Surgery – Respiratory method or device – Means for supplying respiratory gas under positive pressure
Patent
1981-03-23
1984-07-17
Recla, Henry J.
Surgery
Respiratory method or device
Means for supplying respiratory gas under positive pressure
12820525, 13724717, 137251, 251315, A61M 1600
Patent
active
044599838
DESCRIPTION:
BRIEF SUMMARY
The present invention relates to a breathing apparatus for the reanimation of newborn infants, including a water column serving as an inhalation valve, with a T-connector member attached to the riser tube of the water column, by means of which the water column is connected through breathing hoses with a breathing gas source and with a patient adapter, which includes a free closable opening for exhalation in communication with the atmosphere, in which the quantity of the breathing gas introduced from the breathing gas source is adjustable through a regulator, wherein the maximum immersed depth of the riser tube determines the maximum inspiratory breathing pressure for which the closing period of the exhaling opening determines the breathing frequency and breathing phase.
The most important event after birth is the commencement of the pulmonary gas change, in effect, the inherent lung breathing (spontaneous breathing) of the newborn infant. The extended primary apnoe (breathing stoppage) is the most important intermediate case. It is predicated on a paralysis of the breathing center through a lack of oxygen during the birth or because of narcotics which have been given to the mother prior to or during the birth. This extremely dangerous condition must be eliminated without delay through reanimation. An airation of the lungs of the newborn infant which is not rapid produces the most serious adaptability and development difficulties to the child. As a rule, in this acutely dangerous condition, an instant initial blowing up of the lungs with compromised oxygen for a duration of presently 10-15 seconds, a so-called blow pressure breathing, leads through an unfolding of the alveolas, rapidly to the intended spontaneous breathing.
In particular for premature newborn infants (premies), not infrequently the breathing must additionally be supported over a lengthy period of time. An important sign of the premature infant is the lack of a sufficient quantity of surface active substance, the so called lack of surfactant syndrom, or idiopathic breathing emergency syndrom. The result is that, during each exhalation phase (expiration), due to the inadequately reduced surface tension, alveolas will collapse. Collapsed alveolas, however, can no longer take part with the breathing gas change. The blood is under-saturated with oxygen. This lack of oxygen leads in an increasing measure to breathing difficulty and finally, through paralysis of the breathing center to a breathing stoppage when there is not timely prevented that the collapsing pressure in the alveolas be distrupted. For support of the breathing during idiopathic breathing emergency syndrom, in recent times there has been utilized a breathing procedure with great success, which constantly maintains a continuous positive pressure (CPAP) of up to about 15 cm H.sub.2 O in the breathing passages, which is directed counter to the alveolar collapse, the socalled CPAP breathing. An early consequential application of this method immediately after the birth upholds the spontaneous breathing, and thus saves such children from more intensive breathing techniques with their not inconsiderable side effects.
Nevertheless, if the newborn shows signs of an increasing breathing emergency, the breathing cycle must be timely artificially imitated by means of a breathing apparatus. Thereby, periodically, within the inhalation phase (inspiration) there is produced a positive pressure for the blowing up (IPPV), and in the exhalation phase, a positive end expirational pressure (PEEP) maintained above the collapsing pressure of the aveolas; there is effectuated the socalled IPPV+PEEP breathing. The lower pressure limit (PEEP) hereby corresponds to the pressure during the CPAP breathing, the upper however, not to the initial blowing pressure breathing required. The initial unfolding of the lungs, in essence, generally demands a higher breathing pressure than would be necessary for maintaining the breathing.
It is demanded of a breathing apparatus for newborn infants with the major utilizat
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patent: 2989069 (1961-06-01), Nixon
patent: 3036589 (1962-05-01), Mosier
patent: 4011866 (1977-03-01), Klein et al.
patent: 4030492 (1977-06-01), Simbruner
patent: 4171697 (1979-10-01), Arion
K. Riegel et al., 99 German Medical Weekly, (1974), 1624-1626.
Beyreuther Christian
Riegel Klaus
Beyreuther Christian
Recla Henry J.
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