U.S. patent number 3,923,056 [Application Number 05/480,799] was granted by the patent office on 1975-12-02 for compliance compensation for electronically controlled volume respirator systems.
This patent grant is currently assigned to General Electric Company. Invention is credited to Richard Bingmann, Frank J. Desiderio, Donald O'Neal Edwards.
United States Patent |
3,923,056 |
Bingmann , et al. |
December 2, 1975 |
Compliance compensation for electronically controlled volume
respirator systems
Abstract
A volume-cycled respirator for delivering a prescribed volume of
gas to a patient utilizing pressure responsive apparatus to monitor
the gas pressure developed at the patient interface. The apparatus
produces a signal proportional to gas pressure and includes a
variable gain amplifier to proportion the signal to volume. The
signal is then used to compensate a volume cycled control signal
for the volume of gas required to fill the interconnecting hoses
and equipment between the volume measuring apparatus and the
patient interface to assure that the prescribed volume of gas is
delivered to the patient.
Inventors: |
Bingmann; Richard (Audobon,
PA), Desiderio; Frank J. (West Chester, PA), Edwards;
Donald O'Neal (Philadelphia, PA) |
Assignee: |
General Electric Company (New
York, NY)
|
Family
ID: |
23909412 |
Appl.
No.: |
05/480,799 |
Filed: |
June 19, 1974 |
Current U.S.
Class: |
128/204.21 |
Current CPC
Class: |
A61M
16/024 (20170801); A61M 2016/0039 (20130101) |
Current International
Class: |
A61M
16/00 (20060101); A61M 016/00 () |
Field of
Search: |
;128/145.8,145.5,145.6,145.7,DIG.17 ;73/194F |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Michell; Robert W.
Assistant Examiner: Cohen; Lee S.
Government Interests
The invention herein described was made under a contract with the
Department of the Navy, Office of Naval Research.
Claims
What is new and desired to be secured by Letters Patent of the
United States is:
1. In a respirator including
an interconnecting hose assembly adapted to be connected to a
patient and connected to an inhalation passageway and to an
exhalation passageway and further including a pressurized gas
source connected to said inhalation passageway and a flow control
valve and flow rate sensor connected in said inhalation passageway
intermediate said source and said interconnecting hose, a flow
control valve in said exhalation passageway and control means
responsive to said flow rate sensor to control operation of said
flow control valves, the improvement comprising:
pressure responsive means connected to said interconnecting hose
assembly for developing a first signal representative of a gas
pressure in said interconnecting hose assembly, means for supplying
said first signal to said control means for modifying the operation
of said control means in proportion to gas pressure in said
interconnecting hose assembly; and
an integrating circuit means connected to said flow rate sensor for
developing a second signal proportional to a volume of gas passing
through said flow sensor, means for supplying said second signal to
said control means for controlling the operation of said control
means in response to said volume of gas flowing through said flow
sensor, wherein said control means responds to said second signal
by controlling the operation of said flow control valves.
2. The apparatus as defined in claim 1 wherein said pressure
responsive means includes:
a pressure transducer connected to said interconnecting hose
assembly for producing said first signal representative of said gas
pressure in said hose assembly;
differential amplifier means for combining said first signal with
said second signal representative of said volume of gas flowing
into said hose assembly to produce a third signal representative of
a difference therebetween; and
means for comparing said third signal to a voltage proportional to
said prescribed volume of gas for controlling said flow control
valves.
3. The apparatus as defined in claim 2 and including a variable
gain amplifier connected intermediate said pressure transducer and
said differential amplifier means for adjusting the amplitude of
said first signal to proportion said first signal to a volume
signal.
Description
BACKGROUND OF THE INVENTION
The present invention relates to respirators and, more
particularly, to a control system for a fixed volume delivery
respirator.
Forced breathing respirators are generally either of a type for
providing a breathable gas to a patient at a prescribed pressure or
of a type for providing a prescribed volume of breathable gas to a
patient. These types of respirators are referred to respectively as
pressure-cycled and volume-cycled. A third type of respirator is a
time-cycled respirator in which breathable gas is made available to
a patient at timed intervals. Of the foregoing three types, the
volume-cycled is preferable for long-term patient ventilation since
physiological changes in a patient require frequent adjustment of
the pressure-cycled and time-cycled types of respirators.
Volume cycling is advantageous because a predetermined volume of
gas is delivered to a patient regardless of any change in
compliance of the patient. However, any change in compliance of the
interconnecting hoses and equipment between the patient and the gas
supply will result in a change in the volume of gas delivered to
the patient. Since compliance with respect to the interconnecting
hoses is defined as the change in the volume of gas in the hoses
with respect to the change in pressure across the hoses, it can be
seen that the volume of gas required to fill the hoses will vary
with temperature and pressure thus resulting in a change in
compliance. Even with a constant temperature, the volume of gas
required to fill the hoses will vary as patient resistance varies
and will change the amount of gas which is actually delivered to
the patient. Obviously as the hose length increases the change in
the volume of gas delivered to the patient increases and such
change may reach a point where the patient's life is threatened by
the change, particularly where the change is such as to
significantly reduce the volume of gas delivered.
Accordingly, it is an object of the present invention to provide a
volume-cycled respirator control system which can be calibrated to
deliver a desired volume of breathable gas to a patient.
It is a further object of the present invention to provide a
volume-cycled respirator control system which automatically
compensates for changes in compliance of interconnecting hoses and
equipment.
It is another object of the present invention to provide a
volume-cycled respirator control system which automatically adjusts
the volume of gas applied to the interconnecting hoses and
equipment to assure that the desired volume of gas is delivered to
the patient.
SUMMARY OF THE INVENTION
In accordance with the present invention, a volume-cycled
respirator of the type including a gas source, an inhale valve, a
flow sensor and interconnecting hoses and further including control
apparatus responsive to the flow sensor for controlling the inhale
valve, is provided with pressure responsive apparatus connected to
monitor the gas pressure developed at the patient interface. The
pressure responsive apparatus is conected to adjust the control
apparatus to correct for changes in pressure such that the desired
volume of gas is delivered to the patient. The pressure responsive
apparatus includes a calibrating adjustment which allows initial
calibration of the volume-cycled controlled apparatus to compensate
for the volume of gas required to fill the interconnecting hoses
and equipment.
BRIEF DESCRIPTION OF THE DRAWING
For a better understanding of the invention, reference may be had
to FIG. 1 of the accompanying drawing showing a block diagram of a
volume-cycled respirator control system incorporating a pressure
responsive apparatus in accordance with the present invention.
DETAILED DESCRIPTION
Referring now to the drawing, there is shown a simplified
representation of an electronically controlled volume-cycled
respirator in which those elements not essential to an
understanding of the present invention have been omitted. The
respirator includes a pressurized source 10 for supplying a
breathable gas through a passageway 11 to an inhale valve 12 and
from inhale valve 12 through a passageway 13 to a flow sensor 14.
From flow sensor 14, which provides a signal representative of the
gas flow therethrough, the gas passes through a flexible
interconnecting hose 15 to a patient indicated generally at 16. As
is shown, interconnecting hose 15 is formed generally in a Y
configuration with one arm of the Y connected to receive a gas from
flow sensor 14 during an inhalation phase and the other arm of the
Y connected to expel air through an exhale valve 17 to atmosphere
during an exhalation phase. Check valves may be incorporated in
both the inhale and exhale portions of the respirator, and other
controls such as, e.g., pattern or flow rate controls may also be
incorporated in the inhalation passageway of the respirator
intermediate the gas source and the patient, all of the thus far
mentioned elements being well known in the art.
In order to control the opening and closing of the inhale and
exhale valves 12 and 17, respectively, to thereby provide a
prescribed volume of gas to the patient 16, there is provided a
control system connected to respond to an electrical signal from
flow sensor 14, which signal is representative of the mass flow of
gas per unit time passing through flow sensor 14, for controlling
the operation of inhale and exhale valves 12 and 17. The signal
from flow sensor 14 is directed into a linearizer 18 of a type well
known in the art which converts the signal from flow sensor 14 to a
voltage signal proportional to flow rate. The voltage signal or
flow rate signal from linearizer 18 is supplied to an integrator 19
also of a type well known in the art which integrates the flow rate
signal. Since the integral of flow rate is a volume equivalent, the
amplitude of the output signal developed by flow integrator 19 is
proportional to the volume of gas which has passed through flow
sensor 14. In the prior art systems, the signal from a flow
integrator such as flow integrator 19 would be compared to a volume
set signal and when the two were equal would be utilized to close
off an inhale valve and open an exhale valve on the assumption that
the volume of air flowing through the flow sensor represented a
constant volume of air being delivered to the patient under all
given sets of temperature, pressure, and patient resistance.
In the present invention the output signal from flow integrator 19
is combined with a signal generated by a pressure responsive
circuit to produce a resultant signal which is proportional to the
actual amount of gas delivered to the patient. The pressure
responsive circuit comprises a pressure transducer 20 and a
pressure amplifier 21. Pressure transducer 20 is connected to
monitor the gas pressure in interconnecting hose 15 and to provide
an output signal to amplifier 21 which signal is proportional to
the pressure of the gas in hose 15. Amplifier 21 includes a gain
adjust 22 which provides calibration adjustment. Since hose 15 is
of a semi-rigid quality and is not conducive to stretch, its
geometric volume, i.e., length of hose multiplied by
cross-sectional area, is substantially constant. Under such
conditions and considering the small pressure range over which a
gas is supplied to a patient, the well-known relationship of
pressure being equal to a constant times volume is applicable.
Therefore, a measurement of pressure in hose 15 will yield a signal
directly proportional to the volume of gas in the hose.
The output signal developed by amplifier 21 is applied to a first
input terminal of a differential amplifier 23 which differential
amplifier also includes a second input terminal connected to
receive the output signal from flow integrator 19. The output
signal from differential amplifier 23 is applied to a first input
terminal of a threshold detector 24. A second input terminal of
threshold detector 24 is connected to receive a voltage from a
volume set control 25 which voltage is proportional to the desired
volume of gas to be supplied to patient 16. Threshold detector 24
is connected to supply control signals to inhale valve 12 and
exhale valve 17 for controlling respectively the inhalation and
exhalation phases of the respiration cycle of patient 16.
In operation, the system is initially calibrated by energizing
source 10 and setting control 25 to cause threshold detector 24 to
provide a signal to open inhale valve 12 and close exhale valve 17
such that a flow of gas is supplied to interconnecting hose 15. At
this time the end of hose 15 which would normally be connected to a
patient is blocked off, e.g., by placing one's hand over the end of
the hose, and hose 15 is allowed to be pressurized to the full
pressure of source 10. The amplified signal from flow sensor 14 as
integrated by integrator 19 will represent the amount of gas
necessary to fill the volume of interconnecting hose 15. Likewise,
the output signal from pressure transducer 20 as amplified by
pressure amplifier 21 will represent the pressure of the gas and
thus be proportional to the volume of the gas in hose 15. These two
signals are combined in subtractive relationship in differential
amplifier 23.
A volt meter 26 is connected to monitor the amplitude of the signal
produced by differential amplifier 23 as a result of the
subtraction of the signals from integrator 19 and amplifier 21.
Gain adjust 22 is then adjusted until the amplitude of the output
signal from differential amplifier 23 is zero. A repeated series of
steps of alternately blocking the hose and adjusting gain adjust 22
for calibration will result in zero reading of volt meter 26 when
the input to the differential amplifier 23 from flow integrator 19
is equal to the input signal from pressure amplifier 21. At this
point the volume of air which is required to fill the hoses has
been compensated for. Any subsequent compliance change will result
in a change of the output signal from transducer 20 in a direction
to adjust the volume of gas supplied to the hoses 15 to assure that
the prescribed volume is delivered to patient 16. This means that
when a patient is connected to the respirator, the output signal
developed by differential amplifier 23 will be directly
proportional to the volume of air which is actually received by the
patient independently of the interconnecting hoses. This output
signal is then compared in threshold detector 24 with the volume
set signal developed from set control 25. When the amplitude of the
signal from differential amplifier 23 indicates that the prescribed
volume of gas has been delivered to patient 16, threshold detector
24 produces a signal which is applied to inhale valve 12 to
terminate the inhalation cycle and to exhale valve 17 to initiate
the exhalation cycle. It is noted that suitable circuitry (not
shown) is normally provided to control the duration of the
exhalation cycle and to provide a reset signal to integrator 19 to
initiate a new inhalation cycle.
It will thus be seen that the present invention provides a
respirator in which the volume of gas actually delivered to the
patient is accurately determined and may be compensated for by a
pressure transducer to assure that the prescribed volume is applied
to the patient regardless of interconnecting hose or equipment
compliance or patient compliance.
Although the invention has been described with respect to a single
embodiment, it is intended that the appended claims not be limited
to the specific embodiment of the invention described, but that
they cover modifications falling within the spirit and scope of the
claims.
* * * * *