The present disclosure relates to chest compression devices and in particular to a high-frequency chest wall oscillation (HFCWO) device.
Manual percussion techniques of chest physiotherapy have been used for treatment of a variety of diseases in order to remove the excess mucus that collects in the lungs. A non-exhaustive list of such diseases includes cystic fibrosis, emphysema, asthma and chronic bronchitis to remove the excess mucus that collects in the lungs. Subjecting the patient's chest and lungs to pressure pulses or vibrations decreases the viscosity of lung and air passage mucus, thereby enhancing fluid mobility and removal from the lungs to open airways and mobilize secretions.
To alleviate dependency on a care giver to provide this therapy, chest compression devices have been developed to produce high frequency chest wall oscillation (HFCWO). These devices use an air pulse generator, a vest having air bladders that surround the chest of the patient, and one or more hoses pneumatically coupling the air pulse generator with the vest. The air pulse generator is a mechanical device which operates to supply air under pressure to the bladders in regular patterns of pulses. Illustratively, the vests may be reusable or single patient use items.
One illustrative devices used to produce HFCWO is The Vest® airway clearance system by Hill-Rom Services, Inc. (Batesville, Ind.). Additional pneumatic chest compression devices have been described in U.S. Pat. Nos. 4,838,263; 5,543,081; 6,036,662; 6,254,556; 6,547,749; and 7,725,203, the disclosures of each of which are hereby expressly incorporated by reference herein.
The present invention comprises a HFCWO vest, or a component thereof, that has any one or more of the features listed in the appended claims and/or any one or more of the following features, which alone or in any combination may comprise patentable subject matter:
According to one aspect of the present disclosure, a garment for applying HFCWO treatment to a patient includes an outer shell, an inner liner coupled to the outer shell to define a pocket between the outer shell and the inner liner, and an air bladder removably received within the pocket. The inner liner is made from a three dimensional (3D) material.
In one illustrative embodiment, the 3D material may include an outer layer, an inner layer, and a third layer woven between the outer and inner layers. Both the outer and inner layers may be made from a woven fabric. Further, the outer layer may include first apertures formed therethrough and the inner layer may include second apertures formed therethrough. The first apertures may be larger than the second apertures. Illustratively, the inner layer including the second apertures may be configured to lie adjacent a patient during HFCWO treatment and the outer layer including the second aperture may be adjacent an inner surface of the outer shell.
In another illustrative embodiment, an outer edge of the inner liner and an outer edge of the outer shell may be aligned with and coupled to each other. Illustratively, the garment may further includes a zippered connection between a bottom edge of each of the outer shell and the inner liner.
In still another illustrative embodiment, the inner liner may be configured to be compressed and expanded during HFCWO treatment as the bladder is pulsed.
In yet another illustrative embodiment, the bladder may include two plastic sheet members welded to each other only at the outer edge of the sheet members such that the bladder is void of any welds which extend away from the outer edge of the sheet members toward a center of the sheet members. Illustratively, one of the plastic sheet members may be perforated to allow air to pass therethrough. Further illustratively, the plastic sheet member adjacent the inner liner may be perforated. Alternatively, or in addition to the perforations, the outer edges of the plastic sheet members may be welded intermittently to provide leak areas to allow air to pass therethrough.
In still another illustrative embodiment, the bladder may include first snap fastener connectors and the outer shell may include second snap fastener connectors configured to mate with the first snap fastener connectors in order to removably couple the bladder to the outer shell.
Illustratively, a portion of at least one of the bladder, the inner liner, and the outer shell may be antimicrobial.
In yet another illustrative embodiment, the inner liner may include an inner mesh layer and an outer mesh layer. Illustratively, the inner liner may further include a middle region between the inner and outer mesh layers. The middle region may include a plurality of fibers coupled to and woven between each of the inner and outer layers as well as air spaces between the fibers. Illustratively, fibers of the middle region may be substantially vertically oriented between the inner and outer layers. Further illustratively, the inner layer may include first apertures and the outer layer may include second apertures larger than the first apertures. The inner layer may be configured to lie adjacent the patient and the outer layer may be configured to engage the bladder. Illustratively, the first apertures may be diamond-shaped and the second apertures may be circular in shape.
According to another aspect of the present disclosure, a method of providing HFCWO treatment includes securing a garment around the chest of a patient, wherein the garment includes an outer shell, an inner liner coupled to the outer shell, and a bladder removably received within a space between the outer shell and the inner liner. The method further includes coupling the bladder to an air pulse generator, pulsing the bladder between 5-20 Hz, circulating air between the bladder and the patient to cool the patient and remove moisture vapor.
Illustratively, the inner liner may include inner and outer layers and support fibers woven between the inner and outer layers. Further illustratively, circulating air between the bladder and the patient may include collapsing and expanding the inner and outer layers at approximately the same rate at which the bladder is pulsed.
Additional features, which alone or in combination with any other feature(s), such as those listed above, may comprise patentable subject matter and will become apparent to those skilled in the art upon consideration of the following detailed description of various embodiments exemplifying the best mode of carrying out the embodiments as presently perceived.
The detailed description particularly refers to the accompanying figures, in which:
A high frequency chest wall oscillation (HFCWO) system 10 includes a vest 12 which fits around the chest of a patient 14, an air pulse generator 16, and two illustrative air hoses 18 coupled to and configured to extend between the vest 12 and the air pulse generator 16 in order to communicate the air pulses from the generator 16 to the vest 12 to provide HFCWO therapy to the patient 14. During treatment, the air pulse generator 16 generates oscillatory pulses which travel to the vest 12 through the hoses 18 in order to deliver oscillatory chest compressions to the chest of the patient 14 to open airways, mobilize secretions, and clear mucus from the lungs of the patient 14. As is discussed in greater detail below, an inner liner 22 of the vest operates to circulate and cool air between the patient 14 and the vest 12.
Illustratively, the air pulse generator 16 includes, among other things, an outer shell or housing 29, and a controller and an air pulse module contained within the housing 29 in order to produce the oscillatory pulses needed to treat the patient 14. Illustrative air pulse generators are described within U.S. Pat. Nos. 7,121,808; 7,316,658; 7,582,065; 7,425,203; and 7,115,104, the disclosures of each of which are hereby incorporated by reference herein. It is within the scope of this disclosure, however, for the HFCWO system 10 to include other air pulse generators as well. Further, while the system 10 is shown to include two hoses 18, it is within the scope of this disclosure to provide a HFCWO system having any suitable number of hoses between the air pulse generator 16 and the vest 12.
Looking now to
The outer shell 26 includes an outer surface 28 configured to face away from the patient 14 when the vest 12 is worn by the patient 14 and an inner surface 30 configured to face toward the patient 14 when the vest 12 is worn by the patient 14. Illustratively, the outer shell 26 is made from a generally non-stretch nylon material. It is within the scope of this disclosure, however, for the outer shell 26 to include portions made from a stretch material, such as a Lycra® fabric material and or a stretch Lycra® binding, for example. Of course, other suitable stretchable and non-stretchable materials may be used as well.
Illustratively, the outer shell 26 may also be made of a water resistant and/or stain resistant material. Further, the outer shell 26 may be made of a washable material to allow the patient 14 or other caregiver to remove the inner bladder 24 and liner 22 from the outer shell 26 such that the shell 26 may be washed in a washing machine or otherwise disinfected. Illustratively, the inner liner 22 may be washed in a washing machine or otherwise disinfected as well. The outer shell 26 may also be made of a light weight material in order to reduce the overall weight of the vest 12 and accommodate the comfort of the patient 14. Illustratively, the outer shell 26 may also include one or more pockets (not shown) to allow a patient 14 to carry or store items such as MP3 player, medications, etc., therein.
The outer vest portion 20 further includes buckles 31 coupled to the outer surface 28 of the shell 26. Illustratively, the vest 12 shown in
Illustratively, each buckle 31 includes a first strap 32 having a first strap member 34 coupled at one end to the outer surface 28 of the shell 26, and a male fastener 36 coupled to the other end of the strap member 34. Each buckle 31 also includes a second strap 42 including a second strap member 44 coupled at one end to the outer surface 28 of the shell 26, and a female fastener 46 coupled to the other end of the second strap member 44. In use, the male fastener 36 is received within the corresponding female fastener 46 in order to couple the first and second straps 32, 42 together to secure the vest 12 about the patient 14. Further illustratively, the length of the first and/or second strap members 34, 44 (i.e., the length between the end of the strap member 34, 44 coupled to the outer surface 28 of the shell 26 and the respective fastener 36, 46) may be adjusted in order to tighten or loosen the vest 12 on the patient 14.
As shown in
Looking still to
Accordingly, the shoulder strap flaps 60, 64 of the outer shell 26 cooperate to define a pair of upright shoulder straps of the shell 26 which are laterally spaced-apart by a concave, or U-shaped, upper back edge of the shell 26. The front chest flaps 64 of each of the right and left front chest portions 50, 52 are separated from the center strap flaps 60 with concave curved upper edges which allow the vest 12 to fit under the arms of the patient 14. As shown in
As noted above, the outer portion 20 of the vest 12 further includes the inner liner 22 coupled to the outer shell 26 to define the pocket 27 therebetween. The inner liner 22 is coupled to and configured to lie adjacent the inner surface 30 of the outer shell 26 such that the inner liner 22 is also configured to lie adjacent the patient 14, as shown diagrammatically in
Illustratively, the inner liner 22 is also coupled to the outer shell 26 through a zippered connection at the bottom edge of both the inner liner 22 and the outer shell 26. As shown in
Alternatively, the inner liner 22 may include an upper portion and a lower portion releasably coupled to the upper portion via the zippered closure in order to provide access to the pocket 27 between the inner liner 22 and the outer garment 20. In other words, it is within the scope of this disclosure to provide access to the pocket 27 via any suitable releasable fastener coupled to one or more of the inner liner 22 and the outer shell 26.
Looking again to
Illustratively, the bladder 24 is made from two air impermeable plastic sheet members. These sheet members may also include an antimicrobial treatment and/or be made from an antimicrobial material. Furthermore, the outer shell 26 and inner liner 22 may also include an antimicrobial treatment and/or be made from an antimicrobial material. The sheet members of the bladder 24 each define outer peripheral edges which are RF welded together to define a single airspace therein. In other words, no portions of the bladder 24 other than the outer peripheral edges of each of the two separate sheets are welded together to create the bladder 24. However, it is within the scope of this disclosure to provide a bladder wherein the front and back panels of the bladder are connected to each other at locations other than the outer peripheral edges to define one or more separate or interconnected airspaces therein. As noted above, the bladder 24 is RF welded along its outer edge or periphery to create and define the internal airspace between the two bladder sheets. It is also within the scope of this disclosure to heat seal, glue, or otherwise couple the two sheet members of the bladder 24 together to create an air impermeable seal or seals along the outer edges of each sheet member.
Illustratively, the bladder sheets 24 are welded to each other intermittently along the outer edges to provide small gaps or spaces between the bladder sheets 24 to allow air to leak therethrough. Such low air loss or leakage through the outer edges of the bladder 24 operates to circulate air around the patient to help cool the patient and remove moisture vapor between the patient 14 and the vest 12. Alternatively, or in addition to the openings at the outer edges of the bladder 24, the bladder 24 may be provided with small perforations (not shown) formed in the inner sheet of the bladder 24 which faces the patient 14 when the vest 12 is worn by the patient 14. Such perforations may also help to circulate air and remove moisture vapor between the patient 14 and the vest 12 to improve the comfort and fit of the vest 12 on the patient 14 during use. While the bladder 24 of the present disclosure is configured to include peripheral openings and/or perforation formed in one or more of the sheets of the bladder 24, it is within the scope of this disclosure to provide a vest having a generally airtight bladder which does not provide any intentional low air loss leaks therefrom.
The bladder 24 further includes first and second elbow connectors or air duct pipes 68 coupled to the outer sheet of the bladder 24. Illustratively, the connectors 68 are positioned near the bottom edge of the bladder 24. In particular, a first connector 68 is coupled to the first chest portion 51 of the bladder 24 while the second connector 68 is coupled to the second chest portion 53 of the bladder 24. The connectors 68 are aligned with the apertures 54 of the outer shell 26 and are configured to be received through the respective apertures 54 of the outer shell 26 to connect with one of the two hoses 18 of the system 10. As shown in
Looking still to
As noted above, the vest 12 includes the inner liner 22 coupled to the outer shell 26 to create a pocket 27 configured to removably receive the air bladder 24 therein. As noted above, the inner liner 22 is illustratively made from a breathable, three-dimensional (3D) material which operates to cool the patient 14 wearing the vest 12 during operation of the HFCWO system 10 and which also operates to remove moisture vapor from the area between the bladder 24 and the patient 14. In other words, the 3D inner liner 22 operates to facilitate a micro-climate that helps to pull away moisture and heat build up during a HFCWO treatment.
Looking now to
As shown in
As discussed above, the 3D inner liner 22 includes a fiber network formed of the woven, first mesh layer 80, the woven, second mesh layer 82, and the middle layer or region 84 including the spaces 90 and the fibers 86 woven back and forth between each of the first and second mesh layers 80, 82 to give the material its third dimension. The mesh layers 80, 82 and the fibers 86 within the middle region 84 of the inner liner are made from polyester. However, it is within the scope of this disclosure to include an inner liner made from other suitable natural and/or synthetic materials as well. The illustrative inner liner 22 shown in
While the specific inner liner 22 is shown in
Reference also is made to U.S. Pat. Nos. 5,731,062 and 5,454,142 disclosing three dimensional fiber networks made from textile fabrics that have projections and optional depressions which are compressible and return to their original shape after being depressed. U.S. Pat. Nos. 5,731,062 and 5,454,142 are owned by Hoechst Celanese Corporation, Somerville, N.J. Such material is a synthetic thermoplastic fiber network in flexible sheets having projection and/or indentations for use as cushions and/or impact-absorbing components. The descriptions of such patents are incorporated herein by reference to establish the nature of an alternative example of a 3D material.
It should be further understood that the inner liner 22 may be made from any type of 3D material having a spring rate in both the X and Y axes such that the inner liner is stretchable in at least two directions. Preferably such material is open and breathable to provide air passage through the material. Further preferably, the material used to make the inner liner includes three dimensional fiber layer networks made from textile fibers wherein the liner is compressible and able to return to its original shape after being compressed. Therefore, the term “three dimensional material” is meant to include any of these types of materials used in accordance with the present invention.
In use, the vest 12 is secured around the patient 14, as illustrated in
The present disclosure also contemplates preferred characteristics of the three dimensional engineered material which operate to optimize the heat and moisture vapor distribution, but which also operate to prevent or minimize any attenuation of the pressure pulses felt by the patient wearing the vest. In particular, if the inner liner is too thick or too dense, the bladder 24 may not be able to sufficiently expand against the patient 14 to effectively provide the HFCWO treatment to the patient 14. If the inner liner is too stiff, the inner liner may effectively operate like a spring and dampen the pulsing force. However, if the inner liner is too soft, it may remain in a collapsed or crushed state throughout the HFCWO treatment and thus not provide sufficient air circulation and cooling of the area between the patient 14 and the vest 12.
While the inner liner 22 operates to circulate and cool the air around the patient 14, the inner liner 22 also helps to prevent the vest 12 from “creeping” upwardly on the patient 14. Oftentimes, during HFCWO treatment, a vest worn by a patient may tend to move upwardly relative to the patient. However, the diamond-shaped apertures 98 of the top mesh layer 82 operate to grab or cling to the cotton T-shirt 23 or other such shirt worn by the patient 14. Therefore, when the patient's T-shirt is tucked in, the mesh layer 82 clings to the T-shirt to prevent movement of the vest 12 relative to the patient's T-shirt 23, thus preventing the vest 12 from creeping upwardly on the patient 14.
Illustratively, while the particular vest 12 is shown and described herein, it is within the scope of this disclosure for inner liner 22 to be used with other vests as well. For example, U.S. Application Publication No. 2008/0000477, the disclosure of which is hereby expressly incorporated herein, discloses a number of illustrative vests which may be used with a liner, such as the inner liner 22, in order to circulate and cool the air around the patient 14 as well as reduce creep of the vest on the patient 14. Further, the inner liner 22 may be used on other similar devices such as chest wraps (which do not include the shoulder straps of many vest-like devices) as well as on chest vest devices which include a bladder that is only located on the front part of the vest. Such chest vest devices are typically used for patients who are to receive the HFCWO therapy treatment while lying down. Further illustratively, the two-piece design of the vest 12 disclosed herein which allows the user to remove the bladder 24 from within the pocket 27 of the outer garment 20 may similarly be applied to such wrap and chest vest devices as well.
Although certain illustrative embodiments have been described in detail above, variations and modifications exist within the scope and spirit of this disclosure as described and as defined in the following claims.
The present application claims the benefit, under 35 U.S.C. §119(e), of U.S. Provisional Application No. 61/251,518 which was filed Oct. 14, 2009 and which is hereby incorporated by reference herein.
Number | Date | Country | |
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61251518 | Oct 2009 | US |