Synchronizing chest compression and ventilation in cardiac resuscitation

• US 20070225623A1
• Filed: 02/16/2006
• Published: 09/27/2007
• Est. Priority Date: 02/16/2006
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Freeman, Gary
• Granted Patent: US 8,105,249 B2
• Time in Patent Office: Days
• US Class Current: 601/41
• CPC Class Codes: A61H 2201/0207 heated
• CPC Class Codes: A61H 2201/0214 cooled
• CPC Class Codes: A61H 2201/025 by direct air flow on the patient's body
• CPC Class Codes: A61H 2201/0257 by a heat accumulator, e.g. a sand or liquid reservoir
• CPC Class Codes: A61H 2201/0285 with Peltier elements
• CPC Class Codes: A61H 2201/10 with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
• CPC Class Codes: A61H 2201/105 with means for delivering media, e.g. drugs or cosmetics
• CPC Class Codes: A61H 2201/107 Respiratory gas
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2201/501 connected to external computer devices or networks
• CPC Class Codes: A61H 2201/5043 Displays
• CPC Class Codes: A61H 2201/5048 Audio interfaces, e.g. voice or music controlled
• CPC Class Codes: A61H 2201/5089 Gas sensors, e.g. for oxygen or CO2
• CPC Class Codes: A61H 2230/04 Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
• CPC Class Codes: A61H 2230/08 Other bio-electrical signals
• CPC Class Codes: A61H 2230/205 partial CO2-value
• CPC Class Codes: A61H 2230/207 partial O2-value
• CPC Class Codes: A61H 31/004 Heart stimulation
• CPC Class Codes: A61H 31/006 Power driven
• CPC Class Codes: A61M 16/00 Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes stimulating the respiratory movement by mechanical, pneumatic or electrical means, iron lungs combined with gas breathing means A61H31/00
• CPC Class Codes: A61M 16/0069 : the speed thereof being controlled by respiratory parameters, e.g. by inhalation
• CPC Class Codes: A61M 16/021 : operated by electrical means A61M16/202 – A61M16/205 take precedence
• CPC Class Codes: A61M 16/1075 : by influencing the temperature A61M16/1045 takes precedence
• CPC Class Codes: A61M 2205/3344 : Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/50 : with microprocessors or computers
• CPC Class Codes: A61M 2230/04 : Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61N 1/39044 : in combination with cardiopulmonary resuscitation [CPR] therapy
• CPC Class Codes: A61N 1/3987 : characterised by the timing or triggering of the shock
• CPC Class Codes: Y10S 601/08 : Artificial respiration with computer control

Abstract

Apparatus for automatic delivery of chest compressions and ventilation to a patient, the apparatus including: a chest compressing device configured to deliver compression phases during which pressure is applied to compress the chest and decompression phases during which approximately zero pressure is applied to the chest a ventilator configured to deliver positive, negative, or approximately zero pressure to the airway; control circuitry and processor, wherein the circuitry and processor are configured to cause the chest compressing device to repeatedly deliver a set containing a plurality of systolic flow cycles, each systolic flow cycle comprising a systolic decompression phase and a systolic compression phase, and at least one diastolic flow cycle interspersed between sets of systolic flow cycles, each diastolic flow cycle comprising a diastolic decompression phase and a diastolic compression phase, wherein the diastolic decompression phase is substantially longer than the systolic decompression phase.

Claims

1. Apparatus for automatic delivery of chest compressions and ventilation to a patient, the apparatus comprising:

a chest compressing device configured to deliver compression phases during which pressure is applied to compress the chest and decompression phases during which approximately zero pressure is applied to the chest;

a ventilator configured to deliver positive, negative, or approximately zero pressure to the airway;

control circuitry and processor, wherein the circuitry and processor are configured to cause the chest compressing device to repeatedly deliver

a set containing a plurality of systolic flow cycles, each systolic flow cycle comprising a systolic decompression phase and a systolic compression phase, and

at least one diastolic flow cycle interspersed between sets of systolic flow cycles, each diastolic flow cycle comprising a diastolic decompression phase and a diastolic compression phase,

wherein the diastolic decompression phase is substantially longer than the systolic decompression phase.

2. The apparatus of claim 1 wherein the control circuitry and processor are configured to cause the ventilator to deliver a negative ventilation pressure during the diastolic decompression phase.

3. The apparatus of claim 2 wherein the time durations of the systolic compression phases and systolic decompression phases are approximately the same.

4. The apparatus of claim 3 wherein the time duration of the diastolic decompression phase is greater than twice the time duration of the diastolic compression phase.

5. The apparatus of claim 4 wherein the time duration of the diastolic decompression phase is approximately four times the time duration of the diastolic compression phase.

6. The apparatus of claim 2 wherein the diastolic flow cycle comprises a second compression phase and a second decompression phase, and wherein the negative ventilation pressure is delivered during one of the first and second decompression phases and a positive ventilation pressure is delivered during the other of the first and second decompression phases.

7. The apparatus of claim 2 wherein the ventilator delivers positive and negative ventilation pressures during the systolic flow cycles.

8. The apparatus of claim 7 wherein negative ventilation pressure is delivered during the majority of the decompression phase of the systolic flow cycle.

9. The apparatus of claim 8 wherein positive ventilation pressure is delivered during the majority of the compression phase of the systolic flow cycle.

10. The apparatus of claim 9 wherein the ventilation pressure varies gradually in an approximately ramp shaped variation from negative to positive and back to negative, with the pressure being approximately zero at the onset of the compression phase.

11. The apparatus of claim 10 wherein the pressure changes rapidly from positive to negative at or just prior to the onset of the decompression phase.

14. The apparatus of claim 7 wherein the ventilation pressure waveform is at or near a peak at the onset of decompression.

15. The apparatus of claim 2 wherein the compressions and ventilations are synchronized with the patient'"'"'s ECG to augment a patient'"'"'s underlying systolic and diastolic activity.

16. The apparatus of claim 2 further comprising a fluid infusion device.

17. The apparatus of claim 16 wherein fluids infused by the infuser are configured to provide metabolic substances during reperfusion.

18. The apparatus of claim 17 wherein the substances are amino acids.

19. The apparatus of claim 18 wherein the amino acids are aspartate or glutamate.

20. The apparatus of claim 2 further comprising a defibrillator and infuser, and wherein the defibrillator, compressor, ventilator, and infuser are separate devices and are linked by a communications link.

21. The apparatus of claim 20 further comprising an additional device to synchronize the defibrillator, compressor, ventilator, and infuser.

22. The apparatus of claim 2 wherein there are both negative and positive pressures available from the ventilator.

23. The apparatus of claim 2 wherein oxygen levels are elevated to greater than 40%.

24. The apparatus of claim 2 wherein the apparatus is configured to be used for victims of both cardiac and traumatic arrest wherein conditions of global ischemia are present and the reoxygenation process during resuscitation puts the victims at risk of reperfusion injury.

12. Apparatus for automatic delivery of chest compressions and ventilation to a patient, the apparatus comprising:

a chest compressing device configured to deliver compression phases during which pressure is applied to compress the chest and decompression phases during which approximately zero pressure is applied to the chest;

a ventilator configured to deliver positive, negative, or approximately zero pressure to the airway;

control circuitry and processor, wherein the circuitry and processor are configured to cause the chest compressing device to repeatedly deliver systolic flow cycles, each systolic flow cycle comprising a systolic decompression phase and a systolic compression phase, and

wherein the control circuitry and processor are configured to cause the ventilator to deliver a ventilation pressure during the compression phase that increases from approximately zero pressure at the onset of the compression phase to approximately a maximum at or near the end of the compression phase.

13. The apparatus of claim 12 wherein the control circuitry and processor are configured to cause the ventilator to deliver a ventilation pressure that is negative at the onset of the decompression phase.

25. Apparatus for automatic delivery of chest compressions and ventilation to a patient, the apparatus comprising:

a chest compressing device configured to deliver compression phases during which pressure is applied to compress the chest and decompression phases during which approximately zero pressure is applied to the chest;

a ventilator configured to deliver positive, negative, or approximately zero pressure to the airway;

cooling apparatus for cooling gases delivered by the ventilator, wherein the cooling is configured to cool the lungs, heart and the pulmonary blood flow.