Systems and methods for therapeutic intrathoracic pressure regulation

• US 10,034,991 B2
• Filed: 12/22/2015
• Issued: 07/31/2018
• Est. Priority Date: 12/19/2011
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Homuth, James, Voss, Greg, Lurie, Keith, Metzger, Anja
• Primary Examiner(s): Ho, (Jackie) Tan-Uyen T
• Assistant Examiner(s): Boecker, Joseph D
• Application Number:
  US14/978,412
• Publication Number:
  US 20160114113A1
• Time in Patent Office: 952 Days
• Field of Search: 12820024, 12820418, 12820421, 12820423, 12820513, 12820518
• 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 control assembly comprising a housing having a vent, a gas mover disposed within the housing, wherein the gas mover is one or more of an impeller, a reciprocating pump, a turbine, a venturi, a centrifugal blower, and a roots blower, and a motor in operative association with the gas mover; and

a positive pressure source,

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

wherein the gas mover of the control assembly is disposed between the patient connection mechanism and the positive pressure source, along a fluid passage that extends between the patient connection mechanism and the positive pressure source, and

wherein the control assembly is configured to allow airflow from the positive 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 gas mover is an impeller.

3. The system according to claim 2, wherein the impeller is operatively associated with the motor by way of a magnetic clutch.

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

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

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

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

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

9. The system according to claim 1, wherein the positive pressure source is one or more of a manual bag valve mask mechanism, a mechanical ventilator machine, and an anesthesia machine.

10. The system according to claim 1, wherein interaction of the positive pressure source and the gas mover allows for intermittent airflow from the positive pressure source to an individual'"'"'s lungs.

11. A device for providing intrathoracic pressure regulation to an individual, comprising:

a housing having at least two ports, a first port configured to be in fluid communication with a positive pressure source and a second port configured to be in fluid communication with an individual'"'"'s airway;

a gas mover disposed within the housing and configured to provide negative intrathoracic pressure within the individual by moving air from the individual'"'"'s airway, through the second port, and through the first port, the gas mover positioned such that at least one passage exists between the gas mover and the housing, the passage being in fluid communication with the first port and the second port and allowing retrograde airflow from a positive pressure source, through the first port, through the second port, and to the individual'"'"'s airway, against the movement of air caused by the gas mover; and

a motor in operative association with the gas mover.

12. The device according to claim 11, wherein the gas mover is one of an impeller, a reciprocating pump, a turbine, a venturi, a centrifugal blower, and a roots blower.

13. The device according to claim 11, wherein the gas mover is an impeller.

14. The device according to claim 13, wherein the motor is operatively associated with the impeller by way of a magnetic clutch.

15. The device according to claim 11, wherein the gas mover is configured to move air from the individual'"'"'s airway at a constant rate.

16. The device according to claim 11, wherein the gas mover provides a continuous pressure differential within a range from about 3 cm H₂O to about 16 cm H₂O.

17. The device according to claim 11, wherein the gas mover is configured to move air from the individual'"'"'s airway such that air pressure within the individual'"'"'s airway is −

10 cm H₂O.

18. The device according to claim 11, wherein the positive pressure source with which the first port is in fluid communication is one of a manual bag valve mask mechanism, a mechanical ventilator machine, and an anesthesia machine.

19. 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, a gas mover disposed within the housing, a motor in operative association with the gas mover, and a positive pressure source in fluid communication with the housing vent, wherein the gas mover is disposed between the airway and the positive pressure source, along a fluid passage that extends between the airway and the positive pressure source, and

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

20. The method according to claim 19, wherein the gas mover is one or more of an impeller, a reciprocating pump, a turbine, a venturi, a centrifugal blower, and a roots blower.

21. The method according to claim 19, wherein the gas mover is an impeller.

22. The method according to claim 21, wherein the impeller is operatively associated with the motor by way of a magnetic clutch.

23. The method according to claim 19, comprising producing, with the gas mover, a continuous pressure differential throughout a respiratory cycle of the individual within a range from about 3 cm H₂O to about 16 cm H₂O.

24. The method according to claim 19, comprising providing a respiratory cycle duration of about 5 seconds with the positive pressure source.

25. The method according to claim 19, comprising continuously permitting airflow between the patient connection mechanism and the positive pressure source, without forming a physical barrier that prevents airflow therebetween.

26. The method according to claim 19 comprising maintaining sub-atmospheric pressures within the thorax of the individual throughout a respiratory cycle.

27. The method according to claim 19, further comprising monitoring the individual'"'"'s airway pressure between the gas mover and the individual, and controlling operation of the gas mover based on the monitored pressure.

28. The method according to claim 19, wherein the intrathoracic pressure regulation lowers intrathoracic pressure and increases venous return from the head of the individual, thereby lowering intracranial pressure in the individual.

29. The method according to claim 19, wherein interaction of the positive pressure source and the gas mover allows for intermittent airflow from the positive pressure source to the individual'"'"'s lungs.

30. 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 control assembly comprising a housing having a vent, a gas mover disposed within the housing, wherein the gas mover is one or more of an impeller, a reciprocating pump, a turbine, a venturi, a centrifugal blower, and a roots blower, and a motor in operative association with the gas mover, and

a positive pressure source,

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

wherein the gas mover of the control assembly is disposed between the patient connection mechanism and the positive pressure source, along a fluid passage that extends between the patient connection mechanism and the positive pressure source, and

wherein the control assembly is configured to allow airflow from the positive 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 gas mover.

31. The method according to claim 30, wherein the gas mover is an impeller.

32. The method according to claim 31, wherein the impeller is operatively associated with the motor by way of a magnetic clutch.

33. The method according to claim 30, 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.

34. The method according to claim 30, wherein the positive pressure source is one or more of a manual bag valve mask mechanism, a mechanical ventilator machine, and an anesthesia machine.

35. The method according to claim 30 comprising producing, with the gas mover, a continuous pressure differential within a range from about 3 cm H₂O to about 16 cm H₂O.

36. The method according to claim 30, further comprising monitoring the individual'"'"'s airway pressure between the gas mover and the individual, and controlling operation of the gas mover based on the monitored pressure.

37. The method according to claim 30, wherein interaction of the positive pressure source and the gas mover allows for intermittent airflow from the positive pressure source to the individual'"'"'s lungs.

38. A system comprising:

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

a control assembly comprising a housing having a vent and an impeller disposed within the housing, the impeller being operatively associated with a motor by way of a magnetic clutch;

a ventilator in fluid communication with the housing vent of the control assembly; and

a pressure sensor that monitors the individual'"'"'s airway pressure between the control assembly and the individual, and a controller device that receives information from the pressure sensor and controls operation of the control assembly based on the information,

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

wherein the impeller is disposed within the housing such that a passage is present between the housing and the impeller, the passage being in fluid communication with the ventilator, and

wherein the control assembly is configured to allow airflow from the ventilator to the patient connection mechanism through the passage while simultaneously compelling airflow from the patient connection mechanism to the housing vent.