The invention relates to ventilation apparatus and systems for ventilation. More specifically, the invention relates to a ventilation apparatus comprising modular components to provide time controlled adaptive ventilation to one or more individuals. According to the invention, the components of the apparatus are easy to manufacture and assemble, inexpensive, portable, and may be disposable or simple to sterilize.
The earliest breathing machine was the Drinker respirator. It was invented in 1928 and was known as an “iron lung”. These machines were used from the 1930s and 1950s by patients whose breathing muscles had been paralyzed by polio. They used negative pressure to help patients breathe while lying inside the iron lung's airtight chamber. A pump removed air inside the chamber, creating low air pressure around the patient's chest. This enabled the lungs to expand, causing the patient to breathe in. Other negative-pressure devices included the “cuirass”, a shell-like device that was tightly strapped over the chest. A pump created a vacuum across the chest, forcing the patient to breathe in.
These types of respirators were replaced by ventilators in the 1950s. Ventilators use positive pressure, meaning they actively pumped air directly into the lungs through a face mask or a tube in the throat. Ventilators were developed during the World War II to supply oxygen to fighter pilots flying at high altitude. Hand-pumped and mechanical positive-pressure devices helped patients breathe during polio epidemics in the 1950s. During this time, the development of ventilators that actively pumped air directly into and out of the lungs was credited with rapidly dropping the mortality rates in patients with polio from more than 80 percent to about 40 percent “almost overnight”. (see Slutsky, A. S., History of Mechanical Ventilation—From Vesalius to Ventilator-induced Lung Injury, Am J Respir Crit Care Med. (May 15, 2015) 191(10): 1106-15).
Ventilators have since become essential tools within surgery as well as in intensive-care medicine. In fact, mechanical ventilation is one of the most common interventions implemented in the intensive care unit (ICU). More than half of the patients in the ICU are ventilated the first 24 hours after ICU admission, including individuals who have acute respiratory failure, compromised lung function, difficulty breathing, or failure to protect their airway (see Kirton, O., Mechanical Ventilation in the Intensive Care Unit, AAST.org (2011) General Information, Mechanical Ventilation).
Accordingly, ventilators play an important role in the care of patients with compromised lung function. The ling's primary function is to add oxygen and to remove carbon dioxide from the blood passing through the lung's blood vessels. Anytime the lungs are compromised, the patient's ability to exchange oxygen and carbon dioxide becomes difficult. The lungs can be compromised if a patient has COVID-19, pneumonia or any other disease or condition that affects the lung's function. Ventilators basically assist patient's lungs with this function.
Modern ventilators operate in a defined ventilatory mode, which is the process by which the mechanical ventilator determines, either partially or fully, when the mechanical breaths are to be provided to the patient, thus determining the breathing pattern of the patient during mechanical ventilation.
Early ventilators provided only machine-triggered volume-control inspiration. However, as technology advanced, pressure-targeted ventilators were developed, and these became the norm.
Airway pressure release ventilation (APRV) was described in 1987, as a mode that allows spontaneous breathing throughout the ventilation cycle. (See Downs J B, Stock M C. Airway pressure release ventilation: a new concept in ventilatory support. Crit Care Med. 1987; 15:459-461). APRV is a time-cycled alternant between two levels of positive airway pressure, with the main time on the high level and a brief expiratory release to facilitate ventilation.
Bird, U.S. Pat. No. 3,974,828 discloses a ventilator with an inhalation phase and an exhalation phase in its operative cycle having an inlet adapted to be connected to a supply of gas under pressure and first, second and third outlets. A servo controller is provided having an inlet and an outlet with control valve means movable between open and closed positions to control the flow of gas from the inlet to the outlet. A conduit system is provided for supplying gas from the first outlet to the patient adapter. An exhalation valve assembly is coupled to the patient adapter and is movable between open and closed positions. A conduit system is provided for supplying gas from the second outlet to the exhalation valve assembly to maintain the exhalation valve assembly in a closed position during the time the gas is being supplied from the outlet of the servo controller. A sensing mechanism is provided for sensing the pressure of the gas in the conduit system for supplying gas from the outlet of the servo controller to the patient adapter and for switching the servo controller from an open position to a closed position when a predetermined pressure is reached. A flow acceleration system is provided for augmenting the flow of gases through the first outlet when the pressure in the first outlet is of a certain predetermined pressure. A fail-safe apneustic plateau system is provided. In addition, an expiratory termination circuit is provided for commencing the inspiratory phase with high constant positive pressures existing in the inspiratory breathing circle.
Bird, U.S. Pat. No. 4,060,078 discloses a ventilator having an inhalation phase and an exhalation phase in its operative cycle for use with a source of gas under pressure. A demand flow accelerator is responsive to the pressure of the gases in a breathing head assembly and provides additional gases to the breathing head assembly when the pressure of the gases in the breathing head assembly falls below a predetermined pressure. A sensor is also provided responsive to the pressure of the gases in the breathing head assembly for supplying gases to the breathing head assembly when the pressure of the gases in the breathing head assembly falls below a predetermined value to cause the patient to exhale against a substantially constant positive airway pressure. An additional sensor is also provided which is sensitive to the airway pressure being sensed for bleeding gases from the breathing circuit when pressure greater than a predetermined pressure are reached. Lock-out means is provided for locking out an inspiratory phase which exceeds a predetermined time. Starting means is provided for ensuring that the ventilator will be switched to an expiratory phase before an inspiratory phase is initiated.
Bird, U.S. Pat. No. 5,007,420 discloses a ventilator for use with a source of gas under pressure for supplying such gas to the airway of a patient having an inlet adapted to be connected to the source of gas, and an outlet adapted to be connected to the airway of the patient. A pneumatic oscillator is connected to the inlet for supplying pulsatile gas in the form of successive small volumes of gas to the airway of the patient during a breath of the patient to cause diffusive ventilation of the airway to the patient. An exhalation valve assembly is connected to the patient airway for permitting the patient to exhale gases introduced into the patient airway.
McDaniel, et al., U.S. Pat. No. 9,314,579 discloses a ventilator that is small, lightweight, and portable, yet capable of being quickly adapted to operate in a plurality of different modes and configurations to deliver a variety of therapies to a patent. A porting system having a plurality of sensors structured to monitor a number of parameters with respect to the flow of gas, and a number of porting blocks is used to reconfigure the ventilator so that it operates as a single-limb or dual limb ventilator. In the single-limb configuration, an active or passive exhaust assembly can be provided proximate to the patient. The ventilator is capable of operate in a volume or pressure support mode, even in a single-limb configuration. In addition, a power control mechanism controls the supply of power to the ventilator from an AC power source, a lead acid battery, an internal rechargeable battery pack, and a detachable battery pack.
Koch, et al., WO 2012/062 266 discloses a device and a method for ventilation with gas and/or with liquid, containing a ventilation tube with an attached pressure sensor, an inspiration pump, which is attached to the tube and is controlled by a motor controller, an expiration pump, which is attached to the tube and is controlled by the motor controller, an oxygenator unit, which is connected at the inlet side to the expiration pump, a main container, which is connected to the inspiration pump and of which the temperature is stabilized by a dedicated thermostat, an additional container for liquid, which additional container is arranged between the outlet of the oxygenator unit and the inlet of the main container, a balance for determining the ventilated amount of liquid of the subject to be ventilated, and a control unit, which switches valves of the overall circuit in order to perform the ventilation and is connected at least to motor controller and sensors. Between the outlet side of the main container and the inlet side of the oxygenator unit, a peristaltic pump connecting the two is arranged for transporting the respective fluid from the main container to the oxygenator via hose lines, wherein a valve is connected to an additional container for gas, and wherein the control unit is designed at least with a first function block for calculating ventilation parameters for the gas ventilation, for the total liquid ventilation and for the combination of the two fluid ventilations in a first function unit, with a second function block for the motor control in a second function unit, and with a third function block for data acquisition in a third function unit.
Modern ventilators are complex and expensive medical equipment. During a health crisis, such as the COVI-19 pandemic, many patients may not receive adequate medical care because of a shortage of ventilators. While ventilators do not directly cure disease, they can save lives by supporting lung function to allow patients to recuperate. Accordingly, there is a need for a means of ventilating multiple patients from a single gas source that can be controlled individually for each patient, in a simple, cost effective, portable, disposable, modular and/or easy to assemble manner, and optionally without access to a power source.
The invention relates to a modular ventilation system that provides ventilation to one patient or multiple patients simultaneously such as in mass causality situations or pandemics. The ventilation system connects to a single gas source, such that multiple patients may share the single gas source, and comprises components of individual ventilator apparatus that provide ventilation to each individual patient. Each ventilation apparatus is made of components that are modular and can easily be assembled in multiple configurations.
The components of the system are preferably stand-alone components that are disposable and modular, such that the system has modular configurations.
The system may utilize different power sources or be entirely mechanical and require no electrical power to provide maximum flexibility for different situations, including emergency situations. According to a preferred embodiment, the power source comprises a compressed gas driven turbine or a source of electricity such as a battery or an alternating current from a wall outlet or generator or power outlet. The battery may be rechargeable, such as by wind, solar, nuclear, or other source of electricity.
The gas source for the ventilation system supplies pressurized gas, which may utilize different gas sources to provide maximum flexibility for emergency situations, such as for example, compressed gas, high flow generator, turbine, or centrifugal pump. The gas source generates flow pressure and determines gas concentrations. The system may use a venturi to entrain different gases or a gas blender to obtain a preferred gas concentration or mixture.
According to a preferred embodiment, the venturi introduces oxygen to produce a gas flow with less than 100% oxygen, preferably about 70% oxygen. Alternatively, the gas blender introduces oxygen to produce a gas flow that is up to 100% oxygen. Preferably, the inspiratory patient pressure is no more than 100 cm H2O, and the manifold pressure is 100 cm H2O times a number of patients or lungs connected to the system. According to a preferred embodiment, the system further comprises an alarm that sounds when any of these pressure thresholds are not met.
The ventilation system connects the gas flow through a circuit configured to accommodate one or more patients. With more than one patient, the main limb for pressurized gas functions as a manifold to provide separate gas supply to each patient.
The gas pressure in the system is controlled by various valves, including a flow-pressure regulator, an inspiratory pressure relief valve, a time cycled pressure release valve, an expiratory pressure relief valve, and a manifold pressure regulator valve. The time cycled pressure release valve is time controlled. The expiratory pressure relief valve depressurizes the exhalation limb and is indirectly time controlled by the time cycled pressure release valve. The manifold pressure regulator valve regulates pressure in the manifold and can bleed off excess pressure.
The system of the invention may regulate the pressure, the pressure relief, and the timing of ventilation. Alternatively, the system may allow for control of pressure regulation, pressure relief, and the duration of different pressures. The system may provide a patient or a lung with continuous positive pressure (CPAP) or cyclic ventilation by adjusting the inspiratory pressure relief valve and/or the expiratory pressure relief valve. Alternatively, the system may ventilate a patient or lung in a pressure and time-controlled mode by adjusting the inspiratory pressure relief valve and the time cycled pressure release valve.
According to a preferred embodiment, the inspiratory pressure relief valve, the time cycled pressure release valve, and the expiratory pressure relief valve are relatively closer to the patient or lung as opposed to being closer to the gas source, for ease of adjusting individual patient or lung ventilation parameters, especially when the gas source is remote from the patient. According to a more preferred embodiment, the inspiratory pressure relief valve, the time cycled pressure release valve, and the expiratory pressure relief valve are part of a patient wearable, for example, part of a mask or tubing.
The system may include a graphic display of information about the ventilation status, as well as a controller to control and adjust ventilation. A user interface can be placed at a distance away from the patient in the event of a highly contagious process. Data output may provide data streaming to remote location(s) as a central station for expert guidelines, clinical support, technical support, and device support.
An object of the invention is to provide a modular ventilation system to ventilate at least one patient or lung, wherein the system comprises:
Preferably, the connectors are mechanical connections comprising threaded, snap, friction or quick connect connectors. More preferably, the pressure relief valves are mechanical valves comprising spring loaded pressure valves or pneumatic valves, or electrical valves comprising solenoid valves.
It is another object of the invention to provide a method of ventilating at least one patient or lung with the modular ventilation system of the invention.
It is yet another object of the invention to provide a kit for a modular ventilation system comprising:
It is another object of the invention to provide a modular ventilator apparatus comprising the components of kit.
These and other objects will be described in further detail below and in the appended drawings.
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The flow/pressure controller B regulates the flow of gas (i.e., oxygen) and pressure through the system manifold L and the ventilation circuit D from a gas source A. The gas passes from the gas source A through the system manifold L, through the ventilation circuit D and the venturi valve C to entrain gas and increase the flow/pressure of gas through the circuit and alter the gas concentration to the patient connected at F.
According to the invention, the pressurized gas source A may be a wall source of gas at a pressure of about 20-60 psi, preferably about 40-50 psi, with flow that can be regulated by a flow/pressure regulator B. Alternatively, the pressurized gas source may be compressed gas, flow generator, turbine, or displacement pump. According to a preferred embodiment, the pressurized gas source is an axial flow turbine (vertical or centrifugal). A main line delivers pressurized gas through a gas tube to a patient and controls depressurization of the ventilator apparatus circuit. Oxygen can be delivered through a standard oxygen tank or a wall source. The oxygen concentration of the pressurized gas delivered to the patient depends on the ratio of the oxygen/air mix. A venturi device functions to accelerate and entrain the gas.
The patient may be connected to the ventilation apparatus by invasive or non-invasive means, including nasal cannula, mask, endotracheal tube, or tracheotomy.
The inspiratory pressure relief valve E may be a pop-up valve that is designed to relieve pressure if the patient exhales and the pressure in the expiratory limb exceeds a desired pressure. Preferably, the inspiratory pressure relief valve E maintains the pressure set by flow/pressure regulator B in the expiratory limb. The inspiratory pressure relief valve E is in open communication to the expiratory pressure relief valve H.
The timer controller I controls the expiratory time by controlling the time of gas that flows through the expiratory pressure relief valve H and the time cycled pressure release valve G. The time controller I also controls the pressure by controlling the aperture of the expiratory pressure relief valve H. Pressure is maintained above ambient by not opening the expiratory pressure relief valve H all the way. The expiratory pressure relief valve H controls both the time and the amount of gas flow. The expiratory pressure relief valve H can be a controlled by a timer controller I or a manual valve (not shown).
The timer control I may be any type of device that allows for repeated execution of a rule after an interval.
Each component of the ventilator apparatus is modular and can be easily assembled. The invention contemplates a kit with various components for assembly of a ventilator apparatus and optionally, a ventilator system. Each component can be independently manufactured, such as by 3D printing, or other suitable method. As each component of the ventilator apparatus and system is modular, each component can be mixed/matched to suit the needs of multiple patients.
The ventilator apparatus and system may be used for time controlled adaptive ventilation mode that controls both pressure and time. The ventilator parts are modular, disposable and can be easily assembled without needing any special skill.
Preferably, the ventilator system monitors pressure and flow, and the volume is derived from calculating flow/time.
According to a preferred embodiment, the ventilator system includes a user interface that is removable and connectable wirelessly such as to create distance from the patient and a contaminated area. The user interface may be a touch screen that may be controlled by a mobile application. More preferably, the ventilator system may be remotely monitored from a central location.
This application claims priority to Provisional Application Ser. No. 62/994,285 filed Mar. 25, 2020, and Provisional Application Ser. No. 63/002,349 filed Mar. 30, 2020, the disclosures of which are incorporated herein by reference in their entireties and to which priority is claimed.
Filing Document | Filing Date | Country | Kind |
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PCT/US2021/024258 | 3/25/2021 | WO |
Number | Date | Country | |
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62994285 | Mar 2020 | US | |
63002349 | Mar 2020 | US |