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WO1999040961A1 - Appareil permettant de melanger des gaz et technique afferente - Google Patents

Appareil permettant de melanger des gaz et technique afferente Download PDF

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Publication number
WO1999040961A1
WO1999040961A1 PCT/SE1999/000129 SE9900129W WO9940961A1 WO 1999040961 A1 WO1999040961 A1 WO 1999040961A1 SE 9900129 W SE9900129 W SE 9900129W WO 9940961 A1 WO9940961 A1 WO 9940961A1
Authority
WO
WIPO (PCT)
Prior art keywords
gas
carbon dioxide
exhalation
cleaning step
inhalation
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/SE1999/000129
Other languages
English (en)
Inventor
Tommy Kvarnhem
Danilo Malic
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
ANMEDIC AB
Original Assignee
ANMEDIC AB
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by ANMEDIC AB filed Critical ANMEDIC AB
Priority to EP99906621A priority Critical patent/EP1051213A1/fr
Priority to AU26482/99A priority patent/AU2648299A/en
Publication of WO1999040961A1 publication Critical patent/WO1999040961A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

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
    • A61M16/22—Carbon dioxide-absorbing devices ; Other means for removing carbon dioxide
    • 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
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/20—Blood composition characteristics
    • A61M2230/202—Blood composition characteristics partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
    • 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
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/40—Respiratory characteristics
    • A61M2230/43—Composition of exhalation
    • A61M2230/432—Composition of exhalation partial CO2 pressure (P-CO2)

Definitions

  • the present invention relates to a method for mixing in breathing systems of the so- called circle type, comprising circulation of gas intended for breathing, removal of carbon dioxide from exhaled gas in a cleaning step and supply of fresh gas.
  • the invention also regards a device for performing the method.
  • the fresh gas flow is significantly smaller than the amount of gas which the patient is breathing per minute: the minute ventilation.
  • the breathing gas of the patient is brought to pass an absorber unit, which absorbs the carbon dioxide of the exhalation air.
  • the inhalation gas then will consist of "used" gas free from carbon dioxide and a minor portion of fresh gas from the breathing system. Typical values may be 1.5 litres/ minute fresh gas and a minute ventilation of 10 litres/minute.
  • the blood gas values of the patient is set by the composition of the inhaled gas mixture (concent- ration of oxygen and carbon dioxide, the number of breaths per minute and the volume of each breath, the so-called tidal volume.
  • the number of breaths per minute (frequency) and the tidal volume is set by physiological circumstances, like e.g. the age. size and sex of the patient. It has proved difficult to obtain correct blood gas values at a correct tidal volume and frequency using known circle systems. Using e.g. 12-14 breaths/minute and a tidal volume of 8-10 ml/kg body weight, the patient will be hyperventilated, i.e. have too low a carbon dioxide content in the blood.
  • the hyperventilation caused by the breathing system causes several disadvantages.
  • One of these is that the time from the end of the narcosis until the patient can breathe by himself (spontaneous breathing ) will be very long, since the carbon dioxide content of the blood must reach a certain level for spontaneous breathing to occur. This, in turn, means a low operation efficiency, since the time for each patient to pass will be long.
  • the present invention constitutes a simple and inexpensive solution to the above described problems, which are associated with the circle system being very efficient from other points of view.
  • the invention relates to a method according to the introductory part of the attached claim 1.
  • the method is especially characterized in what is specified in the characterizing part of said claim.
  • the invention relates to a breathing system according to the introductory part of the attached claim 8.
  • the breathing system is particularly characterized in what is specified in the characterizing part of the last mentioned claim.
  • Fig. 1 schematically shows a circle system having an arrangement according to the invention:
  • Fig. 2 schematically shows a by-pass valve according to the invention con- nected to an absorber unit and a connection housing to a unit, the bypass valve being built-in in said housing;
  • Fig. 3 shows an arrangement substantially according to Fig. 2, in which the by-pass valve is arranged to be arranged to a present connection housing as a separate unit;
  • Fig. 4 schematically and more in detail shows a first embodiment of a by-pass valve arrangement substantially according to Fig. 2. in which a by-pass valve comprised by a cleaning step, a shunt valve, is totally open so that no exhalation gas passes an absorber unit comprised by the cleaning step:
  • Fig. 5 shows an arrangement substantially according to Fig. 4, in which the shunt valve is totally closed so that all exhalation gas passes the absorber unit;
  • Fig. 6 schematically shows a manoeuver control of a shunt valve set in a totally closed position;
  • Fig. 7 shows the manoeuver control according to Fig. 6 in a totally open position
  • Fig. 8 schematically shows a preferred embodiment of a system according to the invention having an automatic regulation based on carbon dioxide content in the exhalation air at the end of an exhalation.
  • Fig. 1, 1 designates a breathing system of the circle type, in which in- and exhalation gas is intended to be circulated in a substantially closed pipe system 2.
  • compression means 4 are provided and arranged, when compressing, to drive the circulation of the gas in the system.
  • 5 designates a pipe for exhalation gas running from the patient and comprising a back valve 6 between the patient and the compression means, arranged for preventing that exhaled gas is directly returned to the patient.
  • 7 designates a cleaning step arranged to be passed by the exhalation gas. which is intended to be pressed through the cleaning step and further in a pipe 8 for inhalation gas mnning to the patient.
  • a connection for the addition of fresh gas and a back valve 10 arranged to control exhalation gas to the pipe 5 for exhalation gas, when the exhalation gas enters the pipe system at exhalation, are provided.
  • the cleaning step comprises an absorber unit comprising lime and being arranged to be supplied to and passed by exhalation gas and hereby absorb carbon dioxide present in the exhalation gas.
  • Absorber units of this kind are extremely efficient and absorb all or substantially all carbon dioxide which is present in the exhalation gas.
  • the system also comprises a settable excess valve, not shown, arranged to let excess gas out of the system in order to avoid undesired pressure increase in the system.
  • devices are provided for supplying carbon dioxide to the gas intended for inhalation in order to replace part of the carbon dioxide removed in the cleaning step.
  • a by-pass valve 12 is provided, via which a part of the exhaled gas can be led past the cleaning step 7 and which, according to the embodiment shown is, e.g. via a pipe 13. connected to the circle 10 system in parallel with the cleaning step, whereby such uncleaned gas comprising carbon dioxide is intended to be supplied to the pipe 8 for inhalation gas.
  • the valve 12 is manually and/or automatically settable so that a certain amount of exhalation air can be brought to pass past the cleaning step.
  • the gas intended for inhalation is intended to be supplied with external and not pre-circulated gas comprising carbon dioxide, e.g. via a pipe 14 connected to the pipe 8 for inhalation gas. as shown by a broken line in Fig. 1. Also combinations of external and internal carbon dioxide supply, e.g. according to the alternatives described, can be imagined.
  • the measurements are intended to be a base for regulating the amount of carbon dioxide, which is supplied to the gas intended for inhalation in order to obtain a desired carbon ⁇ dioxide content in the blood of the patient.
  • the regulation may be intended to be performed manually by means of e.g. the by-pass valve or the corresponding or a valve, not shown, for regulating the amount of gas comprising carbon dioxide, which is supplied externally.
  • the regulation may also be intended to be performed automatically, whereby a control unit 16 is provided and arranged to be supplied with measuring values from the measuring devices and to control the by-pass valve or the corresponding, so that a desired carbon dioxide content value of the blood of the patient is maintained.
  • the measuring devices 15 are arranged for the measurement of the carbon dioxide content of the exhalation air at the end of an exhalation, the so-called endtidal carbon dioxide value.
  • the necessary valves, such as the by-pass valve 12, are then e.g. servo-controlled.
  • connection housing 18 is provided, by means of which the gas flow in the system is controlled.
  • the housing 18 comprises a connection 19 for a bladder/bellows 4, a connection 20 for fresh gas, an excess valve 11, a connection 21 for exhaled gas, a connection 22 for gas intended to be inhaled and connections 23,24 for a lime container 25, which is marked only by broken lines in both Figures and which is arranged to be passed by the exhaled gas and arranged to be exchange- ably fastened to the housing.
  • a by-pass valve is integrated with the housing, which then includes a control 26, by means of which the by-pass flow may be controlled.
  • the by-pass valve is comprised by a separate valve unit 27, which is arranged to be applied to the housing and intended, among other things, for present housings as a complement.
  • the valve unit 27 hereby includes the connections 23, 24 for the lime container.
  • Figs. 4 and 5 two end positions of by-pass valve, the shunt valve, are shown in more detail, whereby the gas flow in the valve arrangement arranged in the connection housing is shown by means of arrows showing the flow direction of the gas.
  • the shunt valve is totally open, whereby all the patient exhalation gas will be returned to the patient. This corresponds to a max position, position 9. of the valve control 26, Fig. 7.
  • the shunt valve is totally closed, whereby all the exhalation gas supplied will pass through the absorber unit and hereby be cleaned as far as carbon dioxide is concerned, which corresponds to a minimum position, position 9, of the valve control 26, Fig. 6.
  • the shunt valve is also arranged to take positions between the end positions, whereby the exhalation gas supplied will be divided into two flows, where one runs through the absorber unit and is cleaned before it returns to the patient and one returns to the patient uncleaned.
  • the setting of the shunt valve then decides to what extent the exhalation gas supplied is brought to pass the absorber unit.
  • a measuring unit 15 for measuring the carbon dioxide content of the exhalation air from the patient
  • the measuring unit comprises a connection 28, via which, normally digital, measuring signals corresponding to the carbon dioxide content of the exhalation air of the patient at the end of the exhalation.
  • the unit may be of a known kind, where said connection normally is intended for obtaining remote supervision or the corresponding.
  • the measuring signals is here intended to be supplied as a present value to a control unit arranged so that a desired carbon dioxide content in the exhalation air of the patient, which content corresponds to a certain carbon dioxide content in the blood of the patient, may be set as a desired value.
  • the control unit is preferably arranged so that the present measuring unit is detected via the signals from it and/or are set on the control unit, which is necessary since the signals from different measuring units are somewhat different.
  • Said by-pass valve 12 is in this case a motor-driven shunt valve arranged to be affected by signals from the control unit, so that control of the by-pass flow takes place for adaptation to the desired value set. i.e. when the carbon dioxide in the exhalation air is too low. the valve is set so that a larger amount of gas is shunted past the cleaning step, and when the 7 carbon dioxide content is too high, the valve is set so that a smaller amount of gas is shunted past the cleaning step.
  • Fig. 8 the advantages offered by an automatically controlled system substantially according to Fig. 8 should be pushed forward.
  • the patient is correctly ventilated as far as possible and may be brought to regain the spontaneous breathing quickly and the shunt valve and present measuring values do not have to be firmly supervized since changes are obstructed by the control described.
  • the measurement of the carbon dioxide content of the blood of the patient preferably takes place by capnography or in another suitable known way.

Landscapes

  • 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)
  • Investigating Or Analysing Biological Materials (AREA)

Abstract

Cette invention a trait à une technique permettant de réaliser un mélange dans des appareils respiratoires du type clos en circuit-filtre, laquelle technique consiste à faire circuler un gaz prévu pour être respiré, à extraire le dioxyde de carbone du gaz expiré lors d'une opération d'épuration (7) et à alimenter en gaz frais. Cette technique se caractérise essentiellement par le fait que le gaz prévu pour être inhalé est administré accompagné de dioxyde de carbone. L'invention concerne également un appareil permettant d'effectuer des mélanges.
PCT/SE1999/000129 1998-01-30 1999-02-01 Appareil permettant de melanger des gaz et technique afferente Ceased WO1999040961A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP99906621A EP1051213A1 (fr) 1998-01-30 1999-02-01 Appareil permettant de melanger des gaz et technique afferente
AU26482/99A AU2648299A (en) 1998-01-30 1999-02-01 Method and device for mixing of gases

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE9800276A SE9800276L (sv) 1998-01-30 1998-01-30 Förfarande för blandning jämte blandningsanordning
SE9800276-9 1998-01-30

Publications (1)

Publication Number Publication Date
WO1999040961A1 true WO1999040961A1 (fr) 1999-08-19

Family

ID=20410042

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/SE1999/000129 Ceased WO1999040961A1 (fr) 1998-01-30 1999-02-01 Appareil permettant de melanger des gaz et technique afferente

Country Status (4)

Country Link
EP (1) EP1051213A1 (fr)
AU (1) AU2648299A (fr)
SE (1) SE9800276L (fr)
WO (1) WO1999040961A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2803758A1 (fr) * 2000-01-19 2001-07-20 Taema Ventilateur d'anesthesie avec commutation automatique de circuit
EP1424091A1 (fr) * 2002-11-28 2004-06-02 Maquet Critical Care AB Dispositif pour échanger des volumes de gaz
WO2007033271A1 (fr) * 2005-09-13 2007-03-22 Automedx, Inc. Ventilateur autonome en boucle fermee
WO2011043651A1 (fr) 2009-10-07 2011-04-14 Alcmair Partners Bv Appareil respiratoire destiné à des patients

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2543266A1 (de) * 1975-09-27 1977-04-07 Moyat Peter Dr Phil Nat Co tief 2 - regelung am patienten unter narkose
WO1996036385A1 (fr) * 1995-05-15 1996-11-21 Jacob & Allard Ab Circuits de respiration sous anesthesie

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2543266A1 (de) * 1975-09-27 1977-04-07 Moyat Peter Dr Phil Nat Co tief 2 - regelung am patienten unter narkose
WO1996036385A1 (fr) * 1995-05-15 1996-11-21 Jacob & Allard Ab Circuits de respiration sous anesthesie

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2803758A1 (fr) * 2000-01-19 2001-07-20 Taema Ventilateur d'anesthesie avec commutation automatique de circuit
EP1120126A3 (fr) * 2000-01-19 2002-02-13 Taema Ventilateur d'anesthésie avec commutation automatique de circuit
EP1424091A1 (fr) * 2002-11-28 2004-06-02 Maquet Critical Care AB Dispositif pour échanger des volumes de gaz
US6863067B2 (en) 2002-11-28 2005-03-08 Maquet Critical Care Ab Device for exchange of gas volume
WO2007033271A1 (fr) * 2005-09-13 2007-03-22 Automedx, Inc. Ventilateur autonome en boucle fermee
WO2011043651A1 (fr) 2009-10-07 2011-04-14 Alcmair Partners Bv Appareil respiratoire destiné à des patients

Also Published As

Publication number Publication date
EP1051213A1 (fr) 2000-11-15
SE9800276D0 (sv) 1998-01-30
SE9800276L (sv) 1999-07-31
AU2648299A (en) 1999-08-30

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