DEVICE AND SYSTEM FOR RESPIRATORY SUPPORT

Abstract

The present invention relates to a device (100) for positive pressure ventilation (PPV) and continuous positive airway pressure (CPAP) treatment comprising a fresh gas flow inlet (2) arranged to receive a fresh gas flow from a fresh gas flow tube connectable thereto; a patient interface end (3) which is connectable with a patient interface; an outlet (4) having an open end (5); and several variable flow CPAP generators (6), wherein each of the several variable flow CPAP generators is connected with the fresh gas flow inlet, the patient interface end and the outlet of the device. A simplified device and system is provided, respectively, which is easy to use and allows for a rapid switch between PPV and CPAP treatment without change of equipment.

Claims

1. A device for positive pressure ventilation and continuous positive airway pressure (CPAP) treatment comprising: a fresh gas flow inlet arranged to receive a fresh gas flow from a fresh gas flow tube connectable thereto; a patient interface end which is connectable with a patient interface; an outlet having an open end; and several variable flow CPAP generators, wherein each of the several variable flow CPAP generators is connected with the fresh gas flow inlet, the patient interface end and the outlet of the device.

2. The device according to claim 1, wherein each of the several variable flow CPAP generators comprises first, second and third connection portions, wherein the first connection portion is connected with the fresh gas flow inlet, the second connection portion is connected with the patient interface end, and the third connection portion is connected with the outlet of the device.

3. The device according to claim 1, further comprising an inlet chamber arranged at the fresh gas flow inlet, a patient interface chamber arranged at the patient interface end, and an outlet chamber arranged at the outlet of the device, wherein each of the several variable flow CPAP generators is connected with the fresh gas flow inlet, the patient interface end, and the outlet through the inlet chamber, the patient interface chamber and the outlet chamber, respectively.

4. The device according to claim 1, wherein the device comprises three variable flow CPAP generators.

5. The device according to claim 1, wherein the device comprises four variable flow CPAP generators.

6. The device according to claim 1, further comprising a pressure release connection portion having a first end connected with the patient interface end of the device and a second end connectable with a pressure release tube.

7. A system for PPV and CPAP treatment comprising a device according to claim 1, a fresh gas flow tube, a fresh gas source connected with the fresh gas flow inlet by means of the fresh gas flow tube, and a pressure release valve arranged to prevent an excessive positive pressure in a PPV mode.

8. The system according to claim 7, arranged such that when the open end of the outlet of the device is occluded, the pressure will increase from the variable flow CPAP generators until an opening pressure of the pressure release valve is reached, which increase in pressure results in an inspiratory flow, whereby the pressure in the system will remain at the set PPV pressure until the occlusion is removed from the outlet, and when the occluded outlet is opened, the pressure will return to the set CPAP level, whereby the reduction in pressure leads to an expiratory flow.

9. The system according to claim 7, arranged such that during spontaneous breathing, the patient flow and the fresh gas flow leaves the system through the variable flow CPAP generators keeping the positive pressure within the airway of the patient stable, by varying the flow that generates the CPAP, whereby the CPAP in the airway can be adjusted as needed.

10. The system according to claim 7, wherein the pressure release valve is connected with one of the patient interface end and the outlet of the device.

11. The system according to claim 7, wherein the device further comprises: a pressure release connection portion having a first end connected with the patient interface end of the device and a second end connectable with a pressure release tube; and wherein the pressure release valve is connected with the pressure release connection portion.

12. The system according to claim 7, further comprising a pressure measuring device.

13. The system according to claim 12, wherein the pressure measuring device is arranged at the patient interface end of the device, or in connection with the pressure release connection portion of the device, further comprising a pressure release connection portion having a first end connected with the patient interface end of the device and a second end connectable with a pressure release tube.

14. Use of a device according to claim 1 in PPV and CPAP treatment for neonatal resuscitation.

15. Use of a system according to claim 7 for PPV and CPAP treatment neonatal resuscitation.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0035] The invention will now be described in more detail and with reference to the appended drawings. The drawings are included to provide a further understanding of the present invention and are incorporated in and are a part of this specification. Other embodiments of the present invention, and many of the intended advantages of the present invention, will be readily appreciated as they become better understood by reference to the following detailed description. The elements of the drawings are not necessarily to scale relative to each other. The same reference numerals designate corresponding similar parts.

[0036] FIG. 1 is a schematic, partly cut-away, illustration of an embodiment of the device according to the present invention;

[0037] FIG. 2 is a schematic, partly cut-away, illustration of another embodiment of the device according to the present invention;

[0038] FIG. 3 is a schematic cross-sectional illustration of yet another embodiment of the device according to the present invention;

[0039] FIGS. 4-5 are schematic cross-sectional illustrations of embodiments of the system according to the present invention;

[0040] FIGS. 6a-b schematically illustrate flows of the system shown in FIG. 4 during positive pressure ventilation, i.e. PPV mode; and

[0041] FIG. 7 schematically illustrates flows in the system shown in FIG. 4 during spontaneous ventilation, i.e. CPAP mode.

DESCRIPTION OF PREFERRED EMBODIMENTS

[0042] Examples of different embodiments of the present invention are provided. Common for the embodiments of the device for PPV and CPAP treatment described herein is that they comprise a fresh gas flow inlet 2, a patient interface end 3, an outlet 4 having an open end 5, and several variable CPAP generators 6, each connected with the fresh gas flow inlet 2, the patient interface end 3, and the outlet 4. More particularly, the device further comprises an inlet chamber 21 at the fresh gas flow inlet 2, a patient interface chamber 31 at the patient interface end 3, and an outlet chamber 41 at the outlet 4. Each of the variable flow CPAP generators 6 is connected with the fresh gas flow inlet 2, the patient interface end 3, and the outlet 4 through the inlet chamber 21, the patient interface chamber 31, and the outlet chamber 41, respectively. That is, the inlet chamber 21, the patient interface chamber 31, and the outlet chamber 41 are common to the several variable flow CPAP generators 6, as are the fresh gas flow inlet 2, the patient interface end 3, and the outlet 4 of the device.

[0043] With reference to FIG. 1, according to a first embodiment of the device 100, the device 100 comprises three variable flow CPAP generators 6, arranged adjacent to each other. Each of the variable flow CPAP generators 6 comprises a first connection portion 10, a second connection portion 11, and a third connection portion 12. The first connection portions 10 of the variable flow CPAP generators 6 are connected with the fresh gas flow inlet 2, the second connection portions 11 are connected with the patient interface end 3, and the third connection portions 12 are connected with the outlet 4 of the device 100. More particularly, the first connection portions 10 of the variable flow CPAP generators 6 are connected with the fresh gas flow inlet 2 through the inlet chamber 21. The inlet chamber 21 is generally delimited by the inner walls of a tubular portion extending between the fresh flow gas inlet 2 and the first connection portions 10 of the variable flow CPAP generators 6. Correspondingly, the second connection portions 11 are connected with the patient interface end 3 through the patient interface chamber 31. The patient interface chamber 31 is generally defined by a tubular portion extending between the second connection portions 11 and the patient interface end 3. It may, however, be of any other shape suitable for the purpose of providing a common chamber connecting the second connection portions 11 of the variable flow CPAP generators 6 to the common patient interface end 3 of the device 100. The patient interface end 3 of the device 100 is further connectable with any patient interface, such as for example a face mask, nasal prongs, or an endotracheal tube.

[0044] In a corresponding manner, the third connection portions 12 of the variable flow CPAP generators 6 are connected with the outlet 4 of the device 100 through the outlet chamber 41. The outlet chamber 41 is typically tubular and arranged as a protruding tube ending, which extends between the second connection portions 12 and the outlet 4 having a free open end 5. The three variable flow CPAP generators 6 of the exemplifying embodiment shown in FIG. 1 are thus arranged in parallel, extending between the common fresh flow gas flow inlet 2, patient interface end 3 and outlet 4 of the device 100, providing a compact device 100.

[0045] In the exemplifying embodiment shown in FIG. 1, the second and third connection portions 11, 12 of each variable flow CPAP generator 6 are arranged at an angle to each other. The first connection portion 10 is connected with the third connection portion 12 at an angle, and is further arranged substantially coaxially with the second connection portion 11. Such a geometry of the variable flow CPAP generators 6 is advantageous as it provides a stable CPAP generated by the variable flow CPAP generators 6, and a low imposed work of breathing for the patient when in use. However, providing several variable flow CPAP generators 6 in the device 100 having a different geometry is also conceivable within the concept of the present invention.

[0046] With reference to FIG. 2, according to another embodiment of the device 200, the device 200 comprises four variable flow CPAP generators 6. Each of the four variable flow CPAP generators 6 comprises a first connection portion 10, a second connection portion 11, and a third connection portion 12. The first connection portions 10 of the variable flow CPAP generators 6 are connected with the fresh gas flow inlet 2, the second connection portions 11 are connected with the patient interface end 3, and the third connection portions 12 are connected with the outlet 4 of the device 200. Also in this embodiment, the first connection portions 10 of the variable flow CPAP generators 6 are connected with the fresh gas flow inlet 2 through the inlet chamber 21. Correspondingly, the second connection portions 11 are connected with the patient interface end 3 through the patient interface chamber 31, and the third connection portions 12 of the variable flow CPAP generators 6 are connected with the outlet 4 of the device 100 through the outlet chamber 41. The outlet chamber 41 is typically tubular and arranged as a protruding tube ending, which extends between the second connection portions 12 and the outlet 4 having a free open end 5. The patient interface end 3 of the device 100 is connectable with any patient interface, such as for example a face mask, nasal prongs, or an endotracheal tube. The four variable flow CPAP generators 6 are arranged in parallel, extending between the fresh flow gas flow inlet 2, the patient interface end 3 and the outlet of the device 4, providing a compact device 200.

[0047] With reference now to FIG. 3, according to yet another embodiment, the device 300 comprises three variable flow CPAP generators 6 arranged as described with respect to FIG. 1. Due to the cross-sectional illustration of FIG. 3, only one of the variable flow CPAP generators 6 is visible therein. Furthermore, the device 300 comprises a pressure release connection portion 14 having a first end 16 and a second end 17. The first end 16 is connected with the patient interface end 3 of the device 300 and the second end 17 is connectable to a pressure release tube 15, see FIG. 5. More particularly, the first end 16 is connected with the patient interface end 3 through the patient interface chamber 31. The pressure release connection portion 14 is generally tubular and extends partially in parallel with the second connection portions 11 of the variable flow CPAP generators 6, and partially at an angle thereof towards a side wall 18 of the device, see FIG. 5. This embodiment is useful in a system that will be described with reference to FIG. 5. It should be noted that the pressure release connection portion 14 is applicable to a device having any number of variable flow CPAP generators.

[0048] A first embodiment of the system 400, as shown in FIG. 4, comprises the embodiment of the device 100 described with reference to FIG. 1. Due to the cross-sectional illustration shown in FIG. 4, only one of the three variable flow CPAP generators 6 is visible therein. The system 400 further comprises a fresh gas source 20, which provides a fresh gas flow to the fresh gas flow inlet 2 through a fresh gas flow tube 22 of the system 400. The level of CPAP is adjusted at the fresh gas source 20. The system further comprises a pressure release valve 7 and a pressure measuring device 8. The pressure release valve 7 is here arranged in connection with the outlet 4 of the device 100. More particularly, the system 400 further comprises an outlet tube 19 connected with the outlet 4 of the device 100. The pressure release valve 7 is arranged along the outlet tube 19. The outlet tube 19 comprises an open end 23. The pressure measuring device 8 is arranged at the patient interface end 3 of the device 100. The pressure measuring device 8 can be omitted in all embodiments, however, if there is no interest in measuring the pressure.

[0049] With reference to FIG. 5, according to a second embodiment of the system 500, the system 500 comprises the device 300 as described with reference to FIG. 3, i.e. the device comprising a pressure release connection portion 14. As for the embodiment shown in FIG. 4, due to the cross-sectional illustration of the system 500, only one of the variable flow CPAP generators 6 is visible in FIG. 5. The system 500 further comprises a pressure release tube 15 connected with the pressure release connection portion 14. The pressure release valve 7 is arranged at an end of the pressure release tube 15 which is distal to the pressure release connection portion 14. The pressure measuring device 8 is here arranged at the pressure release tube 15 between the pressure release valve 7 and the pressure release connection portion 14.

[0050] The system is operated as follows. Reference will be made to the first embodiment of the system 400, but the second embodiment of the system 500 has a corresponding operation. Oxygen concentration and fresh gas flow are adjusted by a standard blender and a flow meter. The fresh gas flow could be varied and is typically set to between 5 and 15 litres per minute. Typically, the fresh gas flow provided is between 10 and 12 litres per minute. A fresh gas flow in this range should prevent rebreathing, provide flow to achieve an adequate inspiration flow, volume and time, and provide some allowance for leakage at the patient interface. However, a fresh gas flow above 15 litres per minute is also possible to provide, particularly for treatment of an older child. The system is further configured such that this range of supplied fresh gas flow generates a level of CPAP of 3-10 cm H.sub.2O. In a preferred embodiment, the generated level of CPAP is 5-6 cm H.sub.2O.

[0051] The fresh gas flow is used to drive the variable flow CPAP generators 6. The fresh gas flow to the variable flow CPAP generators 6 is always adjustable. In the exemplifying embodiment of the device 100 comprising three variable flow CPAP generators 6, a typical value of the fresh gas flow provided to the fresh gas flow inlet 2 is 5-15 liters per minute, typically generating a CPAP level of 3-10 cm H.sub.2O. To provide higher levels of CPAP, the flow driving the variable flow CPAP generators 6 can be increased further.

[0052] The outlet 4 of the variable flow CPAP generator 6 has an open end 5. In the system 400 shown in FIG. 4, the outlet tube 19 is connected with the open-ended outlet 4 of the device and has an open end 23. If the open end 23 of the outlet tube 19 is occluded, see FIGS. 4 and 6a, the pressure delivered to the infant will increase from the pressure set by the variable CPAP generators 6 until the opening pressure of the pressure release valve 7 is reached. In the system 500 comprising the device 300 described with reference to FIG. 3, occlusion of the open end 5 of the outlet 4 of the device 300 will have the same effect. A typical value for the pressure release valve 7 to open is around 20-30 cm H.sub.2O. The increase in pressure results in an inspiratory flow. The pressure in the system 400 will remain at the set positive pressure ventilation pressure until the outlet occlusion is removed. When the occluded open end 5 is opened, see FIG. 6b, the pressure delivered to the patient will return to the set CPAP level and this reduction in pressure will lead to an expiratory flow.

[0053] During spontaneous breathing, the infant flow and the fresh gas flow leaves the system 400 through the variable flow CPAP generators 6, see FIG. 7. This keeps the positive pressure within the airway stable. By varying the driver flow, i.e. the fresh gas flow that generates the CPAP pressure, the CPAP level in the airway can be adjusted as needed.

[0054] The patient interface end 3 can be designed in any suitable form such to be suitable for connection with a patient interface. Further, the patient interface can assume a variety of designs suitable for establishing a connection to the patient nasal airways, not shown. Thus, the patient interface can include an opposing pair of nasal prongs, a mask, an endotracheal tube or any other suitable devices.

[0055] The system 400, 500 could have a backup system for malfunctioning of the pressure release valve 7. This could either be an alarm, a second release valve or a system that cuts the fresh gas flow.

[0056] The pressure measuring device 8 should be positioned as close to the patient as possible to provide accurate recording of the pressure of the gas delivered to the patient. The accuracy will depend on the flow resistance of the patient interface and, for an infant, a low resistance interface should be used if possible. The embodiment of the device described with reference to FIGS. 1 and 2 could be regarded as beneficial since there will be less tubes needed in the system 400.

[0057] Notably, the device, in accordance with principles of the present invention is useful with a wide variety of patient interface configurations that may or may not incorporate some or all of the features described above with respect to the patient interface. Thus, the patient interface is in no way limiting.

[0058] Notably, the device, in accordance with principles of the present invention is useful with a wide variety of variable flow CPAP generators that may or may not incorporate some or all of the features described above with respect to the variable flow CPAP generators 6. Thus, the model of the variable flow CPAP generators 6 is in no way limiting.

[0059] Notably, the device, in accordance with principles of the present invention, is useful with a wide variety of pressure release valves 7 or similar devices that achieve the purpose of releasing air depending on the pressure in the system. Thus, the model or type of pressure release valve is in no way limiting.

[0060] Notably, the device, in accordance with principles of the present invention is useful with a wide variety of pressure measuring devices 8 or similar devices that achieve the purpose of measuring the pressure in the system. Thus, the model or type pressure measuring devices is in no way limiting.

[0061] A typical CPAP level for resuscitating or stabilising an infant is in the range of 4-10 cm H.sub.2O. A typical peak pressure for PPV is 20-30 cm H.sub.2O. It is obtained by occluding the system and having a correctly adjusted pressure release valve.

[0062] Above embodiments of the device and system according to the present invention as defined in the appended claims have been described. These should only be seen as merely non-limiting examples. As understood by the person skilled in the art, many modifications and alternative embodiments are possible within the scope of the invention as defined by the appended claims.

[0063] It is to be noted that for the purposes of his application, and in particular with regard to the appended claims, the word “comprising” does not exclude other elements or steps, and the word “a” or “an” does not exclude a plurality, which per se will be evident to a person skilled in the art.