System and method for providing mechanical ventilation support to a patient

• US 8,770,191 B2
• Filed: 01/07/2011
• Issued: 07/08/2014
• Est. Priority Date: 01/07/2011
• Status: Active Grant

• Current Assignee: General Electric Company
• Original Assignee: General Electric Company
• Inventors: Tham, Robert Q.
• Primary Examiner(s): YOUNG, RACHEL T
• Application Number:
  US12/986,782
• Publication Number:
  US 20120174925A1
• Time in Patent Office: 1,278 Days
• Field of Search: 128/204.18, 12820421-20423, 128/204.26, 128/204.28, 12820511-20513, 128/205.17, 128/205.24
• US Class Current: 128/204.21
• CPC Class Codes: A61M 16/0075 Bellows-type
• CPC Class Codes: A61M 16/0081 Bag or bellow in a bottle
• CPC Class Codes: A61M 16/01 specially adapted for anaesthetising A61M16/104, A61M16/18 take precedence
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/08 Bellows; Connecting tubes having means for taking samples G01N1/22; Water traps; Patient circuits
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 16/0891 Closed circuit, e.g. for anaesthesia
• CPC Class Codes: A61M 16/1015 using a gas flush valve, e.g. oxygen flush valve
• CPC Class Codes: A61M 16/12 by mixing different gases
• CPC Class Codes: A61M 16/22 Carbon dioxide-absorbing devices ; Other means for removing carbon dioxidecartridges with absorbing substances for respiratory apparatus A62B19/00
• CPC Class Codes: A61M 2016/0015 inhalation detectors
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 in the expiratory circuit
• CPC Class Codes: A61M 2016/102 Measuring a parameter of the content of the delivered gas
• CPC Class Codes: A61M 2016/1025 the O2 concentration
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2230/43 Composition of exhalation
• CPC Class Codes: A61M 2230/435 partial O2 pressure (P-O2)

Abstract

A system for providing mechanical ventilation support to a patient and includes a mechanical ventilator. A breathing circuit is pneumatically connected between the mechanical ventilator and a patient connection. An inspiratory check valve is disposed within an inspiratory limb of the breathing circuit. A fresh gas manifold provides fresh gas to the breathing circuit for delivery to the patient. A fresh gas valve is disposed between the fresh gas manifold and the breathing circuit. The fresh gas valve is operable between a first position which directs fresh gas upstream of the inspiratory check valve and a second position that directs fresh gas downstream of the inspiratory check valve. A digital signal processor operates the fresh gas valve selectively between the first position and the second position. A method of ventilating a patient includes introducing a flow of fresh gas into an inspiratory limb of the breathing circuit. A ventilatory support value is sensed with at least one sensor disposed within the breathing circuit. An operational condition of the breathing circuit is identified with a digital signal processor. A fresh gas valve is operated with the digital processor between a first position that directs fresh gas to the inspiratory limb upstream from the inspiratory check valve and a second position that directs the fresh gas downstream from the inspiratory check valve.

Claims

1. A system for providing mechanical ventilation support to a patient, the system comprising:

a mechanical ventilator configured to pneumatically provide mechanical ventilation support to the patient;

a breathing circuit pneumatically connected between the mechanical ventilator and a patient connection configured to deliver the mechanical ventilation support to the patient, wherein the breathing circuit comprises an inspiratory limb upstream of the patient connection and an expiratory limb downstream of the patient connection;

an inspiratory check valve disposed within the inspiratory limb of the breathing circuit;

a fresh gas manifold configured to provide fresh gas to the breathing circuit for delivery to the patient;

a fresh gas valve disposed between the fresh gas manifold and the breathing circuit, the fresh gas valve being operable between at least two positions, wherein in a first position the fresh gas valve directs fresh gas through an upstream conduit that provides the fresh gas to the breathing circuit upstream of the inspiratory check valve, and in a second position the fresh gas valve directs the fresh gas through a downstream conduit that provides the fresh gas to the breathing circuit downstream of the inspiratory check valve; and

a digital signal processor that operates the fresh gas valve selectively between the first position and the second position to provide mechanical ventilation support to the patient;

wherein the inspiratory limb and the expiratory limb are fluidly connected downstream of the patient and wherein when the fresh gas valve is in the second position fresh gas combines with the expired gas from the expiratory limb downstream of an expiratory check valve.

2. The system of claim 1, further comprising:

an inspiratory gas sensor disposed within the inspiratory limb, the inspiratory gas sensor communicatively connected to the digital signal processor; and

an expiratory gas sensor disposed within the expiratory limb, the expiratory gas sensor communicatively connected to the digital signal processor;

wherein the digital signal processor monitors a condition of the delivery of mechanical ventilation support to the patient and operates the fresh gas salve between the first position and the second position based upon the condition.

3. The system of claim 2, wherein the digital signal processor identifies a blockage in the expiratory limb and the digital signal processor operates the fresh gas valve to the first position.

4. The system of claim 2, wherein the digital signal processor identifies that the patient is receiving ventilation at a low tidal volume and the digital signal processor operates the fresh gas valve to the second position.

5. The system of claim 1, wherein operation in the first position minimizes a loss of medical gas from the system.

6. The system of claim 1, wherein operation in the second position maximizes the delivery of medical gas to the patient.

7. The system of claim 1 further comprising a bellows operated by the mechanical ventilator, the bellows being pneumatically connected to the breathing circuit and receiving expired gases from the expiratory limb of the breathing circuit.

8. The system of claim 7, further comprising a carbon dioxide absorber pneumatically connected in the breathing circuit, downstream from the bellows and upstream from the inspiratory check valve.

9. The system of claim 7, wherein the bellows further comprises an exhaust valve, wherein excess pressure within the breathing circuit is released through the exhaust valve.

10. The system of claim 9, further comprising:

an oxygen flush conduit that is selectively fluidly connected to the breathing circuit through the fresh gas valve, a flow of oxygen gas in the oxygen flush conduit being selectively controlled by the digital signal processor;

wherein the digital signal processor operates the fresh gas valve in the first position when the flow of oxygen gas in the oxygen flush conduit is selectively initiated.

11. A method of ventilating a patient with a mechanical ventilator pneumatically connected to the patient through a breathing circuit with an inspiratory check valve and a patient connection, the method comprising:

operating the mechanical ventilator to provide a series of breaths of ventilatory support to the patient;

introducing a flow of fresh gas into an inspiratory limb of the breathing circuit through a fresh gas valve, the flow of fresh gas being delivered to the patient in the series of breaths of ventilatory support;

sensing a ventilatory support value with at least one gas sensor disposed within the breathing circuit;

identifying an operational condition of the breathing circuit with a digital signal processor that receives the sensed ventilatory support value;

operating the fresh gas valve with the digital signal processor between a first position and a second position, wherein the first position directs the flow of fresh gas into a first conduit that introduces the flow of fresh gas into the inspiratory limb upstream from the inspiratory check valve and the second position directs the flow of fresh gas into a second conduit that introduces the flow of fresh gas into the inspiratory limb downstream from the inspiratory check valve;

and recirculating expired gases to the patient by fluidly connecting an expiratory limb of the breathing circuit having an expiratory check valve to the inspiratory limb wherein when the fresh gas valve is in the second position the flow of fresh gas combines with the expired gases downstream of the expiratory check valve.

12. The method of claim 11, further comprising:

wherein the expired gases are further recirculated to the patient by fluidly connecting the expiratory limb of the breathing circuit to a bellows of the mechanical ventilator;

exhausting any excess gasses in the bellows through an exhaust port during an expiratory phase of an operation of the mechanical ventilator.

13. The method of claim 12, further comprising:

identifying the operational condition of the breathing circuit as delivering a low tidal volume; and

operating the fresh gas valve to the second position.

14. The method of claim 12, further comprising:

identifying the operational condition of the breathing circuit as having a blocked expiratory limb; and

operating the fresh gas valve to the first position.

15. The method of claim 11, further comprising:

receiving, with the digital signal processor, an initiation of an oxygen flush procedure;

identifying, with the digital signal processor, that the operational condition of the breathing circuit as performing an oxygen flush;

operating the fresh gas valve to the first position with the digital signal processor; and

delivering an oxygen flush through the fresh gas valve.

16. A system for providing mechanical ventilation support to a patient, the system comprising:

a breathing circuit pneumatically connected to the patient through a patient connection configured to deliver the mechanical ventilation support to the patient, wherein the breathing circuit comprises an inspiratory limb upstream of the patient connection and an expiratory limb downstream of the patient connection;

a bellows pneumatically connected to the inspiratory limb and the expiratory limb of the breathing circuit, the bellows receives expired gases from the expiratory limb and releases excess pressure from the breathing circuit through an exhaust valve, the bellows further being connected to a mechanical ventilator that operates the bellows to provide mechanical ventilation support to the patient through the inspiratory limb;

an inspiratory check valve disposed within the inspiratory limb of the breathing circuit;

at least one gas sensor disposed within the breathing circuit, the at least one gas sensor measures a ventilation support value from the gases in the breathing circuit;

a fresh gas manifold configured to provide fresh gas to the breathing circuit for delivery to the patient;

a fresh gas valve disposed between the fresh gas manifold and the breathing circuit, the fresh gas valve being operable between at least two positions, wherein in a first position the fresh gas valve directs fresh gas through an upstream conduit that provides the fresh gas to the breathing circuit upstream of the inspiratory check valve, and in a second position the fresh gas valve directs the fresh gas through a downstream conduit that provides the fresh gas to the breathing circuit downstream of the inspiratory check valve;

a digital signal processor that receives the at least one ventilation support value from the at least one gas sensor, the digital signal processor determines an operational condition of the breathing circuit from at least one of the ventilation support values and operates the fresh gas valve selectively between the first position and the second position based upon the determined operational condition.

17. The system of claim 16, further comprising:

an oxygen flush conduit that is connected to the breathing circuit through the fresh gas valve, a flow of oxygen gas in the oxygen flush conduit being detected or controlled by the digital signal processor;

wherein when the digital signal processor detects or controls the flow of oxygen in the oxygen flush conduit and operates the fresh gas valve in the first position.

18. The system of claim 16, wherein the at least one gas sensor measures a low tidal volume as the ventilation support value;

and

wherein the digital signal processor determines that the operational condition is a low tidal volume and the digital signal processor operates the fresh gas valve in the second position.

19. The system of claim 16, wherein the at least one gas sensor measures at least one of sustained high airway pressure, increasing airway pressure at an end of an expiratory phase, and a decrease in gas flow through the expiratory limb;

wherein the digital signal processor determines that the operational condition is a blocked expiratory limb and the digital signal processor operates the fresh gas valve in the first position.

20. The system of claim 19, wherein operation of the fresh gas valve in the first position reduces wasted fresh gas as expired gases from the patient are exhausted from the bellows before the fresh gas.