EP2265239A1 - Appliance for diagnosis, performance and/or regulation of physiological functions, in particular in an anaesthetized patient - Google Patents
Appliance for diagnosis, performance and/or regulation of physiological functions, in particular in an anaesthetized patientInfo
- Publication number
- EP2265239A1 EP2265239A1 EP09732481A EP09732481A EP2265239A1 EP 2265239 A1 EP2265239 A1 EP 2265239A1 EP 09732481 A EP09732481 A EP 09732481A EP 09732481 A EP09732481 A EP 09732481A EP 2265239 A1 EP2265239 A1 EP 2265239A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- pressure
- patient
- temperature
- control device
- control
- 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.)
- Granted
Links
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H9/00—Pneumatic or hydraulic massage
- A61H9/005—Pneumatic massage
- A61H9/0078—Pneumatic massage with intermittent or alternately inflated bladders or cuffs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
- A61H31/02—"Iron-lungs", i.e. involving chest expansion by applying underpressure thereon, whether or not combined with gas breathing means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H9/00—Pneumatic or hydraulic massage
- A61H9/005—Pneumatic massage
- A61H9/0078—Pneumatic massage with intermittent or alternately inflated bladders or cuffs
- A61H9/0092—Cuffs therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/02—Characteristics of apparatus not provided for in the preceding codes heated or cooled
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/02—Characteristics of apparatus not provided for in the preceding codes heated or cooled
- A61H2201/0207—Characteristics of apparatus not provided for in the preceding codes heated or cooled heated
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/02—Characteristics of apparatus not provided for in the preceding codes heated or cooled
- A61H2201/0214—Characteristics of apparatus not provided for in the preceding codes heated or cooled cooled
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/16—Physical interface with patient
- A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
- A61H2201/165—Wearable interfaces
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/50—Control means thereof
- A61H2201/5002—Means for controlling a set of similar massage devices acting in sequence at different locations on a patient
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/50—Control means thereof
- A61H2201/5007—Control means thereof computer controlled
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/50—Control means thereof
- A61H2201/5058—Sensors or detectors
- A61H2201/5082—Temperature sensors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2205/00—Devices for specific parts of the body
- A61H2205/06—Arms
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2205/00—Devices for specific parts of the body
- A61H2205/08—Trunk
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2205/00—Devices for specific parts of the body
- A61H2205/10—Leg
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/04—Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/04—Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
- A61H2230/06—Heartbeat rate
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/08—Other bio-electrical signals
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/20—Blood composition characteristics
- A61H2230/207—Blood composition characteristics partial O2-value
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/25—Blood flowrate, e.g. by Doppler effect
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/30—Blood pressure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/50—Temperature
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/65—Impedance, e.g. skin conductivity; capacitance, e.g. galvanic skin response [GSR]
Definitions
- the invention relates to a device for diagnosis
- Execution and / or regulation of physiological functions in particular a device for regulating the body temperature, the peripheral blood volume, the peripheral blood circulation, for testing the heart function and / or mechanical ventilation, in particular in an anesthetized patient
- the vascular tone is generally reduced, but especially in the low pressure system.
- vasodilation there is a redistribution of the circulating blood volume from intrathoracic to extrathoracic, the venous return and the filling of the heart decrease.
- a compensatory increase in heart rate usually remains, as the counter-regulation by the sympatheticus is inhibited by anesthetics.
- volume usually in the form of crystalloid (eg, Ringer's lactate solution, saline, etc.) or colloidal infusion solutions (eg, hydroxyethyl starch, plasma protein solution, etc.) ).
- crystalloid eg, Ringer's lactate solution, saline, etc.
- colloidal infusion solutions eg, hydroxyethyl starch, plasma protein solution, etc.
- the object of the present invention was therefore to provide a device for the diagnosis, execution and / or regulation of physiological functions which avoid the disadvantages of the prior art.
- the object is achieved by a device for the diagnosis, execution and / or regulation of physiological functions, in particular in an anesthetized patient, comprising a pressure device
- Pressure increasing means (21) and the pressure reducing means (22), the pressure in the pressure device (10) is continuously controllable.
- the effects of anesthesia introduction are at least partially compensated by the device according to the invention. It can be counteracted by the device according to the invention the redistribution of the circulating blood volume by suitable external compression.
- the patient core temperature is thereby preferably also increased Normal values held or deliberately lowered or increased, for example, by continuously exchanged tempered air or tempered liquid is used as the pressure medium.
- the diagnostic device is opened via the device according to the invention to determine whether the heart of the patient would respond to a volume, ie whether it is volume-responsive, which is to determine on which part of the Frank Starling curve, the heart works like .
- a volume ie whether it is volume-responsive, which is to determine on which part of the Frank Starling curve, the heart works like .
- diagnostic compression for example of the extremities or of the lower half of the body, there is an increase in the venous return current and an increase in the preload of the heart, which increases the stroke volume in the volume-responsive heart.
- the indication for the administration of cardiovascular active medication can be made.
- a device for diagnosing, executing and / or regulating physiological functions may, in particular, be a device for regulating body temperature, peripheral blood volume, peripheral blood circulation, cardiac function testing and / or mechanical ventilation.
- a pressure device (10) is a device with which a pressure, in particular an external pressure, can be applied to at least part of the limb of the patient.
- a pressure in particular an external pressure
- the following two options for applying external compression to extremities or parts of the body are preferably conceivable:
- Pressure device (10) can be based either on the principle of the pressure chamber or a compression.
- the external compression can thus be achieved either by a pressure chamber over the extremity or by materials, which envelop the corresponding body parts.
- the pressure device therefore preferably comprises at least one pressure chamber (12) and / or one pressure cuff (11).
- a pressure chamber is preferably an airtight chamber for the controlled increase and decrease of the air pressure. This can be achieved for example by a rigid outer body with airtight sealable cuffs.
- a pressure cuff is a cuff that can be attached to a limb and then cause external compression by increasing or decreasing applied pressure.
- Such a pressure cuff can be designed similar to a piece of clothing and be designed for example as a pressure pants or sleeves or upper part.
- the pressure pants also include the feet, the pressure leg also include the respective foot and the pressure sleeve and the respective hand.
- the printing device extends over at least 20 cm, more preferably over at least 30 cm, most preferably over at least 40 cm of the body part towards the heart.
- prints are used in the printing device, which are well below the arterial pressure.
- the pressure device is therefore preferably designed to apply a pressure of less than the arterial pressure in the corresponding body part.
- the pressure device is therefore preferably designed to apply a pressure of less than 20 mmHg, particularly preferably less than 10 mmHg, above the corresponding venous pressure in the corresponding body part. Thus, the arterial circulation of this body part is not stopped.
- a body region or body part is an area or a part of the body of the patient, for example the upper body.
- a limb or a limb is preferably at least a part of the upper extremity (shoulder girdle, Arm, hand) or lower limb (hip, buttocks, thighs, lower legs, feet).
- shoulder girdle, Arm, hand or lower limb
- hip, buttocks, thighs, lower legs, feet In the foreground are the extremities, if there are no operations on them. In particular, it may also be the free extremities, for example arms or legs.
- the pressure device (10) is preferably designed for at least two extremities. Extremity within the meaning of the present invention also represents a body half, for example, the lower or upper body half.
- the pressure device (10) is designed for at least one arm and / or at least one leg and / or the thorax and / or a body half of the patient.
- the pressure device (10) is particularly preferably designed for at least part of the body (53) (upper body and / or lower abdomen) of the patient (50).
- the pressure increasing means (21) and pressure lowering means (22) are means which can increase or decrease the pressure in the pressure means (10). They represent a type of supply device for the printing device. By changing the pressure in the printing device, the externally applied pressure is changed. This can be done by the use of pumps that promote a suitable medium and thereby change the applied pressure.
- the pressure booster increases the pressure and thus increases the compression.
- the increase may preferably lead to a pressure in the order of the venous blood pressure to the arterial blood pressure in the corresponding body part.
- the pressure increase is 10 to 20 mmHg.
- the pressure used is preferably between the venous and the arterial blood pressure. With a human the mean venous blood pressure in the respective body regions is approximately 0 to 30 mmHg and the mean arterial blood pressure is approximately 60 to 140 mmHg.
- the procedure described above leads to a compression of the extrathoracic venous system primarily in the extremities and possibly in the abdomen.
- the thorax itself can not be used to compress the venous system.
- the applied pressure is lowered, for example in the corresponding chamber between the inside of the chamber and the skin of the patient, wherein in individual structures of the chamber, a greatly increased pressure can be used.
- Chamber inside and skin of the patient be lowered below the atmospheric pressure.
- a suction effect is preferably exerted on the thorax, so that it comes in the expiratory phase to an enlargement of the chest and thus an inhalation of the patient can be effected.
- the exhalation may be effected passively by the retracting force of the ribcage and the lungs, or even forced (supported) exhalation may be effected by generating a positive pressure in the interior of the chamber by - preferably - reducing or eliminating the suction effect.
- the control device (30) is preferably a processor or a computing unit.
- the pressure increase and decrease means can be controlled via the control device.
- This control device can be discontinued exclusively for this task, for example, a processor that is installed and provided exclusively for the device according to the invention, or by a device with be taken, which already fulfills other tasks, such as an existing computer, especially a monitor that already applies to the patient.
- the control device is designed to control a pump which supplies a pressure medium via the pressure increase and decrease pressure means in the printing device or leaves out of the printing device.
- the control device may preferably also be associated with a memory.
- the pressure in the printing device is continuously controlled via the control device. It is thus possible to control the pressure preoperatively during the entire operation and the aftercare postoperatively or before anesthesia is initiated. It is thus possible to adjust the pressure again and again. By this constant adjustment of the pressure, a displacement of the blood volume within the patient can be effected. It is thus possible via the control device not only inflate the pressure device or drain medium, but to control the pressure targeted over time.
- a device in which the pressure device (10) has more than one pressure segment (15). This makes it possible to apply the external pressure even more accurate and more variant rich.
- the individual pressure segment can be controlled independently. So can in each pressure segment by the
- Control means are set a separate pressure which is applied to the region of the extremity of this pressure segment.
- the pressure segments can also be controlled in groups. This makes it possible to apply a special print pattern, preferably to vary over time or to apply the same pressure in different combined into a group pressure segments. It is also conceivable to design the pressure segments jointly controllable, either with the same pressure or with different pressures in the pressure segments at the same time.
- the individual pressure segments are also tempered, also different temperature, in particular also over the time variable temperature. Temperable here means that
- a temperature in the pressure segment preferably on the conditioning of the pressure medium, particularly preferably the air or water, in the pressure segment of the pressure chamber or the pressure cuff. It can be an increase or a decrease of temperature.
- the segments may be at the e.g. on the back lying patients in addition to the horizontal segmentation are also arranged vertically one above the other in order to counteract the gravitational increased accumulation of blood in dependent (med.: dorsal or posterior) peripheral body regions by increased pressure in the lower vertical pressure segments stronger.
- an apparatus in which the pressure increasing means (21) comprise a fluid or a gas that can be supplied to the pressure device (10) or in which the pressure reduction means (22) comprise a fluid or a gas which is removable from the printing device (10).
- the pressure in the printing device can be easily controlled.
- a fluid is primarily water into consideration.
- the gas used is preferably room air.
- a negative pressure or subatmospheric pressure (suction) can thereby also be set between the inside of the chamber and the skin of the patient or by changing the segmental applied pressure according to a pressure pattern on the venous blood distribution in the patient and the venous blood flow into the relevant one peripheral body regions are influenced.
- a device is provided, in which the pressure device (10) can be controlled pneumatically or hydraulically. By a pneumatic control, for example, the compression pressure of the segments of the pressure can be easily adjusted.
- a device in which the printing device (10) is air-conditioned, in particular physiologically air-conditioned.
- Climatizable here means that the temperature and / or humidity is adjustable. This can be done by an air conditioning device. This preferably comprises tempering or a tempering and / or a moisture conditioning. In this way, it is additionally possible to regulate the body shell temperature of the patient in the area of the pressure device. It is preferably provided that the individual segments of a printing device can be individually conditioned or tempered.
- pressure chambers are provided over the lower body half, the arms, and optionally over the rib cage.
- the air (or the medium) in the Segments or chambers is pneumatically controlled and physiologically conditioned. All chambers are constructed either as reusable systems, but preferably as single-use systems.
- the pressure and temperature conditions in each pneumatic chamber are regulated by a supply and control device separately or together or grouped. Before induction of anesthesia can be warmed up by appropriate temperatures in the chambers (by continuous circulation tempered air or tempered water), the body shell, so that it does not lead to a drop in temperature in the body core with induction of anesthesia. This avoids the problems of intraoperative and postoperative hypothermia.
- the body shell temperature of the patient can preferably be lowered or raised in a targeted manner.
- a tightly closing pressure chamber is provided above the rib cage (thorax) as a pressure device. In the non-pressurized state, the thorax chamber closes hermetically airtight around the thorax in a limp-flexible manner.
- pressure line structures are preferably incorporated (for example, pressure hoses), which take on filling with pressure medium corresponding pressure a more rigid, outwardly arching arc shape and thereby generate a negative pressure on the chest, resulting in air or breathing gas flowing into the Lungs to an enlargement of the thorax and thus leads to a Einamtung.
- exhalation may be passively inhibited by, preferably, reducing or eliminating the effect of the sough
- Retraction force of the chest and the lungs are effected, or even a forced (assisted) exhalation by generating a positive pressure in the chamber inside can be effected.
- Stiffening system of the chest chamber is a support or complete ventilation possible.
- the same volumes could be realized in the respiratory cycle with less positive pressure of the ventilator and thus also with low intrathoracic pressures.
- complete external mechanical ventilation based on the iron lung principle is ensured by external suction on the chest. In this case, only a respiratory protection (ensuring a free Respiratory tract access) and aspiration protection (sealing the airway to prevent inhalation of
- Gastric fluid e.g. through a laryngeal mask sufficient to perform the anesthesia.
- a device in which the control device (30) is set up to receive signals from at least one sensor (35). In this way, measured signals can be forwarded to the control device for further processing. The control device can then determine or apply a corresponding pattern for regulating the pressure in the pressure device as a function of these measured signals or measured values.
- a device in which the skin temperature, core temperature, blood pressure, and the pulse oxymetry are determined via this at least one sensor
- At least one sensor may be provided in the thoracic chamber (s) for detecting the ECG and thoracic electrical impedance to measure heart rate, impedance cardiac output, impedance-thoracic fluid volume, and impedance tidal volume.
- Control device (30) is arranged to process venous return current and / or preload of the heart and / or stroke volume of the heart. So can these values of the control device for adjusting the pressure are taken into account.
- Control device (30) is arranged, the pressure and / or the temperature in the pressure device (10) in dependence on the signal values of the sensors (35) and / or derived therefrom values, such as the pulse pressure variation PPV, the global end-diastolic volume, the intrathoracic blood volume, cardiac output, arterial pressure, etc.
- Control device (30) is arranged to control the pressure and / or the temperature in the printing device (10) according to a changing over time pressure or temperature pattern. Through such patterns over time, it is possible to act specifically on the displacement of body fluids, especially blood. A ventilation of the patient by a pattern with a change of sub- and supraatmospheric pressure is feasible.
- This Druck L. Temperature patterns are preferably variable or adjustable as a function of the measured values or the derived values. Thus, when changing a measured value can be specifically responded by changing the applied pressure pattern.
- the control is thus preferably online, i. in a control loop in response to the measured or derived values.
- a device in which the control device (30) is coupled to a monitor (39).
- a monitor Preferably, it is also possible to couple the supply and control device with a monitor.
- the monitor preferably records intrathoracic fluid and blood volumes as a sum or in individual compartments.
- the monitor preferably determines the heartbeat and cardiac output and / or continuously collects the body core temperature.
- the monitor preferably causes the supply and control device to increase the compression pressure to user preselectable body compartments to a preselected maximum pressure (preferably peristaltically vibrating / oscillating) with decreasing intrathoracic fluid and blood volume and consequently decreasing cardiac output Move more blood into the ribcage and lift the cardiac output.
- a preselected maximum pressure preferably peristaltically vibrating / oscillating
- the compression pressure can also be lowered or even not applied at all.
- the pressure in the individual compression chambers or in the pressure cuff or the segments is not held constant sturdy, but there is a directed control of the individual pressure segments / chambers successively continuous pressure wave, which contributes blood quasi peristaltic with oscillating superposition of peripherally to pump centrally, for example, with a period of 15 s.
- Such a wave-like compression can be controlled more accurately and effectively, the more individual controllable pressure segments / or chambers, for example, the pressure cuff or pressure pants for the lower Body region exists.
- the wave-like compression can - depending on need and cycle condition - start from atmospheric pressure or even a higher pressure and return to it.
- the peak pressure, that is the maximum pressure in the pressure pattern, of the pressure wave to be generated is chosen so that the average venous pressure in the body region to be compressed is safely exceeded, but certainly below the mean diastolic arterial pressure.
- the mean pressure of the applied pressure pattern can be below, equal to or above the venous pressure of the corresponding body region.
- the body core temperature can be controlled by appropriate heating of the peripheral and abdominal or thorax pressure chambers by appropriate control of the temperature of the air flowing through the chambers under pressure or by additional convective heating by means of other heat sources.
- the monitor preferably causes the supply and / or control device to run through a preselectable compression pressure pattern in preselectable time units in preselectable body compartments or pressure segments. This is preferably an increase and a release of the compression pressure, but it can also be a release of the compression pressure subsequent recovery.
- Pressure device (10) has at least one sealing sleeve (13).
- a hydraulic seal is provided at the respective transitions in the pressure chamber systems.
- sealing sleeves are provided, which are formed tight fitting. These sealing collars, for example, around the waist in the
- Pressure chamber compartment for the lower half of the body or be provided on the upper arm at the extremity chambers.
- a device in which the at least one sealing collar (13) has at least one sensor (35).
- the thus accommodated sensors are so well on the patient due to the close body contact of the sealing cuff.
- the sealing cuffs thus preferably have various non-invasive biosensors, eg for ECG, temperature, oscillometric or other types of blood pressure measurement, sphygmomanometry, pulse oximetry, electrical impedance tomography and / or electrical impedance cardiography.
- disposable biosensors can also be provided in the corresponding disposable collars or already incorporated.
- the chamber system are designed so that it hinder as little as possible the actually operation.
- the chamber systems for the lower half of the body could also serve as a storage surface for surgical instruments, etc.
- a pressure cuff has been described, which encloses the corresponding body part.
- air is preferably used as the medium and in addition to the pneumatic control of the compression pressure is preferably a temperature of the cuff by continuous circulation tempered air to prevent heat loss of the body and to transfer heat to the body can.
- All sleeves can be constructed either as reusable systems, but preferably as disposable systems.
- the pressure cuffs are preferably carried out individually for each of the legs (if possible, including the feet).
- the pressure cuffs are designed in the sense of a "pressure pants" as pants, which closes at the level of the pelvic girdle.
- individual arm cuffs are preferably provided, as well as a "pressure jacket”.
- a particular advantage of the pressure cuff is the almost ideal protection against storage damage which can be achieved at the same time.
- a whole-body surgical suit is provided. This can be attracted to the patient already on station.
- the OP-FeId is preferably previously prepared sterile on station and is located under a transparent window in the surgical suit.
- the sterile covers are preferably integrated in the suit and are only deployed at the beginning of the operation. All connections of the biosensors and the pneumatic / climatic control are preferably designed flange. This allows an enormous process advantage in the perioperative process.
- Fig. 1 is a schematic view of a
- Fig. 2 is a view of another embodiment of the present invention for the legs;
- Fig. 3 is a view of another embodiment of the present invention for the thorax;
- Fig. 4 a is a further view of the embodiment of Figure 3 in the inhaled state
- Fig. 4 b is another view of the embodiment of Figure 3 in the exhaled state.
- FIG. 1 shows a schematic view of a
- a device 1 for the diagnosis, execution and / or regulation of physiological functions, in particular in an anesthetized patient, comprises a pressure device 10.
- This pressure device 10 is designed as a pressure cuff in the form of a sleeve for an upper arm with an attached hand part in the form of a glove.
- a control device 30 is provided which is connected to a pressure increasing means 21 and a pressure reducing means 22.
- Pressure reducing means 22 are connected via lines 25.1 and 25.2 to the printing device 10.
- the printing device 10 consists of six pressure segments 15.1 to 15.6. These pressure segments 15.1 to 15.6 are along the from the pressure device to comprehensive arm in regular
- the first five pressure segments 15.1 to 15.5 are designed as pressure cuffs with a cylindrical cross section, in which the arm can be inserted.
- the sixth section is as
- Pressure segment 15.6 formed in the form of a glove into which the hand can be inserted.
- the individual pressure segments 15.1 to 15.6 are through the pressure increasing means 21 and pressure reducing means 22 via the lines 25.1 and 25.2 individually controllable.
- temperature control means 29 are connected, via which the medium used in the pressure increasing means 21 and pressure reducing means 22, here air, can be tempered.
- the temperature control means 29 is also connected to the control unit 30, so that it can be controlled via the control unit 30.
- the sensor 35.1 is a temperature sensor and the sensor 35.2 is a sensor for measuring the moisture of the skin.
- an arm of a patient is inserted into the pressure device 10 in the form of a sleeve with the glove section 15.6.
- the sensors 35.1 and 35.2 are fixed on the skin.
- the pressure segments 15.1 to 15.6 are now set to a predetermined pressure. This pressure is applied to the patient's arm.
- the controller 30 now controls the pressure increasing means 21 and the pressure reducing means 22 so that a pressure wave is sent across the segments 15.6 to 15.1.
- the tempering device 29 can be used to temper the air or the pressurized fluid, which is then conducted into the sleeve. This allows the cuff to be heated or cooled to control the temperature of the arm. Alternatively, it would also be possible for the
- Tempering device 29 is incorporated directly as a heating coil in the pressure cuff and generates heat or cold there electrically or chemically.
- Figure 2 shows a view of another
- the device for diagnosing, executing and / or regulating physiological functions 1 comprises a pressure device 10 which is designed in the form of a "trouser.” These "trousers” each comprise a leg dress with bootlet and a section for the hip area. At the top, this pressure device 10 is limited by a sealing collar 13.
- the "pressure pants” 10 further comprises individual pressure segments 15. 1 to 15.7, which are arranged adjacent to each other from the hip area to the footlet
- Pressure device 10 and the individual pressure segments 15.1 to 15.7 are connected via lines 25.1 to 25.7 with a control device 40.
- the regulating device 40 comprises pressure increasing means 21 and pressure reducing means 22, an air conditioning device 27 and a control device 30.
- the air conditioning device 27 comprises
- Moisture conditioning agent 28 and temperature control 29 In the region of the sealing sleeve 13 is a sensor 35th arranged by the contact pressure of the
- Sealing collar 13 is fixed on the skin of the patient.
- the patient is now put on the "pressure pants" 10 and sealed against the skin of the patient by means of the sealing collar 13 in the hip region in such a way that air can not escape from the pressure pants 10.
- the control device 40 now uses the pressure increasing means 21 and pressure reducing means 22
- the pressure segments 15.2 to 15.7 can either be joined together for both legs so that a pressure pattern acts in parallel on the corresponding body regions under the respective pressure segments 15.2 to 15.7 separately provided for the right and the left leg and to control the individual pressure segments 15.2 left to 15.7 left and 15.2 right to 15.7 right individually and separately from each other
- Air conditioning device 27 it is possible to adjust the temperature or humidity of the air supplied via the lines 25.1 to 25.7.
- the jacket temperature of the patient can be regulated.
- Temperature or humidity of the patient or the air in the pressure chambers can be detected via the sensor 35. This measured value can be supplied again as the regulating device in order to readjust temperature and humidity via the air-conditioning device 27.
- Peristaltic and rhythmic compression can be used to avoid infusion. It can also promote the peripheral circulation become.
- these pressure pants embolic prophylaxis is possible.
- FIG. 3 shows a view of another embodiment of the present invention for the thorax.
- a pressure device 10 is provided in the form of a "vest of pressure.”
- pressure segments 15.1 are provided in the form of tubular chambers and fixedly attached to the pressure vest.
- pressure segments 15.2 are also provided in the form of tubular chambers.
- These pressure segments 15.2 and 15.2 are preferably designed for a high pressure, preferably up to a bar and especially longitudinally stretchable, but not in diameter stretchable. They may be made of silicone, for example, so that change such hoses when using such pressures in length and thus lead to an expansion or a reduction of the vest.
- tubular pressure chambers are ruffled applied to the vest or sewn, ie as a kind of Zieharmonikaschlauch. It would then be fixed on the side of the contact with the vest more material of the tubular pressure segment per stretch, as on the side facing away from the vest is present. This would also expand the vest when inflating such Zieharmonika Modellen depending on the nature of the application. If the gathering is different, ie on the opposite side If the tubular element is gathered, then the vest would be compressed.
- the pressure vest itself has at least one pressure segment 15.3, via which pressure can be applied directly to the surface of the patient in the region of the vest.
- the individual pressure segments 15.1 to 15.3 are connected via hose lines 25.1 to 25.3 with the control device 40 - for example, constructed as in Figure 2 - connected.
- a pressure pattern can again be exerted on the patient and body temperature can be regulated similarly as in the exemplary embodiments of FIGS. 1 and 2.
- the pressure is here in the venous pressure range or slightly above (0-30 torr).
- the pressure segment 15.3 is acted rhythmically and vibrating with pressure.
- FIG. 4 a shows a further view of the exemplary embodiment from FIG. 3 in the inhaled state.
- the lines and the control device of Figure 3 are not shown again here.
- the pressure segments 15.1 are pressureless or even supplied with subatmospheric pressure, which is a Shortening causes and overall erecting the structure similar to the change in the rib position during spontaneous inhalation has the consequence.
- subatmospheric pressure which is a Shortening causes and overall erecting the structure similar to the change in the rib position during spontaneous inhalation has the consequence.
- the vest is widened and thereby exerted a suction effect on the chest.
- the chest raises and simultaneously the patient breathes.
- FIG. 4 b shows a further view of the exemplary embodiment from FIG. 3 in the exhaled state.
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- Health & Medical Sciences (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Epidemiology (AREA)
- Pain & Pain Management (AREA)
- Physical Education & Sports Medicine (AREA)
- Rehabilitation Therapy (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Pulmonology (AREA)
- Emergency Medicine (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
- External Artificial Organs (AREA)
- Percussion Or Vibration Massage (AREA)
- Massaging Devices (AREA)
- Accommodation For Nursing Or Treatment Tables (AREA)
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE102008019647A DE102008019647A1 (en) | 2008-04-18 | 2008-04-18 | Device for the diagnosis, execution and / or regulation of physiological functions, in particular in an anesthetized patient |
PCT/EP2009/002837 WO2009127427A1 (en) | 2008-04-18 | 2009-04-17 | Appliance for diagnosis, performance and/or regulation of physiological functions, in particular in an anaesthetized patient |
Publications (2)
Publication Number | Publication Date |
---|---|
EP2265239A1 true EP2265239A1 (en) | 2010-12-29 |
EP2265239B1 EP2265239B1 (en) | 2016-10-12 |
Family
ID=40933500
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP09732481.8A Active EP2265239B1 (en) | 2008-04-18 | 2009-04-17 | Appliance for diagnosis, performance and/or regulation of physiological functions, in particular in an anaesthetized patient |
Country Status (6)
Country | Link |
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US (2) | US20110098741A1 (en) |
EP (1) | EP2265239B1 (en) |
JP (1) | JP5497004B2 (en) |
CN (1) | CN102006849B (en) |
DE (1) | DE102008019647A1 (en) |
WO (1) | WO2009127427A1 (en) |
Families Citing this family (14)
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EP2401984A1 (en) * | 2010-07-02 | 2012-01-04 | MyoPowers Medical Technologies SA | Medical device comprising an artificial contractile structure |
DE102010048519B4 (en) * | 2010-10-14 | 2016-12-22 | Charité-Universitätsmedizin Berlin | Apparatus for the treatment of peripheral circulatory disorders in the lower extremities |
DE102011107813A1 (en) | 2011-07-13 | 2013-01-17 | Otto-Von-Guericke-Universität Magdeburg | Multifunctional system for use in e.g. space suit for astronaut, for providing treatment of e.g. skin lesions of human, has two pumps supplying fluids and continuously controlled by computer-aided system over sensor unit |
EP2594244A1 (en) * | 2011-11-15 | 2013-05-22 | Barrett Reed Mitchell | Medical vest for high frequency chest wall oscillation (HFCWO) system |
US9375586B2 (en) * | 2013-03-15 | 2016-06-28 | Pavel V. Efremkin | Apparatus and method for treatment of foot and nail diseases |
JP6775280B2 (en) * | 2015-03-30 | 2020-10-28 | 国立大学法人高知大学 | Compression system |
US20200268601A1 (en) * | 2015-09-25 | 2020-08-27 | Delta Dynamics Llc | System and methods for pulmonary expansion therapy (pxt) |
CN106038201A (en) * | 2016-07-11 | 2016-10-26 | 广州彩磁信息技术有限公司 | Bionic rhythmical diastole and systole type wearable device capable of promoting lymph and vein circulation |
US11866173B2 (en) * | 2017-09-21 | 2024-01-09 | Nippon Telegraph And Telephone Corporation | G tolerance improvement device and control method |
FR3081704B1 (en) * | 2018-05-31 | 2023-11-17 | Neuraltide | PRESSURE APPLICATION CLOTHING |
WO2020131736A1 (en) * | 2018-12-17 | 2020-06-25 | The Trustees Of The University Of Pennsylvania | Improvements on ambulatory respiratory assist device |
US20230023355A1 (en) * | 2019-12-04 | 2023-01-26 | Colin Felton | Conformal vest ventilator |
WO2022245785A1 (en) * | 2021-05-18 | 2022-11-24 | Inova Labs, Inc. | Systems and methods for determining physical shape properties of a limb during therapy and fit of a compression garment |
US11839587B1 (en) | 2023-02-03 | 2023-12-12 | RightAir, Inc. | Systems, devices, and methods for ambulatory respiration assistance |
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JPS61253060A (en) * | 1985-05-02 | 1986-11-10 | カルレ ペカンマキ | Apparatus for massaging terminal parts of leg |
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2008
- 2008-04-18 DE DE102008019647A patent/DE102008019647A1/en not_active Withdrawn
-
2009
- 2009-04-17 US US12/988,292 patent/US20110098741A1/en not_active Abandoned
- 2009-04-17 JP JP2011504382A patent/JP5497004B2/en active Active
- 2009-04-17 WO PCT/EP2009/002837 patent/WO2009127427A1/en active Application Filing
- 2009-04-17 EP EP09732481.8A patent/EP2265239B1/en active Active
- 2009-04-17 CN CN200980113721.0A patent/CN102006849B/en active Active
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2017
- 2017-09-08 US US15/699,237 patent/US20170367922A1/en not_active Abandoned
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Also Published As
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CN102006849A (en) | 2011-04-06 |
US20110098741A1 (en) | 2011-04-28 |
JP5497004B2 (en) | 2014-05-21 |
US20170367922A1 (en) | 2017-12-28 |
WO2009127427A1 (en) | 2009-10-22 |
CN102006849B (en) | 2017-05-10 |
DE102008019647A1 (en) | 2009-11-05 |
EP2265239B1 (en) | 2016-10-12 |
JP2011516223A (en) | 2011-05-26 |
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