Volume ventilator

• US 4,340,044 A
• Filed: 03/20/1980
• Issued: 07/20/1982
• Est. Priority Date: 03/20/1980
• Status: Expired due to Term

• Current Assignee: Berkshire Research Partners
• Original Assignee: Berkshire Research Partners
• Inventors: Levy, Donald, Rusz, Tibor
• Primary Examiner(s): Recla, Henry J.
• Application Number:
  US06/131,920
• Time in Patent Office: 852 Days
• Field of Search: 128/204.21, 128/204.22, 128/204.23, 128/205.14, 128/205.15, 128/205.16, 128/203.28, 128/205.11, 128/204.24, 128/205.24 , 128/205.13, 128/204.19, 128/204.25
• US Class Current: 128/204.21
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0075 Bellows-type
• CPC Class Codes: A61M 16/0081 Bag or bellow in a bottle
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit

Abstract

A medical ventilator is disclosed for switching and mixing oxygen with air in a driving and oxygen mixing means (2) and delivering the mixture to a gas flow control apparatus (3) for application directly to a patient breathing apparatus (5) or to storage in a bellows reservoir (81) of a continuous positive airway pressure facility (4). The ventilator is equipped with a control module (1) having directly set control adjustments (6-9, 105-112) for determining respiratory rate, inspiration-to-expiration ratio, oxygen concentration and the prescribed minute volume of the oxygen mixture to be delivered to a patient. The adjustment control circuitry which performs the calculations, logic and drive operations for switching and mixing oxygen in plural chambers (14, 18, 29, 30) of module (2), the switching of the mixture through module (3), and sensing fill and refill needs of reservoir (81). Module (4) includes apparatus (83, 84) for exerting a positive pressure on the oxygen in reservoir (81).

Claims

1. A volume ventilator for artificial ventilation of a patient during inspiration and expiration cycles of the ventilator comprising

patient breathing apparatus,

gas flow control apparatus operably connected to said patient breathing apparatus for supplying a delivered air/oxygen gas mixture to said breathing apparatus,

a driving and air/oxygen mixing means operably connected to said flow control apparatus and controllable for delivering a prescribed mixture of air/oxygen gas to said flow control apparatus, and

control means operably connected to said flow control apparatus and said driving and air/oxygen mixing means including

adjustment means cooperating with said flow control apparatus and said driving and air/oxygen mixing means for setting a prescribed minute volume, respiratory rate and inspiration-to-expiration ratio,

said control means comprising control circuitry activated by settings of said adjustment means for furnishing control signals corresponding to said prescribed minute volume, respiratory rate and inspiration-to-expiration ratio for controlling the driving and air/oxygen mixing means to mix and deliver said air/oxygen gas mixture to said gas flow control apparatus and for controlling the operation of said gas flow control apparatus for supplying to said patient breathing apparatus said air/oxygen gas mixture at said prescribed minute volume, respiratory rate and inspiration-to-expiration and the air/oxygen concentration of said predetermined volume of air/oxygen gas mixture,

said driving and air/oxygen mixing means comprises a driving chamber,

said control means comprises a plurality of flow valve means actuable for delivering oxygen gas from a source to said driving chamber,

said control circuitry further comprises circuitry responsive to furnished ones of said control signals for actuating predetermined ones of said valve means for delivering said oxygen gas to said driving chamber during an inspiration cycle of said ventilator, and

said driving and air/oxygen mixing means further comprises

a driving chamber for receiving said oxygen under pressure during an inspiration cycle of the ventilator from said supplying means,

a storing chamber for storing the oxygen receivable from said driving chamber,

valve means controlled by said control circuitry during an expiration cycle of said ventilator for communicating the oxygen from said driving chamber to said storing chamber,

a mixing bellows mounted within said storing chamber and having an interior bellows mixing chamber for storing an air/oxygen mixture,

valve means controlled by said control circuitry during an inspiration cycle of said ventilator for communicating some or all of the oxygen from said storing chamber to said bellows mixing chamber,

valve means actuatable during an inspiration cycle of said ventilator in response to differential pressures for exhausting oxygen in said storing chamber to the atmosphere and for mixingly admitting air into said bellows mixing chamber,

a drive bellows mounted within said driving chamber and having an interior drive bellows chamber for storing an air/oxygen mixture,

means operable during an expiration cycle of said ventilator for communicating the air/oxygen mixture from said bellows mixing chamber to said drive bellows chamber,

means communicating the air/oxygen mixture in said drive bellows chamber to said gas flow control apparatus;

a spacing member spaced between said driving and storing chambers and having first and second surfaces each of which is affixed to a fixed end of said mixing and driving bellows,

plate members each of which is secured to a respective movable end of each respective said bellows for providing respective inner chambers, and

a rigid rod extending through a bore in said spacing member and secured at ends of said rod to facing surfaces of said plate members.

2. The volume ventilator of claim 1 further characterized in that

said driving and air/oxygen mixing means (2) further comprises

an exhaust valve (38) controllable for exhaustingly communicating oxygen gas from said driving chamber (14) to said storing chamber (18), and

said control circuitry (1) further comprises

exhaust control circuitry (144, 145, 146) responsive to a receipt of control signals from said calculations circuitry (120) and flow control signals from said valve means actuating circuitry (135) for controlling said exhaust valve (38) to effect the communication of said oxygen gas from said driving chamber (14) to said storing chamber (18) during an expiration cycle of said ventilator.

3. The volume ventilator of claim 2 further characterized in that

said valve means actuating circuitry comprises

valve enable logic apparatus (135) responsive to a receipt of binary number control signals from said calculations circuitry for supplying number control signals to said exhaust control circuitry, and

said exhaust control circuitry comprises a summer circuit (146) responsive to the supplied number control signals for producing an output actual flow signal.

4. The volume ventilator of claim 3 further characterized in that

said exhaust control circuitry further comprises a flow integrator (144) responsive to a receipt of an inspiration rate timing control signal from said calculations circuitry (120) for commencing an integration of said actual flow signal and

a comparator (145) for comparing a calculated tidal volume signal from said calculations circuitry (120) with the integrated actual flow signal to produce a flow gate control signal as long as the calculated tidal volume signal is greater than said integrated actual flow signal and for effecting the actuation of said exhaust valve (38) during an inspiration cycle of said ventilator.

5. The volume ventilator of claim 4 further characterized in that

the produced flow gate control signal enables the valve enable logic apparatus (135) to switch the binary number signals for activating a valve driver means (136) to actuate prescribed ones of the flow valve means (137-142) and thereby communicate oxygen from said source to said driving chamber (14).

6. The volume ventilator of claim 5 further comprising

a nebulizer for supplying a medicinal gas flow to said driving and air/oxygen mixing means (2), and further characterized in that

said control circuitry (1) further comprises nebulizer control circuitry including a nebulizer "on" signaling means (128) nebulizer flow logic (165) responsive to a receipt of an "on" signal from said signaling means (128) and a flow signal from an inspiratory flow sensor (63) in said gas flow control apparatus (3) for operating a valve driver means (136) in said valve means actuating circuitry to supply a predetermined driving gas to said nebulizer for medicinal spray mixing and entry into said driving chamber (18) during an inspiration cycle of said ventilator, and

said summer circuit (146) is responsive to said nebulizer "on" signal for summing said nebulizer gas flow with said supplied number signals from said valve enable logic (135) for producing an output actual flow signal including the contribution by the nebulizer gas flow.

7. The volume ventilator of claim 5 further characterized in that

said driving and air/oxygen mixing means (2) further comprises

an oxygen mixing valve (45) actuatable during an inspiration cycle of said ventilator under control of said control circuitry (1) for effecting a transfer of oxygen gas from said mixing chamber (18) to said inner bellows chamber (30) in said mixing chamber (18), and

said control circuitry (1) further comprises

oxygen concentration control circuitry (9) responsive to said tidal volume control signal from said calculations circuitry (120) for generating a compensated tidal volume control signal and

a tidal volume comparator (147) for comparing said compensated tidal volume control signal with said integrated actual flow signal from said flow integrator (144) to produce a signal for actuating said oxygen mixing valve (45) when the compensated tidal volume control signal is greater than the integrated actual flow signal and thereby effecting a transfer of oxygen gas from said mixing chamber (18) to said inner bellows chamber (30) of said bellows (20).

8. The volume ventilator of claim 7 further characterized in that

said tidal volume comparator (147) interrupts the production of said oxygen mixing valve actuating signal when the compared compensated tidal volume control signal and the integrated actual flow signal are equal and thereby effects a deactuation of said oxygen mixing valve (45), and

said driving and air/oxygen mixing means (2) further comprises

a first check valve (54) effective subsequent to the deactuation of said mixing valve (45) for expelling oxygen gas from said mixing chamber (18) to the atmosphere.

9. The volume ventilator of claim 8 further characterized in that

said spacing member (17) further comprises another bore (53) for transferring said oxygen gas from said mixing chamber (18) and said mixing valve (45) to said inner bellows chamber (30) of said mixing chamber bellows (20), and

said driving and air/oxygen mixing means (2) further comprises a check valve (55) effective subsequent to the deactuation of said mixing valve (45) for drawing air into said inner bellows chamber (30) of said mixing chamber bellows (20) to mix with the oxygen therein.

10. The volume ventilator of claim 9 further characterized in that

said spacing member (17) further comprises a transfer bore (40) extending between said inner bellows chamber (30) of said mixing chamber bellows (20) and said inner bellows chamber (29) of said driving chamber bellows (19), and

said driving and air/oxygen mixing means (2) further comprises a check valve (39) effective for transferring an oxygen air mixture from said inner bellows chamber (30) of said mixing chamber bellows (20) to said inner bellows chamber (29) of said driving chamber bellows (19) during an expiratory cycle of said ventilator, said check valve (39) being responsive to a compression of said driving chamber bellows (19) under control of pressure on said plate member (27) in said driving chamber (14) by oxygen gas flow in said driving chamber (14) during an inspiration cycle for closing said transfer bore (40) and delivering said oxygen air mixture from said inner bellows chamber (29) of said driving chamber bellows (19) through a bore conduit (41) in said spacing member (17) to said gas flow control apparatus (3).

16. The volume ventilator of claim 5 further characterized in that

said control circuitry (1) further comprises

a breathing assist sensor (88) cooperating with said bellows assembly (76) for sensing an excess fill of oxygen in said internal chamber (81) when a patient breathes less than a prescribed minute volume, and

logic means activated by said assist sensor (88) sensing an excess fill of oxygen in said internal chamber (81) for deactuating said control valve (56) and switching said expiratory valve (58) for connecting said diaphragm (75) to said patient breathing passageway (92) and whereby the remaining portion of the volume of oxygen mixture from said driving and air/oxygen mixing means (2) is delivered directly to the patient through said patient breathing passageway (92) and apparatus (5) for assisted breathing.

17. The volume ventilator of claim 16 further characterized in that

said logic means comprises

a gating arrangement (152, 156, 151) operable for controlling said deactuation of said control valve (56) and said switching of said expiratory valve (58),

a sensor (63) and inspiratory logic and comparator (154) responsive to a patient inspiratory flow in said patient breathing passageway (92) for operating said gating arrangement.

18. The volume ventilator of claim 17 further characterized in that

said control circuitry (1) further comprises

a control level sensor (89) cooperating with said bellows assembly (76) for sensing an excessively large fill of oxygen in said internal chamber (81) when a patient is breathing very little or not at all, and

said gating arrangement (151, 156) is operated by said control level sensor (89) sensing said excessively large fill for automatically switching said ventilator from an automatic breathing mode to a control mode of operation by effecting the deactuation and closure of control valve (56) and the switching of said expiratory valve (58) for delivering the oxygen mixture from said driving and air/oxygen mixing means (2) directly to the patient through said breathing passageway (92) and apparatus (5) at the prescribed minute volume, respiratory rate and inspiration-to-expiration ratio set by said adjustment means (6, 7, 8).

11. A volume ventilator for artificial ventilation of a patient during inspiration and expiration cycles of the ventilator comprising

patient breathing apparatus,

gas flow control apparatus operably connected to said patient breathing apparatus for supplying a delivered air/oxygen gas mixture to said breathing apparatus,

a driving and air/oxygen mixing means operably connected to said flow control apparatus and controllable for delivering a prescribed mixture of air/oxygen gas to said flow control apparatus,

control means operably connected to said flow control apparatus and said driving and air/oxygen mixing means including

adjustment means cooperating with said flow control apparatus and said driving and air/oxygen mixing means for setting a prescribed minute volume, respiratory rate and inspiration-to-expiration ratio,

said control means comprising control circuitry activated by settings of said adjustment means for controlling the driving and air/oxygen mixing means to mix and deliver said air/oxygen gas mixture to said gas flow control apparatus and for controlling the operation of said gas flow control apparatus for supplying to said patient breathing apparatus said air/oxygen gas mixture at said prescribed minute volume, respiratory rate and inspiration-to-expiration, and

facilities for supplying said air/oxygen gas mixture at a continuous positive airway pressure,

said facilities comprising

a flexible bellows assembly having an internal storage chamber,

conduit means fluidically connecting said gas flow apparatus to said internal chamber for storing therein an air/oxygen gas mixture receivable from said gas flow control apparatus during an inspiration cycle of said ventilator,

means exerting a continuous positive pressure on an air/oxygen mixture stored in said internal chamber,

said gas flow control apparatus comprises means for selectively coupling said air/oxygen mixture at a continuous positive airway pressure from said conduit means to said patient breathing apparatus during both inspiration and expiration cycles of said ventilator,

said patient breathing apparatus comprises

a device for patient breathing,

an expiratory valve coupled to said device for selectively controlling the pressure against which a patient inhales and exhales,

said expiratory valve comprising an inlet coupled to said device, an outlet coupled to the atmosphere and an internal chamber housing an inflatable diaphragm inflatably connected to an expiration control tube, and

said gas flow control apparatus further comprises

a multiport expiratory valve having a first port coupled to said expiration control tube, a second port coupled to said conduit means and a third port coupled to a patient breathing apparatus and said multiport expiratory valve being operable under control of said control circuitry during inspiration and expiration cycles of said ventilator for coupling said first port to a selectable individual one of the second and third ports for inflating said diaphragm to occlude said inlet when the pressure within the inflated diaphragm is equal to and greater than the pressure at said inlet and thereby to provide a positive pressure against which the patient inhales and exhales to the atmosphere.

12. The volume ventilator of claim 11 further characterized in that

said gas flow control apparatus (3) further comprises

a control valve (56) selectively actuatable under control of said control circuitry (1) for coupling said driving and air/oxygen mixing means (2) with said conduit means (79, 80) for filling said internal bellows chamber (81) during an inhalation cycle of said ventilator for maintaining said continuous positive airway pressure during inhalation and exhalation.

13. The volume ventilator of claim 12 further characterized in that

said control circuitry (1) comprises

a circuit arrangement (120, 135, 136, 144, 145, 146) for controlling the supply of said oxygen mixture to said patient breathing apparatus (5) and being operable for controlling the supply of a prescribed larger volume of the oxygen mixture to said driving and air/oxygen mixing means (2) for delivery to said gas flow control apparatus (3),

a sensor (86) cooperating with said bellows assembly (76) for sensing a low fill of oxygen mixture in said internal chamber (81),

a fill monitor circuit (134) activated by said sensor (86) in response to a sensing of the low fill in said internal chamber (81) for operating said circuit arrangement (120, 135, 136, 144-146) to effect the supply of said prescribed larger volume of oxygen mixture to said gas flow control means (3), and

means (150, 151) controlled by the activation of said fill monitor circuit for actuating said control valve (56) for coupling said prescribed larger volume of oxygen from said driving and oxygen mixing means (2) to said coupling means (79, 80) for filling said internal chamber (81) of said bellows assembly (76).

14. The volume ventilator of claim 13 further characterized in that

said control circuitry (1) further comprises

means (151, 156) for actuating said control valve (56) and said expiratory valve (57) in an automatic mode of the ventilator operation,

said control valve actuation being effective for communicating the prescribed minute volume of said oxygen mixture from said driving and oxygen mixing means (2) to said conduit means (79, 80) for storage in said internal bellows chamber (81), and

said expiratory valve (57) actuation being effective to couple said internal chamber (81) to said inflatable diaphragm (75) and inflating diaphragm (75) for occulating said inlet (73) of said expiratory valve (57) and air/thereby providing a continuous positive airway pressure against which the patient inhales and exhales.

15. The volume ventilator of claim 14 further characterized in that

said control circuitry (1) comprises

a circuit arrangement (120, 135, 136, 144, 145, 146) for controlling the supply of said oxygen mixture to said patient breathing apparatus (5) and being operable for controlling the supply of a preprogrammed larger volume of the oxygen mixture to said driving and oxygen mixing means (2) for delivery to said gas flow control apparatus (3) when the patient inhales more than a predetermined amount of the oxygen mixture in said internal chamber (81) during the automatic mode of the ventilator operation,

a sensor (86) cooperating with said bellows assembly (76) for sensing a low fill of oxygen mixture in said internal chamber (81) when a patient breathes more than the prescribed minute volume prescribed by the setting of said adjustment means,

a fill monitor circuit (134) activated by said sensor (86) in response to a sensing of the low fill in said internal chamber (81) for operating said circuit arrangement (120, 135, 136, 144-146) to effect a supply of said preprogrammed larger volume of oxygen mixture to said gas flow control means (3) for communication through said control valve (56) and conduit means (79, 80) to said internal chamber (81).

19. The volume ventilator of claim 12 further characterized in that

said gas flow control apparatus (3) comprises means for enabling the patient naturally to inhale the oxygen mixture in said internal chamber (81),

said enabling means comprising

a check valve (167) connected in parallel to and bypassing said control valve (56), and

another check valve (93) serially connected with said parallel arrangement of said check valve (167) and said control valve (56) for coupling the oxygen mixture from said internal chamber (81) and said conduit means (79, 80) to said patient breathing apparatus (5).

20. A volume ventilator for artificial ventilation of a patient during inspiration and expiration cycles of the ventilator comprising

patient breathing apparatus,

gas flow control apparatus operably connected to said patient breathing apparatus for supplying a delivered oxygen gas mixture to said breathing apparatus,

a driving and air/oxygen mixing means operably connected to said flow control apparatus and controllable for delivering a prescribed mixture of air/oxygen gas to said flow control apparatus, and

control means operably connected to said flow control apparatus and said driving and air/oxygen mixing means including

adjustment means cooperating with said flow control apparatus and said driving and air/oxygen mixing means for setting a prescribed minute volume, respiratory rate and inspiration-to-expiration ratio,

said control means comprising control circuitry activated by settings of said adjustment means for controlling the driving and air/oxygen mixing means by controlling the flow of air and oxygen through said driving and air/oxygen mixing mixing means during an inhalation cycle of said ventilator to simultaneously receive and store a predetermined volume of oxygen gas, mix a previously stored predetermined volume of oxygen with air to provide a predetermined tidal volume of air/oxygen mixture, store said predetermined tidal volume of air/oxygen mixture, and deliver a previously stored tidal volume of air/oxygen to said gas flow control apparatus, and

a continuous positive airway pressure means operably connected with said control circuitry, said gas flow control apparatus and said patient breathing apparatus for storing an oxygen gas mixture received from said gas flow control apparatus and for exerting a continuous positive pressure thereon and for subjecting said stored air/oxygen gas mixture under continuous positive pressure to said patient breathing apparatus during both inhalation and exhalation cycle of the ventilator against which a patient breathes during inhalation and exhalation.

21. The volume ventilator of claim 20 further characterized in that

said control circuitry (1) includes means (88, 89, 90, 151, 156) for selectively operating said ventilator in an automatic mode in which a patient breathes spontaneously from the oxygen gas mixture stored by said continuous positive airway pressure means (4) and for cooperating with said gas flow control apparatus (3) and said continuous positive airway pressure means (4) for delivering a mandatory minute volume of the oxygen gas mixture from said continuous positive airway pressure means (4) and said driving and air/oxygen mixing means (2) through said gas flow control apparatus (3) to said patient breathing apparatus (5) when said patient breathes less than a predetermined volume of the oxygen gas mixture stored by said continuous positive airway pressure means (4).

22. A volume ventilator for artificial ventilation of a patient during inspiration and expiration cycles of the ventilator comprising

patient breathing apparatus,

gas flow control apparatus operably connected to said patient breathing apparatus for supplying a delivered oxygen gas mixture to said breathing apparatus,

a driving and air/oxygen mixing means operably connected to said flow control apparatus and controllable for delivering a prescribed mixture of air/oxygen gas to said flow control apparatus, and

control means operably connected to said flow control apparatus and said driving and air/oxygen mixing means including

adjustment means cooperating with said flow control apparatus and said driving and air/oxygen mixing means for setting a prescribed minute volume, respiratory rate and inspiration-to-expiration ratio,

said control means comprising control circuitry activated by settings of said adjustment means for controlling the driving and air/oxygen mixing means to mix and deliver said air/oxygen gas mixture to said gas flow control apparatus and for controlling the operation of said gas flow control apparatus for supplying to said patient breathing apparatus said air/oxygen gas mixture at said prescribed minute volume, respiratory rate and inspiration-to-expiration, and

said driving and air/oxygen mixing means comprises

chambers means for receiving and storing a predetermined volume of oxygen gas receivable from a source and for mixing said predetermined volume of oxygen with air to provide a predetermined tidal volume of air/oxygen mixture and delivering said air/oxygen mixture to said gas flow control means,

and wherein said control circuitry is activated by settings of said adjustment means for controlling the driving and air/oxygen mixing means by controlling the flow of air and oxygen through said chamber means during an inhalation cycle of said ventilator to simultaneously receive and store a predetermined volume of oxygen gas, mix a previously stored predetermined volume of oxygen with air to provide a predetermined tidal volume of air/oxygen mixture, store said predetermined tidal volume of air/oxygen mixture, and deliver a previously stored tidal volume of air/oxygen mixture to said gas flow control means,

said ventilator further comprising a continuous positive airway pressure assembly means operably connected with said gas flow control apparatus, said control circuitry and said patient breathing apparatus for providing a continuous positive airway pressure on said air/oxygen mixture in said gas flow control apparatus during both inspiration and expiration cycles of said ventilator against which a patient breathes during inhalation and exhalation, and

the gas flow control apparatus comprises valve means controlled by said control circuitry for delivering to said patient breathing apparatus said air/oxygen mixture at said prescribed minute volume, respiratory rate, inspiration-to-expiration ratio and continuous positive pressure.

23. A volume ventilator for artificial ventilation of patient during inspiration and expiration cycles of the ventilator comprising

patient breathing apparatus,

gas flow control apparatus operably connected to said patient breathing apparatus for supplying a delivered oxygen gas mixture to said breathing apparatus,

a driving and air/oxygen mixing means operably connected to said flow control apparatus and controllable for delivering a prescribed mixture of air/oxygen gas to said flow control apparatus, and

control means operably connected to said flow control apparatus and said driving and air/oxygen mixing means including

adjustment means for setting a prescribed minute volume, respiratory rate and inspiration-to-expiration ratio,

characterized in that

said control means comprises control circuitry activated by settings of said adjustment means for controlling the driving and oxygen mixing means to mix and deliver said air/oxygen gas mixture to said gas flow control apparatus and for controlling the operation of said gas flow control apparatus for supplying to said patient breathing apparatus said air/oxygen gas mixture at said prescribed minute volume, respiratory rate and inspiration-to-expiration, and

said driving and air/oxygen mixing means comprise

a first chamber for receiving a prescribed volume of oxygen from a source of oxygen during an inspiration cycle of the ventilator,

a second chamber for storing the volume of oxygen transferrable from said first chamber during a subsequent expiration cycle of said ventilator,

exhaust valve means actuatable by said control circuitry during said expiration cycle for communicating said oxygen from said first chamber to said second chamber,

a third chamber for storing an oxygen mixture in response to oxygen transferrable thereto from said second chamber,

transfer valve means actuatable by said control circuitry during a succeeding inspiration cycle of said ventilator for communicating oxygen from said second chamber to said third chamber,

a fourth chamber for storing the oxygen mixture transferrable from said third chamber during a subsequent expiration cycle of said ventilator, and

means responsive during a subsequent inspiration cycle of said ventilator for expelling said oxygen mixture from said fourth chamber to said gas flow control apparatus.

24. A volume ventilator for artificial ventilation of a patient during inspiration and expiration cycles of the ventilator comprising

patient breathing apparatus,

gas flow control apparatus operably connected to said patient breathing apparatus for supplying a delivered oxygen gas mixture to said breathing apparatus,

a driving and air/oxygen mixing means operably connected to said flow control apparatus and controllable for delivering a prescribed mixture of air/oxygen gas to said flow control apparatus, means for supplying a source of oxygen under pressure to said driving and air/oxygen mixing means, and control means operably connected to said flow control apparatus and said driving and air/oxygen mixing means including

adjustment means cooperating with said flow control apparatus and said driving and air/oxygen mixing means for setting a prescribed minute volume, respiratory rate and inspiration-to-expiration ratio,

said control means comprising control circuitry activated by settings of said adjustment means for controlling the driving and air/oxygen mixing means to mix and deliver said air/oxygen gas mixture to said gas flow control apparatus and for controlling the operation of said gas flow control apparatus for supplying to said patient breathing apparatus said air/oxygen mixture at said prescribed minute volume, respiratory rate and inspiration-to-expiration, and

said driving and air/oxygen mixing means comprises

a driving chamber for receiving said oxygen under pressure during an inspiration cycle of the ventilator from said supplying means,

a storing chamber for storing the oxygen receivable from said driving chamber,

valve means controlled by said control circuitry during an expiration cycle of said ventilator for communicating the oxygen from said driving chamber to said storing chamber,

a mixing bellows mounted within said storing chamber and having an interior bellows mixing chamber for storing an air/oxygen mixture,

valve means controlled by said control circuitry during an inspiration cycle of said ventilator for communicating some or all of the oxygen from said storing chamber to said bellows mixing chamber,

valve means actuatable during an inspiration cycle of said ventilator in response to differential pressures for exhausting oxygen in said storing chamber to the atmosphere and for mixingly admitting air into said bellows mixing chamber,

a drive bellows mounted within said driving chamber and having an interior drive bellows chamber for storing an air/oxygen mixture,

means operable during an expiration cycle of said ventilator for communicating the air/oxygen mixture from said bellows mixing chamber to said drive bellows chamber,

means communicating the air/oxygen mixture in said drive bellows chamber to said gas flow control apparatus.

25. The volume ventilator of claim 24 further characterized in that

said driving and air/oxygen mixing means (2) further comprises

an assembly (27, 28, 31) secured to said bellows (19, 20) and being movable in a first direction during an inspiration cycle of said ventilator to compress said drive bellows (19) and expand said mixing bellows (20) in response to the receipt of said gas mixture communicated thereto by means (11, 12, 13) and a communication of said gas mixture from said mixing chamber (18) to said mixing bellows chamber (30) and

being further movable in a second direction during an expiration cycle of said ventilator to compress said mixing bellows (20) and expand said drive bellows (19) in response to a communication of said gas mixture from said driving chamber (14) to said mixing chamber (18) and a communication of said gas mixture from said mixing bellows chamber (30) to said drive bellows chamber (29).

26. The volume ventilator of claim 25 further characterized in that

said driving and air/oxygen mixing means (2) further comprises

a spacing member (17) separating said driving chamber (14) from said mixing chamber (18) and spaced between said drive bellows chamber (29) and said mixing bellows chamber (30),

said spacing member (17) comprising

a first bore (53) coupled to said valve apparatus (45) for communicating said gas mixture from said mixing chamber (18) to said bellows mixing chamber (30),

a second bore (40) coupled to said communicating means (39, 40) for communicating the oxygen gas mixture from said bellows mixing chamber (30) to said drive bellows chamber (29), and

a third bore (41) for communicating said oxygen gas mixture from said drive bellows chamber (29) to said gas flow control apparatus (3).

27. The volume ventilator of claim 26 further characterized in that

said assembly comprises

plate members (27, 28) each of which is secured to a respective individual movable end (25, 26) of an individual one of said bellows (19, 20) for providing said respective drive bellows chamber (29) and mixing bellows chamber (30) and

a rigid rod (31) movably extending through a fourth bore (32) of said spacing member (17) and secured at ends (33, 34) of said rod (31) to facing surfaces (35, 36) of said plate members (27, 28) for the compression and expansion of said drive bellows (19) and said mixing bellows (20).

28. A volume ventilator for artificial ventilation of a patient during inspiration and expiration cycles of the ventilator comprising

patient breathing apparatus,

gas flow control apparatus operably connected to said patient breathing apparatus for supplying a delivered air/oxygen gas mixture to said breathing apparatus,

a driving and air/oxygen mixing means operably connected to said flow control apparatus and controllable for delivering a prescribed mixture of air/oxygen gas to said flow control apparatus,

said driving and air/oxygen mixing means comprises

chamber means for receiving and storing a predetermined volume of oxygen gas receivable from a source and for mixing said predetermined volume of oxygen with air to provide a predetermined tidal volume of air/oxygen mixture and delivering said air/oxygen mixture to said gas flow control apparatus, and

control means operably connected to said flow control apparatus and said driving and air/oxygen mixing means including

adjustment means cooperating with said flow control apparatus and said driving and air/oxygen mixing means for setting a prescribed minute volume, respiratory rate and inspiration-to-expiration ratio,

said control means further comprising control circuitry activated by settings of said adjustment means for controlling the driving and air/oxygen mixing means by controlling the flow of air and oxygen through said chamber means during an inhalation cycle of said ventilator to simultaneously receive and store a predetermined volume of oxygen gas, mix a previously stored predetermined volume of oxygen with air to provide a predetermined volume of air/oxygen mixture, store said predetermined volume of air/oxygen mixture, and deliver a previously stored tidal volume of air/oxygen mixture to said gas flow control apparatus,

said control circuitry comprises

calculations circuitry responsive to settings of said adjustment means for furnishing control signals for determining prescribed minute volume, respiratory rate and inspiration-to-expiration and the air/oxygen concentration of said predetermined volume of air/oxygen gas mixture, and

said driving and air/oxygen mixing means comprises a delivery chamber fluidically connected to said gas flow control apparatus and a driving chamber operably connected to said delivery chamber for forcing air/oxygen mixture from said delivery chamber,

further comprising

a plurality of flow valve means actuable for delivering oxygen gas from a source to said driving chamber, and

said control circuitry further comprises circuitry responsive to furnished ones of said control signals for actuating predetermined ones of said valve means for delivering said oxygen gas to said driving chamber during an inspiration cycle of said ventilator.

29. A volume ventilator for artificial ventilation of a patient during inspiration and expiration cycles of the ventilator comprising

patient breathing apparatus,

gas flow control apparatus operably connected to said patient breathing apparatus for supplying a delivered oxygen gas mixture to said breathing apparatus,

a driving and air/oxygen mixing means operably connected to said flow control apparatus and controllable for delivering a prescribed mixture of air/oxygen gas to said flow control apparatus, and

said driving and air/oxygen mixing means comprises

chamber means for receiving and storing a predetermined volume of oxygen gas receivable from a source and for mixing said predetermined volume of oxygen with air to provide a predetermined tidal volume of air/oxygen mixture and delivering said air/oxygen mixture to said gas flow control apparatus, and

control means operably connected to said flow control apparatus and said driving and air/oxygen mixing means including

adjustment means cooperating with said flow control apparatus and said driving and air/oxygen mixing means for setting a prescribed minute volume, respiratory rate and inspiration-to-expiration ratio,

characterized in that

said control means comprising control circuitry activated by settings of said adjustment means for controlling the driving and air/oxygen mixing means by controlling the flow of air and oxygen through said chamber means during an inhalation cycle of said ventilator to simultaneously receive and store a predetermined volume of oxygen gas, mix a previously stored predetermined volume of oxygen with air to provide a predetermined tidal volume of air/oxygen mixture, store said predetermined tidal volume of air/oxygen mixture, and deliver a previously stored tidal volume of air/oxygen mixture to said gas flow control apparatus,

facilities for supplying said air/oxygen gas mixture at a continuous positive airway pressure, and

said control circuitry selectively operates said driving and air/oxygen mixing means, gas flow control apparatus, facilities and the patient breathing apparatus in an automatic mode for delivering a mandatory volume of said air/oxygen gas mixture at said continuous positive airway pressure to said patient breathing apparatus for patient ventilation even if the patient respiratory drive ceases completely.

30. A volume ventilator for artificial ventilation of a patient during inspiration and expiration cycles of the ventilator comprising

patient breathing apparatus,

gas flow control apparatus operably connected to said patient breathing apparatus for supplying a delivered air/oxygen gas mixture to said breathing apparatus,

a driving and air/oxygen mixing means operably connected to said flow control apparatus and controllable for delivering a prescribed mixture of air/oxygen gas to said flow control apparatus,

said driving and air/oxygen mixing means comprises

chamber means for receiving and storing a predetermined volume of oxygen gas receivable from a source and for mixing said predetermined volume of oxygen with air to provide a predetermined tidal volume of air/oxygen mixture and delivering said air/oxygen mixture to said gas flow control apparatus, and

control means operably connected to said flow control apparatus and said driving and air/oxygen mixing means including

adjustment means cooperating with said flow control apparatus and said driving and air/oxygen mixing means for setting a prescribed minute volume, respiratory rate and inspiration-to-expiration ratio,

said control means comprising control circuitry activated by settings of said adjustment means for controlling the driving and air/oxygen mixing means by controlling the flow of air and oxygen through said chamber means during an inhalation cycle of said ventilator to simultaneously receive and store a predetermined volume of oxygen gas, mix a previously stored predetermined volume of oxygen with air to provide a predetermined tidal volume of air/oxygen mixture, stored said predetermined tidal volume of air/oxygen mixture and deliver a previously stored tidal volume of air/oxygen mixture to said gas flow control apparatus, and

said ventilator is equipped with facilities for supplying said air/oxygen mixture at a continuous positive airway pressure,

said facilities comprising

a flexible bellows assembly having an internal storage chamber,

conduit means fluidically connecting said gas flow apparatus to said internal chamber for storing therein an air/oxygen gas mixture receivable from said gas flow control apparatus during an inspiration cycle of said ventilator and

means exerting a continuous positive pressure on an air/oxygen mixture stored in said internal chamber, and

said gas flow control apparatus comprises means for selectively coupling said air/oxygen mixture at a continuous positive airway pressure from said conduit means to said patient breathing apparatus during both inspiration and expiration cycles of said ventilator.