Methods and apparatus for measuring infant lung function and providing respiratory system therapy

• US 5,261,397 A
• Filed: 05/10/1991
• Issued: 11/16/1993
• Est. Priority Date: 05/10/1991
• Status: Expired due to Term

• Current Assignee: Children's Hospital of Philadelphia (Children's Hospital of Philadelphia Foundation)
• Original Assignee: Children's Hospital of Philadelphia (Children's Hospital of Philadelphia Foundation)
• Inventors: Grunstein, Michael M.
• Primary Examiner(s): Burr, Edgar S.
• Assistant Examiner(s): Lewis, Aaron J.
• Application Number:
  US07/698,401
• Time in Patent Office: 921 Days
• Field of Search: 128/720, 128/725, 128/204.18, 128/204.21, 128/204.23
• US Class Current: 128/204.18
• CPC Class Codes: A61B 5/085 Measuring impedance of respiratory organs or lung elasticity

Abstract

Methods and apparatus for determining respiratory system compliance (C_rs) and resistance (R_rs) are disclosed. The present invention provides apparatus whereby an airflow is introduced to a patient via a set of one way valves such that the inspiratory and expiratory flow paths are separate. By selectively occluding expiration, C_rs can be determined and, following subsequent release of the occlusion, the respiratory system time constant (τ_rs) is measured, from which R_rs can be derived. In another embodiment, by selectively occluding inspiration after expiration has been occluded, a drop in pressure due to the compliance of the lungs can be measured and from this and other data, another measure of R_rs can be obtained. The introduction of an airflow into the patient permits the present invention to obtain passive and dynamic respiratory function data. Additionally, in certain embodiments, the present invention permits medication to be effectively introduced into the airways of the patient. The present invention also permits analysis of the airway pressure waveform to determine the relative homogeneity of the air passageways leading to the alveolar sacs.

Claims

1. Respiratory apparatus comprising:

a hollow body portion having an inlet and an outlet for permitting the passage of ambient air therethrough;

at least three one way valves disposed within the body portion in spaced relation to one another, at least two of the valves being selectively occludable, wherein a first one way valve is disposed at the inlet, a third one way valve is disposed at the outlet, and a second one way valve disposed within the hollow body between the first and third one way valves;

a source of pressurized gas connected to a flow restrictor connecting the pressurized gas to the body portion at a point between the first and second one way valves;

a mask for connecting the apparatus to the respiratory system of a patient;

an airflow sensor for generating a signal representing airflow; and

a pressure sensor for generating a signal representing pressure.

2. The apparatus of claim 1, further comprising a safety valve for releasing pressure from within the body portion when the pressure exceeds a predetermined level.

3. The apparatus of claim 1, further comprising a means for generating a signal representing the volume of the airflow.

4. The apparatus of claim 1, further comprising a nebulizer connected to the flow restrictor.

5. The apparatus of claim 4, wherein the nebulizer is connected to the body portion at an inlet disposed between the first one way valve and the second one way valve.

6. The apparatus of claim 1, wherein the airflow sensor and the pressure sensor are disposed immediately adjacent the face mask, whereby the pressure and airflow in the region of the patient'"'"'s mouth are measured.

7. The apparatus of claim 1, wherein the face mask is adapted to cover the mouth and nose of a patient.

8. The apparatus of claim 1, wherein the patient is an infant.

9. The apparatus of claim 4 wherein the nebulizer contains a medicament.

10. Respiratory apparatus comprising:

a hollow body portion having an inlet, an outlet and two selectively occludable one way valves and at least a third one way valve in a spaced-apart relationship, wherein a first one way valve is disposed at the inlet, a third one way valve is disposed at the outlet, and a second one way valve disposed within the hollow body between the first and third one way valves;

a source of pressurized gas flowing through a restrictor into the body portion;

means for connecting the body portion to a patient;

an airflow sensor; and

a pressure sensor.

11. The apparatus of claim 10 further comprising a nebulizer connected to the restrictor.

12. The apparatus of claim 10 wherein the means for connecting is a face mask.

13. The apparatus of claim 10 wherein the airflow and pressure sensors produce airflow and pressure signals respectively.

14. The apparatus of claim 13 further comprising means for displaying the airflow and pressure signals.

15. A method of determining the dynamic respiratory system compliance of a normally breathing patient comprising the steps of:

administering respiratory gas to the patient at a constant flow rate;

recording data indicative of the airway pressure, airflow and volume of the patient over time;

occluding the expiration of the patient while continuing to administer the respiratory gas at the constant flow rate;

releasing the expiratory occlusion while continuing to administer the respiratory gas at the constant flow rate;

determining the change in volume during a time interval prior to release;

determining the change in pressure during a time interval prior to release; and

dividing the change in volume by the change in pressure,

whereby dynamic respiratory system compliance is determined.

16. The method of claim 15, wherein the step of determining the change in volume is undertaken during a time interval of at least one second wherein the change in pressure over time is substantially linear.

17. The method of claim 15, wherein the step of determining the change in pressure is undertaken during a time interval of at least one second wherein the change in volume over time is substantially linear.

21. The method of claim 16, further comprising the step of analyzing the change in pressure occurring during the time after the occlusion to expiration is introduced and before the change in pressure over time becomes substantially linear.

22. The method of claim 21 wherein the step of analyzing comprises determining the first moment of the mean pressure equilibration time.

18. A method of determining the mechanical properties of the respiratory system of a normally breathing patient comprising the steps of:

administering respiratory gas to the patient at a constant flow rate;

recording data indicative of the airway pressure, airflow and volume of the patient over time;

occluding the expiration of the patient while continuing the administer the respiratory gas at the constant flow rate;

releasing the expiratory occlusion while continuing to administer the respiratory gas at the constant flow rate;

recording the relationship between volume and flow after release of expiratory occlusion;

determining the change in volume during a time interval prior to release;

determining the change in pressure during a time interval prior to release; and

dividing the change in volume by the change in pressure;

determining if the volume-flow relationship exhibits a substantially linear portion; and

determining the slope of the substantially linear portion,

whereby the respiratory system time constant is determined.

19. The method of claim 18, further comprising the step of inverting the respiratory system time constant, whereby the respiratory system resistance is determined.

20. A method of determining the mechanical properties of the respiratory system of a normally breathing patient comprising the steps of:

administering respiratory gas to the patient at a constant flow rate;

recording data indicative of the airway pressure, airflow and volume of the patient over time;

occluding the expiration of the patient while continuing to administer the respiratory gas at the constant flow rate;

occluding the inspiration of the patient prior to releasing the expiratory occlusion;

determining the maximum pressure at a time prior to the inspiratory occlusion;

determining the near steady state pressure of a time after the inspiratory occlusion;

releasing both the inspiratory and the expiratory occlusions while continuing to administer the respiratory gas at the constant flow rate;

determining the change in volume during a time interval prior to release;

determining the change in pressure during a time interval prior to release;

dividing the change in volume by the change in pressure; and

dividing the difference between the maximum pressure and the near steady state pressure immediately after inspiratory occlusion by the constant flow rate, whereby respiratory system resistance is determined.