Methods and devices for providing inspiratory and expiratory flow relief during ventilation therapy

• US 8,567,399 B2
• Filed: 09/26/2008
• Issued: 10/29/2013
• Est. Priority Date: 09/26/2007
• Status: Active Grant

• Current Assignee: Breathe Technologies, Inc. (Baxter International Inc.)
• Original Assignee: Breathe Technologies, Inc. (Baxter International Inc.)
• Inventors: Wondka, Anthony, Kapust, Gregory
• Primary Examiner(s): Dixon, Annette
• Application Number:
  US12/239,723
• Publication Number:
  US 20090151724A1
• Time in Patent Office: 1,859 Days
• Field of Search: 128/200.24, 128/200.26, 128/204.18, 128/204.21, 128/204.23, 128/205.25, 128/206.21, 128/206.29, 128/207.14, 128/207.18, 604/256, 604/523, 604533-539, 604/284, 604/93.01, 604/95.02, 604/118, 604/264, 604/258, 604/94.01
• US Class Current: 128/204.23
• CPC Class Codes: A61M 16/0096 High frequency jet ventilation
• CPC Class Codes: A61M 16/0463 combined with suction tubes, catheters or the like; Outside connections
• CPC Class Codes: A61M 16/0465 Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
• CPC Class Codes: A61M 16/202 electrically actuated
• CPC Class Codes: A61M 16/206 Capsule valves, e.g. mushroom, membrane valves
• CPC Class Codes: A61M 16/208 Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• CPC Class Codes: A61M 16/209 Relief valves
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• 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 2230/10 Electroencephalographic signals
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/50 Temperature
• CPC Class Codes: A61M 2230/60 Muscle strain, i.e. measured on the user
• CPC Class Codes: A61M 2230/65 Impedance, e.g. conductivity, capacity

Abstract

Respiratory support and/or controlled mechanical ventilation of a patient are provided. A ventilation apparatus may include a ventilator, a transtracheal prosthesis, and a respiratory relief device. The transtracheal prostheses and ventilation catheter may be arranged such that the patient can breathe freely through the upper airway and/or the tracheal prostheses. Respiratory sensors may measure a breathing rate, lung pressure, airway pressure, or a combination thereof. Pulses of gas may be provided to the patient through the ventilation catheter during inspiration. The pulses may have a first volume while the patient breathes normal and a second volume when the sensors detect a cessation of breathing or reduction in breathing volume. The second volume may be provided at 1-5 times the normal breathing rate, with a volume 25-500% times the first volume, or both.

Claims

1. A ventilation apparatus comprising

(a) a ventilator adapted to

(i) provide a pulse of gas to the patient during inspiration by a patient, wherein the pulse has a first volume;

and

(ii) provide pulses of gas to a patient after detection of a cessation of breathing or reduction in breathing volume of the patient, wherein the pulses each have a second volume and wherein (1) the pulses are provided at a rate that is 1-5 times the normal breathing rate, (2) the second volume is 25-500% greater than the first volume, or (3) the pulses are provided at a rate that is 1-5 times the normal breathing rate and the second volume is 25-500% greater than the first volume;

(b) a gas delivery circuit operably connected to the ventilator;

(c) one or more respiratory sensor adapted to determine when the patient inspires, to calculate a normal breathing volume for the patient, to detect a cessation of breathing or reduction in breathing volume of the patient; and

(d) a respiratory relief device, wherein the respiratory relief device is configured to allow the patient to exhale to atmosphere;

(e) a pressure transducer to measure the pressure in the lungs, to detect overpressure in the lungs, or both; and

wherein the respiratory relief device comprises an active valve.

2. The ventilation apparatus of claim 1, wherein the respiratory relief device comprises a seat and a diaphragm;

wherein the valve receives a pilot pressure signal from the lungs or from the ventilator, and wherein the pilot pressure signal regulates the position of the diaphragm against the seat.

3. The ventilation apparatus of claim 1, wherein the respiratory relief device has an open state and a closed state.

4. The ventilation apparatus of claim 3, wherein the respiratory relief device is adapted to be provided in a closed state while the one or more respiratory sensor detects that the patient is breathing within the normal breathing rate, normal lung pressure, normal airway pressure, or a combination thereof.

5. The ventilation apparatus of claim 3, wherein the one or more respiratory sensor is adapted to detect a variation in the patient'"'"'s breathing rate from the normal lung pressure, a variation in the patient'"'"'s lung pressure from the normal lung pressure, a variation in the patient'"'"'s airway pressure from the normal airway pressure, or a combination thereof.

6. The ventilation apparatus of claim 5, wherein the respiratory relief device is adapted to open or be opened in response to detection of the variation.

7. The ventilation apparatus of claim 1, further comprising:

a ventilation catheter operably connected to the gas delivery circuit;

wherein the pulses of gas are provided to the patient through the ventilation catheter.

8. The ventilation apparatus of claim 7, further comprising:

a patient ventilation interface, wherein the ventilation catheter is placed coaxially in the patient ventilation interface; and

wherein the patient ventilation interface and the ventilation catheter are arranged such that a patient using the ventilation apparatus can breathe freely through the patient'"'"'s upper airway.

9. The ventilation apparatus of claim 1, wherein the respiratory relief device comprises an active valve.

10. The ventilation apparatus of claim 1, wherein the respiratory relief device comprises a seat and a diaphragm;

wherein the respiratory relief device receives a pilot pressure signal from the lungs or from the ventilator, and wherein the pilot pressure signal regulates the position of the diaphragm against the seat.

11. A method of providing ventilation to a patient comprising

(a) using one or more respiratory sensor to determine when the patient inspires;

(b) providing a pulse of gas to the patient during inspiration by the patient, wherein the pulse has a first volume;

(c) using the one or more respiratory sensor to calculate a normal breathing volume for the patient;

(d) providing a respiratory relief device, wherein the respiratory relief device is configured to allow the patient to exhale to atmosphere;

(e) detecting a cessation of breathing or reduction in breathing volume of the patient;

(f) after detecting a cessation of breathing or reduction in breathing volume of the patient, providing pulses of gas to the patient, wherein the pulses each have a second volume and wherein (i) the pulses are provided at a rate that is 1-5 times the normal breathing rate, (ii) the second volume is 25-500% greater than the first volume, or (iii) the pulses are provided at a rate that is 1-5 times the normal breathing rate and the second volume is 25-500% greater than the first volume;

(g) using a pressure transducer to measure the pressure in the lungs, to detect overpressure in the lungs, or both; and

(h) opening the respiratory relief device when overpressure in the lungs is detected.

12. The method of claim 11, further comprising:

using the one or more respiratory sensor to measure the patient'"'"'s breathing rate;

using the one or more respiratory sensor to calculate a normal breathing rate for the patient;

providing the respiratory relief device in a closed state while the one or more respiratory sensor detects that the patient is breathing within the normal breathing rate;

using the one or more respiratory sensor to detect a variation in the patient'"'"'s breathing rate from the normal breathing rate; and

opening the respiratory relief device in response to detection of the variation in the patient'"'"'s breathing rate from the normal breathing rate.