U.S. patent application number 12/271484 was filed with the patent office on 2009-06-18 for tracheal catheter and prosthesis and method of respiratory support of a patient.
This patent application is currently assigned to Breathe Technologies, Inc.. Invention is credited to Lutz Freitag.
Application Number | 20090151726 12/271484 |
Document ID | / |
Family ID | 34129567 |
Filed Date | 2009-06-18 |
United States Patent
Application |
20090151726 |
Kind Code |
A1 |
Freitag; Lutz |
June 18, 2009 |
TRACHEAL CATHETER AND PROSTHESIS AND METHOD OF RESPIRATORY SUPPORT
OF A PATIENT
Abstract
A method and apparatus is described for supporting the
respiration of a patient. The spontaneous respiration of a patient
can be detected by sensors and during inhalation an additional
amount of oxygen can be administered to the lungs via a jet gas
current. If required, during exhalation a countercurrent can be
administered to avoid collapse of the respiration paths. This
therapy can be realized by an apparatus including a transtracheal
catheter, an oxygen pump connected to an oxygen source, spontaneous
respiration sensor(s) connected to a control unit for activating
the oxygen pump and, if needed, a tracheal prosthesis. The tracheal
prosthesis may include a connection for the catheter and the breath
sensor(s). The tracheal prosthesis, if used, and the catheter can
be dimensioned so the patient can freely breathe, cough, swallow
and speak without restriction, and the system can be wearable to
promote mobility.
Inventors: |
Freitag; Lutz; (Hemer,
DE) |
Correspondence
Address: |
PATTON BOGGS LLP
8484 WESTPARK DRIVE, SUITE 900
MCLEAN
VA
22102
US
|
Assignee: |
Breathe Technologies, Inc.
Fremont
CA
|
Family ID: |
34129567 |
Appl. No.: |
12/271484 |
Filed: |
November 14, 2008 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
10771803 |
Feb 4, 2004 |
7487778 |
|
|
12271484 |
|
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Current U.S.
Class: |
128/204.25 ;
128/204.26; 623/9 |
Current CPC
Class: |
A61M 2016/0036 20130101;
A61M 16/0072 20130101; A61M 16/0465 20130101; A61M 2202/0208
20130101; A61M 2205/106 20130101; A61M 16/127 20140204; A61M
2025/0002 20130101; A61M 16/0677 20140204; A61M 16/12 20130101;
A61M 2016/0021 20130101 |
Class at
Publication: |
128/204.25 ;
128/204.26; 623/9 |
International
Class: |
A61M 16/00 20060101
A61M016/00; A61F 2/20 20060101 A61F002/20 |
Foreign Application Data
Date |
Code |
Application Number |
Aug 11, 2003 |
DE |
20/40963-001 |
Aug 11, 2003 |
DE |
10337138.9 |
Claims
1. A method for supporting the respiration of a patient comprising
the steps of: detecting the spontaneous respiration of the patient
is by sensors; identifying the end of the inhalation process; and
administering an additional amount of oxygen to the lungs.
2. The method of claim 1, wherein the additional amount of oxygen
is administered at the end of an inhalation process.
3. The method of claim 1, wherein the amount of oxygen has a volume
of about between 25 ml-150 ml.
4. The method of claim 2, wherein the amount of oxygen has a volume
of about between 25 ml-150 ml.
5. The method of claim 1, further comprising the step of braking
the exhalation process of the patient with a countercurrent.
6. The method of claim 2, further comprising the step of braking
the exhalation process of the patient with a countercurrent.
7. An apparatus for supporting the respiration of a patient that
comprises an oxygen pump operatively connected to an oxygen source,
the apparatus further comprising sensors for detecting the
spontaneous respiration of the patient, the sensors are connected
to a control unit for activating the oxygen pump.
8. The apparatus of claim 7, wherein the oxygen pump comprises a
tracheal prosthesis connectable by a catheter, the tracheal
prosthesis having a tubular support body with a connection for the
catheter.
9. The apparatus of claim 8, wherein the sensors are associated
with the support body of the tracheal prosthesis.
10. The apparatus of claim 9, wherein at least one sensor is
coupled with the inner wall of the support body.
11. The apparatus of claim 9, wherein the end of the catheter
located in the support body is deflected approximately parallel to
its longitudinal axis (L) and is provided on the end with a jet
nozzle.
12. The apparatus of claim 10, wherein the end of the catheter
located in the support body is deflected approximately parallel to
its longitudinal axis and is provided on the end with a jet
nozzle.
13. The apparatus of claim 7, wherein the oxygen pump is a piston
pump.
14. The apparatus of claim 12, wherein the oxygen pump is a piston
pump.
15. The apparatus of claim 8, wherein the catheter has a
double-lumen design.
16. The apparatus of claim 14, wherein the catheter has a
double-lumen design.
17. The apparatus of claim 7, further comprising additional
respiration sensors.
18. The apparatus of claim 9, further comprising additional
respiration sensors.
19. A tracheal prosthesis comprising a tubular support body, a
connection for a jet catheter and at least two sensors coupled with
the support body.
20. The tracheal prosthesis of claim 19, wherein at least one of
the sensors is coupled with the inner wall of the support body.
21. The tracheal prosthesis of claim 19, wherein the catheter is
operatively coupled with the support body.
22. The tracheal prosthesis of claim 20, wherein the catheter is
operatively coupled with the support body.
23. A catheter having a first and second end, one end affixable by
at least one sensor.
24. The catheter of claim 23, wherein the at least one end
comprises a jet nozzle.
25. The catheter of claim 23, wherein the at least one end has a
curved course.
26. The catheter of claim 24, wherein the at least one end has a
curved course.
Description
PRIORITY CLAIM
[0001] This application is a continuation of U.S. application Ser.
No. 10/771,803, filed Feb. 4, 2004, which claims the benefit of
priority under 35 U.S.C. .sctn. 119 to co-pending German Patent
Application Serial No. 10337138.9, filed Aug. 11, 2003, the
contents of each of which is incorporated herein in its
entirety.
FIELD OF INVENTION
[0002] The present invention relates generally to respiratory
systems directed and more particularly to specialized mechanisms
for enhanced ventilation of a patient.
BACKGROUND OF THE INVENTION
[0003] In order that the body can take in oxygen and give off
carbon dioxide, both components of the respiratory bronchial system
must function--the lungs as a gas-exchanging organ and the
respiratory pump as a ventilation organ that transports air into
the lungs and back out again. The breathing center in the brain,
central and peripheral nerves, the osseous thorax and the breathing
musculature as well as free, stable respiratory paths are necessary
for a correct functioning of the respiratory pump.
[0004] In certain diseases there is a constant overload on or
exhaustion of the respiratory pump. A typical syndrome is pulmonary
emphysema with flat-standing diaphragms without the ability to
contract. In the case of pulmonary emphysema the respiratory paths
are usually extremely slack and tend to collapse. As a consequence
of the flattened, over-extended diaphragms the patient cannot
inhale deep enough. In addition, the patient cannot exhale
sufficiently on account of the collapsing respiratory paths. This
results in an insufficient respiration with an undersupply of
oxygen and a rise of carbon dioxide in the blood, the so-called
ventilatory insufficiency.
[0005] The treatment for inhalation difficulty often makes use of a
breathing device. The so-called home respiration is an artificial
respiration for supporting or completely relieving the respiratory
pump.
[0006] The respiration can take place non-invasively via a tube and
a nose mask or mouth mask that the patient can put on and take off
as needed. However, this prevents the patient from breathing freely
and speaking freely. In addition, a blocked tracheal cannula can be
inserted into the trachea. This also has the consequence that the
patient can no longer speak.
[0007] In the case of invasive respiration this usually occurs via
a tracheostomy. This involves an opening placed in the trachea by
an operation. A catheter about the diameter of a finger with a
blocking balloon is inserted via the opening into the trachea and
connected to a breathing apparatus. This makes a sufficiently deep
respiration possible but prevents the patient from speaking. In
addition to the respiration there is the transtracheal
administration of oxygen via thinner catheters. U.S. Pat. Nos.
5,181,509 or 5,279,288 disclose corresponding embodiments. In this
manner a highly dosed administration of oxygen is administered to
the patient in a continuous stream with a permanently adjusted
frequency. The flow of oxygen is regulated manually by a throttle
device. However, simulation of the natural breathing process of a
patient is not achieved because breathing is not deep enough. Also,
the catheter end introduced into the trachea can result in
irritations and a local traumatizing of the surrounding tissue in
that it strikes against the trachea as a consequence of the
respiratory movement or in that the surrounding tissue is dried out
by the jet stream.
[0008] Furthermore, so-called "Montgomery T-tubes" are known that
are inserted into the trachea. The patient can obtain oxygen via
the shank of the T-piece run to the outside. In addition, the
patient can draw off secretions himself if needed. The patient can
breathe freely and speak when the front shank is closed; however,
respiration is not possible via the Montgomery T-tube since the
introduced air escapes upward into the buccal cavity or the
pharyngeal area. An additional limitation of the above-referenced
therapies is the impaired mobility of the patient because of
inadequate ventilation as well as the bulk of the apparatus.
[0009] Therefore, there is an existing need for a respiratory
system that provides a more efficient method for supporting the
respiration of a patient and of creating an apparatus to this end
that can also be taken along by the patient and is reliable in its
use. Moreover, the there is a need for a tracheal prosthesis and a
catheter that make possible a respiratory support synchronized with
the spontaneous respiration of the patient without adversely
affecting the patient's ability to speak.
SUMMARY OF EXEMPLARY EMBODIMENTS
[0010] It is a principal objective of the present invention to
provide an apparatus and method that improves the quality of life
of patients that require respiratory support. In the furtherance of
this and other objectives, the present inventor provides a
respiratory system that provides a more efficient method of
supporting the respiration of a patient by providing additional
oxygen when needed.
[0011] I is an additional objective in accordance with the present
invention to provide as system that is portable and reliable in its
use.
[0012] Yet another objective in accordance with the present
invention is to provide a tracheal prosthesis and a catheter that
make possible a respiratory support synchronized with the
spontaneous respiration of the patient without adversely affecting
the patient's ability to speak.
[0013] Further objectives, features and advantages of the invention
will be apparent from the following detailed description taken in
conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE FIGURES
[0014] FIG. 1 shows the upper body of a patient carrying an
apparatus in accordance with the invention for respiration
support.
[0015] FIG. 2 shows a diagram with a view of the respiration flow
of an emphysema patient with and without respiration support.
[0016] FIG. 3 shows a technically simplified view of a tracheal
prosthesis in accordance with the invention.
[0017] FIG. 4 shows another embodiment of a tracheal
prosthesis.
[0018] FIG. 5 shows, also in a scheme, an oxygen pump belonging to
the apparatus of the invention showing the conduction of air and a
control unit.
[0019] FIG. 6 shows the end section of a catheter in accordance
with the invention.
[0020] FIG. 7 shows the catheter according to FIG. 6 inserted in a
support body.
DETAILED DESCRIPTION OF AN EMBODIMENT
[0021] The present invention, in a preferred embodiment, provides
an apparatus for supporting the respiration of a patient and to a
tracheal prosthesis. According to the invention the spontaneous
respiration of a patient is detected by sensors and at the end of
an inhalation procedure an additional amount of oxygen is
administered to the lungs via a jet gas current. This improves the
absorption of oxygen during inhalation. If required, the exhalation
procedure of the patient can be arrested or slowed by a
countercurrent in order to avoid a collapse of the respiration
paths in this manner. This procedure is realized by an apparatus
comprising an oxygen pump that can be connected to an oxygen source
and comprising a tracheal prosthesis that can be connected via a
catheter. The spontaneous respiration of the patient is detected by
sensors connected to a control unit for activating the oxygen pump.
The tracheal prosthesis comprises a tubular support body with a
connection for the catheter and two of the sensors are associated
with the support body. The tracheal prosthesis and the jet catheter
that is integrated or can be introduced are dimensioned in such a
manner that the patient can freely breath and speak without
restriction.
[0022] Referring specifically to FIG. 1, P designates a patient
suffering from a pulmonary emphysema with an overloading and
exhaustion of the respiratory pump. As a consequence, the patient
can not inhale deeply enough. In addition, the exhalation process
is hindered by slack and collapsing respiratory paths.
[0023] Such a respiration process with inhalation/inspiratory flow
and exhalation (expiratory flow) without respiratory support is
shown in FIG. 2 in the left half of the image. The curve for
inhalation is designated by E1 and the curve for exhalation by
A1.
[0024] In order to support and relieve the strain on the
respiratory pump the patient's spontaneous respiration is detected
by sensor and at the end of an inhalation process of the lungs an
additional amount of oxygen is administered. This respiratory flow
is illustrated in the right half of FIG. 2. The additional amount
of oxygen increases the respiratory volume during inhalation
according to curve E2 by the difference volume shown darkened in
the upper curve and designated by E3. The additional amount of
oxygen can have a volume between 25 ml and 150 ml.
[0025] In addition, the exhalation process of the patient is braked
by a countercurrent. As a consequence thereof, the respiratory flow
shifts during exhalation along the curved designated by A2. This
purposeful resistance acting opposite to the exhalation prevents a
collapsing of the respiratory paths during exhalation. In this
manner the exhalation volume is increased by the volume also shown
darkened and designated by A3.
[0026] As a consequence, this method avoids an insufficient
respiration with an undersupply of oxygen and an increase of carbon
dioxide in the blood. Patient P is significantly less stressed and
more mobile and in addition he perceives less or no shortage of
air.
[0027] In order to carry out the respiration support of patient P,
an apparatus is provided comprising oxygen pump 1 that can be
connected to an oxygen source (see FIG. 5) and comprising tracheal
prosthesis 2, 3 (see FIGS. 3, 4). According to FIG. 1 oxygen pump 1
is a component of a compact, mobile respiration device 4. Oxygen
pump 1 and tracheal prosthesis 2, 3 are connected via catheter
5.
[0028] As FIGS. 3, 4 show, each tracheal prosthesis 2, 3 comprises
tubular support body 6 with connection 7 for catheter 5. In order
to detect the spontaneous respiration of patient P two sensors 8, 9
in the form of thermistors are associated with support body 6. One
sensor 8 is fixed on inner wall 10 of support body 6 and the other
sensor 9 is located on outer wall 11 of support body 6. Sensors 8,
9 communicate with control unit 12 for activating oxygen pump 2.
Control unit 12 is schematically shown in FIG. 5 with its inputs
and outputs. As already stated, sensors 8, 9 are thermistors, that
is, temperature-dependent resistors. They are connected together in
a bridge circuit in the apparatus so that a compensation of
measured value differences between inner sensor 8 and outer sensor
takes place as a consequence of environmental influences.
[0029] FIG. 1 also shows that other respiration sensors 13, 14 are
provided. They are also sensors for detecting the spontaneous
respiration of patient P. An exact image of the respiration process
of patient P can be obtained by adjusting the measured values
received via sensors 8, 9 and 13, 14. In addition, the safety
against false measurements or the failure of one of sensors 8, 9
and/or 13, 14 is increased.
[0030] In tracheal prosthesis 2 according to FIG. 3 the jet
catheter 5 can be inserted via connection 7 into support body 6.
End 15 of jet catheter 5 located in support body 6 is guided or
deflected approximately parallel to its longitudinal axis L. The
data lines from sensors 8, 9 to control unit 12 are designated with
16, 17 running inside catheter 5. On the discharge side the end 15
of jet catheter 5 is designed as jet nozzle 25. This can take place
by reducing the cross section of the catheter. This increases the
speed of the oxygen current at the discharge from catheter 5 and it
is conducted in the direction of the bronchial tract. The diameter
of support body 6 is dimensioned with a sufficiently free lumen in
such a manner that patient P can freely breathe and speak even with
integrated catheter 5.
[0031] Separate coupling 18 is provided on connection 7 in tracheal
prosthesis 3 according to FIG. 4 via which catheter 5 is connected
to tracheal prosthesis 3. In this instance fixed longitudinal
section 19 aligned parallel to longitudinal axis L is provided as
catheter end in support body 6 and the oxygen current is conducted
via jet nozzle 26 in the direction of the bronchial tract.
[0032] Oxygen pump 1 is schematically shown in FIG. 5. It is a
piston pump with double-acting piston 20 arranged in cylinder 27.
The apparatus comprises four valves V1 to V4. The supply of oxygen
takes place from an external oxygen reservoir via connection 21.
The switching states of valves V1 to V4 and the supply lines and
removal lines are designated by letters a to g.
[0033] Oxygen pump 1 functions in the apparatus during the support
of respiration as follows: When valve V1 is open from c to a (b to
c closed) and valve V2 open from b to e (e to d closed), piston 20
moves to the left in the plane of the figure and the oxygen flows
via outlet 22 and jet catheter 5 to patient P. The additional
amount of oxygen E3 is administered during the inhalation process
of patient P.
[0034] When valve V1 is open from b to c (c to a closed) and valve
V2 is open from e to d (b to e closed), piston 20 moves to the
right in the plane of the figure in the flow of oxygen takes place
in the direction of valve V3. Valve V3 is connected to the ambient
air via outlet 23. In the instance in which valve V3 is open from d
to g the oxygen flows off without expiration brake. That means that
the exhalation process is not braked by a countercurrent.
[0035] If valve V3 is closed from d to g and open from d to f the
oxygen flows via access path 24 in the direction of outlet 22 and
catheter 5 in order to be administered to patient P during the
exhalation process and in order to break the respiratory flow. The
countercurrent prevents a collapsing of the respiratory paths and
keeps them open. This makes a deeper exhalation possible.
[0036] Furthermore, valve V4 is located in access path 24 of the
apparatus, via which the flowthrough (f to a) can be variably
adjusted. This can advantageously be a proportional valve with
pulse-width modulation.
[0037] FIG. 6 shows catheter 28 with long, flexible tube 29 and end
31 on the discharge side bent in curvature 30. Two sensors 32, 33
for detecting the spontaneous respiration of patient P are fastened
on the end. Sensors 32, 33 are preferably thermistors. Data lines
are not shown in the drawing for the sake of simplicity. They run
through catheter 28 and the catheter wall. 34 designates a
stop.
[0038] It can also be seen that end 31 of catheter 28 is provided
with jet nozzle 35. The cross section of the flow is reduced
relative to the cross section of the catheter in jet nozzle 35 so
that the discharge rate of the supplied oxygen is increased.
[0039] Catheter 28 can be introduced into support body 36, as FIG.
7 shows. Support body 35 is located in the trachea of patient P.
The connection to the outside is established via connection 37.
Support body 36 can be a traditional Montgomery T-stent.
[0040] The present invention may be embodied in other specific
forms without departing from its spirit or essential
characteristics. The described embodiments are to be considered in
all respects only as illustrative, and not restrictive. The scope
of the invention is, therefore, indicated by the appended claims,
rather than by the foregoing description. All changes, which come
within the meaning and range of equivalency of the claims, are to
be embraced within their scope.
* * * * *