Systems and methods for increasing cerebral spinal fluid flow

• US 20040211416A1
• Filed: 06/11/2003
• Published: 10/28/2004
• Est. Priority Date: 04/28/2003
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Advanced Circulatory Systems, Inc. (Asahi Kasei Corporation)
• Inventors: Lurie, Keith G.
• Granted Patent: US 7,185,649 B2
• Time in Patent Office: Days
• US Class Current: 128/203.11
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/0825 with ball-sockets
• CPC Class Codes: A61M 16/107 in the inspiratory path
• CPC Class Codes: A61M 16/20 Valves specially adapted to medical respiratory devices
• CPC Class Codes: A61M 16/208 Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/50 Temperature

Abstract

In one embodiment, the invention provides a device for decreasing intracranial or intraocular pressures. The device comprises a housing having an inlet opening and an outlet opening that is adapted to be interfaced with a person'"'"'s airway. The device further includes a valve system that is operable to regulate respiratory gas flows through the housing and into the person'"'"'s lungs during spontaneous or artificial inspiration. The valve system assists in lowering intrathoracic pressures during each inspiration to repetitively lower pressures in the venous blood vessels that transport blood out of the head to thereby reduce intracranial or intraocular pressures.

Claims

1. A device for treating a person suffering from head trauma associated with elevated intracranial pressures, the device comprising:

a housing having an inlet opening and an outlet opening that is adapted to be interfaced with a person'"'"'s airway;

a valve system that is operable to regulate respiratory gas flows through the housing and into the person'"'"'s lungs during spontaneous or artificial inspiration, the valve system assisting in lowering intrathoracic pressures during at least some inspirations to repetitively lower pressures in the venous blood vessels that transport blood out of the head to thereby reduce intracranial pressures and increase movement of cerebral spinal fluid to thereby further decrease intracranial pressures.

2. A device as in claim 1, wherein the valve system is normally closed and is configured to open to permit respiratory gasses to freely flow to the person'"'"'s lungs when the negative intrathoracic pressure reaches a pressure in the range from about 0 cmH2O to about −

25 cmH2O in order to reduce intracranial pressures and increase movement of cerebral spinal fluid.

3. A device as in claim 1, further comprising means for causing the person to artificially inspire through the valve system.

4. A device as in claim 3, wherein the means for causing the person to artificially inspire is selected from a group consisting of an electrode, an iron lung cuirass device, a chest lifting device and a ventilator.

5. A device as in claim 1, further comprising a mechanism for varying the level of impedance of the valve system.

6. A device as in claim 5, further comprising at least one physiological sensor that is configured to monitor at least one physiological parameter of the person, and wherein the mechanism for varying the level of impedance is configured to receive signals from the sensor and to vary the level of impedance of the valve system based on the signals.

7. A device as in claim 6, wherein the sensor is selected from a group of sensors that are configured to measure parameters selected from a group consisting of respiratory rate, intrathoracic pressure, intratracheal pressure, intracranial blood flow, blood pressure, heart rate, end tidal CO2, oxygen level, and intracranial pressure.

8. A device as in claim 1, further comprising a coupling mechanism that is configured to couple the valve system to the person'"'"'s airway.

9. A device as in claim 8, wherein the coupling mechanism is selected from a group consisting of a mouthpiece, an endotracheal tube, and a face mask.

10. A device as in claim 1, wherein the valve system comprises an inflow valve that is selected from a group of valves consisting of a fish mouth valve, a spring-poppet valve, a ball valve, a flexible plug valve, a slotted airway resistance valve, a spring biased valve, a movable disk valve, a compressible airway valve, an iris valve, an automated valve, and a sequential series of adjusting valves.

11. A method for treating a person suffering from head trauma associated with elevated intracranial pressures, the method comprising:

coupling a valve system to a person'"'"'s airway, the valve system being configured to at least periodically reduce or prevent respiratory gases from flowing to the person'"'"'s lungs;

repetitively decreasing the person'"'"'s negative intrathoracic pressure using the valve system when coupled to the person'"'"'s airway to repetitively lower pressures in the venous blood vessels that transport blood out of the head to thereby reduce intracranial pressures and increase movement of the cerebral spinal fluid to thereby decrease intracranial pressures.

12. A method as in claim 11, wherein respiratory gases are prevented from entering the lungs through the valve system until a negative intrathoracic pressure in the range from about 0 cmH2O to about −

25 cmH2O is achieved, at which time the valve system permits respiratory gases to flow to the lungs.

13. A method as in claim 11, wherein the person'"'"'s negative intrathoracic pressure is repetitively decreased by repeatedly inspiring through the valve system.

14. A method as in claim 11, wherein the person'"'"'s negative intrathoracic pressure is repetitively decreased every other breath, every third breath, or in a repetitive sequence by breathing through the valve system, to reduce intracranial pressure and increase the movement of cerebral spinal fluid.

15. A method as in claim 13, wherein the person spontaneously inspires through the valve system to repetitively decrease the intrathoracic pressure.

16. A method as in claim 13, further comprising artificially causing the person to repeatedly inspire through the valve system.

17. A method as in claim 16, wherein the person is artificially caused to repeatedly inspire by repeatedly stimulating the phrenic nerve, by manipulating the chest with an iron lung cuirass device, by generating negative pressures within the thorax using a ventilator, or by applying a high frequency ventilator that supplies oscillations at a rate of about 200 to about 2000 per minute.

18. A method as in claim 11, further comprising fixing an impedance level of the valve system.

19. A method as in claim 11, further comprising varying an impedance level of the valve system over time.

20. A method as in claim 19, further comprising measuring at least one physiological parameter of the person, and wherein the impedance level is varied based on the measured parameters.

21. A method as in claim 20, wherein the parameters are selected from a group consisting of respiratory rate, intrathoracic pressure, intratracheal pressure, blood pressure, heart rate, end tidal CO2, oxygen level, intracranial blood flows, and intracranial pressure.

22. A method as in claim 11, wherein the valve system is coupled to a mouthpiece, an endotracheal tube, or a face mask that is coupled to the person'"'"'s airway.

23. A method for treating a person suffering from a heart condition that results in elevated intracranial pressures, the method comprising:

coupling a valve system to a person'"'"'s airway, the valve system being configured to at least periodically reduce or prevent respiratory gases from flowing to the person'"'"'s lungs;

repetitively decreasing the person'"'"'s negative intrathoracic pressure using the valve system when coupled to the person'"'"'s airway to repetitively lower pressures in the venous blood vessels that transport blood out of the head to thereby reduce intracranial pressures and increase movement of the cerebral spinal fluid to thereby decrease intracranial pressure.

24. A method for treating a person suffering from a heart condition that results in elevated intracranial pressures, the method comprising:

coupling a pressure reducing means to a person'"'"'s airway to reduce the person'"'"'s intrathoracic pressure;

repetitively decreasing the person'"'"'s negative intrathoracic pressure using the pressure reducing means when coupled to the person'"'"'s airway to repetitively lower pressures in the venous blood vessels that transport blood out of the head to thereby reduce intracranial pressures and increase movement of the cerebral spinal fluid to thereby decrease intracranial pressure.