Apparatus for controlling the pressure in a tracheal cuff

• US 4,285,340 A
• Filed: 03/16/1979
• Issued: 08/25/1981
• Est. Priority Date: 03/16/1979
• Status: Expired due to Term

• Current Assignee: Kearfott Guidance and Navigation Corporation
• Original Assignee: James Crittenden, Walter A. Gezari
• Inventors: Crittenden, James, Gezari, Walter A.
• Primary Examiner(s): Recla, Henry J.
• Application Number:
  US06/021,072
• Time in Patent Office: 893 Days
• Field of Search: 128/351, 128/349 B, 128/349 BV, 128/145.6, 128/145.8, 128/208, 128/204.24, 128/204.25, 128/205.24, 128/207.14, 128/207.15, 128/207.16, 137/102
• US Class Current: 128/205.24
• CPC Class Codes: A61M 16/0436 Special fillings therefor
• CPC Class Codes: A61M 16/044 External cuff pressure control or supply, e.g. synchronisation with respiration
• CPC Class Codes: A61M 16/0452 following the inspiration and expiration pressure
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 16/0841 for sampling
• CPC Class Codes: Y10T 137/2544 Supply and exhaust type

Abstract

An apparatus for controlling the pressure in a tracheal cuff used with a tracheal tube to seal the walls of the trachea with respect to the tube, the cuffed tracheal tube being of the type used with an automatic respirator which cycles between an inhalation mode and an exhalation mode.

Claims

1. Apparatus for regulating the fluid pressure within a conventional tracheal cuff, so as to inflate or deflate the cuff, coupled to a conventional automatic respirator which has inhalation and exhalation cycles, the respirator having associated therewith a source of pressurized fluid, the respirator providing a rapid pressure increase which is coordinated with the onset of inhalation, the regulating apparatus comprising;

adjustable pressure regulator means, said regulator means adapted to be in communication with the source of pressurized fluid associated with the respirator, said regulator means controlling the pressure of the pressurized fluid, said regulator means also setting the desired fluid pressure for inflation of a tracheal cuff and the desired fluid pressure for cuff deflation;

gate means, said gate means having multiple fluid passageways which may be opened or closed, said gate means having multiple ports which receive and discharge pressurized fluid, said gate means being coupled to said pressure regulator means and including connector means for coupling said gate means to a tracheal cuff associated with a respirator whereby said gate means may place said adjustable pressure regulator means in communication with the cuff when the respirator is in the inhalation cycle;

gate control means, said gate control means including connector means whereby said gate means may be coupled to the respirator, said gate control means controlling the opening and closing of said passageways of said gate means in response to the cycling of the respirator, said gate control means being in communication with said adjustable pressure regulator means; and

cuff deflator control means, said deflator control means being in communication with said adjustable pressure regulator means, said deflator control means including connector means whereby said deflator control means may be placed in communication with the cuff through an open passageway of said gate means when the respirator is in the exhalation cycle, said deflator control means thereby causing adjustment of the fluid pressure in the cuff from said inflating pressure to said deflating pressure and maintaining said deflating pressure when the respirator is in the exhalation cycle.

2. The apparatus of claim 1 wherein said adjustable pressure regulator means is comprised of:

adjustable power pressure means, said power pressure means adjusting and setting the fluid pressure, said power pressure means in communication with said gate control means;

adjustable inflating pressure means, said inflating pressure means in communication with said power pressure means, said inflating pressure means setting the desired fluid pressure for cuff inflation, said inflating pressure means in communication with the cuff through an open passageway of said gate means when the respirator is in the inhalation cycle; and

adjustable deflating pressure means, said deflating pressure means in communication with said power pressure means, said deflating pressure means setting the desired fluid pressure for cuff deflation, said deflating pressure means in communication with said cuff deflator control means.

3. The apparatus of claim 2 wherein said cuff deflator control means is comprised of;

pressure differential sensor means, said sensor means in communication with the cuff through an open passageway of said gate means when the respirator is in the exhalation cycle, said sensor means in communication with said adjustable deflating pressure means, said sensor means comparing the pressure of the fluid within the cuff with the fluid from said adjustable deflating pressure means when the respirator is in the exhalation cycle, said sensor means adjusting the fluid pressure within the cuff to said desired fluid pressure and maintaining said desired fluid pressure during the exhalation cycle.

4. The apparatus of claim 3 wherein said cuff deflator control means is further comprised of:

switch means, said switch means controlling the flow of pressurized fluid from the source to said adjustable power pressure means, said switch means further controlling the flow of the fluid from said adjustable deflating pressure means to said pressure differential sensor means, said switch means maintaining the cuff at said desired inflating pressure by disconnecting said adjustable deflating pressure means from said pressure differential sensor means.

5. The apparatus of claim 3 wherein said pressure differential sensor means adjusts the fluid pressure to said deflating pressure by venting the fluid to the surrounding environment.

6. The apparatus of claim 4 wherein said cuff deflator control means is further comprised of:

deflating sensor means, said deflating sensor means storing some fluid at said inflating pressure from the cuff said inflating pressure means through an open passageway of gate means during the inhalation cycle, said deflating sensor means comparing the fluid at said inflating pressure with fluid at said deflating pressure from said adjustable deflating pressure means during the exhalation cycle, said deflating sensor means adjusting said deflating pressure if it exceeds said inflating pressure.

7. The apparatus of claim 6 wherein said deflating sensor means adjusts said deflating pressure by venting some fluid to the surrounding environment.

8. The apparatus of claim 6 further comprising;

gauge means, said gauge means registering the fluid pressure within the cuff during both the exhalation and inhalation cycles; and

adjustable excess fluid means, said excess fluid means being positioned in between the cuff and said open passageway of said gate means that connects said inflating pressure means and the cuff during the inhalation cycle, said excess fluid means venting excess fluid if the fluid pressure exceeds a given pressure.

9. The apparatus of claim 8 wherein said adjustable excess pressure means is a one-way check valve that releases fluid into the surrounding environment.

10. The apparatus of claim 8 further comprising:

safety means, said safety means in communication with said adjustable power pressure means through an open passageway of said gate means during both cycles, said safety means receiving a constant flow of the pressurized fluid from said adjustable power pressure means while the source is supplying the fluid, said safety means storing a set volume of pressurized fluid from said adjustable power pressure means, said safety means venting excess fluid to the surrounding environment, said safety means put into communication with the cuff through an open passageway of said gate means when the source fails to supply fluid, said safety means discharging pressurized fluid to the cuff through an open passageway of said gate means when the source fails to supply a fluid.

11. The apparatus of claim 10 wherein said safety means is capable of storing the pressurized fluid at 25 pounds per square inch.

12. The apparatus of claim 10 further comprised of:

adjustable pressure release means, said adjustable pressure release means being positioned between the cuff and said open passageway of said gate means that connects said safety means to the cuff, said release means preventing the pressure of the fluid from exceeding a predetermined pressure, said release means venting excess fluid into the surrounding environment.

13. The apparatus of claim 12 wherein said release means is an adjustable one-way check valve.

14. The apparatus of claim 12 wherein said gate means comprises:

first valve means, said first valve means being provided with two passageways and three ports;

second valve means, said second valve means being provided with four passageways and five ports;

third valve means, said third valve means being provided with two passageways and three ports;

fourth valve means, said fourth valve means being provided with two passageways and three ports;

fifth valve means, said fifth valve means being provided with two passageways and three ports;

said first valve means receiving fluid from said adjustable power pressure means and discharging fluid during the inhalation cycle to said second valve means and discharging the fluid during the exhalation cycle to said pressure differential sensor means of said cuff deflator control means;

said second valve means receiving fluid from said first valve means and discharging fluid to the third valve means and to said adjustable pressure release means of the said safety means and to said gauge means and to the cuff and through said fourth valve means during the inhalation cycle of the respirator, said second valve means receiving fluid from said safety means and discharging the fluid to said adjustable pressure release means and to said gauge means and to the cuff when the source fails to provide fluid;

said third valve means receiving fluid from said second valve means and discharging the fluid to said adjustable excess fluid means during the inhalation cycle of the respirator;

said fourth valve means receiving fluid from said second valve means and discharging the fluid to said deflating sensor means and said switch means of said cuff deflating means during the inhalation cycle of the respirator; and

said fifth valve means receiving fluid from said valve control means and discharging fluid to said valve control means.

15. The apparatus of claim 14 wherein:

said first, third and fourth valve means are three port valves having two fluid passageways.

16. The apparatus of claim 14 wherein said valve control means comprises:

first amplifier means, said first amplifier means receiving fluid from said adjustable power pressure means, said first amplifier means discharging fluid from said adjustable power pressure means to said first, third, fourth and fifth valve means, said first amplifier means discharging fluid only after receiving fluid from the source of the fluid having a rapid pressure increase, said first amplifier means receiving said fluid from the source of the fluid having a rapid pressure increase only during the inhalation cycle;

said fluid which is discharged from said first amplifier means to said first, third, fourth and fifth valve means opening said passageways of said first, third, fourth and fifth valve means for the inhalation cycle;

one way stop means, said stop means providing only one way fluid passage, said stop means receiving fluid from said power pressure means through an open passageway of said fifth valve means during the inhalation cycle;

storage means, said storage means in communication with said stop means, said storage means receiving fluid from said stop means during the inhalation cycle, said storage means storing a volume of fluid, said storage means slowly venting fluid to the surrounding environment; and

second amplifier means, said second amplifier means receiving fluid from said adjustable power pressure means, said second amplifier means discharging said fluid from said adjustable power pressure means to said second valve means, said second amplifier means discharging said fluid to said second valve means only when receiving fluid from said storage means.

17. The apparatus of claim 16 wherein said first and second amplifier means have operational characteristics of a three-way pneumatic valve with a very low pilot pressure requirement.

18. The apparatus of claim 16 further comprising:

distress signal means, said distress signal means receiving fluid from said power pressure means through said second valve means when said second valve means fails to receive said fluid from said second amplifier means, said second amplifier means failing to discharge said fluid to said second valve means when said second amplifier means fails to receive fluid from said storage means, said storage means failing to discharge said fluid to said second amplifier means when said storage means fails to receive fluid from said power regulator means through said fifth valve means and said stop means because said first amplifier means fails to discharge fluid to said fifth valve means, said first amplifier means fails to discharge fluid to said fifth valve means when said first amplifier means fails to receive said fluid from the source of the fluid having a rapid pressure increase.

19. The apparatus of claim 18 wherein said distress signal means is further comprised of:

button means, said button means providing fluid to said second amplifier means from said adjustable power pressure means when said first amplifier means fails to receive fluid from the source of fluid having a rapid pressure increase.

20. The apparatus of claim 19 wherein said button means is a spring operated push button valve.

21. The apparatus of claim 1 further comprising;

safety means, said safety means in communication with said adjustable power pressure means through an open passageway of said gate means during both cycles, said safety means receiving a constant flow of the pressurized fluid from said adjustable power pressure means while the source is supplying the fluid, said safety means storing a set volume of pressurized fluid from said adjustable power pressure means, said safety means venting excess fluid to the surrounding environment, said safety means put into communication with the cuff through an open passageway of said gate means when the source fails to supply fluid, said safety means discharging pressurized fluid to the cuff through an open passageway of said gate means when the source fails to supply a fluid.

22. The apparatus of claim 21 wherein said safety means is capable of storing the pressurized fluid at 25 pounds per square inch.

23. The apparatus of claim 21 further comprised of:

adjustable pressure release means, said adjustable pressure release means being positioned between the cuff and said open passageway of said gate means that connects said safety means to the cuff, said release means preventing the pressure of the fluid from exceeding a predetermined pressure, said release means venting excess fluid into the surrounding environment.

24. The apparatus of claim 23 wherein said release means is an adjustable one-way check valve.