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WO1992015355A1 - Respirateur - Google Patents

Respirateur Download PDF

Info

Publication number
WO1992015355A1
WO1992015355A1 PCT/EP1992/000340 EP9200340W WO9215355A1 WO 1992015355 A1 WO1992015355 A1 WO 1992015355A1 EP 9200340 W EP9200340 W EP 9200340W WO 9215355 A1 WO9215355 A1 WO 9215355A1
Authority
WO
WIPO (PCT)
Prior art keywords
pressure
nasopharyngeal
tubes
gas
breathing
Prior art date
Application number
PCT/EP1992/000340
Other languages
German (de)
English (en)
Inventor
Volker Lang
Original Assignee
Volker Lang
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Volker Lang filed Critical Volker Lang
Publication of WO1992015355A1 publication Critical patent/WO1992015355A1/fr

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. ventilators; Tracheal tubes
    • A61M16/0096—High frequency jet ventilation
    • 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. ventilators; Tracheal tubes
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816—Joints or connectors
    • A61M16/0833—T- or Y-type connectors, e.g. Y-piece
    • 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. ventilators; Tracheal tubes
    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816—Joints or connectors
    • A61M16/0841—Joints or connectors for sampling
    • A61M16/0858—Pressure sampling ports
    • 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. ventilators; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter

Definitions

  • the invention relates to a device for generating a continuous positive pressure in the airways during spontaneous breathing according to the preamble of claim 1.
  • tracheal tube (breathing tube), which is inserted directly into the patient's trachea, in order to supply the breathing gas directly to the bronchial system and the lungs, in order to build up and maintain the desired overpressure there. This allows very constant pressures to be achieved in the lungs.
  • the patient has to be intubated and has a tube as a foreign body in his windpipe, which can cause permanent irritation, damage to the vocal cords and trachea as well as infections of the bronchial system and the lungs.
  • this tube in the trachea requires continuous, intermittent artificial mucus suction to keep the airways open.
  • this breathing tube represents a considerable flow resistance, which must be overcome by the patient during inhalation and exhalation.
  • the fresh breath gas is introduced through one or two hoses through the nose into the nasopharyngeal mouth and builds up the desired continuous overpressure there and in the airways and lungs communicating with it.
  • Breathing gas is fed into the nasopharynx-mouth and the connected airways and lungs with the help of a tightly fitting mask which includes both the nose and the mouth. This means that the mouth and nose leaks disappear and the possibility of breathing gas being supplied via the nose and mouth. This would ensure good pressure consistency.
  • Difficulty sealing (leaks) the mask on the face of the newborn, some of which cannot be remedied despite the application of dangerously high pressure on the face, skull and neck, and complications such as Pressure damage to the skin and possibly even brain bleeding.
  • it is necessary to install a large, bulky holding device in the incubator (incubator). This results in significant disabilities and a restriction of nursing and therapeutic measures.
  • a ventilation device which is further developed in accordance with the teaching of the characterizing part of the main claim.
  • two nasopharyngeal tubes are used to supply fresh breathing gas, which have one or two thin pressure measurement tubes (channels) in their lumen or wall.
  • the fresh breathing gas fed in is not under the desired therapeutic pressure of 5 to 10 cm H2O, but under 25 to 30 cm H2O overpressure and additionally has modulated pressure oscillations.
  • a first pressure limitation at an increased pressure level is given in the device according to the invention by the feed pressure of the fresh breathing gas limited to 25 to 30 cm H2O.
  • the second pressure limitation at a therapeutic pressure level of 5 to 10 cm H2O is carried out by the continuous exact pressure measurements in the nasopharyngeal-oral cavity and the fresh gas supply regulated as a function thereof. If pressure probe clogging due to nasal mucus occurs, a not uncommon event, then the downstream pressure measuring element, if it does not have a vent to the outside, will continue to be pressurized for a long time with the pressure in the nasal cavity just before the probe is blocked. Pharynx mouth.
  • the device according to the invention uses fresh breathing gas to which pressure vibrations are modulated.
  • these pressure vibrations are only transmitted to the downstream electrical-electronic pressure element in the case of an open pressure probe, but not after it has become blocked. In this way, this blockage can be recognized very easily when evaluating the signals in special electronics.
  • An immediate activation of the automatic probe blow-through device integrated in the device can eliminate this disturbance. If this is not possible in rare cases, the device alarm is triggered automatically and at the same time the fresh gas supply is reduced to a minimum.
  • FIG. 1 shows schematically the individual building blocks of the device according to the invention and their logical combination
  • FIG 3 is a perspective view from the front and side of the special mouth and throat tube for breathing gas supply, pressure control and ventilation of the nasopharynx.
  • Fresh breathing gas passes from a commercially available high-pressure compressed-air-oxygen mixer 1 to the electromagnetically operated metering valve 2 with a fixed bypass (2 to 5 l / min. Purging continuous gas flow) and from here to the low-pressure regulator 3, which Pressure limited to 25 to 30 cm H2O.
  • This regulator delivers breathing gas to the modulator 5, which modulates pressure oscillations (frequency range used 0.1 to 100 Hz, stroke 0.5 to 10 cm H2O) before the fresh gas then flows through and over a commercially available breathing gas humidification heating device 6 the connecting hose 7 reaches the Y gas distributor 8.
  • the two special nasopharyngeal tubes 9 with their adapters 10 are inserted here and supply the schematically illustrated nasopharyngeal mouth 16 and the trachea 19 and lungs communicating with it with breathing gas under the preselected excess pressure (5 to 10 cm H 2 O). Varying gas leaks 18 across the lips are symbolized by parallel lines.
  • a tube inserted in the mouth (kink-proof tube) 17 serves as a fixed leak to the outside for safe flushing out of the used exhaled air from the nasopharynx-oral cavity 16 by means of fresh breathing gas flowing continuously via the regulator 3. Due to the thin pressure measuring probes 11 running in the lumen of the nasopharyngeal tubes 9, each via connecting hoses 12, 13, each with an electrical-electronic pressure measuring element 14, 15 and through a further downstream selective electronics 21 and an electronic control element 22, only the metering valve is used til 2 and pressure relief valve 4 controlled.
  • Fig. 2 shows the holding device for the nasopharynx tubes and the mouth tube. It consists of a base plate 26 made of elastic material (rubber, silicone rubber) which has openings. The openings 27, 28 serve for the clamping insertion of the nasopharyngeal tubes 9 and the opening 29 for the mouth tube 17. Rectangular punchings 30, 31 attached to the right and left serve for the attachment of retaining straps. As can be seen, the openings 24, 25 are only surrounded by a narrow sow of elastic material 32, which is connected to the base plate 26 via a respective narrow web 33, 34.
  • FIG. 3 shows, as an alternative device for the described breathing gas supply via nasopharynx tubes, a special mouth throat tube 35 made of soft plastic. It represents a slightly angled tube with an oval cross-section, the underside 36 on the tongue and the open end 37 thereof , in which the hoses 40, 41, 42 and 43 open about 1 cm from the end, protected from mucus, lies in the patient's pharynx (throat entrance).
  • the plate 38 attached to the front end of the mouth and throat tube lies on the outside of the patient's lips and can be fixed there, for example, by means of the fastening slots 39.
  • the hoses fitted in the tube lumen and fixed in a gastight manner are used for pressure measurement 40, 41 (low-volume), the breathing gas feed 42 (wide-volume) and for ventilation 43 of the nasopharyngeal-oral cavity and the airways and lungs communicating therewith.

Landscapes

  • 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)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Investigating Or Analysing Biological Materials (AREA)

Abstract

Un dispositif permet de générer une pression positive continue dans les voies respiratoires pendant la respiration spontanée. On introduit du gaz respirable sous surpression, modulé par des oscillations de pression, dans la cavité rhino-bucco-pharyngienne (16) par des tubes rhino-pharyngiens (9) ou par un tube bucco-pharyngien spécial pourvu de canaux (tubes flexibles) manométriques (12, 13) ainsi que d'un canal (tube flexible) d'amenée de gaz ayant un large passage et d'un canal d'évacuation d'air ayant un passage étroit. On peut ainsi compenser même des fuites importantes dans la région buccale. La constance de la pression positive voulue aux fins de thérapie dans la cavité rhino-bucco-pharyngienne (16), dans les voies respiratoires en communication avec celle-ci et dans les poumons est assurée par des mesures électriques-électroniques continues du gaz sous pression effectuées par des sondes manométriques (11) agencées dans la cavité rhino-bucco-pharyngienne (16) et par une régulation de l'amenée de gaz respirable frais en fonction de ces mesures. L'obstruction des sondes manométriques (11), par exemple par des mucosités nasales, est immédiatement reconnue par détection de l'absence de signaux de pression oscillatoire et d'éventuelles pressions différentielles des capteurs manométriques (14, 15) et est en règle générale immédiatement éliminée par actionnement d'un dispositif automatique de purge des sondes. Par conséquent, un signal d'avertissement ne se déclenche que dans des cas très rares.
PCT/EP1992/000340 1991-02-27 1992-02-18 Respirateur WO1992015355A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DEP4106098.9 1991-02-27
DE4106098A DE4106098C2 (de) 1991-02-27 1991-02-27 Vorrichtung zur Erzeugung kontinuierlich positiver Drucke in den Luftwegen bei Spontanatmung

Publications (1)

Publication Number Publication Date
WO1992015355A1 true WO1992015355A1 (fr) 1992-09-17

Family

ID=6425973

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1992/000340 WO1992015355A1 (fr) 1991-02-27 1992-02-18 Respirateur

Country Status (4)

Country Link
EP (1) EP0573468A1 (fr)
CA (1) CA2101647A1 (fr)
DE (1) DE4106098C2 (fr)
WO (1) WO1992015355A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8302602B2 (en) 2008-09-30 2012-11-06 Nellcor Puritan Bennett Llc Breathing assistance system with multiple pressure sensors
US8322339B2 (en) 2006-09-01 2012-12-04 Nellcor Puritan Bennett Llc Method and system of detecting faults in a breathing assistance device

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19515739C2 (de) * 1995-05-03 1997-09-11 Holger Krohn Verfahren und Vorrichtung zur Erzeugung gesundheitsverträglicher Atemluft in nasalen Überdruck - Beatmungsgeräten
DE10017193B4 (de) * 2000-04-07 2007-05-24 Map Medizin-Technologie Gmbh Vorrichtung zur Zufuhr eines Atemgases und Verfahren zur Steuerung
DE10161057A1 (de) * 2001-12-12 2003-07-10 Heptec Gmbh Verfahren zur Steuerung des Differenzdrucks in einem CPAP-Gerät sowie CPAP-Gerät

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4265237A (en) * 1978-07-17 1981-05-05 Dragerwerk Aktiengesellschaft Apparatus for enhancing a person's breathing and/or artificial respiration
GB2063686A (en) * 1979-11-27 1981-06-10 Draegerwerk Ag Respiratory apparatus
WO1982003014A1 (fr) * 1981-03-10 1982-09-16 Olsson Sven Gunnar Respirateur destine a etre connecte aux voies respiratoires de l'homme ou de l'animal
US4417573A (en) * 1981-07-02 1983-11-29 Bear Medical Systems, Inc. Patient adaptor for medical ventilator

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3401384A1 (de) * 1984-01-17 1985-07-25 Drägerwerk AG, 2400 Lübeck Vorrichtung fuer die zufuhr von beatmungsgas in den geschlossenen atemkreis eines medizinischen beatmungsgeraetes
DE3412118A1 (de) * 1984-03-31 1985-10-10 Allihn & Co Sauerstoffgeräte, 8000 München Atemphasenregler

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4265237A (en) * 1978-07-17 1981-05-05 Dragerwerk Aktiengesellschaft Apparatus for enhancing a person's breathing and/or artificial respiration
GB2063686A (en) * 1979-11-27 1981-06-10 Draegerwerk Ag Respiratory apparatus
WO1982003014A1 (fr) * 1981-03-10 1982-09-16 Olsson Sven Gunnar Respirateur destine a etre connecte aux voies respiratoires de l'homme ou de l'animal
US4417573A (en) * 1981-07-02 1983-11-29 Bear Medical Systems, Inc. Patient adaptor for medical ventilator

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8322339B2 (en) 2006-09-01 2012-12-04 Nellcor Puritan Bennett Llc Method and system of detecting faults in a breathing assistance device
US8302602B2 (en) 2008-09-30 2012-11-06 Nellcor Puritan Bennett Llc Breathing assistance system with multiple pressure sensors
US9649458B2 (en) 2008-09-30 2017-05-16 Covidien Lp Breathing assistance system with multiple pressure sensors

Also Published As

Publication number Publication date
CA2101647A1 (fr) 1992-08-28
DE4106098C2 (de) 2000-08-31
EP0573468A1 (fr) 1993-12-15
DE4106098A1 (de) 1992-09-03

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