Method and apparatus for supplying fresh gas to a patient during manual ventilation

• US 5,497,767 A
• Filed: 01/31/1994
• Issued: 03/12/1996
• Est. Priority Date: 02/05/1993
• Status: Expired due to Term

• Current Assignee: Maquet Critical Care AB (Getinge AB)
• Original Assignee: Siemens Elema AB
• Inventors: Cewers, Goeran, Olsson, Sven-Gunnar, Rydgren, Goeran
• Primary Examiner(s): Lewis, Aaron J.
• Application Number:
  US08/188,763
• Time in Patent Office: 771 Days
• Field of Search: 128/203.12, 128/205.14, 128/205.13, 128/205.17
• US Class Current: 128/205.13
• 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 16/0078 Breathing bags
• CPC Class Codes: A61M 16/01 specially adapted for anaesthetising A61M16/104, A61M16/18 take precedence
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/08 Bellows; Connecting tubes having means for taking samples G01N1/22; Water traps; Patient circuits
• CPC Class Codes: A61M 16/204 used for inhalation control
• CPC Class Codes: A61M 16/205 used for exhalation control
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 in the expiratory circuit
• CPC Class Codes: A61M 2205/17 with redundant control systems
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)

Abstract

In a method for supplying fresh gas in manual ventilation of a patient and in a ventilator system for practicing the method, the supply of fresh gas to a breathing bag is regulated. During inspiration, the breathing bag is squeezed, imposing an inspiration on the patient. A detector at the breathing bag senses when the patient exhales, and an identical flow of gas is fed to the system via an inspiratory valve, the flow of fresh gas is directed into the breathing bag and expired gas is prevented from entering the breathing bag. An expiratory valve simultaneously opens to conduct expired gas out of the system.

Claims

1. A method for ventilating a patient comprising the steps of:

connecting an automatically operating ventilator end a manually operable breathing bag to airways of a patient;

manually squeezing said breathing bag in an inspiration phase to impose an inspiration on the patient and subsequently manually relaxing squeezing of said breathing bag to permit exhalation by, the patient of a flow of expired gas during an expiration phase;

non-manually feeding fresh gas from said ventilator into said breathing bag during said expiration phase with a flow corresponding to said flow of expired gas; and

conducting said flow of expired gas out of said ventilator system.

2. A method as claimed in claim 1 comprising the additional steps of:

measuring a parameter related to the expiration of the patient at a location between the patient and said breathing bag; and

controlling said flow of fresh gas dependent on said parameter.

3. A method as claimed in claim 2 wherein the step of measuring a parameter related to the expiration of the patient is further defined by measuring one of the parameters of said flow of expired gas, the temperature of said expired gas, the relative humidity of said expired gas or the concentration of a selected gas in said expired gas.

4. A method as claimed in claim 2 comprising the additional steps of:

measuring an additional, separate parameter related to the expiration of said patient for starting the controlling of said flow of fresh gas; and

taking a remedial step if said additional, separate parameter meets at least one defined condition.

5. A method as claimed in claim 4 wherein the step of taking a remedial step is further defined by generating an alarm.

6. A method as claimed in claim 4 wherein the step of taking a remedial step is further defined by switching to an alternative ventilation mode.

7. A method as claimed in claim 2 comprising the additional steps of:

measuring an additional, separate parameter for starting a functional check on the ventilation of said patient; and

taking a remedial step if said functional check meets at least one defined condition.

8. A method as claimed in claim 7 wherein the step of taking a remedial step is further defined by generating an alarm.

9. A method as claimed in claim 7 wherein the step of taking a remedial step is further defined by switching to an alternative ventilation mode.

10. A ventilator system comprising:

a patient tube connectable to a patient;

ventilator means, connected to said patient tube, for non-manually controlling a flow of gas in the patient tube to ventilate a patient;

a breathing bag connected to said patient tube for manually controlling a flow of gas in the patient tube for ventilating a patient;

parameter detector means for sensing a parameter related to respiration of a patient;

control means in said ventilator means for controlling said flow of gas in said patient tube dependent on the parameter sensed by said parameter detector means for feeding a flow of fresh gas, during expiration by a patient, into said breathing bag corresponding to a flow of gas expired by a patient; and

means for conducting said gas expired by a patient out of said ventilator system.

11. A ventilator system as claimed in claim 10 wherein said parameter detector means comprises means for sensing gas flow into said breathing bag.

12. A ventilator system as claimed in claim 10 wherein said parameter detector means comprises means for sensing gas flow from said breathing bag.

13. A ventilator system as claimed in claim 10 wherein said parameter detector means comprises means for sensing gas pressure in said breathing bag.

14. A ventilator system as claimed in claim 10 wherein said parameter detector means is disposed between a patient and said breathing bag, and wherein said parameter detector means comprises means for sensing a parameter related to expiration by a patient.

15. A ventilator system as claimed in claim 14 wherein said parameter detector means comprises means for sensing one of the parameters of the flow of said gas expired by a patient, the temperature of said gas expired by said patient, the relative humidity of said gas expired by a patient or the concentration of a selected gas in said gas expired by a patient.

16. A ventilator system as claimed in claim 10 further comprising:

a controllable inspiratory valve disposed at a first end of said patient tube;

a controllable expiratory valve disposed at a second, opposite end of said patient tube; and

wherein said control means comprises means for controlling said controllable inspiratory valve and said controllable expiratory valve dependent on said parameter.

17. A ventilator system as claimed in claim 16 wherein said parameter detector means comprises a first detector means, and said ventilator system further comprising:

second detector means for sensing gas flow at said inspiratory valve;

third detector means for sensing gas flow at said expiratory valve, each of said first, second and third detector means generating an output signal; and

said control means including means for combining said output signals of said first, second and third detector means to obtain a combined signal, and for controlling said flow of gas in said patient tube dependent on said combined signal.

18. A ventilator system as claimed in claim 17 further comprising integrator means for integrating each of said output signals of said first, second and third detector means to determine the respective volumes of gas passing each of said first, second and third detector means, and wherein said means for combining comprises means for comparing said gas volumes and wherein said control means includes means for controlling said flow of gas in said patient tube so as to maintain each of said gas volumes substantially equal.

19. A ventilator system as claimed in claim 18 wherein said control means includes means for continuously zeroing said first detector means.

20. A ventilator system as claimed in claim 16 wherein said parameter detector means comprises a first detector means, and said ventilator system further comprising:

second detector means for sensing gas pressure at said inspiratory valve;

third detector means for sensing gas pressure at said expiratory valve, each of said first, second and third detector means generating an output signal; and

said control means including means for combining said output signals of said first, second and third detector means to obtain a combined signal, and for controlling said flow of gas in said patient tube dependent on said combined signal.

21. A ventilator system as claimed in claim 20 wherein said control means includes means for continuously zeroing said first detector means.

22. A ventilator system as claimed in claim 16 wherein said control means comprises means for controlling said controllable inspiratory valve and said controllable expiratory valve for passing a flow of fresh gas through said patient tube during expiration by a patient.

23. A ventilator system as claimed in claim 22 wherein said control means comprises means for controlling said controllable inspiratory valve and said controllable expiratory valve for maintaining a flow of gas at said inspiratory valve less than a flow of gas at said expiratory valve, wherein said parameter detector means comprises means for measuring pressure in said breathing bag, and wherein said control means includes means for controlling said inspiratory valve, when pressure in said breathing bag falls below a defined pressure, to feed a flow of gas into said patient tube for filling said breathing bag.

24. A ventilator system as claimed in claim 22 wherein said control means comprises means for controlling said controllable inspiratory valve and said controllable expiratory valve for maintaining a flow of gas at said inspiratory valve greater than a flow of gas at said expiratory valve, and further comprising further parameter detector means for measuring pressure in said patient tube, and said control means including means for controlling said expiratory valve, when pressure in said patient tube exceeds a predetermined pressure, for causing said pressure in said patient tube to drop.

25. A ventilator system as claimed in claim 16 wherein said control means comprises means for controlling said controllable inspiratory valve and said controllable expiratory valve for passing a flow of fresh gas through said patient tube during inspiration by a patient.

26. A ventilator system as claimed in claim 25 wherein said control means comprises means for controlling said controllable inspiratory valve and said controllable expiratory valve for maintaining a flow of gas at said inspiratory valve less than a flow of gas at said expiratory valve, wherein said parameter detector means comprises means for measuring pressure in said breathing bag, and wherein said control means includes means for controlling said inspiratory valve, when pressure in said breathing bag falls below a defined pressure, to feed a flow of gas into said patient tube for filling said breathing bag.

27. A ventilator system as claimed in claim 25 wherein said control means comprises means for controlling said controllable inspiratory valve and said controllable expiratory valve for maintaining a flow of gas at said inspiratory valve greater than a flow of gas at said expiratory valve, and further comprising further parameter detector means for measuring pressure in said patient tube, and said control means including means for controlling said expiratory valve, when pressure in said patient tube exceeds a predetermined pressure, for causing said pressure in said patient tube to drop.

28. A ventilator system as claimed in claim 10 further comprising:

further parameter detector means for generating a measurement signal corresponding to a measurement of one of the parameters of gas flow of gas expired by a patient, temperature of gas expired by said patient, relative humidity of gas expired by a patient, or the concentration of a selected gas in gas expired by a patient, said measurement signal being supplied to said control means; and

said control means comprising means for determining whether said signal meets a defined condition and for starting control of said gas flow in said patient tube when said measurement signal meets said defined condition.

29. A ventilator system as claimed in claim 28 wherein said control means includes comparator means having said measurement signal and a signal corresponding to said defined condition as input signals for comparing said measurement signal to said signal corresponding to said defined condition, and for generating an output signal enabling controlling of said flow of gas by said control means in said patient tube.

30. A ventilator system as claimed in claim 10 further comprising:

further parameter detector means for generating a measurement signal corresponding to a measurement of one of the parameters of gas flow of gas expired by a patient, temperature of gas expired by said patient, relative humidity of gas expired by a patient, or the concentration of a selected gas in gas expired by a patient, said measurement signal being supplied to said control means; and

said control means including means for determining when said measurement signal meets a defined condition and for setting said ventilatory system in a safe state if said measurement signal meets said defined condition.

31. A ventilator system as claimed in claim 30 wherein said control means includes comparator means supplied with said measurement signal and a signal corresponding to said defined condition as input signals for comparing said measurement signal with said signal corresponding to said defined condition, and for generating an output signal causing said ventilator system to be placed in said safe state dependent on the comparison.

32. A ventilator system as claimed in claim 31 wherein said means for setting said ventilator system in a safe state comprises means for generating an alarm signal.

33. A ventilator system as claimed in claim 31 wherein said means for setting said ventilator system in a safe state comprises means for switching said ventilator system to an alternative ventilation mode.

34. A ventilator system as claimed in claim 10 further comprising:

further parameter detector means for generating a measurement signal corresponding to a measurement of one of the parameters of gas flow of gas expired by a patient, temperature of gas expired by said patient, relative humidity of gas expired by a patient, or the concentration of a selected gas in gas expired by a patient, said measurement signal being supplied to said control means;

said control means comprising means for determining whether said signal meets a first defined condition and for starting control of said gas flow in said patient tube when said measurement signal meets said first defined condition, and said control means further including means for determining whether said measurement signal meets a second defined condition and for setting said ventilator system in a safe state if said measurement signal meets said second defined condition.

35. A ventilator system as claimed in claim 34 wherein said control means includes:

first comparator means supplied with said measurement signal and a signal corresponding to said first defined condition as input signals for comparing said measurement signal with said signal corresponding to said first defined condition, and for generating an output signal enabling controlling of said flow of gas by said control means in the patient tube when said measurement signal equals said signal corresponding to said first defined condition, and second comparator means supplied with said measurement signal and a signal corresponding to said second defined condition as input signals for comparing said measurement signal with said signal corresponding to said second defined condition, for generating a further output signal causing said control means to set said ventilator system in said safe state if said measurement signal equals said signal corresponding to said second defined condition.

36. A ventilator system as claimed in claim 34 wherein said means for setting said ventilator system in a safe state comprises means for generating an alarm signal.

37. A ventilator system as claimed in claim 34 wherein said means for setting said ventilator system in a safe state comprises means for switching said ventilator system to an alternative ventilation mode.