BREATHING ASSISTANCE APPARATUS
20170095637 ยท 2017-04-06
Inventors
Cpc classification
A61M16/0003
HUMAN NECESSITIES
A61M16/1085
HUMAN NECESSITIES
A61M16/08
HUMAN NECESSITIES
A61M2016/102
HUMAN NECESSITIES
A61M16/024
HUMAN NECESSITIES
A61M16/142
HUMAN NECESSITIES
International classification
Abstract
A humidifier and humidity sensor is disclosed for use with a breathing assistance apparatus. The humidity sensor preferably includes means to sense absolute humidity, relative humidity and/or temperature at both the patient end and humidifier end. The humidifier may also include provision to both control independently the humidity and temperature of the gases. Further, a chamber manifold is disclosed to facilitate easy connection of the humidifier to various outlets, inlets and sensors. A heated conduit is described which provides a more effective temperature profile along its length.
Claims
1.-24. (canceled)
25. A humidification apparatus for humidifying a gases flow to be supplied to a patient or other person comprising: a humidifier base having a side profile that includes a horizontal base extending a greater distance in a horizontal direction than in a vertical direction and an upwardly extending wall extending a greater distance in the vertical direction than in the horizontal direction, the upwardly extending wall extending from and perpendicular to the horizontal base, the upwardly extending wall and the horizontal base forming a monolithic L-shaped structure, wherein the L-shape is visible when viewed from a side, the upwardly extending wall and the horizontal base being integrally formed with a rigid material, the upwardly extending wall having front and back surfaces, the front surface being perpendicular to the horizontal base, the back surface of the upwardly extending wall and a back surface of the horizontal base defining a back surface of the humidifier base; and a heater plate positioned on the horizontal base, the heater plate including a heat conductive material, the front surface of the upwardly extending wall being perpendicular to the heater plate.
26. The humidification apparatus of claim 25, wherein the humidifier base is configured to removably receive a humidification chamber and the heater plate is configured to conduct heat to the humidification chamber, wherein when the humidification chamber is received by the humidifier base, a horizontal base of the humidification chamber is urged into contact with the heater plate and a tallest part of the upwardly extending wall of the humidifier is higher than a tallest part of the humidification chamber.
27. The humidification apparatus of claim 25, wherein the back surfaces of the upwardly extending wall and the horizontal base are coplanar along a vertical plane.
28. The humidification apparatus of claim 27, wherein the back surfaces of the upwardly extending wall and the horizontal base are integrally connected to each other.
29. The humidification apparatus of claim 25, comprising a humidification chamber, wherein the humidification chamber has an inlet and an outlet to allow the gases flow to pass through the humidification chamber from the inlet to the outlet, the humidification chamber configured to hold a volume of water.
30. The humidification apparatus of claim 29, wherein the humidification chamber includes a side wall and a chamfered section extending between the top wall and the side wall, the chamfered section connecting the side wall to the top wall.
31. The humidification apparatus of claim 29, wherein the humidification chamber has a cut-out portion on the chamber to define a ledge, the ledge being between the inlet and outlet, the ledge defining an intermediate wall between the horizontal heater base and a top wall of the humidification chamber.
32. The humidification apparatus of claim 31, wherein the intermediate wall is parallel to the horizontal heater base.
33. The humidification apparatus of claim 26, wherein the upwardly extending wall comprises first and second temperature sensors, the first and second temperature sensors being spaced apart from each other and being integrated into the upwardly extending wall, wherein when the humidification chamber is received by the humidifier base, the first sensor is aligned with an inlet of the humidification chamber and the second sensor is aligned with an outlet of the humidification chamber, the second sensor configured to measure a temperature of gases at or near the outlet of the humidification chamber.
34. The humidification apparatus of claim 25, further comprising a first fluid port and a second fluid port, the first fluid port configured to provide fluid connection between an inlet of a humidification chamber and a gases source, the second fluid port configured to provide fluid connection between an outlet of a humidification chamber and a breathing circuit, wherein the breathing circuit is configured to extend vertically from the humidification apparatus such that at least a portion of the breathing circuit makes contact with the upwardly extending wall, the breathing circuit including a temperature sensor at a patient end and a heater wire.
35. A humidification apparatus for humidifying a gases flow to be supplied to a patient or other person comprising: a humidifier base having a side profile that includes a horizontal base extending a greater distance in a horizontal direction than in a vertical direction and a upwardly extending wall extending a greater distance in the vertical direction than in the horizontal direction, the upwardly extending wall extending from and perpendicular to the horizontal base, the upwardly extending wall and the horizontal base forming an L-shape, the upwardly extending wall and the horizontal base being integrally formed with a rigid material, the upwardly extending wall having front and back surfaces, the front surface being perpendicular to the horizontal base, the back surface of the upwardly extending wall and a back surface of the horizontal base defining a back surface of the humidifier base, wherein the humidifier base includes a heater plate configured to conduct heat to a humidification chamber, wherein the humidifier base is configured to receive a humidification chamber configured to hold a volume of water and having an inlet and an outlet to allow the gases flow to pass through the humidification chamber from the inlet to the outlet, wherein the upwardly extending wall comprises first and second sensors, the first and second sensors being spaced apart from each other and being integrated into the upwardly extending wall, wherein when the humidification chamber is received by the humidifier base, at least one of the first and second sensors is aligned with the inlet or outlet of the humidification chamber.
36. The humidification apparatus of claim 35, comprising the humidification chamber.
37. The humidification apparatus of claim 35, wherein when the humidification chamber is received by the humidifier base, the heater base of the humidification chamber is urged into contact with the heater plate and a tallest part of the upwardly extending wall is higher than a tallest part of the humidification chamber, the humidification chamber having a cut-out portion on the chamber to define a ledge, the ledge located between the inlet and outlet, the ledge defining an intermediate wall between the horizontal heater base and a top wall of the humidification chamber.
38. The humidification apparatus of claim 35, wherein the first and second sensors are temperature sensors, the second sensor configured to measure a temperature of gases at or near the outlet of the humidification chamber.
39. The humidification apparatus of claim 35, wherein the upwardly extending wall and the horizontal base form a monolithic L-shaped structure.
40. The humidification apparatus of claim 39, wherein the L-shape is visible when viewed from a side.
41. The humidification apparatus of claim 35, wherein the back surfaces of the upwardly extending wall and the horizontal base are coplanar along a vertical plane.
42. The humidification apparatus of claim 41, wherein the back surfaces of the upwardly extending wall and the horizontal base are integrally connected to each other.
43. A humidification apparatus for humidifying a gases flow to be supplied to a patient or other person comprising: a humidifier base including an upwardly extending wall, the upwardly extending wall having front and back surfaces, the back surface of the upwardly extending wall defining at least a portion of a back surface of the humidifier base, wherein the upwardly extending wall comprises first and second sensors, the first and second sensors being spaced apart from each other and being located within the upwardly extending wall, the humidifier base including a heater plate, wherein the first and second sensors are configured to detect a property of the gases flow.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0036] One preferred form of the present invention will now be described with reference to the accompanying drawings in which;
[0037]
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[0039]
[0040]
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DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0049]
[0050] The gas to be humidified flows into the chamber 1 from port 4 and leaves the delivery system 2 at gas exit port 5. Gas from exit port 5 flows to a patient via a face mask or similar (not shown). The system is controlled using sensors located at positions 7 and 8typically temperature probes. Dry gases at the gas input 4 are heated and humidified by passing over the surface of hot water 6 in the chamber 1 so that they are substantially saturated with water vapour when they leave chamber 1 at exit port 10. Hot water 6 is heated by heater plate 9 and the amount of heating is controlled so that the gas reaches a predetermined temperature at exit port 10. This temperature is measured by sensor 7. Therefore the humidification chamber 1 acts to heat and humidify the medical gases so that they are substantially saturated at the output of chamber 1, and are at a predetermined temperature.
[0051] The gas delivery system 2 (also known as a delivery tube or breathing circuit) consists of a flexible tube 11 containing a heater 12, which may consist of a heated resistance wire. The gas from the humidification chamber 1 passes through the tube 11 and is heated by heater 12 to offset heat losses through the walls of tube 11. The amount of heating applied to heater 12 is regulated so that the gas reaches a predetermined temperature at gas outlet 5, as measured by sensor 8. The control temperature at sensor 8 is usually higher than the control temperature at sensor 7, so that the gas is heated along tube 11 to ensure that condensation doesn't occur in the tube.
[0052] The system as described has gas entering gas inlet 4 from a continuous flow gas source (not shown) and exiting the system through gas outlet 5. However the system is equally applicable where the gas source is a ventilator, which creates intermittent flow patterns to provide breaths to a patient. In this case gas outlet port 5 is connected directly to gas inlet port 16. The patient is connected to port 17 via an endotracheal tube or similar (not shown). During patient inspiration dry gases from the ventilator enter the system at inlet port 4, pass through chamber 1, delivery system 2, pass through wye-piece 13 and reach the patient through port 17. During patient exhalation gases pass back through port 17, through wye-piece 13, tube 14 and leave through gas outlet port 18. Tube 14 may also be heated by heater 15 to prevent condensation.
Absolute Humidity Sensing
[0053] Humidifiers incorporating humidity sensors for display or control have been described in the prior art, however all used humidity sensors which were positioned at the patient airway. The current work describes novel humidifier configurations incorporating a humidity generating chamber located at a position which is remote from the patient, a heated breathing circuit to transfer humidity to the patient, and humidity sensors to control the level of absolute or relative humidity supplied to the patient. These humidity sensors are to be located either: 1) at the chamber outlet only, 2) at both the chamber outlet and near the patient, or 3) near the patient only.
[0054] One aspect of the present invention would be to use a humidity sensor as sensor 7. The purpose of humidity sensor 7 is to determine the absolute amount of humidity which is being generated by chamber 1. Accordingly an absolute humidity sensor would be ideal for use as sensor 7, although the use of a relative humidity sensor with associated temperature sensor could equally be used. This system has the advantage of creating a controlled level of absolute humidity at chamber outlet 10, however this level of absolute humidity may not reach the patient if condensation is allowed to occur in tube 11.
[0055] An alternative system which would overcome this disadvantage is to use a second absolute humidity sensor at point 8 instead of a temperature sensor. The difference in absolute humidity between sensors 7 and 8 allows the humidifier to determine whether condensation is occurring between the two points. If the two absolute humidity sensors 7 and 8 read the same level of absolute humidity then no condensation is occurring in the tube. If the absolute humidity at sensor 7 is greater than at sensor 8, then the difference shows the rate of condensation that is occurring.
[0056] One control strategy would be to control the amount of heating provided to heater 12 so that the absolute humidity difference is reduced to zero. However the tube may still contain mobile condensate because the humidity difference only describes the rate of condensation, not the absolute amount of condensate in the tube. Another control strategy is to remove this condensate and hence create a dry tube by heating heater 12 so that the rate of measured condensation is negative (i.e. condensation is being evaporated in tube 11) until the measured condensation rate reaches zero, indicating that all of the condensate has been removed. The amount of heating can then be reduced until the sensors show that condensation has just started to occur, then the heating can be increased slightly to the optimum level. Drying out of the tube may be a continuous process, or may be initiated at regular time intervals.
[0057] Another variation of the system shown in
Low Relative Humidity Chambers
[0058] All systems described so far have used a chamber 1 which attempts to humidify the gas leaving gas outlet 10 to a high level of relative humidity. While this condition isn't essential for the correct operation of the new humidification configurations just described because they use humidity control, it was essential for the prior art humidifier where control is purely based on temperature. However there are some advantages to be gained from using a chamber which heats gases to the correct absolute humidity, but at a low relative humidity (i.e. the temperature of the gas is higher than the dewpoint of the gas, therefore the gas is not saturated).
[0059] The first advantage is that it is easier to design a heated delivery system to transport such a gas without condensation, since the gas doesn't need to be heated immediately after it enters the delivery tube to prevent condensation. Secondly, the use of low relative humidity gases leaving the chamber means that the heater element 12 can be rated at a lower power than would otherwise be the case, as the gas already has a higher energy content and can tolerate a greater loss of energy before the gas condenses in the tube 12. It may even be possible to use an unheated, well insulated breathing circuit instead of a heated breathing circuit if the chamber provides gas with enough energy. Note that low relative humidity chambers can only be used if the heating to the chamber is controlled using an absolute humidity sensor, not a temperature sensor, since otherwise the absolute humidity output would be too low.
[0060] To this end, some humidification chamber configurations which provide a high temperature, low relative humidity gas output are shown in
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[0063] The angle of variable valves 26 and 30 in
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[0065] Any of the low relative humidity, high temperature chambers shown in
Insulated Delivery Tube
[0066] Another facet of the invention is shown in
[0067] Several different sensor configurations are proposed. Firstly, sensor 43 could be an absolute humidity sensor which controls heater plate 38 so that chamber 36 produces the desired level of humidity. In one embodiment sensor 45 is a temperature sensor, which controls heater 40 so that the gas passing sensor 45 remains at a certain desired temperature. If this temperature is greater than the dewpoint of the gas at sensor 43, then condensation should not occur in tube 41. However there may already be condensate in tube 41 when the humidifier is turned on. If a humidity sensor is used for sensor 45 instead of a temperature sensor, then the level of condensate occurring in the tube 41 can be controlled. The algorithms described earlier in this patent for dual-humidity sensor control can be used with this system.
[0068] An alternative location for the absolute humidity sensor is at position 44 instead of 43. The absolute humidity here should be the same as at 43 because the gas has been heated and so hasn't lost any moisture. However there may be advantages to placing the absolute humidity sensor at 44, for instance due to better sensor operation in a low relative humidity environment. This location for the absolute humidity sensor can be used with either a temperature or absolute humidity sensor at location 45.
Humidifier Configurations without any Patient Airway Sensors
[0069] Yet another aspect of this patent relates to removing the need for a sensor at the patient airway. To remove this sensor safely, we must be certain that the gas entering the delivery tube has a safe level of temperature and absolute humidity, and that the surfaces inside the delivery tube do not exceed safe temperature levels. This implies a delivery tube that has a constant internal wall temperature.
[0070] It would be desirable, therefore, to have a heated delivery tube which self-regulates its temperature at a desired level. The heater could either be embedded in the wall of the delivery tube itself, or it could lie inside the lumen of the delivery tube, or it could be wrapped around the outside of the delivery tube. Such a heater could be made from positive temperature coefficient (PTC) material (such as Winterguard from Raychem Corp., Menlo Park, Calif. USA), so that the resistance of the heater increases if the heater is hot, resulting in reduced power. However the delivery tube may pass through more than one environment, or may have localised drafts present on certain parts of the tube. If the PTC elements are arranged in parallel, then the full benefit of the PTC heater can be envisaged. If the PTC elements are arranged in parallel, then the cold portions of the tube will have a lower resistance, which will result in more heat being dissipated. Thus the tube will tend to regulate its own temperature.
[0071]
[0072] Although one specific PTC heated tube design has been envisaged and described, other PTC tube designs could be used. It may also be of advantage to create a PTC tube that has a differing temperature profile along its length rather than a constant temperature profile. The PTC design could also be extended to incorporate PTC heaters in other parts of the patient breathing circuit, such as the flexible extension tube which is usually connected between the Y-piece (port 17 of
[0073] The PTC tube described in
[0074] A variation of the system shown in
Use of a Sensor/Heater Manifold
[0075] Traditional humidifiers have tended to use sensors that are probe shaped, so that they can be inserted through specifically designed holes in the side of the breathing circuit to measure temperature. However the humidifier configurations that have been described in this patent incorporate many sensors around the chamber, so the use of a manifold 59 as shown in
[0076] The humidification chamber 60 is a removable item which can be slid onto the humidifier base 61 as shown in
[0077] After leaving chamber 60 the humid gas passes through chamber port 64 into manifold port 68. Finally the humid gas leaves manifold 59 through port 66 and passes to the breathing circuit.
[0078] The manifold may be a separate, removable assembly, or it may be an integral part of the humidifier base. It may contain temperature sensors, humidity sensors, flow sensors, or a heater element. These would be located inside the manifold 59 at positions 72 and 73. The manifold 59 may be heated to prevent condensation of humid gas. It could connect to both chamber ports 63 and 64 as described, or it may only connect to the outlet port 64. One advantage of using a manifold is that many sensors or heaters can be combined in a single, cleanable assembly, rather than requiring separate probes which need to be plugged into the breathing circuit. This simplifies connection and setup for the user. Another advantage of a manifold is that the incoming dry gas temperature and flow rate can easily be measured without additional probes and connections.
Variations on the Described Configurations
[0079] Although absolute humidity sensors have been described with all of the different humidification schemes described in this patent, relative humidity sensors could also be used. This may involve slightly different control algorithms to the ones described in this patent. Alternatively, a relative humidity sensor could be combined with a temperature sensor. This allows the absolute humidity to be calculated from relative humidity and temperature, rather than being measured directly.
[0080] All of the novel humidification schemes that have been described in this patent could be used with additional temperature sensors. These may provide additional benefits such as providing a safety backup in the event of a failed humidity sensor. Another benefit would be maintaining the temperature being delivered to the patient within certain limits so that the relative humidity is not too low, even though the absolute humidity was acceptable.
[0081] Similarly it may be useful to measure the air flowrate through the humidifier, as this is an important parameter which affects humidifier control. Therefore flow sensors could be incorporated within any of the previously described systems. One useful prior art flow sensor construction would be to use a sensor based on heat loss from a hot element in the airstream. If a heated humidity sensor is used, the amount of heating that is required for the sensor to achieve temperature can be used to determine the gas flow rate.
[0082] Infection control is a prime consideration when designing medical components. To prevent bacterial colonisation of the components in the humidification system, any parts which come in contact with the gas stream could be made out of antibacterial plastic. To prevent contamination of sensor probes, the probe ports could incorporate a disposable sheath which protects the probe from pathogens in the breathing circuit. This would be particularly applicable to temperature probes. In general humidity probes need to have contact with the gas stream so a disposable sheath would be inapplicable to humidity sensors, unless they worked on optical principles, or unless the sheath was made of water vapour permeable material, which did not allow the passage of pathogens. The protective sheath could be an integral part of a disposable breathing circuit.