Note: Descriptions are shown in the official language in which they were submitted.
11 1161332
6 SUMMARY OF THE INVENTION
7 The present invention is directed towards a controllable
8 partial rebreathing anesthesia system and respiratory assist
9 aevice. The rebreathing improves heating and humidificat~on
of the inspired gases which is not obtained by prior systems.
11 The inhalation breathing circuit can be used in the field
12 during emergencies` or in the transportation of patients
13 requiring supplemental oxygen, ventilation, end-expired
14 pres5ure breathing, and tracheal suctioning, Por greater
safety and eficiency, the invented device may be connected
16 to a control module as describea in ~.S. Patent No. 4,188,946.
17
18 A non-kinking corrugated tube is used as the fresh gas
19 flow line and is connected to the fresh air supply externally
where the integrity of the connection can be visually seen
21 to avoid undetected disconnection. In aadition, the fresh
22 gas is delivered at the patient end by a substantially
23 perpendicular dischargé into the oscillatory flow of the
24 patient's exhalation gases and inhalation gases. Such a
delivery conserves the exhaled humidity by giving a cool
26 circumferential screen of gas into which the patient exhales
27 thereby causing a condensing of humidity at the patient end,
28 prevents venturi gas flows which cou~d create a vacuum in
29 the exhalation tube that would be dangerous to certain
patients, and efficiently mixes t~e gases.
- 31 The present invention pre~ents bacterial contamination
32 of the hospital and ventilator with exhaled gases by attachment
~ f an anesthesia bacterial filter, a dispos;able aerosal trap
11 1161332
1 or hospital suction tube upon the exhaust valve.
2 The circuit may be used with an oxygen tank for trans-
3 portation of the patient from one location to another.
4 During transportation, positive end expiratory pressure can
be maintained (via adaptability to a Carden valve).
6 An endotracheal tube elbow adapter is provided with a
7 stoppered and sealed evacuation portal, the top of which may
be removed to allow tight fitting suction tubes and/or
9 flexible bronchoscopes to pass into the endotracheal tube
and trachea for diagnosis and/or removal of secretions while
11 maintaining volumetric pressure and oxygenation of the
12 system. The lack of spring loaded type valves alleviates
1~ any difficulty concerning those types of springs malfunctioning.
14 BRIEF DESCRIPTION OF THE DRAWINGS
Fig. 1 iB a perspective view of the invention showing
1~ concentric placement of the intake tube and expiration tube.
17 Fig. l(a) i8 a cross-sectional view of Fig. 1 taken
18 along lines l(a)-l(a).
19 Fig. 2 i6 a cross-sectional view of Fig. 1 along lines
2-2.
21 Fig. 3 shows a modification wherein an exhaust outlet
22 ¦ is attached to exhaust control valve.
23 ¦ Fig. 4 shows a modified version of the intake and
24 ¦ expiration portions of the invention.
25 ¦ Figs. 4(a) and 4(b) show cross-sectional views of
26 ¦ Fig. 4 along lines 4(a)-4(a) and 4~b)-4(b), respectively.
27 ¦ Fig. 5 shows an additional modified view of the intake
28 ¦ and expiration portions of the invention.
29 ¦ Figs. 5(a) and 5(b) show cross-sectional views of
30 ¦ Fig. 5 taken along lines 5(a)-5(a) and 5(b)-5(b), respectively.
31 ¦ Fig. 6 shows an additional modification of the intake
32 and expiration portions of the invention.
~ I 6 1 3 3 2 ~
l Fig. 6(a) is a cross-sectional view of Fig. 6 taken
2 along lines 6~a)-6(a).
DESCRIPTION OF THE P~EFERRED EMBODIMENT
4 The main components of the rebreathing device 10 are
the elbow adapter 12, mixing connector 14, exhalation tube
6 16, intake tube 18, circuit connector 20, fresh gas adapter
7 22, exhaust control 24, ana reservoir bag 26 as shown in
8 Figs. 1 and 2.
9 ' Passage 28 of the elbow adapter 12 is adapted to fit
upon or about a patient oral-input, such as a mask or an ,-
11 endotracheal tube. Plug 30 fits securely within sealable
12, 5~ opening 32 and fits within retaining ring 34 to ensure a
~3 continued seal by plug 30. Sealable opening 32 i8 located
1~ generally upon the elongated ax~ 5 of passage 28 for allowing
entry to the patient' B lungs wi'thout interrupting the supply
lB of fresh gas to the patient.
17 ~he posterior end of the elbow adapter 36 fits securely
18 within mixing connector 14, which in turn fits securely
l9 within the patient end of exhalation tube 16. Radial
flanges 38 fit upon inner shoulder 40 of the mixing connector
21 14 to hold intake delivery 42 in place. The posterior end
22 ~of intake -delivery 42 fits within intake tube 18 which
23 delivers fresh gas through intake delivery 42 and out through
24 end p,ort'~3'and side ports 44.
Intake tube 18 is located concentrically through
26 exhalation tube 16, as shown in Eig. l(a), with sufficient
27 annular space between the tubes 16 and 18 to provide an air
28 passage from the patient having a predetermined reservoir
29 'capacity of air. Circuit connector 20 fits within exhalation
tube 16 and upon exhaust control 24 as shown. Intake tube
31 18 is positioned through intake tube holder 46 and extends
32 I out o circuit connector 20 to a junction with fresh gas
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1 adapter 22.
2 Exhaust control 24 consists of a pair of closely fitting ;-
3 cylinders, inner cylinder 48 and outer cylinder 50. Cylinder
4 48 has a wedge-shaped opening 52 about which hole 54 of the
6 outer cylinder 50 may be rotated as a valve to give varying
6 outlet diameters from within to without exhaust control 24.
7 The outer portion of hole 54 is threaded to allow threadable
B attachment of either a bacterial filter 56, as shown in
9 Figs. 1 and 2, or an exhaust outlet 58, as shown in Fig. 3,
lG and which may be connected to an aerosal trap or a hospital
11 suction tube. Bacterial filter 56 comprises a radial stem
12 60 fitting within hole 54, filter 62, and filter housing 64.
~3 Openings 66 upon exhaust outlet 58 allow suction tubes to be
14 used upon it without creating a vacuum within the exhalation
1~ tube 16,
1~ Reservoir bag 26 fits upon the posterior end of exhaust
17 control 24 and is in communication therethrough with exhalation
18 passage 68.
19 In operation, predetermined volumés and pressures of
oxygen or other selected gases are introduced through fresh
21 gas adapter 22, intake tube 18, and intake delivery 42, and
22 are radially discharged through end port 43 and side ports
44 to within exhalation passage 68. Intake delivery 42 is
24 located within exhalation passage 68 to be within the tidal
exhalation/ inhalation distance from the patient and thus
26 the oxygen is inhaled by the patient. As oxygen enters the
27 exhalation/inhalation area of exhalation passage 68, like
28 quantities of expired gases are forced from exhalation
29 passage 68 through exhalation tube 68, wedge-shaped opening
52, hole 54, and bacterial filter 56. Reservoir bag 26 is
31 responsive to exhalation passage 68 pressure changes due to
32 1l patient respiration and patient respiration rate and volume
¦¦ can be observed and modified thereby.
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1 Attachment of fresh gas adaptor 22 upon compressed
2 corrugations of intake tube 18 upon the outside of the
3 device 10 allows the operator to maintain a visual check of
4 the attachment at all times. Intake tube 18 is colored
(for instance, blue) so that the intake tube 18/intake
e delivery 42 connection can be easily visualized. The
7 orientation of intake tube 18 away from the patient's oral
8 area is helpful in reducing clutter and confusion in the
9 oral area. Both tubes 16 and 18 are corrugated to reduce
the probability of crimping, and exhalation *ube 16 is--- ---
11 transparent to allow visual checking of the intake tube
12 18/intake delivery 42 connection.
~5 Prior art respiratory circuits normally direct incoming
14 gas directly at the patient. In the invented device 10, the
radial discharge of incoming fresh gas through radially
1~ positioned ~ide ports 44, in addition to an end port 43,
17 cau~es the fresh gas to flow to within the oscillatory flo~
18 of the exhalation gases and inhalation gasex within the
19 patient end of exhalation tube 16. This prevents a venturi
gas flow within exhalation tube 16 which could lead to a
21 pressure buildup at the patient end of e~halation tube 16.
22 This is esp~cially critical in treating small children who
23 cannot tolerate pressures appreciably above atmospheric
24 pressure without damage to their lungs. Because of the
localized nature of such a venturi caused pressure buildup
26 at the patient end of the exhalation tube 16, the pressure
27 buildup is often undetected by prior art respirators. The
28 substantially perpendicular injection of the incoming fresh
29 gas also mi~es the fresh gas with the exhalation and inhalation
gases much more efficiently than prior art respiratory circuits.
31 The 90 angle within elbow adapter 12 allows a linear
~2 l route entry to the patient' L lungY through sea1able
''
~5
1 161332
1 opening 20, and passage 28 of elbow adapter 12 without
2 interruption o~ respiratory assistance~ Suctioning, obser-
3 vation with a fiberoptic bronchoscope, or other treatments
4 through or upon the patient's oral area may thus occur
during ventilation if the tools used seal sealable opening
B 32.
7 Due to patient exhalation/inhalation, gas flow through
8 exhaust passage 68 will be partially oscillatory with the
9 patient rebreathing a portion of exhaled gases left within
exhalation passage 68 and breathing an amount of fresh gases
11 delivered to exhalation passage 68 by intake tube 18 with-
12 each breath. The radial discharge arrangement causes the
~3 warm humid exhalation gases to pass through a cool circumferentia
14 screen of fresh gas resulting in condensation and thus
retention of the exhaled humidity. Humidification and heat
1~ retention problems attendant to fresh gas inhalation are
17 thereby reduced and inhaled gas humidity content is determined
18 by regulating the flow and composition of fresh gas, and
19 by the minute ventilation of the patient.
Reservoir bag 26 provides the system elasticity necessary
21 to accomodate patient inhalation/exhalation. A pressure
22 relief governor and/or alarm valve may be attached to the
23 device to insure the exhaust control is set to maintain
24 proper exhaust passage 68 pressure parameters and an oxygen
sensor may be attached to monitor oxygen content of the
26 inspired gases.
27 It is additionally contemplated that a hand-held
28 resuscitator to ventilate the patient with or without a
29 separate oxygen supply may be created by attachment of a
self-inflating bag in place of reservoir bag 26 and addition
31 of a Laeral type valve to the device 10 at the patient end
32 of exhalation tube 16. Further, a one-way check valve may
be added to gas adapter 22 to prevent expired gases from
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1 l 1613~2 1
1 being expired back through gas adapter 22 to contaminate the
2 fresh gas source. After use the device may either be
3 disassembled for sterilization and reused in whole or in
4 part:, or it may be thrown away.
Figures 4-6(a) show alternative versions of the intake
6 and expiration portions of rebreathing device 10. Figs. 4,
7 4(a), and 4~b) show modified device 10(a) having a modified
8 intake delivery 42(a), modified intake tube 18(a), and a
9 modified circuit connector 20(a). Figs. 5, 5(a), and 5(b)
show modified device 10(b) having modified intake 18(b)
11 molded within the external wall of modified exhalation tube
12 16(b). A mixing connector may be used or not used (as
~3 shown in Fig. 5), and modified intake delivery 42(b) is
14 formed by creating modified side ports 44~b) through modified
exhau~t tube 16~b) and modified intake tube 18~b). Figs. 6
1~ and 6~a) show modified device 10~c) having-modified intake
17 tube 18~c) spiraled integrally with the wall of modified
18 exhalation tube 16~c). Other variations among device 10 and
19 modified devices 10~a), 10~b), and 10(c) are apparent from
the drawings.
21 Preserved in all modifications are radial entry of
22 fresh gas into exhaust passage 68, visual means of checking
23 to assure the input circuit is complete, and means for
24 providing controlled rebreathing of portions of expired gas.
It is apparent from the above description that improvements
26 in the art of resuscitating, administering anesthesia to, or
27 administering respiratory care to a patient are achieved by
28 the instant invention. While the invention has been described
29 in connection with the preferred embodiment, it is not
intended to limit the invention to the particular forms set
31 forth, but, on the contrary, it is intended to cover such
3~ alternatives, modifications, and equivalents as may be
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1 included within the spirit and scope of the invention as
I define by ~h appe~ded claims.
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