The invention is described in further detail by the attached drawings. The following are shown:
FIG. 1 The upper body of a patient who is wearing a respiratory support arrangement as per the invention.
FIG. 2 A diagram showing the respiratory flow of an emphysema patient, with and without respiratory support.
FIG. 3 A technically simplified representation of an airway prosthesis as per the invention.
FIG. 4 A further embodiment of an airway prosthesis.
FIG. 5 Also, in the schema, an oxygen pump belonging into the arrangement as per the invention, depicting control of the air flow, as well as a control unit.
FIG. 6 The end section of a catheter as per the invention, and
FIG. 7 the catheter placed into a support body as in FIG. 6.
FIG. 1 uses P to indicate a patient suffering from lung emphysema, with overwork and exhaustion of the respiratory pump. This renders the patient unable to inhale deeply enough. The exhalation process is furthermore obstructed by limp and collapsing airways.
Such a respiration process with inhalation (inspiratorial flow) and exhalation (expiratorial flow) is shown in FIG. 2 in the left half of the image. The inhalation curve is identified as E1, while the exhalation curve is identified with A1.
To support and unburden the respiratory pump, the patient's spontaneous respiration is recorded by sensors, and an additional quantity of oxygen is administered to the lungs at the end of an inhalation process. This respiration flow is further clarified in FIG. 2 in the right half of the image. The additional quantity of oxygen increases the respiration volume during inhalation as shown in curve E2 by the differential volume which is darkened in on the upper curve, and identified as E3. The additional oxygen quantity may possess a volume between 25 ml and 150 ml.
The patient's exhalation process is furthermore slowed by a counter-flow. This causes the respiratory flow during exhalation to shift as shown in the curve which is identified as A2. This resistance, which specifically counteracts the exhalation flow, prevents airway collapse during exhalation. This process enlarges the exhalation volume by the volume which is also darkened in, and identified as A3.
This process consequently prevents insufficient respiration with oxygen undersupply and increased carbon dioxide levels in the bloodstream. The patient P is significantly more stressable and mobile, as well as feeling less or no respiratory distress.
The arrangement which is intended to provide respiratory support to the patient P includes an oxygen pump 1 which can be connected to an oxygen source (see FIG. 5) and an airway prosthesis 2, 3 (see FIGS. 3 and 4). In accordance with FIG. 1, the oxygen pump 1 is part of a compact mobile respiration unit 4. The oxygen pump 1 and the airway prostheses 2 and 3 are connected via a catheter 5.
As FIGS. 3 and 4 show, each airway prosthesis 2 and 3, respectively, possesses a tubular support body 6 with a connector 7 for the catheter 5. Two sensors 8, 9 are assigned to the support body 6 in the form of thermistors for the purpose of recording the patient's spontaneous respiration. Herein, a sensor 8 is fastened to the internal wall 10 of the support body 6, while the other sensor 9 is located at the outside wall 11 of the support body 6. The sensors 8, 9 are connected with a control unit 12 for activating the oxygen pump 2. The control unit 12 is schematically shown in FIG. 5 with its entries and exits. As already mentioned, the sensors 8, 9 are thermistors, that is, temperature dependent resistors. These are linked in a bridge circuit within the arrangement, so that the compensation of measurement values between the inner sensor 8 and the outer sensor 9 takes place in response to environmental influences.
It is furthermore shown in FIG. 1 that further respiration sensors 13, 14 are intended. These are likewise sensors for recording the spontaneous respiration of the patient P. Equalization of the measurement values recorded by the sensors 8 and 9, as well as 13 and 14, provide a precise depiction of the respiratory process of the patient P. Security against erroneous measurements or failure of one of the sensors 8, 9 as well as 13, 14 is furthermore improved.
In the airway prosthesis 2 as per FIG. 3, the jet catheter 5 can be introduced into the support body 6 via the connector 7. The end of the jet catheter 15 which is located within the support body 6 is guided/redirected parallel to the longitudinal axis L of the support body. The data conduits of the sensors 8, 9 for the control unit 12 are identified as 16 and 17. These run within the catheter 5. At the outflow end 15, the jet catheter 5 is designed as a jet nozzle 25. This can be accomplished by a reduction of the catheter cross-section. This increases the speed of the oxygen flow at the exit of the catheter 5, directing it into the direction of the bronchial tract. The diameter of the support body 6 is dimensioned with a lumen which is sufficiently large so that the patient P can breathe and speak freely even with the integrated catheter 5.
In the airway prosthesis 3 as per FIG. 4, a separate coupling 18 is provided at the connector 7 to connect the catheter 5 to the airway prosthesis 3. In this case, within the support body 6 and parallel to the longitudinal axis L, a fixed length segment 19 is intended as a catheter end, wherein the oxygen flow is directed into the direction of the bronchial tract via a jet nozzle 26.
The oxygen pump 1 is schematically shown in FIG. 5. It involves a cylinder pump with a double-action piston 20 which is arranged within a cylinder 27. The arrangement possesses a total of four valves V1 to V4. Oxygen is supplied out of an external oxygen reservoir via the connector 21. The switching conditions of the valves V1 to V4, as well as the incoming and outgoing supply lines, are identified by the letters a to g.
In respiratory support, the function of the oxygen pump 1 within the arrangement is as follows:
When the valve V1 from c to a are open (b to c closed) and the valve V2 from b to e is open (e to d closed), the piston 20 at the image level moves to the left, and oxygen flows through the outlet 22 and the jet catheter 5 to the patient P. The additional quantity of oxygen E3 is administered during the inhalation process of the patient P.
When the valve V1 from b to c (c to a closed) is open, and the valve V2 from e to d is open (b to e closed), the piston 20 at the image level moves to the right, and oxygen flows out in the direction of the valve V3. The valve V3 is connected to the outside air via an outlet 23. If the valve V3 from d to g is open, the oxygen flows without an expiration resistor: This means that the exhalation process is not slowed by a counter-flow.
If the valve V3 from d to g is closed, and is open from d to f, the oxygen flows in the direction via the supply line 24 to the outlet 22 and the catheter 5 to be administered to the patient P during the exhalation process, as well as slowing the respiratory flow. The counter-flow prevents airway collapse and keeps the airways open. This enables deeper exhalation.
In the supply line 24 of the arrangement, the valve V4 is also switched, allowing variable adjustment of the flow-through (f to a). This may preferably consist of a proportional valve with pulse width modulation.
FIG. 6 shows a catheter 28 with a long, flexible tube 29 and an outflow end 31 which is angled through the use of a bent segment 30. The end includes two sensors 32, 33 to record the spontaneous respiration of a patient P. The sensors 32, 33 preferably consist of thermistors. The representation of data cables has been omitted for the sake of simplicity. These run through the catheter 28 or the catheter wall 34 identifies a stop.
It is furthermore recognizably shown that the end 31 of the catheter 28 is provided with a jet nozzle 35. Within the jet nozzle 35, the flow cross-section is reduced relative to the cross-section of the catheter, so that the exit speed of the supplied oxygen is increased.
The catheter 28 may be introduced into a support body 36, as shown in FIG. 7. The support body 35 is located within the airway of a patient P. The connection to the outside is provided via a connector 37.
The support body 36 may consist of a customary “Montgomery-T-Stent”.
LIST OF REFERENCE SYMBOLS
1—Oxygen pump
2—Airway prosthesis
3—Airway prosthesis 4
- Respirator
5—Catheter
6—Support body 7
- Connector
8—Sensor
9—Sensor
10 Internal wall, front 611
- External wall, front 612
- Control unit
13—Respiration sensor
14—Respiration sensor
15—End, front 5
16—Data cable
17—Data cable
18—Coupling
19—Length segment
20—Piston
21—Connector
22—Outlet
23—Outlet 24
- —supply line
25—Jet nozzle
26—Jet nozzle
27—Cylinder
28—Catheter
29—Tube
30—Bend
31—End, front 28
32—Sensor 33 -
- Sensor
34—Stop
35—Jet nozzle
36—Support body
37—Connector
- P—Patient
- E1—Inhalation curve
- E2—Inhalation curve
- E3—Volume A1 —
- Exhalation curve A2 —
- Exhalation curve A3 —
- Volume
- V1—Valve
- V2—Valve
- V3—Valve
- V4—Valve
- L—Longitudinal axis, front 5
- a—line
- b—line
- c—line
- d—line
- e—line
- f—line
- g—line
Patent Application
20080041371
