EP1019129A1 - Respirateur portable - Google Patents
Respirateur portableInfo
- Publication number
- EP1019129A1 EP1019129A1 EP98944188A EP98944188A EP1019129A1 EP 1019129 A1 EP1019129 A1 EP 1019129A1 EP 98944188 A EP98944188 A EP 98944188A EP 98944188 A EP98944188 A EP 98944188A EP 1019129 A1 EP1019129 A1 EP 1019129A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- pressure
- select
- diversion
- valve
- conduit
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/20—Valves specially adapted to medical respiratory devices
- A61M16/201—Controlled valves
- A61M16/206—Capsule valves, e.g. mushroom, membrane valves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0057—Pumps therefor
- A61M16/0066—Blowers or centrifugal pumps
- A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
- A61M16/022—Control means therefor
- A61M16/024—Control means therefor including calculation means, e.g. using a processor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/20—Valves specially adapted to medical respiratory devices
- A61M16/201—Controlled valves
- A61M16/202—Controlled valves electrically actuated
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0057—Pumps therefor
- A61M16/0066—Blowers or centrifugal pumps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/105—Filters
- A61M16/106—Filters in a path
- A61M16/107—Filters in a path in the inspiratory path
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
- A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
- A61M2016/0021—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with a proportional output signal, e.g. from a thermistor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2202/00—Special media to be introduced, removed or treated
- A61M2202/02—Gases
- A61M2202/0208—Oxygen
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2202/00—Special media to be introduced, removed or treated
- A61M2202/03—Gases in liquid phase, e.g. cryogenic liquids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/82—Internal energy supply devices
- A61M2205/8206—Internal energy supply devices battery-operated
Definitions
- the present invention is directed toward relieving dyspnea and improving exercise tolerance in patients subject to respiratory distress, and more particulariy toward a method and apparatus for relieving dyspnea and improving exercise tolerance in ambulatory patients subject to respiraiory distress.
- COPD Chronic Obstructive Pulmonary Disease
- exercise we mean activities beyond the resting state, e.g., the act of walking sho ⁇ distances.
- the dyspnea and the fear of a spell of dyspnea creates great anxiety in such patients and can severely limit their ability to perform even the most simple tasks such as walking to the end of the driveway to pick up a newspaper.
- Such relief will allow greater mobility for such patients so that they can perform more functions on their own, thereby enhancing the patient's quality of life while reducing dependence on costly outside assistance.
- bronchodilators One method of treating dyspnea is application of medication such as bronchodilators. While in some instances such medications can be effective for a given patient, they do not provide immediate relief from the dyspnea and sometimes do little to improve exercise tolerance. Thus, a patient who is out for a walk may be forced to endure the dyspnea for a considerable period of time before experiencing any relief. The resultant anxiety such a patient suffers while being extremely short of breath can exasperate the dyspnea causing the patient to become disoriented and unstable, subjecting the patient to potential serious injury. Moreover, a given bronchodilator may not be effective for a given patient.
- Another method for treating dyspnea and improving exercise tolerance is providing supplementary oxygen from either a gaseous or liquid oxygen supply.
- This method attempts to relieve the patient by enriching the oxygen content of the limited amount of air the patient is able to breathe while subject to COPD.
- supplemental oxygen in such instances does little to treat or prevent dyspnea. but merely tries to ensure the patent will get a sufficient supply of oxygen in their blood stream.
- These oxygen supplementing devices also suffer other serious problems.
- Gas delivery devices are inherently bulky and heavy by virtue of the compressed gas having to be contained in a sufficiently thick wailed cylinder. Liquid delivery systems do not afford the patient the capability of refilling the liquid oxygen without access to a liquid base station. Moreover, both systems require constant replenishment, making the systems both inconvenient and expensive.
- CPAP Continuous Positive Airway Pressure
- OPD Obstructive Sleep Apnea
- One example of a device capable of providing CPAP which may be beneficial for treating dyspnea for a non-ambulatory patient is described in Rapoport, U.S. Patent No. Re. 35,339.
- Rapoport U.S. Patent No. Re. 35,339.
- such a device is unsuited for treatment of an ambulatory patient because it is bulky and heavy to carry and does not allow control of pressure by the patient.
- CPAP is also a ventilation mode available on commercial intensive care unit ventilators and is typically used to wean a patient off a ventilator post-operatively.
- Portable ventilators such as the AUTO VENT 2000 and 3000 are available for emergency life support, but require a source of pressurized air from a gaseous supply, and therefore suffer the problems discussed above.
- the LP6 volume ventilator distributed by Aequetron can provide alternative ventilation modes, but cannot provide CPAP.
- the prior art also teaches a variety of portable personal ventilating systems for delivering filtered air to a user in a contaminated environment.
- O'Connor U.S. Patent No. 4,590,951
- O'Connor also teaches supplying the filtered air at a greater pressure during inhalation than exhalation.
- personal ventilators have the advantage of being readily attached to an ambulatory person, these devices are not designed to provide respiratory assist to a patient subject to respiratory distress, such as dyspnea. They typically require both the mouth and nose to be covered and do not address themselves to providing portable CPAP delivery.
- the present invention is directed toward overcoming one or more of the problems discussed above.
- a first aspect of the invention is a method for treating dyspnea and improving exercise tolerance in an ambulatory patient which includes providing a housing defining a form factor having an air inlet and an air outlet, the housing being sufficiently small to be readily mounted to the body of an ambulatory patient.
- a pressure generator is provided in the defined form factor of the housing for drawing ambient air in the air inlet and delivering the air at a seiect pressure greater than ambient pressure to the air outlet.
- the housing is releasably attached to the body of the patient and the pressurized air is conveyed to the patient airway. Pressure is maintained in the airway, sufficiently greater than the pressure in the airway when the patient is breathing under ambient conditions, to relieve the dyspnea and improve the exercise tolerance of the ambulatory patient.
- An adjustable control may be provided for varying the select pressure as necessary to prevent the occurrence of dyspnea while ⁇ nimizing patient discomfort.
- the air may be filtered before it reaches the air outlet to provide a clean air supply to the patienL thereby minimizing the risk of introducing irritants to normal respiration.
- the method described above may further include the provision of supplemental oxygen to yield a selected elevated concentration of oxygen in the patient gas mixture.
- a second aspect of the present invention is an apparatus for treating dyspnea and improving exercise tolerance in an ambulatory patient
- the apparatus includes a housing defining a form factor having an air inlet and an air outlet, the housing being sufficiently small to be readily mounted to the body of an ambulatory patient.
- a pressure generator is located within the defined form factor of the housing for drawing ambient air into the air inlet and delivering the air at a select pressure greater than ambient pressure to the outlet.
- a strap is provided on the housing for reieasably attaching the housing to a patient.
- a flexible conduit is attached at a proximal end to the air outlet of the housing.
- a connector attached at a distal end of the conduit connects the distal end of the conduit to the patient airway.
- a releasable coupling is provided between the strap and the connector so that the connector can be readily accessed by a patient in need of respiratory assist.
- Another aspect of the invention is an apparatus for treating dyspnea in an ambulatory patient including a housing defining a form factor having an air inlet and an air outlet, the housing being sufficiently small to be readily mounted to the body of an ambulatory patienL
- a pressure generator is provided within the defined form factor of the housing for drawing ambient air into the air inlet and delivering the air at a select pressure greater than ambient pressure to the outlet.
- a strap is provided on the housing for reieasably attaching the housing to a patient.
- a flexible conduit is attached at a proximal end to the air outlet of the housing and a connector is attached at a distal end of the conduit for connecting the distal end of the conduit to the patient airway.
- a regulator is provided within the form factor in communication with an oxygen supply to provide for delivery of an air oxygen mixture to the outlet at a select elevated level of oxygen concentration.
- Yet another aspect of the present invention is an apparatus for delivering pressurized gas to the airway of a patient who is breathing in repeated breathing cycies. each cycle including an inspiration and exhalation phase.
- the apparatus includes a generator of a flow of gas.
- a conduit conveys the flow of gas to the airway of a patien t .
- An exhalation vent is provided in fluid communication with the conduit in operative association with the patient airway for passing exhaled gas to the atmosphere.
- a pressure sensor is in fluid communication with the conduit and the presstire sensor outputs a signal indicative of the pressure in the conduit.
- a diversion vent has an iniet in fluid communication with the conduit and an outlet to the atmosphere.
- a diversion valve in fluid communication with the diversion vent selectively permits and prevents a portion of the flow of gas to flow through the diversion venL
- a first threshold valve is operatively associated with the diversion vent for permitting outlet of a portion of the flow of gas to the atmosphere when the pressure in the diversion vent is above a select diversion vent pressure.
- a controller receives the signal from the pressure sensor and is operatively associated with the diversion valve. The controller actuates the valve to permit gas to flow through the diversion vent when the signal indicates a first select rate of increase in pressure and actuates the valve to prevent flow through the diversion vent when the signal indicates a second select rate of decrease in pressure.
- the apparatus may also include a second threshold valve in fluid communication with the conduit to maintain a constant pressure in the conduit.
- the second threshold valve permits outlet of a portion of the flow of gas to the atmosphere when the pressure in the conduit is above a select conduit pressure.
- a control may be associated with the generator for causing the generator to generate a substantially constant flow rate of gas.
- the controller is alternatively made to actuate the diversion valve open after some select period after the controller actuates the diversion valve closed. As a f rther aspect of the invention, the controller alternatively actuates the diversion valve open for an expiration phase period and actuates the diversion valve closed for an inspiration phase period to provide a breathing cycle for the patient.
- the method of treating dyspnea and improving exercise tolerance in an ambulatory patient provides virtually instantaneous relief from the distressful and harmful effects of dyspnea.
- the method may by administered wherever the patient might be because the respiratory assistance device is readily transpo ⁇ able by an ambulatory patient. Because the method further provides for the introduction of air to a patient at enhanced oxygen concentrations, even where the dyspnea is too severe to be treated effectively by the method, enriched oxygen air is delivered to the patient to ensure adequate supply of oxygen in the patient's limited breaths.
- the apparatus for treating dyspnea is compact, lightweight and readily carried by even an infirm ambulatory patienL
- the patient connector is readily available to the patient by virtue of the releasable coupling between the strap and the connector.
- the apparatus is battery powered, an ambulatory patient has complete freedom of movement when using the apparatus.
- the apparatus may be used with rechargeable batteries, thereby further decreasing the cost of use and facilitating acceptance in the home care market.
- the apparatus is capable of providing greater pressure to the " lungs during inspiration than during exhalation, so called bi-level positive airway pressure or pressure support ventilation, which minimizes patient discomfort in overcoming the high inspiratory pressure assist during the exhalation period, such as occurs when the CPAP modality is used.
- the apparatus can provide a short burst of elevated pressure gas during the inception of an inspiration phase, so called burst of positive airway pressure or
- the invention provides a method of treating dyspnea and improving exercise tolerance in an ambulatory patient wherein the method comprises:
- the method further comprises in step (b) filtering the air before the air outlet.
- the method further comprises:
- the pressure generator is electrically powered, the method further comprising: (f) providing an electric source electronically coupled to the pressure generator within the housing.
- the airway pressure is maintained at about a first select pressure greater than ambient pressure during inspiration and at about a second select pressure greater than ambient pressure during exhalation, the first select pressure being greater than the second select pressure.
- the first select pressure is maintained at a level providing respiratory assist to the ambulatory patient during at least the inception of inspiration and the second select pressure is maintained at a level which serves to keep the alveoli from collapsing prior to the inception of inspiration.
- the first select pressure is maintained for only a portion of inspiration at the inception of inspiration.
- the invention provides apparatus for treating dyspnea and improving exercise tolerance in an ambulatory patient
- the apparatus comprises: a housing defining a form factor having an air inlet and an air outlet, the housing being sufficiently small to be readily mounted to the body of an ambulatory patient; a pressure generator within the defined form factor of the housing for drawing ambient air into the air inlet and delivering the air at a select pressure greater than ambient pressure to the outlet; a strap on the housing for reieasably attaching the housing to the patient; a flexible conduit attached at a proximal end to the air outlet of the housing; a connector attached at a distal end of the conduit for connecting the distal end of the conduit to an airway of the patient; and a releasable coupling between the strap and the connector.
- the pressure generator is electrically powered.
- the apparatus further comprises an electric source within the housing electronically coupled to the pressure generator.
- the apparatus further comprises a means for introducing oxygen between the air inlet and the air outlet to deliver air to the outlet at a select elevated concentration of oxygen.
- the connector is a nose piece.
- the connector is a mouth piece.
- the connector is a face mask.
- the connector is a tracheostomy fitting.
- the apparatus further comprises a means for varying the select pressure delivered to the outlet.
- the apparatus provides apparatus for treating dyspnea and improving exercise tolerance in an ambulatory patient
- the apparatus comprises: a housing defining a form factor having an air channel with an air inlet and an air outlet, the housing being sufficiently small to be readily mounted to the body of an ambulatory patient; a pressure generator within the defined form factor of the housing for drawing ambient air into the air inlet and delivering the air at a select pressure greater than ambient pressure to the outlet; a strap on the housing for reieasably attaching the housing to the patient; a flexible conduit attached at a proximal end to the air outlet of the housing; a connector attached at a distal end of the conduit for connecting the distal end of the conduit to an airway of the patient; an oxygen regulator in fluid communication with the air channel within the form factor; a means for connecting the oxygen regulator to a supplemental oxygen supply; and a means coupled to the regulator for controlling the regulator to introduce supplemental oxygen in the air channel to provide a select elevated concentration of oxygen at the air outlet.
- the invention provides apparatus for delivering pressurized gas to the airway of a patient who is breathing in repeated breathing cycles each including an inspiration and an exhalation phase
- the apparatus comprises: a generator of a flow of gas; a conduit for conveying the flow of gas to the airway of the patient at a first select pressure; an exhalation port in fluid communication with the conduit in operative association with the patient airway for passing exhaled gas to the atmosphere; a pressure sensor in fluid communication with the conduit, the pressure sensor outputting a signal indicative of the pressure in the conduit; a diversion vent having an inlet in fluid communication with the conduit; a diversion valve in fluid communication with the diversion vent for selectively permitting and preventing a portion of the flow of gas to flow through the diversion vent; a first threshold valve operatively associated with the diversion vent for permitting outlet of gas to the atmosphere when the pressure in the diversion vent is above a second select pressure; and a control means receiving the signal from the pressure sensor and operatively associated with the diversion valve, the control means actuating the valve
- the apparatus further comprises a means associated with the generator for causing the generator to generate a substantially constant flow rate of gas .
- the apparatus further comprises a second threshold valve in fluid communication with the conduit, the second threshold valve permitting outlet of gas to the atmosphere when the pressure in the conduit is above the first select pressure.
- the generator comprises: an electric motor; a blower driven by the electric motor, an electric source coupled to the motor; a means for producing a blower signal indicative of the blower output; and a controller receiving the blower signal, the controller being coupled to the electric source to increase or decrease current or voltage to the motor as required to maintain a substantially constant rate of air flow output of the blower.
- the apparatus further comprises a means operatively associated with the second threshold valve for varying the first select pressure.
- the apparatus further comprises a means operatively associated with the first threshold valve for varying the second select pressure.
- the control means will actuate the valve to permit gas flow through the diversion vent only if the increase in pressure at the first select rate is detected after the pressure sensor has indicated pressure at the first select pressure for longer than a select period.
- the select period is about 200-300 milliseconds .
- control means will actuate the valve to prevent gas flow through the diversion vent only if the decrease in pressure of the second select rate is detected after the pressure sensor has indicated pressure at the second select pressure for longer than a second select period.
- the select period is about 200-300 milliseconds .
- the invention also provides apparatus for delivering pressurized gas to the airway of a patient who is breathing in repeated breathing cycles each including an inspiration and an exhalation phase
- the apparatus comprises: a generator of a flow of gas; a conduit for conveying the flow of gas to the airway of the patient at a first select pressure; an exhalation port in fluid communication with the conduit in operative association with the patient airway for passing exhaled gas to the atmosphere; a pressure sensor in fluid communication with the conduit, the pressure sensor outputting a signal indicative of the pressure in the conduit; a diversion vent having an inlet in fluid communication with the conduit; a diversion valve in fluid communication with the diversion vent for selectively permitting and preventing a portion of the flow of gas to flow through the diversion vent; a first threshold valve operatively associated with the diversion vent for permitting outlet of gas to the atmosphere when the pressure in the diversion vent is above a second select pressure; and a control means receiving the signal from the pressure sensor and operatively associated with the diversion valve, the control means actuating the
- the apparatus further comprises a second threshold valve in fluid communication with the conduit, the second threshold valve permitting outlet of gas to the atmosphere when the pressure in the conduit upstream of the second threshold valve is above the first select pressure.
- the apparatus further comprises a means associated with the generator for causing the generator to generate a substantially constant flow rate of gas.
- the apparatus further comprises a means operatively associated with second threshold valve for varying the first select pressure.
- the apparatus further comprises a means operatively associated with the first threshold valve for varying the second select pressure.
- the invention also provides a kit for modifying a respiratory assist device from a continuous airway pressure (CPAP) to a bi-level pressure support assist device, the respiratory assist device comprising a generator of a substantially consistent first select pressure flow of gas and a conduit for delivering the flow gas to the airway of a patient, wherein the kit comprises: a diversion vent having an inlet adapted for connection in fluid communication with the conduit of the respiratory assist device; a pressure sensor in fluid communication with the diversion vent, the pressure sensor outputting a signal indicative of the pressure in the diversion vent; a diversion valve in fluid communication with the diversion vent downstream of the pressure sensor for selectively permitting and preventing flow of gas through the diversion vent; a first threshold valve operatively associated with the diversion vent for permitting flow of gas to the atmosphere when the pressure in the diversion vent is above a second select pressure; and a control means receiving the signal from the pressure sensor and operatively associated with the diversion valve, the control means actuating the valve to permit gas flow through the diversion vent when the signal indicates
- the invention also provides a kit comprising a second threshold valve having an inlet adapted for connection in fluid communication with the conduit of the respiratory assist device upstream from the diversion vent, the second threshold valve permitting outlet of gas to the atmosphere when the pressure in the conduit is above the first select pressure.
- the invention also provides a kit for modifying a respiratory assist device from a continuous positive airway pressure (CPAP) to a bi-level pressure support assist device, the respiratory assist device comprising a generator of a substantially consistent first select pressure flow of gas and a conduit for delivering the flow gas to the airway of a patient, wherein the kit comprises : a diversion vent having an inlet adapted for connection in fluid communication with the conduit of the respiratory assist device; a pressure sensor in fluid communication with the diversion vent, the pressure sensor outputting a signal indicative of the pressure in the diversion vent; a diversion valve in fluid communication with the diversion vent downstream of the pressure sensor for selectively permitting and preventing flow of gas to flow through the diversion vent; a first threshold valve operatively associated with the diversion vent for permitting flow of gas to the atmosphere when the pressure in the diversion vent is above a second select pressure; and a control means receiving the signal from the pressure sensor and operatively associated with the diversion valve, the control means actuating the valve to prevent flow through the diversion vent when
- the invention also provides a kit for modifying a respiratory assist device from a continuous positive airway pressure (CPAP) to a bi-level pressure support assist device, the respiratory assist device comprising a generator of a substantially consistent first select pressure flow of gas and a conduit for delivering the flow gas to the airway of a patient, wherein the kit comprises; a diversion vent having an inlet adapted for connection in fluid communication with the conduit of the respiratory assist device; a pressure sensor in fluid communication with the diversion vent, the pressure sensor outputting a signal indicative of the pressure in the diversion vent; a diversion valve in fluid communication with the diversion vent downstream of the pressure sensor for selectively permitting and preventing a portion of the flow of gas to flow through the diversion vent; a first threshold valve operatively associated with the diversion vent for permitting flow of gas to the atmosphere when the pressure in the diversion vent is above a second select pressure; and a control means receiving the signal from the pressure sensor and operatively associated with the diversion valve, the control means actuating the valve to permit gas flow through
- the invention provides apparatus for delivering pressurized gas to the airway of a patient who is breathing in repeated breathing cycles, each including an inspiration and an exhalation phase
- the apparatus comprises: a generator of a flow of gas; a conduit for conveying the flow of gas to the airway of the patient at a first select pressure; an exhalation port in fluid communication with the conduit in operative association with the patient airway for passing exhaled gas to the atmosphere; a pressure sensor in fluid communication with the conduit, the pressure sensor outputting a signal indicative of the pressure in the conduit; a diversion vent having an inlet in fluid communication with the conduit; a diversion valve in fluid communication with the diversion vent for selectively permitting and preventing flow of gas through the diversion vent; a first threshold valve operatively associated with the diversion vent for permitting outlet of gas to the atmosphere when the pressure in the diversion vent is above a second select pressure; and a control means receiving the signal from the pressure sensor and operatively associated with the diversion valve, the control means actuating the valve to permit gas flow
- Fig. 1 is a perspective view of an apparatus for treating dyspnea in an ambulatory patient in accordance with the present invention
- Fig. 2 is a perspective view of the apparatus of Fig. 1 worn on the side of a patient in a ready position
- Fig. 3 is a perspective view of the apparatus of Fig. 1 wom on the side of a patient in use:
- Fig. 4 is a perspective view of the apparatus of Fig. 1 illustrated on t he back of a patient;
- Fig. 5 is a functional biock diagram of the components of the appara t us of Fig. 1;
- Fig. 6 is a functional block diagram of the control circuit of Fig. 5;
- Fig.7 is a schematic representation of the apparatus for relieving dyspnea in an ambulatory patient of Fig. 1;
- Fig. 8 is an alternate embodiment of Fig. 7 including a schematic illustration of an apparatus for enabling air to be provided to the patient at different pressures;
- Fig. 9 is an alternate embodiment of the apparatus of Fig. 8.
- Fig. 10 is a graph of bi-level pressure versus time generated during a breathing cycle, with P hlsh being the inspiration pressure level and P, ow being the exhalation pressure level.
- the portable respirator or apparatus/ tor relieving dyspnea in an ambulatory patient is illustrated in perspective view in Fig. 1.
- the apparatus consists of a housing 12 which defines an internal form factor.
- the housing 12 is sufficiently small to be readily worn by a patient as illustrated in Figs.2-4.
- a dual element mounting strap 14 is attached to the housing so that the housing may be mounted to a patient.
- Air flow from the air outlet 20 is passed through a flexible conduit 22 to a mouth piece 24, which can be any suitable patient connector.
- a mouth piece 24 can be any suitable patient connector.
- Other patient connectors which may be used in lieu of a mouth piece include a mask, a nose piece, a nasal cannula, an endotracheal rube, a tracheostomy fitting or any other suitable appliance for interfacing between a source of breathing gas and the airway of the patient consisten t wi t h t he intended purpose of the apparatus 10.
- the mouth piece 24 includes a suitable exhaust port, indica t ed schematically at 26.
- the exhaust port exhausts breathing gases during expiration and is preferably configured to allow build up of suitable pressure to provide the desired respiratory assist described in greater detail beiow.
- Such exhaust ports are known in t he art and the choice and location of the precise exhaust port to be used with this invention is considered to be a matter of design choice.
- a reieasable coupling 28 is located between the strap 14 and proximate to the distal end of a flexible conduit 22. As illustrated in Fig. 1 , the reieasable coupling comprises a tab 30 affixed to the mouth piece 24. Alternatively, the tab 30 may be located on the conduit 22 proximate the mouth piece 24.
- the reieasable coupling 28 also includes a receptor 32 mounted on the strap 14 into which the tab 30 can be slidably engaged. Other reieasable couplings such as a VELCRO loop and hook fastener may also be suitable.
- the housing 12 also includes on its exterior surface a pressure control switch 34, an indicator light 36 and an oxygen concentration control panel 38.
- the housing 12 may be mounted either to the side of patient or to a patient's back using the mounting strap 14.
- the reieasable coupling 28 is located on the strap 14 on the patient' s chest such that the mouth piece 24 is conveniently and readily accessible by a patient 39.
- Air is driven between the air inlet 18 and the air outlet 20 through an air flow channel 40 by a blower 41 consisting of a DC electric motor 42 and an impeller 44.
- a filter 46 is snap fit to the housing 12 so that particulates are removed as air indicated by the arrows 48 enters the inlet 18.
- the motor 42 is coupled to a control circuit 50 at 51.
- the control circuit 50 processes inputs from the pressure control 34, sensors associated with the motor and the control panel 38 to maintain operation of the apparatus 10.
- a DC power source or battery 52 is also contained within the housing 12.
- the battery is coupled at 53 to the control circuit 50 which in turn delivers electric energy under pulse with modulation, to the DC electric motor 42 via the coupling 51.
- a regulator 56 has an inlet 57 and an outlet 58, the outlet 58 being in fluid communication with the airflow channel 40 between the inlet 18 and the outlet 20 of the housing 12. As shown, the regulator outlet 58 is upstream from the impeller 44. The regulator outlet could alternatively bleed into the airflow channel upstream from the impeller 44.
- the regulator 56 is electrically coupled to the control circuit 50 at 59 so that • operation of the regulator 56 may be controlled by the control circuit 50.
- the inlet 57 may be connected in fluid communication with a remote oxygen supply 60. With the inlet 57 connected to the oxygen supply 60, supplemental oxygen may be provided in a select concentration ranging from 21% to near 100%.
- the control circuit 50 is shown in greater detail in the functional block diagram of Fig. 6.
- the control circuit 50 includes a power stage 70 for delivering three phase power to the windings of the motor 42 through the electrical conduit 72.
- a current detector 74 is in electrical communication with the conduit 72 and delivers a signal indicative of the current in the conduit 72 to the control stage via the connection 76.
- a Hall sensor 78 is coupled at 80 to the output shaft 82 of the motor 42 and sends a signal via the connection 84 to the control stage 88, which may be a microprocessor.
- the control stage 88 contains logical circuitry or is programmed to receive inputs from the current detector 74 and the Hail sensor 78 along with the pressure control 34 which enables it to control the voltage delivered to the power stage 70 by connection 90 so that air is delivered to the outlet 20 at a select pressure.
- the control stage 88 also includes logical circuitry for controlling to what extent oxygen is introduced by the regulator 56 through the outlet 58 into the air flow channel 40 between the inlet 18 and the outlet 20.
- the control stage 88 further monitors the power output of the battery 52 and displays an indication of the battery level by the indicator light 36.
- the indicator light 36 preferably includes a number of illuminated panels. As power is consumed, the lights serially turn off to apprize the user of the approximate power remaining in the battery.
- an indicator alerts the patient.
- the indicator could be an audible or visible alarm.
- a patient prone to dyspnea or requiring improved exercise tolerance mounts the housing 12 to his body using die strap 14 in either manner illustrated in Figs. 2-4.
- the configuration illustrated in Figs. 2 and 3 is preferred because of ease of access to the controls on the housing.
- the mouth piece is thus conveniently located on die user's chest. Should the user begin experiencing breathlessness, the mouth piece can be readily brought into operative engagement in the mouth of the user and the pressure control 34 can be turned on to begin delivering pressurized air to the outlet 20 and the patient's airway.
- the delivered air at elevated pressure relieves dyspnea by reducing the patient's work of breathing. This is accomplished by the air at elevated pressure keeping open alveoli which otherwise collapse, such as happens in emphysema. In this manner, the patient receives air as soon as the breath effort is initiated.
- the patient uses the pressure control
- Fig. 7 illustrates schematically the flow of air in the apparatus /for relieving dyspnea •
- Air is conveyed from the air outlet 20 of the housing 12 through the flexible conduit 22 to patient mouth piece 24.
- the mouth piece 24 has an exhaust port 26.
- pressurized air flows to the mouth piece.
- the air is maintained at a substantially constant pressure by keeping the gas flow rate substantially constant by controlling blower output and venting die gas flow through the exhaust port 26.
- the blower output is kept substantially constant by monitoring the rate of rotation of the output shaft of the motor and adjustment of the current or supplied to the motor to keep the rate of rotation of the output shaft substantially constant (see discussion above).
- the apparatus is configured to provide air at between 0-15 cm H,0 above ambient air pressure, as selected by the patient.
- Fig. 8 illustrates schematically an alternate embodiment of the appara t us for relieving dyspnea in an ambulatory patient 10'.
- the embodiment 10' is an apparatus for providing a flow of air at a first select pressure greater than ambient pressure during inspiration and a second select pressure greater than ambient during exhalation, d e first select pressure being greater than the second select pressure.
- this embodiment includes a blower housing 12' having a conduit 22' connected at the outlet 20' with the conduit 22' terminating at the mouth piece 24'.
- the mouth piece 24' includes an exhaust port 26'.
- the first select pressure is maintained by keeping the blower output substantially constant, as described above with reference to Fig.7.
- the voltage or current to the blower motor may be varied to vary the first select pressure.
- a diversion vent 110 is in fluid communication with the conduit 22'.
- the diversion vent 110 as illustrated consists of a diversion conduit 112 which terminates at a positive end expiratory pressure (“PEEP") valve 114.
- PEEP positive end expiratory pressure
- the PEEP valve functions as a threshold valve which vents air through the outlet 116 when the pressure in the diversion conduit 112 exceeds some select threshold corresponding to the second select pressure.
- the threshold pressure would be slightly above ambient pressure to provide a level of pressure to maintain lung alveoli open to a greater extent than under ambient pressure. Typically this pressure would be about 1-5 cm H ; 0 above ambient pressure.
- the PEEP valve 114 is preferably adjustable to vary the second select pressure.
- One form of a variable PEEP valve is described in Rapoport, U.S. Patent No. 5,065,756.
- a diversion valve 118 is in fluid communication with the diversion vent. The diversion valve selectively permits and prevents a flow of gas through the diversion vent 110 by opening or closing the diversion conduit 112 at the seat 120. More particularly, in the embodiment illustrated in Fig. 8, the diversion valve 118 pneumatically actuates a mushroom valve 122.
- An exhaust port 124 is provided in the pneuma t ic diversion valve 118 to vent the gas used to drive the mushroom valve 122 into abutment with the seat 120.
- the pneumatic diversion valve 118 is in fluid communication through the diversion valve conduit 126 wi t h the conduit 22'.
- a pressure sensor 130 Also in fluid communication with the conduit 22' through a pressure sensor conduit 128 is a pressure sensor 130.
- the pressure sensor 130 is in turn electrically coupled to die controller 132 by connection 134.
- Connection 136 maintains the controller 132 in electric communication with the pneumatic diversion valve 118.
- the embodiment illustrated in Fig. 8 functions as follows.
- the blower 12' provides a flow of gas at a substantially constant rate to the mask 24'.
- the exhaust port 26 allows the pressure in the conduit 22' to then remain substantially constant at the first select pressure.
- the pneumatic diversion valve 118 would be seated so as to prevent flow of air through the diversion conduit 112.
- the pressure in the conduit 22' would increase rapidly, as illustrated in phantom lines in Fig. 10.
- the pressure sensor would detect tiiis rise in pressure and send a signal indicating this rise in pressure to the controller 1 2. If the rate at which pressure rises (i.e. the pressure slope) is greater than a select rate (e.g.
- the controller 132 will then send a signal to the pneumatic diversion valve 118 to actuate, whereby an internal valve cuts off gas flow from die diversion valve conduit 126 and allows the mushroom valve 122 to exhaust the actuating air through the exhaust port 124.
- the controller will only actuate the pneumatic diversion valve if d e positive pressure slope is detected after a select period of time (e.g., 200-300 milliseconds) has elapsed in die inspiratory phase. In other words, pressure has been at P hlgh for 200-300 milliseconds in Fig. 10. In is manner, false positives are minimized.
- the sudden increase in pressure is indicated in the phantom line 150 of Fig.
- the pressurized gas in the diversion conduit 112 will unseat die mushroom valve from the seat 120.
- a spring or the like may also be provided to bias die mushroom valve open.
- the flow of air through die diversion conduit 1 12 to die threshold valve 1 14 will be enabled. If die ⁇ pressure in the diversion conduit 112 exceeds the tlireshold pressure of the threshold valve, excess gas will be vented to die atmosphere through the exhaust outiet 1 16.
- the threshold valve 114 is designed to prevent flow of air at a pressure above ambient pressure but considerably below the pressure in die conduit 22' when die mushroom valve 122 is seated (i.e.. the second select pressure).
- the pressure in the diversion conduit 112 as well as the conduit 22' decreases and die amount of the air delivered to d e patient tiirough the mask 24' diminishes significantly, easing the opposition to die patient exhaling.
- the pressure in the conduit 22' will spike downward due to patient triggering as indicated in at 154 Fig. 10.
- die rate at which the pressure drops i.e., die pressure slope
- a select rate (again, about 10 cm H : 0/sec)
- the controller 132 will determine that inspiration has begun and a signal will be sent to die pneumatic diversion valve 118 causing actuation of vaiving within the pneumatic diversion valve 118 which causes flow of air through the diversion valve conduit 126 to actuate and extend the mushroom valve 122 into contact with the seat 120. Simultaneously, of course, flow through the exhaust port 124 is prevented.
- the conduit 22' therefore quickly repressurizes to the initial (i.e., first select pressure or P hlgh ) pressure thereby enhancing the respiratory assist available to the patient during inspiration.
- die controller will only actuate the pneumatic diversion valve if the drop in pressure occurs after exhalation has been maintained for a select period (e.g., 200-300 milliseconds) to mimmize false positives.
- a select period e.g. 200-300 milliseconds
- the exhalation phase would correspond to P low .
- the controller will actuate the pneumatic valve open if at the end of inspiration die pressure rises some seiect amount over the first select pressure, typically 2 cm H ; O.
- the controller will actuate the pneumatic valve closed when the pressure drops some select amount (e.g.. 2 cm H,O) below die second select pressure.
- a phantom line 139 in Fig. 8 represents schematically that die enclosed elements could be part of a kit for installation in fluid communication widi d e conduit 22 * .
- the phantom line represents a housing for the kit.
- a diversion vent 1 10 is connected in fluid communication with die conduit 22' by a suitable connector be t ween die diversion conduit 112 and die conduit 22'.
- Fig. 9 illustrates a modification of die embodiment 10' illustrated in Fig. 8. This modification provides a threshold or PEEP valve 140 in fluid commumcation witii the conduit 22' upstream from the pressure sensor 130 and the diversion vent 110.
- the threshold valve 1 0 is configured to vent dirough the outiet 142 any airflow from d e blowerl2' in excess of that required to maintain pressure in die conduit 22' at a select pressure, that is, the first select or inspiratory pressure.
- the advantage of using the direshold valve 140 is tiiat it is no longer necessary to maintain die output of the blower 12' substantially constant in order to maintain a constant pressure in die conduit 22'. All tiiat is required is tiiat d e blower maintain sufficient excess airflow to the outlet 20' so that airflow in excess of that necessary to maintain die select pressure in the conduit 22' can be vented through die outlet 142.
- the threshold valve 140 therefore affords a more precise and lower cost apparatus to maintain a constant pressure in the conduit 22' than tiiat afforded by monitoring of die blower output described above with reference to Fig.
- die threshold valve 140 is preferably adjustable to vary die first select pressure. This configuration is otherwise identical to tiiat described above with regard to Fig. 8.
- a phantom line 143 in Fig. 9 represents schematically that die enclosed elements could be part of a kit for installation in fluid communication with the conduit
- the phantom line 143 represents a housing for die kit.
- the threshold vaive 140 and is connected in fluid communication with d e conduit 22' and downstream of the threshold valve 140 and is in fluid communication with botii the conduit 22' and the diversion vent 110, as illustrated. A fluid tight seal is maintained by a suitable connector.
- Botii die embodiments illustrated in Figs.8 and 9 include a pneumatically actuated diversion vaive 118.
- otiier valve structures are suitable for functioning as the diversion vaive 118.
- die mushroom valve 122 could be actuated by conventional electric solenoid, diereby eliminating die need for diversion vaive conduit valve 126 and die exhaust port 124 of the pneumatically actuated diversion valve.
- the diversion valve 118 is actuated by detection in a change of the slope of die pressure curve 150 within the conduit 22', as illustrated in Fig. 10.
- die diaphragm plays its most important role in the early phases of inspiration, whereas the chest wall muscles perform most of the work during die rest of the inspiration cycle.
- a more palliative mode of treatment employs the higher respiratory assist pressure only for a small portion of the inspiration phase necessary to relieve work of the diaphragm, and hence relieve dyspnea resulting from diaphragmatic fatigue, while diminishing the pressure in die conduit 22' to only slightiy greater than ambient during he remainder of die inspiration phase where the chest muscles are assisting in breathing and during die exhalation phase.
- the controller would actuate die diversion valve 118' closed for only a select assist period upon detecting the start of die inspiration phase of a breathing cycle. While this period may vary from patient to patient, it is typically in the range of 0-300 milliseconds.
- the controller would therefore be programmed not to actuate the valve open at die detection of the beginning of an exhalation phase of a breathing cycle, but at die end of die select period.
- the configuration 10' could also be used for pressure control ventilation in a patient incapable of spontaneous breathing.
- die controller 132 would alternately actuate die diversion valve to prevent gas flow through the diversion valve for a first select period of time and actuate the diversion valve to prevent gas flow dirough die diversion valve for a second select period of time, the first and second select periods of times corresponding to a desired period of inspiration and a desired period of exhalation of a breathing cycle, respectively. Typically these periods range from 0.2-3 seconds.
- the embodiments discussed above provide a simple pneumatic configuration to enable a generator of a constant gas flow such as a blower 12' to be used to provide differing levels of pressure assist during die inspiration and exhalation phases of a breathing cycle.
- Other sources of gas flow such as compressed gas, could be used as the flow generator.
- the pressure of the gas provided to die patient during exhalation can be reduced significantly from that provided during inspiration to enhance patient comfort and decrease die amount of work a patient must do in order to exhale properly.
- Use of the direshold or PEEP valve 140 in die embodiment illustrated in Fig. 9 eliminates the need for precise controls on the output of the blower 12', which can further serve to reduce die cost of die apparatus while still providing the many advantages discussed above.
- tiiis system can also be programed to provide a burst of air for only a short period following the beginning of inspiration, thereby leaving the patient's chest muscles to complete the inspiration phase.
- controller could also be programed so as to provide pressure control ventilation to a patient unable to breath spontaneously.
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- Health & Medical Sciences (AREA)
- Emergency Medicine (AREA)
- Pulmonology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
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- Respiratory Apparatuses And Protective Means (AREA)
Abstract
L'invention concerne un appareil (10) permettant de traiter la dyspnée et d'améliorer la tolérance à l'effort chez un malade en traitement ambulatoire. Cet appareil comprend un boîtier (12) dont la forme définit une entrée d'air (18) et une sortie d'air (20), le boîtier (12) étant suffisamment petit pour être facilement monté sur le corps d'un malade (39) en traitement ambulatoire; un générateur de pression (41) à l'intérieur de l'espace délimité par le boîtier (12), destiné à aspirer de l'air ambiant dans l'entrée d'air (18) et à évacuer l'air à travers la sortie (20) à un niveau de pression sélectionné supérieur à la pression ambiante; une sangle (14) sur le boîtier (12) destinée à fixer de manière libérable le boîtier (12) au malade (39); un conduit flexible (22) fixé au niveau d'une extrémité proximale à une sortie d'air (20) du boîtier (12); un raccord (24) fixé au niveau d'une extrémité distale du conduit (22) permettant de relier l'extrémité distale du conduit (22) aux voies aériennes du malade (39); et un élément de couplage libérable (28) placé entre la sangle (14) et le raccord (24).
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US5926497P | 1997-09-18 | 1997-09-18 | |
US59264P | 1997-09-18 | ||
PCT/IE1998/000079 WO1999013931A1 (fr) | 1997-09-18 | 1998-09-18 | Respirateur portable |
Publications (1)
Publication Number | Publication Date |
---|---|
EP1019129A1 true EP1019129A1 (fr) | 2000-07-19 |
Family
ID=22021870
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP98944188A Withdrawn EP1019129A1 (fr) | 1997-09-18 | 1998-09-18 | Respirateur portable |
Country Status (3)
Country | Link |
---|---|
EP (1) | EP1019129A1 (fr) |
AU (1) | AU9182298A (fr) |
WO (1) | WO1999013931A1 (fr) |
Families Citing this family (21)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN102309807A (zh) | 2003-09-25 | 2012-01-11 | 雷斯梅德有限公司 | 呼吸机面罩及其*** |
WO2008028247A1 (fr) | 2006-09-07 | 2008-03-13 | Resmed Ltd | Masque et système générateur de flux |
US20080216831A1 (en) * | 2007-03-08 | 2008-09-11 | Mcginnis William J | Standalone cpap device and method of using |
EP3736005B1 (fr) | 2008-01-31 | 2024-02-28 | ResMed Pty Ltd | Appareil respiratoire |
US10252020B2 (en) | 2008-10-01 | 2019-04-09 | Breathe Technologies, Inc. | Ventilator with biofeedback monitoring and control for improving patient activity and health |
WO2010080709A1 (fr) | 2009-01-08 | 2010-07-15 | Hancock Medical | Systèmes de pression des voies respiratoires positifs intermittents et autonomes, et méthodes de traitement de l'apnée du sommeil, du ronflement et d'autres troubles respiratoires |
US10238822B2 (en) | 2009-05-29 | 2019-03-26 | Resmed Limited | PAP system |
EP3388101A1 (fr) | 2009-08-28 | 2018-10-17 | Resmed Limited | Système pap |
CN104314843B (zh) | 2009-11-19 | 2018-07-24 | 瑞思迈发动机及马达技术股份有限公司 | 鼓风机 |
US8336546B2 (en) | 2011-02-08 | 2012-12-25 | Hancock Medical, Inc. | Positive airway pressure system with head control |
CA3035508A1 (fr) | 2011-07-13 | 2013-01-17 | Fisher & Paykel Healthcare Limited | Ensemble rotor et moteur |
US20150136129A1 (en) * | 2012-05-30 | 2015-05-21 | Koninklijke Philips N.V. | Portable handheld blending gas enriched pressure support system and method |
DE212013000256U1 (de) | 2012-12-18 | 2015-07-22 | Fisher & Paykel Healthcare Ltd. | Impeller und Rotor Baugruppe |
WO2014117179A1 (fr) | 2013-01-28 | 2014-07-31 | Hancock Medical, Inc. | Dispositifs et procédés de commande de position destinés à être utilisés avec des systèmes de pression de voie aérienne positive |
US10881829B2 (en) | 2014-08-18 | 2021-01-05 | Resmed Inc. | Portable pap device with humidification |
WO2016075193A1 (fr) * | 2014-11-11 | 2016-05-19 | Breas Medical Ab | Dispositif pour fournir une pression de gaz inspiratoire à un patient |
USD776802S1 (en) | 2015-03-06 | 2017-01-17 | Hancock Medical, Inc. | Positive airway pressure system console |
US11389695B2 (en) | 2015-10-30 | 2022-07-19 | Koninklijke Philips N.V. | Breathing training, monitoring and/or assistance device |
JP7063805B6 (ja) * | 2015-10-30 | 2022-06-06 | コーニンクレッカ フィリップス エヌ ヴェ | 呼吸の訓練、観察及び/又は補助装置 |
WO2017201419A1 (fr) | 2016-05-19 | 2017-11-23 | Hancock Medical, Inc. | Système de détection de l'apnée obstructive positionnelle du sommeil |
AU2018256754B2 (en) | 2017-04-23 | 2024-05-30 | Fisher & Paykel Healthcare Limited | Breathing assistance apparatus |
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US4079735A (en) * | 1977-01-31 | 1978-03-21 | Gaffney John P | Emergency air breathing assembly for divers |
DE3471008D1 (en) | 1983-06-07 | 1988-06-16 | Racal Safety Ltd | Improvements in and relating to breathing apparatus |
US5090408A (en) * | 1985-10-18 | 1992-02-25 | Bryan T. Spofford | Transtracheal catheter system and method |
US4676237A (en) * | 1985-01-29 | 1987-06-30 | Boutade Worldwide Investments Nv | Inhaler device |
US5065756A (en) | 1987-12-22 | 1991-11-19 | New York University | Method and apparatus for the treatment of obstructive sleep apnea |
US4905688A (en) * | 1989-02-16 | 1990-03-06 | Figgie International Inc. | Portable light weight completely self-contained emergency single patient ventilator/resuscitator |
EP1149603A3 (fr) * | 1991-12-20 | 2003-10-22 | Resmed Limited | Respirateur pour la ventilation en pression positive continue (CPAP) |
US5490502A (en) * | 1992-05-07 | 1996-02-13 | New York University | Method and apparatus for optimizing the continuous positive airway pressure for treating obstructive sleep apnea |
-
1998
- 1998-09-18 AU AU91822/98A patent/AU9182298A/en not_active Abandoned
- 1998-09-18 EP EP98944188A patent/EP1019129A1/fr not_active Withdrawn
- 1998-09-18 WO PCT/IE1998/000079 patent/WO1999013931A1/fr not_active Application Discontinuation
Non-Patent Citations (1)
Title |
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See references of WO9913931A1 * |
Also Published As
Publication number | Publication date |
---|---|
WO1999013931A1 (fr) | 1999-03-25 |
AU9182298A (en) | 1999-04-05 |
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