012-04-30 2015-09-29 Covidien Lp Minimizing imposed expiratory resistance of mechanical ventilator by optimizing exhalation valve control
WO2013181459A1 (en) * 2012-05-30 2013-12-05 The University Of Kansas Inhalation device, systems, and methods for administering powdered medicaments to mechanically ventilated subjects
US9669172B2 (en) * 2012-07-05 2017-06-06 Resmed Limited Discreet respiratory therapy system
US10362967B2 (en) 2012-07-09 2019-07-30 Covidien Lp Systems and methods for missed breath detection and indication
US9027552B2 (en) 2012-07-31 2015-05-12 Covidien Lp Ventilator-initiated prompt or setting regarding detection of asynchrony during ventilation
US9375542B2 (en) 2012-11-08 2016-06-28 Covidien Lp Systems and methods for monitoring, managing, and/or preventing fatigue during ventilation
US9795752B2 (en) * 2012-12-03 2017-10-24 Mhs Care-Innovation, Llc Combination respiratory therapy device, system, and method
US9289573B2 (en) 2012-12-28 2016-03-22 Covidien Lp Ventilator pressure oscillation filter
US9492629B2 (en) 2013-02-14 2016-11-15 Covidien Lp Methods and systems for ventilation with unknown exhalation flow and exhalation pressure
USD731049S1 (en) 2013-03-05 2015-06-02 Covidien Lp EVQ housing of an exhalation module
USD692556S1 (en) 2013-03-08 2013-10-29 Covidien Lp Expiratory filter body of an exhalation module
USD744095S1 (en) 2013-03-08 2015-11-24 Covidien Lp Exhalation module EVQ internal flow sensor
USD731048S1 (en) 2013-03-08 2015-06-02 Covidien Lp EVQ diaphragm of an exhalation module
USD701601S1 (en) 2013-03-08 2014-03-25 Covidien Lp Condensate vial of an exhalation module
USD731065S1 (en) 2013-03-08 2015-06-02 Covidien Lp EVQ pressure sensor filter of an exhalation module
USD736905S1 (en) 2013-03-08 2015-08-18 Covidien Lp Exhalation module EVQ housing
USD693001S1 (en) 2013-03-08 2013-11-05 Covidien Lp Neonate expiratory filter assembly of an exhalation module
US9358355B2 (en) 2013-03-11 2016-06-07 Covidien Lp Methods and systems for managing a patient move
US9981096B2 (en) 2013-03-13 2018-05-29 Covidien Lp Methods and systems for triggering with unknown inspiratory flow
US9950135B2 (en) 2013-03-15 2018-04-24 Covidien Lp Maintaining an exhalation valve sensor assembly
US10064583B2 (en) 2013-08-07 2018-09-04 Covidien Lp Detection of expiratory airflow limitation in ventilated patient
US9675771B2 (en) 2013-10-18 2017-06-13 Covidien Lp Methods and systems for leak estimation
CN103933648B (en) * 2014-03-26 2016-09-07 北京雅果科技有限公司 A kind of diaphram stimulates suction and discharge system
EP4151258A1 (en) 2014-04-11 2023-03-22 Fisher & Paykel Healthcare Limited Gas therapy system
US9808591B2 (en) 2014-08-15 2017-11-07 Covidien Lp Methods and systems for breath delivery synchronization
US9950129B2 (en) 2014-10-27 2018-04-24 Covidien Lp Ventilation triggering using change-point detection
US9925346B2 (en) 2015-01-20 2018-03-27 Covidien Lp Systems and methods for ventilation with unknown exhalation flow
US10905836B2 (en) 2015-04-02 2021-02-02 Hill-Rom Services Pte. Ltd. Manifold for respiratory device
USD775345S1 (en) 2015-04-10 2016-12-27 Covidien Lp Ventilator console
US10765822B2 (en) 2016-04-18 2020-09-08 Covidien Lp Endotracheal tube extubation detection
CN110049799B (en) 2017-11-14 2022-04-26 柯惠有限合伙公司 Method and system for driving pressure spontaneous ventilation
WO2019147843A1 (en) 2018-01-24 2019-08-01 Ntinika Calvin Pressurized gas adaptor

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE946258C (en) * 1950-07-12 1956-07-26 Draegerwerk Ag Respirator
FR2554351A1 (en) * 1983-11-09 1985-05-10 Sardou Max Process for respiratory assistance and transportable respirator in particular for severe respiratory insufficiency
WO1999047200A1 (en) * 1998-03-20 1999-09-23 Cardiopulmonary Corporation Ventilator control system and method

Family Cites Families (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB689799A (en) 1950-07-22 1953-04-08 Gen Radiological Ltd Operation of x-ray tubes
US4193406A (en) * 1978-09-18 1980-03-18 Jinotti Walter J Dual purpose catheter
US4239039A (en) * 1979-02-28 1980-12-16 Thompson Harris A Dual control valve for positive pressure artificial respiration apparatus
US4391271A (en) * 1981-04-06 1983-07-05 Albert Blanco Respirator circuit
US4605883A (en) * 1982-02-05 1986-08-12 Sunbeam Corporation Motor speed control circuit
US5134995A (en) 1989-05-19 1992-08-04 Puritan-Bennett Corporation Inspiratory airway pressure system with admittance determining apparatus and method
GB9302291D0 (en) * 1993-02-05 1993-03-24 Univ Manitoba Method for improved control of airway pressure during mechanical ventilation
AUPM279393A0 (en) 1993-12-03 1994-01-06 Rescare Limited Estimation of flow and detection of breathing in cpap treatment
GB9410935D0 (en) * 1994-06-01 1994-07-20 Dranez Anstalt Ventilator apparatus
GB9422821D0 (en) * 1994-11-11 1995-01-04 Aid Medic Ltd Atomizer
EP0792177B1 (en) * 1995-02-08 2002-05-22 Puritan-Bennett Corporation Gas mixing apparatus for a ventilator
US5598838A (en) * 1995-04-07 1997-02-04 Healthdyne Technologies, Inc. Pressure support ventilatory assist system
US5937855A (en) * 1995-04-21 1999-08-17 Respironics, Inc. Flow regulating valve in a breathing gas delivery system
US5592935A (en) * 1995-05-03 1997-01-14 Minnesota Mining And Manufacturing Company Positive/negative air pressure adaptor for use with respirators
DE19516536C2 (en) * 1995-05-05 1998-02-12 Draegerwerk Ag Ventilator
GB2306623B (en) * 1995-10-31 1998-08-05 Zamir Hayek Fluid control valves
DE19547124C2 (en) * 1995-12-16 2001-04-19 Lpkf D O O Rotary slide valve for optional pressurization or suction air
US5701883A (en) * 1996-09-03 1997-12-30 Respironics, Inc. Oxygen mixing in a blower-based ventilator
DE19643750C2 (en) * 1996-10-23 2001-01-25 Draegerwerk Ag Valve for setting the flow of a fluid
DE19714644C2 (en) * 1997-04-09 1999-09-02 Draegerwerk Ag Gas delivery device for ventilators and anesthetic devices and their use
JP2001514941A (en) 1997-08-14 2001-09-18 レスメッド・リミテッド Apparatus and method for delivering gas suitable for on-demand additional breathing
JP3945902B2 (en) * 1998-03-31 2007-07-18 スズキ株式会社 Ventilator
DE19823379A1 (en) * 1998-05-14 1999-11-25 Mannesmann Ag Signal generator for determining the speed and direction of rotation of electric motors
US6089229A (en) * 1998-05-26 2000-07-18 Datex-Ohmeda, Inc. High concentration no pulse delivery device
US6694976B1 (en) * 1998-12-07 2004-02-24 Suzuki Motor Corporation Oscillating air pressure generator, diaphragm unit, and high-frequency artificial respiration apparatus using the same
US6708690B1 (en) * 1999-09-03 2004-03-23 Respironics, Inc. Apparatus and method for providing high frequency variable pressure to a patient
DE19947837B4 (en) * 1999-10-05 2005-09-01 Siemens Ag Monitoring method for a drive and corresponding drive
CA2424358A1 (en) * 2000-10-19 2002-04-25 Mallinckrodt Inc. Ventilator with dual gas supply
US6860265B1 (en) * 2003-09-08 2005-03-01 J.H. Emerson Company Insufflation-exsufflation system for removal of broncho-pulmonary secretions with automatic triggering of inhalation phase

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE946258C (en) * 1950-07-12 1956-07-26 Draegerwerk Ag Respirator
FR2554351A1 (en) * 1983-11-09 1985-05-10 Sardou Max Process for respiratory assistance and transportable respirator in particular for severe respiratory insufficiency
WO1999047200A1 (en) * 1998-03-20 1999-09-23 Cardiopulmonary Corporation Ventilator control system and method

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003002176A3 (en) * 2001-06-29 2003-07-17 Map Medizin Technologie Gmbh Method and device for supplying a breathing gas
WO2003002176A2 (en) * 2001-06-29 2003-01-09 Map Medizin-Technologie Gmbh Method and device for supplying a breathing gas
EP1663361A4 (en) * 2003-09-08 2010-12-01 Respironics Inc Insufflation-exsufflation system for removal of broncho-pulmonary secretions with automatic triggering of inhalation phase
EP1663361A2 (en) * 2003-09-08 2006-06-07 J.H. Emerson Company Insufflation-exsufflation system for removal of broncho-pulmonary secretions with automatic triggering of inhalation phase
WO2005070488A1 (en) * 2004-01-09 2005-08-04 Sensormedics Corporation Sensorless proportional positive airway pressure apparatus and method
AU2005301097B2 (en) * 2004-11-04 2012-03-15 ResMed Pty Ltd Using motor speed in a PAP device to estimate flow
WO2007045017A3 (en) * 2005-10-21 2007-07-12 Compumedics Ltd Apparatus for delivery of pressurised gas
US8985105B2 (en) 2005-10-21 2015-03-24 Compumedics Medical Innovation Pty Ltd Apparatus for delivery of pressurised gas
WO2012042255A1 (en) * 2010-09-28 2012-04-05 Noel Martin Davis Treatment device and method of use
GB2498121A (en) * 2010-09-28 2013-07-03 Noel Martin Davis Treatment device and method of use
GB2498121B (en) * 2010-09-28 2013-10-16 Noel Martin Davis Treatment device and method of use
AU2011309905B2 (en) * 2010-09-28 2014-10-09 Breas Medical Limited Treatment device and method of use
US10272222B2 (en) 2010-09-28 2019-04-30 Breas Medical Limited Treatment device and method of use

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US20030015200A1 (en) 2003-01-23

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