Cardiopulmonary resuscitation ventilator and methods

• US 6,155,257 A
• Filed: 10/07/1998
• Issued: 12/05/2000
• Est. Priority Date: 10/07/1998
• Status: Expired due to Term

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Advanced Circulatory Systems, Inc. (Asahi Kasei Corporation)
• Inventors: Lurie, Keith G., Zielinski, Todd M.
• Primary Examiner(s): Weiss, John G.
• Assistant Examiner(s): SRIVASTAVA, VIRENDRA KUMAR
• Application Number:
  US09/168,049
• Time in Patent Office: 790 Days
• Field of Search: 128/204.23, 128/204.18, 128/204.24, 128/204.28, 128/205.13, 128/205.14, 128/205.16, 128/205.24, 600/534, 600/538
• US Class Current: 128/204.23
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2201/5058 Sensors or detectors
• CPC Class Codes: A61H 2201/5061 Force sensors
• CPC Class Codes: A61H 2201/5064 Position sensors
• CPC Class Codes: A61H 2230/50 Temperature
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61H 31/006 Power driven
• CPC Class Codes: A61M 16/022 Control means therefor
• CPC Class Codes: A61M 2205/332 Force measuring means
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/435 partial O2 pressure (P-O2)
• CPC Class Codes: A61M 2230/50 Temperature

Abstract

The invention provides systems and methods for ventilating a patient in association with cardiopulmonary resuscitation procedures. In one exemplary embodiment, a system comprises a ventilator to periodically supply respiratory gases to a patient'"'"'s lungs. A sensor is provided to detect chest compressions by sensing changes in intrathoracic pressure. A controller is coupled to the sensor and controls actuation of the ventilator after a predetermined number of chest compressions have been detected by the sensor.

Claims

1. A system for ventilating a patient in association with a cardiopulmonary resuscitation procedure, the system comprising:

a ventilator to periodically supply respiratory gases to a patient'"'"'s lungs;

a sensor to detect chest compressions;

a controller coupled to the sensor, the controller controlling actuation of the ventilator after a predetermined number of chest compressions have been detected by the sensor;

a valve that is adapted to be placed in communication with the patient'"'"'s airway, the valve being configured to prevent respiratory gases from flowing to the lungs until a threshold negative intrathoracic pressure is exceeded at which time the valve opens to allow the flow of respiratory gases to the lungs, and wherein the controller is configured to open the valve to permit respiratory gases to flow to the lungs once the patient begins spontaneously breathing.

2. A system as in claim 1, wherein the controller is configured to actuate the ventilator to supply respiratory gases to the patient once about every 2 to about 10 chest compressions.

3. A system as in claim 1, wherein the sensor is configured to sense changes in intrathoracic pressure to detect chest compressions.

4. A system as in claim 1, wherein the sensor is disposed to detect the flow of respiratory gases through the valve upon compression of the chest.

5. A system as in claim 4, wherein the sensor comprises a strain gauge which is strained as respiratory gases flow through the valve and deflect a diaphragm, and a resistance sensing circuit to sense a change in resistance of the strain gauge when strained.

6. A system as in claim 4, wherein the sensor is configured to detect an increase in pressure in the patient'"'"'s airway with each chest compression.

7. A system as in claim 1, further comprising a chest compression member coupled to the controller, and wherein the sensor is disposed to sense when a compressive force is applied to the chest compression member.

8. A system as in claim 7, wherein the chest compression member comprises a chest pad.

9. A system as in claim 1, wherein the sensor comprises an impedance sensor to sense a change in impedance in the chest wall of the patient upon compression of the chest.

10. A system as in claim 1, wherein the ventilator comprises a compressible member and a compression mechanism to compress the compressible member.

11. A system as in claim 1, wherein the valve comprises an occlusion mechanism to prevent respiratory gases from entering the patient'"'"'s lungs during at least a portion of a decompression phase of the cardiopulmonary resuscitation procedure.

12. A system as in claim 11, wherein the occlusion mechanism comprises an airway and a threshold valve disposed in the airway.

13. A system as in claim 11, wherein the occlusion mechanism comprises an airway and a rotary cam wheel to compress the airway.

14. A system as in claim 11, wherein the occlusion mechanism comprises an airway, and a linear actuator and a compression member to compress the airway.

15. A system as in claim 11, wherein the occlusion mechanism comprises an airway, and a pair of caliper arms to compress the airway.

16. A system as in claim 11, wherein the occlusion mechanism has adjustable operating pressure levels to vary a threshold negative intrathoracic pressure level that must be exceeded before the occlusion mechanism will allow respiratory gases to flow to the patient'"'"'s lungs.

17. A system as in claim 16, wherein the occlusion mechanism is coupled to the controller which is configured to operate the occlusion mechanism.

18. A system as in claim 1, further comprising a compression mechanism coupled to the controller to compress the chest.

19. A system as in claim 1, further comprising a power supply to supply power to the controller and the ventilator.

20. A system as in claim 1, further comprising at least one feedback sensor coupled to the controller.

21. A system as in claim 20, wherein the feedback sensor is selected from the group of sensors consisting of oxygen sensors, carbon dioxide sensors, temperature sensors, chest compression force sensors, depth of chest compression sensors, chest compression pressure sensors and pH sensors.

22. A system as in claim 1, further comprising a control panel having a mode control to change the operational mode of the ventilator.

23. A system as in claim 22, wherein the mode control includes a compression detect mode where the ventilator is actuated after the predetermined number of chest compressions have been detected by the sensor.

24. A system as in claim 22, wherein the mode control includes a manual ventilation mode, and wherein the control panel includes a manual ventilation switch which is manually actuatable to actuate the ventilator when the mode control is in the manual ventilation mode.

25. A system as in claim 22, wherein the mode control includes an automatic ventilation mode, and wherein the controller is configured to actuate the ventilator at regularly timed intervals when the mode control is in the automatic ventilation mode.

26. A system as in claim 22, wherein the control panel further includes a threshold compression control to vary the sensitivity level of the sensor.

27. A system as in claim 22, wherein the control panel further includes a respiratory gas volume control to control the volume of respiratory gases supplied by the ventilator upon each actuation.

28. A system as in claim 22, wherein the control panel further includes a respiratory gas control to control the pressure of the respiratory gases delivered with each actuation of the ventilator.

29. A system as in claim 22, wherein the control panel further includes a compression counter display to display the number of detected chest compressions, and a compression detect display to display the detection of a chest compression.

30. A system as in claim 22, wherein the control panel includes a compression display to display compression pressures or forces supplied to the chest.

31. A system as in claim 22, wherein the control panel further includes a ventilation indicator to indicate when the ventilator is actuated.

32. A method for performing cardiopulmonary resuscitation, the method comprising:

repeatedly compressing a patient'"'"'s chest;

detecting each chest compression with a sensor that is coupled to a controller;

periodically ventilating the patient after a predetermined number of chest compressions have been detected;

preventing respiratory gases from flowing to the lungs with a valve until a threshold negative intrathoracic pressure is exceeded at which time the valve opens to allow the flow of respiratory gases to the lungs; and

sensing when the patient begins to spontaneously breath, and permitting respiratory gases to flow to the patient'"'"'s lungs once spontaneous breathing is detected.

33. A method as in claim 32, further comprising ventilating the patient once about every 2 to about 10 chest compressions.

34. A method as in claim 32, further comprising placing a valve in the patient'"'"'s airway, and wherein the sensing step comprises sensing when respiratory gases flow through the valve upon compression of the chest.

35. A method as in claim 34, further comprising preventing respiratory gases from flowing to the lungs with the valve until a threshold negative intrathoracic pressure is exceeded at which time the valve opens to allow the flow of respiratory gases to the lungs.

36. A method as in claim 32, further comprising sensing changes in intrathoracic pressure to detect chest compressions.

37. A method as in claim 32, further comprising sensing when a force has been applied to the patient'"'"'s chest to detect chest compressions.

38. A method as in claim 32, further comprising preventing respiratory gases from entering into the patient'"'"'s lungs during at least a portion of a decompression phase.

39. A method as in claim 38, further comprising varying an intrathoracic pressure level at which respiratory gases are allowed to enter into the patient'"'"'s lungs during the decompression phase.

40. A method as in claim 32, further comprising manually compressing the patient'"'"'s chest or providing chest compressions with a compression mechanism coupled to the controller.

41. A method as in claim 32, further comprising mechanically compressing an air bag to ventilate the patient.

42. A method as in claim 41, wherein the air bag is automatically compressed after the predetermined number of chest compressions have been detected.

43. A method as in claim 41, wherein compression of the air bag is manually actuated.

44. A method as in claim 32, further comprising stopping compression of the patient'"'"'s chest and ventilating the patient at regular intervals.

45. A method as in claim 32, further comprising sensing at least one physiologic parameter while performing chest compressions.

46. A method as in claim 43, wherein the physiologic parameter is selected from the group consisting of oxygen, carbon dioxide, temperature and pH.

47. A method as in claim 45, further comprising visually displaying when each chest compression has been detected.

48. A method as in claim 45, further comprising counting the number of chest compression and displaying the number of counted compressions.

49. A method as in claim 32, further comprising visually displaying an indicator each time the patient is ventilated.

50. A method as in claim 32, further comprising controlling the volume of respiratory gases supplied to the patient by sensing the amount of positive inspiratory pressure supplied to the patient'"'"'s airway and maintaining the supplied gases at the sensed pressure for a specified time period.

51. A method as in claim 32, further comprising sensing when the patient takes a spontaneous breath and initiating an inspiratory ventilation cycle to assist the patient'"'"'s breathing.

52. A method as in claim 51, further comprising sensing when the patient begins regular spontaneous breathing and ceasing the inspiratory ventilation cycle.

53. A method as in claim 52, further comprising sensing if the patient stops spontaneous breathing and periodically ventilating the patient after the predetermined number of chest compressions have been detected.