Medical valve and method to monitor intra-abdominal pressure

• US 20070038143A1
• Filed: 08/09/2005
• Published: 02/15/2007
• Est. Priority Date: 03/04/2003
• Status: Active Grant

• Current Assignee: Convatec Technologies, Inc. (ConvaTec Group Plc)
• Original Assignee: Wolfe TORY Medical Incorporated
• Inventors: Kimball, Edward, Croll, Perry, Denton, Marshall, Christensen, Mark, Wolfe, Timothy
• Granted Patent: US 7,644,722 B2
• Time in Patent Office: Days
• US Class Current: 600/561
• CPC Class Codes: A61B 5/036 by means introduced into body tracts A61B5/032 and A61B5/035 take precedence
• CPC Class Codes: A61B 5/205 Determining bladder or urethral pressure
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61M 25/0017 specially adapted for long-term hygiene care, e.g. urethral or indwelling catheters to prevent infections
• CPC Class Codes: A61M 39/223 Multiway valves
• CPC Class Codes: F16K 7/126 the seat being formed on a rib perpendicular to the fluid line
• CPC Class Codes: Y10T 137/2557 Waste responsive to flow stoppage
• CPC Class Codes: Y10T 137/7722 Line condition change responsive valves

Abstract

An apparatus for monitoring the intra-abdominal pressure of a hospitalized patient includes a urinary catheter connected to a urine valve providing selectable communication between a discharge end of the urinary catheter and either a drain or a fluid source. Preferably, the urine valve is adapted for remote actuation and has a housing adapted to resist patient discomfort from leg-valve contact. Plumbing structure desirably maintains fluid supply and drain conduits in a substantially parallel arrangement to assist routing those conduits between a patient'"'"'s legs. When the urine valve is oriented to permit communication with the fluid source, an infusion pump may be used to infuse a known quantity of fluid through the urine valve and into the patient'"'"'s bladder. A pressure transducer desirably is connected in-circuit to indicate the fluid'"'"'s pressure. To facilitate the infusion process, an automatic flow control device may be included in a fluid supply path and arranged to permit repetitive operation of a syringe to inject a bolus of fluid into the patient'"'"'s bladder. Subsequent to a period of time in which to make a pressure measurement, preferred embodiments of the urine valve automatically return to a bladder draining position.

Claims

1. A hydraulically actuated valve, comprising:

a housing configured and arranged to permit fluid communication between an entrance port, a control port, and a drain port;

a seal member arranged inside said housing for hydraulic actuation between a valve-open position and a valve-closed position, said valve-open position permitting draining fluid flow between said entrance port and said drain port, and said valve-closed position resisting said draining fluid flow;

a fluid-flow restriction valve disposed in a first fluid path along which control fluid may flow from said control port toward said entrance port, said fluid-flow restriction valve being structured to generate a back-pressure responsive to a flow of said control fluid, said back-pressure being effective to urge flow of actuation fluid toward said seal member; and

a bleed-down port configured and arranged to permit evacuation, as bleed-down fluid, of actuation fluid confined by said seal member.

2. The hydraulically actuated valve of claim 1, wherein:

subsequent to being displaced beyond a valve-closed position, said seal member is biased to urge said bleed-down fluid to flow through said bleed-down port effective to cause a time-delayed opening of said valve.

3. The hydraulically actuated valve of claim 1, wherein:

said seal member comprises an expandable diaphragm configured and arranged to be self-biased from said valve-closed position toward said valve-open position.

4. The hydraulically actuated valve of claim 1, wherein:

a time-delay volume is created by displacement of said seal member to encompass a confined volume in excess of that volume required to form an initial blockage of said draining fluid flow.

5. The hydraulically actuated valve of claim 1, wherein:

said bleed-down port is arranged to discharge said bleed-down fluid along a path that overlaps a portion of a second fluid path between said control port and said drain port.

6. The hydraulically actuated valve of claim 5, wherein:

flow of said bleed-down fluid is directed along a third fluid path defined, in-part, between said bleed-down port and said fluid-flow restriction valve.

7. The hydraulically actuated valve of claim 1, wherein:

a fluid path followed by said bleed-down fluid overlaps a portion of said first fluid path.

8. The hydraulically actuated valve of claim 1, wherein:

said first fluid path is defined, at least in-part, by structure of said housing disposed between said control port and said entrance port.

9. The hydraulically actuated valve of claim 1, wherein:

a bleed-down valve associated with said bleed-down port is structured to cause the rate of flow of said bleed-down fluid to be sufficiently low that it does not generate a significant back-pressure when passing through said flow-restriction valve.

10. The hydraulically actuated valve of claim 1, wherein:

said seal member comprises a membrane configured and arranged to form a traveling wall operable to collapse a cross-section of said first flow path at a seal location effective to form a fluid-flow resisting seal in cooperation with valve-closing seal structure carried by a fixed wall.

11. The hydraulically actuated valve of claim 1, wherein:

a perimeter forming a wetted boundary to a seal area of said valve is a 3-dimensional entity.

12. The hydraulically actuated valve of claim 1, wherein:

structure forming a seal to resist said draining fluid flow is configured and arranged such that a normal to a portion of a bounded seal area has a component oriented substantially perpendicular to a vector indicating valve-open fluid flow through the opening defined by the perimeter of the bounded seal surface.

13. A normally-open, hydraulically actuated valve, comprising:

a control port, an entrance port, and a drain port, said valve being operable to resist draining fluid flow along a normally-open first flow path between said entrance port and said drain port;

an expansion chamber disposed in fluid communication between said entrance port and said drain port, said expansion chamber carrying valve-closing seal structure on a fixed wall;

a membrane arranged to receive fluid communication from said control port effective to cause a traveling wall to collapse a cross-section of said first flow path and create, in cooperation with said valve-closing seal structure, a blockage of said first flow path, said membrane being biased toward a valve-open position.

14. The hydraulically actuated valve of claim 13, wherein:

said expansion chamber comprises one or more timing chambers arranged in association with said membrane to accommodate inflation of said membrane, by timing fluid, beyond a first valve-closed position.

15. The hydraulically actuated valve of claim 14, further comprising:

a bleed-down port configured and arranged to permit discharge of timing fluid confined by said seal member effective to cause a time-delay prior to removal of said blockage.

16. The hydraulically actuated valve of claim 13, wherein:

a sealing perimeter defined as a wetted boundary formed by contact of said membrane onto seal structure associated with said expansion chamber, when said membrane is displaced to a valve first-closed configuration, is noncircular.

17. The hydraulically actuated valve of claim 16, wherein:

said sealing perimeter is a 3-dimensional entity.

18. The hydraulically actuated valve of claim 13, wherein:

said membrane is self-biased from a valve-closed position toward a valve-open position.

19. A method, for hydraulically actuating a valve to block a drain path through the valve, comprising the steps of:

a) providing control fluid to said valve by placing a fluid source in fluid communication, through a pressure-inducing apparatus, with a control port of said valve;

b) operating said pressure-inducing apparatus to urge a flow of said control fluid through said control port toward a fluid restriction port operably to generate a back-pressure in said control fluid causing actuation fluid to displace a diaphragm from a normally-open position to a first-closed position effective to occlude said drain path;

c) further operating said pressure-inducing apparatus to urge a flow of timing fluid causing additional displacement of said diaphragm effective to create a timing volume;

d) stopping operation of said pressure-inducing apparatus; and

e) waiting during a time-delay while said timing volume is permitted to drain through a bleed-down port to permit said diaphragm to return to a valve-open position.

20. The method according to claim 19 wherein said valve is included in an assembly adapted to periodically measure the bladder pressure in a medical patient to infer the abdominal pressure in that patient, the method further comprising the steps of:

i) installing a urinary catheter in said patient to provide fluid communication between said bladder and a discharge portion of said catheter;

ii) disposing an entrance port of said valve in fluid communication with said discharge portion so that said valve can provide a drain orientation and a measure orientation, said drain orientation permitting fluid flow from said entrance port through said valve and along said drain path toward a receptacle, said measure orientation providing fluid communication between said entrance port and said control port while said drain path is occluded;

iii) disposing a pressure transducer in-circuit effective to measure the pressure of fluid in said bladder;

iv) operating said pressure-inducing apparatus to place said valve into said measure orientation and to introduce a bolus of control fluid into said bladder; and

v) using said pressure transducer to measure a hydrostatic pressure of the fluid in said bladder during said time-delay.