Heat and moisture exchange devices are often used to provide moisture to gases from a ventilator for respiratory therapy. To this end, a heat-moisture exchanger (HME) is positioned in the respiratory circuit, such a device containing a material or composition capable of absorbing heat/moisture from patient exhaled gas and desorbing the heat/moisture into the cool/dry respiratory gas stream from the ventilator for patient inhalation.
For treating some respiratory conditions, it is desirable to introduce an aerosol generated by a nebulizer to the gas delivered to a patient. When such treatment is provided, it is desirable to bypass the HME to avoid absorption of the aerosol in the HME material. To avoid the inconvenience and inefficiency of removing the HME device each time aerosol treatment is to be administered, HME bypass devices have been designed, such as described in U.S. Patent Application Publication No. 2004/0084046. However, operating the prior art device between HME and bypass functions requires rotation of the housing portions causing rotation of the pipes at each end of the housing portions. Such housing and pipe rotation is transferred to the attached patient circuit tubing resulting in disturbing or loosening the pipe connections and contributes to inadvertent tubing disconnects affecting patient ventilation or necessitates repositioning of the patient ventilator circuit to relieve the added torque along the tubing.
The heat and moisture exchange device described herein is provided with a mechanism that allows an operator to select and change the mode of operation between HME and aerosol treatment, but does not transfer rotation and torque to the patient respiratory circuit tubing. The device comprises a housing wall structure defining an interior chamber in which is positioned a heat and moisture exchange (HME) material or composition capable of absorbing moisture and heat from a patient exhaled gas and thereafter releasing the absorbed heat and moisture into a dry respiratory gas for patient inhalation. Within the walled housing are a heat and moisture exchange passageway and a bypass passageway. Stationary pipes secured on opposite ends of the housing communicate with the interior chamber. A valve adjacent to the distal pipe end is configured to provide selective fluid communication through the HME passageway or the bypass passageway, the valve including a valve selector providing such selective communication without moving the wall structure or either of the end pipes relative to one another. The selectively operated valve comprises a first apertured wall and a second apertured wall. One wall is stationary, and the other is moved by the valve selector to align apertures for selectively directing fluid flow through the HME passageway or the bypass passageway. In a preferred embodiment, the valve selector is rotatably mounted on the device housing whereby an operator can conveniently rotate the valve selector, causing rotation of the movable apertured member for selectively aligning apertures to direct fluid flow for HME or bypass operation.
Major components of the HME device assembly are illustrated in
Referring again to
The interior space or chamber defined by the housing walls between opposite pipes 12 and 14 is configured to provide a heat and moisture exchange passageway 34 and an elongated bypass passageway 32. As particularly illustrated in
Positioned within the heat and moisture exchange passageway 34 is a heat and moisture exchange (HME) cartridge 30, as illustrated in the embodiment of
Prior to bonding the housing wall components together, the rotatable apertured member 22 is installed as is the HME material. As shown in
In the embodiment illustrated, a cylindrical tube or conduit is provided along at least a portion of the length of bypass passageway 32. The cylindrical tube provides a coaxial spool for supporting an annular cartridge or roll of the HME material which may be wrapped around the cylindrical conduit. In a preferred embodiment, the cylindrical tube is formed as an integral part of rotatable apertured member 22. The tube is preferably long enough so that the end opposite the valve is received in or otherwise supported by a spacer 26 formed as a component of housing wall member 18. A plurality of notches 29 are illustrated in
In operating the HME devices, when aerosol is to be delivered to a patient, the valve selector is rotated to a HME bypass or nebulizer position whereby the rotatable apertured member 22 is rotated to align apertures 21 with apertures 27 on apertured member 25 so that substantially all gas directed through the device bypasses the HME passageway. In the bypass mode, the HME device operates to direct the aerosol-gas mixture from pipe 14 through the elongated passageway 32 to pipe 12. When aerosol delivery to the patient is eliminated or terminated, the valve selector is rotated to align apertures 23 in apertured member 22 with apertures 27, and whereby apertures 21 are not in alignment. In this HME mode of operation, substantially all of the gas is delivered between pipes 12 and 14 through HME passageway 34. When the valve selector is rotated, there is no rotational movement of the housing wall structure or housing wall components 16 and 18 relative to one another nor rotational movement of pipes 12 and 14 relative to one another. Thus, the HME mode and bypass mode can be selected by an operator without transferring rotation to a patient circuit. The device may be operated by holding the housing with one hand and rotating the valve selector with the other hand without transferring rotational movement to either the patient, proximal pipe 12 side, or ventilator, distal pipe 14 side, so that the connections to the tubing on both sides of the device are not disturbed, loosened or otherwise disconnected.
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