[Not Applicable]
The invention relates to heat transfer and cooling systems for cooling a portion of an individual's body via a body-conformed apparatus, and more particularly relates to a method and device for controlling the amount of temperature change caused to the portion of the individual's body for treating in situ various human injuries, for example, stroke, traumatic brain injury, cardiac arrest, and significant blood loss.
In treating and successfully recovering from head injury, time is critical. In particular, when brain cells die, the associated function provided by those brain cells is more apt to be lost by the patient. When a sufficient number of brain cells have died, such function is lost, and the potential for the function returning decreases as more and more brain cells die. Hence, it is imperative that therapy directed to the brain injury be executed as soon as possible after the brain injury occurs to minimize such deleterious effects.
An interesting phenomenon has been observed by those who study brain injury relating to the brain cell survival rate as a function of time when brain temperature is reduced. In particular, drowning victims in exceptionally cold water have in some cases been submerged and deprived of oxygen for tens of minutes. While such a time period would ordinarily cause such extensive brain cell loss that significant brain function loss would occur, it has been observed that brain function has in many cases been restored completely, or nearly completely. Based on these observations, it has been determined that by cooling the patient's head, an effect similar to “slowing down the clock” can be achieved. Accordingly, a need exists for extending this observed benefit from accidental occurrences to intentional use of this effect in the beneficial treatment of brain injury, and particularly stoke and head trauma.
It is therefore an object of the present invention to protect a patient's brain from further damage from a moment of injury until and during brain injury therapy.
Another object is to provide a cooling system which can be used to cool the patient or a particular potion of the patient's body shortly after brain or other body injury.
It is another object to provide a cooling system for use remotely from a medical facility.
It is another object to provide a cooling system for use within a medical facility.
It is another object to provide two cooling systems wherein the first cooling system may be interchanged during treatment of a patient with the second cooling system.
These and other objects of the invention are achieved in a cooling system for cooling a portion of an individual's body. The system includes a body conformed apparatus for attachment directly to the patient, a unit remote from the body and an umbilical tubing connecting the body conformed apparatus to the unit. A coolant flows from the unit to the body conformed apparatus via several pathways relative to a heat sink cooling source in order to regulate the temperature of the coolant and thus control the cooling of the body portion to which the body conformed apparatus is connected.
Referring to
Operation of cooling systems 11, 13 is illustrated in
Liquid coolant returns from conformal heat exchanger 17 passing back through umbilical tubing 15 to the EMT/ICU conditioning unit 13, 19. A control valve 27 within units 13, 19 channels the return liquid coolant along a pathway 29 to a cooling heat exchanger 31, and then back into coolant reservoir 21. Cooling heat exchanger 31 interacts with a removable ice cartridge 33 to cool the liquid coolant.
Additionally, control valve 27 is able to channel the return liquid coolant along a pathway 35 which bypasses cooling heat exchanger 31, and returns the liquid coolant to coolant reservoir 21. Thus, the bypassing of cooling heat exchanger 31 avoids cooling of the return coolant.
Control valve 27 is operable to control the temperature of the liquid coolant to within a particular range, as for example, between 5° C. (41° F.) and 25° C. (77° F.). The coolant temperature is controlled by regulating the coolant's circulation, either along pathway 29 through cooling heat exchanger 31 (chilling the coolant) or bypassing it, completely or partially along pathway 35. As used in EMT conditioning unit 13, control valve 27 may vary the percentage of coolant moving along bypass pathway 35 from 0 percent to 100 percent.
The conformal heat exchanger 17 may be pneumatically pressurized by the conditioning units 13, 19 in order to improve surface contact and thermal conductivity with the patient. An air pump 37 within unit 13, 19 provides pressurized air to conformal heat exchanger 17 via tubing 15. In addition, air pump 37 may supply pressurized air to cooling heat exchanger 31.
Conformal heat exchanger 17 may be constructed to cover the head of a patient, as represented in
Headliner assembly 41 includes a cap portion 43 and a neck brace 42. Cap portion 43 is a thin, compliant, “one-size-fits-all” conformal heat exchanger, which may be sized to cover the cranium, neck including the carotid triangle, and sides of the face. Cap portion 43 is shaped to fit snugly over the head of the patient. Neck brace 42 may be formed from a modified Aspen Vista Cervical Collar assembly. As shown in
As shown in
A heat transfer liquid pathway (represented by line 47 in the dotted pathway area in
Referring to
Referring again to
As shown in
Ice cartridge 33 is constructed from a high density polyethylene. Its configuration, as shown in
Ice cartridge 33 is removably insertable into the EMT conditioning unit 13, or into the ICU conditioning unit 19, and thereafter is contained within the unit 13, 19. Heat exchanger 31 is wrapped around the cartridge, or disposed such that the surfaces of heat exchanger 31 are in a heat transfer relationship with the ice cartridge. As will suggest itself, other ways may be used to engage the cooling exchanger with the cartridge. Further the pressurized air from air pump 37 (
Referring to
The heat exchanger outer layer 619 is secured to a thermoplastic wall 621. A 3M Thinsulate layer 623 is secured to wall 621 and to a composite layer formed of two nylon fabric layers 625, 627. Between the two nylon fabric layers 625, 627 are four layers of scrim 629, and three layers of aluminized Mylar 631. These alternating layers of aluminized Mylar and scrim form a heat radiation ebarrier similar to that used in space suit micrometeoroid garments.
The EMT unit 13 additionally includes an outer layer of a heat formable fabric foam composite 633 which serves to protect the inner layers. The ICU unit 19, on the other hand, includes a thermoplastic wall (not shown) in place of layer 633.
Referring again to
Referring to
Microcontroller 203 begins to control the patient's temperature once the patient's core temperature is one degree centigrade above a set point. The core temperature may reach less than one degree Celsius above the set point depending on the amount of time that the patient was attached to the EMT unit before being transferred to the ICU unit. The time required for the EMT unit to drop the patient's temperature depends on the weight of the patient. During the time that the patient's core temperature is above the set point by more than one degree centigrade, the microcontroller is in a FULL COLD mode and does not control the rate of core temperature drop. When the patient's temperature reaches a point that is one degree Celsius above a set point temperature for the patient, the microcontroller begins to adjust the coolant temperature using the control valve 27. Until that time at which the patient's temperature is one degree above the set point, ICU conditioning unit 19 remains in a FULL COLD mode with the control valve 27 providing the coolant along the path through the cooling heat exchanger 31. This coolant adjustment over a single degree is performed in accordance with a number of temperature set points, for example, 72 set points, shown below in Table 1. As understood, the decimal numeral in the right column of Table 1 represents a value used by the microcontroller 203 to regulate the control valve 27.
These set points of Table 1 represent a “feedback curve” which illustrates how the patient's temperature is to be decreased by 1 degree over time. Microcontroller 203 uses each of the 72 temperature set points which are stored in memory 205. One set point is used every five (5) minutes to decrease the patient's temperature over that five minute period. Microcontroller 203 adjusts the coolant temperature downwardly by operating control valve 27 while monitoring the patient's temperature. Microcontroller 203 monitors the patient's temperature with respect to the five minute set point temperature. The patient's temperature is thus decreased each five minutes, starting at a time when the patient's temperature is 1 degree over a set point temperature. Other temperatures and sampling time intervals may be used, and other than a 1 degree decrease may be used, as will suggest itself.
As will suggest itself, the microcontroller 203 may be used to rewarm a patient to slowly return a patient's core temperature to normal.
Control valve 27 in the EMT unit may operate differently than the control valve 27 in the ICU unit. Control valve 27 may be a digitally controlled solenoid operated pinch valve used in ICU conditioning unit 19, and, which receives control signals from output 209 of microcontroller 203. The control valve of the ICU unit may have two positions: OPEN and CLOSED, as described below.
Control valve 27 as used in the EMT conditioning unit 13, may be manually controlled by the user. The control valve 27 which is used in the EMT unit may be comprised of a cam (not shown) that is manually moveable relative to two flexible tubes (not shown). Manual movement (e.g., rotation) of the cam linearly squeezes the two flexible tubes to a degree dependent on the position of the cam. With the cam in a first position, one of the flexible tubes is fully opened and the other flexible tube is fully closed. With the cam in a second position, the one flexible tube is opened approximately two-thirds (⅔) and the other flexible tube is opened approximately one-third (⅓). With the cam in the third position, the one flexible tube is opened approximately one-third (⅓) and the other flexible tube is opened approximately two-thirds (⅔). This provides for a COLDEST, COLDER and COLD settings of the EMT, as describe below.
Additionally, the cam of control valve 27 may be adjusted to more than three positions, and may be linearly adjusted between two points. Valve 27 may have a temperature range of 180° that would allow a full range from FULL COLD to FULL WARM. As another example, the EMT may be constructed to limit the temperature range to 135°, so that temperature range is limited linearly to moderately cold through full cold. As will suggest itself, two cams may be used, one cam for one flexible tube and the other cam for the other flexible tube. Other manually controlled pinch valves may be used as well.
Referring to
Referring to
The ICU unit delivers coolant at the coldest (FULL COLD) setting until patient core temperature has been reduced to a level at 1° C. above the target patient temperature. Below this point, within 1° C. above the target patient temperature, the system initiates an automatic temperature control algorithm, which adjusts coolant temperature by shuttling the solenoid valve 27 between FULL COLD/valve closed, and FULL WARM/valve open in order to approach the target patient temperature in a roughly asymptotic-type curve. To modulate coolant temperature and approach target temperature asymptotically, the control algorithm cools or warms the liquid coolant by modulating its flow. Specifically, ICU microcontroller 203 commands the solenoid valve to open or close, modulating the flow of liquid coolant through two liquid paths: first, through the cooling heat exchanger to cool down the liquid in circulation and to provide increased cooling therapy for the patient (FULL COLD/valve closed), or in a mode that bypasses the heat exchanger and only circulates liquid without lowering its temperature (FULL WARM/valve open). The precise mixture of FULL COLD to FULL WARM (valve closed to valve opened) is determined by the microcontroller algorithm, based on the patient's core temperature relative to the asymptotic curve. If, for example, the patient temperature is trending above the curve (i.e. not cooling fast enough), the system will automatically increase the valve ratio of FULL COLD to FULL WARM in order to increase cooling and return the patient temperature to the curve.
Microcontroller 203 uses the values shown above in Table 1 of seventy-two 5-minute increments (0-72), each with an associated temperature set point (effectively defining a temperature curve from 1 degree to 0 degrees over a 360 minute period). The frequency of the valve action may be 20 seconds to assure proper mixing of the cooled and warm liquid to have the resultant temperature of the liquid that exits being at an average temperature. This curve is asymptotic in that the curve approaches zero, the base horizontal of 0 degrees, as shown in
The solenoid valve cyclic frequency is related to the volume of the coolant reservoir so that substantial mixing occurs between the FULL COLD and FULL WARM coolant returning to the reservoir. The resultant coolant is then returned to the headliner assembly.
Referring to
Referring to
In addition, control knob 1011 may be used to select a setting 1019 in order to activate a refill procedure (“Auto-Fill”) in which the polarity of coolant pump 25 is reversed and pump 25 is activated in order to refill reservoir 21 (as discussed below). A button 1020 must be depressed in order to rotate control knob 1011 to the Auto-Fill setting 1019.
Referring to
Touch screen monitor 1111 includes a target temperature area 1117. A default temperature value as the treatment setting may be loaded into memory 205 (
Touch screen monitor 1111 also includes a cooling duration area 1123. A default duration value may be loaded into memory 205 (
Also, touch screen monitor 1111 includes a start button 1129 (having an arrow icon) or a pause button 1131 (having vertical rectangles). When the unit is running, the start button is displayed green and the pause button is displayed grey; when paused, the start button is grey, and the pause button blinks blue-grey.
To increase or decrease the volume of system alarms and warnings (which may be generated from an audio speaker (not shown in FIG. 13)), users may press a HIGH-LOW VOLUME button 1133. The speaker icon on button 1133 will visually change to reflect whether the speaker volume is set to a HIGH or a LOW by displaying a number of partial circles on button 1133. Alternatively, users may mute system alarms by pressing a MUTE button 1135. The icon on the MUTE button will glow blue when muted.
The user's current temperature, based on the reading from the indwelling temperature probe 101, is displayed in area 1137 at the top center of the touch screen monitor.
Elapsed time is displayed in area 1139 in hours and minutes (HH:MM) in the top right corner of the touch screen monitor, and represents the total duration of active cooling in the current treatment. When the system is paused via button 1131, the elapsed time counter (not shown) is paused as well and display 1139 remains fixed to the time duration at the point of the pause.
To switch the displayed units between degrees Celsius and Fahrenheit (° F.), a button 1141 may be used. Also, the user may lock cooling treatment parameters during operation by toggling a button 1143. When locked, touch screen controls will not respond to contact, but the user temperature, elapsed time, and status displays will continue to function normally. ICU conditioning unit 19 continually monitors its performance and the health of major components, and issues warnings or alarms to notify the user of conditions that may interfere with user safety or system performance. A warning may notify a user of an error condition that can be corrected or cleared by the user, and does not pose an immediate hazard to the user, or device. An alarm may notify the user of an error condition that cannot be corrected by the user.
Visual warnings and alarms may be provided by status indicators positioned on the left side of touch screen monitor 1111, which illuminate and display relevant information when an issue is detected. There are six primary indicator areas shown in
Referring to
An air pump 1329 may provide compressed air along tube 1331 to the cooling heat exchanger 1325, and provide compressed air along tube 1333 to an exit port 1330 which is connected to tubing 15 leading to conformal heat exchanger 17 (
Referring to
An air pump 1451 may provide compressed air along tube 1453 to cooling heat exchanger 1427, and provide compressed air along tube 1455 to an exit port 1457 connected to tubing 15 (
As shown in
Referring again to
Air pump 1329 (
Referring to
The cap on the refill bottle is replaced with a cap having valved connectors for attachment to the umbilical ports. The control knob 1011 (
Thus, for both the ICU unit and the EMT unit, the internal filters may be backflushed into the refill kit and be captured in the refill kit filter. The fill kit filter element may be replaced as needed. If necessary, the internal filter in the ICU or EMT can be replaced during annual inspections or sooner if required. One of the coolant filters in the ICU may be removed and replaced with a new filter which is provided in the refill kit.
Referring again to
The connectors 81, 83, 85, may be quick-disconnect assemblies that are quickly pushed-on or pulled-off to make or break the connection. The connectors may be either three-port or two port connectors. An example two port connector 82 is shown in
Connectors 81, 83, 85 may take on various configurations including being formed by injection molding. A plastic cap or dust cover may be used to cover the connectors 81, 83, 85, and such dust cover may be spring loaded.
The connector ports are formed of a number of portions which provide a connection area for receipt of larger but like tube portions from connector assembly 81 which is secured to the umbilical tubing. The fit connection is by frictional fit. A latching mechanism may be used in which a spring loaded male piece with chamfers on both sides of the element locks into a groove on the male portion. The chamfers are angled such that a calibrated pull force is required for the chamfer to ride up the groove and release the male element. The pull force to disconnect may be eight (8) pounds.
Alternatively, a two port connector configuration may be used in conjunction with connection of the umbilical tubing 15 to a body conformal heat exchanger 17. Liquid coolant enters on the right side of exchanger 17 and exits on the left side. Liquid coolant enters and exits on the lower of the two ports. Air enters and exits on both sides of the headliner using the upper one of the two ports. Only the liquid sides (lower) have mechanical push-on pull-off connections. Alternatively, a quick release latch may be used.
Internal control of flow direction and pressures may be accomplished through the use of calibrated-directional check valves. Variable internal pressures are controlled to various elements of the system. For instance, the internal air pressure at the cooling heat exchanger 31 (
Referring again to
Memory 205 may store other important information, such as the date of use, the time of day of the use, the duration of the use, the important temperatures of the coolant and the temperatures of the patient. A memory circuit (not shown) may be incorporated into the EMT unit as well.
A number of sensors may be used to monitor the reservoir level, coolant flow rate, air pressure, and coolant temperature. Such monitored values may be stored in memory 205 for use by microcontroller 203 in order to provide display information and visual or audible alarms to the user. In addition, a USB port (not shown) and associated interface circuitry (not shown) may be used for connection of controller board 201 to a remote server (not shown). Microcontroller 203 may then communicate with the remote server or other device via the USB port. Additionally, a personal computer may be connected to the unit via the USB port.
Referring to
Liquid pump 25 makes use of three phase motor technology, and may be controlled by a microprocessor. The speed of the pump may be adjustable as well as reversible. Upon fault detection, the pump may be automatically shut down.
Liquid pump 25 consists of two nearly identical intermeshing gears. One of gears is centered in the pump assembly when viewed from a top view. It is connected directly to the rotor shaft and is identified as the driving gear. The second gear is fixed at its centerline to the housings such that it intermeshes with the driving gear.
The gears are placed within a closely fitting cavity that resembles a figure eight. There is an inlet path and an outlet path at the coincidence of the figure eight formed by two circles (cylindrical shapes).
Liquid is sucked in at the inlet side of the pump and carried within the gear cavities as the motor rotor rotates the driving gear. The liquid contained within the gear teeth cavities is forced out of the outlet side of the pump.
The gear housing assembly is sealed by a peripheral “O” ring against an intermediate plate so there cannot be leakage. Similarly, an “O” ring on the opposite side of the plate seals the stator portion of the motor.
This design eliminates the need for a magnetic clutch or, alternatively, dynamic shaft seals.
Batteries to power the EMT conditioning unit may be held in a battery tray. The battery tray may be located, for example, at the top of the housing of the EMT conditioning unit.
Filters may be used in the coolant pathways, as for example, filter 1312 (
A filter assembly 1347 (
The use of a replaceable or back flushable filter in the Auto-Fill kit eliminates the need for quick disconnects in either the ICU or EMT units and simplifies the assembly and serviceability of either system.
The cooling process may be commanded to start by a program that is executed after the system's power-on self-test (POST) is complete, but only if the system has passed all of the POST tests.
Referring again to
This application claims priority to, U.S. Provisional Patent Application No. 61/681,505 having a filing date of Aug. 9, 2012, which is incorporated herein by reference, in its entirety.
This invention was made with government support under DoD Contract HQ003410-C-0031 awarded by the Department of Defense and administered by WHS ACQUISITION & PROCUREMENT OFFICE for the Joint IED Defeat Organization (JIE DDO). The contract gives the government certain rights in the invention. However, the government later terminated the contract.
Number | Date | Country | |
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61681505 | Aug 2012 | US |