Shock treatment systems and methods

• US 20020170562A1
• Filed: 04/08/2002
• Published: 11/21/2002
• Est. Priority Date: 11/09/1993
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Advanced Circulatory Systems, Inc. (Asahi Kasei Corporation)
• Inventors: Lurie, Keith G., Zielinski, Todd M.
• Granted Patent: US 7,210,480 B2
• Time in Patent Office: Days
• US Class Current: 128/205.24
• CPC Class Codes: A61H 2201/0173 Means for preventing injuries
• CPC Class Codes: A61H 2201/1238 with hydraulic or pneumatic drive
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2201/5048 Audio interfaces, e.g. voice or music controlled
• CPC Class Codes: A61H 2201/5058 Sensors or detectors
• CPC Class Codes: A61H 2201/5071 Pressure sensors
• CPC Class Codes: A61H 2201/5089 Gas sensors, e.g. for oxygen or CO2
• CPC Class Codes: A61H 2201/5097 wireless
• CPC Class Codes: A61H 2230/207 partial O2-value
• CPC Class Codes: A61H 2230/42 Rate
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61H 31/006 Power driven
• CPC Class Codes: A61H 31/007 Manual driven
• CPC Class Codes: A61M 16/0078 Breathing bags
• CPC Class Codes: A61M 16/0084 self-reinflatable by elasticity, e.g. resuscitation squeeze bags
• CPC Class Codes: A61M 16/022 Control means therefor
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0858 Pressure sampling ports
• CPC Class Codes: A61M 16/1055 bacterial
• CPC Class Codes: A61M 16/106 in a path
• CPC Class Codes: A61M 16/20 : Valves specially adapted to medical respiratory devices
• CPC Class Codes: A61M 16/202 : electrically actuated
• CPC Class Codes: A61M 16/208 : Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• CPC Class Codes: A61M 16/209 : Relief valves
• CPC Class Codes: A61M 2016/0021 : with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0027 : pressure meter
• CPC Class Codes: A61M 2016/0033 : electrical
• CPC Class Codes: C09K 5/042 : comprising compounds containing carbon and hydrogen only

Abstract

According to the invention, methods and devices for increasing cardiopulmonary circulation induced by chest compression and decompression when performing cardiopulmonary resuscitation are provided. According to one method, a pressure responsive inflow valve is coupled to a patient'"'"'s airway. Chest compressions and chest decompressions are performed. During chest decompression the inflow valve prevents respiratory gases from entering the lungs until a certain negative intrathoracic pressure level is exceeded at which time the one inflow valve opens. In this way, the inflow valve assists in increasing the magnitude and duration of negative intrathoracic pressure during decompression to enhance the amount of blood flow into the heart and lungs. Further, the patient is supplied with a pressurized respiratory gas through the inflow valve when the inflow valve opens to ventilate the patient.

Claims

1. A device for facilitating an increase in blood pressure in a breathing patient, said device comprising:

a housing having an opening that is adapted to be interfaced with a patient'"'"'s airway;

an inflow flow valve that is operable to increase or decrease respiratory gas flow through the housing due to patient inhalation, the inflow valve assisting in manipulating intrathoracic pressures to increase blood flow back to the patient'"'"'s chest;

a mechanism for operating the inflow valve to vary the respiratory gas flow through the housing; and

a sensor that is adapted and configured to sense at least one physiological parameter of the patient.

2. A device as in claim 1, wherein the inflow valve is operable to achieve a negative intrathoracic pressure within the range from about 0 cm H₂O to about −

50 cm H₂O when the patient breathes at flow rates in the range from about zero flow to about 70 liters per minute.

3. A device as in claim 1, further comprising a controller that is coupled to the sensor and the mechanism, and wherein the controller is configured to send signals to the mechanism to operate the inflow valve based on the sensed physiological parameter from the sensor.

4. A device as in claim 1, wherein the sensor is selected from a group consisting of pressure sensors, flow sensors, CO₂ sensors, and oxygen sensors.

5. A device as in claim 1, wherein the inflow valve comprises a slotted opening and a slotted plate that is movable across the slotted opening.

6. A device as in claim 1, wherein the inflow valve comprises an airway and an occlusion member that is movable across the airway.

7. A device as in claim 1, wherein the inflow valve comprises an airway and a compression occluding system to compress the airway

8. A device as in claim 1, wherein the inflow valve comprises an airway and an iris occluding system.

9. A device as in claim 1, wherein the mechanism comprises a stepper motor and a shaft extending from the stepper motor.

10. A device as in claim 1, wherein the housing includes an inspiratory port and an expiratory port, and further comprising a face mask that is coupled to the housing.

11. A device as in claim 1, further comprising means to add supplemental oxygen or periodic assisted ventilation to the patient.

13. A method as in claim 12, wherein the person has low blood pressure due to conditions selected from a group consisting of blood loss, the administration of a drug, a high gravitational state, vasovagal syncope, cardiac tamponade, drowning, heat stroke, heart attack, right heart failure, return to earth after space flight, and sepsis.

14. A method as in claim 12, further comprising sending a signal to a controller that is representative of the sensed parameter, and sending a signal from the controller to a mechanism to operate the valve based on the sensed parameter.

15. A method as in claim 12, wherein the parameter sensed is selected from a group consisting of negative intrathoracic pressure, blood pressure, respiratory rate, end tidal CO₂, positive end expiratory pressure, and oxygen saturation.

16. A method as in claim 12, wherein the inflow valve is operated to achieve a negative intrathoracic pressure within the range from about 0 cm H₂O to about −

50 cm H₂O when the person breathes at flow rates in the range from about zero flow to about 70 liters per minute.

17. A method as in claim 12, wherein the inflow valve comprises an airway and an occlusion member, wherein the occlusion member is moved across the airway to vary the flow rate through the inflow valve.

18. A method as in claim 12, wherein the physiological parameter is repeatedly sensed, and wherein the valve is repeatedly operated based the sensed parameters.

19. A method as in claim 12, further comprising supplying supplemental ventilation or oxygen to the person.

20. A method as in claim 12, further comprising supplying a drug or a medicament to the person upstream or downstream of the inflow valve.

12. A method for increasing the blood pressure in a spontaneously breathing person, the method comprising the steps of:

sensing at least one physiological parameter of the person;

interfacing an inflow valve to the person'"'"'s airway that is operable to increase or decrease respiratory gas flow to the person'"'"'s lungs;

operating the inflow valve based on the sensed parameter to increase or decrease respiratory gas flow to the person'"'"'s lungs while the person is inhaling to create a vacuum within the thorax and increase blood flow back to the right heart of the person, thereby enhancing the person'"'"'s blood pressure.