U.S. patent application Ser. No. 10/976,874, filed Nov. 1, 2004, pending, which is a continuation of U.S. patent application Ser. No. 10/377,110, filed Mar. 3, 2003, now U.S. Pat. No. 6,823,865, which is a continuation of U.S. patent application Ser. No. 09/570,907, filed on May 15, 2000, now U.S. Pat. No. 6,581,594, are incorporated herein by reference in their entireties.
The present invention relates to a respiratory mask and a vent for a respiratory mask.
The application of Continuous Positive Airway Pressure (CPAP) via a nasal mask is a common ameliorative treatment for sleep disordered breathing (SDB) including obstructive sleep apnea (OSA) as described in commonly-assigned U.S. Pat. No. 4,944,310, incorporated herein by reference in its entirety. In CPAP treatment for OSA, air or other breathable gas is supplied to the entrance of a patient's airways at a pressure elevated above atmospheric pressure, typically in the range 3-20 cm H2O, as measured in the patient interface. It is also known for the level of treatment pressure to vary during a period of treatment in accordance with patient need, that form of CPAP being known as automatically adjusting nasal CPAP treatment, as described in commonly-assigned U.S. Pat. No. 5,245,995, incorporated herein by reference in its entirety.
Non-invasive positive pressure ventilation (NIPPV) is another form of treatment for breathing disorders including sleep disordered breathing. In a basic form NIPPV involves a relatively high pressure of gas being provided in the patient interface during the inspiratory phase of respiration and a relatively low pressure or atmospheric pressure being provided in the patient interface during the expiratory phase of respiration. In other NIPPV modes the pressure can be made to vary in a complex manner throughout the respiratory cycle. For example, the pressure at the patient interface during inspiration or expiration can be varied through the period of treatment as disclosed in the commonly-assigned International PCT Patent Application No. WO 98/12965 and International PCT Patent Application No. WO 99/61088, both incorporated herein by reference in their entireties.
In this specification any reference to CPAP treatment is to be understood as embracing all of the above-described forms of ventilatory treatment or assistance.
Typically, the patient interface for CPAP treatment includes a nasal mask. The nasal mask is generally defined by a mask shell which forms an inner cavity defined by its interior surface, mask cushion and the user's face, a gas inlet which may or may not include a separate component such as a swivel elbow. Alternatively, a nose-mouth mask or full-face mask or nasal prongs or nasal pillows can be used. In this specification any reference to a mask is to be understood as incorporating a reference to a nasal mask, nose-mouth mask, full face mask, nasal prongs or nasal pillows unless otherwise specifically indicated. The mask incorporates, or has in close proximity, a gas washout vent for venting exhaled gases to atmosphere. The gas washout vent (the vent) is sometimes referred to as a CO2 washout vent.
It is important that the apparatus is quiet and comfortable to encourage patient compliance with therapy. The exhausting to atmosphere of exhaled gas through the vent creates noise. As CPAP and NIPPV treatments are normally administered while the patient is sleeping, minimization of such noise is desirable for both the comfort of the patient and any bed partner. It is also desirable to minimize the exhaust gas jet by diffusing the air flow, in order to avoid any further disturbance or noise which may be caused by the exhaust gas jet hitting bedding or other obstacles.
From a clinical perspective it is desirable for a mask and vent combination to maximize both the elimination of exhaled CO2 through the vent and also the inhalation of the supplied breathable gas. In this way, retention of exhaled CO2 within the mask, which is “rebreathed’ by the wearer, is minimized. Generally by locating the vent in the mask shell, CO2 washout will be superior to locating the same vent between the mask shell and the breathable gas supply conduit.
It is desirable to minimize the weight of the vent assembly for greater patient comfort.
Systems for the delivery of nasal CPAP treatment often incorporate in-line humidifiers to minimize drying of the nasal mucosa and increase patient comfort. Accordingly, it is also desirable that a vent not block when used with humidified gas. It is also desirable that a vent be easily cleaned or economically disposable.
A number of vent configurations are known. One approach to vent configuration is to create within the mask shell one or more openings that allow for the flow of exhaust gas from the inner cavity to atmosphere. The exhaust flow may be directed through the incorporation of an additional pipe extending out from the opening located on the mask shell outer surface.
The Assignee's nasal mask system known by the name “ResMed Modular Mask System” incorporates an outlet vent located in the swivel elbow connected to the mask shell. The ports defining the vent have the same cross-sectional thickness and are formed from the same polycarbonate material that is used to form the swivel elbow and mask shell frame.
The whisper swivel, manufactured by Respironics, Inc., provides three slots on the circumference of a generally cylindrical attachment piece. In use, the attachment piece is to be interposed between the mask shell and the gas conduit. The attachment piece is made of the same material and thickness as is used to make the mask shell.
European Patent No. 0 697 225, which is incorporated herein by reference in its entirety, discloses a vent formed from a porous sintered material.
A known vent, manufactured by Gottleib Weinmann Gerate Fur Medizin Und Arbeitsschutz GmbH and Co., comprises a generally cylindrical insert to be interposed, in use, between the mask shell and the gas conduit. The insert includes a window which is covered with a porous sintered material of approximately 3-4 mm thickness.
Another type of vent intended to be inserted between the mask shell and the breathable gas supply conduit is the E-Vent N by Draeger Medizintechnik GmbH (the Draeger vent). The Draeger vent comprises a stack of 21 annular disks that have slots in their adjacent surfaces for gas to flow therethrough. Each slot has a length of 5 to 7 mm, as measured along the path from the interior of the vent to atmosphere.
The Assignee produces a respiratory mask known as the MIRAGE® nasal mask system and the MIRAGE® full-face mask (the MIRAGE® mask). The MIRAGE® mask has a crescent shaped opening in the mask shell in which is located a complementary shaped crescent elastometric insert with six holes therein which constitutes the vent. The elastomeric inset has a cross-sectional thickness of 3 to 4 mm. The vent of the type used in the MIRAGE® is described in International Patent Application No. WO 98/34665 and Australian Patent No. 712236, both of which are incorporated herein in their entireties.
It is an aspect of the present invention to provide an alternative form of vent that is suitable for use in a respiratory mask.
One aspect of the present invention provides a vent assembly suitable for use with a mask used in CPAP treatment wherein the vent assembly is a thin air permeable membrane.
In one form of the invention, the membrane is thinner than the mask frame.
In another form of the invention, the membrane is thinner than 0.5 mm.
In another form of the invention the membrane has an approximate thickness of 0.05 mm.
In another form of the invention the membrane is constructed from a hydrophobic material such as polytetrafluoroethylene (PTFE).
In embodiments, the membrane may comprise a mesh material, such as a porous fabric or a PTFE mesh. The mesh material may be capable of thickening upon stretching, e.g., by use of an auxetic material including auxetic fibers. The fibers may have negative Poisson's Ratio, as well as low Young's Modulus (to enable easy stretching). The auxetic material can be in the form of sheet material having one or more perforations and/or slits, instead of a mesh.
In another form of the invention the membrane is constructed from expanded PTFE.
In another form of the invention the expanded PTFE membrane is mounted on a polypropylene scrim.
In another form, the pores of the membrane have a reference pore size of 10 to 15 microns.
In another form of the invention the membrane is constructed from stainless steel. The stainless steel sheet has a thickness of approximately 0.45 mm and a number of holes, each hole having a diameter of approximately 0.1 mm. The total open area of such a stainless steel membrane is approximately 5%.
In another form of the invention the membrane of the vent has a superficial cross-sectional area of approximately 500 mm2.
In another form of the invention the vent assembly comprises a membrane attached to a vent frame, the vent assembly forming an insert which can be remove ably attached to a mask frame.
In another form of the invention there is provided a respiratory mask for communicating breathable gas to the entrance of a wearer's airways, the mask including (i) mask shell, (ii) a gas inlet and (iii) an opening into which an insert constructed from a thin air permeable membrane with a corresponding shape may be placed. The opening may be positioned in the mask shell or in the gas inlet.
In one form, the mask includes a mask shell with an integrally formed gas inlet and the opening is provided in the mask shell remote the inlet. In another form, the mask includes a mask shell with an integrally formed gas inlet and the opening is provided in the gas inlet. In yet another form, the mask includes a mask shell with a separately formed gas inlet attached thereto and the opening is provided in the mask shell remote the inlet. In still yet another form, the mask includes a mask shell with a separately formed gas inlet attached thereto and the opening is provided in the gas inlet.
Another aspect of the present invention provides a respiratory mask arrangement for communicating breathable gas to the entrance of a wearer's airways, the mask arrangement including a vent assembly comprising an opening with a thin air permeable membrane extending across an opening.
In further aspects, the present invention provides an apparatus for delivering CPAP, which apparatus includes a mask arrangement for communicating breathable gas to the entrance of a wearer's airways, the mask arrangement including a gas washout vent assembly comprising an opening with a thin air permeable membrane extending across said opening.
These and other aspects will be described in or apparent from the following detailed description of preferred embodiments.
The present invention will be described with reference to the following drawings, in which like numerals represent like structures throughout the several views, and in which:
The mask shell 12 includes a breathable gas inlet 20 which is rotatably mounted to the shell 12. The inlet 20 has a first end 22 which is adapted for connection with a breathable gas supply conduit (not shown) and a second end 24 which is adapted to connect to, and communicate the supplied gas to the interior of the shell 12 for subsequent communication with the wearer's airways.
The mask 10 includes a gas washout vent constituted by an opening 26 in the shell 12 across which extends a thin air permeable membrane 28.
In the
Preferably the holes have a diameter of less than 0.2 mm, and preferably provide a total open area of approximately 1% to 25% of the superficial surface area of the steel. The holes may be tapered (in a gradual or stepped manner) through their internal bore. In use, if the larger end of the vent's openings are located on the atmosphere side of the vent, the opportunity for blockage occurring by the insertion of particulate matter will be minimized, because larger particles may not be able to enter the smaller end of the vent's openings on the inside of the vent. Alternatively, the smaller end of the vent's openings may be located on the atmosphere side, which may make the vent quieter.
In another example, the membrane includes a plurality of holes each having a diameter in the range of about 0.1-0.3 mm, with an open area ranging from 5 to 60%, and sufficient area (i.e., number of holes) to provide adequate flow at low pressures such as 4 cmH2O to meet the requirements to flush CO2. A preferred embodiment of this invention is a mask shell that has a thickness of 0.45 mm, holes with a diameter of 0.1 mm that are drilled, molded, laser cut or otherwise constructed therethrough, an open area of about 5% in the region containing the holes, and a total area of the vent of about 300-400 mm2, preferably about 320-330 mm2, and more preferably about 322 mm2. Preferably, the holes are tapered such that the diameter at the exterior of the mask is marginally smaller than that at the interior of the mask.
The mask 40 also includes a vent constituted by an opening 26 formed in the gas inlet 20 across which extends a thin air permeable membrane 28.
As best seen in
The thin air permeable membrane of the present invention may be attached to the mask by any suitable means. For example the stainless steel vent described above may be attached to a polycarbonate mask shell by way of hot glue adhesive (for example) or any other suitable adhesive. The durability sought to be achieved will determine the suitable approach for attachment.
In a further embodiment there is provided a means to indicate the volume of air that has passed through the vent, or alternatively the time that the vent assembly has been used. When a sufficient volume of air has passed through the vent assembly, or the assembly has been used for a sufficient time and may have become blocked, the indicator will signal that the vent assembly should be replaced.
For convenience, the thin air permeable membrane can be provided in an insert which is releasably attachable to the mask shell via a push-fit mechanism, as shown in
Formation of the vent through use of an insert configuration facilitates the selection and fitting of a vent to suit a user's requirements. For a fixed orifice vent, low flow occurs at low pressures and high flow occurs at high pressures. Therefore, a relatively large vent area may be adopted to facilitate achievement of the clinically desirable mask CO2 washout rate. Should a higher treatment pressure be required then the previously selected vent may be exchanged for a vent that is more restrictive to flow. The more restrictive vent will allow achievement of the clinically desirable mask CO2 washout rate while avoiding the intensity of noise and exhaust gas jetting that would occur had the previously selected low pressure vent been used with the higher treatment pressure.
Locating the vent in the mask shell results in an improvement in the minimization of CO2 retention within the mask compared to locating the vent as an inline mask component.
In other further embodiments of the invention, another type of air permeable membrane may be used in the mask vents. Instead of the ePTFE membrane described above, a vent of a mesh material may be used as an air permeable membrane. One suitable type of mesh material includes a PTFE mesh sold by Spectrum Laboratories of Rancho Dominguez, Calif., USA under the name Fluorocarbon SPECTRA/MESH®. In one preferred form, the SPECTRA/MESH® membrane has the following characteristics:
The PTFE mesh is preferably hydrophobic and may be used in the same manner as described above with respect to
PTFE mesh may also be used in a number of other vent configurations. For example, the PTFE mesh may be installed above an existing air vent or air restrictive element with essentially no gap between the PTFE mesh and the air vent. For example, PTFE mesh may be installed above an air vent such as the MIRAGE® air vent described above and in International Patent Application No. WO 98/34665 incorporated herein by reference in its entirety. In this configuration, the air vent would cause the majority of the pressure drop between the inside of the mask and the outside of the mask and the PTFE mesh would act to diffuse the air leaving the vent and reduce noise. Alternatively, PTFE mesh may be installed above an air vent with a small gap (e.g., 0.5-1 mm) between the vent and the PTFE mesh, such that the gap would help to diffuse the escaping air over a larger area of the mesh.
In any of the PTFE mesh configurations described above, one or several layers of PTFE mesh may be used. If multiple layers of PTFE mesh are used, the airflow restriction created by the mesh would be increased.
The PTFE mesh may be provided in the form of a disposable insert, similar to the inserts 82 of
The shape of the vent 106 may be symmetrical about at least one axis as shown in
The sail portion 304 in
While the embodiments of
Although the invention has been described with reference to specific examples, it is to be understood that these examples are merely illustrative of the application of the principles of the invention. Thus it is to be understood that numerous modifications may be made in the illustrative examples of the invention and other arrangements may be devised without departing from the spirit and scope of the invention.
This application claims the benefit of U.S. Provisional Application No. 60/640,184, filed Dec. 30, 2004, incorporated herein by reference in its entirety.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/AU05/01941 | 12/22/2005 | WO | 00 | 10/28/2008 |
Number | Date | Country | |
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60640184 | Dec 2004 | US |