Systems and methods for therapeutic intrathoracic pressure regulation

• US 9,238,115 B2
• Filed: 12/19/2012
• Issued: 01/19/2016
• Est. Priority Date: 12/19/2011
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Resqsystems Inc.
• Inventors: Homuth, James, Voss, Greg, Lurie, Keith, Metzger, Anja
• Primary Examiner(s): Ho, Tan-Uyen (Jackie) T
• Assistant Examiner(s): Boecker, Joseph D
• Application Number:
  US13/720,858
• Publication Number:
  US 20140005566A1
• Time in Patent Office: 1,126 Days
• Field of Search: 128/200.24, 128/201.25, 128/203.12, 128/203.13, 128/203.18, 128/204.18, 128/204.21, 128/204.23, 128/204.26, 128/204.28, 128/205.12, 128/205.13, 128/205.17, 128/205.19, 128/205.24, 128/205.28, 128/207.14, 128/207.16, 600/529, 600/540, 600/541
• US Class Current: 1/1
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61M 16/00 Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes stimulating the respiratory movement by mechanical, pneumatic or electrical means, iron lungs combined with gas breathing means A61H31/00
• CPC Class Codes: A61M 16/0009 with sub-atmospheric pressure, e.g. during expiration
• CPC Class Codes: A61M 16/0012 by Venturi means
• CPC Class Codes: A61M 16/0063 Compressors
• 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 16/0072 Tidal volume piston pumps
• CPC Class Codes: A61M 16/0078 Breathing bags
• CPC Class Codes: A61M 16/0081 Bag or bellow in a bottle
• CPC Class Codes: A61M 16/0084 self-reinflatable by elasticity, e.g. resuscitation squeeze bags
• 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 16/0816 Joints or connectors
• CPC Class Codes: A61M 16/0875 Connecting tubes
• 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 16/1055 bacterial
• CPC Class Codes: A61M 16/1065 in the expiratory path
• CPC Class Codes: A61M 16/12 : by mixing different gases
• CPC Class Codes: A61M 16/18 : Vaporising devices for anaesthetic preparations
• CPC Class Codes: A61M 16/204 : used for inhalation control
• 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 16/22 : Carbon dioxide-absorbing devices ; Other means for removing carbon dioxidecartridges with absorbing substances for respiratory apparatus A62B19/00
• CPC Class Codes: A61M 2016/0027 : pressure meter
• CPC Class Codes: A61M 2016/0036 : in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2016/0042 : in the expiratory circuit
• CPC Class Codes: A61M 2205/05 : combined with other kinds of therapy
• CPC Class Codes: A61M 2206/10 : Flow characteristics
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)

Abstract

Embodiments of the present invention provide systems and methods for delivering respiratory treatment to a patient. For example, a treatment system may include a mechanism for delivering a positive pressure breath to a patient, and one or more limb flow control assemblies which modulate gas flow to and from the patient. Exemplary treatment techniques are embodied in anesthesia machines, mechanical ventilators, and manual ventilators.

Claims

1. A system for providing intrathoracic pressure regulation (IPR) to an individual, the system comprising:

a patient connection mechanism for coupling with an airway of the individual;

a flow control assembly comprising a housing having a vent, an impeller disposed within the housing, and a motor in operative association with the impeller; and

an external pressure source selected from the group consisting of a manual bag valve mask mechanism, a mechanical ventilator machine, and an anesthesia machine,

wherein the external pressure source is in fluid communication with the housing vent of the flow control assembly,

wherein the impeller of the flow control assembly is disposed between the patient connection mechanism and the external pressure source, along a fluid passage that extends between the patient connection mechanism and the external pressure source, and

wherein the flow control assembly is configured to allow retrograde airflow from the external pressure source to the patient connection mechanism while simultaneously compelling airflow from the patient connection mechanism to the housing vent.

2. The system according to claim 1, wherein the impeller of the flow control assembly is configured to produce a continuous pressure differential within a range from about 3 cm H₂O to about 16 cm H₂O.

3. The system according to claim 1, wherein the external pressure source is configured to provide a respiratory cycle duration of about 5 seconds.

4. The system according to claim 1, wherein operation of the flow control assembly continuously permits airflow between the patient connection mechanism and the external pressure source, without forming a physical barrier that prevents airflow therebetween.

5. The system according to claim 1, wherein the external pressure source is configured to maintain sub-atmospheric pressures within the thorax of the individual.

6. The system according to claim 1, further comprising a pressure sensor that monitors the individual'"'"'s airway pressure between the flow control assembly and the individual, and a controller device that receives information from the pressure sensor and controls operation of the flow control assembly motor based on the information.

7. A method of providing intrathoracic pressure regulation (IPR) to an individual, the method comprising:

coupling an IPR system with an airway of the individual, the IPR system having a housing with a vent, an impeller disposed within the housing, a motor in operative association with the impeller, and an external pressure source in fluid communication with the housing vent, wherein the impeller is disposed between the airway and the external pressure source, along a fluid passage that extends between the airway and the external pressure source, and

activating the impeller and the external pressure source, so as to allow retrograde airflow from the external pressure source to the individual while simultaneously compelling airflow from the airway to the housing vent.

8. The method according to claim 7, comprising producing with the impeller a continuous pressure differential throughout a respiratory cycle of the individual within a range from about 3 cm H₂O to about 16 cm H₂O.

9. The method according to claim 7, comprising providing a respiratory cycle duration of about 5 seconds with the external pressure source.

10. The method according to claim 7, comprising continuously permitting airflow between the patient connection mechanism and the external pressure source, without forming a physical barrier that prevents airflow therebetween.

11. The method according to claim 7, comprising maintaining sub-atmospheric pressures within the thorax of the individual throughout a respiratory cycle.

12. The method according to claim 7, further comprising monitoring the individual'"'"'s airway pressure between the impeller and the individual, and controlling operation of the impeller based on the monitored pressure.

13. The method according to claim 7, wherein the intrathoracic pressure regulation lowers intrathoracic pressure and increases venous return from the head of the individual, thereby lowering intracranial pressure of the individual.

14. A method of providing intrathoracic pressure regulation (IPR) to an individual, the method comprising:

coupling an IPR system with an airway of the individual, wherein the IPR system comprises;

a patient connection mechanism for coupling with an airway of the individual;

a flow control assembly comprising a housing having a vent, an impeller disposed within the housing, and a motor in operative association with the impeller, and

an external pressure source selected from the group consisting of a manual bag valve mask mechanism, a mechanical ventilator machine, and an anesthesia machine,

wherein the external pressure source is in fluid communication with the housing vent of the flow control assembly,

wherein the impeller of the flow control assembly is disposed between the patient connection mechanism and the external pressure source, along a fluid passage that extends between the patient connection mechanism and the external pressure source, and

wherein the flow control assembly is configured to allow retrograde airflow from the external pressure source to the patient connection mechanism while simultaneously compelling airflow from the patient connection mechanism to the housing vent;

using the IPR system to manipulate respiratory gas exchange such that intrathoracic pressures during exhalation remain at or below atmospheric pressure, thereby enhancing venous blood flow back to the thorax into the heart and lungs; and

periodically injecting air to the individual'"'"'s lungs while simultaneously operating the impeller.

15. The method according to claim 14, comprising using the IPR system to manipulate respiratory gas exchange such that intrathoracic pressures during at least a portion of an inhalation phase remain at or below atmospheric pressure.