CPR DEVICES AND METHODS UTILIZING A CONTINUOUS SUPPLY OF RESPIRATORY GASES

• US 20070221222A1
• Filed: 02/27/2007
• Published: 09/27/2007
• Est. Priority Date: 09/11/2003
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Advanced Circulatory Systems, Inc. (Asahi Kasei Corporation)
• Inventors: Lurie, Keith
• Granted Patent: US 8,011,367 B2
• Time in Patent Office: Days
• US Class Current: 128/204.180
• CPC Class Codes: A61M 16/0009 with sub-atmospheric pressure, e.g. during expiration
• CPC Class Codes: A61M 16/0012 by Venturi means
• 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 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/0486 Multi-lumen tracheal tubes
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/208 Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• CPC Class Codes: A61M 2016/0018 electrical
• CPC Class Codes: A61M 2016/003 with a flowmeter
• CPC Class Codes: A61M 2016/0413 with detectors of CO2 in exhaled gases
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/581 by audible feedback
• CPC Class Codes: A61M 2205/587 Lighting arrangements
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/30 Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)

Abstract

A method for increasing circulation and providing oxygen to a patient in cardiac arrest includes the step of coupling an interface to the patient'"'"'s airway, the interface providing access to the patient'"'"'s respiratory system. A valve system is operably attached to the interface. Oxygen is delivered through the interface a rate of between about 1.0 to about 10.0 L/min to provide a continuous supply of oxygen to the patient. While supplying the oxygen, a body structure of the patient is manipulated to increase the magnitude and duration of the patient'"'"'s negative intrathoracic pressure. During the manipulation, the valve system prevents additional respiratory gases from entering the lungs until a negative intrathoracic pressure level in the range from about −1 cm H2O to about −15 cm H2O, the valve system assisting in increasing the magnitude and duration of negative intrathoracic pressure thereby enhancing the amount of blood flow in the heart and lungs and lowering intracranial pressure, therein further increasing blood flow to the brain.

Claims

1. A method for increasing circulation and providing oxygen to a patient in cardiac arrest, said method comprising:

coupling an interface to the patient'"'"'s airway, the interface providing access to the patient'"'"'s respiratory system;

operably attaching a valve system with the interface;

delivering oxygen through the interface at a rate of between about 1.0 to about 10.0 L/min to provide a continuous supply of oxygen to the patient;

while supplying the oxygen, manipulating a body structure of the patient to increase the magnitude and duration of the patient'"'"'s positive and negative intrathoracic pressure, wherein during said manipulation the valve system prevents additional respiratory gases from entering the lungs until a negative intrathoracic pressure level in the range from about −

1 cm H2O to about −

15 cm H2O, the valve system assisting in increasing the magnitude and duration of negative intrathoracic pressure thereby enhancing the amount of blood flow in the heart and lungs and lowering intracranial pressure, therein further increasing blood flow to the brain.

2. A method as in claim 1, wherein the interface comprises a ventilation tube comprising at least an inflow lumen and an outflow lumen, wherein gases exit the patient'"'"'s lungs through the outflow lumen, and wherein the oxygen is supplied through the inflow lumen.

3. A method in claim 1, wherein the patient is receiving cardiopulmonary resuscitation.

4. A method as in claim 1, wherein the body structure is manipulated by actively compressing the chest and then actively decompressing the chest.

5. A method as in claim 4, wherein the body structure is manipulated.

using an active compression/decompression device secured to the patient'"'"'s chest or a vest/carrass that actively expands the chest.

6. A method as in claim 1, further comprising periodically providing a positive pressure breath to the patient.

7. A method as in claim 6, further comprising actively removing carbon dioxide from the patient'"'"'s lungs.

8. A method as in claim 1, further comprising periodically squeezing the patient'"'"'s lower limbs.

9. A method in claim 8 wherein the timing of the lower limb compression is synchronized with a decompression phase of CPR.

10. A method for increasing circulation and providing oxygen to a patient, said method comprising:

placing a ventilation tube within the patient'"'"'s airway, wherein the ventilation tube includes an inflow lumen for permitting oxygen to be supplied to the lungs and an outflow lumen for permitting respiratory gases to exit the lungs;

interfacing a valve system with the outflow lumen such that gases exiting the patient may pass through the outflow lumen and exit the valve system;

delivering of oxygen through the inflow lumen at a rate of between about 1.0 to about 10.0 L/min to permit a continuous supply of oxygen to be supplied to the patient'"'"'s lungs;

while delivering oxygen through the inflow lumen, manipulating a body structure of the patient to increase the magnitude and duration of the patient'"'"'s negative intrathoracic pressure, where in during said manipulation the valve system prevents respiratory gases from entering the lungs through the outflow lumen in the ventilation tube until a negative intrathoracic pressure level in the range from about −

1 cm H2O to about −

15 cm H2O, the valve system assisting in increasing the magnitude and duration of negative intrathoracic pressure thereby enhancing the amount of blood flow in the heart and lungs and lowering intracranial pressure, therein further increasing blood flow to the brain.

11. A method as in claim 10, wherein the body structure is manipulated by actively compressing the chest and allowing the chest to then recoil passively and/or actively, and wherein the patient is in a condition selected from a group consisting of cardiac arrest and hypotension.

12. A method as in claim 10, wherein the valve system includes a threshold inflow valve, and wherein the inflow valve is configured to open if the threshold negative intrathoracic pressure is exceeded.

13. A method as in claim 10, further comprising periodically providing a positive pressure breath to the patient.

14. A method as in claim 13, further comprising monitoring at least one physiological parameter of the person and supplying the positive pressure breath based on the monitored parameter.

15. A method as in claim 14, wherein the physiological parameter comprises end tidal CO₂.

16. A method as in claim 10, further comprising interfacing an oxygen source to the inflow lumen to continuously supply the oxygen to the patient'"'"'s lungs.

17. A method as in claim 10, wherein a balloon is coupled to the ventilation tube, wherein the ventilation tube includes a balloon inflation lumen and further comprising inflating the balloon when within the patient'"'"'s airway.

18. A system for increasing circulation and providing oxygen to a patient, the system comprising:

an interface that is configured to interface with a patient'"'"'s airway;

a valve system that is configured to be coupled to the interface, the valve system having an inflow valve that is configured to prevent respiratory gases from flowing to the lungs until a negative intrathoracic pressure level in the range from about −

1 cm H2O to −

15 cm H2O;

an oxygen source that is configured to be coupled to the interface so as to continuously deliver oxygen through the inflow lumen at a rate of between about 1.0 to about 10.0 L/min.

19. A device as in claim 18, wherein the interface comprises a ventilation tube that is configured to be placed within the patient'"'"'s airway, wherein the ventilation tube has a proximal end, a distal end, an inflow lumen and an outflow lumen, wherein the valve system is configured to be coupled to the outflow lumen and wherein the oxygen source is configured to be coupled to the inflow lumen.

20. A device as in claim 18, further comprising a manipulation apparatus that is configured to manipulate a body structure of the patient to increase the magnitude and duration of the patient'"'"'s negative intrathoracic pressure.

21. A device as in claim 18, further comprising at least one physiological sensor to measure at least one physiological parameter of the person.

22. A device as in claim 21, wherein the physiological sensor comprises an end tidal CO₂ sensor.

23. A system for increasing circulation and providing oxygen to a patient, the system comprising:

a ventilation tube that is configured to be placed within the patient'"'"'s airway, wherein the ventilation tube has a proximal end, a distal end, an inflow lumen to permit oxygen to be supplied to the lungs and an outflow lumen to permit respiratory gases to exit the lungs;

a valve system that is configured to be coupled to the outflow lumen of the ventilation tube such that gases exiting the patient may pass through the outflow lumen and exit the valve system;

an oxygen source that is configured to be coupled to the inflow lumen so as to continuously deliver oxygen through the inflow lumen at a rate of between about 1.0 to about 10.0 L/min.

24. A system as in claim 23, further comprising a manipulation apparatus that is configured to manipulate a body structure of the patient to increase the magnitude and duration of the patient'"'"'s negative intrathoracic pressure, wherein the valve system includes an inflow valve that prevents respiratory gases from entering the lungs through the outflow lumen in the ventilation tube until a negative intrathoracic pressure level in the range from about −

1 cm H2O to −

15 cm H2O, the inflow valve assisting in increasing the magnitude and duration of negative intrathoracic pressure thereby enhancing the amount of blood flow in the heart and lungs and lowering intracranial pressure, therein further increasing blood flow to the brain.

25. A system as in claim 24, wherein the manipulation apparatus is selected from a group of apparatus consisting of an active compression/decompression device that is configured to be secured to the patient'"'"'s chest and a vest/carrass that is configured to actively expand the chest.

26. A system as in claim 23, further comprising a balloon that is coupled to the ventilation tube near the distal end, wherein the ventilation tube includes a balloon inflation lumen.

27. A system as in claim 23, further comprising a device to provide positive pressure ventilation to the patient through the valve system.