A view optimizing assembly, method and kit for use in combination with a laparoscope having a lens located on the shaft tip of the laparoscope, and a source of insufflation CO.sub.2. The invention includes a multi-lumen sheath assembly, a deflector assembly in fluid communication with the lumens of the sheath assembly, wherein the flow of CO.sub.2 through the lumens forms a vortex when coming into contact with the deflector assembly, thereby preventing fogging of the laparoscope lens.

Methods and apparatus provide automated circuit disconnection monitoring such as for a respiratory apparatus or system. Disconnection of a patient circuit, including a patient interface and air delivery circuit, may be detected and a message or alarm activated. In some versions, detecting occurrences of circuit disconnection event(s), such as by a processor, may be based on an instantaneous disconnection parameter as a function of a disconnection setting. The disconnection setting may be determined based on patient circuit type. The instantaneous disconnection parameter may be determined from detected pressure and flow rate, and may be, for example, a conductance value or an impedance value. Disconnection events may be qualified by one or more detected respiratory indicators. In some cases, instantaneous impedance or conductance may be used to assess re-connection of a patient circuit, detection of flow starvation, determine breath shape for triggering and cycling and to detect patient or circuit obstructions.

Methods and apparatus provide automated circuit disconnection monitoring such as for a respiratory apparatus or system. Disconnection of a patient circuit, including a patient interface and air delivery circuit, may be detected and a message or alarm activated. In some versions, detecting occurrences of circuit disconnection event(s), such as by a processor, may be based on an instantaneous disconnection parameter as a function of a disconnection setting. The disconnection setting may be determined based on patient circuit type. The instantaneous disconnection parameter may be determined from detected pressure and flow rate, and may be, for example, a conductance value or an impedance value. Disconnection events may be qualified by one or more detected respiratory indicators. In some cases, instantaneous impedance or conductance may be used to assess re-connection of a patient circuit, detection of flow starvation, determine breath shape for triggering and cycling and to detect patient or circuit obstructions.

A patient interface may include a plenum chamber pressurisable to a therapeutic pressure; a seal-forming structure constructed and arranged to form a seal with a region of the patient's face; a positioning and stabilising structure to provide an elastic force to hold the seal-forming structure on the patient's head, the positioning and stabilising structure may include a tie; a vent structure; a decoupling structure configured to provide a fluid connection between the plenum chamber and an air circuit for the flow of air at the therapeutic pressure for breathing by the patient; and a frame having at least one tie attachment structure to receive the tie, wherein the frame is configured to be resiliently movable in any direction having at least one of a component parallel to the patient's sagittal plane, a component parallel to the patient's coronal plane, a component parallel to the patient's Frankfort horizontal plane.

A patient interface may include a plenum chamber pressurisable to a therapeutic pressure; a seal-forming structure constructed and arranged to form a seal with a region of the patient's face; a positioning and stabilising structure to provide an elastic force to hold the seal-forming structure on the patient's head, the positioning and stabilising structure may include a tie; a vent structure; a decoupling structure configured to provide a fluid connection between the plenum chamber and an air circuit for the flow of air at the therapeutic pressure for breathing by the patient; and a frame having at least one tie attachment structure to receive the tie, wherein the frame is configured to be resiliently movable in any direction having at least one of a component parallel to the patient's sagittal plane, a component parallel to the patient's coronal plane, a component parallel to the patient's Frankfort horizontal plane.

A mask system for delivery of respiratory therapy to a patient includes a nares portion and a mouth portion and an inlet conduit connected to at least one of the nares portion and the mouth portion to deliver the pressurized, breathable gas. The mask system is adapted to selectively utilize the nares portion and/or the mouth portion in a first mode utilizing both the nares portion and the mouth portion, and in a second mode utilizing the nares portion and not utilizing the mouth portion.

A mask system for delivery of respiratory therapy to a patient includes a nares portion and a mouth portion and an inlet conduit connected to at least one of the nares portion and the mouth portion to deliver the pressurized, breathable gas. The mask system is adapted to selectively utilize the nares portion and/or the mouth portion in a first mode utilizing both the nares portion and the mouth portion, and in a second mode utilizing the nares portion and not utilizing the mouth portion.

A patient interface includes a cushion configured to sealingly engage the patient's face, a support structure configured to support the cushion, the support structure being more rigid than the cushion, a plenum chamber formed at least in part by the cushion, and a connector configured to convey the pressurized respiratory gas to the plenum chamber. The connector includes a first portion formed from a first material and adapted to removably connect to the support structure. A plurality of vent holes are formed on the first portion. The connector also includes a continuous flexible portion that is formed from a second material, is more flexible than the first portion, and is configured to flex to permit engagement and disengagement of the first portion. The continuous flexible portion comprises a pair of opposing release buttons that are configured to be inwardly flexed to allow release of the connector from the support structure.

A patient interface includes a cushion configured to sealingly engage the patient's face, a support structure configured to support the cushion, the support structure being more rigid than the cushion, a plenum chamber formed at least in part by the cushion, and a connector configured to convey the pressurized respiratory gas to the plenum chamber. The connector includes a first portion formed from a first material and adapted to removably connect to the support structure. A plurality of vent holes are formed on the first portion. The connector also includes a continuous flexible portion that is formed from a second material, is more flexible than the first portion, and is configured to flex to permit engagement and disengagement of the first portion. The continuous flexible portion comprises a pair of opposing release buttons that are configured to be inwardly flexed to allow release of the connector from the support structure.

A nasal interface uses asymmetrical nasal delivery elements to deliver an asymmetrical flow through the interface to both nares or to either nare, and a mouthpiece may be inserted to maintain a leak, to improve dead space clearance in the upper airways, decrease peak expiratory pressure, reduce noise, increase safety of the therapy for smaller patients and reduce resistance in the interface allowing desired flow rates to be achieved at reduced motor speeds of associated flow generating devices. Different forms of fittings, such as sleeves or inserts can be attached to nasal delivery elements to improve or optimize the therapeutic effects of nasal high flow. It may allow high pressures to be achieved at lower flow rates, reduce noise, improve patient comfort and efficiently clear anatomical dead space.