U.S. patent number 3,683,913 [Application Number 05/078,129] was granted by the patent office on 1972-08-15 for underwater drainage apparatus with air flow meters.
This patent grant is currently assigned to Deknatel Inc.. Invention is credited to Robert Bidwell, Edward Hallstein, Leonard Kurtz, Sidney Mishkin.
United States Patent |
3,683,913 |
Kurtz , et al. |
August 15, 1972 |
UNDERWATER DRAINAGE APPARATUS WITH AIR FLOW METERS
Abstract
An underwater drainage apparatus is provided for evacuating
fluids from body cavities and comprises an integrally formed
collection chamber, underwater seal chamber and a pressure
regulating manometer chamber. Air flow meters are provided in the
underwater seal chamber and the pressure regulating chamber for
measuring the flow of gasses there through. A valve is provided
between the underwater seal and the collection chamber to permit
high negative pressures to be developed in the pleural cavity when
required by the patient.
Inventors: |
Kurtz; Leonard (Woodmere,
NY), Bidwell; Robert (Melville, NY), Mishkin; Sidney
(Great Neck, NY), Hallstein; Edward (Smithtown, NY) |
Assignee: |
Deknatel Inc. (Queens Village,
Long Island, NY)
|
Family
ID: |
22142085 |
Appl.
No.: |
05/078,129 |
Filed: |
October 5, 1970 |
Current U.S.
Class: |
604/321 |
Current CPC
Class: |
A61M
1/61 (20210501) |
Current International
Class: |
A61M
1/00 (20060101); A61m 001/00 () |
Field of
Search: |
;128/276-278,295 |
References Cited
[Referenced By]
U.S. Patent Documents
|
|
|
3279467 |
October 1966 |
Hofstra et al. |
3363626 |
January 1968 |
Bidwell et al. |
3363627 |
January 1968 |
Bidwell et al. |
3429313 |
February 1969 |
Romanelli |
3559647 |
February 1971 |
Bidwell et al. |
|
Primary Examiner: Rosenbaum; Charles F.
Parent Case Text
FIELD OF THE INVENTION
This invention relates to underwater drainage apparatus of the type
disclosed in our prior U.S. Pat. Nos. 3,363,626 and 3,363,627 and
in patent application Ser. No. 734,645 filed June 5, 1968, now U.S.
Pat. No. 3,559,647 issued Feb. 2, 1971, the present invention being
a continuation-in-part of the aforesaid prior patent application.
Claims
We claim:
1. In a drainage device for draining fluids from a cavity
comprising an inlet opening adapted to be placed in communication
with the cavity to be drained, a collection chamber in fluid
communication with the inlet opening, a seal chamber having first
and second columns in fluid communication with each other at the
lower ends thereof, the upper end of the first column being in
fluid communication with the collection chamber, the upper end of
the second column being in fluid communication with a preselected
fluid pressure level, said chamber adapted to receive a body of
liquid within the first and second columns, and air flow measuring
means disposed in said seal chamber, said air flow measuring means
including a series of independent gas passageways and a common duct
extending beneath said passageways, the gas passageway at one end
of said measuring means being disposed immediately above and in the
path of fluid flow from the connection of said first column to said
second column and said common duct extending angularly downwardly
across said second column.
2. In a drainage device according to claim 1 wherein each of said
independent gas passageways of said air flow measuring means
includes a plenum chamber disposed adjacent said common duct and an
aperture of a diameter less than said plenum chamber at the upper
end of said plenum chamber providing communication between said
plenum chamber and said second column.
3. In a drainage device according to claim 2 wherein the apertures
of said independent gas passageways are of varying diameter.
4. In a drainage device according to claim 3 and further including
walls extending upwardly between said apertures forming separate
passages in said second column for each of said independent gas
passageways.
5. In a drainage device according to claim 4 wherein said column
duct extends angularly downwardly across said second column at an
angle to the horizontal of between 7.degree. and 13.degree..
6. In a drainage device for draining fluids from a cavity
comprising an inlet opening adapted to be placed in fluid
communication with the cavity to be drained, a vacuum opening
adapted to be placed in fluid communication with a vacuum source
and with the inlet opening for drawing fluid from the cavity into
the device, a manometer for regulating the vacuum, said mano-meter
comprising first and second columns in fluid communication with
each other, said manometer adapted to receive a body of liquid
within the first and second columns, the first column being exposed
to atmosphere and the second column being exposed to the vacuum
source, and air flow measuring means disposed in said manometer for
measuring the air flow from said first column into said second
column, said air flow measuring means including a series of
independent gas passageways and a common duct extending beneath
said passageways, the gas passageway at one end of said measuring
means being disposed immediately above and in the path of fluid
flow from the connection of said first column to said second column
and said common duct extending angularly downwardly across said
second column.
7. In a drainage device according to claim 6 wherein each of said
independent gas passageways of said air flow measuring means
includes a plenum chamber disposed adjacent said common duct and an
aperture of a diameter less than said plenum chamber at the upper
end of said plenum chamber providing communication between said
plenum chamber and said second column.
8. In a drainage device according to claim 7 wherein the apertures
of said independent gas passageways are of varying diameters.
9. In a drainage device according to claim 8 and further including
walls extending upwardly between said apertures forming separate
passages in said second column for each of said independent gas
passageways.
10. In a drainage device according to claim 9 wherein said common
duct extends angularly downwardly across said second column at an
angle to the horizontal of between 7.degree. and 13.degree..
11. In a drainage device for draining fluids from a cavity
comprising an inlet opening adapted to be placed in communication
with the cavity to be drained, a collection chamber in fluid
communication with the inlet opening, a seal chamber having first
and second columns in fluid communication with each other at the
lower ends thereof, the upper end of the first column being in
fluid communication with the collection chamber, the upper end of
the second column being in fluid communication with a preselected
fluid pressure level, said seal chamber adapted to receive a body
of liquid within the first and second columns, and valve means
disposed in said first column, said valve means closing the fluid
communication between said first column and the collection chamber
in response to a predetermined fluid pressure differential between
the cavity to be drained and the second column of the seal
chamber.
12. In a drainage device for draining fluids from a cavity
comprising an inlet opening adapted to be placed in communication
with the cavity to be drained, a collection chamber in fluid
communication with the inlet opening, a seal chamber having first
and second columns in fluid communication with each other at the
lower ends thereof, the upper end of the first column being in
fluid communication with the collection chamber, the upper end of
the second column being in fluid communication with a preselected
fluid pressure level, said seal chamber adapted to receive a body
of liquid within the first and second columns, and valve means
disposed in said first column, said valve means closing the fluid
communication between said first column and the collection chamber
in response to liquid rising in said first column from the seal
chamber to move said valve means upwardly.
13. In a drainage device according to claim 12 wherein said valve
means comprises a cylinder within a valve chamber having a
restricted aperture at the upper end thereof, said cylinder having
a weight sufficient to rest at the lower end of the valve chamber
and maintain said aperture open during normal operation of said
device and to float upwardly to close said aperture when the
pressure differential between the cavity and the second column is
sufficient to cause the liquid within the seal chamber to rise into
the valve chamber.
14. In a drainage device for draining fluids from a cavity
comprising an inlet opening adapted to be placed in communication
with the cavity to be drained, a collection chamber in fluid
communication with the inlet opening, a seal chamber having first
and second seal columns in fluid communication with each other at
the lower ends thereof, the upper end of the first seal column
being in fluid communication with the collection chamber, the upper
end of the second seal column being in fluid communication with a
preselected fluid pressure level, said seal chamber adapted to
receive a body of liquid within the first and second seal columns,
first air flow measuring means disposed in said seal chamber, said
air flow measuring means including a series of first independent
gas passageways and a first common duct extending beneath said
passageways, the gas passageway at one end of said measuring means
being disposed immediately above and in the path of fluid flow from
the connection of said first seal column to said second seal column
and said first common duct extending angularly downwardly across
said second seal column, a vacuum opening in said drainage device
adapted to be placed in fluid communication with a cacuum source
and with the inlet opening for drawing fluid from the cavity into
the device, a manometer for regulating the vacuum, said manometer
comprising first and second manometer columns in fluid
communication with each other, said manometer adapted to receive a
body of liquid within the first and second manometer columns, the
first manometer column being exposed to atmosphere and the second
manometer column being exposed to the vacuum source, and second air
flow measuring means disposed in said manometer for measuring the
air flow from said first manometer column into said second
manometer column, said second air flow measuring means including a
series of second independent gas passageways and a second common
duct extending beneath said passageways, the gas passageway at one
end of said measuring means being disposed immediately above and in
the path of fluid flow from the connection of said first manometer
column to said second manometer column and said second common duct
extending angularly downwardly across said second manometer
column.
15. In a drainage device for draining fluids from a cavity
comprising an inlet opening adapted to be placed in communication
with the cavity to be drained, a collection chamber in fluid
communication with the inlet opening, means forming a water seal
chamber in communication with said collection chamber, and air flow
measuring means for measuring the air flow from the collection
chamber through the water seal chamber, said air flow measuring
means including a series of independent gas passageways and a
common duct extending beneath said passageways, said common duct
extending angularly downwardly along the path of the air flow from
the collection chamber through the water seal chamber.
16. In a drainage device according to claim 15 wherein each of said
independent gas passageways of said air flow measuring means
includes a plenum chamber disposed adjacent said common duct and an
aperture of a diameter less than said plenum chamber at the upper
end of said plenum chamber.
17. In a drainage device for draining fluids from a cavity
comprising an inlet opening adapted to be placed in communication
with the cavity to be drained, a collection chamber in fluid
communication with the inlet opening, means forming a water seal
chamber in communication with said collection chamber, a pressure
regulator chamber in communication with the water seal chamber, and
air flow measuring means for measuring the air flow through the
pressure regulator chamber, said air flow measuring means including
a series of independent gas passageways and a common duct extending
beneath said passageways, said common duct extending angularly
downwardly along the path of the air flow through the pressure
regulator chamber.
18. In a drainage device according to claim 17 wherein each of said
independent gas passageways of said air flow measuring means
includes a plenum chamber disposed adjacent said common duct and an
aperture of a diameter less than said plenum chamber at the upper
end of said plenum chamber.
19. In a drainage device for draining fluids from a cavity
comprising an inlet opening adapted to be placed in communication
with the cavity to be drained, a collection chamber in fluid
communication with the inlet opening, a water seal chamber, a
passageway interconnecting the collection chamber and water seal
chamber, and valve means disposed in said passageway, said valve
means being normally open and closing said passageway when water
from said water seal chamber rises in said passageway.
20. In a drainage device for draining fluids from a cavity
comprising an inlet opening adapted to be placed in communication
with the cavity to be drained, a collection chamber in fluid
communication with the inlet opening, a water seal chamber, a
pressure regulator chamber, passageways interconnecting the
collection chamber and water seal chamber and interconnecting the
water seal chamber and pressure regulator chamber, a passageway to
atmosphere in the pressure regulator chamber, and valve means in
said passageway to atmosphere, said valve means being normally open
and closing said passageway in response to water rising in said
passageway from the pressure regulator chamber.
21. In a drainage device for draining fluids from a cavity
comprising an inlet opening adapted to be placed in communication
with the cavity to be drained, a collection chamber, a fluid
passageway in fluid communication with the inlet opening and the
collection chamber to receive fluids drained from the cavity and
means in said fluid passageway for preventing the flow of fluid
into the cavity during conditions of high negativity within the
cavity, said means comprising a chamber with a restricted aperture
at the upper end thereof and a valve within said chamber, liquid
seal means disposed in said device on the side of said valve away
from said cavity to prevent atmospheric pressure from reaching said
cavity, said valve having a weight sufficient to rest at the lower
end of the valve chamber and maintain said aperture open during
normal operation of said device and to float upwardly to close said
aperture when the pressure differential between the collection
chamber and the cavity is sufficient to cause liquid fluid to rise
within the passageway.
Description
BACKGROUND OF THE INVENTION
Prior U.S. Pat. Nos. 3,363,626 and 3,363,627, both issued Jan. 16,
1968 disclose and claim an underwater drainage apparatus which is
constructed as a one piece unitary device having a collection
chamber, underwater seal chamber and pressure regulating manometer
chamber. There is also provided an underwater seal saver which
prevents the loss of the underwater seal during conditions of high
negativity in the patient's pleural cavity. This device also
provides an indicator so that the physician can readily ascertain
whether such high negativity conditions occurred.
In prior application Ser. No. 734,645, now U.S. Pat. No. 3,559,647
issued Feb. 2, 1971, there is disclosed an improved underwater
drainage apparatus which incorporates all of the advantages of the
prior patents hereinbefore referred to and provides a unique
construction in the pressure regulator manometer to prevent the
loss of water due to bubbling through the manometer chamber. In
addition such prior patent provides air flow meters which measure
the flow rate of air through the pressure regulator monometer and
through the underwater seal.
Problems have arisen in the measurement of air flow through the
pressure regulator manometer and through the underwater seal
chamber with the air flow meters disclosed in U.S. Pat. 3,559,647
referred to herein above. Such air flow meters are provided with a
series of apertures and as air flow through the manometer or
underwater seal increases the air passes upwardly through
additional apertures. However, it has been found that the air flow
cannot always be regulated so that it flows through sequential
apertures as the flow increases. That is to say, the air bubbles
sometimes tend to pass down the passageway to an aperture intended
to measure a substantially greater air flow. Thus, it is difficult
at times to accurately measure the air flow with the meters so
constructed.
Another problem which has arisen in connection with the use of
underwater drainage apparatus is in providing means which will
permit the patient to develop high negativity in the pleural cavity
when such condition is necessary for the patient's breathing
efforts. That is to say, if there is a blockage in the patient's
bronchial tubes, the patient must make a strong respiratory effort
in order to expand the lungs and permit air to flow around this
blockage into the lung cavity. In doing this the rib cage is
expanded so as to produce a very high negativity in the pleural
cavity. However, prior types of underwater drainage apparatus will
defeat such respiratory efforts by permitting the air to be drawn
back into the pleural cavity from the drainage apparatus. Thus, it
has been found desirable to provide some means to prevent the
back-flow of gasses from the underwater drainage apparatus to the
pleural cavity during such conditions of high negativity so as to
permit the negative pressures to develop in the pleural cavity
necessary for an inspiratory effort.
SUMMARY OF THE INVENTION
The purpose of the present invention is to provide a new and
improved underwater drainage apparatus which overcomes the problems
referred to herein in the use of previous underwater drainage
apparatus.
According to the present invention there are provided air flow
meters in the underwater seal and in the pressure regulator
manometer, these meters being of an improved design to provide a
more accurate means of measuring air flow through the water seal
and through the pressure regulator manometer. This is achieved by
an air flow meter of unique design having a passageway which is
inclined downwardly from the point where the air enters the meter.
Disposed above the downwardly extending passageway is a series of
chambers having apertures therein to permit the passage of air
upwardly there through. The first chamber and aperture for passage
of air through the flow meter is located directly above the point
at which air enters the meter. Thus, the first air flow through the
meter will always pass through the first chamber and aperture of
the air flow meter. As the air flow increases the air bubbles must
pass along the downwardly extending passageway and as these bubbles
are constantly seeking to rise through the liquid they will pass
upwardly through the next chamber and aperture in the sequence of
passageways through the air flow meter. Means are provided in the
air flow meter for maintaining the bubbles in alignment with the
passageways which they pass through so that the number of
passageways through which gasses are passing can be readily
determined. In this manner the gas flow through the underwater seal
and through the pressure regulator manometer may be accurately
determined.
In the passageway interconnecting the collection chamber and the
underwater seal there is provided a cylinder valve which is
normally open to permit the passage of gasses from the pleural
cavity through the underwater seal. However, during conditions of
high negativity in the pleural cavity the water in the underwater
seal rises through this passageway and in so doing raises the
cylinder valve to close the passageway thus maintaining the high
negativity in the pleural cavity. The cylinder valve is so designed
that it will move to the closed position in response to hydraulic
pressure but will not be moved from its open position in response
to the passage of gasses through the passageway interconnecting the
collection chamber and the underwater seal nor will it close due to
differences in gas pressures within the passageway.
It is a primary object of the present invention to provide an
improved underwater drainage apparatus.
It is a further object of this invention to provide a drainage
apparatus in which air flow meters are provided which accurately
measure the passage of air through the pressure regulating
manometer and through the underwater seal.
It is still another object of the present invention to provide in
an underwater drainage apparatus a means for maintaining a high
negative pressure within the pleural cavity when such conditions
arise.
Other objects and many of the attendant advantages of the present
invention will become apparent from the detailed description that
follows with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
There follows a detailed description together with accompanying
drawings of a preferred embodiment of the invention. However, it is
to be understood that the invention in capable of numerous
modifications and variations apparent to those skilled in the art
within the spirit and scope of the invention.
In the drawings:
FIG. 1 is a sectional view through the center plane of an
underwater drainage apparatus constructed according to the present
invention.
FIG. 2 is a sectional view along the lines 2--2 of FIG. 1.
FIG. 3 is a perspective view of the valve and the casing for the
valve.
FIG. 4 is a sectional view along the lines 4--4 of FIG. 1.
FIG. 5 is a perspective view of the air flow meter.
FIG. 6 is a top plan view of the air flow meter shown in FIG.
5.
FIG. 7 is a sectional view along the lines 7--7 of FIG. 5.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring now to the drawings there is shown an improved drainage
apparatus 10 constructed in accordance with the present invention.
The apparatus may be formed from two separate sections, one section
being molded with all of the chambers and walls formed therein and
the other section being a flat sheet which is secured to the first
section along all walls. Alternatively, the apparatus could be
molded in two separate halves, the mold for each half being
identical with the halves joined together along the center
plane.
Referring now to FIG. 1 there is shown an improved underwater
drainage apparatus and having a collection or trap chamber 11, an
underwater seal chamber 12 comprising a first column 12a and a
second column 12b. There is also provided a pressure regulator
chamber 13 having a first column 13a and a second column formed in
two portions 13b and 13c. The apparatus is completely enclosed
except for an opening 14 from the collection chamber 11 which
opening is adapted to be connected to the pleural cavity of the
patient, an opening 15 adapted to be connected to a vacuum source
and an opening 16 which is open to atmosphere from the pressure
regulator chamber 13.
One feature of the present invention is the provision of a
pediatric collection compartment which is formed by a partition 20
in the main collection chamber 11. The angled upper end portion 20a
of the partition 20 reflects the liquid entering through opening 14
into the pediatric collection compartment 21. The compartment 21 is
of a relatively small cross section so that the amounts of liquid
collecting therein can be readily measured in increments of one
cubic centimeter. In a preferred embodiment of the invention this
compartment will hold 250 cubic centimeters after which additional
liquid will flow over the upper end portion 20a of the partition 20
into the adjacent chamber 22 and when chamber 22 is filled the
liquid will flow over the upper end of partition 23 into
compartment 24. As is more clearly shown in FIG. 2 the partitions
20 and 23 are formed by the walls of that portion of the unit in
which the chambers are formed being secured directly to the back
face of the flat member 25 forming the other portion of the
unit.
The underwater seal chamber 12 is formed with columns 12a and 12b,
these columns being separated by a partition element 26 which is
formed as shown in FIG. 2 by securing wall portion 26 directly to
the flat member 25.
At the upper end of column 12b there is provided an enlarged
reservoir 35 which has a recessed lower end portion 36. This
structure provides a water seal saver and tell tale as described in
our prior U.S. Pat. No. 3,363,627.
There is also provided at the upper end of column 12b a means for
preventing the water forming the underwater seal from rising in
column 12b. This means comprises a cylindrical check valve 37 the
structure of which is more clearly shown in FIG. 3. There is
provided a chamber 38 which is offset with respect to column 12b
and this chamber has a lower wall 39 and an upper wall 40 having an
aperture 41 therein. The edge 42 of the upper wall 40 and the side
edges 43 and 44 of chamber 38 are secured directly to the rear face
of member 25 so that only entry into chamber 38 is through column
12b and through aperture 41. Within chamber 38 there is provided a
cylindrical valve member 45 having a height slightly less than the
length of the chamber 38 as shown more clearly in FIG. 1. Normally
the valve 45 rests on the bottom 39 of chamber 38. However, during
conditions of high negativity within the patient's pleural cavity
such that liquid from the water seal rises in column 12b to pass
into chamber 38, valve 45 floats and rises within chamber 38 to
close off aperture 41, thus preventing the liquid from the water
seal from rising into chamber 35. In this manner the high negative
pressure which the patient has built up in the pleural cavity which
the patient may require in order to fully expand the lung is
permitted to be maintained. When the high negative pressure in the
pleural cavity is reduced, the water within chamber 38 returns to
the water seal at the lower end of column 12b, thus permitting the
valve 45 to return to its position on the bottom wall 39 and normal
operation of the device is resumed. It has been found that scoring
lines (not shown) across the upper surface of valve 45 prevents the
valve from sticking in the upper position closing off aperture
41.
At the lower end of column 12a of the underwater seal chamber 12
the cavity is enlarged as shown at 12c and within this enlarged
cavity there is provided an air flow meter 46. The air flow meter
measures the amount of air passing from the pleural cavity through
the opening 14 into the collection chamber 11 and downwardly
through column 12b and upwardly through column 12a to the vacuum
pump. The air flow meter provides means for accurately measuring
the quantity of air passing through the underwater seal and for
conveniently determining whether this air flow is increasing or
decreasing. This determination would be significant for diagnosing
a patient's condition suffering, for example, from a bronchopleural
fistula. The details of construction of the air flow meter are
shown in greater detail in FIG. 5 to 7 inclusive. The meter is
provided with a rear wall 47 and a front wall 48 having a common
duct or passageway 49 formed therein. Front wall 48 and rear wall
47 have an integral connecting portion 50 which forms the upper
wall of passageway 49. Connecting portion 50 has a series of
apertures 51a, 51b...51i and beneath each of these apertures there
is formed in portion 50 a separate and independent plenum chamber
52. The lower end of each plenum chamber connects with the common
passageway 49. Disposed above and separating each of the apertures
51a, 51b....51i is a partition member 53.
The air flow meter 46 is disposed within the underwater seal
chamber at the lower end thereof between the columns 12a and 12b
with the duct 49 extending at a slight angle to the horizontal. The
lower wall of duct 49 is cut away beneath the aperture 51i and its
plenum chamber 52 so that this passageway is disposed in the path
of flow and directly above passageway 12e forming the end of the
curved end portion of column 12b. Thus gasses passing downwardly
along column 12b will flow upwardly through passageway 12e into
plenum chamber 52 and its associated aperture 51i. By inclining the
passageway 49 as shown greater volumes of gasses will pass through
succeeding apertures in sequence. Thus, the air flow meter 46
provides a means for measuring the quantity of gasses passing from
the patient's pleural cavity. For example, aperture 51i measures a
volume of gas flow of from 0 to 2 liters per minute. Aperture 51h
measures a gas flow of from 2 to 4 liters per minute. The last
aperture 51a measures a gas flow in excess of 28 liters per
minute.
It has been found that the angle at which the air flow meter is
disposed within the underwater seal chamber is important for proper
operation of the meter. Angles of from 7.degree. to 13.degree. to
the horizontal have been found generally satisfactory with best
results being obtained where the duct 49 extends at an angle of
10.degree. with respect to the horizontal. It has also been found
that the dimensions of the apertures 51a, 51b...51i are critical
and these values have been empirically determined to be as
follows:
Underwater Seal Air Flow Meter
Aperture Size Volume (Inch) (measured liters per minute)
__________________________________________________________________________
51a .120 28- 51b .120 22-28 51c .120 16-22 51d .120 10-16 51e 0.63
8-10 51f 0.73 6-8 51g .073 4-6 51h .078 2-4 51i .070 0-2
__________________________________________________________________________
The partitions 53 provide a means for separating the bubbles
passing through each of the apertures so that the number of
passageways through which gas is passing can be readily
determined.
The pressure regulator manometer 13 is formed with a first column
13a having its upper end exposed to atmosphere and a second column
which comprises portions 13b and 13c. The upper ends of columns 13b
and 13c are connected via passageway 54 with the vacuum source
through opening 15. The purpose of portions 13b and 13c is to
confine the bubbles rising through the chamber to the portion 13b
so that liquid rising with the air bubbles will engage the baffle
55 which will serve to deflect the liquid downwardly into portion
13b or 13c after which the gas may continue its upward movement
through passageway 54 to the opening 15.
In practice, water will flow clockwise around the partition
separating column 13b and 13c forming "racetrack" like path of
water. Much of the water engaging the baffle 55 will flow into
portion 13c.
It can be seen that with the arrangement shown the portion 13c
provides a relatively calm body of liquid as compared with the
portion 13b which may be bubbling vigorously. Consequently, the
level of liquid in the second column of the pressure regulator
chamber 13 can be readily determined by noting the level of liquid
in portion 13c.
In the event that some liquid does flow upwardly past the baffle 55
it will be engaged by a second baffle 56.
At the lower end of the column 13b there is provided an air flow
meter 57. This air flow meter 57 is identical to the air flow meter
46 previously described except with respect to the size of the
apertures therein. The aperture 51i' is located directly above and
in the path of flow of the passageway 13e which is the end of the
lower upturned end portion of passageway 13a. The common duct in
the lower end portion of the air flow meter 57 is disposed at an
angle of from 7.degree. to 13.degree. to the horizontal with best
results being obtained at an angle of 10.degree.. The hole sizes
for the air flow meter are as follows:
Pressure Regulator Air Flow Meter
Aperture Size Volume (Inch) (measured liters per minute)
__________________________________________________________________________
51a' .147 38- 51b' .128 32-38 51c' .128 26-32 51d' .120 20-26 51e'
.120 16-20 51f' .093 12-16 51g' .101 8-12 51h' .101 4-8 51i' .116
0-4
__________________________________________________________________________
The basic operation of the apparatus 10 is similar to the basic
operation of the apparatus as described in prior U.S. Pat. Nos.
3,363,626 and 3,363,627. The improvements described in the present
invention have not changed this basic operation. Rather, they have
been designed for the purpose of increasing the efficiency,
controllability and applicability of the present type of apparatus.
The effect that each of these individual features has on the basic
operation is believed to be clear from the preceeding description
of these structional elements. However, for purposes of
convenience, the operation of the invention will be briefly
summarized.
When the apparatus is to be used with a vacuum pump, an amount of
liquid is introduced into the pressure regulator chamber 13 through
opening 16 which will give the desired vacuum after the pump is
turned on. Because of the relative sizes of column 13a on the one
hand and 13b and 13c on the other hand, the water may be filled to
the level of the desired degree of vacuum as once the vacuum pump
is operated and column 13a evacuated, the water level will not
change significantly. The desired amount of liquid is introduced
through opening 15 into the underwater seal chamber and the opening
15 is then connected to the vacuum pump. Opening 14 is connected to
the pleural cavity of the patient and the vacuum pump is started.
The liquid is evacuated from column 13a and air bubbles through the
pressure regulator chamber 13b to maintain the vacuum within the
device at the water level set. Any liquid rising through the
pressure regulator chamber with the air bubbles will engage the
baffle 55 and fall downwardly into portion 13c. The liquid in the
underwater seal chamber will rise in column 12a and any air or
gasses within the pleural cavity will pass downwardly through
column 12b and through air flow meter 46.
Any fluid (gasses and liquids) coming from the patient's pleural
cavity enter the apparatus through opening 14. Liquids fall into
the collection chamber 11 and gasses pass through the underwater
seal column 12b and 12a. Initially liquids from the pleural cavity
fill the compartment 21 and subsequently overflow into compartment
22 and compartment 24.
When the pressures within the pleural cavity reach a very high
negativity as, for example, when the patient attempts to expand the
lungs but some blockage exists in the bronchial passages, the
pressures within the collection chamber 11 may be reduced below the
pressure within the column 12a. Consequent1y, the liquid in seal
chamber 12 will rise rapidly in column 12b. As described in prior
U.S. Pat. No. 3,363,627 the water seal saver chamber 35 prevents
this liquid from passing into the collection chamber 11. However,
in accordance with a further feature of this invention the valve 37
operates to close off the passageway from collection chamber 11 to
column 12b and thus permits the patient to maintain the high
negative pressure within his pleural cavity which is necessary to
expand the lungs.
When normal breathing is resumed the valve 37 will return to its
open position and permit communication between the chamber 11 and
column 12b and the water within the water seal saver chamber 35
will pass downwardly into the underwater seal except for a small
portion within the depressed part 36 which will remain to indicate
to the attending physician that such a condition of high negativity
has existed.
The air flow meters 46 and 57 give a clear indication of the degree
of gasses passing through the underwater seal and pressure
regulator chamber respectively. If gas is passing through all of
the apertures in the air flow meter 46 and no air flow is indicated
in the meter 57, the physician is aware that the leakage in the
patient's pleural cavity is completely overcoming the pump and than
an emergency condition exists. The physician can determine
improvement in the patient by noting decreased gas flow through
meter 46 from day to day and the particular air flow meter provided
according to the present invention gives an exceedingly accurate
measurement of such gas flow.
If desired, a valve and housing structure similar to valve 37 could
be located within column 13a. This valve would normally be open to
permit passage of air downwardly through passageway 13a. However,
when very high positive pressure develops in the patient's pleural
cavity caused, for example, by a coughing spell, the water in the
pressure regulator manometer rises in column 13a to close the
valve. Otherwise the water in the pressure regulator manometer
would pass outwardly through opening 16.
It is possible to use the air flow meters 46 and 57 and/or the
valve 37 in connection with conventional one, two or three bottle
systems. The air flow meter and a check valve similar to valve 37
may be made as separate units and installed in the tubing
connecting conventional bottle systems. For example, in a single
bottle system a check valve similar to valve 37 may be inserted
between the patient and the collection chamber. This would permit
flow of fluid from the patient to the collection chamber but the
valve would close upon the development of high negativity in the
pleural cavity to prevent the return of fluids to the pleural
cavity. In a two bottle system the check valve could be installed
between the collection chamber and water seal bottle to prevent
loss of the water seal during periods of high negativity. Similarly
an air flow meter similar to meter 46 could be mounted in fluid in
or adjacent to the water seal to measure gas flow from the pleural
cavity.
Although the invention has been described in considerable detail in
respect to a preferred embodiment thereof, it should be apparent
that the invention is capable of numerous modifications and
variations which are readily apparent to those skilled in the art
without departing from the spirit or scope of the invention as
defined in the appended claims.
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