Apparatus for assisting in ventilating the lungs of a patient

• US 5,572,993 A
• Filed: 07/06/1995
• Issued: 11/12/1996
• Est. Priority Date: 07/06/1994
• Status: Expired due to Term

• Current Assignee: Teijin Limited
• Original Assignee: Teijin Limited
• Inventors: Nakagawa, Yoshiki, Hashimoto, Yoshihito, Oku, Yoshitaka, Wakou, Harutomo, Asahina, Atsushi, Kurome, Kanji
• Primary Examiner(s): Burr, Edgar S.
• Assistant Examiner(s): RACITI, ERIC
• Application Number:
  US08/498,751
• Time in Patent Office: 495 Days
• Field of Search: 128/204.18, 128/204.21, 128/204.23, 128/204.26, 128/205.24, 128/205.25
• US Class Current: 128/204.23
• 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 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase

Abstract

An apparatus for assisting in ventilating the lungs of a patient comprises a respiratory gas source means; a breathing mask means; a conduit means for fluidly connecting the respiratory gas source means to the mask; a means fop regulating the pressure within the conduit means; a flow meter means for detecting the flow rate of the respiratory gas; and a pressure sensor means for detecting the pressure within the conduit adjacent to the breathing mask. The apparatus further comprises a means for calculating the flow impedance parameter of the flow system downstream the pressure sensing means; a means for storing the relationship between the operation of the pressure regulating means, the flow impedance parameter, and the pressure within the conduit means; a means for predicting the flow impedance parameter after a predetermined time interval; and a means for generating a target pressure to which the pressure regulating means regulates the pressure within the conduit. The pressure regulating means is controlled such that the pressure within the conduit adjacent to the breathing mask is substantially the target pressure based on the predicted flow impedance parameter and the data.

Claims

1. An apparatus for assisting in ventilating the lungs of a patient comprising:

a respiratory gas source means for supplying the respiratory gas to a patient;

a breathing mask means for introducing the respiratory gas into the lungs of a patient, the breathing mask being suitable to be put on the face of a patient;

a conduit means for fluidly connecting the respiratory gas source means to the breathing mask for delivering the respiratory gas from the respiratory gas source means to the breathing mask;

a means for regulating the pressure within the conduit means;

a flow meter means for detecting the flow rate of the respiratory gas from the respiratory gas source to the breathing mask;

a pressure sensor means for detecting the pressure within the conduit adjacent to the breathing mask;

a means for obtaining a flow impedance parameter of the flow system downstream of the pressure sensing means, including the airways and the lungs of the patient, based on the flow rate and pressure detected by the flow meter and the pressure sensor means;

a means for storing the relationship between the operation of the pressure regulating means, the flow impedance parameter, and the pressure within the conduit means;

a means for predicting the flow impedance parameter after a predetermined time interval within a respiratory cycle;

a means for generating a target pressure signal to which the pressure regulating means regulates the pressure within the conduit; and

a means for controlling the operation of the pressure regulating means such that the pressure within the conduit adjacent to the breathing mask becomes substantially the target pressure during the respiratory cycle based on the predicted flow impedance parameter and the relationship between the operation of the pressure regulating means, the flow impedance parameter, and the pressure within the conduit means.

2. An apparatus for assisting in ventilating the lungs of a patient according to claim 1 in which the flow impedance parameter is defined by the following equation:

##EQU7## where α

;

flow impedance parameter

P;

pressure within the conduit

Q;

flow rate of the respiratory gas.

3. An apparatus for assisting in ventilating the lungs of a patient according to claim 1 in which the means for predicting the flow impedance parameter comprises a means for storing a preceding value of the flow impedance parameter and the present value of the flow impedance parameter;

and

the predicted flow impedance parameter being calculated by a first order extrapolation based on the preceding and present values of the flow impedance parameter.

4. An apparatus for assisting in ventilating the lungs of a patient according to claim 1 in which the means for predicting the flow impedance parameter comprises a means for storing a plurality of preceding values of the parameter and the present value of the flow impedance parameter;

and

the predicted flow impedance parameter being calculated by an extrapolation higher than or equal to the second order based on the plurality of preceding values and present value of the flow impedance parameter.

5. An apparatus for assisting in ventilating the lungs of a patient according to claim 1 further comprising a means for determining whether the respiration is in the expiration phase or in the inspiration phase.

6. An apparatus for assisting in ventilating the lungs of a patient according to claim 5 in which the means for determining the respiration phase comprises a means for comparing the pressure detected by the pressure sensor means with the target pressure;

a means for differentiating the flow rate of the respiratory gas;

a means for comparing the differential flow rate with a predetermined value; and

the expiration phase being determined when the detected pressure is higher than the target pressure and the differential flow rate is lower than the predetermined value.

7. An apparatus for assisting in ventilating the lungs of a patient according to claim 5 in which the means for determining the respiration phase comprises:

a means for comparing the pressure detected by the pressure sensor means with the target pressure;

a means for differentiating the flow rate of the respiratory gas;

a means for comparing the differential flow rate with a predetermined value;

a means for differentiating the pressure detected by the pressure sensor;

a means for comparing the differential pressure with a predetermined value; and

the expiration phase being determined when the detected pressure is higher than the target pressure, the differential flow rate is lower than the predetermined value, and the differential pressure is higher than the predetermined value.

8. An apparatus for assisting in ventilating the lungs of a patient according to claim 6 further comprising an expiratory valve means for exhausting the expiratory gas from the patient, the expiratory valve means being provided in the conduit means downstream of the pressure regulating means.

9. An apparatus for assisting in ventilating the lungs of a patient according to claim 8 in which the expiratory valve means comprises a first expiratory valve provided in the conduit means downstream of and near the pressure regulating means, and a second expiratory valve provided in the conduit means upstream of the pressure sensor means and near the breathing mask;

the apparatus further comprising a means for comparing the pressure detected by the pressure sensor means with a predetermined pressure level; and

the first expiratory valve being open during the expiration phase, the second expiratory valve means being open when the expiration phase is initiated and being closed when the detected pressure is equal to or lower than the predetermined pressure level.

10. An apparatus for assisting in ventilating the lungs of a patient according to claim 9 in which the pressure regulating means comprises a motor operated butterfly valve provided in the conduit means, the butterfly valve being closed when the expiration phase is initiated, after which the butterfly valve is kept closed until the detected pressure becomes equal to or lower than the predetermined level, and after which, and during the inspiration phase, the degree of the opening of the butterfly valve is controlled.

11. An apparatus for assisting in ventilating the lungs of a patient according to claim 10 in which the motor operated butterfly valve has an inlet port which is connected to the outlet port of the respiratory gas source means, and an outlet port which is connected to the inlet of the breathing mask.

12. An apparatus for assisting in ventilating the lungs of a patient according to claim 10 in which the motor operated butterfly valve has an inlet port which is connected to the outlet of the respiratory gas source means and to the inlet of the breathing mask, and an outlet port which is open to the environment.

13. An apparatus for assisting in ventilating the lungs of a patient comprising:

a respiratory gas source means for supplying the respiratory gas to a patient;

a breathing mask means for introducing the respiratory gas into the lungs of a patient, the breathing mask being suitable to be put on the face of a patient;

a conduit means for fluidly connecting the respiratory gas source means to the breathing mask for delivering the respiratory gas from the respiratory gas source means to the breathing mask;

a means for regulating the pressure within the conduit means;

an expiratory valve means for exhausting the expiratory gas from the patient, the expiratory valve means being provided in the conduit means downstream of the pressure regulating means;

a flow meter means for detecting the flow rate of the respiratory gas from the respiratory gas source to the breathing mask;

a pressure sensor means for detecting the pressure within the conduit adjacent to the breathing mask;

a means for determining whether the respiration is the expiration phase or in the inspiration phase;

a means for obtaining a flow impedance parameter of the flow system downstream of the pressure sensing means including the airways and the lungs of a patient based on the flow rate and pressure detected by the flow meter and the pressure sensor means;

the flow impedance parameter being defined by the following equation;

##EQU8## where α

;

flow impedance parameter

P;

pressure within the conduit

Q;

flow rate of the respiratory gas

a means for storing the relationship between the operation of the pressure regulating means, the flow impedance parameter, and the pressure within the conduit means;

a means for predicting the flow impedance parameter after a predetermined time interval;

a means for generating a target pressure signal to which the pressure regulating means regulates the pressure within the conduit; and

a means for controlling the operation of the pressure regulating means such that the pressure within the conduit adjacent to the breathing mask becomes substantially the target pressure based on the predicted flow impedance parameter and the relationship between the operation of the pressure regulating means, the flow impedance parameter, and the pressure within the conduit means.

14. An apparatus for assisting in ventilating the lungs of a patient according to claim 13 in which the means for predicting the flow impedance parameter comprises a means for storing a preceding value of the parameter and the present value of the parameter;

and

the predicted flow impedance parameter being calculated by a first order extrapolation based on the preceding and present values of the impedance parameter.

15. An apparatus for assisting in ventilating the lungs of a patient according to claim 13 in which the means for predicting the flow impedance parameter comprises a means for storing a plurality of preceding values of the parameter and the present value of the parameter;

and

the predicted flow impedance parameter being calculated by an extrapolation higher than or equal to the second order based on the plurality of preceding values and present value of the impedance parameter.

16. An apparatus for assisting in ventilating the lungs of a patient according to claim 13 in which the means for determing the respiration phase comprises a means for comparing the pressure detected by the pressure sensor means with the target pressure;

a means for differentiating the flow rate of the respiratory gas;

a means for comparing the differential flow rate with a predetermined value; and

the expiration phase being determined when the detected pressure is higher than the target pressure and the differential flow rate is lower than the predetermined value.

17. An apparatus for assisting in ventilating the lungs of a patient according to claim 13 in which the means for determining the respiration phase comprises:

a means for comparing the pressure detected by the pressure sensor means with the target pressure;

a means for differentiating the flow rate of the respiratory gas;

a means for comparing the differential flow rate with a predetermined value;

a means for differentiating the pressure detected by the pressure sensor;

a means for comparing the differential pressure with a predetermined value; and

the expiration phase being determined when the detected pressure is higher than the target pressure, the differential flow rate is lower than the predetermined value, and the differential pressure is higher than the predetermined value.

18. An apparatus for assisting in ventilating the lungs of a patient according to claim 13 in which the expiratory valve means comprises a first expiratory valve provided in the conduit means downstream of and near the pressure regulating means, and a second expiratory valve provided in the conduit means upstream of the pressure sensor means and near the breathing mask;

the apparatus further comprising a means for comparing the pressure detected by the pressure sensor means with a predetermined pressure value; and

the first expiratory valve being open during the expiration phase, the second expiratory valve means being open when the expiration phase is initiated and being closed when the detected pressure is lower than the predetermined pressure value.

19. An apparatus for assisting in ventilating the lungs of a patient according to claim 13 in which the pressure regulating means comprises a motor operated butterfly valve provided in the conduit means, the butterfly valve being closed when the expiration phase is initiated, after which the butterfly valve is kept closed until the detected pressure becomes equal to or lower than the predetermined level, and after which, and during the inspiration phase, the degree of the opening of the butterfly valve is controlled.

20. An apparatus for assisting in ventilating the lungs of a patient according to claim 19 in which the motor operated butterfly valve has an inlet port which is connected to the outlet port of the respiratory gas source means, and an outlet port which is connected to the inlet of the breathing mask.

21. An apparatus for assisting in ventilating the lungs of a patient according to claim 19 in which the motor operated butterfly valve has an inlet port which is connected to the outlet of the respiratory gas source means and to the inlet of the breathing mask, and an outlet port which is open to the environment.