Method and apparatus for partial liquid ventilation or fluorocarbons

• US 5,540,225 A
• Filed: 01/13/1994
• Issued: 07/30/1996
• Est. Priority Date: 11/14/1991
• Status: Expired due to Term

• Current Assignee: Alliance Pharmaceutical Corporation
• Original Assignee: Alliance Pharmaceutical Corporation
• Inventors: Schutt, Ernest G.
• Primary Examiner(s): Lewis, Aaron J.
• Application Number:
  US08/180,700
• Time in Patent Office: 929 Days
• Field of Search: 128/207.14, 128/207.15, 128/913
• US Class Current: 128/207.15
• CPC Class Codes: A61K 9/0026 Blood substitute; Oxygen transporting formulations; Plasma extender
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0054 Liquid ventilation
• CPC Class Codes: A61M 16/021 operated by electrical means A61M16/202 – A61M16/205 take precedence
• CPC Class Codes: A61M 16/0463 combined with suction tubes, catheters or the like; Outside connections
• CPC Class Codes: A61M 16/0486 Multi-lumen tracheal tubes
• CPC Class Codes: A61M 16/107 in the inspiratory path
• CPC Class Codes: A61M 2202/0476 Oxygenated solutions
• CPC Class Codes: Y10S 128/913 Breathable liquids

Abstract

A method and apparatus for performing partial liquid ventilation, in connection with which a liquid such as an oxygen carrying fluorocarbon liquid is introduced into the lung and removed from the lung of a patient while the patient is simultaneously breathing an oxygen-carrying breathing gas.

Claims

1. An apparatus for partial liquid ventilation of a patient, comprising:

a source of a biocompatible liquid suitable for ventilation of a patient;

a first relatively small conduit adapted for connection to an airway of a patient, said first conduit operatively connected to said liquid source in such a manner as to introduce a first volume of said liquid into a portion of a lung already containing a second volume of said liquid;

a source of breathing gas; and

a relatively large conduit adapted for connection to an airway of a patient, said large conduit operatively connected to said gas source in such a manner as to deliver a breathing gas to said portion of said lung containing said liquid simultaneous with but separate and apart from said liquid introduction in the same portion of a lung, whereby said breathing gas mixes with and oxygenates a second volume of liquid in a lung.

2. The apparatus of claim 1, further comprising a second relatively small conduit adapted to remove a volume of said liquid from a lung while a patient is simultaneously breathing a gas.

3. The apparatus of claim 2, wherein the second conduit is adapted to remove excess liquid to maintain a relatively constant volume of liquid in a lung while a patient is simultaneously breathing gas.

4. The apparatus of claim 2, wherein the second conduit is adapted to remove said liquid during a portion of the breathing cycle in which a lung is substantially deflated.

5. The apparatus of claim 2, wherein said second conduit includes an inlet adapted to be positioned in a patient'"'"'s trachea or in close proximity thereto to remove liquid from a trachea that comes in contact with said inlet.

6. The apparatus of claim 5, wherein the first small conduit is adapted to continuously introduce liquid, and wherein the second conduit is adapted to remove liquid at a rate greater than or equal to the rate of introduction.

7. The apparatus of claim 5, wherein said relatively large conduit comprises an endotracheal tube in which said inlet is located, said tube adapted to be located at a fixed position in the trachea, said inlet adapted to remove liquid while such liquid is in contact with said inlet so that during the breathing cycle at the end of expiration, the liquid level in the pulmonary system of the patient is approximately at the level of said inlet.

8. The apparatus of claim 7, wherein the first and second conduits are attached to said endotracheal tube.

9. The apparatus of claim 7, further comprising a gas ventilation device connected to said endotracheal tube and adapted to introduce breathing gas to the lungs and to remove gas from the lungs.

10. The apparatus of claim 9, further comprising a fluorocarbon reservoir for receiving fluid removed from the patient by said removing means and a gas vent connecting the reservoir to the endotracheal tube to permit outside equalization of pressure between the endotracheal tube and the fluorocarbon reservoir.

11. The apparatus of claim 9, further comprising a gas flow sensor associated with said endotracheal tube and a means responsive to the sensor that pauses the introduction of liquid into the lung during exhalation.

12. The apparatus of claim 9, wherein said second conduit includes a gas flow sensor associated with said endotracheal tube that pauses the removal of liquid from the lung during inhalation.

13. The apparatus of claim 2, further comprising a reservoir into which said second conduit directs the removed liquid.

14. The apparatus of claim 13, wherein the first conduit is connected to the reservoir in such as way as to remove liquid from said reservoir for introduction into the lungs.

15. The apparatus of claim 14, further comprising a separator for separating contaminating material from the liquid in the reservoir prior to reintroduction into the lungs.

16. The apparatus of claim 15, wherein said liquid is at least one fluorocarbon liquid and said separator is adapted to separate floating contaminants from a fluorocarbon liquid.

17. The apparatus of claim 15, wherein the reservoir has a fluorocarbon/aqueous aspirant interface and wherein the first conduit removes fluorocarbon liquid from the reservoir from a point below the level of the fluorocarbon/floating contaminant interface.

18. The apparatus of claim 2, further comprising a gas pathway for gas exiting a patient'"'"'s lungs through the large conduit, and a gas/liquid separator interposed in said gas pathway.

19. The apparatus of claim 18, wherein said gas/liquid separator is adapted to separate fluorocarbon liquid exiting the lungs from gas exhaled by the patient, so that at the end of exhalation the liquid level in the patient'"'"'s breathing passageway extends substantially up to but not beyond the gas/liquid separator.

20. The apparatus of claim 18, wherein said apparatus further includes an endotracheal tube connected to said gas/liquid separator.

21. The apparatus of claim 1, wherein said first conduit is adapted to continuously introduce said liquid.

22. The apparatus of claim 1, wherein said first conduit is adapted to introduce said liquid simultaneously with the inhalation of said gas.

23. The apparatus of claim 1, further comprising a flow controller adapted to pulse the introduction of liquid into the lungs in synchrony with a portion of the breathing cycle.

24. The apparatus of claim 2, further comprising a flow controller adapted to pulse the removal of liquid from the lungs in synchrony with a portion of the breathing cycle.

25. The apparatus of claim 1, wherein said apparatus includes a temperature control device to control the temperature of the liquid introduced into the lungs.

26. A methodfor partial liquid ventilation, comprising:

introducing a first volume of liquid into a portion of a lung already containing a second volume of such liquid; and

simultaneously delivering an oxygen containing breathing gas, separate and apart from said first volume of liquid, into said portion of patient'"'"'s lung containing said second volume of liquid, whereby said breathing gas mixes with and thereby oxygenares said second volume of liquid in a patient'"'"'s lung.

27. The method of claim 26, further comprising a removing step of positioning a liquid remover having an inlet in a trachea of a patient or in close proximity thereto, and removing liquid from an airway of patient that rises to the level of said inlet during the portion of the breathing cycle when patient'"'"'s lungs are substantially deflated.

28. The method of claim 27, further comprising inserting an endotracheal tube having a distal end and a proximal end wherein said distal end of said endotracheal tube is located in a patient'"'"'s trachea and positioning the inlet of the liquid remover between a distal end of the trachea and about the proximal end of the endotracheal tube.

29. The method of claim 28, comprising maintaining the sum of said first and second volumes of liquid in the pulmonary system of the patient at about the functional residual capacity of the patient'"'"'s pulmonary system plus the internal volume of the trachea and endotracheal tube.

30. The method of claim 27, further comprising removing liquid from the patient in at least a portion of said removing step at a rate equal to or greater than the average rate of introduction of liquid into the lungs.

31. The method of claim 27, further comprising the step of condensing evaporated liquid from breathing gas exhaled by the patient.

32. The method of claim 27, further comprising the step of collecting the liquid removed from the patient.

33. The method of claim 32, further comprising the steps of separating contaminants from the collected liquid, and reintroducing that liquid into the lungs of the patient.

34. The method of claim 33, comprising providing a fluorocarbon as said liquid and the separating step is accomplished by the step of floating said contaminants on said fluorocarbon.

35. The method of claim 32, wherein said collecting step comprises filtering the liquid collected from a patient to separate debris or aqueous materials from the collected liquid.

36. The method of claim 26, providing an oxygen-carrying fluorocarbon as said first and second volumes of liquid.

37. The method of claim 26, comprising maintaining the sum of said first and second volumes of liquid in the pulmonary system of the patient at about the functional residual capacity of the patient'"'"'s pulmonary system.

38. The method of claim 26, additionally comprising the step of introducing a pharmacologic agent into the lung while performing the method.

39. In a liquid breathing system having a means for introducing liquid perfluorocarbon into a lung and a means for oxygenating the liquid perfluorocarbon with an oxygen-containing gas, the improvement comprising:

means for collecting said oxygen-containing gas from lung after it has been used for oxygenating said liquid perfluorocarbon, said used oxygen-containing gas further comprising evaporated liquid perfluorocarbon; and

a perfluorocarbon condenser in said system adapted to remove said evaporated liquid perfluorocarbon from said collected oxygen-containing gas.

40. The apparatus of claim 39, further comprising a means for reintroducing condensed perfluorocarbon into the lung.

41. A liquid breathing method, comprising:

introducing liquid perfluorocarbon into a patients lung;

oxygenating said liquid perfluorocarbon with an oxygen-containing gas, to provide a used oxygen-containing gas comprising evaporated liquid perfluorocarbon;

collecting said used oxygen-containing gas comprising evaporated liquid perfluorocarbon from said lung; and

condensing said evaporated liquid perfluorocarbon from said collected used oxygen-containing gas.

42. The method of claim 41, further comprising the step of reintroducing said condensed fluorocarbon into the lung.

43. The method of claim 41, wherein said oxygen-containing gas is collected after passing through said lung.

44. The method of claim 41, wherein said oxygen-containing gas is vented to the atmosphere.

45. An apparatus for performing partial liquid breathing, comprising:

an endotracheal tube adapted for attachment to a gas ventilator;

a perfluorocarbon delivery conduit feeding into said endotracheal tube in such a manner that discrete breathing gas and liquid perfluorocarbon phases can simultaneously move into the same portion of a patient'"'"'s lungs through said endotracheal tube; and

a source of liquid perfluorocarbon connected to said delivery conduit through a flow controller that is responsive to gas flow from said ventilator.

46. The apparatus of claim 45, wherein said flow controller is adapted to pulse the introduction of liquid into the lung in synchrony with a portion of the gas breathing cycle.

47. In a method for partial liquid breathing in which breathing gas and liquid perfluorocarbon are simultaneously present in the same portion of a patient'"'"'s lung in discrete phases, and said breathing gas first physically mixes with and oxygenares said liquid perfluorocarbon in the lung as said breathing gas moves into and out of the lung in a gas breathing cycle, the improvement comprising:

pulsing the introduction or removal of liquid perfluorocarbon from the patient'"'"'s lungs in synchrony with said gas breathing cycle.

48. The method of claim 47, wherein additional liquid perfluorocarbon is introduced in synchrony with inhalation.

49. The method of claim 47, wherein liquid perfluorocarbon is removed from the lungs in synchrony with exhalation.