MANUAL VENTILATION WITH ELECTRONICALLY CONTROLLED APL VALVE

• US 20090277448A1
• Filed: 12/21/2006
• Published: 11/12/2009
• Est. Priority Date: 12/21/2005
• Status: Active Grant

• Current Assignee: Maquet Critical Care AB (Getinge AB)
• Original Assignee: Maquet Critical Care AB (Getinge AB)
• Inventors: Videbrink, Petter, Emtell, Pär, Wong, Kin-Chun, Kock, Mikael, Ahlmén, Christer
• Granted Patent: US 8,459,262 B2
• Time in Patent Office: Days
• US Class Current: 128/204.210
• CPC Class Codes: A61M 16/0078 Breathing bags
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/18 Vaporising devices for anaesthetic preparations
• CPC Class Codes: A61M 16/205 used for exhalation control
• CPC Class Codes: A61M 16/208 Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• CPC Class Codes: A61M 16/22 Carbon dioxide-absorbing devices ; Other means for removing carbon dioxidecartridges with absorbing substances for respiratory apparatus A62B19/00
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/102 Measuring a parameter of the content of the delivered gas
• CPC Class Codes: A61M 2230/43 Composition of exhalation

Abstract

A breathing apparatus for ventilating the lungs of a patient with breathing gas, has: a breathing circuit configuration; a mechanical ventilation system; a manual ventilation system provided with a manual ventilation bag; a manual ventilation valve for enabling manual ventilation of breathing gas from the breathing circuit; a pressure sensor devised to detect the pressure level in the breathing circuit; an electronically controlled expiration valve (40) that in a mechanical ventilation mode is controlled to control the pressure level in the breathing circuit according to a first set of predetermined control rules adapted to mechanical ventilation mode requirements; said electronically controlled expiration valve in a manual ventilation mode being coupled to enable ventilation of breathing gas from the breathing circuit by means of the manual ventilation system according to a second set of predetermined control rules adapted to manual ventilation mode requirements. In a method for controlling a breathing apparatus, an electronic expiration valve is controlled during the mechanical ventilation mode as well as during the manual ventilation mode of the apparatus. The control of the expiration valve can be implemented by means of a software product for the breathing apparatus embodying programming instructions as control rules, which, when executed in the apparatus, enable control of the expiration valve during manual ventilation.

Claims

1-36. -36. (canceled)

37. A breathing apparatus for ventilating the lungs of a patient with breathing gas, comprising:

a breathing circuit configured for interaction with a respirating subject;

a mechanical ventilation system in communication with said breathing circuit to supply breathing gas to, and to receive exhaled gas from, the respirating patient;

a manual ventilation system configured to interact with the respirating subject, said manual ventilation system comprising a manually operable ventilation bag;

a manual ventilation valve operable to place said manual ventilation system in communication with said breathing circuit to enable manual ventilation of breathing gas in said breathing circuit in a manual ventilation mode by manual operation of said ventilation bag;

a pressure sensor that detects a pressure level in the breathing circuit;

an electronically controlled expiration valve operable, in a mechanical ventilation mode, to adjust the pressure level in the breathing circuit dependent on a first set of predetermined control rules adapted to manual ventilation mode requirements, said electronically controlled expiration valve also being operable, in a manual ventilation mode, to adjust the pressure level in the breathing circuit according to a second set of predetermined control rules adapted to manual ventilation mode requirements; and

said second set of predetermined control rules causing said expiration valve to maintain said pressure level in the breathing circuit at a predetermined minimum pressure level and to enable a predetermined maximum pressure level in said breathing circuit in response to a detected predetermined pattern, selected from the group consisting of a pattern of said pressure level in said breathing circuit and a pattern of flow characteristics in said breathing circuit.

38. A breathing apparatus as claimed in claim 37 wherein said pattern is said pattern of pressure level, and wherein said pattern of pressure level comprises an increase in said pressure level corresponding to a predetermined pressure increase rate.

39. A breathing apparatus as claimed in claim 37 wherein said second set of predetermined control rules cause said expiration valve to operate to allow a predetermined maximum pressure level in said breathing circuit in response to said detected predetermined pattern in said breathing circuit.

40. A breathing apparatus as claimed in claim 37 wherein said pattern is a first pattern, and wherein said second set of predetermined control rules causes said expiration valve to operate to attain a predetermined standby pressure level in response to a detected predetermined second pattern selected from the group consisting of a pattern of said pressure level in said breathing circuit and a pattern of flow characteristics in said breathing circuit.

41. A breathing apparatus as claimed in claim 40 wherein said predetermined second pattern is a pattern of pressure level, and comprises a decrease in said pressure level corresponding to a predetermined pressure decrease rate.

42. A breathing apparatus as claimed in claim 41 wherein said second set of predetermined control rules causes said expiration valve to operate to allow a predetermined minimum pressure level in said breathing circuit in response to said detected predetermined first pattern.

43. A breathing apparatus as claimed in claim 37 wherein said second set of predetermined control rules causes said expiration valve to operate to enable a predetermined first pressure level in said breathing circuit in response to said detected predetermined pattern.

44. A breathing apparatus as claimed in claim 43 wherein said predetermined pattern is a predetermined first pattern, and wherein said second set of predetermined control rules causes said expiration valve to operate to attain a second pressure level in response to a detected predetermined second pattern selected from the group consisting of a pattern of said pressure level in said breathing circuit and a pattern flow characteristics in said breathing circuit.

45. A breathing apparatus as claimed in claim 44 wherein said second set of predetermined control rules causes said expiration valve to enable pressure variations in said breathing circuit around at least one of said first pressure level and said second pressure level within a predetermined pressure variation range.

46. A breathing apparatus as claimed in claim 37 wherein said second set of predetermined control rules causes said expiration valve to operate to allow a predetermined maximum pressure level in the breathing circuit in response to a command signal received from a command signal input source.

47. A breathing apparatus as claimed in claim 37 wherein said second set of predetermined control rules causes said expiration valve to operate to enable predetermined pressure characteristics that depend on at least one of a detected pressure in said breathing circuit and a detected flow characteristic in said breathing circuit, in response to a command signal received from a command signal input source.

48. A breathing apparatus as claimed in claim 47 wherein said predetermined pressure characteristics represent pressure characteristics of Berner valve.

49. A breathing apparatus as claimed in claim 47 wherein said predetermined pressure characteristics represent pressure characteristics of APL valve.

50. A breathing apparatus as claimed in claim 37 wherein said first set of predetermined control rules trigger a change from said mechanical ventilation mode to said manual ventilation mode in response to said detected predetermined pattern.

51. A breathing apparatus as claimed in claim 37 wherein said predetermined pattern is a predetermined first pattern, and wherein said second set of predetermined control rules trigger a change from said manual ventilation mode to said mechanical ventilation mode in response to a detected predetermined second pattern, said predetermined second pattern comprising pressure characteristics in said breathing circuit.

52. A computer-readable medium encoded with programming instructions for operating a breathing-assist device comprising a breathing circuit configured for interaction with a respirating subject, a mechanical ventilation system in communication with said breathing circuit to supply breathing gas to, and to receive exhaled gas from, the respirating patient, a manual ventilation system configured to interact with the respirating subject, said manual ventilation system comprising a manually operable ventilation bag, a manual ventilation valve operable to place said manual ventilation system in communication with said breathing circuit to enable manual ventilation of breathing gas in said breathing circuit in a manual ventilation mode by manual operation of said ventilation bag, and a pressure sensor that detects a pressure level in the breathing circuit, said programming instructions causing:

an electronically controlled expiration valve operable, in a mechanical ventilation mode, to adjust the pressure level in the breathing circuit dependent on a first set of predetermined control rules adapted to manual ventilation mode requirements, and to operate said electronically controlled expiration valve in a manual ventilation mode, to adjust the pressure level in the breathing circuit according to a second set of predetermined control rules adapted to manual ventilation mode requirements; and

said second set of predetermined control rules causing said expiration valve to maintain said pressure level in the breathing circuit at a predetermined minimum pressure level and to enable a predetermined maximum pressure level in said breathing circuit in response to a detected predetermined pattern, selected from the group consisting of a pattern of said pressure level in said breathing circuit and a pattern of flow characteristics in said breathing circuit.

53. A method for operating a breathing apparatus, comprising a breathing circuit configured for interaction with a respirating subject, a mechanical ventilation system in communication with said breathing circuit to supply breathing gas to, and to receive exhaled gas from, the respirating patient, a manual ventilation system configured to interact with the respirating subject, said manual ventilation system comprising a manually operable ventilation bag, a manual ventilation valve operable to place said manual ventilation system in communication with said breathing circuit to enable manual ventilation of breathing gas in said breathing circuit by manual operation of said ventilation bag, and a pressure sensor that detects a pressure level in the breathing circuit, said method comprising the steps of:

operating an electronically controlled expiration valve, in a mechanical ventilation mode, to adjust the pressure level in the breathing circuit dependent on a first set of predetermined control rules adapted to manual ventilation mode requirements, and operating said electronically controlled expiration valve, in a manual ventilation mode, to adjust the pressure level in the breathing circuit according to a second set of predetermined control rules adapted to manual ventilation mode requirements; and

using said second set of predetermined control rules to cause said expiration valve to maintain said pressure level in the breathing circuit and a predetermined minimum pressure level and to enable a predetermined maximum pressure level in said breathing circuit in response to a detected predetermined pattern, selected from the group consisting of a pattern of said pressure level in said breathing circuit and a pattern of flow characteristics in said breathing circuit.

54. A method as claimed in claim 53 comprising controlling said expiration valve during said manual ventilation mode to maintain the pressure level in the breathing circuit at a predetermined standby pressure level.

55. A method as claimed in claim 53 comprising controlling said expiration valve during said manual ventilation mode to set a predetermined manual ventilation pressure level in the breathing circuit in response to said detected predetermined pattern.

56. A method as claimed in claim 53 wherein said pattern is said pattern of pressure level, and using said pattern of pressure level to increase in said pressure level corresponding to a predetermined pressure increase rate.

57. A method as claimed in claim 53 comprising using said second set of predetermined control rules to cause said expiration valve to operate to allow a predetermined maximum pressure level in said breathing circuit in response to said detected predetermined pattern in said breathing circuit.

58. A method as claimed in claim 53 wherein said pattern is a first pattern, and comprising using said second set of predetermined control rules to cause said expiration valve to operate to attain a predetermined standby pressure level in response to a detected predetermined second pattern selected from the group consisting of a pattern of said pressure level in said breathing circuit and a pattern of flow characteristics in said breathing circuit.

59. A method as claimed in claim 58 wherein said predetermined second pattern is a pattern of pressure level, and comprising using said predetermined second pattern to cause a decrease in said pressure level corresponding to a predetermined pressure decrease rate.

60. A method as claimed in claim 59 comprising using said second set of predetermined control rules to cause said expiration valve to operate to allow a predetermined minimum pressure level in said breathing circuit in response to said detected predetermined first pattern.

61. A method as claimed in claim 53 comprising using said second set of predetermined control rules to cause said expiration valve to operate to enable a predetermined first pressure level in said breathing circuit in response to said detected predetermined pattern.

62. A method as claimed in claim 61 wherein said predetermined pattern is a predetermined first pattern, and comprising using said second set of predetermined control rules to cause said expiration valve to operate to attain a second pressure level in response to a detected predetermined second pattern selected from the group consisting of a pattern of said pressure level in said breathing circuit and a pattern flow characteristics in said breathing circuit.

63. A method as claimed in claim 61 comprising using wherein said second set of predetermined control rules to cause said expiration valve to enable pressure variations in said breathing circuit around at least one of said first pressure level and said second pressure level within a predetermined pressure variation range.

64. A method as claimed in claim 53 comprising using said second set of predetermined control rules to cause said expiration valve to operate to allow a predetermined maximum pressure level in the breathing circuit in response to a command signal received from a command signal input source.

65. A method as claimed in claim 53 comprising using said second set of predetermined control rules to cause said expiration valve to operate to enable predetermined pressure characteristics that depend on at least one of a detected pressure in said breathing circuit and a detected flow characteristic in said breathing circuit, in response to a command signal received from a command signal input source.

66. A method as claimed in claim 53 comprising employing, as said predetermined pressure characteristics, characteristics that represent pressure characteristics of Berner valve.

67. A method as claimed in claim 53 comprising employing, as said predetermined pressure characteristics, characteristics that represent pressure characteristics of APL valve.

68. A method as claimed in claim 53 comprising using said first set of predetermined control rules to trigger a change from said mechanical ventilation mode to said manual ventilation mode in response to said detected predetermined pattern.

69. A method as claimed in claim 53 wherein said predetermined pattern is a predetermined first pattern, and comprising using said second set of predetermined control rules to trigger a change from said manual ventilation mode to said mechanical ventilation mode in response to a detected predetermined second pattern, said predetermined second pattern comprising pressure characteristics in said breathing circuit.