Method and system for controlling breathing

• US 7,900,626 B2
• Filed: 04/17/2006
• Issued: 03/08/2011
• Est. Priority Date: 04/17/2006
• Status: Active Grant

• Current Assignee: The Periodic Breathing Foundation, LLC
• Original Assignee: Robert W. Daly
• Inventors: Daly, Robert W.
• Primary Examiner(s): Thanh; Loan
• Assistant Examiner(s): SKORUPA, VALERIE LYNN
• Application Number:
  US11/405,948
• Publication Number:
  US 20070240718A1
• Time in Patent Office: 1,786 Days
• Field of Search: 128/201.28, 128/204.18, 128/204.21, 128/204.22, 128/205.12, 128/205.24, 128/205.28, 128/204.23, 128/205.19, 600/529, 600/538
• US Class Current: 128/204.18
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61M 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• CPC Class Codes: A61M 16/0045 Means for re-breathing exhaled gases, e.g. for hyperventilation treatment
• CPC Class Codes: A61M 16/0057 Pumps therefor
• CPC Class Codes: A61M 16/0066 Blowers or centrifugal pumps
• CPC Class Codes: A61M 16/0069 the speed thereof being controlled by respiratory parameters, e.g. by inhalation
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/0605 Means for improving the adaptation of the mask to the patient
• CPC Class Codes: A61M 16/0633 with forehead support
• CPC Class Codes: A61M 16/0666 Nasal cannulas or tubing devices for improving normal breathing through the nose A61F5/08; nose filters A62B23/06; outside holding devices A61M25/02
• CPC Class Codes: A61M 16/0683 Holding devices therefor
• CPC Class Codes: A61M 16/0694 Chin straps
• CPC Class Codes: A61M 16/08 Bellows; Connecting tubes having means for taking samples G01N1/22; Water traps; Patient circuits
• CPC Class Codes: A61M 16/0875 Connecting tubes
• CPC Class Codes: A61M 16/12 by mixing different gases
• CPC Class Codes: A61M 16/20 Valves specially adapted to medical respiratory devices
• CPC Class Codes: A61M 16/202 electrically actuated
• CPC Class Codes: A61M 16/209 : Relief valves
• CPC Class Codes: A61M 2016/0027 : pressure meter
• CPC Class Codes: A61M 2016/0036 : in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2016/103 : the CO2 concentration
• CPC Class Codes: A61M 2230/005 : Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/202 : partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)
• CPC Class Codes: Y10S 128/911 : Unilimb inhalation-exhalation breathing tubes
• CPC Class Codes: Y10S 128/914 : Rebreathing apparatus for increasing carbon dioxide content in inhaled gas

Abstract

The present invention relates to a method and a system for controlling breathing of a patient. A system for controlling breathing of a patient includes a respiratory conduit. The respiratory conduit is configured to be coupled to a patient interface device and is further configured to be coupled to a pressurized air generating device. The respiratory conduit includes at least two air flow control devices, positioned between the patient interface device and the pressurized air generating device. The respiratory conduit includes at least two volumes, wherein one volume is positioned between a first air flow control device and a second air flow control device and another volume is positioned between a second air flow control device and a third air flow control device.

Claims

1. A system for controlling breathing of a patient, comprising:

a respiratory conduit configured to be coupled to a patient interface device and to a pressurized air generating device;

said respiratory conduit includes at least three air flow control devices, each of said air flow control devices comprises an orifice being in communication with ambient air, said airflow control devices being positioned between said patient interface device and said pressurized air generating device; and

said respiratory conduit includes at least two volumes, wherein one volume is positioned between a first air flow control device and a second air flow control device and another volume is positioned between a second air flow control device and a third air flow control device,

wherein said volumes are partial dead space volumes configured to accumulate at least a portion of breath expired by the patient,

wherein said air flow control devices and said volumes are configured to control a rate of excretion of carbon dioxide from said respiratory conduit and a concentration of said carbon dioxide in blood of the patient,

wherein said air flow control devices and said volumes are configured to allow a range of amounts of said carbon dioxide excreted from said respiratory conduit to be substantially equal to a range of production of said carbon dioxide by the patient during a period of time,

wherein said first air flow control device is configured to allow an escape of an amount of said carbon dioxide that is lower than or equal to said amount of said carbon dioxide produced by the patient during a period of time, and

wherein said second air flow control device is configured to allow an escape of an amount of said carbon dioxide that is based on i) said amount of carbon dioxide allowed to escape from said first air flow control device, and ii) a maximum total amount of carbon dioxide produced by the patient during a period of time.

2. The system according to claim 1, wherein said patient interface device is selected from a group consisting of a nasal mask, an oral mask, an orofacial mask, a nasal prong device, an intra-oral device, and an endotracheal tube.

3. The system according to claim 2, wherein said patient interface device includes at least one seal that is configured to create a substantially sealed connection between said respiratory conduit and a breathing airway passage of the patient.

4. The system according to claim 1, wherein said respiratory conduit includes an auxiliary air flow control device located substantially adjacent to said patient interface device configured to control flow of air to an airway of the patient.

5. The system according to claim 4, wherein said auxiliary air flow control device is controlled by the patient.

6. The system according to claim 1, wherein said respiratory conduit includes an anti-asphyxiation valve configured to create an access to air and to bypass said respiratory conduit, if said pressurized air generating device fails, and located substantially adjacent to said patient interface device.

7. The system according to claim 1, wherein said air flow control devices are configured to adjust said rate of carbon dioxide flow through said air flow control devices based on at least one physiological variable of the patient.

8. The system according to claim 1, wherein said third air flow control device is configured to allow an escape of air that is based on said amount of air produced by said pressurized air generating device, the amount of air allowed to escape from said first and said second air flow control devices, and the amount of air required to prevent re-breathing of excess amounts of said carbon dioxide by the patient.

9. The system according to claim 1, wherein said respiratory conduit is configured to be rotatably coupled to said patient interface device.

10. The system according to claim 1, further comprising a collector configured to be coupled to said respiratory conduit and further configured to collect condensation during breathing of the patient.

11. A system for controlling breathing of a patient, comprising:

a respiratory conduit configured to be coupled a patient interface device and to a pressurized air supply device, wherein said pressurized air supply device supplies air to the patient;

wherein said respiratory conduit includes;

a first valve located substantially adjacent to said patient interface device, said first valve includes a first opening being in communication with ambient air and being configured to control an escape of carbon dioxide to the ambient air;

a second valve including a second opening being in communication with ambient air and being configured to control an escape of carbon dioxide to the ambient air;

a third valve including a third opening being in communication with ambient air and being configured to control an escape of carbon dioxide to the ambient air;

a first volume connector coupled to said first valve and said second valve, said first volume connector is configured to contain a mixture of said air as supplied by said pressurized air supply device and said carbon dioxide as generated by the patient; and

a second volume connector coupled to said second valve and said third valve, wherein said second volume connector is configured to contain a mixture of said air as supplied by said pressurized air supply device and said carbon dioxide as generated by the patient;

wherein said volume connectors are partial dead space volumes configured to accumulate at least a portion of breath expired by the patient,

wherein said valves and said volume connectors are configured to control a rate of excretion of carbon dioxide from said respiratory conduit and a concentration of said carbon dioxide in blood of the patient,

wherein said valves and said volume connectors are configured to allow a range of amounts of said carbon dioxide readily excreted from said respiratory conduit to be substantially equal to a range of production of said carbon dioxide by the patient during a period of time,

wherein an amount of carbon dioxide allowed to escape from said first valve is determined by the amount of air allowed to escape from said first valve, an amount of air and said carbon dioxide contained in said first connector, an amount of air and said carbon dioxide allowed to escape from the second valve, and an amount of air and said carbon dioxide contained in said second connector,

wherein an amount of carbon dioxide allowed to escape from said second valve is determined by said amount of air allowed to escape from said first valve, a volume of said first connector, an amount of air allowed to escape from said second valve, and an amount of air and said carbon dioxide contained in said second connector.

12. The system according to claim 11, wherein said patient interface device is configured to create a substantially sealed connection to a breathing airway of the patient and said respiratory conduit.

13. The system according to claim 11, wherein said first valve is incorporated in said patient interface device.

14. The system according to claim 11, wherein an amount of air allowed to escape from said third valve is determined by the total amount of said air allowed to escape from said first and second valves, the amount of air supplied by said pressurized air supply device, and the amount of air required to expel an excessive amount of said carbon dioxide from said respiratory conduit.

15. The system according to claim 14, wherein at least a portion of an amount of gas that exceeds the amount of gas accumulated in said first volume connector plus the amount of gas accumulated in said second volume connector is completely expelled from said respiratory conduit through said third valve.

16. The system according to claim 11, wherein at least a portion of an amount of carbon dioxide that does not escape from said first valve is re-breathed by the patient.

17. The system according to claim 11, wherein at least a portion of an amount of carbon dioxide that does not escape from said second valve is re-breathed by the patient.

18. The system according to claim 11, wherein said respiratory conduit includes an auxiliary air flow control device located substantially adjacent to said patient interface device.

19. The system according to claim 11, wherein said respiratory conduit includes an anti-asphyxiation valve configured to control flow of air into the airway of the patient.

20. An apparatus for stabilizing breathing, comprising:

a conduit configured to receive air containing carbon dioxide exhaled from a patient, the conduit comprising at least three airflow control devices configured to permit a metered escape of the exhaled air containing carbon dioxide from the conduit to the ambient air, wherein each airflow control device comprises an orifice in communication with the ambient air;

an airflow measurement device configured to measure airflow through each of said airflow control devices;

at least two volumes configured as partial deadspaces, each of said volumes being paired with an airflow control device, where each airflow control device is disposed between said paired volume and the patient, wherein said airflow control devices and said volumes are configured to provide a reduction in an open-loop plant gain of a respiratory plant over an entire range of variation in metabolic output expected to occur in the patient during a period of time;

a concentration measurement device configured to measure a concentration of carbon dioxide in the flow of air through said airflow control devices;

a controller configured to adjust a value of at least one of i) the amount of air that can escape from said airflow control devices and ii) a size of said volumes such that a range of metabolic output over which said apparatus produces said reduced plant gain is automatically adjusted; and

wherein such reduction of plant gain is of sufficient magnitude to restore closed-loop respiratory loop gain to a value below unity in a patient suffering from Cheyne-Stokes respiration throughout the normal physiologic range of said metabolic output.