U.S. patent number 3,683,655 [Application Number 05/023,197] was granted by the patent office on 1972-08-15 for breathing assist apparatus.
Invention is credited to John S. Chapman, Arlton H. White.
United States Patent |
3,683,655 |
White , et al. |
August 15, 1972 |
BREATHING ASSIST APPARATUS
Abstract
A device for providing assistance to persons with emphysema and
problems relating to breathing. Essentially the invention provides
means for applying pressure to the abdominal and lower rib region
which assists in forcing air from a person's lung. The pressure is
applied during the exhalation phase of the breathing cycle and the
pressure applying means is activated by the person's efforts to
exhale. The pressure is released upon completion of the exhalation
phase avoiding interference with the inhalation phase.
Inventors: |
White; Arlton H. (Dallas,
TX), Chapman; John S. (Dalla, TX) |
Family
ID: |
21813641 |
Appl.
No.: |
05/023,197 |
Filed: |
March 27, 1970 |
Current U.S.
Class: |
601/44 |
Current CPC
Class: |
A61H
31/00 (20130101); A61H 31/005 (20130101); A61H
31/006 (20130101); A61H 9/0078 (20130101); A61H
2201/5048 (20130101); A61H 2201/165 (20130101); A61H
2201/1238 (20130101); A61F 5/56 (20130101); A61H
2201/5058 (20130101) |
Current International
Class: |
A61H
31/00 (20060101); A61H 23/04 (20060101); A61F
5/56 (20060101); A61h 031/02 () |
Field of
Search: |
;128/28-30.2 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Trapp; Lawrence W.
Claims
What is claimed is:
1. Apparatus for assistance in breathing which comprises a
self-contained fluid and actuating means for applying pressure to
the abdomen and lower ribs over a time period equivalent to the
exhalation phase in breathing, said means assisting in forcing air
from a person's lungs and releasable at the end of the exhalation
cycle, and sensing means minimizing impediments to breathing and
operable upon detection of breath upon exhalation for actuating
said means for applying pressure.
2. Apparatus for assistance in breathing which comprises a belt for
attachment around the abdominal and lower rib region, said belt
including expandable means, a reservoir connected to said
expandable means and providing a self contained fluid supply,
actuating means, and sensing means detecting the impingement of
breath, said sensing means providing an output upon the beginning
of exhalation to said actuation means whereby said actuating means
is activated and causes fluid to flow from said reservoir to said
expandable means during exhalation and to return to said reservoir
at the end thereof.
3. The apparatus as defined in claim 2 which said sensing means
comprises a microphone supported in non-breathing impediment manner
adjacent a person's nose and mouth.
4. The apparatus as defined in claim 2 in which said expandable
means comprises an elongated sack and said reservoir is
compressible by said actuation means.
5. In a breathing assist apparatus, a pressure applying means for
positioning around the abdomen and lower ribs, a reservoir of air
connected to said pressure applying means in a self contained
system, actuation means for alternately transferring air in said
system to and from said reservoir and said pressure applying means,
and breath signal detection means controlling said actuation
means.
6. In a breathing assist apparatus as defined in claim 5, hand
operated pump means for adjusting the pressure in said pressure
applying means and in said reservoir.
7. Apparatus for assisting in breathing which comprises a
self-contained fluid and actuating means for applying pressure to
the abdomen and lower ribs over a time period equivalent to the
exhalation phase in breathing, said means assisting in forcing air
from a person's lungs and releasable at the end of the exhalation
cycle, said means for applying pressure being actuated periodically
corresponding to the breathing cycle of inhalation and exhalation.
Description
Emphysema is a disease affecting a person's lungs and the muscles
used in exhaling air from the lungs. During the inhalation phase of
breathing, the normal lung capability of persons suffering from
emphysema seems to be a relatively little affected and breathing is
almost normal. In a normal person, air is exhaled by elastic recoil
without muscular effort whereas the act of expiration in persons
with emphysema is accomplished by active muscular work.
Furthermore, with emphysema, there is atrophy of the diaphragm
which becomes markedly depressed so that it no longer serves as a
functional respiratory muscle. Thus, a characteristic of emphysema
is difficulty in exhalation or expiration. The principle upon which
this invention is based is that of providing compression of the
abdomen and lower ribs during the exhalation phase of breathing and
initiating the compression coincident, as closely as possible, with
the beginning of exhalation, in replacement of the elastic recoil
or of active muscular exhalation. As an added benefit, in applying
a pressure to the diaphragm and pushing it upward, there is the
probability of returning the muscle to a partial functional
state.
Accordingly, it is an object of this invention to provide
assistance during the portion of the breathing cycle when
assistance is required and, thereafter, to release the assisting
means so as not to interfere with otherwise normal breathing.
Another object of this invention is to provide sensitive means for
detecting effort to exhale and, upon detection, activating the
breathing assist means.
Still another object is to detect efforts to exhale without
impeding or hindering the exhalation of air from a person's
lungs.
A still further object of this invention is to provide breathing
assistance which is foolproof in operation and does not expose the
user to hazards or danger especially while sleeping or in a
semiconscious condition.
Another object is to apply pressure over the time period of the
exhalation phase of breathing which pressure increases to a maximum
and then decreases corresponding to the normal movement of a
person's diaphragm.
Another object of this invention is to provide a structure which is
compact for ease of location, use and storage and, as well, simple
in construction and with relatively few moving parts for long life
and maintenance free operation.
Other objects and advantages reside in the details of construction
and operation as more fully described and claimed hereinafter and
as shown in the accompanying drawings.
The drawings are as follows:
FIG. 1 is a representation of the preferred embodiment of the
breathing assist apparatus.
FIG. 2 is a block diagram of the breath signal amplifier and
control circuit for activating the pressure supply apparatus of
FIG. 4.
FIG. 3 is a detailed circuit diagram of the block diagram of FIG.
2.
FIG. 4 shows a side elevation view of a mechanism and air supply
reservoir for applying pressure to the abdomen and lower rib
region.
FIG. 5 is a curve of the pressure provided by the mechanism and air
supply reservoir of FIG. 4 over the time period of the exhalation
phase of breathing.
Describing now the breathing assist apparatus, FIG. 1 shows in
representative form a preferred embodiment of the apparatus. In
this embodiment, the means for applying pressure to the abdomen and
lower rib region is by an expandible sack 11 which can be strapped
in place by means of a belt 10. The belt 10 extends lengthwise of
the sack 11 and is maintained in place by loops, tabs or a separate
cloth cover enclosing the sack. Sack 11 is elongated, double
walled, expandible, sealed at either end and leakproof. Suitable
construction materials for the sack are rubber and plastics. Two
openings are provided in sack 11, one of which connects with tube
16 and the other with air supply hose 20. At either end of belt 10
are clasps 12 and 13 suitable for joining together and holding belt
10 and sack 11 in place. The exact construction of the clasps 12
and 13 is not material to this invention and could be replaced by,
for example, a buckle arrangement. However, it is preferred that
the clasp arrangement allow the wearer to adjust the belt 10 to the
most effective position and degree of tightness and permit easy and
quick release in the manner of standard safety, or seat, belts.
The tube 16 communicates with a hand operated bulb pump 15
controlled by screw closure 17. The purpose of the hand operated
bulb pump is to inflate sack 11 initially and, thereafter, to
adjust the pressure inside the sack and, also, bellows 71
(described as part of FIG. 4 hereinafter). With screw 17 closed,
squeezing bulb pump 15 increases the air supply in the sack and
thus the pressure. When screw 17 is loosened, air escapes and the
pressure within the sack is reduced.
With belt 10 in position, the wearer next positions on his head the
headset support 25 to which is attached strap 26 supporting
microphone 27. Headset 25 may be of any convenient construction
and, instead of fitting over the head and down by the side of the
person's ears as shown, may consist of a strap encircling the head.
In any event, the purpose of the headset is to provide support for
microphone 27 so that it may be positioned in front of the wearer's
mouth and nose. Microphone 27 is of the piezoelectric crystal type
and, when the wearer begins to exhale, no matter how slight, the
breath impinges directly on the microphone and causes an electrical
signal to be produced. The electrical signal is fed by leads 28 to
the amplifier and motor control 30.
It can be seen that, if microphone 27 is positioned in front of the
wearer's mouth and nose, there is no impediment to breathing such
as might be occasioned by a mask or sensor operating on a pressure
drop principle at the beginning of the exhalation cycle. This is
not to say that a mask fitting over the wearer's nose and mouth
might not be required at times, for example, in a hospital in
conjunction with other equipment and medication for the wearer. If
a pressure drop principle is employed, the change in pressure may
be used to close a switch and generate the electrical signal to the
amplifier and motor control. In addition, other kinds of sensors
than microphone 27 may be used such as hot wire anemometers and
thermistors which produce electrical signals by changing resistance
to current flow as the exhaled air passes the sensor. Whatever
device is used, however, the requirement is for high sensitivity to
small movements of air and rapid response so as to initiate timely
activation of the pressure supply mechanism.
The amplifier and motor control is shown in block diagram in FIG. 2
and in detail circuit diagram in FIG. 3. Describing the block
diagram of FIG. 2, AC power is fed into the control by line 31
whose plug end may be connected into any suitable source of 110-
120 volt AC power such as is standard in homes, offices and
hospitals. Within the control, power supply 32 generates a B+
voltage and this voltage is supplied through lead 33 to leads 35
and 36. Lead 35 is connected to amplifier 37 and lead 36 to the
relay trigger circuit 39. The signal from microphone 27 is fed
through lead 28 to amplifier 37. The amplifier 37 amplifies the
signal and feeds the signal through lead 38 to the relay trigger
circuit 39. The coincidence of a signal from amplifier 37 and the
B+ voltage supplied through line 36 permits a silicon controlled
rectifier in the trigger circuit to turn on and provide an output
to activate power control relay 40 and move its armature. Movement
of the armature of relay 40 moves switch contact 55 to the position
shown in dashed lines and the AC power from line 31 then feeds
directly through leads 54 and 56, leaf spring 49 of switch 45, and
lead 46 to a motor in the pressure supply mechanism. Lead 47 is the
return line from the motor. The pressure supply mechanism will be
described subsequently in connection with FIG. 4. However, for
clarity of description at this point, it should be noted that a cam
is carried on the motor and has a contact surface such that switch
contacts 49 and 50 of switch 45 remain in their closed position
until the motor is energized. As the motor begins to turn, the cam
surface and a cam follower then cause the switch contacts 49 and 50
to move to the position as shown in dashed lines and, thereupon, to
connect the motor directly to the source of AC power by way of
switch contact 49. The momentary lapse of power to the motor in
switching from one line to another has been found not to interfere
with its continued operation. Movement of switch contact 50 to the
position shown in dashed lines interrupts the B+ voltage supply to
relay trigger circuit 39 through reset line 57 and the armature of
power control relay 40 and switch contact 55 return to their normal
position. As the motor and cam rotate through a complete
revolution, the cam surface and follower permit switch contacts 49
and 50 to return to their normal position and the AC power to the
motor is disconnected. A back EMF for dynamic braking of the motor
is provided by a circuit which includes power supply 32, line 51,
switch contact 55, lead 56, switch contact 49 in its normally
closed position, and lead 46 to the motor. In this state, the
control is in condition to receive the next signal from microphone
27 and repeat the sequence of steps described above.
FIG. 3 shows the block diagram of FIG. 2 in detailed circuit form.
In FIG. 3, the corresponding portions of the circuit diagram have
been outlined with dashed lines to indicate the portion of the
circuit providing the various functions described above such as the
power supply, amplifier, relay trigger circuit, etc. The silicon
controlled rectifier mentioned in the description of FIG. 2 is
shown as at 52. Similarly, the dynamic braking voltage is supplied
by means of the transformer and diode combination shown generally
as at 53 and the voltage is fed to the motor by means of lead 51
through the normally closed leaf switch 55, lead 56, switch contact
49 and lead 46. Since the operation of the circuit of FIG. 3 has
been described in general terms in connection with FIG. 2 and the
circuit operates in a straight forward fashion to provide the
control desired in accordance with this invention, it is not deemed
necessary to describe in detail here all the circuit elements of
the circuit diagram. It should be understood that other circuits
can be provided that will provide the equivalent function to that
of FIG. 3.
Turning now to the pressure supply mechanism 19, FIG. 4 shows in a
side elevation view the mechanism for providing an air pressure
supply to sack 11. The motor and cam discussed above in connection
with FIG. 2 is shown in FIG. 4 as 60 and 61 respectively. The
centerline of cam 61 is mounted on the output rotor of motor 60.
Motor 60 may be a variable speed or a constant speed motor with the
proviso that, either by a slow motor speed or by suitable reduction
gearing, the output rotor rotates desirably at approximately 30
revolutions per minute which is adequate to provide assistance for
a breathing rate of 20 complete cycles per minute. It is
understood, of course, that motor 60 may be set to the speed which
corresponds to the desired breathing rate.
Switch 45, described above, is shown mounted on the base of motor
60 so that cam follower 62 may control the movement of switch
contacts 49 and 50 according to the surface provided for cam 61.
The action of the cam, cam follower, leaf springs and control of
power has been described above with respect to the operation of the
control of FIG. 2.
Arm 63 is movably mounted by bolt 64 located eccentrically on cam
61. Arm 63 terminates in clevis 65 which is connected to one end of
rod 66. Rod 66 extends through two linear bushings 67 and 68 and is
connected at its other end to connector plate 69. Connector plate
69 is attached at the center of a circular plate 70. A bellows 71
is in position between circular plate 70 and a like circular plate
72. In turn, circular plate 72 is connected to an end support
member 73. The base of motor 60, bearings 67 and 68, and the end
support plate 73 are all supported from a base member 74. An
opening 75 is shown in dashed lines through circular plate 72 and
the support member 73 and communicates with pipe 76. The end of
hose 20 (see FIG. 1) is then fitted over the end of pipe 76.
In operation, as the motor rotates, arm 63 is moved in an
oscillating back and forth motion by its eccentric mounting to cam
61. The oscillating back and forth motion of arm 63 is translated
by clevis 65 to a straight back and forth motion of rod 66. As rod
66 moves back and forth, bellows 71 is compressed from or permitted
to return to its normal position, as the case may be, and the air
contained within bellows 71 is transmitted through hose 20 to sack
11 and back to bellows 71.
The mechanism of FIG. 4 for compressing bellows 71 is only one of
the many possible such mechanisms. For example, bellows 71 may be
rotated 90.degree. and moved up and down by the force of a rod
pressing near its mid-point on plate 69 with the rod being pivoted
at one end and moved at its other end by a crank and slider rotated
by motor 60. As another means, motor 60 and cam 61 may be mounted
to bear against plate 69 with bellows 71 being compressed and
released as a function of the surface of cam. It is even possible
for motor 60 and cam 61 to be positioned internally of bellows 71
with push and pull being exerted by arm 63 suitably attached to
plate 69. Still another means for moving bellows 71 is by a motor
with a centrally rotated helical screw which is advanced or
retracted by the direction of rotation of the motor. The advance of
the screw bearing against plate 69 compresses the bellows and
retraction of the screw permits the bellows to assume its normal
position. In all these embodiments, suitable modifications would be
made to carry out the required electrical connection to and
operation of the motor control circuit and switches. Furthermore,
although perhaps not as feasible for the purposes of this invention
as a source of air pressure, bellows 71 and its associated
mechanisms could be replaced by an air compressor and a valve
arrangement controlled by the signal from microphone 27. It is also
conceivable that the pressure to the abdomen and lower ribs could
be applied by a plate movable by electromotive force or other
mechanism.
As previously indicated, the motor rotor is set to rotate at
approximately 30 revolutions per minute because the breathing cycle
for inhalation and exhalation for persons with emphysema may be
faster than normal and as short a time period as 3 seconds. FIG. 5
shows a curve of pressure against time for the pressure created by
the pressure supply mechanism. According to the curve, pressure
builds up gradually from zero to a maximum, dwells momentarily and
then diminishes gain to zero. The maximum pressure coincides in the
exhalation phase with the need for greatest movement of the
person's diaphragm. Actually, during part of the motor rotation
cycle, a negative pressure is created which assists in pulling air
from sack 11.
Described briefly in its entirety, the person with a lung problem
positions the sack around his abdomen and lower ribs and places the
microphone support mechanism around his head so that the microphone
is adjacent his mouth and nostrils. Upon exhalation, the microphone
senses impingement of the wearer's breath at the beginning of
exhalation and sends a signal to the control mechanism. The signal
is amplified and used to trigger selective operation of switches
which permit current to flow to and rotate an electric motor. A
suitable mechanism translates the rotation of the motor to cause
compression of a flexible air supply reservoir. Upon compression,
air is transferred to the sack and belt around the wearer. The sack
inflates and causes pressure against the abdomen and lower rib
portion and, by compression thereof, assists the wearer in exhaling
air from his lungs. The rotation time of the motor is approximately
2 seconds and during and at the end of each rotation cycle the
switches are reset and the control mechanism is conditioned for the
next signal from the microphone.
In experiments with victims of emphysema a marked degree of
improvement in arterial oxygen, that is, reduction in arterial
carbon dioxide, is found on use of the breathing assist apparatus
of this invention. In measurements made with an intraesophageal
balloon in patients wearing the breathing assistor, the results
indicate sufficient pressure increases within the chest to assist
in expelling respired gas. Three patients were tested two normal
subjects and one with emphysema. The average increase in
end-expiratory intrathoracic pressure produced by the device was
approximately 5 cm. H.sub.2 0. Measurements were then made of the
change in gaseous content of arterial blood produced by application
of the breathing assistor to two emphysema patients. These
measurements indicated a reduction in partial pressure of CO.sub.2
and an increase in partial pressure of O.sub.2. Also one of these
patients showed a change in arterial blood pH from 7.32 to 7.45
after only 10 minutes of use of the breathing assistor. All of
these responses indicate a significant change toward more normal
values. No impediments to breathing were noticeable by the wearers
and no health hazard, safety hazard or undue pressure was noted in
any of the tests conducted over extensive periods thereby
indicating suitability of the apparatus for the purpose
intended.
A preferred embodiment of the apparatus has been described above.
It should be noted that many variations and deviations in equipment
are possible without departing from the scope of the invention. For
example, various kinds of transducers have been mentioned above for
use in place of microphone 27. As other examples, a variety of
materials, arrangements and mechanisms have been mentioned as
suitable for providing the pressure upon a person's abdomen and
lower ribs. Thus, the invention hereof is suitable for being
accomplished by a number of means and embodiments without departing
from the scope of the invention as defined in the claims below.
* * * * *