US3827433A - Respiratory device and procedure - Google Patents

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Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
  • A61M16/06—Respiratory or anaesthetic masks
  • A61M16/0683—Holding devices therefor
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
  • A61M16/06—Respiratory or anaesthetic masks
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
  • A61M16/06—Respiratory or anaesthetic masks
  • A61M16/0605—Means for improving the adaptation of the mask to the patient
  • A61M16/0633—Means for improving the adaptation of the mask to the patient with forehead support
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
  • A61M16/04—Tracheal tubes
  • A61M16/0463—Tracheal tubes combined with suction tubes, catheters or the like; Outside connections
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/33—Controlling, regulating or measuring
  • A61M2205/3331—Pressure; Flow
  • A61M2205/3348—Pressure measurement using a water column

Definitions

• Santa 5 7 ABSTRACT Applying positive end expiratory pressure breathing assistance to, for example, an infant by enclosing the infants face in a gas-tight mask, providing inhalation air into the mask, and restricting the passage for exhaled air from the mask, such as by immersing the end of the passage in a liquid, to maintain a positive pressure above ambient pressure in the passage, and hence within the mask.
• This invention relates to respiration, and particularly to assisting spontaneous human breathing, especially in infants.
• Respiratory distress syndrone has been a large contributing factor to infant mortality, particularly among prematurely born infants. This affliction is characterized, in general, by an inability of the alveolus of the lungs to sustain inflation in the absence of positive air pressure (giving rise to pulmonary atelectasis). Recently proposed forms of treatment rely on supplying and maintaining positive pressure in the lungs during the breathing cycle. For example, Lewey, in
• Another object is to provide a diagnostic procedure for determining if an infants respiratory distress is due to cardiac or pulmonary disease.
• a further object is to provide a mask for carrying out these procedures.
• the invention features a procedure for applying positive end expiratory pressure to a person, such as an infant afflicted with or suspected to be afflicted with RDS, to assist the infants spontaneous breathing.
• a mask comprising an enclosure constructed to enclose the face of, for example, an infant between his forehead and his chin and having a peripheral sealing region, an inhalation tube in to the enclosure, and an exhalation tube out of the enclosure is secured to the infant to form an air-tight seal at the peripheral sealing region.
• Air oxygen-enriched, if desired
• Air is supplied to the enclosure continuously through the inhalation tube while the exterior end of the exhalation tube is immersed in a liquid, e.g., such as water, so that air exhaled by the infant must bubble out through the water, therefore causing a positive pressure above ambient pressure to be maintained in the exhalation tube.
• a liquid e.g., such as water
• the mask includes an additional aperture through which, e.g., a flexible tube may be inserted, usually through the infants nose, into his stomach to exhaust air entering the stomach from the positive pressure enclosure maintaining ambient pressure in the infants stomach.
• a flexible tube may be inserted, usually through the infants nose, into his stomach to exhaust air entering the stomach from the positive pressure enclosure maintaining ambient pressure in the infants stomach.
• a preferred mask has a translucent plastic portion, generally conforming to the contours of the infants face but spaced from it, covering the face, and a soft, resilient sealing material (e.g., a closed cell silicone rubber foam) about the peripheral sealing region, and may be secured to the person by adjustable straps.
• a soft, resilient sealing material e.g., a closed cell silicone rubber foam
• FIG. 1 is a diagrammatic illustration showing treatment of an infant in accordance with the invention
• FIG. 2 is a perspective view of the outside or front of the mask of FIG. 1;
• FIG. 3 is a perspective view of the inside or rear of this mask.
• the figures show an infants mask 10 having a translucent plastic facepiece 12 which is a maximum of about 5 inches wide, and a maximum of about 6 inches high.
• the facepiece is contoured so as to approximate, more or less, the contours of the infants face, being, e.g., rounded along the bottom of the chin l4 and jutting forward at the nose portion 16.
• the concave interior of the mask defines an enclosure which has, at the nose portion 16, a maximum depth of about 2 inches.
• the facepiece may be of a somewhat flexible material but should be self-supporting and capable of withstanding the applied air pressures.
• a M 6 inch thick polycarbonate is useful, particularly because it is translucent and hence allows for constant visual observation of the patient and its hardness avoids scratches which might damage somewhat its optical properties.
• an approximately 1 inch wide molding 18 Disposed around the periphery of facepiece 12 is an approximately 1 inch wide molding 18, which is fabricated of a soft, resilient, air-tight material, and has an inner annular surface defining a sealing region.
• the resilience enables the molding to follow the contours of an infants face, while the softness assures that the pressure of the molding against the skin necessary to maintain a gas-tight seal will not injure or bruise the infants face.
• a particularly useful material is closed cell silicone rubber foam (for example, that manufactured by Dow-Corning under the trade designation medical grade silicone-rubber TRV foam, MDX-4-452l). In addition to forming gas-tight seals, the material has a spongy texture, so that it does not tend to slip along the skin.
• flanges 24, 26 Formed integrally with the facepiece 12 are flanges 24, 26 over which are secured, respectively, an inhalation tube 34 and an exhalation tube 36 (both formed e.g., of Tigon).
• a third flange 38 contains an air-tight plug 40, through which protrudes, in FIG. 1, a thin flexible tube 42.
• a flexible fastening strap 50 is secured at one end by a velcro closure to facepiece l2, and has perforations 52 near its other end by which it is hooked to the studs 54 secured to facepiece 12.
• a second strap 60 is secured to the forehead region of the mask by a Velcro closure (not shown) and has perforations 52 near its other bifurcated end by which the sub-straps 62 are hooked to the studs 64 secured to the chin region of facepiece l2.
• the inhalation tube 34 When the mask is in use, as shown in FIG. 1, the inhalation tube 34 is connected, through a suitable regulator or valve 70, to a source of air or oxygen-enriched air at above ambient pressure.
• the outer end of exhalation tube 36 is immersed in a beaker of water 72.
• the thin flexible tube 42 is open to ambient pressure at its outer end, and its inner end is inserted through the infants nose into the stomach.
• exhalation tube 36 Because of the location of exhalation tube 36 in a beaker of water, a back or end pressure of about 6-10 cm. of water (with a properly sized and elongated tube 36) is applied to the exhalation tube, so that a positive pressure above ambient is maintained at all times within the enclosure of the mask, and hence also within the lungs of the infant.
• the air flow into the inhalation tube is sufficient to continually exhaust spent air and supply fresh air to the enclosure.
• this mask may be kept on the infants face for days (with periodic removal for 10-15 minutes every 4 hours) without causing bruising or even noticeable discomfiture to the infant.
• the translucent facepiece 12 enables constant visual monitoring of the infants condition.
• the use of velcro closures on the straps combine a tight fit between mask and face with practically instantaneous detachability of the straps and removal of the mask in an emergency.
• the bubbling of exhaust gases through the beaker also provides a visual check that adequate air pressure is being maintained within the mask.
• the tube 42 may also be used, if desired, for feeding the infant directly into its stomach (rather than intraveneously).
• the mask In addition to its usefulness in treating RDS, the mask also provides a useful diagnostic tool, such as for distinguishing certain cardiac diseases commonly found in infants from RDS. Certain cardiac diseases lead to build-up of fluid adjacent to the aveolus, and interfere Other embodiments will occur to those skilled in the art and are within the following claims.
• a device for use in applying positive end expiratory pressure to a person comprising a mask with a gastight enclosure capable of substantially enclosing a persons face between forehead and chin, an inhalation tube for supplying air to the enclosure and means to supply air continuously to said enclosure through said inhalation tube, an exhalation tube for directing exhaled air at above ambient pressure out of the enclosure, means for maintaining a positive pressure in said exhalation tube, whereby a positive pressure is maintained in said mask at all times and an additional apperture for gaining access to said enclosure without interrupting the gas-tight seal of said enclosure, said additional apperture having a length of unrestricted flexible tube passing therethrough of a length suitable for insertion into a persons stomach.
• a device including a layer of soft resilient sealing material disposed about the inner periphery of the enclosure so as to be located between the enclosure and face, said material being conformable to the contours of a face in a gas-tight seal.
• a device according to claim 3 wherein said resilient material is a closed-cell silicone rubber foam.
• a device wherein said plastic enclosure is generally shaped to conform to the contours of an infants face, and the sealing material is of a thickness sufficient to prevent contact of the plastic and the face when the mask is secured in gas-tight seal.
• a device including at least one adjustable fastening strap for securing the mask said strap being of sufficient length to surround a head and being detachably mounted at at least one side of said mask and secured to the other side thereof.
• a device including a first flexible sealing strap located to be secured to the mask at opposite sides of the face, and a second strap located to be secured to the mask at the forehead and chin.
• a method of assisting spontaneous breathing of a person by applying positive end expiratory pressure comprising the steps of:
• a mask comprising an enclosure constructed to enclose a persons face between forehead and chin and having a peripheral sealing region,-an inhalation tube into said enclosure, an exhalation tube out of said enclosure and an additional apperture in said mask, said additional apperture having a flexible unrestricted tube of a length suitable for insertion into the persons stomach passing through said apperture,
• a device for use in applying positive end expiratory pressure to a person comprising a mask with a gastight enclosure capable of substantially enclosing a person s face between the forehead and chin, an inhalation tube for supplying air to the enclosure, an exhalation tube for directing exhaled air at above ambient pressure out of the enclosure, said exhalation tube having a free end immersed in a liquid to maintain a positive pressure in said exhalation tube whereby a positive pressure is maintained in said mask at all times, and an additional apperture for gaining access to said enclosure without interrupting the gas-tight seal of said enclosure, said additional apperture having a flexible unrestricted tube passing therethrough of a length suitable for insertion into a persons stomach to exhaust air

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• Health & Medical Sciences (AREA)
• Emergency Medicine (AREA)
• Pulmonology (AREA)
• Engineering & Computer Science (AREA)
• Anesthesiology (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Hematology (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Respiratory Apparatuses And Protective Means (AREA)

Abstract

Description

Claims (9)

Priority Applications (1)

Applications Claiming Priority (1)

Publications (1)

Family

ID=22873065

Family Applications (1)

Country Status (1)

Cited By (37)

Citations (7)

• 1972
  • 1972-03-07 US US00232428A patent/US3827433A/en not_active Expired - Lifetime

Patent Citations (7)

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