Non-airtight pulmonary measuring device

• US 4,221,224 A
• Filed: 06/29/1978
• Issued: 09/09/1980
• Est. Priority Date: 06/29/1978
• Status: Expired due to Term

• Current Assignee: Intermountain Health Care Incorporated (IHC Hospitals, Inc.), Primary Children's Medical Center
• Original Assignee: Intermountain Health Care Incorporated (IHC Hospitals, Inc.), Primary Children's Medical Center
• Inventors: Clark, Justin S.
• Primary Examiner(s): Michell, Robert W.
• Assistant Examiner(s): Jaworski, Francis J.
• Application Number:
  US05/920,167
• Time in Patent Office: 803 Days
• Field of Search: 128/2 A, 128/2.07-2.08, 128/718-719, 128/725, 422/83-84, 422/98, 73/421.5 R, 364/414-415
• US Class Current: 600/531
• CPC Class Codes: A61B 5/083 Measuring rate of metabolism by using breath test, e.g. measuring rate of oxygen consumption
• CPC Class Codes: G01N 33/497 of gaseous biological material, e.g. breath

Abstract

A non-airtight method for determining alveolar ventilation, oxygen uptake and carbon dioxide production which comprises introducing a known amount of an inert gas into the airway of a patient during inspiration and monitoring the expired gas until a steady state is reached wherein the volume of inert gas inhaled is equal to the amount exhaled and subsequently monitoring the expired air containing a known volume of inert gas for inert gas, carbon dioxide and oxygen concentrations.

Claims

1. A method of sampling and analyzing alveolar air in a human subject without requiring an air-tight seal between the subject and the monitoring equipment to determine alveolar ventilation, carbon dioxide production and oxygen uptake comprising the steps of;

(a) determining the onset of inspiration,

(b) directly introducing a known amount of an inert tracer gas into the airway of the patient by non-airtight catheter means during inspiration such that the inert tracer gas is distributed in the inspired air and is carried to the alveoli, leaving essentially no tracer gas in the anatomical dead space,

(c) determining the onset of expiration of alveolar air and directly sampling a portion of alveolar air by a non-airtight catheter means and monitoring the inert gas concentration of a portion of the alveolar air stream by non-airtight means,

(d) repeating cycles (b) and (c) until a steady state in the concentration of inert tracer gas is reached,

(e) continuing cycles (b) and (c) and monitoring the oxygen and carbon dioxide concentrations in the portion of the alveolar air stream at steady state inert tracer gas concentrations, and,

(f) determining the alveolar ventilation, carbon dioxide production and oxygen uptake from the monitored inert tracer gas, carbon dioxide and oxygen values.

2. A method according to claim 1 wherein the monitoring of the inert tracer gas, carbon dioxide and oxygen concentrations and the addition of inert tracer gas into the airway of the patient creates electronic signals which are fed into translation means which convert said electronic signals into visual values showing alveolar ventilation, carbon dioxide production and oxygen uptake.

3. A method according to claim 2 wherein the inert tracer gas is substantially insoluble in blood.

4. A method according to claim 3 wherein the inert tracer gas is helium.

5. A method according to claim 3 wherein the inert tracer gas is introduced into a nostril of the subject.

6. A method according to claim 5 wherein the portion of the alveolar air stream is removed from a nostril of the subject.

7. A method according to claim 3 wherein the inert tracer gas is introduced into and the portion of the alveolar air stream is removed from an endotracheal tube in the trachea of the subject.

8. A method according to claim 3 wherein the inert tracer gas is inserted into the airway of a patient at a fixed time interval after the onset of inspiration.

9. A method according to claim 8 wherein the inert tracer gas in inserted into the airway of a patient at a time interval after the onset of inspiration which time interval is a fixed fraction of the running average of the inspiratory period.

10. A method according to claim 3 wherein the inert tracer gas in introduced into the airway of a subject during maximum inspiratory air flow.

11. A method according to claim 3 wherein the onset of alveolar air expiration is determined by a plateau in the temperature of expired air.

12. A system suitable for determining alveolar ventilation, carbon dioxide production and oxygen consumption comprising,

(a) means which do not require an airtight seal to a patient adapted to supply a known amount of an inert tracer gas into the airway of a patient duriing inspiration,

(b) sampling means which do not require an airtight seal to a patient adapted to withdraw a portion of expired alveolar air stream from the airway of a patient,

(c) actuator means adapted to sense the onset of inspiration in a patient and immediately terminate operation of said sampling means in response thereto and to initiate operation of said inert tracer gas supplying means at a predetermined time relative to the onset of inspiration,

(d) actuator means adapted to sense the onset of expiration and to initiate operation of said sampling means at a time subsequent to the onset of expiration according to a predetermined sensed parameter,

(e) means for analyzing gas collected from said sampling means and from ambient air,

(f) means for supplying gas from said sampling means and from ambient air to said analyzing means,

(g) means connected to said analyzing means adapted to receive signals from said analyzing means and to translate said signals into visual results indicating alveolar ventilation, carbon dioxide production and oxygen uptake.

13. A system according to claim 12 wherein the means for analyzing gas from said sampling means is a gas chromatograph.

14. A system according to claim 12 wherein the means for analyzing gas from said sampling means is a mass spectrometer.

15. A system according to claim 12 wherein the actuator means adapted to sense the onset of inspiration and the onset of expiration are temperature responsive.

16. A system according to claim 15 wherein the sampling means includes a catheter adapted to be inserted into, but not block, a nostril of a patient.

17. A system according to claim 16 wherein the inert tracer gas means includes a catheter adapted to be inserted into, but not block a nostril of a patient.