U.S. patent number 3,759,249 [Application Number 05/173,190] was granted by the patent office on 1973-09-18 for respiratory analysis system and method.
Invention is credited to James C. Administrator of the National Aeronautics and Space Fletcher, Frederick F. Liu, N/A.
United States Patent |
3,759,249 |
Fletcher , et al. |
September 18, 1973 |
RESPIRATORY ANALYSIS SYSTEM AND METHOD
Abstract
A system for monitoring the respiratory process wherein the gas
flow rate and the frequency of respiration and expiration cycles
can be determined on a real time basis. A face mask is provided
with one-way inlet and outlet valves where the gas flow is through
independent flowmeters and through a mass spectrometer. The opening
and closing of a valve operates an electrical switch, and the
combination of the two switches produces a low frequency electrical
signal of the respiratory inhalation and exhalation cycles. During
the time a switch is operated, the corresponding flowmeter produces
electric pulses representative of the flow rate, the electrical
pulses being at a higher frequency than that of the breathing cycle
and combined with the low frequency signal. The high frequency
pulses are supplied to a conventional analyzer computer which also
receives temperature and pressure inputs and computes mass flow
rate and totalized mass flow of gas. From the mass spectrometer,
components of the gas are separately computed as to flow rate as
well. The electrical switches cause operation of up-down inputs of
a reversible counter. To measure a real time, a 1-minute clock
pulse is used to operate the counter. The occurrence of a pulse
alerts the counter, and the next succeeding reverse from down to up
in the breathing cycle causes an electrical sequence to occur in
which the counter is momentarily inhibited while the count therein
is transferred to a printer. The electrical sequence is complete
before the next up-to-down reverse in the breathing cycle occurs,
so that there is no loss in the counting of cycles. Thus, the
number of cycles closest to one-minute time are measured. The
respective up and down cycles can be individually monitored and
combined for various respiratory measurements. ORIGIN OF THE
INVENTION The invention described herein was made in the
performance of work under a NASA Contract and is subject to the
provisions of Section 305 of the National Aeronautics and Space Act
of 1958, Public Law 85-568 (72 Statute 435; 42 USC 2457). FIELD OF
THE INVENTION This invention relates to systems for quantitative
analysis of the human respiratory process. In particular, it
relates to methods and apparatus for obtaining an analysis of
respiratory gas flow rate and frequency of inspiration and
expiration cycles on a "real time" basis. DESCRIPTION OF PRIOR ART
Prior art devices presently known are as follows: 1. U.S. Pat. No.
3,368,212 discloses a gas flow monitor for respiratory supervision.
In this sytem, thermistors are employed in an electrical circuit
and used to monitor breathing. When gas flow fails, the thermistors
trigger an alarm circuit. 2. U.S. Pat. No. 3,201,988 and U.S. Pat.
No. 3,135,116 relate to turbine flowmeters to measure gas flow. 3.
Elastronics Laboratories of Tarzana, Calif. sell a Model FPAC-100
Transient Flowrate Indicator and Electronic Frequency to Period-to
Analog Computer used with flowmeters for accepting a pulse train
signal and acting on the period T of each cycle to compute the
inverse of the next time period e.sub.f = 1/T and hold the
information for the next cycle. 4. Elastronics Laboratories of
Tarzana, Calif. sell a Model PF/T500 Mass-Flow Computer and
Electronic Multiplier-Divider which computes mass flow rate and
totalized mass flow of any gas or liquid providing a digital or
analog output from an input frequency representing flow and analog
voltages representing temperature and pressure. SUMMARY OF THE
INVENTION The human respiratory process is perhaps unique in that
natural breathing varies in accordance with a person's
physiological and metabolic condition and, of course, varies with
physical conditions and activities. It is extremely important to
respiratory physiologists, inhalation toxicologists, doctors and
other biomedical workers to have a reliable analysis of the
respiratory process and, particularly, to have an automated
quantitative analysis of the respiratory process. The respiratory
process involves unrhythmic frequency in number of breaths per
minute and gas flow rate in volume per unit time. The frequency (or
periodicity) of breathing is a wave of alternating inspiration and
exhalation cycles. By use of special switches which are operable by
intake and outflow of gas, it is possible to obtain low frequency
signals of the breath cycles. As will hereinafter be more fully
explained, the breath cycles are correlated to "real time"
intervals. During the inhalation and exhalation cycle, the flow
rate is measured and quantalized as a pulse rate signal. The pulse
rate signal is superimposed onto the alternating low frequency
inspiration and expiration waveform. Thus, both flow and breathing
cycles are combined in a single data channel. In the present
invention, the breathing cycle, as a low frequency signal, is
separated between inspiration and exhalation portions, and each is
counted and processed to provide accurate respiratory measurements.
For example, the uptake rate can be computed by subtracting the
inspired flow quantity from the expired flow quantity during the
same period. This can be accomplished by an up-down counter. The
function of "up" or inspiration portions can be accumulated as can
the exhalation portions. Consecutive counting of "up" and "down"
portions of breathing cycles over a given period of time will give
the desired uptake or expiration quantities. The synchronization of
the respiratory process to time is accomplished by using a time
reference such as a clock which emits a pulse each minute. The
control system to which the consecutive up-down pulses are supplied
includes a counter for each parameter to be monitored. In an
up-down counter, for example, assuming the system is in operation,
the counter will count the up and down pulses. When the 1-minute
pulse is generated it alerts the counter, and on the next
succeeding "up" pulse the counter is momentarily inhibited while
the count on the memory therein is transferred to a printer. Upon
transfer, the inhibiting pulse is removed and the counter continues
counting the pulses until the next 1-minute pulse appears. As is
obvious, the respiratory system thus produces measurements related
to the 1-minute timing pulses. The switches are of a design which
generates an electrical signal at the instant inspiratory flow
begins and turns off this signal when expiration starts or vice
versa. In the respiratory measurement system, two valves are
mounted in the face mask. One valve is open only to let in the
fresh gas (air or oxygen) during the inspiratory period while the
other valve opens only to vent expiratory flow. The valve has a
diaphragm which is held closed by spring force and operated by a
pressure differential. The pressure differential thus serves to
open and close the valves. When the valve diaphragm is lifted from
its seat, a stem on the valve interrupts a light-beam between a
light source and a photoelectric cell. When this occurs, a negative
electric pulse is generated which serves as a signal representative
of the particular respiratory function.
Inventors: |
Fletcher; James C. Administrator of
the National Aeronautics and Space (N/A), N/A
(Northridge, CA), Liu; Frederick F. |
Family
ID: |
22630904 |
Appl.
No.: |
05/173,190 |
Filed: |
August 19, 1971 |
Current U.S.
Class: |
600/532;
73/861.04; 600/538 |
Current CPC
Class: |
A61B
5/087 (20130101); A61B 5/0816 (20130101) |
Current International
Class: |
A61B
5/087 (20060101); A61B 5/08 (20060101); A61b
005/08 () |
Field of
Search: |
;128/2.08,2.07,DIG.17
;73/194R,194E,194M,23R,195 ;324/35,36 ;340/239 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Howell; Kyle L.
Claims
What is claimed is:
1. Apparatus for monitoring the respiratory function
comprising:
respiratory means for receiving inhalation and exhalation gas flow,
said respiratory means having inhalation and exhalation valve means
respectively operative for opening in response to inhalation and
expiration, said respiratory means including means for developing
electrical signals representative of the respiratory functions;
first computing means connected to the output of the respiratory
means and also receiving signals indicative of absolute pressure
and temperatures for providing a signal indicative of mass flow
rate;
analyzing means determining the partial pressures of selected
respiratory gases;
summing means receiving the partial pressures from the analyzing
means and providing a signal representative of total pressure;
second computing means connected to the output of first computing
means, the signal of partial pressure of a selected gas and the
signal from the summing means to provide a signal representing mass
flow of selected respiratory gas; and
first counter means connected to the second computing means and
also receiving signals of inhalation and exhalation cycles to
produce a signal indicative of net difference of selected
respiratory gas.
2. The apparatus of claim 1 wherein there is a second counter means
connected to the first counter means;
timing means for controlling the second counter means by providing
timing signals, said timing signals defining a finite time
reference for the respiratory function;
means responsive to said timing signals for stopping the
measurement of the respiratory function and nearly simultaneously
reinitiating a new measurement of the next respiratory function;
and
means for transferring the counted data from said counter means to
a storage means without affecting the measurement then underway
thereby synchronizing the unrythmic respiratory phenomenon to a
finite timing means so that each measurement begins and ends at the
beginning of a respiratory function after the occurrence of the
timing signal from the timing means.
3. The apparatus of claim 2 including a free running, high
frequency clock to provide discrete time elements to the
measurement.
4. The apparatus of claim 2 and further including means operative
during the inhibition time period for printing the output of said
counter means.
5. The apparatus of claim 1 wherein said valve means includes a
flow passage and a pressure differential operated diaphragm in said
flow passage, and means responsive to movement of said diaphragm
for generating an electrical signal.
6. A method for monitoring the respiratory process wherein the gas
flow rate and the frequency of inhalation and exhalation cycles are
determined on a real time basis, said method comprising:
deriving alternating low frequency signals of the inhalation and
exhalation cycles;
measuring as pulse rate signals the flow rate during the inhalation
and exhalation cycles;
converting the pulse rate signals and frequency signals to up and
down signals representing inhalation and exhalation flow rate;
supplying the up and down signals to a continuous counter; and
providing to the counter a timing signal defining a finite time
which alerts the counter to be synchronized with the respiratory
function whereby upon the next transition of the respiratory cycle
the counter commences counting and continues to count until the
next similar transition of the respiratory cycle after the
succeeding timing signal at which time the counted data is
transferred while the count is continued.
7. The method specified in claim 6 wherein a free-running,
high-frequency clock signal is applied to the counted data.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
Reference to the drawings will further explain the invention
wherein like numerals refer to like parts, and in which:
FIG. 1 is a schematic and functional illustration of an overall
system including a mask and computers for obtaining flow rate and
frequency of breathing indications;
FIG. 2 is a schematic and functional illustration of a typical
counter system for counting respiration frequency in terms of real
time;
FIG. 3 is a functional representation of a valve aned switch for
obtaining signals indicative of the breathing functions; and
FIG. 4 is a timing diagram for illustrating a logic sequence for
obtaining typical measurements.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring now to FIG. 1, a system is illustrated for a
"physiological clock of respiration." The system includes a face
mask, schematically and generally indicated by the numeral 10. The
face mask 10 has an inlet or inspiratory valve 11 and an outlet or
expiratory valve 12. Valves 11 and 12 are one-way valves arranged
so that flow is into the mask 10 via valve 11 and out from the mask
10 via valve 12. Valves 11 and 12 are respectively coupled to
flowmeters 13 and 14 which, in turn, open into a mass spectrometer
15 with a flow conduit 16. Gas flow is into the mask 10 via conduit
16, spectrometer 15, flowmeter 13 and valve 11 and out of the mask
10 via valve 12, flowmeter 14, spectrometer 15 and conduit 16.
Valves 11 and 12 are normally closed and operated by virtue of
differential pressure caused by inhalation or exhalation of
gas.
Referring now to FIG. 3, a typical flow valve 17 includes upper and
lower plate members 18 and 19 which are spaced from one another by
circumferentially disposed spacers 20 and attached to one another
by fasteners 21. The lower plate 19 has a central alignment hub 22
which receives an alignment stub 23 attached to the center of a
diaphragm 24. About the hub 22 are perforations 26 so that gas may
flow through the perforations and between the plates. The diaphragm
24 is cylindrically formed and is constructed of a thin flexible
material such as rubber or plastic. The diaphragm has a peripheral
conically-shaped portion 25 arranged to make contact with the upper
surface of lower plate 19. The arrangement is such that the
diaphragm 24 has a spring force tending to hold it in contact with
the lower plate. Thus, if the valve is inserted into the face mask
with hub 22 facing in one direction, exhalation gas may flow
through the perforations 26 and between the plates 18 and 19. With
the valve facing in an opposite direction, inhalation gas similarly
is passed through the perforations 26 and between the plates 18 and
19.
In the upper plate 19 is a central cavity 27 containing a light
source system 28. Communication passages 29 from the light source
28 extend to cavities respectively containing photoelectric cells
31. Thus, the cells 31 can be activated by the light source 28. The
upper plate 18 has recesses 23 which traverse the communication
passages 29 and receive an upwardly extending extension 33 on the
diaphragm 24. In the normally closed position of the diaphragm, as
illustrated, openings (not shown) in the diaphragm permit light to
pass from the source 28 to a cell 31. When gas flow moves the
diaphragm 24, the openings in the extensions are transported from
registry with the light beam, and interruption of the light beam
deactivates the cell 31 to enable production of an electrical
signal.
Referring now to the system illustrated in FIG. 1, during
inhalation, valve 11 is open and valve 12 is closed. While valve 11
is open, the flowmeter 13 will produce an electrical signal having
a frequency dependent upon the inhalation flow rate. At the same
time, a normally open electrical switch 35 is closed by operation
of the valve 11 to provide a ground potential to set a flip-flop
36. Switch 35 corresponds to the light beam switch previously
described with respect to FIG. 3. When the flip-flop 36 is set, a
d.c. gating signal "A" conditions a NAND gate 37. The NAND gate 37
is also connected to the output of the flowmeter 13 so that the
signals from the flowmeter are passed to another NAND gate 38.
Thus, during inhalation the period of the switch operation defines
the inhalation cycle, and the flow rate is established by the
frequency of the flowmeter pulses during the period.
During exhalation, valve 12 is open and valve 11 is closed. While
valve 12 is open, the flowmeter 14 similarly will produce an
electrical signal having a frequency dependent upon the exhalation
flow rate. At the same time, a normally open electrical switch 40
is closed by operation of the valve 12 to provide a ground
potential to reset the flip-flop 36. When the flip-flop is reset, a
d.c. gating signal A conditions a NAND gate 41. The NAND gate 41 is
also connected to the output of flowmeter 14 so that the signals
from the flowmeter are passed to the NAND gate 38.
During the inhalation period, while the exhalation valve 12 is in
closed position, the corresponding electrical switch 40 is open.
Since the flip-flop 36 is in a "set" position and the NAND 41 is
connected to the other terminal of the flip-flop 36, signals from
flowmeter 14 cannot pass through the NAND 41. Thus, during the
inhalation period, the inhalation signal from the flowmeter 13 is
passed through NAND 37 and 38 to the computer. This condition
prevails unti the inhalation is complete and exhalation begins,
whereupon switch 35 is opened and switch 40 is closed. When switch
40 closes, the flip-flop 36 is "reset" which causes a d.c.
potential at terminal A to open the NAND gate 41, permitting the
flowmeter frequency signals to pass through NAND 41 and 38 to the
computer.
With the foregoing system the inhalation and exhalation flows are
readily segregated, and the breathing frequency or period can be
readily calculated. From the flow rate frequency, the total flow
volume for inhalation and exhalation can easily be determined.
Moreover, the frequency of breathing and flow rate are not
integrated into a single electrical signal system containing all of
the respiratory information, and this signal system can be
correlated with a timing factor.
The flow rate signal for inhalation or exhalation, or both, can be
re-separated, so that the flow rate can be computed with any and
all of its corresponding partial pressure signals from the mass
spectrometer 15.
In the operation of the system, the inhalation of gas produces a
train of electrical pulses which are a linear function of the
inhalation flow, and the exhalation of gas produces a train of
electrical pulses which are representative of the exhalation flow.
The successively occurring trains of pulses which represent total
flow are sent from the NAND circuit 38 to a conventional mass flow
computer 42. With the input of an absolute pressure signal P and an
absolute temperature signal T, the total volumetric flow rate as
determined from computer 42 can be applied simultaneously to one of
the input terminals of four or more computers 43-46. Each of the
computers 43-46 receives from the spectrometer 15 the percentage
concentration (or partial pressure in percent) of O.sub.2,
CO.sub.2, N.sub.2 or H.sub.2 O as its other input. The partial
percentages are also summed by a summing network 47 and applied as
an input to computers 43-46. As a result, the respiratory flow rate
caused by O.sub.2, CO.sub.2, etc., can be determined at any
time.
To compute the up-take rate of O.sub.2, or the release rate of
CO.sub.2, for example, the outputs of the computers 43-46 can be
re-separated. This is accomplished by coupling the inputs of "up"
and "down" NAND gates 48-55 to respective computers for determining
the status of the components. The up and down NAND gates,
respectively, are also coupled to the flip-flop 36 so that "A" and
"A" steering outputs are applied to the gates. Thus, computers
coupled to the up and down inputs can be used to provide an
indication of the breathing function of the separate components in
any detail desired.
Turning now to FIG. 2, the respective signals for up and down
signals are supplied to a circuit 56 which conveys the respective
signal to a reversible BCD counter 57 and to a gate circuit 58. The
gate circuit receives clock pulses which are spaced at 1-minute
intervals. Upon the occurrence of a one-minute clock pulse, the
counter 57 is set or alerted to be synchronized with the breathing
function. When the transition from "up" to "down" next occurs after
the 1-minute alert pulse, the signals applied to the gate actuate
it to inhibit the counter and actuate another gate 59. Gate 59 is
coupled to a high frequency clock 60 which applies a clocking pulse
to the memory that effects a transfer of the stopped count in the
counter 57 to the memory 61 and transfer of the count in the memory
by a transfer circuit 62 to a print system 63. The inhibit and
transfer function occur in less time than it takes to count a
single flowmeter output pulse so that no measurement function is
discontinued prior to the beginning of the count of "up" pulses by
the counter 57. Thereafter, the counter 57 accepts the "up" and
"down" pulses until the next 1-minute pulse to the gate 58 alerts
the counter so that the next "up" transition repeats the operation.
Thus, it will be apparent that the "up" and "down" counting is
governed by the number of complete breath cycles occurring relative
to a 1-minute timing cycle.
A timing diagram is illustrated in FIG. 4 which is more fully
illustrative of the technique. In FIG. 4, timing pulses 65 occur at
1-minute intervals. The operation of switches 35 and 40 of FIG. 1
produce the gating voltages A and A which operate the up and down
gates for the counters. The flow rate "in" and "out" is a high
frequency signal such as typically illustrated at 66 and 67. As
such, the higher frequency signals can be compressed with the
switch signals such as illustrated at 68. At the instant the
respiratory function changes function from exhalation to an
inhalation, the corresponding switch signal triggers a sync signal
69 to inhibit the counter. The sync signal 69 has a lesser period
than ordinarily expected for an inhalation period. Thus, during an
inhalation cycle, the counter is inhibited.
A free-running, high-frequency clock signal 70 is used to cause
generation of another sync signal (identified as 71) with the
generation of the next succeeding clock pulse 70. The sync pulse 71
and the next succeeding clock pulse 70 produces a memory pulse
which causes transfer gates to open and the counts from the counter
to be dumped into the printer memory. Another sync pulse 73 is
generated so that a clear counter pulse 74 can reset the counters.
A print sequence pulse 75 is generated simultaneously with the sync
pulse 71.
One of the advantages of the present invention is that numerous
measurements can be accomplished accurately on a strict 1-minute,
half-minute, breath-by-breath or other period basis. The common
measurement of breath is the so-called T.sub.M mode, where T.sub.M
is the period of time required to encompass a series of complete
breath functions measured from a starting point on the breath
waveform to a corresponding point after a time of approximately 1
minute. Thus it will be readily apparent that the counting function
of the foregoing described function of the foregoing described
system is regulated by the 1-minute pulses, and the T.sub.M is
governed precisely by the breath arrivals.
Further modifications and alternative embodiments will be apparent
to those skilled in the art in view of this description, and,
accordingly, the foregoing specification is considered to be
illustrative only.
* * * * *