U.S. patent number 3,861,385 [Application Number 05/389,233] was granted by the patent office on 1975-01-21 for anaesthetist's ventilation.
Invention is credited to Edward Carden.
United States Patent |
3,861,385 |
Carden |
January 21, 1975 |
ANAESTHETIST'S VENTILATION
Abstract
An anaesthetist's ventilator includes a cylinder adapted for
connection to a respiratory tube connected to an Ayres T-piece and
a face mask or endotrachael tube with a gas supply being connected
thereto, the cylinder having a vent connecting to atmosphere, a gas
flow control valve reciprocable within the cylinder, drive means
for reciprocating the valve between end valving positions
positionally adjusting the valve in a stepless manner for varying
the ratio of the periods of inspiration and expiration with the
vent being fully open in one of the end valving positions for the
passage of gas from the supply and expired air from the respiratory
tube outwardly of the ventilator and with the vent being fully
closed in the other of the end valving positions for the passage of
gas from the supply to the patient, and adjustment means for
adjusting the positioning of the valve.
Inventors: |
Carden; Edward (Heaton Mersey,
Stockport, Cheshire, EN) |
Family
ID: |
10410564 |
Appl.
No.: |
05/389,233 |
Filed: |
August 17, 1973 |
Foreign Application Priority Data
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Aug 25, 1972 [GB] |
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39621/72 |
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Current U.S.
Class: |
128/205.23;
128/205.24 |
Current CPC
Class: |
A61M
16/00 (20130101); A61M 16/0012 (20140204); A61M
2016/003 (20130101) |
Current International
Class: |
A61M
16/00 (20060101); A61m 016/00 () |
Field of
Search: |
;128/145.8,145.5,142,142.3,14R,188,146.5,146.4 ;137/82,608 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Recla; Henry J.
Attorney, Agent or Firm: Ross, Ross & Flavin
Claims
I claim:
1. An anaesthetist's ventilator comprising: a face mask for
application to a patient,
a T-piece connected to the face mask,
a gas supply means connected to the T-piece for continuous gas
supply to the face mask,
a cylinder,
means connecting the cylinder to the T-piece for the continuous
supply of gas to the cylinder,
vent means in the cylinder,
a piston alternatingly reciprocable in the cylinder between a
position of closing off the vent means for the preclusion of gas
escape therethrough and a position of opening the vent means for
the allowance of gas escape and a consequent drop in the pressure
of the gas supply to the face mask, and means for reciprocating the
piston.
2. An anaesthetist's ventilator comprising:
a face mask for application to a patient,
a T-piece connected to the face mask,
a gas supply means connected to the T-piece for continuous gas
supply to the face mask.
a cylinder,
means connecting the cylinder to the T-piece for the continuous
supply of gas to the cylinder,
vent means in the cylinder,
a piston reciprocable in the cylinder between a position of closing
off the vent means for the preclusion of gas escape therethrough
and a position of opening the vent means for the allowance of gas
escape and a consequent drop in the pressure of the gas supply to
the face mask,
means for reciprocating the piston, and adjustment means for
permitting variation of the ratio of the periods during which the
vent means is open and closed in each reciprocation of the
piston.
3. An anaesthetist's ventilator comprising:
a cylinder connected to a respiratory tube connected to a T-piece
adapted for connection to a face mask or endotracheal tube, a gas
supply connected to the T-piece,
a vent in the cylinder connecting the cylinder to atmosphere, a
piston reciprocable within the cylinder,
drive means for alternatingly reciprocating the piston between
opposite end positions in one of which the vent is open to permit
gas from the gas supply and expired air from the respiratory tube
to pass out of the ventilator and in the other of which the vent is
closed so that gas from the gas supply will increase the pressure
in the respiratory tube to pass to the patient, adjustment means
for permitting a variation of the ratio of the periods during which
the vent is closed and opened during each reciprocation of the
piston and during which inspiration and expiration ensues,
a base,
guideways attached to the base, a mounting plate slidably engaged
in the guideways,
the drive means being mounted on the mounting plate and being
displaceable parallel to the cylinder axis, said cylinder attached
to the base,
the adjustment means serving to adjust the position of the mounting
plate with respect to the guideways and thereby to adjust the end
positions of the piston and the opening and closing of the
vent.
4. The anaesthetist's ventilator claimed in claim 3 and further
including a visual indication means for delineating the setting of
the ventilator as determined by the position of the mounting
plate.
5. The anaesthetist's ventilator claimed in claim 4 with the
indication means including a pointer on a spindle carrying a
toothed wheel for engaging a toothed rack on the mounting plate.
Description
This invention concerns anaesthetist's ventilators, and has for its
object to provide a construction thereof which is particularly, but
not exclusively, suitable for use in paediatric anaesthesia in that
it passes small tidal volumes, which can be realised in a
relatively small and inexpensive form, which is efficient in
operation, which can be constructed so as not to require
electricity for its operation, and in which provision for varying
the ratio of the periods during which inspiration and expiration
take place can be made very simply and conveniently.
With this object in view, the present invention provides an
anaesthetist's ventilator comprising a cylinder adapted for
connection thereto of a respiratory tube connected to an Ayres
T-piece which in turn is adapted for connection to a face mask or
endotracheal tube and for a gas supply to be connected thereto,
said cylinder having one or more vents connecting its interior to
atmosphere, a piston being provided within the cylinder, and drive
means to reciprocate the piston between end positions in one of
which the vent is open to permit gas from the supply and expired
air from the respiratory tube to pass out of the ventilator, and in
the other of which the vent is closed so that gas from the supply
will increase the pressure in the respiratory tube, to pass to the
patient.
Preferably the drive means is in the form of a vacuum-powered
reciprocating motor.
Advantageously, the drive means is displaceable parallel to the
axis of the cylinder to vary the ratio of the periods during which
the vent is closed and is open during each reciprocation, thereby
to vary the ratio of the periods during which inspiration and
expiration will take place in each reciprocation.
In order that the invention may be fully understood, it will be
described further, by way of example, with reference to the
accompanying drawings, in which:
FIG. 1 is a perspective view, with various of the parts cut away,
of a preferred embodiment of the ventilator of the invention;
FIG. 2 is a detached sectional view showing certain of the parts of
the ventilator of FIG. 1 and showing, also, diagrammatically, the
ventilator connected to a face mask; and
FIG. 3 is a fragmentary perspective view of a part (which has been
omitted from FIG. 1) of the top of the ventilator of FIG. 1;
FIG. 4 is a schematic diagram showing how the ventilator of FIGS. 1
to 3 may be modified to provide for suction to be applied to a
patient's lungs during expiration; and
FIG. 5 is a view comparable with FIG. 4 but showing the ventilator
modified to provide positive end expiratory pressure.
The preferred embodiment of the anaesthetist's ventilator according
to the invention and illustrated in the drawings has a casing,
indicated generally by the numeral 10, comprising a pair of
parallel angle members 12, 14 extending between end plates 16, 18
formed with respective handles 20 and having secured thereto a
trough-like bottom part 22 and a complementary top cover 24.
Secured to the end plate 18, by bolts 25, so as to be disposed
adjacent to the angle member 12 is a cylinder assembly indicated
generally by the reference numeral 26, which is illustrated in
cross-section in FIG. 2 of the drawings. This cylinder assembly 26
comprises a tubular cylinder body 28 formed at one end with a taper
socket 30 which projects through a respective opening (not visible)
in the end plate 18 and serves to receive a spigot 32 provided on
one end of a respiratory tube 34 whereby the latter can be
connected to the interior 36 of the cylinder body 28. At its other
end, the respiratory tube 34 has connected thereto an Ayres T-piece
38 having a gas inlet 40 and connected in turn to a face mask
42.
As can be seen from FIG. 2, the tubular body 28 is located within a
housing 44 of the cylinder assembly, being sealed relative to the
latter by sealing rings 46.
Close to the socket end of the cylinder body 28 a port 48 is
provided through the wall of such body 28. This port 48 registers
with a corresponding port 50 through the housing 44 whereby the
interior 36 of the cylinder body 28 connects with a space 52
defined by a safety-valve mounting plate 54 sealingly secured to
the top of the housing 44. An orifice 56 in the plate 54 is fitted
with a safety valve indicated generally by the numeral 58 and
comprising a closure member 60 loaded by a spring 64 under a
pressure which is manually adjustable by means of a knob 66 which
protrudes through a respective opening in the top cover 24 of the
casing 10. For normal use such valve 58 will be set to open, so as
to connect the space 52 and the interior 36 of the cylinder body 28
with atmosphere, for example at a pressure of about thirty
centimetres of water and to close at a substantially lower
pressure.
A guage pipe 68 is secured through the plate 54 and this is
connected by way of a flexible tube 70 with a three-way cock 72.
This cock 72 has an arm 74 connected by way of a flexible tube 76
to a pressure gauge 78 mounted on a plate 80 secured by screws 82
and spacers 84 to the angle members 12, 14, as well as an arm 86
connected to a union, illustrated diagrammatically at 88, which
projects through a respective aperture in the end plate 18 and
which can be connected, if desired, to a pressure sensing arm (not
shown) connecting with the Ayres T-piece 38. The arrangement of the
cock 72 is such that in its three positions it provides
respectively (i) for the gauge 78 to be connected to the T-piece 38
by way of the union 86, to provide an indication of the pressure in
the lungs of a patient to whom the face mask 42 has been applied;
(ii) for the gauge 78 to be connected to the interior 36 of the
cylinder body 28 to provide an indication of the pressure therein;
and (iii) for the gauge 78 to be isolated from the gauge pipe 68
and the latter also to be blanked off from the union 88. A knob 90
of the cock 72, projecting through the top cover 24 of the casing
10 permits manual changing of the setting of the cock 72.
At a position about half way along the cylinder body 28 from the
end wherein the socket 30 is provided, a plurality of vent holes 92
are provided through the wall of the cylinder body 28, these holes
92 opening to an external circumferential groove 94 around the
body. A vent pipe 96 (see FIG. 1) secured into the housing 44
connects with the groove 94 and enables the latter to be connected,
if desired, to an exhauster or like device (not shown) for sucking
away unwanted gases.
The cylinder body 28 accommodates a piston 98 which is a close
sliding fit therein and which is connected to one end of a piston
rod 100 which extends axially out of the cylinder body 28 at its
end remote from the socket 30 and is slidingly guided in a bearing
block 102 fixed to the underside of a mounting plate 104 which is
located by its edges is slotted guideways 106 secured by respective
bolts 107 to the respective angle members 12 and 14.
Also mounted on the underside of the mounting plate 104 is a
vacuum-powered motor 108. This motor 108 is of the type commonly
employed on motor vehicles as a vacuum-operated windscreen wiper
motor and comprises a spindle 110 on which is fixed a radial arm
112 which reciprocates with a to-and-fro swinging movement when
vacuum is applied to the motor 108. The radial arm 112 projects
into a slot 114 in the piston rod 100 and is coupled thereto by
means of a pin 116 secured in the rod 100 to extend across the slot
114 and through a slot 118 in the radial arm 112. By this
arrangement, swinging movement of the radial arm 112 is translated
into reciprocating movement of the piston rod 100 and, of course,
of the piston 98 within the cylinder body 28.
The motor 108 is fixed to the mounting plate 104 by bolts 120, and
since the mounting plate 104 is located by its edges in the
guideways 106 which extend parallel to the axis of the cylinder
body 28, the motor 108 can be displaced relative to the casing 10
and relative to the cylinder body 28 in a direction parallel to the
axis of the cylinder body 28. This displacement can be effected by
means of an adjustment screw 122 carried in brackets 124 mounted on
a fixed carrier plate 126 disposed between the mounting plate 104
and the gauge 78, and secured to the angle members 12 and 14 by way
of screws 128 and spacers 130. This adjustment screw 122, which is
provided with a knurled knob 132 exposed through an opening in the
top cover 24 to enable it readily to be rotated manually, extends
through a threaded boss 134 fixed to the fixed carrier plate
126.
It will be appreciated that displacement of the mounting plate 104
and with it the motor 108 by means of the screw 122 results in
corresponding displacement of the piston rod 100 and of the piston
98. Accordingly, it serves to provide for a single adjustment of
the position, during each stroke of the piston 98, at which the
vent holes 92 are uncovered or covered. As a consequence, the
adjustment varies the relative periods, in each complete
reciprocation of the piston 98, during which the vent holes 92 are
closed and open. In a typical example, the arrangement will
normally be disposed so that the ratio of the closed periods
(corresponding to the patient inspiring, as will later be
described) to the open periods (corresponding to the patient
expiring) can be adjusted between 1:1 and 1:4. This ratio may, for
convenience, be regarded as the "inspiration/expiration ratio."
As has been shown in FIGS. 1 and 3, a rack 136 is provided on the
top surface of the mounting plate 104, and this rack 136 is engaged
by a toothed wheel 138 provided on a spindle 140 journalled in the
top cover 24, the wheel 138 being below the cover 24. Secured to
the spindle 140 above the cover 24 is a pointer 142 which
co-operates with a scale 144 marked on a transparent window member
146 secured to the top cover 24 so as to overlie and protect the
point 142. The scale 144 is calibrated to indicate
inspiration/expiration ratios, e.g., in the range 1:1 to 1:4 as
above explained, so that the pointer 142 gives an immediate reading
of the particular ratio at which the ventilator is set, according
to the position of the mounting plate 104 as adjusted by the screw
122. From FIG. 3 it will be appreciated that when the mounting
plate 104, motor 108 and piston 98 are displaced in a direction
towards the pressure gauge 78 the toothed wheel is rotated to swing
the pointer 142 across the scale 144, in an anti-clockwise
direction as viewed in the figure, and that return movement will
then swing the pointer 142 back in the clockwise direction.
A vacuum tube 148 from the vacuum-powered motor 108 connects, by
way for a coupling block 150 and a flexible tube 152, with a
vacuum-control valve 154 which, in turn, is connected to a vacuum
tube 156 provided with a nozzle 158 projecting through a respective
opening in the end plate 18 so as to be accessible for connection
to a vacuum service line (not shown).
In operation of the ventilator, the face mask 42 is applied over
the patient's face (not shown) so that the interior of the
respiratory tube 34 is coupled to the patient's respiratory system.
This is illustrated diagrammatically in FIG. 2 wherein the
patient's lungs have been represented at 160. As an alternative to
the mask 42, the Ayres T-piece 38 may be connected to an
endotracheal tube (not shown) by which the apparatus is connected
to the patient.
Compressed gas is supplied to the T-piece 38 by way of the gas
inlet 40 and the gauge 78 is used to measure the pressure developed
in the patient's lungs 160. Vacuum is applied to the motor 108 by
way of the vacuum tube 148 to cause reciprocating swinging movement
of the radial arm 112, the frequency of reciprocation being
adjusted, of course, by adjusting the vacuum control valve 154.
With available vacuum up to 300 mm. of mercury, a range of
frequency from 0 to about 80 reciprocations per minute will
generally be available using a commercially-available
windscreen-wiper motor as the motor 108.
When the radial arm 112 displaces the piston 98 inwards of the
cylinder body 28, before the piston 98 reaches the end of its
stroke it closes the vent holes 92. As a result, the incoming
compressed gas supplied through the gas inlet 40 to the T-piece 38
is applied to the patient's lungs 160 in an inspiration phase of
each cycle of operation of the ventilator, to cause inflation of
the lungs 160. In the return stroke of the piston 98 in the
opposite direction, the piston 98 clears the vent holes 92, thereby
opening the ports 48 and 50 and the gauge pipe 68, and the
patient's lungs 160, to the vent pipe 96. Accordingly the pressure
in the cylinder's interior 36 drops, the compressed gas supplied to
the T-piece 38 can escape through the vent type 92 to the vent pipe
96 and air is expired from the patient's lungs in an expiratory
phase of each cycle of operation of the ventilator.
As has already been mentioned, the inspiration/expiration ratio can
be adjusted by displacement of the motor 108 and piston rod 100 by
means of the screw 122. This ratio being known, and the compressed
gas flow to the T-piece 38 by way of the gas inlet 40 also being
known (e.g., from a rotameter, not shown, connected to the inlet 40
at an appropriate location) the volume of fresh gas supplied to the
patient per unit of time can readily be calculated. Thus, for
example, with a fresh gas flow of 6 litres per minute and an
inspiration/expiration ratio of 1:2, the patient receives 2 litres
per minute of fresh gas, since the inspiration phase of each cycle
occupies one third of each cycle. If the tidal volume (i.e., the
volume of fresh gas passing to the patient during each cycle of the
ventilator) is required to be known, it is only necessary to
ascertain the frequency of reciprocation of the radial arm 112 and
piston 98 (e.g., by counting the number of cycles occurring per
unit of time) and divide the gas volume passing to the patient by
this frequency.
The ventilator of the invention can be employed, if desired, where
negative phase ventilation and positive end expiratory pressure
ventilation are required to be performed, and FIGS. 4 and 5 of the
drawings, respectively illustrate, diagrammatically how this may be
achieved.
Referring to FIG. 4, use is made, in conjunction with the Ayres
T-piece 38, of a Venturi, indicated at 200. A gas supply tube 202
is connected firstly to the inlet 40 of the T-piece 38 by way of a
stop valve 204 and secondly to a jet 206 of the Venturi 200. With
the stop valve 204 open, this arrangement operates substantially in
the same way as the embodiment above described with reference to
FIGS. 1 to 3. When the valve 204 is closed, however, the flow of
gas from the jet 206 through the Venturi 200 during the expiratory
phase of each cycle (i.e., when the vent holes 92 are open) is such
as to induce a reduced or negative pressure in the patient's lungs
160, so that negative phase ventilation is achieved. In this
figure, the Ayres T-piece 38 is shown as having a pressure sensing
arm 208, this arm being adapted to be connected to the union 88 of
the ventilator.
In FIG. 5, substantially the same components are employed, but in
this case use is made of a Venturi 210 whose jet 212, instead of
being directed towards the cylinder assembly 26 in the system, is
directed towards the patient. This has the effect of assuring that
positive end expiratory pressure is achieved in the expiratory
phase of each cycle of operation of the ventilator.
Naturally, the invention is not confined to the precise details of
the foregoing examples which, as already mentioned, are only
diagrammatically illustrated in the drawings. It will be understood
that the ventilator can be constructed as a unit within a casing 10
of relatively small dimensions, with the gauge, valves, cock and
other components mounted so as to be readily accessible and the
scale 144 readily visible. Further, the unit can, if desired,
incorporate appropriate connections and shut-off valves to enable
it to be set up for use either as illustrated in FIGS. 1 to 3 or in
FIGS. 4 and 5, it being understood that in the latter case the
Venturi 200 or 210 will be provided as a plugin accessory which can
be incorporated or not as required.
* * * * *