Surgery – Respiratory method or device – Inhaled gas heated or humidified by exhaled gas
Reexamination Certificate
1999-07-02
2002-07-09
Weiss, John G. (Department: 3761)
Surgery
Respiratory method or device
Inhaled gas heated or humidified by exhaled gas
C128S205120, C128S205270
Reexamination Certificate
active
06415788
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to an apparatus useful for treating and handling both respiratory gases and liquids going both to and from the patient. More particularly, in the invention relates to an apparatus which includes liquid traps, suction valves, and a check valve that are preferably effective to protect one or more components of the apparatus from being clogged internally or contaminated through exposure to contaminants both internal and external to the apparatus.
2. Description of the Related Art
During surgery and other medical procedures, a patient is frequently connected to an anesthesia machine or ventilator to provide respiratory gases to the patient. The respiratory gases passed to the patient are advantageously filtered, heated and humidified so that the gases entering the patient are of a suitable quality, temperature and humidity so as to positively impact the patient. Heat and moisture exchangers (HMEs) are often used to provide heat and humidity to the respiratory gases entering the patient. Typically, these HMEs are located so that respiratory gases exhaled from the patient pass through a tracheal tube into the HME, including at least one fibrous or other gas permeable material, which accumulates or collects heat and moisture from the exhaled gases. A filter element, for example, an antimicrobial filter element, is often located in the HME to filter respiratory gases passing through the HME. During the inhalation of respiratory gases, for example, from a respiratory ventilator machine, the HME provides higher levels of heat and moisture to these respiratory gases prior to the gases entering the patient. Over a period of time, the HME is effective to maintain a certain level of temperature and humidity in the respiratory gases entering the patient.
Although such HMEs do perform effectively to provide at least some of the useful heat and humidity needed for respiratory gases under normal conditions, additional required patient treatments and/or patient expectorations may cause adverse effects to the HMES. One example of such an additional treatment is the use of saline or other aqueous liquids to loosen partially hydrated mucous secretions in the trachea of the patient. Mucous build-up is of particular concern in situations when the patient is an infant or neonate and/or in long term, for example, about six (6) hours or longer, use of a ventilator. Saline lavage is often used to counter such mucous buildup. Thus, saline or other aqueous solution is introduced through an inserted tracheal catheter to loosen mucous secretions in the trachea. If the clinician accidentally gets the aqueous solution sloshing back with an exhaled breath or does not suction it correctly in a timely manner, the liquid can fill up or block a good portion of the flow area of the HME and/or the HME's filter element, thereby drastically increasing the pressure required to pass respiratory gases back and forth. In this situation, the entire HME may have to be replaced in order to effectively allow respiratory gases to pass to and from the patient. Such HME replacement is an emergency and can be disruptive and/or harmful to the patient and/or can cause additional clinician stress, in addition to opening up the patient's breathing circuit to external contaminants.
Respiratory gas circuits can include a humidifier and a filter located between the patient and the ventilator. Such circuits are of particular value in treating infants and neonates, for example, with lung volumes on the order of about 10 cubic centimeters. However, liquid water can condense in the tubing from the humidifier and be “blown” or carried to the filter, where such liquid can cause increased pressure drop causing non-optimal ventilation and disadvantageously making for more difficult or impossible respiration.
A patient's health is compromised by the introduction of pathogens on dust and other foreign matter into the HME on the patient side of the bacteria filter. The pathogens and foreign matter can invisibly foul the HME filter or treatment unit rendering it ineffective for its desired purpose. The pathogens and other foreign matter are often introduced by exposing the interior of the respiratory equipment to atmospheric air. The interior of the respiratory circuit is exposed to the atmosphere when suction ports connected to the liquid traps are opened to attach a suction conduit thereto and/or the HME filter is replaced frequently or unplugged from the endotracheal suction manifold to drain the liquid manually. The tracheal tube is also exposed to atmospheric air when a port in the endotracheal suction manifold is opened to introduce saline solution to the trachea during a tracheal lavage. The exposure of the interior of the respiratory apparatus components to pathogens and other foreign matter results the patient's lungs being exposed to the contaminants during respiration through the unit.
The decrease in the useful life of the HME unit is costly and not beneficial to the patient in several ways. A shorter useful life of the HME unit results in more units needed to treat a patient, more chances for pathogen contamination, more clinician work, more physical and mental stress on the patient, and an increase in cost of the patient's medical care. The increased exposure to bacteria and other foreign matter results in increased opportunity for respiratory system infections and other detrimental medical situations, as is disclosed in U.S. Pat. No. 4,224,939 to Lang entitled BACTERIA-TIGHT SYSTEM FOR ARTIFICIAL RESPIRATION, which is incorporated herein by reference in its entirety.
It would be advantageous to provide apparatus by which respiratory gases can be effectively and reliably treated and which can be protected against liquid material interfering with such treatment, causing problems with the respiration of the patient, and restricting the exposure of the interior respiratory equipment to the external ambient room atmosphere and its inevitable contamination.
SUMMARY OF THE INVENTION
An apparatus for treating the respiratory gases of a patient has been discovered. The apparatus comprises a housing with a patient side port, a machine side port, two or more liquid trap chambers, a treatment chamber, and a wall. The patient side port is adapted for passing respiratory gases between the housing and the patient. The machine side port is adapted for passing respiratory gases between the housing and a respiration machine. The liquid trap chambers are adapted to receive liquid. The treatment chamber contains a treatment component adapted to provide a benefit to the respiratory gases passing therethrough. The patient side and machine side ports, the treatment chamber, and the liquid trap chambers are positioned to define a respiratory flow path through the housing passing between the patient side and machine side ports and through the treatment chamber and the liquid trap chambers. The wall has one or more openings through which liquid is removable from the liquid trap chambers. The openings are spaced apart from the patient and machine side ports.
In an aspect of the invention, the liquid trap chambers are configured to inhibit liquid passed from outside the housing through the patient side port from entering the treatment chamber.
In an aspect of the invention, the liquid trap chambers are sized and positioned to hold liquid passed from outside the housing through the patient side port.
In an aspect of the invention, the treatment component is selected from the group consisting of: (1) a filter element adapted to filter respiratory gases passing through the housing; (2) a gas permeable member adapted to exchange heat and moisture with respiratory gases passing through the housing; (3) a generating material adapted to generate water and/or heat available to humidify respiratory gases passing through the housing; (4) a hygroscopic component adapted to generate heat available to heat respiratory gases passing through the housing; (5) porous the
Clawson Burrell E.
Weigl James
Enternet Medical, Inc.
Patel Mital
Stout, Uxa, Buvan & Nullius, LLP
Uxa Frank J.
Weiss John G.
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