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WO2008077003A1 - Dispositif de pression des voies aériennes positive à soufflante unique et procédé apparenté - Google Patents

Dispositif de pression des voies aériennes positive à soufflante unique et procédé apparenté Download PDF

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Publication number
WO2008077003A1
WO2008077003A1 PCT/US2007/087845 US2007087845W WO2008077003A1 WO 2008077003 A1 WO2008077003 A1 WO 2008077003A1 US 2007087845 W US2007087845 W US 2007087845W WO 2008077003 A1 WO2008077003 A1 WO 2008077003A1
Authority
WO
WIPO (PCT)
Prior art keywords
therapeutic gas
outlet port
valve
single blower
blower
Prior art date
Application number
PCT/US2007/087845
Other languages
English (en)
Inventor
Alonzo C. Aylsworth
Lawrence C. Spector
Charles R. Aylsworth
Original Assignee
Acoba, L.L.C.
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 Acoba, L.L.C. filed Critical Acoba, L.L.C.
Publication of WO2008077003A1 publication Critical patent/WO2008077003A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Measuring devices for evaluating the respiratory organs
    • A61B5/087—Measuring breath flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4836—Diagnosis combined with treatment in closed-loop systems or methods
    • A61B5/4839—Diagnosis combined with treatment in closed-loop systems or methods combined with drug delivery
    • 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
    • A61M16/0057—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. ventilators; 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. ventilators; Tracheal tubes
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A61M16/201—Controlled valves
    • A61M16/202—Controlled valves electrically actuated
    • A61M16/203—Proportional
    • A61M16/204—Proportional used for inhalation control
    • 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
    • A61M16/06—Respiratory or anaesthetic masks
    • A61M16/0666—Nasal cannulas or tubing
    • 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
    • A61M16/10—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. ventilators; 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
    • 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
    • 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
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit
    • 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
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3306—Optical measuring means
    • 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
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3365—Rotational speed
    • 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
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • 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
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/52—General characteristics of the apparatus with microprocessors or computers with memories providing a history of measured variating parameters of apparatus or patient

Definitions

  • BACKGROUND United States Patent No. 7,114,497 (the '497 patent), sharing two inventors with this specification, describes applying positive airway pressure to a patient for the treatment of sleep- disordered breathing, such as sleep apnea.
  • pressure and flow provided to each naris are individually controlled by a dedicated blower and motor for each naris.
  • Each breathing orifice having a dedicated blower may make the cost of the positive airway pressure device too expensive for some consumers, and thus alternative methods and devices are needed that provide the benefit of individual control of applied pressure and flow.
  • Figure 1 illustrates a system in accordance with at least some embodiments
  • Figure 2A illustrates a valve in accordance with some embodiments
  • Figure 2B illustrates a valve in accordance with some embodiments
  • Figure 3 illustrates the system of Figure 1 in a shorthand notation
  • Figure 4 illustrates other embodiments in the shorthand notation
  • Figure 5 illustrates yet still other embodiments in the shorthand notation
  • Figure 6 illustrates other embodiments in the shorthand notation
  • Figure 7 illustrates yet still other embodiments in the shorthand notation
  • Figure 8 A illustrates other embodiments in the shorthand notation
  • Figure 8B illustrates yet still other embodiments in the shorthand notation
  • Figure 9 illustrates an overhead view of a control valve in accordance with at least some embodiments
  • Figure 1OA illustrates an overhead view of the control valve with a portion of the outer housing removed and with the moveable valve member in a first orientation, in accordance with at least some embodiments
  • Figure 1OB illustrates an overhead view of the control valve with a portion of the outer housing removed and with the moveable valve member in a second orientation, in accordance with at least some embodiments
  • Figure 11 illustrates a side elevation view of the control valve and related stepper motor in accordance with at least some embodiments
  • Figure 12 illustrates a disk having apertures therein to determine orientation in accordance with at least some embodiments
  • Figure 13 illustrates a method in accordance with at least some embodiments; and Figure 14 illustrates yet still other embodiments in the shorthand notation.
  • the term “couple” or “couples” is intended to mean either an indirect or direct connection. Thus, if a first device couples to a second device, that connection may be through a direct connection, or through an indirect connection via other devices and connections.
  • the term “constant speed” in reference to a blower or electric motor shall mean blowers and/or motors whose speed is not controlled to control the pressure or flow of therapeutic gas exiting the blower. As between a fully loaded condition of the blower (providing substantially full therapeutic gas flow) and an unloaded condition of the blower (providing substantially no therapeutic gas flow) there may be speed changes, particularly in the case of alternating current (AC) motors. However, speed changes of the motor and/or blower caused by loading and/or unloading of the blower by operation of control valves either upstream or downstream shall not diminish the "constant speed" character of the blower.
  • AC alternating current
  • Figure 1 illustrates a positive airway pressure device 100 in accordance with at least some embodiments.
  • the positive airway pressure device 100 comprises both electrical components and mechanical components.
  • Figure 1 illustrates electrical connections between components with dashed lines, and fluid connections (e.g., tubing connections between devices) with solid lines.
  • the positive airway pressure device 100 in accordance with at least some embodiments comprises a processor 10.
  • the processor 10 may be a microcontroller, and therefore the microcontroller may be integral with read-only memory (ROM) 12, random access memory (RAM) 14, a digital-to-analog converter (D/ A) 16, and an analog-to-digital converter (AJO) 18.
  • the processor 10 may further comprise a communications logic 20, which allows the positive airway pressure device 100 to communicate with external devices (e.g., compliance reporting).
  • the processor 10 may be implemented as a standalone central processing unit in combination with individual RAM, ROM, communications, D/A and A/D devices.
  • the ROM 12 stores instructions executable by the processor 10.
  • the processor 10 stores instructions executable by the processor 10.
  • the processor 10 stores instructions executable by the processor 10.
  • ROM 12 comprises a software program that implements the individual control of pressure and/or flow to each breathing orifice (e.g., each naris, or the nose as a whole and the mouth).
  • the RAM 14 may be the working memory for the processor 10, where data may be temporarily stored and from which instructions may be executed.
  • Processor 10 may couple to other devices within the system by way of the A/D converter 18 and the D/A converter 16.
  • the positive airway pressure device in accordance with various embodiments also comprises a single fan or blower 22.
  • Blower 22 may be any suitable device, such as a vane-type blower, coupled to an electric motor 24.
  • Therapeutic gas e.g., air
  • the blower 22 is split into two streams, one stream coupled to a first outlet port 23, and a second stream coupled to a second outlet port 25.
  • the therapeutic gas may flow through a flow sensor 26 (of any suitable type) and a pressure sensor 28 (of any suitable type).
  • the therapeutic gas may thus flow through a flow sensor 30 (of any suitable type) and a pressure sensor 32 (of any suitable type).
  • the therapeutic gas pressure and flow then couple to a breathing orifice of the patient (e.g., the patient's nares), where all or substantially all the therapeutic gas inhaled by the patient is supplied from the blower 22.
  • the therapeutic gas flows through a flow conditioning apparatus to heat and/or humidify the therapeutic gas.
  • the positive airway pressure device 100 provides positive airway pressure (even if the primary control parameter for the device 100 is therapeutic gas flow) at least during inhalation of the patient, the flow and/or pressure to reduce sleep-disordered breathing such as snoring, hypopnea and/or apnea events.
  • Individual control of the flow and/or pressure of therapeutic gas delivered to each naris by the positive airway pressure device may take many forms. First consider embodiments where the blower 22 is operated at a constant speed by the motor 24. In some embodiments individual control of the pressure and flow to each naris is provided by the control valves 34 and 36.
  • each valve 34 and 36 has an operator assembly 35 and 37, respectively, that couples to the processor 10 such that the processor 10 controls the therapeutic gas flow through the valve.
  • the pressure and/or flow of therapeutic gas provided to each naris during inhalation are controlled by the respective valves 34 and 36.
  • the gas exhaled by the patient escapes the flow circuit illustrated in
  • each positive airway pressure mask has a calibrated leak.
  • the calibrated leak allows some portion of the therapeutic gas to vent to atmosphere, but during exhalation also allows gasses exhaled to vent to atmosphere.
  • the pressure applied to one naris is higher than the pressure applied to the second naris during a transition, therapeutic gas tends to flow in one naris, crossover in the oral cavity behind the nose, flow out the second naris, and then flow to atmosphere through at least the mask vent. Such crossover may cause irritation in the oral cavity behind the nose.
  • the pressure applied to each naris is controlled to be substantially the same by positioning valve members of the control valves 34 and 36 at the same valve position (e.g., a predetermined position, or fully open).
  • the pressures provided to each naris are substantially constant throughout the respiratory cycle; however, in other embodiments the pressures provided to each naris are reduced during exhalation (e.g., to reduce the effort needed to exhale). In embodiments where the pressure is reduced during exhalation, the reduction in pressure may take place by operation of control valves 34 and 36. Yet still other embodiments comprise dump valves 38 and 40, one dump valve each on each stream. As the name implies, the dump valves 38 and 40 are used to vent pressure within each stream to atmosphere. Each dump valve 38 and 40 has an operator assembly 39 and 41, respectively, that couples to the processor 10 such that the processor 10 controls the flow through the valve.
  • lowering pressure during exhalation may therefore take place by opening the dump valves 38 and 40, or by a combination of fully or partially closing the control valves 34 and 36 and opening the dump valves 38 and 40.
  • the control valves 34 and 36, as well as the dump valves 38 and 40 may take any suitable form.
  • the valves are motor operated butterfly or ball valves.
  • the valve action may take place by selective pinching of a pliable hose.
  • Figures 2A and 2B illustrate valves constructed of pliable hose.
  • valves comprise a pliable hose portion 42 (e.g., a flexible rubber hose) in operational relationship to an eccentric cam shaft 44 having an axis of rotation 46 perpendicular to the page.
  • a pliable hose portion 42 e.g., a flexible rubber hose
  • the eccentric cam shaft 44 By selective rotation of the eccentric cam shaft 44 (e.g., by a motor operator), the pliable hose 42 is pinched, performing a valve function.
  • the pliable hose-type valve may be used as any of the control valves 34 and 36 or the dump valves 38 and 40.
  • Figure 1 illustrates a motor speed control circuit 48 coupled between the processor 10 and the motor 24.
  • the motor speed control circuit selectively controls the motor 24 speed, and therefore the blower 24 speed, based on commands from the processor 10.
  • the motor speed control circuit may take many forms.
  • the motor 24 is a direct current motor (DC)
  • the motor speed control circuit provides either a variable voltage DC drive voltage, or a pulse-width modulated drive voltage, or both.
  • the motor speed control circuit 48 provides a variable frequency drive signal to the motor to control the motor 24 speed.
  • Control of the pressure and flow of therapeutic gas to each naris is, in embodiments shown in Figure 1 having a variable speed motor/blower, based on a combination of blower 22 speed and control valve 34 and 36 positional settings.
  • the control valve for the naris needing higher pressure i.e., the naris having higher narial resistance to airflow
  • the second control valve partially closes or pinches to limit pressure and flow provided to the second naris.
  • the reduced pressure could be based on lowering blower 22 speed.
  • the blower 22 speed is controlled, but also dump valves 38 and 40 are used, and any combination of control valve positioning, blower speed, and dump valve positioning may be used to control applied pressure and flow.
  • Figure 1 is complicated in that Figure 1 shows both electrical and fluid connections. So as not to unduly complicate the presentation of various alternative embodiments, a shorthand notation is adopted.
  • Figure 3 is a simplified version of Figure 1 with the electrical connections and components removed to illustrate a shorthand notation for the embodiments of Figure 1.
  • Figure 3 shows blower 22, with the constant speed and variable speed configurations illustrated as CS and VS, respectively, along with control valves 34 and 36 and optional dump valves 38 and 40.
  • Figure 4 illustrates embodiments using a dump valve 60 positioned between the outlet of the blower 22 and the control valves 34 and 36.
  • the dump valve 60 aids in pressure control during inhalation by selectively venting therapeutic gas flow from the blower. Likewise during exhalation, the dump valve 60 may selectively vent therapeutic gas from the blower 22 to help control applied pressure during exhalation, particularly in embodiments where pressure applied during exhalation is reduced.
  • the dump valve 60 may aid in pressure control during inhalation by selectively venting therapeutic gas during pressure excursions (i.e., overshoot in pressure caused by speed control circuit tuning shortcomings).
  • the dump valve may selectively vent therapeutic gas from the blower 22 to help control applied pressure, particularly in embodiments where the response time of the blower 22 speed is slow in relation to respiration rate and/or where pressure applied during exhalation is reduced.
  • the various embodiments discussed to this point use individual control valves on each of the flow circuits coupled to the outlet ports (and in some embodiments, the nares individually).
  • the functionality of the control valves 34 and 36 are embodied in a single valve.
  • Figure 5 illustrates (in the shorthand notation) embodiments comprising a variable speed blower 22 fluidly coupled to an inlet 64 of the control valve 62.
  • Illustrative control valve 62 further comprises two outlet ports 66 and 68 that couple one each to the outlet ports of the overall device, ports 23 and 25 respectively.
  • therapeutic gas flow provided by blower 22 is selectively proportioned to one of the first and second outlet ports 23 and 25.
  • the illustrative valve 62 comprises rotationally moveable valve member (discussed more below) that, depending on rotational orientation, selectively diverts therapeutic gas flow from the blower 22 to the outlet ports 23 and 25.
  • Figure 6 illustrates embodiments where the control valve 62 is used in combination with a dump valve 60.
  • Figure 6 shows blower 22 fluidly coupled to the control valve 62, which control valve 62 in turn fluidly couples to the outlet ports 23 and 25.
  • Dump valve 60 fluidly couples to the fluid connection between the blower 22 and the control valve 62, and selectively vents therapeutic gas to atmosphere.
  • the dump valve 62 enables use of a constant speed blower 22, or may be used with a variable speed blower 22 to aid in pressure control and/or to (at least in part) enable reduced pressure during exhalation by selective venting of therapeutic gas.
  • FIG 7 illustrates yet still further embodiments where each therapeutic gas flow stream between the control valve 62 and the outlet ports 23 and 25 comprises a dump valve 38 and 40, respectively.
  • Dump valves 38 and 40 selectively vent therapeutic gas to atmosphere.
  • the dump valves 38 and 40 enable use of a constant speed blower 22, or may be used with a variable speed blower 22 to aid in pressure control and/or to (at least in part) enable reduced pressure during exhalation by selective venting of therapeutic gas.
  • the various embodiments discussed to this point are based on use of either a constant speed blower 22 or a variable speed blower 22.
  • any of the various arrangements discussed utilizing a variable speed blower 22 may instead use a constant speed blower 22 in combination with a throttle valve 69, as illustrated in Figure 8A (in the shorthand notation, and in reference to the illustrative arrangement of Figure 5).
  • the device of Figure 8 A comprises a throttle valve 69 fluidly coupled to the inlet of the blower 22.
  • the blower 22 fluidly couples to the control valve 62, which in turn fluidly couples to the outlet ports 23 and 25.
  • the throttle valve 69 selectively controls an amount of therapeutic gas (e.g., air) entering the blower 22.
  • the pressure and/or flow of therapeutic gas exiting the blower 22 may thus be controlled by positioning of a valve member within throttle valve 69.
  • the throttle valve 69 may fluidly couple to the outlet of the blower 22, between the blower 22 and the illustrative control valve 62. While either orientation of the throttle valve is operable, the inventors of the current specification have found that less audible noise is produced if the throttle valve is positioned on the inlet of the blower 22. The specification now turns to various embodiments of the control valve 62.
  • Figure 9 illustrates an overhead view of at least some embodiments of control valve 62.
  • the control valve 62 contains an outer housing 70.
  • the outer housing 70 comprises three ports: an inlet port 72; and two outlet ports 74 and 76.
  • Therapeutic gas from blower 22 (not shown in Figure 9) couples to the control valve inlet port 72.
  • the control valve 62 then selectively divides or proportions the therapeutic gas between the outlet ports 74 and 76.
  • the illustrative mechanism by which the proportioning takes place is shown in Figures 1OA and 1OB.
  • Figures 1OA and 1OB are overhead views of control valve 62 with the top portion of the outer housing 70 removed to show the relationship of the moveable valve member 78 to the various inlet and outlet ports.
  • a moveable valve member 78 that comprises a flow diversion portion 80 and a two blocking portions 82 and 84 held between upper and lower disc members (the disc member visible in the view of Figures 1OA and 1OB is illustrated as clear to make the diversion and blocking portions visible).
  • the moveable valve member 78 is rotationally coupled within the outer housing 70 to enable different orientations of the diversion portion 80 and blocking portions 82 and 84 with respect to the inlet and outlet ports. In the orientation of the moveable valve member 78 shown in Figure 1OA, the leading edge of the flow diversion portion 80 is centered with respect to the inlet port 80.
  • the blocking portions 82 and 84 do not block therapeutic gas flow into their respective outlet ports.
  • the moveable valve member 78 is rotated (discussed more below) in an attempt to evenly distribute the therapeutic gas flow.
  • the distribution of therapeutic gas flow has two components: a diversion portion; and a blocking portion.
  • the diversion portion of the distribution of the therapeutic gas flow is enabled by the diversion portion 80.
  • the diversion portion 80 rotated to favor one outlet port 74, 76 creates flow pathway that has fewer impediments to therapeutic gas flow, and thus less pressure drop occurs along the flow pathway.
  • the moveable valve member 78 is rotated to create a fluid dynamically preferred flow path to outlet port 74. It is noted, however, that in at least some embodiments in spite of the fact that the moveable valve member 78 is rotated, that therapeutic gas flow as between the outlet ports 74 and 76 is substantially evenly distributed.
  • each outlet port 74 and 76 may be substantially the same in spite of the orientation of the moveable valve member 78 (though the absolute pressure within each outlet port will be different).
  • the second aspect of distribution is the blocking portion.
  • the blocking aspect of distribution is enabled by the blocking portions 82 and 84 of the moveable valve member 78.
  • the moveable valve member 78 rotates within the outer housing 70, at least one of the blocking portions 82 and 84 rotate to block the respective outlet port.
  • blocking portion 82 is shown to partially block outlet port 76 while blocking portion 82 moves further away from its outlet port 74.
  • the therapeutic gas flow through each outlet port 74 and 76 are substantially the same, but the blocking portions 82 and 84, when occluding their respective outlet ports, provide additional flow impediments to cause pressure drop along the non-preferred flow pathway.
  • Figure 11 shows an elevation side view of the control valve 62 and a valve movement operator 90 in accordance with at least some embodiments.
  • the orientation of the moveable valve member 78 is controlled without direct physical contact between the valve member 78 and the stepper motor 92.
  • the shaft 94 of the stepper motor 92 couples to a disk 96 having a magnet 98 affixed on an outer edge.
  • the moveable valve member 78 within the outer housing 70 the moveable valve member 78 likewise has a magnet 100 (shown in dashed lines to signify that the magnet resides on a bottom side of a lower disk portion of the valve member 78, and thus is not in the therapeutic gas flow path).
  • the magnet 100 on the valve member 78 magnetically couples to the magnet 98 on the disk 96 coupled to the stepper motor.
  • the stepper motor controls the rotational position of the moveable valve member 78 by turning disk 96.
  • the magnetic force between the two magnets 98 and 100 in turn forces the moveable valve member 78 to a corresponding location.
  • Having the valve member 78 magnetically coupled to the disk 98 and stepper motor 92 reduces valve control sounds detectable by the patient through mask, reduces the number of apertures through the outer housing 70, and also reduces potential toxicity of the control valve 62 by reducing the need for seals and bearings having hydrocarbon-based lubricants.
  • the shaft 94 of the stepper motor 92 extends through the outer housing 70 and directly couples to the moveable valve member 78.
  • the processor 10 ( Figure 1) to have a direct indication of the rotational orientation of the moveable valve member 78.
  • position of the valve member 78 may be sensed from a second disk 97 mechanically coupled to the moveable valve member 98 by way of shaft 99.
  • illustrative disk 97 has associated therewith a position sensing circuit 102.
  • the position sensing is by way of optical sensing, but in other embodiments other types of sensing may be used (e.g., detents in the disk sensed by mircoswitches, Hall effect sensors and associated magnets).
  • Figure 12 shows an overhead view of disk 97 in order to discus the sensing of the rotational orientation of the disk 97 (and thus the valve member 78).
  • disk 97 has a plurality of apertures at 104 varying diameters.
  • three optical sensors are used, one each at each of the varying diameters.
  • optical sensors align with location 114, and an illustrative Boolean value of "Oi l" is sensed.
  • the processor 10 is enabled to sense the orientation of the disk 97 (and thus the valve member 78).
  • fewer or greater numbers of sensors e.g., two may be equivalently used.
  • Figure 13 illustrates a control methodology implemented by the processor 10 ( Figure 1) in accordance with at least some embodiments.
  • the illustrative method is discussed in reference to embodiments using control valve 62; however, after understanding the control methodology in reference to the control valve 62, the methodology is extendable to systems using separate valves 38 and 40 on each control path.
  • the method starts (block 1300) with the valve member 78 of the control valve 62 centered and therapeutic gas pressure set to a predetermined value (e.g., prescribed titration pressure).
  • the illustrative process waits until a first inhalation is sensed (block 1302), and when the first inhalation is sensed the illustrative process proceeds along two parallel paths.
  • the illustrative process simultaneously adjusts the pressure of the therapeutic gas flow for the naris exhibiting less resistance to therapeutic gas flow (i.e., the non-burdened naris) (block 1308) while adjusting the position of the moveable valve member 78 of the control valve 62 to substantially equalize therapeutic gas flow (block 1310).
  • assigning a burdened or non-burdened control status to each naris is based on software determination observing therapeutic gas flows and pressures.
  • the position sensing with respect to disk 98 indicates directly the burdened and non-burdened naris.
  • the valve member 78 of the control valve 62 adjusts to increase pressure to the naris exhibiting greater resistance to therapeutic gas flow (i.e., the burdened naris). If only the valve member 78 position is adjusted, the pressure of the therapeutic gas provided to the non- burdened naris drops. In order to compensate for reduced pressure cause by valve member 78 position changes, therapeutic gas provided from the blower 22 is increased.
  • the controlled parameters therapeutic gas pressure from the blower 22 and valve member 78 position
  • the therapeutic gas pressure provided by the blower 22 is adjusted to control the pressure to the non-burdened naris
  • the position of the valve member 78 is adjusted to balance of therapeutic gas flow to the nares.
  • Adjusting the therapeutic gas pressure from blower 22 may take many forms, as discussed above.
  • a variable speed motor/blower is used, and thus changes in therapeutic gas pressure provided from the blower 22 are made by speed changes.
  • the blower 22 operates at a constant speed, and the therapeutic gas pressure provided may be adjusted by control of a throttle valve 69 and/or dump valve 60.
  • the therapeutic gas pressure provided by the blower 22 may be adjusted by a combination of any of the aforementioned control mechanisms.
  • valve member 78 in some embodiments the position of the valve member 78 is adjusted throughout the inhalation, while in other embodiments the position of the valve member 78 is only adjusted for a portion of the inhalation (e.g., the first quarter of the inhalation and thereafter the valve remains at the last controlled position). In situations where valve member 78 position is only adjusted for a portion each inhalation, several respiratory cycles may be traversed before achieving a substantially equal distribution of therapeutic gas flow as between the nares.
  • the illustrative method continues to adjust therapeutic gas pressure (block 1308) and continues to have the ability to adjust valve member 78 position (block 1310), even if the system elects not to adjust after a predetermined period of time, until exhalation is sensed (block 1312).
  • the system saves the last valve member 78 position, the last therapeutic gas pressure setting, and centers the valve member 78 (block 1314). Saving the last valve member 78 position and the last therapeutic gas pressure setting enables the control methodology illustrated by Figure 13 to return to the last known good settings on the next inhalation. Centering the valve member 78 position ensures that crossover between the nares does not occur, as discussed above.
  • the illustrative method continues until an inhalation is sensed (block 1318), and then proceeds again to the control methodology described with respect to inhalation (blocks 1308 and 1310).
  • the valve member 78 position is placed at the last known good position (block 1306) saved in block 1314. To the extent the last know valve member 78 position is close to the position that provides substantially equalized therapeutic gas flow as between the nares, moving the valve member 78 position to the last know good position increases responsiveness of the therapeutic gas flow control loop.
  • the therapeutic gas pressure applied during exhalation is not the same as that applied during inhalation.
  • the therapeutic gas pressure is reduced (block 1316). Reducing the therapeutic gas pressure may take many forms.
  • a variable speed motor/blower is used, and thus reducing in therapeutic gas pressure provided from the blower 22 is made by lowering blower speed.
  • the blower 22 operates at a constant speed, and the therapeutic gas pressure provided lowered by control of a throttle valve 69 and/or dump valve 60.
  • the therapeutic gas pressure provided by the blower 22 is lowered by opening dump valves 38 and 40 on the respective flow pathways.
  • the therapeutic gas pressure provided by the blower 22 is lowered by a combination of any of the aforementioned control mechanisms. Once an inhalation is sensed (again block 1318), in the pressure control portion of the parallel pathways the therapeutic gas pressure is increased to last know good pressure setting (block 1304) stored in block 1314.
  • the various embodiments of the device 100 of Figure 1 have pressure sensors 28 and 32.
  • the pressure sensors 28 and 32 provide pressure readings to the processor 10 referenced to atmosphere (or possibly absolute pressure). Because of the pressure reference, and because the device 100 has the ability to dynamically control applied therapeutic gas pressure, device 100 can use a permanent or removable blower inlet air filter without adversely affecting device performance.
  • Figure 14 illustrates a device 100 in accordance with alternative embodiments (in the shorthand notation) having a blower inlet air filter 120.
  • the blower inlet air filter 120 may take many forms.
  • the blower inlet air filter 120 is a high efficiency particular air (HEPA) filter which removes 99.99% of airborne particles having diameters of 0.3 micrometers or greater.
  • HEPA high efficiency particular air
  • the blower inlet air filter 120 is a ultra low penetration air (ULPA) filter which removes 99.9995% of airborne particles having diameters of 0.12 micrometers or greater.
  • ULPA ultra low penetration air
  • filter 120 may present a resistance to therapeutic gas flow into the blower 22 and corresponding reduction in pressure provided by the blower 22, the corresponding reduction in pressure can be determined by pressure sensors 28 and 32, and compensated for by control action associated with the blower (e.g., increasing blower speed).
  • Figure 14 also illustrates alternative embodiments (in the shorthand form) where the therapeutic gas supplied by the blower 22 (e.g. , air) is supplemented by another therapeutic gas (e.g., oxygen, helium).
  • a second source of therapeutic gas 122 fluidly couples to a gas inlet port 125 that fluidly couples to the fluid connection between the blower 22 and control valve 62 by way of a valve 124.
  • gas from the second therapeutic gas source is likewise substantially equally divided between the two outlet ports 23 and 25.
  • the second therapeutic gas source 122 provides gas during both inhalation and exhalation, but in other embodiments valve 124 (e.g. a solenoid valve) turns off the second therapeutic gas source during exhalation.
  • the inventors of the present specification have found that the therapeutic gas exiting the blower 22 is non-laminar flow, and in some cases the non-laminar flow exhibits a gas swirl about the axis of travel.
  • the gas swirl may cause inconsistent dividing or proportioning of the therapeutic gas flow by illustrative control valve 62.
  • some embodiments implement a flow straightening device 130 within the therapeutic gas flow downstream of the of the blower 22.
  • the flow straightening device may take the form of a plurality of parallel plates within therapeutic gas flow, or in other embodiments an extended straightener having a honeycomb cross-section.
  • the above discussion is meant to be illustrative of the principles and various embodiments of the present invention. Numerous variations and modifications will become to those skilled in the art once the above disclosure is fully appreciated.
  • the therapeutic gas supplied to each naris is controlled to be substantially equal
  • the therapeutic gas flow provided to each naris is controlled to be different (e.g., where an anatomical blockage allows some therapeutic gas flow, but where substantially equal flow causes irritation). It is intended that the following claims be interpreted to embrace all such variations and modifications.

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Abstract

L'invention concerne un dispositif de pression des voies aériennes positive à soufflante unique et un procédé apparenté. Au moins certains des modes de réalisation illustratifs sont des systèmes comprenant un premier orifice de sortie configuré pour se coupler à un premier orifice de respiration d'un patient, un second orifice de sortie configuré pour se coupler à un second orifice de respiration d'un patient, une soufflante unique couplée de façon fluide au premier orifice de sortie et au second orifice de sortie (la soufflante unique fournit quasiment tout le gaz thérapeutique inspiré par les premier et second orifices de respiration, et une première soupape couplée de façon fluide entre la soufflante unique et le premier orifice de sortie). Le système est configuré pour réguler la pression du gaz thérapeutique appliqué au premier orifice de sortie pour qu'elle soit différente de la pression du gaz thérapeutique appliqué au second orifice de sortie.
PCT/US2007/087845 2006-12-19 2007-12-18 Dispositif de pression des voies aériennes positive à soufflante unique et procédé apparenté WO2008077003A1 (fr)

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Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2010033358A3 (fr) * 2008-09-17 2010-05-06 General Electric Company Respirateur
WO2017191534A1 (fr) * 2016-05-04 2017-11-09 Fisher & Paykel Healthcare Limited Système d'assistance respiratoire et ventilateur pour système d'assistance respiratoire
CN107427651A (zh) * 2014-10-03 2017-12-01 奥克兰理工大学 用于控制气体输送的方法和设备
WO2021061607A1 (fr) * 2019-09-23 2021-04-01 Incoba, Llc Procédé et système de détection d'un écoulement d'air et d'administration d'un gaz thérapeutique à un patient
WO2021076412A1 (fr) 2019-10-14 2021-04-22 Incoba, Llc Procédés et systèmes d'alimentation en gaz thérapeutique basés sur la durée d'inhalation
IT202000028022A1 (it) * 2020-11-23 2022-05-23 Spectra 2000 Srl Dispositivo per la raccolta dell’esalato

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1992011054A1 (fr) * 1990-12-21 1992-07-09 Puritan-Bennett Corporation Systeme de pression inspiratoire des voies respiratoires
US5687715A (en) * 1991-10-29 1997-11-18 Airways Ltd Inc Nasal positive airway pressure apparatus and method
US6532956B2 (en) * 2000-03-30 2003-03-18 Respironics, Inc. Parameter variation for proportional assist ventilation or proportional positive airway pressure support devices
US6722359B2 (en) * 2000-07-31 2004-04-20 Societe D'applications Industrielles Medicales Et Electronique (Saime) Apparatus for assistance for venting a patient
US20050011523A1 (en) * 2003-07-18 2005-01-20 Acoba, Llc Method and system of Individually controlling airway pressure of a patient's nares
US7000612B2 (en) * 2000-10-06 2006-02-21 Ric Investments, Llc. Medical ventilator triggering and cycling method and mechanism

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1992011054A1 (fr) * 1990-12-21 1992-07-09 Puritan-Bennett Corporation Systeme de pression inspiratoire des voies respiratoires
US5687715A (en) * 1991-10-29 1997-11-18 Airways Ltd Inc Nasal positive airway pressure apparatus and method
US6532956B2 (en) * 2000-03-30 2003-03-18 Respironics, Inc. Parameter variation for proportional assist ventilation or proportional positive airway pressure support devices
US6722359B2 (en) * 2000-07-31 2004-04-20 Societe D'applications Industrielles Medicales Et Electronique (Saime) Apparatus for assistance for venting a patient
US7000612B2 (en) * 2000-10-06 2006-02-21 Ric Investments, Llc. Medical ventilator triggering and cycling method and mechanism
US20050011523A1 (en) * 2003-07-18 2005-01-20 Acoba, Llc Method and system of Individually controlling airway pressure of a patient's nares

Cited By (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2010033358A3 (fr) * 2008-09-17 2010-05-06 General Electric Company Respirateur
CN107427651A (zh) * 2014-10-03 2017-12-01 奥克兰理工大学 用于控制气体输送的方法和设备
US10603452B2 (en) 2014-10-03 2020-03-31 Auckland University Of Technology Method and apparatus for the controlled delivery of gases
CN107427651B (zh) * 2014-10-03 2020-12-15 奥克兰理工大学 用于控制气体输送的方法和设备
CN109414554B (zh) * 2016-05-04 2022-06-14 费雪派克医疗保健有限公司 呼吸支持系统和用于呼吸支持系统的鼓风机
WO2017191534A1 (fr) * 2016-05-04 2017-11-09 Fisher & Paykel Healthcare Limited Système d'assistance respiratoire et ventilateur pour système d'assistance respiratoire
CN109414554A (zh) * 2016-05-04 2019-03-01 费雪派克医疗保健有限公司 呼吸支持系统和用于呼吸支持系统的鼓风机
JP2019514594A (ja) * 2016-05-04 2019-06-06 フィッシャー アンド ペイケル ヘルスケア リミテッド 呼吸補助システム及び呼吸補助システムのための送風機
EP3452155A4 (fr) * 2016-05-04 2019-12-25 Fisher&Paykel Healthcare Limited Système d'assistance respiratoire et ventilateur pour système d'assistance respiratoire
EP4442303A3 (fr) * 2016-05-04 2024-11-27 Fisher & Paykel Healthcare Limited Système d'assistance respiratoire et ventilateur pour système d'assistance respiratoire
US11173263B2 (en) 2016-05-04 2021-11-16 Fisher & Paykel Healthcare Limited Respiratory support system and blower for respiratory support system
AU2017260744B2 (en) * 2016-05-04 2022-04-21 Fisher & Paykel Healthcare Limited Respiratory support system and blower for respiratory support system
WO2021061607A1 (fr) * 2019-09-23 2021-04-01 Incoba, Llc Procédé et système de détection d'un écoulement d'air et d'administration d'un gaz thérapeutique à un patient
EP4045117A4 (fr) * 2019-10-14 2023-11-08 Incoba LLC Procédés et systèmes d'alimentation en gaz thérapeutique basés sur la durée d'inhalation
WO2021076412A1 (fr) 2019-10-14 2021-04-22 Incoba, Llc Procédés et systèmes d'alimentation en gaz thérapeutique basés sur la durée d'inhalation
WO2022107092A1 (fr) * 2020-11-23 2022-05-27 Spectra 2000 S.R.L. Dispositif pour collecter l'haleine exhalée
IT202000028022A1 (it) * 2020-11-23 2022-05-23 Spectra 2000 Srl Dispositivo per la raccolta dell’esalato

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