Intrathoracic mechanical, electrical and temperature adjunct to cardiopulmonary cerebral resuscitation, shock, head injury, hypothermia and hyperthermia

• US 5,474,533 A
• Filed: 04/11/1994
• Issued: 12/12/1995
• Est. Priority Date: 04/11/1994
• Status: Expired due to Fees

• Current Assignee: Ohio State University
• Original Assignee: Ohio State University
• Inventors: Ward, Kevin R., Dzwonczyk, Roger R., Brown, Charles G.
• Primary Examiner(s): Rosenbaum, C. Fred
• Assistant Examiner(s): VANOVER, PERRY
• Application Number:
  US08/225,835
• Time in Patent Office: 610 Days
• Field of Search: 604/26, 604/20-22, 604/23-25, 604/27, 604/28, 604/45, 604/48, 604/51, 604/96-99, 604/101-104, 604/113, 604/264, 604/174
• US Class Current: 604/26
• CPC Class Codes: A61H 2201/10 with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
• CPC Class Codes: A61H 31/02 "Iron-lungs" , i.e. involving chest expansion by applying underpressure thereon, whether or not combined with gas breathing means
• CPC Class Codes: A61M 13/003 Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
• CPC Class Codes: A61M 16/0009 with sub-atmospheric pressure, e.g. during expiration
• CPC Class Codes: A61M 2205/054 with electrotherapy
• CPC Class Codes: A61M 2210/10 Trunk
• CPC Class Codes: A61M 2210/101 Pleural cavity
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 25/1011 Multiple balloon catheters
• CPC Class Codes: A61M 60/191 mechanically acting upon the outside of the patient's native heart, e.g. compressive structures placed around the heart
• CPC Class Codes: A61M 60/289 Devices for mechanical circulatory actuation assisting the residual heart function by means mechanically acting upon the patient's native heart or blood vessel structure, e.g. direct cardiac compression [DCC] devices
• CPC Class Codes: A61M 60/468 the force acting on the actuation means being hydraulic or pneumatic
• CPC Class Codes: A61M 60/569 synchronous with the native heart beat
• CPC Class Codes: A61M 60/585 User interfaces
• CPC Class Codes: A61M 60/839 of devices for mechanical circulatory actuation
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence

Abstract

A method and apparatus for treating patients suffering from one or more of the conditions of cardiac arrest, shock, respiratory failure, hypothermia, hyperthermia and head injury. Chest tubes are inserted through respective holes in each hemithorax of the patient and attached to a gas source and an exhaust pump with connections and valves for alternately inflating and deflating a patient'"'"'s thoracic cavity with a gas. A gas regulator, including heat exchanger, is interposed between the gas source and the tubes for warming or cooling the gas, and an electrode is mounted on the tubes and connected through a wire to electronic medical equipment. Collapsed seals are formed annularly around the chest tube and expanded after insertion to form a gas seal between the tube and the chest wall. The seal may be a bladder expanded by filling with a fluid or a wire mesh receptacle which is mechanically expanded and can also serve as the electrode.

Claims

1. A method for treating a patient suffering from at least one of the conditions of cardiac arrest, shock, respiratory failure, hypothermia, hyperthermia, and head injury, the method comprising:

alternately inflating and deflating a patient'"'"'s thoracic cavity with a gas externally of the patient'"'"'s lungs.

2. A method in accordance with claim 1 wherein said method more particularly comprises:

(a) inserting a first tube percutaneously in a patient'"'"'s left hemithorax, so the tube has an intrathoracic, distal end and an external, proximal end;

(b) inserting a second tube percutaneously in a patient'"'"'s right hemithorax so the tube has an intrathoracic, distal end and an external, proximal end; and

(c) alternately pumping a gas into and pumping the gas out of the external end of said tubes.

3. A method in accordance with claim 2 more particularly comprising alternately (a) inflating both of a patient'"'"'s left and right hemithoraces simultaneously and (b) deflating the hemithoraces simultaneously.

4. A method in accordance with claim 2 more particularly comprising alternately inflating a first one of a patient'"'"'s hemithoraces while simultaneously deflating the patient'"'"'s second hemithorax followed by inflating the patient'"'"'s second hemithorax while deflating the first hemithorax.

5. A method in accordance with claim 1 and further comprising binding the chest to restrict outward chest excursion.

6. A method in accordance with claim 1 and further comprising changing the temperature of the gas before inflating the thoracic cavity with the gas.

7. A method in accordance with claim 1 wherein the deflating comprises pumping gas out of the thoracic cavity in alternation with the inflating.

8. A method in accordance with claim 7 wherein the alternate inflation and deflation is between a pressure exceeding 100 cm of H₂ O and a subatmospheric pressure.

9. A method in accordance with claim 8 wherein the pressures are substantially 150 cm of H₂ O and substantially in the range of -30 cm of H₂ O to -20 cm of H₂ O.

10. A method in accordance with claim 8 and further comprising binding the chest to restrict outward chest excursion.

11. A method in accordance with claim 10 wherein said method more particularly comprises:

(a) inserting a first tube percutaneously in a patient'"'"'s left hemithorax, so the tube has an intrathoracic, distal end and an external, proximal end;

(b) inserting a second tube percutaneously in a patient'"'"'s right hemithorax so the tube has an intrathoracic, distal end and an external, proximal end; and

(c) alternately pumping a gas into and pumping the gas out of the external end of said tubes.

12. A method in accordance with claim 11 more particularly comprising alternately (a) inflating both of a patient'"'"'s left and right hemithoraces simultaneously and (b) deflating the hemithoraces simultaneously.

13. A method in accordance with claim 11 more particularly comprising alternately inflating a first one of a patient'"'"'s hemithoraces while simultaneously deflating the patient'"'"'s second hemithorax followed by inflating the patient'"'"'s second hemithorax while deflating the first hemithorax.

14. A method in accordance with claim 11 and further comprising cooling the gas before inflating the thoracic cavity with the gas to induce mild to moderate cerebral hypothermia.

15. An apparatus for treating a patient suffering from at least one of the conditions of cardiac arrest, shock, respiratory failure, hypothermia, hyperthermia, and head injury, the apparatus comprising:

(a) a chest tube for insertion through a hole in a patient'"'"'s chest wall into a first hemithorax and having a distal opening and a proximal opening in communication through the chest tube;

(b) a first collapsible and expandable seal extending annularly around the chest tube between the openings, the first seal being collapsible to a reduced diameter to facilitate insertion through said hole and being expandable after insertion and adapted to form a gas seal at said hole; and

(c) a second collapsible and expandable gas seal extending annularly around the chest tube between the first seal and the distal opening and spaced from the first seal by a distance corresponding to chest thickness.

16. An apparatus in accordance with claim 15 wherein each of said seals comprises a different fluid inflatable, flexible bladder.

17. An apparatus in accordance with claim 16 wherein each of said seals comprises a different flexible wire mesh receptacle.

18. An apparatus in accordance with claim 17 wherein at least one wire mesh receptacle includes externally exposed metal for operating as an electrode and is connected to a wire leading to the proximal side of the seals for connection to electronic medical equipment.

19. An apparatus in accordance with claim 18 wherein each of the wire mesh receptacles is cylindrical in its collapsed state and surrounds the chest tube with one receptacle being more distal and the other being more proximal, the mesh receptacles having juxtaposed ends attached to an intermediate slide tube in telescoping arrangement around the chest tube, the more distal wire mesh receptacle having a distal-most end fixed to the chest tube near the distal end of the chest tube, and the more proximal receptacle having a proximal-most end attached to an external slide tube in telescoping relation about the chest tube.

20. An apparatus in accordance with claim 19 wherein the chest tube is provided with a plurality of holes in the tube sidewall radially inwardly of the more proximal wire mesh receptacle.