Patient interface
11524133 · 2022-12-13
Assignee
Inventors
Cpc classification
A61M16/08
HUMAN NECESSITIES
International classification
A61M16/08
HUMAN NECESSITIES
A61M16/00
HUMAN NECESSITIES
Abstract
A patient interface for delivery of a supply of pressurised air or breathable gas to an entrance of a patient's airways includes a frame member, a cushion assembly provided to the frame member, and an anterior wall member repeatedly engageable with and disengageable from the cushion assembly. The frame member includes connectors operatively attachable to a positioning and stabilizing structure. The cushion assembly includes a seal-forming structure and a void defined by an anterior surface of the cushion assembly. The anterior wall member has a predetermined surface area to seal the void of the cushion assembly and form a gas chamber when the anterior wall member and the cushion assembly are engaged. The void of the cushion assembly is sized such that the patient's nose and/or mouth is substantially exposed when the anterior wall member is disengaged from the cushion assembly thereby improving breathing comfort of the patient.
Claims
1. A patient interface for delivery of a supply of pressurised air or breathable gas to an entrance of a patient's airways for treatment of sleep disordered breathing, comprising: a seal-forming assembly including a frame member and a seal-forming member provided to the frame member, the seal-forming member including nasal pillows, wherein the nasal pillows are configured to only form a seal with the patient's nares; and an anterior wall member repeatedly engageable with and disengageable from the seal-forming assembly, the anterior wall member configured to form a gas chamber when the anterior wall member and the seal-forming assembly are engaged, wherein the anterior wall member and the seal-forming assembly are magnetically engageable.
2. The patient interface of claim 1, wherein the anterior wall member comprises a connection port configured to connect to a gas delivery tube.
3. The patient interface of claim 1, wherein at least a peripheral portion of the anterior wall member is repeatedly engageable with and disengageable from at least a peripheral portion of the frame member.
4. The patient interface of claim 3, wherein the peripheral portion of the anterior wall member and the peripheral portion of the frame member are rigid such that engagement between the peripheral portion of the anterior wall member and the peripheral portion of the frame member is not caused by material deformation of the anterior wall member and/or the frame member.
5. The patient interface of claim 4, wherein the peripheral portion of the anterior wall member and the peripheral portion of the frame member are magnetically engageable.
6. The patient interface of claim 5, wherein the peripheral portion of the anterior wall member and the peripheral portion of the frame member has at least one magnet.
7. The patient interface of claim 6, wherein the at least one magnet is a permanent magnet or an electromagnet.
8. The patient interface of claim 5, wherein magnetic engagement of the peripheral portion of the anterior wall member and the peripheral portion of the frame member causes a flow generator to supply pressurised respiratory gas to the patient interface via a gas delivery tube, and when the anterior wall member and frame member are disengaged the flow generator ceases the supply of pressurised respiratory gas to the patient interface.
9. The patient interface of claim 1, further comprising at least one vent provided on the anterior wall member to allow the washout of exhaled carbon dioxide.
10. The patient interface of claim 2, wherein the connection port is connected to a swivel elbow configured to connect to the gas delivery tube.
11. The patient interface of claim 10, further comprising at least one vent provided on the swivel elbow to allow the washout of exhaled carbon dioxide.
12. The patient interface of claim 1, wherein the seal-forming member is releasably connected to the frame member.
13. The patient interface of claim 1, wherein the frame member includes an annular side wall that encloses or wraps around the seal-forming member.
14. The patient interface of claim 1, wherein the frame member projects from the seal-forming member so as to be exposed for engagement with the anterior wall member.
15. The patient interface of claim 12, wherein the frame member includes retention features structured to engage or interlock with corresponding retention features provided to the seal-forming member.
16. The patient interface of claim 1, wherein the frame member includes connectors configured to attach to one or more straps of a headgear.
17. The patient interface of claim 1, wherein the frame member is more rigid than the seal-forming member.
18. The patient interface of claim 1, wherein the seal-forming member is co-molded to the frame member.
19. The patient interface of claim 1, wherein magnetic attraction between the anterior wall member and the seal-forming assembly guides and aligns the anterior wall member to the seal-forming assembly during engagement.
20. The patient interface of claim 2, wherein the anterior wall member and the frame member each have a pair of magnets, and each of the pair of magnets of the anterior wall member is provided on a respective side of the connection port.
Description
(C) BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
(1) The present technology is illustrated by way of example, and not by way of limitation, in the figures of the accompanying drawings, in which like reference numerals refer to similar elements including:
(2) 2.1 Treatment Systems
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(6) 2.2 Therapy
(7) 2.2.1 Respiratory System
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(10) 2.2.2 Facial Anatomy
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(21) 2.3 PAP Device and Humidifier
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(25) 2.4 Patient Interface
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3 (D) DETAILED DESCRIPTION OF EXAMPLES OF THE TECHNOLOGY
(80) Before the present technology is described in further detail, it is to be understood that the technology is not limited to the particular examples described herein, which may vary. It is also to be understood that the terminology used in this disclosure is for the purpose of describing only the particular examples discussed herein, and is not intended to be limiting.
(81) The following description is provided in relation to several examples which may share one or more common characteristics and features. It is to be understood that one or more features of any one example may be combinable with one or more features of another example or other examples. In addition, any single feature or combination of features in any of the examples may constitute a further example.
3.1 Treatment Systems
(82) In one form, the present technology comprises an apparatus for treating a respiratory disorder, as shown in
3.2 Therapy
(83) In one form, the present technology comprises a method for treating a respiratory disorder comprising the step of applying positive pressure to the entrance of the airways of a patient 1000.
(84) 3.2.1 Nasal CPAP for OSA
(85) In one form, the present technology comprises a method of treating Obstructive Sleep Apnea in a patient by applying nasal continuous positive airway pressure to the patient.
3.3 Patient Interface
(86) Referring to
(87) In one form of the present technology, the frame member 3100, the cushion assembly 3175, and the anterior wall member 3300 are repeatedly and removably engageable with one another. In the illustrated example, the frame member 3100 and the cushion assembly 3175 are connected to one another, with the anterior wall member 3300 being repeatedly and removably engageable with the cushion assembly 3175 (e.g., see
(88) The frame member 3100 (e.g., constructed of a relatively hard plastic material such as polycarbonate) provides a connection between the cushion assembly 3175 and the positioning and stabilising structure 3400, e.g., either in a removable fashion or a more permanent fashion, to allow sealing forces to be transferred to the cushion assembly 3175 from the positioning and stabilising structure 3400.
(89) The frame member 3100 may also be commonly referred to as a shroud, headgear connection structure, or chassis. In the illustrated example, the frame member 3100 engages with the cushion assembly 3175, and provides a 4-point connection to the positioning and stabilising structure 3400. The anterior wall member 3300 comprises a multi-hole vent 3700 surrounding connection port 3302. The connection port 3302 is connected to an elbow or swivel elbow 3600, which is connected to the gas delivery tube 4180 for fluid communication with a gas chamber or plenum chamber 3500 of the patient interface 3000.
(90) In one form of the present technology, the cushion assembly 3175 includes a main body 3180 that is connected or otherwise provided to the seal-forming structure 3200. The main body 3180 may be permanently (e.g., co-molded, overmolded) or removably (e.g., mechanical interlock) connected to the seal-forming structure 3200. In an example, the seal-forming structure 3200 is constructed of a relatively flexible or pliable material (e.g., silicone) and the main body 3180 is constructed of a relatively rigid material (e.g., polycarbonate). In the illustrated example, the cushion assembly 3175 includes a void 3102 defined by an anterior facing surface 3104 of the main body 3180 of the cushion assembly 3175. When the anterior wall member 3300 and the cushion assembly 3175 are engaged, the anterior wall member 3300 (also referred to as the fascia) has a predetermined surface area to pneumatically seal the void 3102 of the cushion assembly 3175 and form the gas chamber or plenum chamber 3500 (e.g., see
(91) As best shown in
(92) As shown in
(93) The sufficiently larger mask opening provided by the void 3102 improves breathing comfort of the patient (e.g., less claustrophobic, less air flow impedance), provides a less bulky/obtrusive mask (very low profile), allows visual inspection, better avoids condensation build-up (fogging), and/or assists with patient acclimatization of the patient interface 3000.
(94) The patient interface 3000 is structured to reduce bulk along the sagittal plane, i.e., reduce depth of the patient interface or protrusion of the patient interface from the patient's face in the anterior-posterior direction. Also, the patient interface 3000 is structured to reduce the facial footprint (the superficial surface area) in the coronal plane, i.e., the surface area projected by the patient interface 3000 on the patient's face. The reduction in size in all three dimensions when the anterior wall member 3300 is removed from the cushion assembly 3175 reduces overall weight and perceived size and weight by the patient.
(95) In an example, as shown in
(96) Engagement between Cushion Assembly and Anterior Wall Member
(97) In one form of the present technology, at least a peripheral portion 3305 of the anterior wall member 3300 is repeatedly engageable with and disengageable from at least a peripheral portion 3105 of the main body 3180 of the cushion assembly 3175. In an example, the peripheral portion 3305 of the anterior wall member 3300 and the peripheral portion 3105 of the cushion assembly 3175 are rigid such that engagement between the peripheral portion 3305 of the anterior wall member 3300 and the peripheral portion 3105 of the cushion assembly 3175 provides a hard-to-hard connection and is not caused by material deformation of the cushion assembly 3175 and/or the anterior wall member 3300.
(98) In an example, the perimeter and/or shape of the anterior wall member 3300 is predetermined to facilitate alignment of the anterior wall member 3300 to the cushion assembly 3175 for mechanical/structural engagement. For example, the shape of the anterior wall member 3300 may be symmetrical in at least one axis to minimise misalignment of the anterior wall member 3300 to the cushion assembly 3175 for engagement.
(99) In an example, when the cushion assembly 3175 and the anterior wall member 3300 are engaged, accidental disengagement caused by tube drag forces is prevented due to the shape, geometry and perimeter of the mating surfaces of the cushion assembly 3175 and the anterior wall member 3300. That is, the cushion assembly 3175 and the anterior wall member 3300 are structured to maintain engagement during use and prevent any unintentional or partial disassembly during use.
(100) Magnetic Engagement
(101) In one form of the present technology, the anterior wall member 3300 is magnetically engageable with the cushion assembly 3175. For example, the peripheral portion 3305 of the anterior wall member 3300 and the peripheral portion 3105 of the main body 3180 of the cushion assembly 3175 may be magnetically engageable.
(102) As shown in
(103) In the example shown in
(104) In an example, the at least one magnet 3110, 3310 provided to the cushion assembly 3175 and the anterior wall member 3300 may be a permanent magnet or an electromagnet.
(105) The magnetic attraction between the magnets 3110, 3310 of the cushion assembly 3175 and the anterior wall member 3300 guides and aligns the anterior wall member 3300 to the cushion assembly 3175 during engagement at least prior to surface contact between the cushion assembly 3175 and the anterior wall member 3300 when they are in close physical proximity to each other. Also, the magnetic attraction between the anterior wall member 3300 and the cushion assembly 3175 may provide the primary engagement force to maintain engagement of the anterior wall member 3300 to the cushion assembly 3175. In an example, the retention force (from the magnets) between the anterior wall member 3300 and the cushion assembly 3175 is less than the retention force (from headgear) to maintain the cushion assembly 3175 in sealing engagement with the patient's face.
(106) The easy magnetic connection/disconnection between the cushion assembly 3175 and the anterior wall member 3300 facilitates use in the dark using macro movement (e.g., useful for bathroom break during the night), provides easy access to the patient for hospital/lab use cases by providing a quick release, and provides a greater sense of control over therapy for the patient (quick release, e.g., without pressing any buttons or rotating a bayonet coupling). Macro movement is contrasted with fine motor skills.
(107) Flow Generator Activation/Deactivation
(108) In one form of the present technology, engagement of the anterior wall member 3300 with the cushion assembly 3175 automatically activates a flow generator 4000 to supply pressurised respiratory gas to the patient interface 3000 via a gas delivery tube 4180 connected to the elbow 3600, and disengagement of the anterior wall member 3300 from the cushion assembly 3175 automatically deactivates the flow generator 4000 to cease the supply of pressurised respiratory gas to the patient interface 3000. In another example, engagement of the anterior wall member 3300 with the cushion assembly 3175 automatically actuates a valve to activate the supply of pressurised respiratory gas to the patient interface 3000.
(109) For example, magnetic engagement of the peripheral portion 3305 of the anterior wall member 3300 to the peripheral portion 3105 of the cushion assembly 3175 causes the flow generator 4000 to supply pressurised respiratory gas to the patient interface 3000 via the gas delivery tube, and when the anterior wall member 3300 and cushion assembly 3175 are disengaged, the flow generator ceases the supply of pressurised respiratory gas to the patient interface 3000.
(110) An electrical activate/deactivate signal may be sent from the patient interface 3000 to the flow generator 4000 in accordance with methods and apparatuses disclosed in U.S. Pat. No. 6,240,921, which is herein incorporated by reference in its entirety.
(111) If the gas delivery tube 4170 is a heated tube comprising at least one wire, the at least one wire may transmit an electrical activate/deactivate signal from the patient interface 3000 to the flow generator 4000 to activate or cease the supply of pressurised respiratory gas to the patient interface 3000.
(112) Alternatively, there may be a wireless transmitter located at the patient interface 3000 which may wirelessly transmit an electrical activate/deactivate signal to a wireless receiver located at the flow generator 4000 to activate or cease the supply of pressurised respiratory gas to the patient interface 3000.
(113) The activate/deactivate signal may be sent upon detection of a magnetic field using a reed sensor, Hall Effect sensor or anisotropic magnetoresistance (AMR) sensor.
(114) Alternative Engagement Examples Between Anterior Wall Member and Cushion Assembly
(115) In an alternative example, the peripheral portion 3305 of the anterior wall member 3300 and the peripheral portion 3105 of the cushion assembly 3175 may be engageable using an adhesive or a hook-and-loop fastener.
(116) In an alternative example, the peripheral portion 3305 of the anterior wall member 3300 and the peripheral portion 3105 of the cushion assembly 3175 may be engageable using a mechanical interlock, e.g., snap-fit connection, barb, hinge, etc.
(117) It should be appreciated that these alternative engagement examples may be used in lieu of or in combination with magnetic engagement. In examples without magnets, some advantages include lower cost and less manufacturing complexity associated with embedding magnets into plastic material.
(118) For example,
(119) In this example, the frame member 14100 is similar to that shown in
(120) The anterior wall member 14300 includes connection port 14302 adapted to be connected to an elbow or swivel elbow which is connected to the gas delivery tube 4180. In the illustrated example, the connection port 14302 includes grooves 14303 structured to allow a bayonet style attachment to the elbow. However, it should be appreciated that the elbow may be releasably or permanently connected to the connection port 14302 in other suitable manners.
(121) As illustrated, each side of the anterior wall member 14300 includes a cantilevered push button 14800 and grooves 14802 along sides of the button 14800 that allow the button 14800 to flex with respect to the anterior wall member 14300. Each button 14800 includes a tab or catch 14804 (e.g., see
(122) In the illustrated example, as best shown in
(123) Each side of a peripheral portion 14105 of the cushion assembly 14175 includes a tab or undercut 14110 structured to interlock with a respective tab or catch 14804 of the anterior wall member 14300 to releasably retain the anterior wall member 14300 to the cushion assembly 14175.
(124) In an example, the elbow connected to the connection port 14302 of the anterior wall member 14300 may be used to grip or handle the anterior wall member 14300 to facilitate engagement/disengagement with the cushion assembly 14175.
(125) In an alternative example, as shown in
(126) As shown in
(127) When the anterior wall member 14300 and the cushion assembly 14175 are engaged, the anterior wall member 14300 seals the void 14102 of the cushion assembly 14175 and forms the gas chamber or plenum chamber. The anterior wall member 14300 is structured to align, seal, and interlock with main body 14180 of the cushion assembly 14175 (and not the frame member 14100) to allow better tolerance control and avoid headgear strap tension forces acting on the anterior wall member 14300. When the anterior wall member 14300 is disengaged from the cushion assembly 14175, e.g., see
(128) In an example, the frame member 14100 and the anterior wall member 14300 may be provided in one size, which may be selectively engageable with multiple sizes of cushion assemblies 14175, e.g., small, medium, and large size cushion assemblies. In an example, regardless of size, the patient interface provides similar locations for the upper headgear connectors 14152 (e.g., based on headgear vectors and clearance with the patient's eyes) and the connection port 14302 for the elbow (e.g., to optimize gas washout). Also, anthropometrics (e.g., clearance with the patient's face, nose and/or mouth) and manufacturability (e.g., line of draw) may be similar across cushion sizes. For example, the axis of the connection port 14302 relative to the line of draw (e.g., about 10°) may be similar across cushion sizes. This may prevent the patient's nose coming into physical contact with the frame member 14100 and the anterior wall member 14300 when the patient interface is donned.
(129)
(130) In this example, the frame member 16100 is similar to that shown in
(131) In an example, the frame member 16100 and the anterior wall member 16300 may be provided in one size, which may be selectively engageable with multiple sizes of cushion assemblies 16175. For example, the cushion assembly 16175 may be provided in three sizes, e.g., a small size cushion assembly 16175A as shown in
(132) The seal-forming structure 16200 is connected to the main body 16180 of the cushion assembly 16175, e.g., seal-forming structure 16200 co-molded to the main body 16180. As shown in
(133) The anterior wall member 16300 includes connection port 16302 adapted to be connected to an elbow or swivel elbow which is connected to the gas delivery tube 4180. In the illustrated example, the connection port 16302 includes grooves 16303 structured to allow a bayonet style attachment to the elbow. However, it should be appreciated that the elbow may be releasably or permanently connected to the connection port 16302 in other suitable manners.
(134) As shown in
(135) The anterior wall member 16300 may be secured and retained to the cushion assembly 16175 in any suitable manner. For example, as shown in
(136) A lip seal 16850 (e.g., constructed of silicone) is provided, e.g., overmolded, along the edge of the peripheral portion 16105 defining the void 16102 of the cushion assembly 16175. The lip seal 16850 provides a compression and pressure assisted seal between the cushion assembly 16175 and the anterior wall member 16300 when engaged with one another. In an example, the lip seal 16850 may extend radially inwardly from the peripheral portion 16105 into the void 16102.
(137) When the anterior wall member 16300 and the cushion assembly 16175 are engaged, the anterior wall member 16300 seals the void 16102 of the cushion assembly 16175 and forms the gas chamber or plenum chamber. When the anterior wall member 16300 is disengaged from the cushion assembly 16175, e.g., see
(138) Engagement and Disengagement Process
(139) In one form of the present technology, e.g., as shown in
(140) In another example, as shown in
(141) However, it is envisaged that the patient may engage the anterior wall member 3300 to the cushion assembly 3175 without any pivoting or tilting of the anterior wall member 3300 downwardly relative to the cushion assembly 3175, or pivoting may be in an upwardly or sideways direction.
(142) In another example, as shown in
(143) In an example, the cushion assembly 3175 and frame member 3100 connected thereto is first positioned against the patient's face using the positioning and stabilizing structure 3400, and then the anterior wall member 3300 is engaged with the cushion assembly 3175 to seal the void 3102 of the cushion assembly 3175. A sealing lip or pressure activated seal may provide a pneumatic seal between the anterior wall member 3300 and cushion assembly 3175. An exemplary method of donning the patient interface 3000 includes positioning the cushion assembly 3175 including the seal-forming structure 3200 and frame member 3100 connected thereto against the patient's face using the positioning and stabilizing structure 3400 and engaging the anterior wall member 3300 having a predetermined surface area with the cushion assembly 3175 to seal the void 3102 of the cushion assembly 3175 and form the gas chamber 3500.
(144) Connection Between Cushion Assembly and Frame Member
(145) In the illustrated example, the cushion assembly 3175 and the frame member 3100 include cooperating retaining structures to connect the cushion assembly 3175 to the frame member 3100. In an example, the frame member 3100 is releasably connectable to the cushion assembly 3175 to facilitate replacement and/or cleaning, and to allow alternative frame members and cushion assemblies to be connected to one another. Such arrangement allows multiple seals (e.g., types and sizes) to be used with the patient interface and therefore provide a patient interface suitable for Multiple Patient Multiple Use (MPMU) usage situations. In an alternative example, the frame member 3100 may be permanently connected or integrally formed in one-piece with the cushion assembly 3175, e.g., co-molded.
(146) In the illustrated example shown in
(147) As shown in
(148) Connection Port
(149) In the illustrated example, the anterior wall member 3300 comprises a connection port 3302 for connection to a gas delivery tube. As illustrated, the connection port 3302 is connected to an elbow or swivel elbow 3600. In an example, as shown in
(150) In an alternative example, the cushion assembly 3175 may comprise a connection port 3302 for connection to a gas delivery tube 4180.
(151) In an alternative example, as shown in
(152) Vent
(153) In one form of the present technology, the patient interface 3000 may include a vent 3700 constructed and arranged to allow for the washout of exhaled air (including carbon dioxide). The vent 3700 is not bulky, i.e., not thick or protrude significantly in the anterior and/or posterior direction. The vent 3700 directs exhaust air away from the cushion assembly 3175 and plenum chamber 3500.
(154) Referring to
(155) In the illustrated example, the vent 3700 is integrated into the anterior wall member 3300 and is implemented as an array of at least thirty (30) vent holes, e.g., at least 40 vent holes 3705, that ring around the connection port 3302, e.g., see
(156) In an alternative example, at least one vent 3700 may be provided on the swivel elbow 3600 or the cushion assembly 3175 to allow the washout of air.
(157) In another example, the vent 3700 may be made from a textile formed of interlaced plastic fibers, e.g., mesh vent.
(158) Seal-Forming Structure
(159) In one form of the present technology, the seal-forming structure 3200 is permanently connected to the main body 3180 of the cushion assembly 3175, e.g., the seal-forming structure 3200 is co-molded to the main body 3180.
(160) In another form of the present technology, the seal-forming structure 3200 may include a retaining structure to connect the seal-forming structure 3200 to the main body 3180. For example, the retaining structure (e.g., constructed of a relatively hard plastic material) may be in the form of a retaining clip structured to releasably connect to the main body 3180 with a snap-fit and provide the seal-forming structure 3200 with a hard-to hard connection with the main body 3180.
(161) In the example shown in
(162) In an alternative example, the seal-forming structure 3200 is of a second type structured to only serve the patient's nares. For example, the seal-forming structure 3200 may be a nasal cushion or nasal cradle structured to form a seal around both nares without being partially located inside the nose. In another example, the seal-forming structure 3200 may include nasal pillows or nasal prongs structured to form a seal surrounding or with the patient's nares (e.g., see
(163) For example,
(164) In another example, as shown in
(165)
(166) As shown in
(167) In yet another example, as shown in
(168) In one form of the present technology, the seal-forming structure 3200 provides a sealing-forming surface, and may additionally provide a cushioning function. A seal-forming structure 3200 of the non-invasive patient interface 3000 in accordance with the present technology may be constructed from a soft, flexible, resilient material such as silicone. However, the seal-forming structure 3200 may comprise other materials, e.g., foam and/or gel and/or low durometer silicone.
(169) In one form of the present technology, the patient interface 3000 may provide a modular system including a single anterior wall member or fascia which is attachable to or otherwise structured to interface with frame members, cushion assemblies, and/or seal-forming structures of multiple types, sizes and/or interface types. For example, cushion assemblies having different seal-forming structures may be attachable to a common frame member and also allow attachment to the single anterior wall member or fascia.
(170) Forehead Support
(171) In one form of the present technology, the patient interface 3000 includes a forehead support. In the illustrated example shown in
(172) The forehead support 3150 includes upper headgear connectors 3152 adapted to connect to upper side straps 3402 of the positioning and stabilizing structure 3400 (e.g., see
(173) In one alternative form, the patient interface 3000 does not include a forehead support. For example,
(174) For example,
(175)
(176) As best shown in
(177) Positioning and Stabilising Structure
(178) Note that in one form of the present technology, a number of structural features form part of a positioning and stabilising structure 3400, e.g., a headgear assembly (which may be referred to simply as headgear). In an alternative form of the present technology, one or more of those features are located on or permanently attached to the frame 3100 or retaining structure of the cushion assembly.
(179) The seal-forming structure 3200 of the patient interface 3000 of the present technology may be held in sealing position in use by the positioning and stabilising structure 3400 (
(180) The positioning and stabilising structure 3400 may comprise two pairs of side straps, i.e., a pair of upper side straps 3402 and a pair of lower side straps 3404, connected to a circular crown strap 3406 that encapsulates the crown of the patient's head. Headgear straps to anchor and maintain the cushion assembly on the patient's face provides a suitable arrangement to comfortably handle tube torque from the gas delivery tube.
(181) The upper side straps 3402 connect to the upper headgear connectors 3152 of the forehead support 3150 and the lower side straps 3404 connect to the lower headgear connectors 3120 of the frame member 3100. The side straps 3402, 3404 may include an adjustable hook and loop (Velcro™) connection mechanism, e.g., Velcro™-like hook tabs, to facilitate connection and/or adjustment to the headgear connectors 3152, 3120.
3.4 PAP Device 4000
(182) A PAP device 4000 in accordance with one aspect of the present technology comprises mechanical and pneumatic components 4100, electrical components 4200 and is programmed to execute one or more algorithms. The PAP device may have an external housing 4010, formed in two parts, an upper portion 4012 of the external housing 4010, and a lower portion 4014 of the external housing 4010. In alternative forms, the external housing 4010 may include one or more panel(s) 4015. The PAP device 4000 may comprise a chassis 4016 that supports one or more internal components of the PAP device 4000. In one form a pneumatic block 4020 is supported by, or formed as part of the chassis 4016. The PAP device 4000 may include a handle 4018.
(183) The pneumatic path of the PAP device 4000 may comprise an inlet air filter 4112, an inlet muffler, a controllable pressure device capable of supplying air at positive pressure (e.g., a controllable blower 4142), and an outlet muffler. One or more pressure sensors and flow sensors may be included in the pneumatic path.
(184) The pneumatic block 4020 may comprise a portion of the pneumatic path that is located within the external housing 4010.
(185) The PAP device 4000 may have an electrical power supply 4210 and one or more input devices 4220. Electrical components 4200 may be mounted on a single Printed Circuit Board Assembly (PCBA) 4202. In an alternative form, the PAP device 4000 may include more than one PCBA 4202.
(186) 3.4.1 PAP Device Mechanical & Pneumatic Components 4100
(187) 3.4.1.1 Air Filter(s) 4110
(188) A PAP device 4000 in accordance with one form of the present technology may include an air filter 4110, or a plurality of air filters 4110.
(189) In one form, an inlet air filter 4112 is located at the beginning of the pneumatic path upstream of a controllable blower 4142. See
(190) In one form, an outlet air filter 4114, for example an antibacterial filter, is located between an outlet of the pneumatic block 4020 and a patient interface 3000. See
(191) 3.4.1.2 Pressure Device 4140
(192) In a form of the present technology, a pressure device for producing a flow of air at positive pressure is a controllable blower 4142. For example the blower 4142 may include a brushless DC motor with one or more impellers housed in a volute. The blower 4142 may be capable of delivering a supply of air, for example about 120 litres/minute, at a positive pressure in a range from about 4 cmH.sub.2O to about 20 cmH.sub.2O, or in other forms up to about 30 cmH.sub.2O.
3.5 Humidifier 5000
(193) 3.5.1 Humidifier Overview
(194) In one form of the present technology there is provided a humidifier 5000, as shown in
3.6 Glossary
(195) In certain forms of the present technology, one or more of the following definitions may apply. In other forms of the present technology, alternative definitions may apply.
(196) 3.6.1 General
(197) Air: Air will be taken to include breathable gases, for example air with supplemental oxygen.
(198) Continuous Positive Airway Pressure (CPAP): CPAP treatment will be taken to mean the application of a supply of air or breathable gas to the entrance to the airways at a pressure that is continuously positive with respect to atmosphere, and preferably approximately constant through a respiratory cycle of a patient. In some forms, the pressure at the entrance to the airways will vary by a few centimeters of water within a single respiratory cycle, for example being higher during inhalation and lower during exhalation. In some forms, the pressure at the entrance to the airways will be slightly higher during exhalation, and slightly lower during inhalation. In some forms, the pressure will vary between different respiratory cycles of the patient, for example being increased in response to detection of indications of partial upper airway obstruction, and decreased in the absence of indications of partial upper airway obstruction.
(199) 3.6.2 Aspects of PAP Devices
(200) Air circuit: A conduit or tube constructed and arranged in use to deliver a supply of air or breathable gas between a PAP device and a patient interface. In particular, the air circuit may be in fluid connection with the outlet of the pneumatic block and the patient interface. The air circuit may be referred to as air delivery tube. In some cases there may be separate limbs of the circuit for inhalation and exhalation. In other cases a single limb is used.
(201) Blower or flow generator: A device that delivers a flow of air at a pressure above ambient pressure.
(202) Controller: A device, or portion of a device that adjusts an output based on an input. For example one form of controller has a variable that is under control—the control variable—that constitutes the input to the device. The output of the device is a function of the current value of the control variable, and a set point for the variable. A servo-ventilator may include a controller that has ventilation as an input, a target ventilation as the set point, and level of pressure support as an output. Other forms of input may be one or more of oxygen saturation (SaO2), partial pressure of carbon dioxide (PCO2), movement, a signal from a photoplethysmogram, and peak flow. The set point of the controller may be one or more of fixed, variable or learned. For example, the set point in a ventilator may be a long term average of the measured ventilation of a patient. Another ventilator may have a ventilation set point that changes with time. A pressure controller may be configured to control a blower or pump to deliver air at a particular pressure.
(203) Therapy: Therapy in the present context may be one or more of positive pressure therapy, oxygen therapy, carbon dioxide therapy, control of dead space, and the administration of a drug.
(204) Positive Airway Pressure (PAP) device: A device for providing a supply of air at positive pressure to the airways.
(205) 3.6.3 Anatomy of the Face
(206) Ala: the external outer wall or “wing” of each nostril (plural: alar)
(207) Alare: The most lateral point on the nasal ala.
(208) Alar curvature (or alar crest) point: The most posterior point in the curved base line of each ala, found in the crease formed by the union of the ala with the cheek.
(209) Auricula or Pinna: The whole external visible part of the ear.
(210) (nose) Bony framework: The bony framework of the nose comprises the nasal bones, the frontal process of the maxillae and the nasal part of the frontal bone.
(211) (nose) Cartilaginous framework: The cartilaginous framework of the nose comprises the septal, lateral, major and minor cartilages.
(212) Columella: the strip of skin that separates the nares and which runs from the pronasale to the upper lip.
(213) Columella angle: The angle between the line drawn through the midpoint of the nostril aperture and a line drawn perpendicular to the Frankfurt horizontal while intersecting subnasale.
(214) Frankfort horizontal plane: A line extending from the most inferior point of the orbital margin to the left tragion. The tragion is the deepest point in the notch superior to the tragus of the auricle.
(215) Glabella: Located on the soft tissue, the most prominent point in the midsagittal plane of the forehead.
(216) Lateral nasal cartilage: A generally triangular plate of cartilage. Its superior margin is attached to the nasal bone and frontal process of the maxilla, and its inferior margin is connected to the major alar cartilage.
(217) Major alar cartilage: A plate of cartilage lying below the lateral nasal cartilage. It is curved around the anterior part of the naris. Its posterior end is connected to the frontal process of the maxilla by a tough fibrous membrane containing three or four minor cartilages of the ala.
(218) Nares (Nostrils): Approximately ellipsoidal apertures forming the entrance to the nasal cavity. The singular form of nares is naris (nostril). The nares are separated by the nasal septum.
(219) Naso-labial sulcus or Naso-labial fold: The skin fold or groove that runs from each side of the nose to the corners of the mouth, separating the cheeks from the upper lip.
(220) Naso-labial angle: The angle between the columella and the upper lip, while intersecting subnasale.
(221) Otobasion inferior: The lowest point of attachment of the auricle to the skin of the face.
(222) Otobasion superior: The highest point of attachment of the auricle to the skin of the face.
(223) Pronasale: the most protruded point or tip of the nose, which can be identified in lateral view of the rest of the portion of the head.
(224) Philtrum: the midline groove that runs from lower border of the nasal septum to the top of the lip in the upper lip region.
(225) Pogonion: Located on the soft tissue, the most anterior midpoint of the chin.
(226) Ridge (nasal): The nasal ridge is the midline prominence of the nose, extending from the Sellion to the Pronasale.
(227) Sagittal plane: A vertical plane that passes from anterior (front) to posterior (rear) dividing the body into right and left halves.
(228) Sellion: Located on the soft tissue, the most concave point overlying the area of the frontonasal suture.
(229) Septal cartilage (nasal): The nasal septal cartilage forms part of the septum and divides the front part of the nasal cavity.
(230) Subalare: The point at the lower margin of the alar base, where the alar base joins with the skin of the superior (upper) lip.
(231) Subnasal point: Located on the soft tissue, the point at which the columella merges with the upper lip in the midsagittal plane.
(232) Supramentale: The point of greatest concavity in the midline of the lower lip between labrale inferius and soft tissue pogonion.
(233) 3.6.4 Anatomy of the Skull
(234) Frontal bone: The frontal bone includes a large vertical portion, the squama frontalis, corresponding to the region known as the forehead.
(235) Mandible: The mandible forms the lower jaw. The mental protuberance is the bony protuberance of the jaw that forms the chin.
(236) Maxilla: The maxilla forms the upper jaw and is located above the mandible and below the orbits. The frontal process of the maxilla projects upwards by the side of the nose, and forms part of its lateral boundary.
(237) Nasal bones: The nasal bones are two small oblong bones, varying in size and form in different individuals; they are placed side by side at the middle and upper part of the face, and form, by their junction, the “bridge” of the nose.
(238) Nasion: The intersection of the frontal bone and the two nasal bones, a depressed area directly between the eyes and superior to the bridge of the nose.
(239) Occipital bone: The occipital bone is situated at the back and lower part of the cranium. It includes an oval aperture, the foramen magnum, through which the cranial cavity communicates with the vertebral canal. The curved plate behind the foramen magnum is the squama occipitalis.
(240) Parietal bones: The parietal bones are the bones that, when joined together, form the roof and sides of the cranium.
(241) Temporal bones: The temporal bones are situated on the bases and sides of the skull, and support that part of the face known as the temple.
(242) Zygomatic bones: The face includes two zygomatic bones, located in the upper and lateral parts of the face and forming the prominence of the cheek.
(243) 3.6.5 Anatomy of the Respiratory System
(244) Diaphragm: A sheet of muscle that extends across the bottom of the rib cage. The diaphragm separates the thoracic cavity, containing the heart, lungs and ribs, from the abdominal cavity. As the diaphragm contracts the volume of the thoracic cavity increases and air is drawn into the lungs.
(245) Larynx: The larynx, or voice box houses the vocal folds and connects the inferior part of the pharynx (hypopharynx) with the trachea.
(246) Lungs: The organs of respiration in humans. The conducting zone of the lungs contains the trachea, the bronchi, the bronchioles, and the terminal bronchioles. The respiratory zone contains the respiratory bronchioles, the alveolar ducts, and the alveoli.
(247) Nasal cavity: The nasal cavity (or nasal fossa) is a large air filled space above and behind the nose in the middle of the face. The nasal cavity is divided in two by a vertical fin called the nasal septum. On the sides of the nasal cavity are three horizontal outgrowths called nasal conchae (singular “concha”) or turbinates. To the front of the nasal cavity is the nose, while the back blends, via the choanae, into the nasopharynx.
(248) Pharynx: The part of the throat situated immediately inferior to (below) the nasal cavity, and superior to the oesophagus and larynx. The pharynx is conventionally divided into three sections: the nasopharynx (epipharynx), the oropharynx (mesopharynx), and the laryngopharynx (hypopharynx).
(249) 3.6.6 Materials
(250) Silicone or Silicone Elastomer: A synthetic rubber. In this specification, a reference to silicone is a reference to liquid silicone rubber (LSR) or a compression molded silicone rubber (CMSR). One form of commercially available LSR is SILASTIC (included in the range of products sold under this trademark), manufactured by Dow Corning. Another manufacturer of LSR is Wacker. Unless otherwise specified to the contrary, a preferred form of LSR has a Shore A (or Type A) indentation hardness in the range of about 35 to about 45 as measured using ASTM D2240.
(251) Polycarbonate: a typically transparent thermoplastic polymer of Bisphenol-A Carbonate.
(252) 3.6.7 Aspects of a Patient Interface
(253) Anti-asphyxia valve (AAV): The component or sub-assembly of a mask system that, by opening to atmosphere in a failsafe manner, reduces the risk of excessive CO.sub.2 rebreathing by a patient.
(254) Elbow: A conduit that directs an axis of flow or air to change direction through an angle. In one form, the angle may be approximately 90 degrees. In another form, the angle may be less than 90 degrees. The conduit may have an approximately circular cross-section. In another form the conduit may have an oval or rectangular cross-section.
(255) Frame: Frame will be taken to mean a mask structure that bears the load of tension between two or more points of connection with a headgear. A mask frame may be a non-airtight load bearing structure in the mask. However, some forms of mask frame may also be air-tight.
(256) Functional dead space: The functional dead space refers to at least one region within a breathing circuit where a patient's exhalate may collect such that the normal flow of gas within the breathing circuit cannot effectively flush the exhalate from the breathing circuit.
(257) Headgear: Headgear will be taken to mean a form of positioning and stabilizing structure designed for use on a head. Preferably the headgear comprises a collection of one or more struts, ties and stiffeners configured to locate and retain a patient interface in position on a patient's face for delivery of respiratory therapy. Some ties are formed of a soft, flexible, elastic material such as a laminated composite of foam and fabric.
(258) Membrane: Membrane will be taken to mean a typically thin element that has, preferably, substantially no resistance to bending, but has resistance to being stretched.
(259) Plenum chamber: a mask plenum chamber will be taken to a mean portion of a patient interface having walls enclosing a volume of space, the volume having air therein pressurised above atmospheric pressure in use. A shell may form part of the walls of a mask plenum chamber. In one form, a region of the patient's face forms one of the walls of the plenum chamber.
(260) Seal: The noun form (“a seal”) will be taken to mean a structure or barrier that intentionally resists the flow of air through the interface of two surfaces. The verb form (“to seal”) will be taken to mean to resist a flow of air.
(261) Shell: A shell will preferably be taken to mean a curved structure having bending, tensile and compressive stiffness, for example, a portion of a mask that forms a curved structural wall of the mask. Preferably, compared to its overall dimensions it is relatively thin. In some forms, a shell may be faceted. Preferably such walls are airtight, although in some forms they may not be airtight.
(262) Stiffener: A stiffener will be taken to mean a structural component designed to increase the bending resistance of another component in at least one direction.
(263) Strut: A strut will be taken to be a structural component designed to increase the compression resistance of another component in at least one direction.
(264) Swivel: (noun) A subassembly of components configured to rotate about a common axis, preferably independently, preferably under low torque. In one form, the swivel may be constructed to rotate through an angle of at least 360 degrees. In another form, the swivel may be constructed to rotate through an angle less than 360 degrees. When used in the context of an air delivery conduit, the sub-assembly of components preferably comprises a matched pair of cylindrical conduits. Preferably there is little or no leak flow of air from the swivel in use.
(265) Tie: A tie will be taken to be a structural component designed to resist tension.
(266) Vent: (noun) the structure that allows a deliberate controlled rate leak of air from an interior of the mask, or conduit to ambient air, to allow washout of exhaled carbon dioxide (CO.sub.2) and supply of oxygen (O.sub.2).
(267) 3.6.8 Terms Used in Relation to Patient Interface
(268) Curvature (of a surface): A region of a surface having a saddle shape, which curves up in one direction and curves down in a different direction, will be taken to have a negative curvature. A region of a surface having a dome shape, which curves the same way in two principle directions, will be taken to have a positive curvature. A flat surface will be taken to have zero curvature.
(269) Floppy: A quality of a material, structure or composite that is the combination of features of: Readily conforming to finger pressure. Unable to retain its shape when caused to support its own weight. Not rigid. Able to be stretched or bent elastically with little effort.
(270) The quality of being floppy may have an associated direction, hence a particular material, structure or composite may be floppy in a first direction, but stiff or rigid in a second direction, for example a second direction that is orthogonal to the first direction.
(271) Resilient: Able to deform substantially elastically, and to release substantially all of the energy upon unloading, within a relatively short period of time such as 1 second.
(272) Rigid: Not readily deforming to finger pressure, and/or the tensions or loads typically encountered when setting up and maintaining a patient interface in sealing relationship with an entrance to a patient's airways.
(273) Semi-rigid: means being sufficiently rigid to not substantially distort under the effects of mechanical forces typically applied during positive airway pressure therapy.
3.7 Other Remarks
(274) Unless the context clearly dictates otherwise and where a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit, between the upper and lower limit of that range, and any other stated or intervening value in that stated range is encompassed within the technology. The upper and lower limits of these intervening ranges, which may be independently included in the intervening ranges, are also encompassed within the technology, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the technology.
(275) Furthermore, where a value or values are stated herein as being implemented as part of the technology, it is understood that such values may be approximated, unless otherwise stated, and such values may be utilized to any suitable significant digit to the extent that a practical technical implementation may permit or require it.
(276) It must be noted that as used herein and in the appended claims, the singular forms “a”, “an”, and “the” include their plural equivalents, unless the context clearly dictates otherwise.
(277) Moreover, in interpreting the disclosure, all terms should be interpreted in the broadest reasonable manner consistent with the context. In particular, the terms “comprises” and “comprising” should be interpreted as referring to elements, components, or steps in a non-exclusive manner, indicating that the referenced elements, components, or steps may be present, or utilized, or combined with other elements, components, or steps that are not expressly referenced.
(278) Although the technology herein has been described with reference to particular examples, it is to be understood that these examples are merely illustrative of the principles and applications of the technology. In some instances, the terminology and symbols may imply specific details that are not required to practice the technology. For example, although the terms “first” and “second” may be used, unless otherwise specified, they are not intended to indicate any order but may be utilised to distinguish between distinct elements. Furthermore, although process steps in the methodologies may be described or illustrated in an order, such an ordering is not required. Those skilled in the art will recognize that such ordering may be modified and/or aspects thereof may be conducted concurrently or even synchronously.
(279) It is therefore to be understood that numerous modifications may be made to the illustrative examples and that other arrangements may be devised without departing from the spirit and scope of the technology.
(280) While the present technology has been described in connection with what are presently considered to be the most practical and preferred examples, it is to be understood that the technology is not to be limited to the disclosed examples, but on the contrary, is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the technology. Also, the various examples described above may be implemented in conjunction with other examples, e.g., aspects of one example may be combined with aspects of another example to realize yet other examples. Further, each independent feature or component of any given assembly may constitute an additional example.
3.8 Reference Signs List
(281) Number Feature Item 302 conventional connection port 1000 patient 1100 bed partner 3000 patient interface 3100 frame member 3102 void 3104 anterior facing surface 3105 peripheral portion 3110 magnet 3115 annular side wall 3117 beads 3120 lower headgear connector 3150 forehead support 3152 upper headgear connector 3175 cushion assembly 3180 main body 3182 recesses 3184 protrusions 3200 seal-forming structure 3300 anterior wall member 3302 connection port 3303 posterior facing surface 3305 peripheral portion 3310 magnet 3400 positioning and stabilizing structure 3402 upper side straps 3404 lower side straps 3406 crown strap 3500 plenum chamber 3600 swivel elbow 3602 first end portion 3604 second end portion 3605 swivel connector 3700 vent 3705 vent holes 3750 HME/HMX cartridge 4000 PAP device 4010 housing 4012 upper portion 4014 lower portion 4015 panels 4016 chassis 4018 handle 4020 pneumatic block 4100 mechanical and pneumatic components 4110 filter 4112 filter 4114 filter 4142 blower 4170 gas delivery tube 4180 gas delivery tube 4190 adaptor 4200 electrical components 4202 PCBA 4210 power supply 4220 input devices 5000 humidifier 6000 patient interface 6100 frame member 6110 magnet 6120 lower headgear connectors 6152 upper headgear connectors 6175 cushion assembly 6200 seal-forming member 6250 retaining structure 6300 anterior wall member 6310 magnet 6600 elbow 7000 patient interface 7100 frame member 7110 magnet 7200 seal-forming member 7205 cushion clip 7300 anterior wall member 7310 magnet 7600 elbow 7750 HME/HMX cartridge 8000 patient interface 8100 frame member 8110 magnet 8200 seal-forming member 8205 cushion clip 8300 anterior wall member 8310 magnet 8311 snap-fit connector 8313 snap-fit connector 8315 snap-fit connector 8600 elbow 13100 frame member 13115 annular side wall 13117 beads 13120 lower headgear connectors 13152 upper headgear connectors 14000 patient interface 14100 frame member 14102 void 14105 peripheral portion 14110 tab or catch 14115 annular side wall 14120 lower headgear connectors 14152 upper headgear connectors 14175 cushion assembly 14180 main body 14200 seal-forming structure 14250 retaining portion 14300 anterior wall member 14302 connection port 14303 grooves 14800 push button 14802 grooves 14804 tab or catch 14820 raised portion 14830 webbing 14850 lip seal 15175 cushion assembly 15180 main body 15800 push button 16000 patient interface 16100 frame member 16102 void 16105 peripheral portion 16110 tab 16115 annular side wall 16120 lower headgear connectors 16152 upper headgear connectors 16175 cushion assembly 16175A small cushion assembly 16175B medium cushion assembly 16175C large cushion assembly 16180 main body 16200 seal-forming structure 16205 retaining portion 16250 retaining portion 16300 anterior wall member 16302 connection port 16303 grooves 16305 peripheral portion 16800 push button 16804 tab 16850 lip seal 16890 retaining structure 16892 horizontal wall section 16894 vertical wall section