WO2005025658A1 - Insufflation-exsufflation system with percussive assist for removal of broncho-pulmonary secretions - Google Patents

Insufflation-exsufflation system with percussive assist for removal of broncho-pulmonary secretions Download PDF

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Publication number
WO2005025658A1
WO2005025658A1 PCT/US2004/028497 US2004028497W WO2005025658A1 WO 2005025658 A1 WO2005025658 A1 WO 2005025658A1 US 2004028497 W US2004028497 W US 2004028497W WO 2005025658 A1 WO2005025658 A1 WO 2005025658A1
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WO
WIPO (PCT)
Prior art keywords
insufflation
exsufflation
pressure
positive
fluctuations
Prior art date
Application number
PCT/US2004/028497
Other languages
French (fr)
Inventor
George P. Emerson
Original Assignee
J.H. Emerson Company
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 J.H. Emerson Company filed Critical J.H. Emerson Company
Priority to AU2004271995A priority Critical patent/AU2004271995B2/en
Priority to JP2006525423A priority patent/JP4617307B2/en
Priority to EP04782897A priority patent/EP1663362A4/en
Priority to CA2537347A priority patent/CA2537347C/en
Publication of WO2005025658A1 publication Critical patent/WO2005025658A1/en
Priority to IL174057A priority patent/IL174057A/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
    • A61M16/0057—Pumps therefor
    • 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
    • A61M16/0006—Accessories therefor, e.g. sensors, vibrators, negative pressure with means for creating vibrations in patients' airways
    • 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
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A61M16/201—Controlled valves
    • A61M16/202—Controlled valves electrically actuated
    • A61M16/203—Proportional
    • 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
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/105—Filters
    • A61M16/1055—Filters bacterial
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/10—Preparation of respiratory gases or vapours
    • A61M16/105—Filters
    • A61M16/106—Filters in a path

Definitions

  • This invention relates to an improved insufflation-exsufflation system with a percussive assist for removal of broncho-pulmonary secretions during at least one of insufflation and exsufflation.
  • MI-E mechanical insufflation and exsufflation
  • SMA spinal muscular atrophy
  • ALS amyotropic lateral sclerosis
  • the technique involves, the use of a blower and valve, which via a facemask, mouthpiece or adapter for a tracheal tube, alternately applies positive pressure first to inflate the lungs, then shifts rapidly to negative pressure to create a high expiratory flow.
  • MI- E One shortcoming of MI- E is its limited effectiveness on patients with unusually thick or tenacious secretions. In such patients MI-E can create high expiratory airflows, but the secretions tend to remain attached to the airways within the lung and cannot be dislodged or loosened.
  • the use of percussion in loosening secretions in patients' airways is also a well- known technique.
  • chest physical therapy wherein a nurse or physical therapist uses cupped hands to rhythmically strike the chest wall, producing vibrations in the lung tissue.
  • devices that accomplish this percussion both external to the body via mechanical “thumpers” or positive pressure vests, and internally via a facemask or mouthpiece, using short bursts of positive pressure to the airway.
  • some devices like the “Flutter®” (Axcan Scandipharm) and the “Acapella®” (DHD Healthcare) use the patient's own expiratory flow to generate oscillations in the airway.
  • this approach employs a diaphragm pump to fluctuate the air provided to the patient.
  • Such pumps are large and not conducive to portability and require significant energy in addition to that used to drive the primary pressure source.
  • this approach must work against the pressures provided by the primary pressure source itself.
  • an improved insufflation- exsufflation system with percussive assist for removal of broncho-puhnonary secretions can be effected by providing alternating positive and negative pressure fluctuations at a first rate corresponding to patient insufflation and exsufflation and varying the pressure during positive and negative pressure fluctuations at a second higher rate to periodically decrease the positive pressure during positive fluctuations and decrease the negative pressure during negative fluctuations to provide percussive pulses during at least one of insufflation and exsufflation to clear broncho-pulmonary secretions from a patient's airway.
  • This invention features an improved insufflation-exsufflation system with percussive assist for removal of broncho-puhnonary secretions.
  • a conduit for connection to a patient's airway and a pressure source for providing to the conduit alternating positive and negative pressure fluctuations at a first rate corresponding to patient insufflation and exsufflation.
  • a control mechanism varies the pressure during positive and negative pressure fluctuations at a second higher rate to periodically decrease the positive pressure during positive fluctuations and decrease the negative pressure during negative fluctuations to provide percussive pulses during at least one of insufflation and exsufflation to clear broncho-pulmonary secretions from the patients airways.
  • the control mechanism may include a valve device.
  • the valve device may vent the positive and negative pressure provided by the air pressure source to generate the positive and negative pressure pulses.
  • There may be a flow control device for setting the level of pressure decreases during the pulses.
  • the flow control device may include a restrictor mechanism.
  • There may be a drive device for controlling the frequency of the second rate.
  • the drive device may include a motor and a motor drive circuit.
  • the valve may have an open position for generating the pressure pulses and a closed position.
  • the valve may have a partially closed position for reducing the overall pressure of the pressure fluctuations produced by the pressure source in the conduit and an open position for generating the percussive pulses.
  • Fig. 1 is a schematic block diagram of an insufflation-exsufflation system according to this invention.
  • Figs. 2 and 3 are schematic diagrams showing alternative connections of the system to a patient's airway.
  • Fig. 4 is an enlarged detail view of the percussive control mechanism of Fig. 1.
  • Fig. 5 is a waveform illustrating the positive and negative pressure fluctuations with the modulating percussive pulses superimposed thereon.
  • Fig. 6 is a more detailed schematic diagram of the positive/negative pressure source of Fig. 1.
  • Fig. 7 is a schematic diagram of an alternative percussive control mechanism for Fig. 1.
  • Fig. 8 is a schematic diagram of another alternative percussive control mechanism usable with Fig. 1.
  • FIG. 1 an improved insufflation-exsufflation system 10, with percussive assist for removal of broncho-pulmonary secretions according to this invention including a positive/negative pressure source 12 and a conduit 14 for supplying air to and withdrawing air from a patient 16 via a face mask 18 which covers the patient's nose and mouth.
  • conduit 14 maybe engaged with a frachostomy tube 20, Fig.
  • a percussive confrol mechanism includes conduit 28 and a valve device 30 operated by a drive device 32 which may include motor 34 and a motor drive circuit 36.
  • Valve 30, Fig. 4, of valve device 26 includes an outer stationary portion 40, Fig. 4, containing port 42 that engages with conduit 28 and a rotor 44 driven by shaft 46 of motor 34.
  • Rotor 44 includes a right angle channel 48 which includes a radial portion 50 that aligns with port 42 once each revolution and an axial portion 52 which is open to the atmosphere at its end 54.
  • the venting by means of valve 30 and motor 34, provides sharp percussive pulses 66 which momentarily decrease the positive pressure during positive pressure fluctuation 62 and creates similar percussive pulses 68 which reduce the negative pressure during negative pressure pulse 64.
  • the combination of this continuous insufflation-exsufflation cycle of the primary positive pressure and negative pressure fluctuation 62 and 64 accompanied by the percussive pulses 66 and 68 provides an extremely effective, safe and comfortable means for simultaneously loosening and withdrawing secretions from the patient's airway.
  • the invention applies as well to percussive pressure applied to at least one of insufflation and exsufflation.
  • a three position slide valve 76 includes a negative port 78 positive port 80 and a dwell port 82 which is typically connected to atmospheric pressure.
  • Eccentric mechanism 84 driven by motor 86 in a conventional manner moves swinger 88 from positive port 80 to negative port 78, to dwell port 82, back to positive port 80 and so on.
  • a flow control device 90 which may include a restrictor valve 92 and some means of adjustment, such as thumb screw 94 which controls the amount of air which will be vented each cycle of valve 30.
  • the restricting function may also be accomplished by means of a flow confrol device 90a, Fig. 7, which employs a cap plate 92a that can be moved to and fro along the longitudinal axis of valve 30a by means of thumb screw 94a.
  • a poppet type valve, 100, Fig. 8 may be operated by a linear actuator 102 between a closed position 104 and an open position 106 for providing the percussive pulses.
  • poppet valve 100 may function as both a generator of percussive pulses and a control for the overall pressure provided by pressure source 12 and conduit 14. In that capacity poppet valve 100 would move between an open position 106 and a partially closed position 108 so that a portion of the pressure is always bled off when the valve is in the partially closed position 108 and then even more is bled off at open position 106 to create the percussive pulses.
  • a frequency and stroke confrol circuit 110 is used to control the frequency of oscillation of poppet valve 100 as well as the distance of its stroke.

Abstract

An improved insufflation-exsufflation system with percussive assist for removal of broncho-pulmonary secretions includes a conduit for connection to a patient's airway; a pressure source for providing to the conduit alternating positive and negative pressure fluctuations at a first rate corresponding to patient insufflation-exsufflation; and a control mechanism for varying pressure during positive and negative pressure fluctuations at a second higher rate to periodically decrease the positive pressure during positive fluctuations and decrease the negative pressure during negative fluctuations to provide percussive pulses during at least one of insufflation-exsufflation to clear broncho-pulmonary secretions from the patient's airway.

Description

INSUFFLATION-EXSUFFLATION SYSTEM WITH PERCUSSIVE ASSIST FOR REMOVAL OF BRONCHO-PULMONARY SECRETIONS
FIELD OF THE INVENTION This invention relates to an improved insufflation-exsufflation system with a percussive assist for removal of broncho-pulmonary secretions during at least one of insufflation and exsufflation.
BACKGROUND OF THE INVENTION The use of mechanical insufflation and exsufflation (MI-E) with negative pressure is a well-known technique for helping patients with an ineffective cough to remove secretions from the respiratory tract. Patients who can benefit from the technique include: post-polio, muscular dystrophy, spinal muscular atrophy (SMA), post-cardiac surgery, amyotropic lateral sclerosis (ALS), mechanically ventilated, or anyone with insufficient muscle strength to generate the high expiratory flows necessary for moving secretions up the fracheo-bronchial tree. The technique involves, the use of a blower and valve, which via a facemask, mouthpiece or adapter for a tracheal tube, alternately applies positive pressure first to inflate the lungs, then shifts rapidly to negative pressure to create a high expiratory flow. One shortcoming of MI- E is its limited effectiveness on patients with unusually thick or tenacious secretions. In such patients MI-E can create high expiratory airflows, but the secretions tend to remain attached to the airways within the lung and cannot be dislodged or loosened. The use of percussion in loosening secretions in patients' airways is also a well- known technique. The most widely used is referred to as "chest physical therapy", wherein a nurse or physical therapist uses cupped hands to rhythmically strike the chest wall, producing vibrations in the lung tissue. There are also devices that accomplish this percussion both external to the body via mechanical "thumpers" or positive pressure vests, and internally via a facemask or mouthpiece, using short bursts of positive pressure to the airway. In addition, some devices, like the "Flutter®" (Axcan Scandipharm) and the "Acapella®" (DHD Healthcare) use the patient's own expiratory flow to generate oscillations in the airway. A shortcoming of these various percussive techniques is that they effectively loosen secretions in a patient's airways, but do not actively remove the secretions, as does MI-E. In fact, for a patient with insufficient peak cough expiratory flow, the use of percussion alone may loosen a mucus plug, which the patient cannot expel, causing blockage of the airway. Also, patients with neuromuscular disease or general muscle weakness cannot generate adequate airflow to use the "Flutter®" or "Acapella®" devices. One approach, U.S. Patent No. 2,918,917, applies a vibration to either a positive pressure, (inhale), or negative pressure, (exhale) but not both. This has not been satisfactory in some applications. Also this approach employs a diaphragm pump to fluctuate the air provided to the patient. Such pumps are large and not conducive to portability and require significant energy in addition to that used to drive the primary pressure source. In addition, in applying pressure oscillations this approach must work against the pressures provided by the primary pressure source itself.
BRIEF SUMMARY OF THE INVENTION It is therefore an object of this invention to provide an improved insufflation- exsufflation system. It is a further object of this invention to provide such an improved insufflation- exsufflation system which provides a percussive assist for removal of broncho- pulmonary secretions. It is a further object of this invention to provide such an improved insufflation- exsufflation system which provides percussive pulse assists during either or both positive pressure fluctuations and negative pressure fluctuations. It is a further object of this invention to provide such an improved insufflation- exsufflation system which provides percussive pulse assists simultaneously with insufflation and exsufflation (positive and negative pressure fluctuations, respectively) of the patient. It is a further object of this invention to provide such an improved insufflation- exsufflation system which is smaller, more portable and more economical of energy. The invention results from the realization that an improved insufflation- exsufflation system with percussive assist for removal of broncho-puhnonary secretions can be effected by providing alternating positive and negative pressure fluctuations at a first rate corresponding to patient insufflation and exsufflation and varying the pressure during positive and negative pressure fluctuations at a second higher rate to periodically decrease the positive pressure during positive fluctuations and decrease the negative pressure during negative fluctuations to provide percussive pulses during at least one of insufflation and exsufflation to clear broncho-pulmonary secretions from a patient's airway. This invention features an improved insufflation-exsufflation system with percussive assist for removal of broncho-puhnonary secretions. There is a conduit for connection to a patient's airway and a pressure source for providing to the conduit alternating positive and negative pressure fluctuations at a first rate corresponding to patient insufflation and exsufflation. A control mechanism varies the pressure during positive and negative pressure fluctuations at a second higher rate to periodically decrease the positive pressure during positive fluctuations and decrease the negative pressure during negative fluctuations to provide percussive pulses during at least one of insufflation and exsufflation to clear broncho-pulmonary secretions from the patients airways. In a preferred embodiment the control mechanism may include a valve device. The valve device may vent the positive and negative pressure provided by the air pressure source to generate the positive and negative pressure pulses. There may be a flow control device for setting the level of pressure decreases during the pulses. The flow control device may include a restrictor mechanism. There may be a drive device for controlling the frequency of the second rate. The drive device may include a motor and a motor drive circuit. The valve may have an open position for generating the pressure pulses and a closed position. The valve may have a partially closed position for reducing the overall pressure of the pressure fluctuations produced by the pressure source in the conduit and an open position for generating the percussive pulses. There maybe a drive circuit for controlling at least one of the frequency and
stroke of the valve.
BRIEF DESCRIPTION OF THE DRAWINGS Other objects, features and advantages will occur to those skilled in the art from the following description of a preferred embodiment and the accompanying drawings, in which: Fig. 1 is a schematic block diagram of an insufflation-exsufflation system according to this invention. Figs. 2 and 3 are schematic diagrams showing alternative connections of the system to a patient's airway. Fig. 4 is an enlarged detail view of the percussive control mechanism of Fig. 1. Fig. 5 is a waveform illustrating the positive and negative pressure fluctuations with the modulating percussive pulses superimposed thereon. Fig. 6 is a more detailed schematic diagram of the positive/negative pressure source of Fig. 1. Fig. 7 is a schematic diagram of an alternative percussive control mechanism for Fig. 1. Fig. 8 is a schematic diagram of another alternative percussive control mechanism usable with Fig. 1.
DISCLOSURE OF THE PREFERRED EMBODIMENT Aside from the preferred embodiment or embodiments disclosed below, this invention is capable of other embodiments and of being practiced or being carried out in various ways. Thus, it is to be understood that the invention is not limited in its application to the details of construction and the arrangements of components set forth in the following description or illustrated in the drawings. There is shown in Fig. 1 an improved insufflation-exsufflation system 10, with percussive assist for removal of broncho-pulmonary secretions according to this invention including a positive/negative pressure source 12 and a conduit 14 for supplying air to and withdrawing air from a patient 16 via a face mask 18 which covers the patient's nose and mouth. Alternatively, conduit 14 maybe engaged with a frachostomy tube 20, Fig. 2, or with an endofracheal tube 22, Fig. 3. A bacterial filter 24 is typically included someplace in the conduit. A percussive confrol mechanism includes conduit 28 and a valve device 30 operated by a drive device 32 which may include motor 34 and a motor drive circuit 36. Valve 30, Fig. 4, of valve device 26 includes an outer stationary portion 40, Fig. 4, containing port 42 that engages with conduit 28 and a rotor 44 driven by shaft 46 of motor 34. Rotor 44 includes a right angle channel 48 which includes a radial portion 50 that aligns with port 42 once each revolution and an axial portion 52 which is open to the atmosphere at its end 54. Thus as shaft 46 rotates by means of motor 34 rotor 44 rotates as well disengaging channel 50 from port 42 through the entire rotation except at the position where it aligns with conduit 28. In operation as can be seen in Fig. 1, this vents the positive and negative pressure provided by pressure source 12 in conduit 14. The faster motor 34 rotates the more times the pressure and conduit 14 will be vented. The effect can be seen more readily in Fig. 5. where the primary pressure cycle is shown as consisting of a positive pressure fluctuation 62 followed by a negative pressure fluctuation 64 that is, the insufflation-exsufflation or inhale-exhale, respectively, periods of operation. During each of the positive and negative fluctuations 62 and 64 the venting, by means of valve 30 and motor 34, provides sharp percussive pulses 66 which momentarily decrease the positive pressure during positive pressure fluctuation 62 and creates similar percussive pulses 68 which reduce the negative pressure during negative pressure pulse 64. The combination of this continuous insufflation-exsufflation cycle of the primary positive pressure and negative pressure fluctuation 62 and 64 accompanied by the percussive pulses 66 and 68 provides an extremely effective, safe and comfortable means for simultaneously loosening and withdrawing secretions from the patient's airway. The invention applies as well to percussive pressure applied to at least one of insufflation and exsufflation. Positive/negative source 12, Fig. 6, may include a conventional blower 70 having a positive or inhale output for insufflation 72 and a negative 74 or exhale output for exsufflation. A three position slide valve 76 includes a negative port 78 positive port 80 and a dwell port 82 which is typically connected to atmospheric pressure. Eccentric mechanism 84 driven by motor 86 in a conventional manner moves swinger 88 from positive port 80 to negative port 78, to dwell port 82, back to positive port 80 and so on. While the frequency of the percussive pulses is determined by the speed of motor 34 the magnitude of those pulses can be controlled using a flow control device 90 which may include a restrictor valve 92 and some means of adjustment, such as thumb screw 94 which controls the amount of air which will be vented each cycle of valve 30. The restricting function may also be accomplished by means of a flow confrol device 90a, Fig. 7, which employs a cap plate 92a that can be moved to and fro along the longitudinal axis of valve 30a by means of thumb screw 94a. In another embodiment a poppet type valve, 100, Fig. 8, may be operated by a linear actuator 102 between a closed position 104 and an open position 106 for providing the percussive pulses. Alternatively, poppet valve 100 may function as both a generator of percussive pulses and a control for the overall pressure provided by pressure source 12 and conduit 14. In that capacity poppet valve 100 would move between an open position 106 and a partially closed position 108 so that a portion of the pressure is always bled off when the valve is in the partially closed position 108 and then even more is bled off at open position 106 to create the percussive pulses. A frequency and stroke confrol circuit 110 is used to control the frequency of oscillation of poppet valve 100 as well as the distance of its stroke. Although specific features of the invention are shown in some drawings and not in others, this is for convenience only as each feature may be combined with any or all of the other features in accordance with the invention. The words "including", "comprising", "having", and "with" as used herein are to be interpreted broadly and comprehensively and are not limited to any physical interconnection. Moreover, any embodiments disclosed in the subject application are not to be taken as the only possible embodiments. Other embodiments will occur to those skilled in the art and are within the following claims:

Claims

What is claimed is:
1. An improved insufflation-exsufflation system with percussive assist for removal of broncho-puhnonary secretions comprising: a conduit for connection to a patient's airway; a pressure source for providing to said conduit alternating positive and negative pressure fluctuations at a first rate corresponding to patient insufflation and exsufflation; and a control mechanism for varying pressure during positive and negative pressure fluctuations at a second higher rate to periodically decrease the positive pressure during positive fluctuations and decrease the negative pressure during negative fluctuations to provide percussive pulses during at least one of insufflation and exsufflation to clear broncho-pulmonary secretions from the patient's airway.
2. The improved insufflation-exsufflation system of claim 1 in which said control mechanism includes a valve device.
3. The improved insufflation-exsufflation system of claim 2 in which said valve device vents the positive and negative pressure provided by said pressure source to generate the positive and negative pressure pulses.
4. The improved insufflation-exsufflation system of claim 1 further includes a flow control device for setting the level of pressure decreases during said pulses.
5. The improved insufflation-exsufflation system of claim 4 in which said flow control device includes a restriction mechanism.
6. The improved insufflation-exsufflation system of claim 1 further including a drive device for controlling the frequency of said second rate.
7. The improved insufflation-exsufflation system of claim 6 in which said drive device includes a motor and a motor drive circuit.
8. The improved insufflation-exsufflation system of claim 2 in which said valve has an open position for generating said pressure pulses and a closed position.
9. The improved insufflation-exsufflation system of claim 2 in which said valve has a partially closed position for reducing the overall pressure of the pressure fluctuations produced by said pressure source in said conduit and an open position for generating said pressure pulses.
10. The improved insufflation-exsufflation system of claim 9 further includes a drive circuit for controlling at least one of the frequency and stroke of said valve.
PCT/US2004/028497 2003-09-08 2004-09-02 Insufflation-exsufflation system with percussive assist for removal of broncho-pulmonary secretions WO2005025658A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
AU2004271995A AU2004271995B2 (en) 2003-09-08 2004-09-02 Insufflation-exsufflation system with percussive assist for removal of broncho-pulmonary secretions
JP2006525423A JP4617307B2 (en) 2003-09-08 2004-09-02 Inspiration / expiration system with percussion assistance to remove bronchopulmonary secretions
EP04782897A EP1663362A4 (en) 2003-09-08 2004-09-02 Insufflation-exsufflation system with percussive assist for removal of broncho-pulmonary secretions
CA2537347A CA2537347C (en) 2003-09-08 2004-09-02 Insufflation-exsufflation system with percussive assist for removal of broncho-pulmonary secretions
IL174057A IL174057A (en) 2003-09-08 2006-03-02 Insufflation-exsufflation system with percussive assist for removal of broncho-pulmonary secretions

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US10/657,424 US6929007B2 (en) 2003-09-08 2003-09-08 Insufflation-exsufflation system with percussive assist for removal of broncho-pulmonary secretions
US10/657,424 2003-09-08

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US (1) US6929007B2 (en)
EP (1) EP1663362A4 (en)
JP (1) JP4617307B2 (en)
CN (1) CN100512900C (en)
AU (1) AU2004271995B2 (en)
CA (1) CA2537347C (en)
IL (1) IL174057A (en)
WO (1) WO2005025658A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2917979A1 (en) * 2007-06-28 2009-01-02 Bear Medical Soc Par Actions S Expectoration assisting domestic apparatus for oxygendependant patient, has air controlling unit including electro valve producing series of positive and negative air pulsations during inspiration and expiration phases respectively

Families Citing this family (56)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007054829A2 (en) * 2005-09-26 2007-05-18 Innovent Medical Solutions, Inc. Combined ventilator inexsufflator
CN101594901A (en) 2006-10-20 2009-12-02 都市健康系统公司 Manual lung ventilation device
US7779841B2 (en) 2006-11-13 2010-08-24 Carefusion 2200, Inc. Respiratory therapy device and method
US8528547B2 (en) * 2007-04-02 2013-09-10 Carefusion 2200, Inc. High frequency oscillation respiratory therapy
US8251876B2 (en) 2008-04-22 2012-08-28 Hill-Rom Services, Inc. Breathing exercise apparatus
US8539951B1 (en) 2008-05-27 2013-09-24 Trudell Medical International Oscillating positive respiratory pressure device
US8327849B2 (en) 2008-10-28 2012-12-11 Trudell Medical International Oscillating positive expiratory pressure device
US8347883B2 (en) * 2008-11-17 2013-01-08 Bird F M Manual controlled bi-phasic intrapulmonary percussive ventilation and methods
US8844530B2 (en) * 2008-11-17 2014-09-30 Hill-Rom Services Pte. Ltd. Combination lung ventilation and mucus clearance apparatus and method
CN102215891B (en) * 2008-11-19 2015-06-17 皇家飞利浦电子股份有限公司 Insufflating-exsufflating system
US8267081B2 (en) 2009-02-20 2012-09-18 Baxter International Inc. Inhaled anesthetic agent therapy and delivery system
US8485179B1 (en) 2009-02-23 2013-07-16 Trudell Medical International Oscillating positive expiratory pressure device
US9149589B2 (en) 2009-02-23 2015-10-06 Trudell Medical International Method and device for performing orientation dependent oscillating positive expiratory pressure therapy
JP6085835B2 (en) 2009-08-11 2017-03-08 レスメド・モーター・テクノロジーズ・インコーポレーテッド Single stage, axisymmetric blower and portable ventilator
AU2011280986B2 (en) 2010-07-23 2015-11-12 Avacen, Inc. Methods and apparatus for therapeutic application of thermal energy
BR112013003293A2 (en) * 2010-08-13 2019-09-24 Koninl Philips Electronics Nv system configured to provide a pressurized inhaled gas flow to an individual's airway
AU2011346629B2 (en) 2010-12-21 2016-06-09 Koninklijke Philips Electronics N.V. System and method for inexsufflating a subject
US9259546B2 (en) * 2010-12-21 2016-02-16 Koninklijke Philips N.V. Ventilator with integrated blower to provide negative or positive pressure in a ventilator system
US8539952B2 (en) 2011-05-13 2013-09-24 Hill-Rom Services Pte. Ltd. Mechanical insufflation/exsufflation airway clearance apparatus
RU2615280C2 (en) 2011-06-06 2017-04-04 Труделл Медикал Интернешнл Device with oscillatory positive pressure at exhalation
WO2013001398A1 (en) * 2011-06-29 2013-01-03 Koninklijke Philips Electronics N.V. Method and apparatus for assisting airway clearance
EP2812059B1 (en) * 2012-02-08 2020-04-08 Koninklijke Philips N.V. Device for increasing cough flow
US9180271B2 (en) 2012-03-05 2015-11-10 Hill-Rom Services Pte. Ltd. Respiratory therapy device having standard and oscillatory PEP with nebulizer
EP2852424A1 (en) * 2012-05-22 2015-04-01 Koninklijke Philips N.V. System and method for pressure support therapy with shaped airflow
BR112014030139A2 (en) 2012-06-05 2017-06-27 Koninklijke Philips Nv system configured to inflate an individual, and method for generating an inflation pressure waveform for delivery to an individual with an inflation system
US10485941B2 (en) 2012-11-19 2019-11-26 Koninklijke Philips N.V. System for enhancing secretion removal from an airway of a subject
US9517315B2 (en) 2012-11-30 2016-12-13 Trudell Medical International Oscillating positive expiratory pressure device
US9795752B2 (en) 2012-12-03 2017-10-24 Mhs Care-Innovation, Llc Combination respiratory therapy device, system, and method
US9687385B2 (en) 2013-03-11 2017-06-27 Avacen, Inc. Methods and apparatus for therapeutic application of thermal energy including blood viscosity adjustment
US9192509B2 (en) * 2013-03-11 2015-11-24 Avacen, Inc. Methods and apparatus for therapeutic application of thermal energy including blood viscosity adjustment
CA2915949C (en) 2013-07-12 2020-01-28 Trudell Medical International Huff cough simulation device
US9849257B2 (en) 2013-08-22 2017-12-26 Trudell Medical International Oscillating positive respiratory pressure device
US10363383B2 (en) 2014-02-07 2019-07-30 Trudell Medical International Pressure indicator for an oscillating positive expiratory pressure device
US10610653B2 (en) * 2014-04-11 2020-04-07 Fisher & Paykel Healthcare Limited Gas therapy system providing positive and negative gas flows
EP3237048A1 (en) * 2014-12-26 2017-11-01 Koninklijke Philips N.V. Secretion loosening and cough segmenting therapy
US10004872B1 (en) 2015-03-06 2018-06-26 D R Burton Healthcare, Llc Positive expiratory pressure device having an oscillating valve
CN107735135B (en) * 2015-04-02 2020-06-26 希尔－罗姆服务私人有限公司 Manifold for a respiratory device
RU2018103090A (en) 2015-06-26 2019-07-29 Конинклейке Филипс Н.В. Cardiopulmonary resuscitation device for the generation of positive pressure pulses
FR3038519B1 (en) * 2015-07-10 2022-03-18 Lantz Jean Sebastien TRACHEO-BRONCHIAL AIR STIMULATING DEVICE
FR3038748B1 (en) * 2015-07-10 2019-06-07 Physio-Assist TOUCH USER INTERFACE FOR A TRACHEO-BRONCHIC AIR STIMULATION DEVICE
MX2018001321A (en) 2015-07-30 2018-08-15 Trudell Medical Int Combined respiratory muscle training and oscillating positive expiratory pressure device.
US10518048B2 (en) 2015-07-31 2019-12-31 Hill-Rom Services, PTE Ltd. Coordinated control of HFCWO and cough assist devices
JP6960905B2 (en) * 2015-08-26 2021-11-05 コーニンクレッカ フィリップス エヌ ヴェKoninklijke Philips N.V. Mechanical air supply and exhaust
USD778429S1 (en) 2015-09-02 2017-02-07 Trudell Medical International Respiratory treatment device
USD780906S1 (en) 2015-09-02 2017-03-07 Trudell Medical International Respiratory treatment device
US10857317B2 (en) 2015-12-04 2020-12-08 Trudell Medical International Huff cough simulation device
US11684282B2 (en) 2017-02-03 2023-06-27 Avacen, Inc. Systems and methods for evaluating blood circulation and early detection of cardiovascular issues
EP3618908A4 (en) 2017-05-03 2021-01-13 Trudell Medical International Combined oscillating positive expiratory pressure therapy and huff cough simulation device
US10953278B2 (en) 2018-02-02 2021-03-23 Trudell Medical International Oscillating positive expiratory pressure device
CN110403813A (en) * 2018-10-12 2019-11-05 北京雅果科技有限公司 A kind of concussion impulse generator and auxiliary expectoration device
CN110038200B (en) * 2019-05-07 2022-03-11 濡新（北京）科技发展有限公司 Expectoration device and method for limiting expectoration amount
CN110038199B (en) * 2019-05-07 2021-09-24 濡新（北京）科技发展有限公司 Online synchronous expectoration method and system
WO2021173014A1 (en) * 2020-02-26 2021-09-02 Aut Ventures Limited System and method for stimulating airways
WO2021188529A1 (en) * 2020-03-16 2021-09-23 Texas Tech University System Respirator designed to mitigate deep lung infections
US20220023559A1 (en) * 2020-07-27 2022-01-27 Pratt & Whitney Canada Corp. Patient ventilator, method of ventilating an airway of a patient, and associated computer program product
EP4115929A1 (en) * 2021-07-09 2023-01-11 Physio-Assist Hospital device for stimulating tracheobronchial air

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2512621A (en) * 1944-11-23 1950-06-27 John H Emerson Therapeutic vibrator
US3653379A (en) * 1970-08-20 1972-04-04 Joseph G Glenn Adjustable pressure ippb ventilator
US4062358A (en) * 1976-04-21 1977-12-13 Kritzer Richard W Respirators

Family Cites Families (48)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1044031A (en) 1908-10-01 1912-11-12 Johann Heinrich Draeger Method of causing artificial respiration.
US1169995A (en) 1909-02-10 1916-02-01 Roscoe S Prindle Method of producing artificial respiration.
US1358893A (en) 1913-10-21 1920-11-16 Stolle Georg Paul Eugen Method for producing artificial respiration
US2364626A (en) 1942-11-09 1944-12-12 John H Emerson Resuscitator
US2481299A (en) 1944-12-12 1949-09-06 John H Emerson Breathing apparatus
US2468741A (en) 1944-12-12 1949-05-03 John H Emerson Breathing apparatus
USRE24193E (en) 1945-02-17 1956-08-07 Pressure resuscitator
US2861568A (en) 1950-09-27 1958-11-25 Quilter John Raymond Cuthbert Pressurized helmet for aviators
US2774348A (en) 1952-05-31 1956-12-18 John H Emerson Artificial respirator
US2774347A (en) 1954-03-17 1956-12-18 John H Emerson Apparatus for producing artificial respiration
US2853998A (en) 1955-02-28 1958-09-30 John H Emerson Respirator casing and methods of producing the same
US2918917A (en) * 1955-03-02 1959-12-29 John H Emerson Apparatus for vibrating portions of a patient's airway
US2914064A (en) 1957-03-14 1959-11-24 Sandelowsky Werner Respirators
US3357428A (en) 1963-12-23 1967-12-12 David L Carlson Respiratory augmentor with electronic monitor and control
US3402711A (en) 1964-01-06 1968-09-24 Westinghouse Electric Corp Breathing apparatus
US3368212A (en) 1964-12-08 1968-02-06 J H Emerson Company Gas flow monitor
GB1338226A (en) 1970-01-21 1973-11-21 British Oxygen Co Ltd Lung ventilators
US3794026A (en) 1970-07-29 1974-02-26 H Jacobs Ventilating apparatus embodying selective volume or pressure operation and catheter means for use therewith
US3850170A (en) 1972-07-26 1974-11-26 Us Army Oxygen powered volume cycled respirator with oxygen air mix
US3976064A (en) 1975-03-11 1976-08-24 Wood William W Intermittent mandatory assisted ventilation system for positive pressure breathing apparatus
US4054134A (en) * 1975-09-15 1977-10-18 Kritzer Richard W Respirators
GB1576118A (en) 1976-06-02 1980-10-01 Boc Ltd Lung ventilators
GB1583273A (en) 1977-05-06 1981-01-21 Medishield Corp Ltd Lung ventilators
GB2015348B (en) 1978-02-27 1982-07-21 Submarine Prod Ltd Underwater breathing apparatus
US4193406A (en) 1978-09-18 1980-03-18 Jinotti Walter J Dual purpose catheter
US4393869A (en) 1981-06-22 1983-07-19 Canadian Patents & Development Limited Electronically controlled respirator
DE3204110C2 (en) 1982-02-06 1984-08-02 Gerhard Dr.med. 7800 Freiburg Meuret Tracheal tube for artificial ventilation and respirator for connection to this tube
FR2538705B1 (en) * 1982-12-29 1987-12-31 Vincent Michel MEDICAL APPARATUS FOR THE EXSUFFLATION OF TIRES
US4595004A (en) * 1984-09-17 1986-06-17 Kurt Czech Apparatus for the treatment of the lungs of humans or animals
US5311862A (en) 1988-11-14 1994-05-17 Blasdell Richard J Inhalation apparatus
US5127398A (en) 1989-04-19 1992-07-07 Cis-Lunar Development Laboratories, Inc. Breathing apparatus mouthpiece
US4977889A (en) * 1989-10-12 1990-12-18 Regents Of The University Of Minnesota Fitting and tuning chest compression device
SE500550C2 (en) 1990-06-18 1994-07-11 Siemens Elema Ab Methods and apparatus for reducing gas re-breathing from the harmful space
US5280784A (en) * 1990-09-19 1994-01-25 Paul Ritzau Pari-Werk Gmbh Device in particular and inhalating device for treating the lung and the respiratory tracts
US5419768A (en) 1991-03-07 1995-05-30 Aeros Instruments, Inc. Electrical medical vacuum regulator
US5645537A (en) * 1993-04-20 1997-07-08 Advanced Cytometrix, Inc. Aspiration needle and syringe for use therewith, apparatus incorporating the same and kit for use in fine needle aspiration cytology, and method
GB9410935D0 (en) 1994-06-01 1994-07-20 Dranez Anstalt Ventilator apparatus
WO1996024401A1 (en) 1995-02-09 1996-08-15 Puritan-Bennett Corporation Piston based ventilator
FR2733917B1 (en) * 1995-05-12 1997-10-17 Benarrouch Jacques OSCILLATORY PRESSURE VARIATOR TO REDUCE THE VISCOSITY OF THIXOTROPIC MUCUS FOR THEIR EXPECTORATION OF LUNGS AND BRONCHES
US5611335A (en) * 1995-06-06 1997-03-18 Makhoul; Imad R. High-frequency fan ventilator
GB2306623B (en) * 1995-10-31 1998-08-05 Zamir Hayek Fluid control valves
JP3898251B2 (en) 1996-03-28 2007-03-28 スズキ株式会社 Diaphragm neutral position controller for ventilator
US6058932A (en) * 1997-04-21 2000-05-09 Hughes; Arthur R. Acoustic transceiver respiratory therapy apparatus
US5829429A (en) * 1997-04-21 1998-11-03 Hughes; Arthur R. Acoustic respiratory therapy apparatus
JP3945902B2 (en) 1998-03-31 2007-07-18 スズキ株式会社 Ventilator
SE9904382D0 (en) * 1999-12-02 1999-12-02 Siemens Elema Ab High Frequency Oscillation Patient Fan System
SE0000206D0 (en) 2000-01-25 2000-01-25 Siemens Elema Ab High frequency oscillator fan
PT1299648E (en) * 2000-07-13 2012-03-20 Electromed Inc Body pulsating apparatus

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2512621A (en) * 1944-11-23 1950-06-27 John H Emerson Therapeutic vibrator
US3653379A (en) * 1970-08-20 1972-04-04 Joseph G Glenn Adjustable pressure ippb ventilator
US4062358A (en) * 1976-04-21 1977-12-13 Kritzer Richard W Respirators

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP1663362A4 *

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2917979A1 (en) * 2007-06-28 2009-01-02 Bear Medical Soc Par Actions S Expectoration assisting domestic apparatus for oxygendependant patient, has air controlling unit including electro valve producing series of positive and negative air pulsations during inspiration and expiration phases respectively
WO2009019339A2 (en) * 2007-06-28 2009-02-12 Scalea Medical Sarl Coughing aid device
WO2009019339A3 (en) * 2007-06-28 2009-05-07 Scalea Medical Sarl Coughing aid device

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JP4617307B2 (en) 2011-01-26
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EP1663362A1 (en) 2006-06-07
US6929007B2 (en) 2005-08-16

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