JP2022184548A - artificial nose - Google Patents

Abstract

To provide an artificial nose capable of reliably securing respiration even when a humidification element is blocked.SOLUTION: An artificial nose 1 comprising a humidification element 7 disposed in an expiration passage 6 for connecting an expiration port 4 of a housing 2 to a patient-side port 5, comprises an opening port 12 connecting to the expiration passage 6 in a section 6a between the patient-side port 5 and the humidification element 7, and an opening valve 20 for opening/closing the opening port 12. The opening valve 20 includes a lid part 21 being movable between a closed position for closing the opening port 12 and an open position for opening the opening port 12, and an engaging part 22 being movable integrally with the lid part 21. The housing 2 includes a locking part 12a engaging with the engaging part 22, formed thereon so as to restrict movement of the lid part 21 from the closed position to the open position. The artificial nose is so configured that with pressure increase in the section 6a, at least any one of the locking part 12a and the engaging part 22 is deformable so as to disengage the engaging part 22 from the locking part 12a.SELECTED DRAWING: Figure 1

Description

The present invention relates to an artificial nose with humidifying elements.

BACKGROUND ART An artificial nose in which a humidifying element is arranged in an expiratory passage is used as one of the means for adding humidity and temperature to the inhaled air of a patient who has undergone tracheal intubation or tracheotomy. In this type of artificial nose, in order to treat the patient's secretions discharged through the patient-side port connected to a tracheostomy tube or the like, a suction port is provided at a position facing the patient-side port, and the suction port Measures have been taken to allow secretions to be suctioned through the In the middle of the expiratory passage between the patient-side port and the humidifying element, a valve body composed of an elastic material such as silicon rubber with cuts is arranged, and the valve body is used when the flow rate of exhalation is normal. is kept closed to direct the patient's exhaled breath to the humidifying element side, and when the flow rate of exhaled air increases, the valve body opens to discharge secretions out of the expiratory passage, thereby discharging secretions to the humidifying element. There has also been proposed an artificial nose that suppresses the infiltration of blood (see Patent Document 1). An artificial nose in which a resistance measuring device whose state changes according to the pressure difference generated in the housing is arranged in the expiratory passage, and the change in the state is made visible from the outside to warn of blockage of the humidifying element. has also been proposed (see Patent Document 2).

Japanese Patent No. 6567966 Japanese Patent Publication No. 2011-523578

As in the artificial nose of Patent Document 1, when the flow rate of exhaled air increases, the valve body opens to discharge secretions to the outside. There is a risk of If the humidifying element is clogged, it will be difficult to secure breathing, so it is desirable to take countermeasures.

SUMMARY OF THE INVENTION Accordingly, it is an object of the present invention to provide an artificial nose that can ensure breathing even when a humidifying element is blocked.

An artificial nose according to an aspect of the present invention is an artificial nose in which a humidifying element is arranged in an expiratory passage connecting an expiratory port of a housing and a patient-side port, and in a section between the patient-side port and the humidifying element, an open port provided on the housing so as to communicate with the expiratory passage, and an open valve for opening and closing the open port, wherein the open valve has a closed position for closing the open port, and a closed position for closing the open port. and an engaging portion movable integrally with the lid. A locking portion that engages with the engaging portion is provided so as to limit movement to a position, and at least one of the locking portion and the engaging portion is engaged with pressure increase in the section of the expiratory passage. and the engaging portion can be deformed so as to be disengaged from the engaging portion.

1 is a diagram showing the overall configuration of an artificial nose according to one embodiment of the present invention; FIG. FIG. 2 is a diagram showing a state in which the artificial nose according to one embodiment of the present invention is viewed from the direction of arrow II in FIG. 1; The figure which shows the state which looked at the artificial nose which concerns on one form of this invention from the arrow III direction of 1. FIG. FIG. 4 is a cross-sectional view showing the state of the open valve when the lid is in the closed position; Enlarged view of the open port. The bottom view of a cover part. The side view of a cover part. The figure which shows the state of an open valve when the pressure of an expiration passage rises. The figure which shows the state of an open valve when an open port opens. The figure which shows the state which the cover part moved to the open position. illustration.

An artificial nose according to one embodiment of the present invention will be described below with reference to the accompanying drawings. As shown in FIGS. 1-3, the artificial nose 1 has a housing 2 . The housing 2 is, for example, a molded resin product. The housing 2 is provided with a substantially cylindrical body portion 3 . Exhalation ports 4 are opened at both ends of the main body 3 in the axial direction, and a patient-side port 5 is provided at an intermediate position of the main body 3 and opens in a direction orthogonal to the axial direction. The internal space of the main body 3 functions as an expiratory passage 6 that connects the expiratory port 4 and the patient-side port 5 . The patient-side port 5 is, for example, formed in a cylindrical shape connectable with a tracheostomy tube attached to a patient. A suction port or a suction slit for suctioning secretions from the patient may be formed on the opposite side of the patient-side port 5 , in other words, at a position directly facing the patient-side port 5 . Furthermore, the housing 2 may be formed with an oxygen port for connecting an oxygen supply tube.

A pair of humidifying elements 7 are provided in the expiratory passage 6 so as to be adjacent to the right and left expiratory ports 4 . Humidification element 7 regulates the humidity and temperature of the patient's inspired air to a moderate range by capturing the moisture and heat of the patient's exhaled breath and returning them to the inspired air entering through expiratory port 4 . The humidifying element 7 may be formed in a known manner, for example by rolling a filter paper material impregnated with a hygroscopic substance into a cylindrical shape.

As also shown in FIG. 4 , the artificial nose 1 is further provided with an opening mechanism 10 . When the humidifying element 7 is blocked and the pressure in the expiratory passage 6 rises, the opening mechanism 10 releases the pressure to the outside of the expiratory passage 6 to secure a breathing passage bypassing the humidifying element 7. is provided. The opening mechanism 10 includes a base 11 attached to the housing 2 and an opening valve 20 attached to the base 11 . The base 11 is, for example, a resin molded product manufactured in a separate process from the housing 2 . The base 11 can substantially function as a part of the housing 2 by being fixed to the housing 2 using an appropriate joining method such as welding. However, the base 11 may be molded integrally with the housing 2 .

An open port 12 is provided in the base 11 . The open port 12 is formed in a cylindrical shape extending in a direction perpendicular to the axis of the body portion 3 . The axial direction (opening direction) of the open port 12 is set in a direction different from the axial direction of the patient-side port 5 . For example, the open port 12 is positioned so that the axis of the patient-side port 5 and the axis of the open port 12 intersect at a wide angle exceeding 90°, in other words, the open port 12 is oriented perpendicular to the axis of the patient-side port 5 . The axial direction of the open port 12 may be set so as to be inclined toward the suction port side behind. In this case, when the patient-side port 5 is connected to a tracheostomy tube or the like, the open port 12 is oriented obliquely upward from the patient, which is convenient for avoiding interference between the jaw of the patient and the opening mechanism 10. be.

The lower end side of the open port 12 penetrates the housing 2 and communicates with the section 6 a of the expiratory passage 6 . The section 6a is located between the patient-side port 5 and the humidifying element 7, and is a section in which the pressure increases as the ventilation resistance of the humidifying element 7 increases. As shown in FIG. 5, the upper end of the open port 12 is formed with a flange portion 12a from which the inner peripheral surface of the open port 12 protrudes. The flange portion 12a may be formed in an annular shape that encircles the open port 12, or may be in a discontinuous arc shape with a part of the circumference notched. Alternatively, instead of or in addition to the flange portion 12a, a locking portion that protrudes independently from a portion of the open port 12 may be formed.

As shown in FIGS. 4, 6 and 7, the open valve 20 includes a lid portion 21 and an insertion portion 22 attached to the lid portion 21 . The lid portion 21 includes a cap 23 and a support shaft 24 connected to the outer circumference of the cap 23 . The cap 23 is formed in a cylindrical cover shape capable of covering the open port 12 from the outside. The cross-sectional shape of cap 23 may be generally circular. However, in order to avoid interference with the open port 12 when the cap 23 is opened and closed, the cross-sectional shape of the cap 23 may be set to an elliptical or elliptical shape whose longitudinal direction is the direction in which the support shafts 24 are arranged.

The support shaft 24 extends linearly in the tangential direction of the cap 23 . The support shaft 24 is fitted to the pair of bearings 14 on the base 11 so as to be rotatable about its own axis. As an example, the bearing portion 14 may have a downwardly open shape, and the support shaft 24 may be fitted into the bearing portion 14 through the opening. Rotation of the support shaft 24 causes the cover 21 to move between the closed position (position shown in FIG. 4) where the open port 12 is closed by the cap 23 and the open position (FIG. 10) where the cap 23 moves away from the open port 12 to open the open port 12. position).

The insertion portion 22 is attached inside the cap 23 . Thereby, the insertion portion 22 can move integrally with the cap 23 of the lid portion 21 . As an example, the insertion portion 22 is formed in an annular shape using an elastic material such as urethane foam. However, the insertion portion 22 may be formed of sponge or other various elastic materials. As shown in FIGS. 4 and 6, a mounting hole 22a is formed in the central portion of the inserting portion 22 so as to penetrate the inserting portion 22 in the axial direction. The enlarged distal end portion 25a of the fixing pin 25 inserted into the mounting hole 22a is inserted into the cap 23 so that the insertion portion 22 is positioned between the cap 23 and the flange 25b at the lower end of the fixing pin 25. Fixed.

The outer diameter of the insertion portion 22 (the outer diameter in a non-loaded state without elastic deformation) is set larger than the inner diameter of the flange portion 12 a of the open port 12 . When the lid portion 21 is in the closed position, the insertion portion 22 is located on the inner side (closer to the exhalation passage 6) than the flange portion 12a. Therefore, when the lid portion 21 is in the closed position, the insertion portion 22 engages with the flange portion 12a so as to restrict the movement of the lid portion 21 to the open position. As a result, the displacement of the insertion portion 22 in the direction of escape from the open port 12 is restricted by the flange portion 12a, and the lid portion 21 is restrained in the closed position.

As shown in FIG. 8, when the pressure (internal pressure) in the section 6a of the expiratory passage 6 increases, the force F that pushes the lid 21 in the opening direction increases. When the internal pressure of the section 6a exceeds a predetermined operating pressure set as a pressure to open the lid portion 21, the insertion portion 22 is elastically deformed so as to overcome the flange portion 12a, and the flange portion 12a and the insertion portion 22 are separated. are disengaged. As a result, as shown in FIG. 9, the restraint of the lid portion 21 by the flange portion 12a is released, the lid portion 21 moves toward the open position, and the open port 12 opens. In this manner, the insertion portion 22 functions as an example of an engaging portion, and the flange portion 12a functions as an example of a locking portion. When the open port 12 is opened, exhalation and inhalation flow between the patient-side port 5 and the open port 12 without passing through the humidifying element 7 . Therefore, even if the humidifying element 7 is blocked and breathing through the expiratory port 4 becomes difficult, breathing can be ensured.

The operating pressure at which the lid 21 opens may be appropriately set according to the required performance of the artificial nose 1, for example, the exhalation flow rate to be ensured. As an example, the operating pressure may be set in a range in which the internal pressure of the section 6a is 10 hPa or more and 40 hPa or less. If the working pressure is set to less than 10 hPa, the opening port 12 may be opened even though breathing through the humidifying element 7 is possible, and the humidifying and heating function may be excessively impaired. On the other hand, if the operating pressure is set to be greater than 40 hPa, even if the humidifying element 7 is blocked beyond the allowable range, the open port 12 will not open, and it may be difficult to ensure breathing at the required flow rate. . However, the operating pressure may be set outside the above range depending on the patient's condition or the like.

As shown in FIG. 10, when the lid portion 21 moves to the open position, the lid portion 21 protrudes outside the housing 2 more than when it is in the closed position. In this case, the inserting portion 22 completely escapes from the open port 12 and is entirely exposed outside the housing 2 . Therefore, a person in the vicinity of the artificial nose 1 is visually alerted that the open port 12 is open, in other words that the humidifying element 7 is blocked and the patient is breathing through the open port 12. It is possible. At least a portion of the insert 22 is colored or patterned differently than the housing 2 so that the insert 22 is visually visible relative to the housing 2 to enhance the warning effect of opening the open port 12 . physically identifiable. As an example, if the housing 2 is a white achromatic color, the insertion portion 22 may be wholly or partly colored with a chromatic color such as blue or red. Alternatively, a specific pattern may be applied to the interpolated portion 22 . The pattern may include letters, symbols, and other marks as aspects thereof.

When the lid part 21 is in the closed position, the insertion part 22 is accommodated in the open port 12, so that its color and pattern are completely or incompletely hidden from the surroundings, resulting in low visibility. On the other hand, when the lid portion 21 moves to the open position, the insertion portion 22 is exposed to the outside of the open port 12, and its color and pattern are clearly visible from the outside. Therefore, the warning effect is enhanced. However, if the opening of the open port 12 can be clearly recognized as the lid portion 21 moves to the open position, the coloring of the insertion portion 22 may be omitted.

When the lid portion 21 moves to the open position, the entire inserting portion 22 escapes from the open port 12 and its outer diameter returns to that of the unloaded state. Therefore, even if an attempt is made to close the lid portion 21 toward the open port 12, the insertion portion 22 interferes with the flange portion 12a, and resistance is generated against the operation of returning the lid portion 21 to the closed position. A certain amount of force is required to elastically deform the insertion portion 22 so that the entire insertion portion 22 passes through the flange portion 12a, and it is not easy or impossible to return the lid portion 21 to the closed position. be. Therefore, it is possible to reduce or eliminate the risk of reuse of the artificial nose 1 with the humidifying element 7 closed and the open port 12 open.

As described above, according to the artificial nose 1 of this embodiment, the open port 12 communicates with the section 6a between the patient-side port 5 and the humidifying element 7, and the open port 12 opens as the pressure in the section 6a increases. Since the opening valve 20 is provided, it is possible to secure breathing of the patient even when the humidifying element 7 is blocked. Since the open valve 20 is operated without depending on the flow rate of exhaled air, even during normal breathing, if the humidifying element 7 is clogged, the open port 12 can be opened to ensure the breathing of the patient. Moreover, by increasing the visibility of the lid portion 21 and the insertion portion 22 of the open valve 20 when the open valve 20 is moved to the open position, it is possible to confirm that the patient is breathing through the open port 12, that is, the humidification element. It is possible to warn the surroundings that 7 is clogged and prompt them to deal with it.

The present invention is not limited to the forms described above, and may be implemented in forms with appropriate modifications or changes. For example, the engaging portion and locking portion for restricting the movement of the lid portion to the open position are not limited to the inserting portion 22 and the flange portion 12a, and can be changed as appropriate. For example, an engaging portion may be provided on the outer surface side of the cap 23, and a locking portion may be provided on the base 11, respectively, and the movement of the lid portion 21 to the open position may be restricted by their engagement. The base 11 may be omitted and the locking portion may be provided directly on the housing 2 . On the other hand, as in the above-described embodiment, when the cover portion 21 is restrained in the closed position by engaging the inner insertion portion 22 with the flange portion 12a within the open port 12, the inside of the open port 12 is The space can be effectively utilized as a space in which the engaging portion and the locking portion should be provided, and the periphery of the open valve 20 can be configured compactly. Note that the bearing portion 14 for attaching the lid portion 21 may also be provided directly on the housing 2 . The lid portion is not limited to rotating between the closed position and the open position, and may be provided to move linearly. For example, the open valve may be configured such that the cover portion moves axially outward of the open port as the pressure in the exhalation passage rises to open the open port.

The engaging portion on the lid side does not necessarily need to be elastically deformable. For example, the engaging portion may be plastically deformed (irreversibly deformed) as the pressure in the expiratory passage rises so that the locking portion on the housing side and the engaging portion on the lid portion are disengaged. Instead of or in addition to the engaging portion on the lid side, the locking portion on the housing side may be deformable. In this case, the locking portion may be elastically deformed so as to disengage from the engaging portion upon receiving a force acting on the lid portion due to the pressure in the expiratory passage, or may be provided so as to be plastically deformed. may be provided. In short, at least one of the engaging portion and the engaging portion should be deformable such that the engaging portion disengages from the engaging portion as the pressure in the expiratory passage increases.

In the above embodiment, an example of applying the present invention to an artificial nose that is connected to a tracheostomy tube was shown, but the present invention is also applicable to a respirator that is attached between a tube for artificial respiration and a tracheal intubation. It is also applicable to artificial noses for circuits.

Various aspects of the present invention derived from each of the embodiments and modifications described above are described below. In the following description, in order to facilitate understanding of each aspect of the present invention, the corresponding components illustrated in the accompanying drawings are added in parentheses, but the present invention is thereby limited to the illustrated form. not something.

An artificial nose (1) according to one aspect of the present invention has a humidifying element (7) arranged in an exhalation passage (6) connecting an exhalation port (4) of a housing (2) and a patient side port (5). In the artificial nose, an open port (12) provided on the housing so as to communicate with the expiratory passage in a section (6a) between the patient side port and the humidifying element, and opening and closing the open port. an open valve (20), said open valve being movable between a closed position (position in FIG. 4) that closes said open port and an open position (position in FIG. 10) that opens said open port. A lid portion (21) and an engaging portion (22) movable integrally with the lid portion are provided, and on the housing, movement of the lid portion from the closed position to the open position is provided. A locking portion (12a) that engages with the engaging portion in a limiting manner is provided, and at least one of the locking portion and the engaging portion engages with the pressure increase in the section of the expiratory passage. The engaging portion is configured to be deformable so as to be disengaged from the engaging portion.

In the artificial nose of the above configuration, as the clogging of the humidifying element progresses, the pressure in the expiratory passage increases in the section between the humidifying element and the patient-side port. The pressure acts on the lid as a force that pushes the lid toward the open position. Therefore, when the pressure exceeds a predetermined limit, at least one of the locking portion and the engaging portion is deformed so as to disengage them, and the lid portion is moved to the open position to open the open port. can be done. Therefore, even if the humidifying element is blocked, breathing can be ensured between the open port and the patient side port.

In the artificial nose of the aspect described above, the engaging portion is provided so as to be accommodated in the open port when the lid portion is in the closed position, and the locking portion is provided in the open port. It may protrude so as to mesh with the engaging portion. According to this, the space in the open port can be utilized as a space in which the engaging portion on the lid side and the locking portion on the housing side should be provided. Therefore, it is possible to construct the periphery of the open valve compactly.

Further, when the lid portion is in the open position, the engaging portion escapes from the open port and is exposed to the outside of the housing, and has at least one of a different color or pattern from that of the housing. It may be visually identifiable with respect to the housing. If the engaging portion is accommodated in the open port when the lid is in the closed position, the color or pattern of the engaging portion is completely or incompletely hidden from the surroundings, resulting in poor visibility. On the other hand, when the lid moves to the open position, the engaging portion escapes from the open port and is exposed to the outside of the housing, thereby increasing its visibility. Therefore, if the engaging portion is provided with a color or pattern different from that of the housing, it becomes easy to recognize that the open port is open. Therefore, it is possible to give a clear warning to the surroundings that the humidifying element is blocked, in other words, that the patient is breathing through the open port, and prompt treatment such as replacement of the artificial nose.

In the artificial nose of the aspect described above, the lid portion may be provided so as to protrude largely outside the housing in the open position as compared with the closed position. According to this, it is possible to clearly indicate to the surroundings that the lid has moved to the open position, and to warn the surroundings of the clogging of the humidifying element.

In the artificial nose of the aspect described above, the engaging portion may be elastically deformable so as to be disengaged from the locking portion. According to this, at least one of the engaging portion and the engaging portion is gradually elastically deformed by the force of pushing the lid toward the open position, and the engagement between them is reliably disengaged by the pressure when the humidifying element is closed. to open an open port.

1 Artificial Nose 2 Housing 4 Expiration Port 5 Patient Side Port 6 Expiration Passage 6a Section 7 Humidification Element 10 Opening Mechanism 12 Opening Port 12a Flange (Locking Part)
20 open valve 21 lid portion 22 insertion portion (engagement portion)

Claims (5)

An artificial nose in which a humidifying element is arranged in an expiratory passage connecting an expiratory port of a housing and a patient-side port,
an open port provided on the housing that communicates with the exhalation passageway in a section between the patient port and the humidification element;
and an open valve that opens and closes the open port,
The open valve is provided with a lid portion that can move between a closed position that closes the open port and an open position that opens the open port, and an engaging portion that can move integrally with the lid portion. be
a locking portion that engages with the engaging portion so as to limit movement of the lid portion from the closed position to the open position is provided on the housing;
At least one of the engaging portion and the engaging portion is configured to be deformable such that the engaging portion disengages from the engaging portion as pressure increases in the section of the expiratory passage. . the engaging portion is provided to be accommodated in the open port when the lid portion is in the closed position;
2. The artificial nose according to claim 1, wherein the locking portion protrudes to engage with the engaging portion within the open port. When the lid is in the open position, the engaging portion protrudes from the open port and is exposed to the outside of the housing, and has at least one of a color and pattern different from that of the housing. 3. The artificial nose of claim 2, wherein the artificial nose is visually distinguishable relative to the housing by. The artificial nose according to any one of claims 1 to 3, wherein the lid portion is provided so as to project largely outside the housing in the open position as compared with the closed position. The artificial nose according to any one of claims 1 to 4, wherein the engaging portion is elastically deformable so as to disengage from the locking portion.

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