Manual controlled bi-phasic intrapulmonary percussive ventilation and methods

• US 8,347,883 B2
• Filed: 04/10/2009
• Issued: 01/08/2013
• Est. Priority Date: 11/17/2008
• Status: Active Grant

• Current Assignee: Percussionaire Corp.
• Original Assignee: Forrest M. Bird
• Inventors: Bird, Forrest M.
• Primary Examiner(s): Thanh, Loan
• Assistant Examiner(s): DITMER, KATHRYN ELIZABETH
• Application Number:
  US12/421,669
• Publication Number:
  US 20100125227A1
• Time in Patent Office: 1,369 Days
• Field of Search: 128/203.12, 128/203.14, 128/203.15, 128/204.18, 128/204.25, 128/205.18
• US Class Current: 128/203.15
• CPC Class Codes: A61M 16/0006 with means for creating vibrations in patients' airways
• CPC Class Codes: A61M 16/0063 Compressors
• CPC Class Codes: A61M 16/0096 High frequency jet ventilation
• CPC Class Codes: A61M 16/021 operated by electrical means A61M16/202 – A61M16/205 take precedence
• CPC Class Codes: A61M 16/0858 Pressure sampling ports

Abstract

The method and system ventilates a patient'"'"'s airway during the inspiratory phase and expiratory phase from a source of pressurized gas, typically from a compressor. The system and method supplies, to the patient airway during the inspiratory phase, a plurality of pulses of small volumes of gas from the gas source, and adds, in succession, pulses of small volumes of gas to provide successively greater volumes of gas successively increasing in pulsatile form the pressure of the gas in the patient'"'"'s airway. This addition of successively greater volumes of gas serves to provide diffusive ventilation to the patient during the inspiratory phase, and, permits the patient to exhale during the expiratory phase.

Claims

1. A method for ventilating a patient airway during the inspiratory phase and expiratory phase from a source of gas under pressure from a compressor comprising:

supplying to the patient airway during the inspiratory phase a plurality of pulses of small volumes of gas from said source of gas, said pulses representing positive pressure endobronchial sub total volumes,

adding in succession the plurality of pulses of small volumes of gas to provide successively greater volumes of gas successively increasing in pulsatile form the pressure of the gas in the airway of the patient during the inspiratory phase by adding the successively greater volumes of gas in the airway of the patient being caused solely by the successive addition of the plurality of pulses of small volumes of gas and serving to provide diffusive ventilation to the patient during the inspiratory phase, and, permitting the patient to exhale during the expiratory phase;

distributing high frequency compressor generated energy spikes created during stroke volume generation, into a distribution system serving as an accumulator in preparation for the energy spikes to be transported into the lungs, wherein said distribution system comprises a primary venturi body with a jet orifice and a nebulizer with a jet orifice; and

,

balancing an endobronchial sub tidal pressure gradient with two outflow orifices serving to create a pressure-volume regulated operational air flow into the primary venturi jet orifice with pressure rise balancing by secondary flow through the jet orifice of the nebulizer.

2. A method for ventilating a patient airway as in claim 1 including manually selecting separate peripheral pulmonary airway mobilization and recruitment amplitudes and oscillatory frequencies for respective aerosol delivery methods during active lung therapy.

3. A method for ventilating a patient airway as in claim 2 wherein

said manually selecting includes manually selecting and manipulating a manual bi-phasic switch controlled orifice.

4. A method for ventilating a patient airway as in claim 2 wherein

the manually selecting separate peripheral pulmonary airway mobilization and recruitment amplitudes and oscillatory frequencies controls two clinical modalities:

a percussive oscillation commenced by allowing ambient venting, and

an oscillatory bi-phasic amplitude supply of air to the patient'"'"'s airway causing mobilization or recruitment of the patient'"'"'s lungs by obstructing or occluding ambient venting.

5. A method for ventilating a patient airway as in claim 1 including muting sub tidal volume delivery with a two-position or bi-modal switch representing “

bi-phasic operation”

or “

nebulization only”

operation.

6. A method for ventilating a patient airway as in claim 1 including automating optimal operational pressures for different patients due to their physical size and therapeutic requirements without an operational pressure monitoring gauge.

7. A method for ventilating a patient airway as in claim 1 including

allowing the patient to select a clinically effective pulmonary airway mobilization and recruitment program without operational pressure manipulation, thereby eliminating a breathing pressure manometer.

8. A method for ventilating a patient airway as in claim 1 including

providing a continuous mandatory ventilation (CMV) ventilator,

wherein a percussive diffusive wave format is supplied to a host convective volume-pressure oriented CMV ventilator.

9. A method for ventilating a patient airway as in claim 1 wherein the method includes

amplifying the air supply from said compressor to create a constant air supply to percuss the lungs with sufficient therapeutic amplitude to mobilize and recruit the peripheral airways with intrapulmonary percussive ventilation, and maintaining compressed air from said compressor to power said nebulizer with a particulate spectrum and volume.

10. A method for ventilating a patient airway as in claim 9 including

balancing the total compressor outflow to provide sufficient percussive amplitude and concomitant nebulization over a selectable frequency band.

11. A method for ventilating a patient airway as in claim 9 wherein the compressor includes a piston and the method including

employing compressional shock waves created during repetitive compressive upstrokes of the air compressor piston which serve to modulate the positive pressure endobronchial sub tidal volume deliveries with energy spikes.

12. A method for ventilating a patient airway as in claim 11 wherein 3500 compressional shock waves are employed.

13. A method for ventilating a patient airway as in claim 9 including

providing a luggage case with a soft padded interior for said compressor;

venting said case for augmented ambient air flow there through for compressor cooling.

14. A method for ventilating a patient airway as in claim 13 wherein said luggage case has interior side walls, the method including

storing therapeutic breathing head components and medications about said side walls and storing an inter connected power cord for said compressor in said luggage case.

15. A method for ventilating a patient airway as in claim 13 including

buffering compressor noise during operation of said compressor.

16. A method for ventilating a patient airway as in claim 13 including

absorbing force shock when said luggage storing said compressor is dropped from an elevation.

17. A method for ventilating a patient airway as in claim 16 wherein

the absorption of said shock force includes absorption of shock force in excess of a vertical drop by a patient from a patient'"'"'s hip-level to a hard surface.

18. A method for ventilating a patient airway as in claim 13 including opening said luggage to expose a control panel including one or more of a compressor start and stop switch, percussion frequency band selection and breathing head service sockets.

19. A method for ventilating a patient airway as in claim 18 including

providing a control panel with controls for said adding in succession the plurality of pulses of small volumes of gas;

covering said control panel with a flip over fabric cover to conceal said control panel, said fabric cover impervious to medication spills.

20. A method for ventilating a patient airway as in claim 19 including

physically separating said luggage from said compressor and controls and control panel thereby said compressor and controls and control panel can provide stand-alone therapy apart from said luggage.

21. A method for ventilating a patient airway as in claim 18 including

providing fringe access for interconnecting a breathing head tubing while substantially simultaneously muting compressor noise during operation thereof.

22. A method for ventilating a patient airway as in claim 18 wherein said compressor is supplied with ac power for operation, the method including

converting dc power into ac power for said compressor, and

providing an interconnection for said ac power source.

23. A method for ventilating a patient airway as in claim 1 including

producing endobronchial shock waves with vibratory ratio of about seven modulating shock waves during each endobronchial sub tidal volume injection.

24. A method for ventilating a patient airway as in claim 23, wherein the ratio of about seven modulating shock waves involves delivery of 500 sub tidal volumes per minute divided into the number of compression strokes of up to about 3500 strokes per minute, resulting in about seven air compression strokes for each sub tidal volume injected into the patient'"'"'s pulmonary airways.

25. A method for ventilating a patient airway as in claim 23 wherein

producing endobronchial shock waves creates endobronchial micro agitation which causes the walls of the pulmonary airways to be more compliable to volume change.

26. A method for ventilating a patient airway as in claim 1 including gradually initiating sub tidal volume delivery, thus preventing an initial hard endobronchial impaction.

27. A method for ventilating a patient airway as in claim 1 including regulating, within a predetermined delivery pressure variance range, injection of the sub tidal volumes into the patient'"'"'s airways.

28. A method for ventilating a patient airway as in claim 1 including wherein the compressor stroke energy spikes, transmitted through the primary venturi jet orifice form micro energy spikes adapted to impact upon elastomeric walls of physiological pulmonary airways of the patient'"'"'s airways, thereby adapted to create an expansive dilating force during a period of a transient pressure rise causing a sub tidal airway inflation.

29. A method for ventilating a patient airway as in claim 28 including

providing the nebulizer jet orifice adapted to convert a liquid into an aerosol with a designed particulate spectrum within a predetermined nebulizer jet orifice pressure variance, such that the constant flow to the nebulizer jet orifice will vary during inspiratory endobronchial sub tidal volume injection and follow on to an expiratory, no-flow period.

30. A method for ventilating a patient airway as in claim 29 including

providing a variable jet orifice flow to regulate or buffer an operational pressure within an operational therapeutic pressure range.

31. A method for ventilating a patient airway as in claim 30 including

creating scheduled pulsatile intrapulmonary sub tidal flows from the primary venturi jet orifice creates a periodic inflow pressure gradient serving to aspirate a volume of the particulate aerosol for concomitant aerosol delivery into the patient'"'"'s airways.

32. A method for ventilating a patient airway as in claim 31 including

after the sub tidal delivery or expiratory interval, purging mechanical airways as part of nebulizer outflow before venting the outflow to ambient with mixed exhaled physiological gases from the patient'"'"'s airways.

33. A method for ventilating a patient airway as in claim 32 including

providing a proximal non-gated venturi tube which is ambient vented allowing the compressible gases being delivered the patient'"'"'s airways to obstructionally increase and decrease the primary venturi body pressures, in near instantaneous compliance with changing inflational endobronchial airway resistances.

34. A method for ventilating a patient airway as in claim 33 including

with a near constant primary jet orifice injection pressure, a constant inflational variance on resistances of the patient'"'"'s airways which cause pressures of the primary venturi body created entrainment gradient to be influenced by the pulmonary airway resistance changes.

35. A method for ventilating a patient airway as in claim 28 including

governing an outflow velocity from the primary venturi body by an ever-changing inflational pulmonary endobronchial resistances to inflow.

36. A method for ventilating a patient airway as in claim 35 including

governing an outflow velocity of the primary venturi body by an ever-changing inflational pulmonary endobronchial resistances of the patient'"'"'s airways to inflow, thereby limiting conversion of a constant inflow into the patient'"'"'s airways due to an abrupt pressure rise within the patient'"'"'s preferential bronchiolar airways.

37. A respirator for ventilating a patient'"'"'s airway during the inspiratory phase and expiratory phase, said respirator being supplied with gas under pressure from a source of pressurized gas with a compressor, comprising:

means for supplying a plurality of pulses of small volumes of gas from said source of gas to the patient airway during the inspiratory phase,

means, coupled to said means for supplying, for adding successively greater volumes of gas pulses as part of said small pulses of gas, to provide successively greater volumes of gas, successively increasing in pulsatile form, the pressure of the gas in the airway of the patient during the inspiratory phase resulting in diffusive ventilation to the patient during the inspiratory phase, and,

means for distributing high frequency compressor generated energy spikes created during stroke volume generation, into a distribution system serving as an accumulator in preparation for the energy spikes to be transported into the lungs, wherein said distribution system comprises a primary venturi body with jet orifice and a nebulizer with jet orifice;

two outflow orifices configured to balance a endobronchial sub tidal pressure gradient by creating a pressure-volume regulated operational air flow into the primary venturi jet orifice with pressure rise balancing by secondary flow through the jet orifice of the nebulizer; and

,

means for permitting the patient to exhale during the expiratory phase.

38. A respirator as claimed in claim 37 wherein the respirator includes:

means, coupled to said means for supplying, for generating a constant air supply to percuss the lungs by amplifying the air supply from said compressor, and

nebulizer maintaining a compressed air volume and particulate spectrum, said aerosol generator or nebulizer coupled to said means for supplying.

39. A respirator as claimed in claim 38:

including a frequency selector means for controlling percussive amplitude and nebulization, said frequency selector means coupled to said means for supplying.

40. A respirator as claimed in claim 37 including a manual bi-phasic switch for said means for supplying which controls amplitudes and oscillatory frequencies delivered to said nebulizer.

41. A respirator as claimed in claim 38 including:

a luggage case with a soft padded interior for said compressor;

a case vent permitting ambient air flow there through for said compressor,

said case having buffering walls limiting compressor noise and shock absorbing wall segments;

said respirator having control panel;

said luggage having a control panel opening with a fabric cover to conceal said control panel.

42. A respirator as claimed in claim 38 wherein the compressor includes a piston and said means for supplying employs compressional shock waves created during repetitive compressive upstrokes of the air compressor piston which serve to modulate a positive pressure endobronchial sub tidal volume deliveries with vibratory energy.

43. A respirator as claimed in claim 42 wherein said means for supplying produces endobronchial shock waves with vibratory ratio of about seven modulating shock waves during each endobronchial sub tidal volume injection.

44. A respirator as claimed in claim 37

wherein said respirator is a continuous mandatory ventilation (CMV) ventilator, and

said means for supplying includes means for generating a percussive diffusive pressure air waves supplied to a host convective volume-pressure oriented CMV ventilator.