CN101743039A - 体积交换器阀系统和在cpr过程中增加循环的方法 - Google Patents

体积交换器阀系统和在cpr过程中增加循环的方法 Download PDF

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CN101743039A
CN101743039A CN200880020411A CN200880020411A CN101743039A CN 101743039 A CN101743039 A CN 101743039A CN 200880020411 A CN200880020411 A CN 200880020411A CN 200880020411 A CN200880020411 A CN 200880020411A CN 101743039 A CN101743039 A CN 101743039A
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chest
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K·G·卢里
A·梅茨格
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Advanced Circulatory Systems Inc
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Abstract

一种用于调节气流流入和流出患者的方法，包括反复地迫使呼吸气体排出肺。每次呼吸气体被迫使排出肺外部时之间，呼吸气体被阻止不能返回肺。周期性的，含氧气体被供给肺。

Description

体积交换器阀系统和在CPR过程中增加循环的方法
相关申请的交叉引用
本申请是非临时申请，要求2007年4月19日提交的美国临时申请No.60/912,891的优先权，其全部内容在此引为参考。
技术领域
本发明大致涉及心肺复苏的领域，特别涉及在进行CPR时增加循环的技术。
背景技术
虽然目前有CPR方法，大多数人在心搏停止之后死亡。其中一个主要原因在于，利用普通的手动闭胸心肺复苏，朝着心脏和大脑的血液流动非常贫乏。在CPR过程中，较大的血液循环将产生改善的结果。
发明内容
一些实施例中，方法被描述用于调节进入和离开患者的气流。根据一个方法，呼吸气体被反复地迫使离开肺部。在胸部挤压之间，呼吸气体同样被防止不能返回进入肺部。周期性地，含氧气体被供给到肺部从而提供通气。
在一个特定的方面，通过反复地挤压胸部并且允许胸部回弹，速率大概60-120次/分钟，气体被反复地迫动到肺部外。在另一个方面，低流动性和体积的氧气被连续地供应给肺部。氧气的这个体积小于利用连续胸部挤压被排出的呼吸气体的体积，从而肺部利用含氧气体膨胀的次数由于低水平的连续氧注入而被降低。
本发明的其它实施例包括在CPR过程中用于增加循环的方法和装置，是通过降低在胸部按压过程中肺部中空气的体积，从而胸部具有更大的空间以允许每个胸部按压/胸部回弹循环中更多的血液流动到心脏。这种实施例包括按压胸部并允许它回弹的方式。每次按压过程中，空气通过一个单向阀被排出肺部。每一次，胸壁将在按压之后回弹，来自患者外部的空气(或者呼吸气体)被防止被动地进入肺部。通过之后的按压，越来越少的空气保留在胸部中。随着每次胸部按压，来自肺部的呼吸气体的这种逐渐排出导致胸部内(肺部，血管和心脏)更大的空间被血液填充。由于胸部中更多的血液和更少的气体，每次胸部被按压，更多的血液从心脏排出。在几次按压之后，例如大约12和大约30次之间(取决于多少人进行CPR，并且如果气道与面罩固定，相对的，并且气管内导管或者等效件)，空气被允许主动地进入肺部，通过从通气源输送正压力呼吸，或者通过负压通气(例如，铁肺等)。
这种技术的一个优点在于，在胸部回弹过程中，颅内压力更快地减小，并且减小到较低值，从而进一步提高脑灌注压力的持续时间和大小。
一个特定方面中，在一系列胸部按压/回弹循环上排出的呼吸气体的体积在大约1-大约15cc/kg的范围中。同样，从胸部排出的该体积的呼吸气体可以逆着低水平的固定或者可变阻力而排出，该阻力在从大约0cmH2O到大约10cm H2O的范围中。
另一个实施例中，本发明提供一种实例性装置，在心搏停止时在患者身上进行心肺复苏的过程中增大循环。该装置包括壳体，具有救助孔和患者孔。阀系统设置在壳体中。另外，壳体和阀系统构造成使得：在每次胸部按压过程中从肺部排出的一定体积的呼吸气体通过患者孔进入壳体，穿过阀系统，并且离开救助孔。同样，当胸壁回弹时，含氧气体被阀系统阻止不能穿过患者孔进入肺部。通气源还可用于将含氧气体注入壳体中，其穿过阀系统，患者孔，并且到达患者，从而周期性地利用含氧气体使得肺部膨胀。
阀系统可以利用多个阀来构造，例如止回阀，弹簧阀，鸭嘴阀，电控阀等。作为另一个实例，一对单向阀可以使用，其单独地构造成随着穿过壳体的相反气流而开启。同样，多种通气源可以使用，例如嘴对嘴通气，嘴-面罩，复苏气囊，自动通气机，半自动通气机，人体胸甲，和铁肺装置等。另一个方面，阀系统可包括这样的装置：以固定的或者可变的阻力阻止呼吸气体从肺部离开，该阻力在大约0cmH2O到大约10cmH2O的范围中。
一种特定的设置中，至少一个生理传感器可用于测量一个或多个生理参数。这种传感器可包括心电图信号传感器，阻力传感器，从而检测胸部中的空气/血液比率等。同样，通讯系统可用于允许来自生理传感器(多个)的信号被传送到在心肺复苏中使用的CPR装置，从而提供各种类型的反馈。这可包括如何进行CPR，利用呼吸气体主动地使得肺部膨胀的最优时间，除纤颤的最优时间等。另外，定时灯可用于辅助抢救人员进行CPR，例如何时提供胸部按压。
另一个方面，供应系统可用于将低流动和体积的连续氧气供应到肺部中，该体积小于通过连续胸部按压排出的呼吸气体的体积。这样，肺部通过含氧气体膨胀的次数由于低水平的连续氧气注入而降低。
另一个实施例中，本发明提供一种装置，在心搏停止时在患者身上进行心肺复苏过程中促进循环。该装置包括壳体，具有施救孔和患者孔。提供用于调节穿过壳体的气流的装置，从而在每次胸部按压过程中从肺部排出的一定体积的呼吸气体通过患者孔进入壳体，并且离开施救孔。同样，当胸壁回弹时，含氧气体被阻止不能通过患者孔进入肺部。通气源用于将含氧气体喷射到壳体中，并且穿过患者孔，并且到达患者，从而利用含氧气体周期性地膨胀肺部。
在一个方面，用于调节气流的装置包括一对单向阀，其单独地构造成随着穿过壳体的相反气流而开启。
附图说明
图1的图形示出了使用根据本发明技术进行CPR时的肺容量。
图2A示意性示出了根据本发明在胸部按压过程中排出的呼吸气体，该气体穿过阀系统，连同控制系统和传感器。
图2B示意性示出了根据本发明在胸部回弹和胸部按压过程中如何防止呼吸气体穿过阀系统并且进入肺部。
图2C示意性示出了根据本发明通过阀系统注入含氧气体，从而提供患者通气。
图2D示意性示出了根据本发明如果患者吸入的话呼吸气体穿过安全止回阀的通道。
图3A示出了根据本发明的阀系统的一个实施例。
图3B是图3A的阀系统的侧面剖视图，示出了随着患者呼出(例如在胸部按压过程中)的气流，连同控制系统和传感器。
图3C是图3A的阀系统的侧面剖视图，示出了当患者胸部回弹或者被提升时气流的缺乏。
图3D是图3A的阀系统的侧面剖视图，示出了当向患者输送含氧气体时的气流。
图4的流程图示出了根据本发明进行CPR的一个方法。
具体实施方式
在心搏停止的患者身上进行CPR时，可以使用多种胸部按压方法。在这种生命受到威胁的情况中，心脏不能循环血液，因此非侵入性(non-invasive)的外部装置用于辅助将血液循环到重要的组织，包括心脏、肺和大脑。可在心搏停止过程中用于循环血液的方法和装置包括手动闭胸CPR，主动按压减压(ACD)CPR，利用手动或自动装置进行机械CPR，其挤压胸部并且允许胸部主动或者被动地回弹，以及下面的装置，其挤压胸壁并且然后如同铁肺(iron lung)一样工作并且主动地膨胀胸廓(thoracic cage)。其中一些这种方法和装置仅挤压胸部的前面，例如胸骨，而其它方法和装置沿圆周挤压胸部的全部或者部分。一些方法和装置还以交替的顺序挤压胸部和腹部。一些方法还包括挤压下肢从而促进静脉血流回到心脏并且增大动脉压力从而更多的血液到达大脑。一些方法还包括挤压背部，其中患者俯卧。一些装置包括上述非侵入的方法和装置，它们与侵入性装置相关联，例如腹内主动脉球囊(intra-aortic balloon)，以及与同时给患者降温的装置相关联。
在CPR的胸部按压阶段过程中，因为心瓣膜在CPR过程中基本保持完整，血液被推到心脏外，进入主动脉。当胸壁回弹(recoil)时，来自胸腔外的室(extrathoracic compartment)(例如腹部，上肢和头部)的血液进入胸部，尤其是心脏和肺部。没有接下来的胸部按压的情况下，在心搏停止过程中，血液将积聚在心脏和肺部中，因为存在不充分的固有的心泵动作以促进向前的血液流动。因此，胸部按压是CPR的关键部分。
在按压阶段，空气被排出胸部并通过气管和气道(airway)进入大气。在减压阶段，它通过相同的气道系统被动地返回到胸部中。这样，呼吸气体离开胸部又回到胸部中。通过每次按压，胸部内的压力几乎同时被传递到心脏，并且也通过脊柱并通过血管连接而传递到大脑。因此，通过每次外部胸部按压，胸部中和胸部中所有组织内的压力增加。施加这里描述的方法和装置，连同上述任一种CPR方法，导致胸部中越来越少的空气，形成了空间用于在胸壁回弹阶段越来越多的血液返回到心脏。在胸壁减压阶段，这增大了给冠状动脉的循环，并且降低了颅内压，并且随着每次随后的挤压，增加了给重要组织的血液流动，特别是大脑。因为氧气的输送是CPR的重要方面，周期性的正压通气需要被输送以使得肺膨胀并且提供氧。肺也可以通过周期性的负压通气而膨胀，例如利用铁肺或者胸甲装置。利用正压和负压通气，在每次主动通气过程中(正压通气)，通常患者接收大约500-1000cc的潮气量。因此，通过实施本发明，在多次挤压的过程中时，等量的呼吸气体从肺部排出，从而在大约2-6次按压之后，被输送的体积已经从胸部被去除，并且它的空间可以被重新填充胸腔的血液代替。这种交换通过下面的事实而变得可能：胸部内的压力几乎同时地从一个组织转换到另一个。这种压力的传递非常快速地以高度的顺应性(compliance)发生在不同的胸部腔室之间，例如肺部和右心，尤其在胸部中的组织之间。例如，正压在按压阶段中从肺部传递到右心，并且这样，随着每次胸部按压，右心压力显著增加。肺部内压力的增加被传递到心脏，将心室内的血液沿着向前方向沿着从右心房到右心室到肺动脉肺静脉、左心室、以及主动脉外的路径推动。相反的也是可行的，随着胸壁回弹，负压穿过胸部传递，包括脊髓。这将血液从胸部外牵拉回心脏和肺部。胸部内压力的降低通过这里描述的方法和装置而增大。随着每次按压被排出肺外部并且不允许返回的气体越多，每次胸壁回弹，就形成更大的空间用于血液流入胸部内的组织中。经过一系列胸部按压/回弹循环排出的呼吸气体的体积可以大约为5-大约15cc/kg。它通常大约在2-6按压/回弹循环之后被排出。从胸部排出的该体积的气体可以逆着低水平的固定或可变阻力而排出，该阻力通常在大约0cm H2O到大约10cmH2O的范围中。这可以是可调的，并且可通过阀系统或者其它装置提供，其具有低流速(low flow)的正压气体，例如氧气。这个过程还可以通过主动按压和主动减压而进一步促进。这个过程还可以另外在正压呼吸之间通过主动地提取(extract)一定量的呼吸气体而增大，随着CPR的每次减压阶段，在胸部中产生甚至更大的空间从而被血液填充，从而使得心脏预备好进行下一次按压。
周期性地，肺部需要膨胀，从而肺血管阻力(肺部中血管中的血压)不会变得太高(当肺部排空并且收缩时会发生太高的情况)，这将限制血流穿过肺部。肺的周期性膨胀还提供氧气，并且有助于清除二氧化碳。这个过程在图1中图示。左边的Y轴显示出肺中呼吸气体的体积，单位为升，X轴表示时间，单位为秒。在点A，正压呼吸被输送(deliver)。上下箭头显示何时发生胸部按压和减压(这个实例中，被动胸壁回弹)。当使用本发明时，肺中呼吸气体的体积的变化通过实线表示。随着每次胸部按压，空气被排出肺，并且由于阀系统，不允许回到肺中。这导致肺内呼吸气体的逐渐减少。阴影区域，标示为B，是随着每次胸部按压从肺排出的呼吸气体的体积。B表示的总体积产生了空间，该空间被在减压阶段返回到心脏和肺的更多血液填充，只要正压没有通过胸部按压施加到胸部。相反，没有本发明的话，肺中的呼吸气体的体积的变化通过虚线示出。每次按压和胸壁回弹循环与气道中压力的微微增大和减小相关联，因为呼吸气体随着每次减压和按压循环而自由进出肺。
在胸部按压过程中，多个阀可以连接到患者的气道从而允许呼吸气体离开肺，同时允许周期性的通气。一种类型的阀可以是单向阀(one-way valve)，通常与另一个单向阀结合使用，所述另一个单向阀沿着相反方向开启，并且沿着闭合方向被偏压，从而在胸部回弹或者胸部减压过程中气体不能进入肺。可使用的另一个阀系统在美国专利No.5692498、6062219、6526973和6604523中描述，这里引为参考。通过这种阀，阈值开启压力(cracking pressure)可以设置的足够高从而呼吸气体总是被阻止不能进入肺，直到被主动通气。
通过本发明一个实施例进入和离开胸部的气流在图2A-2C中示意性示出。图2A中，阀系统10示意性示出。阀系统10具有患者孔(patientport)12，其与患者的气道连接，并包括由施救者使用的施救孔(rescuerport)，从而给患者提供通气。当胸部被按压时(如在胸壁上向下按压的手所示的)，呼吸气体从患者流动穿过阀系统10，如箭头所示。这样做时，呼吸气体从阀系统10以最小的阻力或者没有阻力地进入室内空气。图2B中，随着施救者的手抬起，在减压过程中，胸壁回弹。现在，阀系统10阻止呼吸气体进入患者。图2C中正压通气通过施救孔14被输送，其中穿过阀系统109和从患者孔12排出，其处进入患者的肺。这样，通过每次胸部按压，越来越多的气体被迫使到肺部外。这是因为在减压过程中，气体被阻止从而不能进入。当需要时，气体可以被注入肺中从而提供适当的通气。
一些情况中，患者会开始呼吸或者自发地喘气。如图2D，阀系统10具有一个或多个安全止回阀16，从而允许气体穿过患者孔12并且进入肺。作为一个实例，安全止回阀16可以设置成在大约-10cm H2O开启。这种策略不意味着限制，而是通过本发明的一个可能的实施例说明CPR过程中的气流。
本发明可使用多种技术来促进循环。例如，在心搏停止的患者身上进行心肺复苏的过程中促进循环的装置可以构造成允许来自肺部的一定体积的呼吸气体随着每次外部胸部按压而离开气道，但是每次胸壁回弹，阻止含氧气体被动的重新进入肺。这可以利用一种阀系统和一种装置来进行，阀系统具有单向阀，该装置周期性地利用含氧气体使得肺膨胀。当胸部以大约60-120次/分钟的速度被按压并且被允许回弹时，这种装置是特别有用的。这种装置还可允许一定体积的呼吸气体随着每次按压而从肺部排出。这种装置可以与手动CPR、手动操作的CPR装置或者自动CPR装置一起使用。随着每次胸壁回弹，呼吸气体被单向阀阻止不能返回到肺。在每个连续的胸部按压/胸部回弹循环上，肺内的呼吸气体连续减少。周期性的，肺利用含氧气体主动地膨胀。
阀系统可以由一个或多个止回阀、弹簧阀、鸭嘴阀(duck valve)、其它机械或者电控阀和开关组成。肺由通气源周期性地膨胀，该通气源可包括：嘴-嘴通气，嘴-面罩，复苏气囊，自动或者半自动通气机，身体胸甲或者铁肺等装置。多种传感器可结合在系统中从而引导通气速度和/或确定胸部按压的程度和/或胸壁回弹的程度，包括：气道压力传感器，二氧化碳传感器和/或阻力传感器，检测胸部中空气/血液的比率，从而有助于引导通气和按压速度。
阀系统可包括单向阀，具有这样的装置：以固定或者可变的阻力阻止呼吸气体的呼出或者离开。这可以在大约0-大约20cm H2O的范围中，并且在一些情况中，大约0-大约10cm H2O的范围中。这也可以是可调的。一些情况中，这种呼气阻力有助于将肺外部的血液推动回到左心，并且用作在CPR过程中有助于防止血液积聚在肺中的装置。
阀系统20的一个特定实施例在图3A中示出。阀系统20包括壳体，其方便地制造成吸入接口壳体22和患者接口壳体24。通气源孔26，用于给患者通气，包括在壳体22中，而连接孔28包括在壳体24中。这样，通气源可以连接到孔26，孔28可用于与患者以及患者的气道连接。阀板30，具有一对单路止回阀32、34，位于其间。
如图3B，在胸部按压过程中，呼吸气体从患者流动，并且穿过孔28，在其处，气体开启呼出止回阀34。从那里，气体通过孔26排出到大气。可选的，阀34可以沿着闭合方向被偏压，并且可以当离开的气体施加小于大约20cm H2O的压力时开启。
孔28可以连接到患者接口21，其可包括面罩，气管内管，其它气道装置，或者这里描述的其它接口中的任一种。孔26可以连接到通气源23，例如通气气囊，通气机，用于执行嘴对嘴复苏的管，或者这里描述的任何其它装置。
另外，控制器25可用于控制任何电子设备。例如，如果通气源23，例如通气机，控制器25可用于控制通气机的操作。一个或多个传感器27可连接到控制器，从而监测患者的多个生理参数，如这里所述的。同样，控制器25可以基于感测到的参数改变胸部按压和/或通气的施加。
控制器25还可连接到一个或多个正时灯(timing light)29，其可用于向施救者指示例如何时提供胸部按压和/或通气。
图3C中，胸壁回弹。吸入止回阀32通过使用弹簧、弹性体等沿着闭合方向被偏压，从而没有呼吸气体被允许通过吸入止回阀32。阀32可以被偏压闭合，直到实现了大约-5到大约-10mmHg的范围中的压力。在CPR过程中，当患者进行自发的喘息时，这最可能发生，并且然后气流移动穿过吸入止回阀32通过孔28到达患者。如果急救者以大的潮气量通过孔26快速地给患者通气，如图3D，这也可能发生。
这里描述的任何阀系统也可包括下列部件或者与下列部件相关联：生理传感器，正时灯，阻力传感器，以检测胸部中空气/血液的比率，以及与CPR装置通讯的方式，或者在复苏过程中使用的其它设备(例如除颤器)，从而在如何进行CPR、利用呼吸气体主动使得肺膨胀的最优时间、或者去纤颤的最优时间方面提供反馈。
阀系统或者相关装置也可包括向肺中输送低流速和体积的连续氧气的方式，其小于或者恰好等于胸部按压时呼吸气体的排出量的总体积，从而肺部利用富氧气体膨胀的次数通过低水平的连续氧注入而降低。
用于控制气体流入和流出患者肺部的一个典型方法如图4所示。在步骤40，在心搏停止的患者身上进行心肺复苏。这可以通过按压胸部并且允许胸部回弹来进行，速度为大约60-大约120次/分钟。
对于多次胸部回弹，呼吸气体被阻止不能返回到肺部，从而在连续胸部按压/胸部回弹循环中，在肺部中的呼吸气体存在连续的减少(见步骤42)。这允许更多的血液进入胸廓空间(在一系列胸部按压/回弹循环中排出的呼吸气体的体积可选的在大约4-大约15cc/kg的范围中)。因此，在每个连续胸部按压/胸部回弹循环上，肺内部的呼吸气体连续减少，从而允许更多血液进入胸廓空间。
周期性的，患者会被通气(见步骤46)，例如通过周期性地利用含氧气体主动膨胀肺部。在CPR的胸部回弹阶段，颅内压力被更加快速地减小，并且减小到较低值，从而进一步增加大脑灌注压力的持续时间和大小。可选的，从胸部排出的该体积的呼吸气体可以逆着低水平的固定或者可变阻力而排出，该阻力在从大约0-大约10cm H2O的范围中(见步骤48)。
这里描述的装置和方法可用于任何类型的CPR技术中，其包括在胸部上动作以改变胸部内的压力，将受益于本发明这项改进的方法。同样，用于提供肺部周期性膨胀的方法可包括嘴对嘴通气、复苏气囊、自动或半自动通气机，身体胸甲或者铁肺等装置。该方法也可包括向肺中输送低流速和体积的连续氧气的方式，其小于呼吸气体被排出的总体积，从而通过外部通气源的正压通气频率可以由于低水平的连续氧气注入而降低(见步骤50)。
各种传感器可用于引导周期性通气速度或者确定胸部按压的程度或者胸壁回弹的程度。传感器可包括气道压力传感器、正时灯、二氧化碳传感器，心电图信号传感器，和/或阻力传感器，检测胸部中空气/血液的比率，从而有助于引导通气和按压速度，并且确定是否应当继续CPR、去纤颤的最优时间和方式，以及由于无用而何时停止CPR的努力。
该方法可包括多个不同的通气管附件，从而保持气管和通气源或者咽喉和通气源或者嘴和通气源之间的密封(例如，气管内管，面罩，喉罩气道，声门上气道等)。这些气道内的传感器可用于验证正确的气道附件设置。这种传感器可包括二氧化碳检测器，其可以以被保护防止身体流体的方式被容纳。
该方法可包括这样的装置，将从胸部输送或者排出的呼吸气体的体积的量传送到监测系统，该监测系统可用作闭环回路的一部分，从而使得主动通气之间的按压次数最大化，从而在CPR过程中使得循环最大化。CPR过程中的循环可以通过多个装置测量，包括测量潮气末二氧化碳，在给定的时间间隔上排出的潮气末二氧化碳水平的变化，体内阻力的变化，以及其它生理参数的变化，例如温度。
本发明已经详细描述，目的是清楚和理解。然而应当认为，在权利要求范围内，可以进行一些变化和变形。

Claims (20)

1.一种在心搏停止的患者身上进行心肺复苏过程中促进循环的装置，该装置包括：
壳体，具有施救孔和患者孔、呼出单向阀和吸入单向阀，所述吸入单向阀被偏压在闭合位置；
其中，壳体和单向阀构造成使得：在每次胸部按压过程中从肺部排出的一定体积的呼吸气体通过施救孔进入壳体，穿过呼出单向阀并且离开患者孔，其中，当胸壁回弹时，含氧气体被两个所述单向阀阻止不能通过患者孔进入肺部；
通气源，将含氧气体注入壳体中，从而开启吸入单向阀，并且穿过患者孔，并且到达患者，从而利用含氧气体周期性地膨胀肺部。
2.一种在心搏停止的患者身上进行心肺复苏过程中促进循环的装置，该装置包括
壳体，具有施救孔和患者孔；
阀系统，设置在壳体中；
其中壳体和阀系统构造成使得：在每次胸部按压过程中从肺部排出的一定体积的呼吸气体通过患者孔进入壳体，穿过阀系统并且离开施救孔，其中，当胸壁回弹时，含氧气体被阀系统阻止不能穿过患者孔进入肺部；和
通气源，将含氧气体注入壳体中，从而穿过阀系统，穿过患者孔并到达患者，从而利用含氧气体周期性地膨胀肺部。
3.如权利要求2所述的装置，其特征在于，阀系统包括至少一个从下组中选择的阀，该组包括：止回阀，弹簧阀，鸭嘴阀，和电控阀。
4.如权利要求2所述的装置，其特征在于，通气源从下组中选择，该组包括：嘴-嘴通气，嘴-面罩，复苏气囊，自动通气机，半自动通气机，身体胸甲，和铁肺装置。
5.如权利要求2所述的装置，其特征在于，阀系统包括下面的装置，其以固定或者可变的阻力阻止呼吸气体从肺部离开，该阻力在大约0到大约10cmH2O的范围中。
6.如权利要求2所述的装置，其特征在于，还包括至少一个从下组中选择的生理传感器，该组包括：气道压力传感器，二氧化碳传感器，心电图信号传感器，检测胸部中空气/血液比率的阻力传感器，并且还包括通讯系统，以允许来自生理传感器的信号被传送给在复苏过程中使用的CPR装置，从而提供对于下列中至少一个的反馈：如何进行CPR，主动地利用呼吸气体使得肺膨胀的最优时间，和去纤颤的最优时间，并且还包括正时灯，其构造成发光以辅助施救者进行CPR。
7.如权利要求6所述的装置，其特征在于，还包括供应系统，以将低流速和体积的连续氧气输送到肺中，该体积小于随着连续胸部按压被排出的呼吸气体的体积，从而肺利用含氧气体膨胀的次数由于低水平的连续氧气注入而降低。
8.如权利要求6所述的装置，其特征在于，阀系统包括一对单向阀，所述单向阀单独地构造成利用穿过壳体的相反气流而开启。
9.一种在心搏停止的患者身上进行心肺复苏过程中促进循环的装置，该装置包括
壳体，具有施救孔和患者孔；
用于调节穿过壳体的气流的装置，其中用于调节的装置构造成使得：在每次胸部按压过程中从肺排出的一定体积的呼吸气体通过施救孔进入壳体，并且离开患者孔，其中，当胸壁回弹时，含氧气体被阻止不能通过患者孔进入肺；和
通气源，将含氧气体注入壳体中，并且穿过患者孔并到达患者，从而利用含氧气体周期性地膨胀肺部。
10.如权利要求13所述的装置，其特征在于，用于调节气流的装置包括一对单向阀，所述单向阀单独地构造成利用穿过壳体的相反气流而开启。
11.一种在心搏停止患者身上进行心肺复苏的方法，该方法包括：
以大约60-大约120次/分钟的速度反复地按压胸部并且允许胸部回弹；
其中随着每次按压，一定体积的呼吸气体从肺排出；
其中对于多次胸部回弹，防止呼吸气体返回肺，从而在连续的胸部按压/胸部回弹循环后，肺部内的呼吸气体连续减少，从而允许更多血液进入胸廓空间；和
周期性地利用含氧气体膨胀肺。
12.如权利要求11所述的方法，其特征在于，在胸部回弹过程中，颅内压力更快速地下降并且下降到较低值，从而进一步增大大脑灌注压力的持续时间和大小。
13.如权利要求11所述的方法，其特征在于，在一系列胸部按压/回弹循环上排出的呼吸气体的体积在从大约1-大约15cc/kg的范围中。
14.如权利要求11所述的方法，其特征在于，还包括逆着低水平的固定或者可变阻力将所述体积的呼吸气体从胸部排出，该阻力在从大约0-大约10cmH2O的范围中。
15.一种用于调节流入和流出患者的气流的方法，该方法包括：
反复将呼吸气体迫使到肺部外；
在每次呼吸气体被迫使到肺部外之间，防止呼吸气体返回肺，
周期性地将含氧气体供给肺。
16.如权利要求15所述的方法，其特征在于，通过以大约60到大约120次/分钟的速度反复地按压胸部并且允许胸部回弹，气体被反复地迫使到肺部外。
17.如权利要求16所述的装置，其特征在于，还包括供应低流速和体积的氧气进入肺中，该体积小于随着连续胸部按压排出的呼吸气体的体积，从而肺利用含氧气体膨胀的次数通过低水平的连续氧气注入而降低。
18.如权利要求16所述的装置，其特征在于，在胸部回弹过程中，颅内压力更快速地下降并且下降到较低值，从而进一步增大大脑灌注压力的持续时间和大小。
19.如权利要求16所述的方法，其特征在于，在一系列胸部按压/回弹循环上排出的呼吸气体的体积在从大约1-大约15cc/kg的范围中。
20.如权利要求15所述的方法，其特征在于，还包括逆着低水平的固定或者可变阻力将所述体积的呼吸气体从胸部排出，该阻力在从大约0-大约10cmH2O的范围中。
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CA2684613A1 (en) 2008-10-30
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US20080257344A1 (en) 2008-10-23
US20120216804A1 (en) 2012-08-30
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