VOLUME CONTROL IN A MEDICAL VENTILATOR

• US 20110197884A1
• Filed: 10/09/2009
• Published: 08/18/2011
• Est. Priority Date: 10/17/2008
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Inventors: Milojevic, Ljubisa, Needham, Cheryl L., Mcdaniel, Christopher W., Truschel, William A., Cyprowski, Ronald, Mcdermott, Mark C., Duff, Winslow K.
• Granted Patent: US 10,195,391 B2
• Time in Patent Office: Days
• US Class Current: 128/204.21
• CPC Class Codes: A61M 16/0069 the speed thereof being controlled by respiratory parameters, e.g. by inhalation
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/08 Bellows; Connecting tubes having means for taking samples G01N1/22; Water traps; Patient circuits
• CPC Class Codes: A61M 16/0841 for sampling
• CPC Class Codes: A61M 16/107 in the inspiratory path
• 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 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 in the expiratory circuit
• CPC Class Codes: A61M 2205/12 with interchangeable cassettes forming partially or totally the fluid circuit
• CPC Class Codes: A61M 2205/17 with redundant control systems
• CPC Class Codes: A61M 2205/3358 Measuring barometric pressure, e.g. for compensation
• CPC Class Codes: A61M 2205/505 Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• CPC Class Codes: A61M 2205/8206 battery-operated
• CPC Class Codes: A61M 2205/8237 Charging means

Abstract

A ventilator that is small, lightweight, and portable, yet capable of being quickly adapted to operate in a plurality of different modes and configurations to deliver a variety of therapies to a patient. A porting system having a plurality of sensors structured to monitor a number of parameters with respect to the flow of gas, and a number of porting blocks is used to reconfigure the ventilator so that it operates as a single-limb or dual limb ventilator. In the single-limb configuration, an active or passive exhaust assembly can be provided proximate to the patient. The ventilator is capable of operate in a volume or pressure support mode, even in a single-limb configuration. In addition, a power control mechanism controls the supply of power to the ventilator from an AC power source, a lead acid battery, an internal rechargeable battery pack, and a detachable battery pack.

Claims

1. A ventilator comprising:

(a) a housing having an interior and an exterior;

(b) an inlet port extending from the exterior to the interior of the housing;

(c) a flow generator disposed within the housing and being structured to generate a flow of gas;

(d) an outlet port adapted to discharge the flow of gas from the housing;

(e) a patient circuit including;

(1) a patient interface, and (2) a passive exhalation device adapted to provide an exhaust gas flow from the patient circuit to an ambient atmosphere, wherein the patient circuit is in fluid communication with the outlet port and is structured so as to deliver the flow of gas to an airway of a patient during an inspiratory phase of a ventilatory cycle; and

(f) a controller operatively coupled to the flow generator and adapted to selectively control an inhalation volume of the flow of gas delivered to such a patient taking into account the exhaust gas flow lost during inspiration from the passive exhalation device.

2. The ventilator of claim 1, wherein the patient circuit is a single-limb circuit comprising a single conduit, wherein the single conduit interconnects the outlet port and the patient interface, and wherein both the inhalation volume of the flow of gas and the exhalation gas are transported within at least a portion of the single conduit.

3. The ventilator of claim 2, wherein the passive exhalation device is:

(a) a passive exhaust valve, and wherein the passive exhaust valve is coupled to the single conduit proximate the patient interface, or

(b) an orifice, wherein the exhalation gas contains carbon dioxide, and wherein the orifice is structured to flush the carbon dioxide from the patient circuit.

4. The ventilator of claim 1, wherein the controller is adapted to detect the presence of a leak of the flow of gas in the patient circuit, and wherein, responsive to detecting the leak, the controller selectively adjusts the flow generator to cause the flow of gas to have the inhalation volume which is delivered to the patient during the inspiratory phase of the ventilatory cycle.

5. The ventilator of claim 1, further comprising a sensor in fluid communication with the patient circuit proximate the passive exhalation device, wherein the exhalation gas, which is exhaled by the patient during the expiratory phase of the ventilatory cycle, has a tidal volume, wherein the controller of the ventilator includes a number of sensors, wherein an output of the sensor is provided to the controller, and wherein the controller determines a tidal volume based on the output of the sensor.

6. The ventilator of claim 5, wherein, responsive to determining the tidal volume, the controller selectively adjusts the flow generator to generate a flow of gas having a desired inhalation volume, which is to be delivered to the patient during the inspiratory phase of the next ventilatory cycle.

7. The ventilator of claim 1, wherein the patient interface is (a) a non-invasive patient interface device, or (b) an invasive patient interface device.

8. The ventilator of claim 1, wherein the ventilator is portable, and wherein the ventilator provides volume control ventilation therapy while enabling the patient to move from one location to another.

9. The ventilator of claim 1, wherein the ventilator weighs less than 5 kilograms.

10. The ventilator of claim 1, wherein the controller is adapted to account for known/intended leaks and unknown/unintended leaks using different compensation techniques.

11. A method of ventilating a patient using a ventilator, the method comprising:

(a) generating a flow of gas from a flow generator, wherein the flow of gas is selectively controlled by a controller;

(b) delivering the flow of gas to an airway of a patient during an inspiratory phase of a ventilatory cycle such that a predetermined inhalation volume of gas is delivered to the airway during the inspiratory phase; and

(c) discharging a portion of an exhaust gas flow to the atmosphere using a passive exhalation device of the patient circuit.

12. The method of claim 11, wherein the patient circuit is a single-limb circuit comprising a single conduit, wherein the single conduit interconnects an outlet port of the ventilator to a patient interface of the patient circuit, and wherein the method further comprises transporting both the inhalation volume of the flow of gas and an exhalation gas within the single conduit.

13. The method of claim 11, further comprising:

(a) determining if a leak is present in the patient circuit, and

(b) responsive to detecting a leak in the patient circuit, selectively adjusting the flow generator to cause the flow of gas to have the inhalation volume that is delivered to the patient during the inspiratory phase of the ventilatory cycle.

14. The method of claim 13, further comprising:

differentiation between known/intended leaks and unknown/unintended leaks; and

accounting for known/intended leaks and unknown/leaks using different compensation techniques.

15. The method of claim 11, further comprising a sensor in fluid communication with the patient circuit proximate the passive exhalation device, and wherein the method further comprises:

(a) determining a tidal volume, and

(b) responsive to determining the tidal volume, selectively adjusting the flow generator to generate a flow of gas having a desired inhalation volume, which is to be delivered to the patient during the inspiratory phase of the next ventilatory cycle.

16. The method of claim 11, wherein the ventilator is portable, and wherein the method further comprises providing volume control ventilation to the patient as the patient moves from one location to another location.

17. A ventilator comprising:

a housing having an interior and an exterior;

an inlet port extending from the exterior to the interior of the housing;

a flow generator disposed within the housing and being structured to generate a flow of gas;

an outlet port adapted to discharge the flow of gas from the housing, the flow being delivered to an airway of a patient during an inspiratory phase of a ventilatory cycle; and

a controller disposed in the housing and being operatively coupled to the flow generator, the controller being adapted to selectively operate the ventilator among a plurality of different modes, wherein the modes include a first mode for providing pressure support ventilation therapy to the patient and a second mode for providing volume control ventilation therapy to the patient.

18. The ventilator of claim 17, wherein the controller is adapted to selectively switch the ventilator between the first mode and the second mode.

19. The ventilator of claim 17, further comprising a patient circuit and a patient interface, wherein the patient circuit is in fluid communication with the outlet port of the ventilator, and wherein the patient interface is structured to be selectively disposed in fluid communication with the airway of the patient.

20. The ventilator of claim 19, wherein the patient interface is an invasive patient interface or a non-invasive patient interface.

21. The ventilator of claim 19, wherein the ventilatory cycle includes an expiratory phase, wherein the patient circuit is a single-limb circuit comprising a single conduit, wherein the single conduit interconnects the outlet port of the ventilator and the patient interface, wherein the single conduit transports both the flow of gas delivered to the patient during the inspiratory phase of the ventilatory cycle and exhalation gas exhaled by the patient during the expiratory phase of the ventilatory cycle.

22. The ventilator of claim 21, further comprising a passive exhalation device or an active exhalation device operatively coupled to the patient circuit, the patient interface, or both.

23. The ventilator of claim 22, further comprising an active exhalation device operatively coupled to the patient circuit, the patient interface, or both, and wherein the controller is operatively coupled to the active exhalation device in order to selectively control flow of a exhalation gas exhaled by the patient during the expiratory phase of the ventilatory cycle.

24. The ventilator of claim 23, wherein the active exhalation device includes an anti-asphyxia device, wherein the anti-asphyxia device comprises an aperture in fluid communication with the atmosphere, and wherein, in the event of a failure of the ventilator, the aperture permits ambient gas to enter the patient circuit in order to enable the passive inspiration of ambient gas by the patient.

25. The ventilator of claim 24, wherein the anti-asphyxia device comprises a flapper valve, wherein the flapper valve overlays the aperture of the active exhalation device, and wherein the flapper valve is structured to deflect during the inspiration by the patient in the event of the failure of the ventilator.

26. The ventilator of claim 19, further comprising:

a passive exhalation device operatively coupled to the patient circuit, the patient interface, or both; and

a sensor in fluid communication with the patient circuit proximate the passive exhalation device and operatively coupled to the controller, wherein the controller determines a tidal volume of the patient based on an output of the sensor.

27. The ventilator of claim 26, wherein responsive to determining the tidal volume of the exhalation gas, the controller selectively adjusts the flow generator to provide a desired flow or pressure of gas to the patient during an inspiratory phase of a ventilatory cycle.

28. The ventilator of claim 17, further comprising a first patient circuit including a passive exhalation device and a second patient circuit including an active exhalation device, wherein the ventilatory cycle includes an expiratory phase, and wherein the outlet port of the ventilator is structured to be selectively connected to one of the first patient circuit to provide passive exhalation during the expiratory phase of the ventilatory cycle, and the second patient circuit to provide active exhalation during the expiratory phase of the ventilatory cycle.

29. The ventilator of claim 17, wherein the ventilator is portable, and wherein the ventilator is operable among the plurality of different modes while enabling the patient to move from one location to another.

30. The ventilator of claim 17, wherein the ventilator has a weight, and wherein the weight of the ventilator is less than about 5 kilograms.

31. The ventilator of claim 17, wherein the ventilator further comprises a number of interface mechanisms, wherein the ventilator is adaptable for use with a plurality of different accessories, and wherein at least one of the number of interface mechanisms is structured to operatively couple a corresponding one of the accessories to the ventilator.

32. The ventilator of claim 17, further comprising:

a first power connection being electrically connectable to an alternating current (AC) power source,

a second power connection being electrically connectable to a lead acid battery,

an internal rechargeable battery pack disposed within the interior of the housing,

a detachable battery pack removably coupled to the exterior of the housing, and

a power control mechanism structured to control the supply of power to the ventilator from a corresponding at least one of the AC power source, the lead acid battery, the internal rechargeable battery pack, and the detachable battery pack.

33. A method of ventilating a patient using a ventilator, the ventilator comprising a flow generator, a patient circuit in fluid communication with the flow generator, and a controller, the method comprising:

(a) selecting one of a plurality of different operating modes of the ventilator, wherein the modes of the ventilator include a first mode for providing pressure support ventilation therapy to a patient, and a second mode for providing volume control ventilation therapy to the patient;

(b) selectively controlling the flow generator to generate a flow of gas in accordance with the selected one of the modes; and

(c) delivering the flow of gas to an airway of the patient during an inspiratory phase of a ventilatory cycle.

34. The method of claim 33, wherein the step of selecting one of the modes includes switching from one of the first and second modes of the ventilator to the other of the first and second modes of the ventilator.

35. The method of claim 33, wherein the patient circuit of the ventilator is structured to selectively include one of a passive exhalation device and an active exhalation device, and wherein the method further comprises replacing one of the passive exhalation device and the active exhalation device with the other of the passive exhalation device and the active exhalation device.

36. The method of claim 33, wherein the patient interface of the patient circuit of the ventilator is structured to selectively include one of an invasive patient interface and a non-invasive patient interface, and wherein the method further comprises:

(a) removing the one of the invasive patient interface and the non-invasive patient interface from the airway of the patient,

(b) replacing the one of the invasive patient interface and the non-invasive patient interface with the other one of the invasive patient interface and the non-invasive patient interface, and

(c) causing the other one of the invasive patient interface and the non-invasive patient interface to be in fluid communication with the airway of the patient.

37. The method of claim 33, wherein the patient circuit of the ventilator is a single-limb circuit comprising a single conduit, wherein the single conduit interconnects an outlet port of the ventilator to the patient circuit, and wherein the method further comprises transporting both the flow of gas from the flow generator during the inspiratory phase of the ventilatory cycle, and an exhalation gas exhaled by the patient during an expiratory phase of the ventilatory cycle.

38. The method of claim 33, wherein the ventilator further comprises a number of sensors, wherein at least one of the sensors is in fluid communication with the patient circuit proximate an exhalation device of the patient circuit, and wherein the method further comprises:

(a) determining at least one parameter with respect to an exhalation gas which is exhaled by the patient during an expiratory phase of the ventilatory cycle,

(b) responsive to determining the at least one parameter of the exhalation gas, selectively adjusting the flow generator to provide a desired flow of gas to the patient during the next ventilatory cycle, and

(c) delivering the desired flow of gas to the patient.

39. The method of claim 33, wherein the patient circuit of the ventilator is selectively configurable to include an active exhalation device, wherein the active exhalation device comprises an anti-asphyxia device, and wherein the method further comprises enabling the patient to inhale ambient gas through the anti-asphyxia device in response to a ventilator failure.

40. The method of claim 33, wherein the ventilator is portable, and wherein the method further comprises switching among the modes of the ventilator to provide a plurality of different ventilation therapies to the patient as the patient moves from one location to another.

41. The method of claim 33, wherein the ventilator further comprises a number of interface mechanisms, and wherein the method further comprises:

(a) connecting at least one of the number of interface mechanisms to a corresponding accessory for the ventilator, and

(b) operating the ventilator with the accessory.

42. The method of claim 33, further comprising:

(a) providing a plurality of available sources of power, the sources of power comprising;

(1) an AC connector selectively connectable to an alternating current (AC) power source,

(2) a lead acid battery connector selectively connectable to a lead acid battery,

(3) an internal rechargeable battery pack, and

(4) at least one detachable battery pack selectively attachable to and detachable from the ventilator;

(b) providing power to the ventilator from at least one of the available sources of power; and

(c) operating the ventilator using the power.