Medical ventilator

• US 5,474,062 A
• Filed: 09/13/1989
• Issued: 12/12/1995
• Est. Priority Date: 11/04/1987
• Status: Expired due to Fees

• Current Assignee: Bird Products Corporation (Becton, Dickinson & Co)
• Original Assignee: Bird Products Corporation (Becton, Dickinson & Co)
• Inventors: DeVires, Douglas F., Baker, Lindon A.
• Primary Examiner(s): Howell, Kyle L.
• Assistant Examiner(s): Lacyk, John P.
• Application Number:
  US07/406,914
• Time in Patent Office: 2,281 Days
• Field of Search: 128/205.24, 128/204.23, 128/204.21, 128/204.18, 128/200.24, 128/204.22, 128/204.25, 128/205.11, 128/205.18, 128/205.23, 251/256
• US Class Current: 128/205.24
• CPC Class Codes: A61M 16/00 Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes stimulating the respiratory movement by mechanical, pneumatic or electrical means, iron lungs combined with gas breathing means A61H31/00
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 16/12 by mixing different gases
• CPC Class Codes: A61M 16/204 used for inhalation control
• CPC Class Codes: A61M 16/205 used for exhalation control
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A62B 9/02 Valves non-return valves mounted in breathing masks or helmets A62B18/10

Abstract

A medical ventilator having a valve which controls the flow of gas from a pressurized gas source to a patient for inhalation. Flow through the valve is choked and pressure upstream of the valve is held stable so that a known relationship exists between the position of the valve and the flow rate through the valve. An open loop control system causes the valve to open or close as needed to deliver a preselected tidal volume of gas to the patient on each breath. Since the flow rate is known, no feedback to the controller regarding actual flow conditions is required. The exact positioning of the valve and length of time that the valve is to be held open is predetermined by the controller before the breath is delivered, and is repeated for subsequent breaths. Preferably, the valve is driven by a stepping motor, and the controller comprises a microcomputer. The controller compensates for ramping of the stepping motor as the valve opens and closes in determining the positions of the valve required to deliver the preselected tidal volume. To ensure precise engagement between a valve member and a valve seat, the valve member is mounted on a flexible, linear wire. Additionally, a spirally-wound spring surrounds a stepping motor shaft and biases the shaft so as to close the valve in the event of a power loss.

Claims

1. A method of ventilating in which a breath of a predetermined tidal volume is delivered at a variable flow rate to a patient whose breathing ability is impaired, the flow rate rapidly increasing during the initial portion of the breath and rapidly decreasing during the final portion of the breath, the tidal volume of the delivered breath being made substantially equal to a preselected tidal volume by taking into account and compensating for the variability of the flow rate at which the breath is delivered, said method comprising the steps of:

(a) providing a breath delivery period based upon the preselected tidal volume, the undelivered volume that would be lost during the increase of the flow rate during the initial portion of the breath, the extra volume that would be delivered during the decrease of the flow rate during the final portion of the breath, and a peak flow rate, the contribution of the undelivered volume that would be lost increasing the breath delivery period and the contribution of the extra volume that would be delivered decreasing the breath delivery period; and

(b) after said providing step, delivering a complete breath at a pre-determined variable flow rate to a patient using the breath delivery period provided in step (a) whereby the actual tidal volume delivered to the patient substantially equals the preselected tidal volume.

2. A method of ventilating as defined in claim 1, wherein the breath delivery period includes the initial portion of the breath during which the flow rate is increasing but excludes the final portion of the breath during which the flow rate is decreasing.

3. A method of ventilating as defined in claim 1, additionally comprising the step of computing an actual peak flow rate based upon a preselected peak flow rate and using said actual peak flow rate in said step (a) to compute the breath delivery period.

4. A method of ventilating as defined in claim 1, wherein said undelivered volume that would be lost is related to the sum of a plurality of time-flow products derived from a ramp-up profile for a stepping motor, and wherein said extra volume that would be delivered is related to the sum of a plurality of time-flow products derived from a ramp-down profile for a stepping motor.

5. A method of ventilating as defined in claim 4, wherein said breath delivery period is increased by substantially one-third to deliver a breath with a tapered breath profile whereby the breath has an actual tidal volume substantially equal to the preselected tidal volume.

6. A method of ventilating in which a breath of a predetermined tidal volume is delivered at a variable flow rate to a patient whose breathing ability is impaired, the flow rate rapidly increasing during the initial portion of the breath and rapidly decreasing to zero during the final portion of the breath, the tidal volume of the delivered breath being made substantially equal to a preselected tidal volume by taking into account and compensating for the variability of the flow rate at which the breath is delivered, said method comprising the steps of:

(a) determining a breath delivery period in accordance with the following equation;

space="preserve" listing-type="equation">BDP=(V.sub.X +VOLUME-V.sub.Y)/FLOW

where V_X is the undelivered volume that would be lost during the increase of the flow rate during the initial portion of the breath, V_Y is the extra volume that would be delivered during the decrease of the flow rate to zero during the final portion of the breath, VOLUME is the preselected tidal volume, FLOW is the peak flow rate, and BDP is the breath delivery period;

(b) starting to deliver a breath to a patient at an initial time by increasing the flow rate from zero to a peak flow rate;

(c) continuing to deliver the breath by maintaining a pre-determined non-zero flow rate until a later time, said later time following said initial time by a time period substantially equal to the breath delivery period determined in said step (a); and

(d) after said later time, decreasing the flow rate to zero to complete the delivery of the breath.

7. A method of ventilating as defined in claim 6, additionally comprising the step of determining an actual peak flow rate based upon a preselected peak flow rate and using said actual peak flow rate for FLOW in the equation in said step (a) to determine the breath delivery period.

8. A method of ventilating as defined in claim 6, wherein the breath delivery period is increased by substantially one-third to deliver a breath with a tapered breath profile whereby the breath has an actual tidal volume substantially equal to the preselected tidal volume.

9. A method of delivering a plurality of substantially identical breaths to a patient whose breathing ability is impaired by determining what the flow profile of a plurality of breaths will be prior to the delivery of the breaths, said method comprising:

(a) determining what the flow profile of a breath will be prior to the delivery of a plurality of breaths, said flow profile being determined based upon a desired peak flow rate and a desired tidal volume; and

(b) delivering a plurality of complete breaths to a patient at a pre-determined variable flow rate, each of each breaths being substantially identical.

10. A method as defined in claim 9, wherein said determining what the flow profile in step (a) will be comprises preparing a ramp-up profile for the initial portion of a breath whereby the breath flow rate increases from zero to a peak flow rate when said ramp-up profile is used to deliver a breath in said step (b).

11. A method as defined in claim 10, wherein said determining what the flow profile will be additionally comprises preparing a ramp-down profile for the final portion of a breath whereby the breath flow rate decreases from a peak flow rate to zero when said ramp-down profile is used to deliver a breath in said step (b).

12. A method as defined in claim 11, wherein said ramp-up profile comprises a plurality of predetermined time delays which control the incremental opening of a flow control valve, and said ramp-down profile comprises a plurality of predetermined time delays which control the incremental closing of a flow control valve.

13. A method as defined in claim 12, wherein said determining what the flow profile will be additionally comprises determining a breath delivery period which determines what the tidal volume of a breath will be.

14. A method of delivering a plurality of substantially identical breaths at a variable flow rate to a patient whose breathing ability is impaired by determining a breath delivery period prior to the delivery of a plurality of breaths, said method comprising:

(a) determining a breath delivery period prior to the delivery of a plurality of breaths, said breath delivery period being determined based upon a desired peak flow rate and a desired tidal volume; and

(b) using the breath delivery period determined in said step (a) to deliver a plurality of complete breaths at a predetermined variable flow rate to a patient whereby each of said breaths is substantially identical.

15. A method as defined in claim 14, wherein said breath delivery period includes the initial portion of a breath during which the flow rate is increasing but excludes the final portion of the breath during which the flow rate is decreasing.

16. A method of controlling the position of a valve including a valve member add a valve seat in a ventilator which provides artificial respiration to a patient through the use of a control means so that a predetermined tidal volume of gas is delivered to the patient on each breath, wherein a known relationship exists between the position of said valve member relative said valve seat and the flow rate through the valve, said method comprising the steps of:

inputting the desired tidal volume into said control means;

determining the required positions of the valve member relative said valve seat over time in order to deliver said desired tidal volume;

generating command signals which cause said valve to move to said positions determined in said second step; and

delivering a breath to said patient having said desired tidal volume by incrementally varying the displacement of said valve member relative said valve seat in accordance with said command signals.

17. The method of claim 16, wherein said valve is driven by a stepping motor, and said command signals result in a sequence of steps which are carried out by the stepping motor, each step corresponding to a known change in flow rate through the valve.

18. The method of claim 17, wherein said control means causes said breaths to be delivered with a square flow rate versus time waveform, said control means receiving input providing the desired peak flow rate of respiratory gas to the patient, wherein the required positions of the valve are determined by the steps of:

determining the number of steps of the stepping motor required to bring the valve to a position in which the flow rate is substantially equal to the peak flow rate; and

determining the length of time that the peak flow rate must be maintained in order to deliver the desired tidal volume.

19. The method of claim 17, further comprising the step of compensating for ramping of the stepping motor as the valve opens and closes in determining the length of time during which the valve is to be held open.