Extrathoracic augmentation of the respiratory pump
First Claim
1. An apparatus comprising:
- a pressure delivery mechanism comprising a plurality of gas outlets, said pressure delivery mechanism configured to augment respiratory function of a patient by applying pulses of pressurized gas directly to and in contact with an uncovered portion of the frontal torso area of the patient exposed to ambient, said pulses being provided at a frequency of from about 3 to 10 Hz to vibrate the thoracic cavity of the patient, without the mechanism contacting the frontal torso area portion of the patient; and
a gas supply mechanism configured to deliver gas to the patient'"'"'s airway.
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Accused Products
Abstract
Systems and methods for assisting respiration extrathoracically, particularly useful for augmenting respiration in neonatal patients, including providing a positive pressure to a torso area of a patient. The positive pressure may be delivered to the torso area of the patient while the torso area is exposed to an ambient pressure, such as by providing positive pressure with high frequency gas jets that are positioned in proximity to the torso area. The positive pressure may be delivered to different parts of the torso area of the patient at different times, such as by controlling gas jets independently. The positive pressure may also be controlled in coordination with a gas flow and concentration to the patient'"'"'s airway, such as by increasing the positive pressure as a gas flow pressure delivered to the patient'"'"'s airway is reduced. The gas flow to the patient'"'"'s airway may be provided by, for example, a high-flow nasal cannula (HFNC) mechanism or a continuous positive airway pressure (CPAP) mechanism that is controlled in coordination with the positive pressure based upon a desired respiratory function of the patient. The control of the gas flow and the positive pressure may be based on an input of patient monitored parameters and/or calculated values based on the patient monitored parameters.
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Citations
56 Claims
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1. An apparatus comprising:
a pressure delivery mechanism comprising a plurality of gas outlets, said pressure delivery mechanism configured to augment respiratory function of a patient by applying pulses of pressurized gas directly to and in contact with an uncovered portion of the frontal torso area of the patient exposed to ambient, said pulses being provided at a frequency of from about 3 to 10 Hz to vibrate the thoracic cavity of the patient, without the mechanism contacting the frontal torso area portion of the patient; and
a gas supply mechanism configured to deliver gas to the patient'"'"'s airway.- View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method of assisting respiration, said method comprising the steps of:
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positioning an uncovered portion of a patient'"'"'s frontal torso area in an environment open to ambient and proximate to a plurality of gas outlets of a positive pressure device, wherein said plurality of gas outlets are configured for applying a positive pressure to the uncovered torso portion of the patient by applying pressurized gas directly to and in contact with said uncovered torso portion without the gas outlets contacting the frontal torso area; and applying positive pressure to the uncovered portion of the frontal torso area of the patient via the positive pressure device by applying pressurized gas directly to and in contact with said torso portion in pulses at a frequency of from about 3 to 10 Hz during at least an exhalation phase and during a time in which the portion of the patient'"'"'s torso area in contact with the pressurized gas is exposed to the ambient without the gas outlets contacting the frontal torso area, to assist respiration of the patient by vibrating the thoracic cavity of the patient; and
delivering gas to the patient'"'"'s airway via a gas supply device. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23)
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24. A method of assisting respiration extrathoracically, said method comprising the steps of:
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positioning an uncovered portion of a patient'"'"'s frontal torso area in an environment open to ambient; providing a pressure delivery mechanism comprising a plurality of gas outlets positioned in proximity to the uncovered portion of the frontal torso area of the patient without contacting the frontal torso area, said gas outlets configured for applying pressurized gas directly to and in contact with said uncovered torso portion in pulses at a frequency of from about 3 to 10 Hz, to provide a positive pressure to the uncovered torso portion of the patient to assist respiration of the patient; providing a gas supply mechanism to deliver a gas to the patient'"'"'s airway; and while the uncovered portion of the patient'"'"'s torso area in contact with the pressurized gas is in the environment open to the ambient and is not contacted by the pressure delivery mechanism, controlling a pressure of the gas supply mechanism in coordination with a pressure provided by a positive pressure subsystem.
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25. An extrathoracic breathing augmentation apparatus comprising:
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an adjustable housing configured to be positioned in a number of predetermined positions over a frontal torso area of a patient while the torso area is exposed to ambient; and a pressure delivery mechanism including a plurality of gas jets supported by said housing, said plurality of jets being configured to apply pressurized gas to and in contact with at least an uncovered portion of the frontal torso area of the patient without the jets contacting the uncovered portion, to augment the respiratory function of the patient, at least one gas jet of said plurality of gas jets being configured to provide gas pulses at a frequency of from about 3 to 10 Hz; and a control system operatively connected to said pressure delivery mechanism to control the pressure delivery mechanism based upon a selected respiratory function of the patient; and a gas supply mechanism configured to deliver gas to the patient'"'"'s airway; wherein at least two of said plurality of gas jets are configured to be activated separately from one another. - View Dependent Claims (26, 27, 28, 29, 30)
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31. An apparatus comprising:
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a pressure delivery mechanism configured to augment respiratory function of a patient by applying a positive exterior pressure to an uncovered portion of a frontal torso area of the patient by blowing gas directly against the uncovered torso area portion in pulses at a frequency of from about 3 to 10 Hz without sealing the torso area portion which is contacted by the gas and without the mechanism contacting the frontal torso area;
a gas supply mechanism configured to deliver gas to the patient'"'"'s airway; anda control system operatively connected to said pressure delivery mechanism to control the pressure delivery mechanism based upon a selected respiratory function of the patient. - View Dependent Claims (32, 33, 34, 35, 36, 37, 38, 39, 40)
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41. An extrathoracic breathing augmentation apparatus comprising:
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an adjustable housing configured to be positioned in a number of predetermined positions over a frontal torso area of a patient while the torso area is exposed to ambient; and a pressure delivery mechanism including a plurality of gas jets supported by said housing, said plurality of jets being configured to apply a positive pressure to an uncovered portion of the torso area of the patient without the jets contacting the frontal torso area portion, to augment respiratory function of the patient by blowing gas against the uncovered torso area portion, at least one gas jet of said plurality of gas jets being configured to provide gas pulses at a frequency of from about 3 to 10 Hz; a gas supply mechanism configured to deliver gas to the patient'"'"'s airway; and a control system operatively connected to said pressure delivery mechanism to control the pressure delivery mechanism based upon a selected respiratory function of the patient. - View Dependent Claims (42)
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43. A method of assisting respiration, said method comprising the steps of:
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positioning an uncovered portion of a patient'"'"'s frontal torso area in an environment open to ambient and proximate to a positive pressure device for applying a positive pressure to the torso of the patient without the positive pressure device contacting the frontal torso area; applying positive pressure to the uncovered torso portion of the patient via the positive pressure device by blowing a first gas directly against the uncovered torso area portion in pulses at a frequency of from about 3 to 10 Hz during at least an exhalation phase and during a time in which the uncovered portion of the patient'"'"'s torso area which is contacted by said gas is exposed to the ambient and is not in contact with the positive pressure device, wherein said positive pressure applied augments the respiratory function of the patient; and delivering a second gas comprising air, oxygen or an oxygen-enriched gas mixture to the patient'"'"'s airway via a gas supply device. - View Dependent Claims (44, 45, 46, 47, 48, 49)
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50. A method of assisting respiration, said method comprising the steps of:
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positioning an uncovered portion of a patient'"'"'s frontal torso area in an environment open to ambient and proximate to a positive pressure device for applying a positive pressure to the uncovered portion of the frontal torso area of the patient, applying positive pressure to the uncovered portion of the frontal torso area of the patient via the positive pressure device, wherein said positive pressure applied augments the respiratory function of the patient, by blowing a gas directly against and in contact with the uncovered frontal torso area portion via the positive pressure device in pulses at a frequency of from about 3 to 10 Hz during at least an exhalation phase and during a time in which the uncovered portion of the patient'"'"'s frontal torso area which is contacted by the gas is substantially exposed to the ambient and is not in contact with the positive pressure device, delivering gas to the patient'"'"'s airway via a gas supply device; controlling the application of positive pressure to the uncovered frontal torso area via the positive pressure device based on (i) an input of patient monitored parameters including at least one of a respiratory rate, a tidal volume, a pressure development, a rib cage motion, and an abdominal motion, or (ii) calculated values of patient monitored parameters, the calculated values including at least one of phase angle and minute ventilation.
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51. An apparatus comprising:
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a pressure delivery mechanism configured to augment respiratory function of a patient by applying a positive exterior pressure to at least an uncovered portion of a frontal torso area of the patient without contacting the uncovered torso area portion and without sealing the portion from ambient, said pressure delivery mechanism including a plurality of gas outlets that are configured to be positioned at an operating distance of less than about 1 centimeter from the patient'"'"'s uncovered frontal torso area portion to apply pulses of pressurized gas at a frequency of about 3 to 10 Hz, to augment respiratory function of the patient; a control system to regulate the output of said plurality of gas outlets and configured to apply the pressurized gas to different areas of the torso area of the patient at different times, said control system being operatively connected to said pressure delivery mechanism to control the pressure delivery mechanism based upon a selected respiratory function of the patient, and configured to control the delivery of a gas supplied to the patient'"'"'s airway from a gas supply, in coordination with operation of said pressure delivery mechanism. - View Dependent Claims (52, 53)
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54. A method of assisting respiration, said method comprising the steps of:
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positioning a portion of a patient'"'"'s torso in an environment open to ambient pressure and proximate to a plurality of gas outlets of a positive pressure device, wherein said plurality of gas outlets are configured for applying a positive pressure to the torso portion of the patient by applying pressurized gas directly to said torso portion; applying positive pressure to the portion of the torso area of the patient via the positive pressure device by applying pressurized gas directly to said torso portion during at least an exhalation phase and during a time in which the portion of the patient'"'"'s torso area is substantially exposed to the ambient pressure, to assist respiration of the patient; delivering a gas to the patient'"'"'s airway via a gas supply device; and controlling the application of positive pressure to the torso area via the positive pressure device and the delivery of gas to the patient'"'"'s airway via the gas supply device in coordination to augment the patient'"'"'s respiratory function; wherein the pressure of gas delivered to the patient'"'"'s airway is controlled to provide from 5 to 8 cm H2O of pressure in a first state corresponding to an inhalation phase and from 2 to 5 cm H2O of pressure in a second state corresponding to an exhalation phase, and the positive pressure applied to the patient'"'"'s torso area is controlled to deliver a mean pressure of from 2 to 5 cm H2O at a frequency of from 3 to 10 Hz and amplitude +/−
20 cm H2O in the first state and a mean pressure of from 5 to 8 cm H2O at a frequency of 3 to 10 Hz and amplitude +/−
20 cm H2O in the second state.
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55. An apparatus comprising:
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a pressure delivery mechanism configured to augment respiratory function of a patient by applying a positive exterior pressure to at least a portion of a torso area of the patient by blowing gas directly against the torso area without sealing the torso area portion which is contacted by the gas from ambient pressure; a gas supply mechanism configured to control a gas flow and concentration to the patient'"'"'s airway; a control system operatively connected to said pressure delivery mechanism to control the pressure delivery mechanism based upon a selected respiratory function of the patient, wherein the control system is configured to regulate the positive exterior pressure provided by said pressure delivery mechanism and the gas flow and concentration to the patient'"'"'s airway provided by said gas supply mechanism; and
wherein said control system is operable to regulate said gas supply mechanism to provide from 5 to 8 cm H2O of pressure in a first state corresponding to an inhalation phase and from to 5 cm H2O of pressure in a second state corresponding to an exhalation phase, and to control said pressure delivery mechanism to deliver a mean pressure of from 2 to 5 cm H2O at a frequency of from 3 to 10 Hz and amplitude +/−
20 cm H2O in the first state and a mean pressure of from 5 to 8 cm H2O at a frequency of 3 to 10 Hz and amplitude +/−
20 cm H2O in the second state.
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56. A method of assisting respiration, said method comprising the steps of:
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positioning an uncovered portion of a patient'"'"'s frontal torso in an environment open to the ambient and within an operating distance of less than about 1 centimeter from a plurality of gas outlets of a positive pressure device without the gas outlets contacting the uncovered torso portion; and applying positive pressure to the uncovered torso portion of the patient via the positive pressure device by applying pressurized gas from the plurality of gas outlets directly to and in contact with said uncovered torso portion in pulses at a frequency of about 3 to 10 Hz during at least an exhalation phase and during a time in which the uncovered torso portion is substantially exposed to the ambient, to assist respiration of the patient; and
delivering gas to the patient'"'"'s airway via a gas supply device.
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Specification