US20100179442A1 - System for sensing, diagnosing and treating physiological conditions and methods - Google Patents

System for sensing, diagnosing and treating physiological conditions and methods Download PDF

Info

Publication number
US20100179442A1
US20100179442A1 US12/723,205 US72320510A US2010179442A1 US 20100179442 A1 US20100179442 A1 US 20100179442A1 US 72320510 A US72320510 A US 72320510A US 2010179442 A1 US2010179442 A1 US 2010179442A1
Authority
US
United States
Prior art keywords
person
valve system
blood
physiological parameter
imaging
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US12/723,205
Inventor
Keith Lurie
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Advanced Circulatory Systems Inc
CPRx LLC
Original Assignee
Advanced Circulatory Systems Inc
CPRx LLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US10/251,080 external-priority patent/US6863656B2/en
Application filed by Advanced Circulatory Systems Inc, CPRx LLC filed Critical Advanced Circulatory Systems Inc
Priority to US12/723,205 priority Critical patent/US20100179442A1/en
Publication of US20100179442A1 publication Critical patent/US20100179442A1/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/0205Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/08Detecting, measuring or recording devices for evaluating the respiratory organs
    • A61B5/097Devices for facilitating collection of breath or for directing breath into or through measuring devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/48Other medical applications
    • A61B5/4884Other medical applications inducing physiological or psychological stress, e.g. applications for stress testing

Definitions

  • This invention relates generally to the field of diagnostics, and in particular to the diagnosis of cardiovascular conditions. More specifically, the invention relates to systems and methods for stressing a patient's cardiovascular system and then measuring various physiological parameters in order to diagnose the patient's condition.
  • Cardiovascular ailments such as high blood pressure, coronary artery disease, and the like pose a significant health threat to millions of individuals.
  • the early and proper diagnosis of such ailments can be beneficial in placing the patient on the road to recovery.
  • a variety of techniques have been developed to diagnose such conditions. Some of these techniques involve stressing the patient's cardiovascular system by requiring the patient to physically exercise. For example, one common stress test is to place various monitors on the patient and then require the patient to run on a treadmill. As the patient's system is stressed, parameters such as the patient's blood pressure, heart rate and ECG are measured. These are compared against a set of generally accepted “normal” responses, and abnormal responses are observed based upon the set of “normal” values.
  • this invention is related to systems and methods for stressing the patient's cardiovascular system in a more convenient and friendly manner.
  • Such systems and methods provide a wide range of advantages as set forth below.
  • the invention provides various systems and methods for diagnosing a cardiovascular-related condition in a breathing person.
  • the method proceeds by interfacing a valve system to the person's airway.
  • the valve system is configured to decrease or prevent respiratory gas flow to the person's lungs during at least a portion of an inhalation event.
  • the valve system coupled to the person, the person is permitted to inhale and exhale through the valve system.
  • the valve system functions to produce a vacuum within the thorax to increase blood flow back to the right heart of the person, thereby increasing blood circulation and blood pressure.
  • at least one physiological parameter is measured while the person inhales and exhales through the valve system. This parameter is evaluated to diagnose a cardiovascular condition.
  • a method permits a person's cardiovascular system to be stressed, without having the person physically exercise.
  • the physiological parameter is measured in a base line state prior to permitting the person to inhale and exhale through the valve system.
  • the measured physiological parameter in the base line state is then compared with the measured physiological parameter following inhaling and exhaling to facilitate diagnosis. Further, such measurements may be compared with normal or expected responses, i.e. with historical data from healthy individuals.
  • the valve system may be incorporated into a facial mask that is coupled to the person's face.
  • the valve system may include a pressure responsive inflow valve having an actuating pressure in the range from about 0 cm H 2 0 to about ⁇ 50 cm H 2 0.
  • the actuating pressure may be increased or decreased over time and the physiological parameter re-measured. Further, the actuating pressure may be increased or decreased based on the previously measured physiological parameter.
  • valve system may be further configured to prevent or decrease exhaled gases from exiting the person's lungs during at least a portion of an exhalation.
  • physiological parameter may be measured following an exhalation.
  • the physiological parameter may be measured by an imaging or mapping technique, such as by an ECG, by echo-imaging of the heart, by imaging of radio-labeled markers in the blood, by MRI imaging, by CT imaging, by imaging of markers for cardiac ischemic, and the like.
  • an imaging or mapping technique such as by an ECG, by echo-imaging of the heart, by imaging of radio-labeled markers in the blood, by MRI imaging, by CT imaging, by imaging of markers for cardiac ischemic, and the like.
  • imaging or mapping techniques is possible during the stress test since the person needs only to be coupled to the valve system and is not required to physically exercise during the test.
  • Use of the valve system also permits a wide range of parameters to be measured, such as blood pressure, expired CO 2 , heart rate, air flow and pressure through the airway and lungs, oxygen saturation, blood levels of O 2 , blood lactate, blood pH, tissue lactate, tissue pH, body temperature, and the like.
  • one or more substances may be introduced into the person to stress the person's heart.
  • Such substances may be injected into the person's blood stream (such as by use of a needle), may be delivered orally, may be inhaled, or the like.
  • the substance may comprise a volume load of saline solution that is injected into the person's blood stream to stress the person's system.
  • the substance may comprise nitroglycerine that is injected into the person to lower the person's blood pressure.
  • Other drugs that may be used to stress the heart include adenosine, adrenaline, dobutamine and the like.
  • the invention provides an exemplary system for diagnosing a cardiovascular-related condition in a breathing person.
  • the system includes a valve system that is capable of being coupled to the person's airway.
  • the valve system is configured to decrease or prevent respiratory gas flow to the person's lungs during at least a portion of an inhalation event to produce a vacuum within the thorax to in turn increase blood flow back to the right heart of the person. In so doing, blood circulation and blood pressure is increased.
  • the system also includes a monitoring system to monitor changes in at least one physiological parameter while the person inhales and exhales through the valve system. In this way, the person's cardiovascular system may be stressed on monitored simply by coupling the valve system to the person's airway and measuring the parameters.
  • the monitoring system includes a computer for evaluating the measured parameter to diagnose a cardiovascular condition. Conveniently, at least a portion of the monitoring system may be physically incorporated into the valve system.
  • the monitoring system may also include a controller to change the configuration of the valve system over time to vary the level of inspiratory impedance. For example, the controller may be configured to change the configuration of the valve system based on the measured parameters.
  • the valve system may be configured to prevent or decrease exhaled gases from exiting the person's lungs during at least a portion of an exhalation.
  • the valve system may be incorporated into a facial mask that is configured to be coupled to the person's face.
  • the valve system may conveniently include a pressure responsive inflow valve that has an actuating pressure in the range from about 0 cm H 2 0 to about ⁇ 50 cm H 2 0. Such a valve permits gases to flow to the person's lungs during a latter portion of an inhalation event in order to provide sufficient ventilation.
  • the monitoring system may comprise an imaging or mapping system.
  • systems that may be used include an ECG system, a heart echo-imaging system, a radio-labeled marker imaging system for measuring makers in the blood, an MRI imaging system, a CT imaging system and a cardiac ischemic imaging system.
  • the monitoring system may use a wide range of sensors, such as blood pressure sensors, expired CO 2 sensors, heart rate sensors, air flow and pressure sensors, oxygen saturation sensors, O 2 blood level sensors, blood lactate sensors, blood pH sensors, tissue lactate sensors, tissue pH sensors and body temperature sensors.
  • FIG. 1 is a flow chart illustrating one method for diagnosing a cardiovascular-related condition according to the invention.
  • FIG. 2 is a perspective view of one embodiment of a facial mask and a valve system that may be used to facilitate a diagnosis according to the invention.
  • FIG. 3 is a perspective view of the valve system of FIG. 2 .
  • FIG. 4 is a cross sectional side view of the valve system of FIG. 3 .
  • FIG. 5 is an exploded view of the valve system of FIG. 3 .
  • FIG. 6 is a schematic diagram of a system for diagnosing cardio-vascular-related conditions according to the invention.
  • the invention provides various systems and methods to facilitate the measurement of one or more physiological parameters while a person's cardiovascular system is being stressed.
  • the stress tests of the invention may be used when diagnosing a wide range of cardiovascular conditions, such as coronary artery disease, high blood pressure, pulmonary hypertension, cardiac function, severity of peripheral vascular disease, integrity of certain autonomic nervous system reflexes (including the carotid-baro reflex and the vagovagal reflex), intracardiac shunting of blood, and the like.
  • the invention may utilize some type of inspiratory impedance, at one or more predetermine levels, to increase venous blood flow to the heart, thereby increasing-overall circulation and blood pressure.
  • a perturbation of the normal physiological system of the body may be assessed by concurrent physiological monitoring.
  • the level of inspiratory impedance, and the way it is altered may vary.
  • the level of impedance may vary by performing an automatic step-up or step-down of impedance, or it may vary depending upon physiological feedback
  • the resistance to the inflow of respiratory gases may be set between about 0 cm H 2 O and about 50 cm H 2 O and may be variable or fixed as described above.
  • monitoring during the stress test may include, but is not limited to, ECG, blood pressure, echo-images of the heart (such as with an ultrasonic transducer or catheter), radio-labeled markers to visualize blood flow, MRI-imaging, CT imaging, measurement of expired CO 2 , heart rate, air flow and pressure through the airway and lungs, oxygen saturation and/or blood levels of O 2 , blood lactate, blood pH, tissue lactate, tissue pH, markers for cardiac ischemic (including tissue and serum creatinine phospho-kinase, serum troponin, serum adenosine—that may all be measured non-invasively or with minimal invasive techniques), temperature, and the like.
  • the imaging may need to be gated based upon the respiratory rate, or motion associated with the change in the position of the heart and other body structures (such as when taking MRI or CT images).
  • the valve system permits measurements to be made while the person is standing, sitting or lying down.
  • the valve may be configured to decrease intrathoracic pressures relative to both atmosphere pressures and extrathoracic pressures during diagnosis. Its use results in a greater vacuum in the thorax relative to the rest of the body during an inhalation maneuver. This forces more blood back to the chest, thereby increasing blood available for the heart beat. This results in a greater organ perfusion and thus stresses the cardiovascular system in a manner similar to performing exercise.
  • valve systems may be incorporated into a facial mask to facilitate coupling of the valve system to the person's airway.
  • the physiological measures may be made in a baseline state.
  • the valve system may then be actuated or coupled to the airway and measurements taken while the person is breathing through the valve system (which functions to stress the person's cardiovascular system).
  • the valve system may be connected to or be able to communicate with monitoring systems to record, either directly or remotely from a transmitted signal, a wide variety of diagnostic information. These measurements may be taken before, during and after performing the stress test.
  • the level of inspiratory impedance (plus or minus a small decrease of expiratory impedance) may be varied over a wide range of pressure using designs described in the above referenced patents and applications.
  • one or more substances may be introduced into the person to stress the person's heart.
  • the person's system may be stressed both by the impedance provided by the valve system while breathing and by the substance that is introduced into the patient.
  • These substances may be introduced at one or more times, and using one or more techniques. For example, such substances may be injected into the person's blood stream (such as by use of a needle), may be delivered orally, may be inhaled, or the like. Further, the substances may be introduced before, during and/or after the valve system is coupled to the person.
  • the substance may comprise a volume load of saline solution that is injected into the person's blood stream to stress the person's system.
  • the volume of saline solution may be in the range from about 500 cc to about 1,000 cc.
  • the substance may comprise nitroglycerine that is injected into the person to lower the person's blood pressure.
  • Other drugs that may he used to stress the heart include adenosine, adrenaline, dobutamine and the like.
  • baseline physiological parameters may be measured and recorded.
  • the baseline parameters are preferably taken before any stressing of the person's cardiovascular system. These parameters may comprise any of those previously described. Conveniently, these measurements may be stored in a computer and used for later analysis when comparing subsequent measurements.
  • an initial diagnosis may also be performed. For example, a person's blood pressure may be measured. If the measured blood pressure is less than an expected blood pressure for a healthy person having the same physical characteristics (age, weight, sex, etc), then the person can be diagnosed as having low blood pressure.
  • a person's heart rate variability may be measured, such as by a routine ECG testing analysis. If the heart rate variability is less than would be expected from a healthy patient, then an initial diagnosis may be that the person's heart rate variability is low.
  • the method also involves the step of coupling a valve system to the patient's airway as shown in step 12 . This may be performed prior to taking any baseline measurements, provided the valve system is not actuated, or after the baseline measurements have been taken. If before, the valve system may simply be actuated when ready to begin stressing of the person's system. As the person breathes through the valve system, various physiological parameters are measured and recorded as shown in step 14 . While breathing through valve system 200 , the augmentation of pressures within the thorax increases venous blood flow to the heart, to increase overall circulation and blood pressure. As previously described, a substance may also be introduced into the person to increase the amount of stress on the person's system.
  • measurements may be made using equipment that have typically been incompatible with stress tests.
  • the person may be imaged in a MRI or CT imaging device while breathing through the valve system. Echo images of the heart may also be taken while breathing through the valve system. Further, other measurements may be taken as previously described.
  • the level of impedance may be varied as illustrated in step 18 , and the process reverts back to step 14 where the parameters are measured with the modified settings.
  • the decision to vary the impedance may be made based on measurements previously recorded.
  • the computer may be programmed to evaluate the measured parameters over time and to send one or more signals to the valve system to change the impedance based on the analysis.
  • the impedance may automatically vary depending on a certain routine.
  • the computer could control an automatic step-up or step-down of impedance. This variance could also be accomplished manually. Techniques for varying the impedance level are described in the previously mentioned patents and patent applications.
  • the valve system may be decoupled or deactuated as shown in step 20 .
  • measurements may also be taken after competition of the stress test as shown in step 22 .
  • an analysis of the measured parameters may be made as shown in step 24 .
  • These parameters may be measured against themselves, e.g., the change in blood pressure may be evaluated before, during and after the stress test, and/or against a set of historical data.
  • Such historical data may have expected “normal” responses or ranges of normal responses that are compared against the measured data. If outside of the expected normal ranges, the comparison may be flagged for further consideration. In this way, a variety of cardiovascular conditions or problems may be evaluated in a convenient and more efficient manner.
  • a further diagnosis may be performed to confirm that the initial diagnosis was correct and that the treatment was at least partially successful. For example, if the initial diagnosis was low blood pressure and the person was permitted to breathe through the valve system, new measurements may be taken to evaluate the person's blood pressure. If the blood pressure rose, then one can conclude that the diagnosis was low blood pressure secondary at least in part to a reduction in central venous volume or cardiac preload. In such a case, the patient could be instructed to continue to breathe through the valve system.
  • the person may be instructed to breathe through the valve system. If this caused the heart rate variability to increase, then one could conclude that this was a proper diagnosis and may be instructed to continue breathing through the valve system regularly to maintain a heart rate variability which is associated with few lethal arrhythmias.
  • FIG. 2 illustrates one embodiment of a facial mask 100 to which is coupled a valve system 200 .
  • Mask 100 is configured to be secured to a patient's face so as to cover the mouth and nose.
  • Mask 100 and valve system 200 are examples of one type of equipment that may be used to stress a person's cardiovascular system.
  • valve systems and other coupling arrangements may be used including, for example, those previously referenced. As such the invention is not intended to be limited to the specific valve system and mask described below.
  • Valve system 200 includes a valve housing 202 with a socket 204 into which a ball 206 of a ventilation tube 208 is received.
  • ventilation tube 208 may rotate about a horizontal axis and pivot relative to a vertical axis.
  • a respiratory source such as a ventilation bag, may be coupled to tube 208 to assist in ventilation.
  • Disposed in ventilation tube 208 is a filter 210 that is spaced above a duck bill valve 212 .
  • a diaphragm holder 214 that holds a diaphragm 216 is held within housing 202 .
  • Valve system 200 further includes a patient port 218 that is held in place by a second housing 220 .
  • Housing 220 conveniently includes tabs 222 to facilitate coupling of valve system 200 with facial mask 100 .
  • a check valve 224 that comprises a spring 224 a, a ring member 224 b, and an o-ring 224 c.
  • Spring 224 a biases ring member 224 b against patient port 218 .
  • Patient port 218 includes bypass openings 226 that are covered by o-ring 224 c of check valve 224 until the pressure in patient port 218 reaches a threshold negative pressure to cause spring 224 a to compress.
  • expired gases flow through port 218 and lift up diaphragm 214 .
  • the gases then flow through a passage 227 in ventilation tube 208 where they exit the system through openings 229 (see FIG. 16 ).
  • valve system 200 prevents respiratory gases from flowing into the lungs until a threshold of negative intrathoracic pressure level is exceeded.
  • a threshold of negative intrathoracic pressure level When this pressure level is exceeded, check valve 224 is pulled downward as springs 224 a are compressed to permit respiratory gases to flow through openings 226 and to the patient's lungs by initially passing through tube 208 and duck bill valve 212 .
  • Valve 224 may be set to open when the negative intrathoracic pressure is in the range from about 0 cm H 2 O to about ⁇ 50 cm H2O, and more preferably from about ⁇ 5 cm H2O to about ⁇ 30 cm H2O. Hence, the magnitude and duration of negative intrathoracic pressure may be enhanced during patient inhalation by use of valve system 200 .
  • recoil spring 224 a again close check valve 224 . In this way, circulation is increased to cause more blood to flow into the thorax and thereby increase vital organ perfusion. In so doing, the person's cardiovascular system is stressed in a convenient manner.
  • System 300 may conveniently include facial mask 100 and valve system 200 , although any of the valve systems or interfacing mechanisms described herein or the like may be used.
  • Valve system 200 may conveniently be coupled to a controller 310 .
  • controller 310 may be used to control the impedance level of valve system 200 in a manner similar to any of the embodiments described herein. The level of impedance may be varied based on measurements of physiological parameters, or using a programmed schedule of changes.
  • System 300 may include a wide variety of sensors and/or measuring devices to measure any of the physiological parameters described herein. These sensors or measuring devices may be integrated within or coupled to valve system 200 or facial mask, or may be separate.
  • valve system 200 may include a pressure transducer for taking pressure measurements (such as the intrathoracic pressures), a flow rate measuring device for measuring the flow rate of air into or out of the lungs, or a CO 2 sensor for measuring expired CO 2 .
  • system 300 may include an imaging device 320 for taking internal images of the person. Imaging device 320 may comprise a CT scanner, a MRI scanner, or the like. Other examples include equipment for producing echo images of the heart, such as ultrasonic transducers that are used either externally or internally within the heart. With such imaging devices, imaging may need to be gated based upon the respiratory rate, or motion associated with the change in position of the heart and other body structures. This may be accomplished using controller 310 .
  • valve system 200 permits the use of such imaging equipment because the person's cardiovascular system may be stressed without requiring the person to physically exercise. Instead, the person may sit or lie essentially motionless (except for breathing motion) and be imaged or have other measurements taken.
  • sensors or measuring devices examples include a heart rate sensor 330 , a blood pressure sensor 340 , and a temperature sensor 350 . These sensors may also be coupled to controller 310 so that measurements may be recorded. Further, it will be appreciated that other types of measuring devices may be used to measure various physiological parameters, such as oxygen saturation and/or blood levels of O 2 , blood lactate, blood pH, tissue lactate, tissue pH and the like.
  • controller 310 may be used to control valve system 200 , to control any sensors or measuring devices, to record measurements, and to perform any comparisons.
  • a set of computers and/or controllers may be used in combination to perform such tasks.
  • This equipment may have appropriate processors, display screens, input and output devices, entry devices, memory or databases, software, and the like needed to operate system 300 .
  • controller 310 may access a database to obtain information on expected responses. Controller 310 may then perform a comparison to determine any differences and to recommend a possible diagnosis. This information may be stored in a patient record and may also be displayed to a physician and/or printed using a printer.
  • Controller 310 may also be used to assist in performing an initial diagnosis prior to using the valve system. For example, if blood pressure measurements were taken, controller 310 could be used to diagnose whether the measured blood pressure was low based on established blood pressure values for similarly situated individuals. A similar diagnosis could be performed for heart rate variability. After breathing through the valve system and new measurements are taken, controller 310 may be used to compare the measurements before and after using the valve to confirm whether the initial diagnosis was correct and whether breathing through the valve system should be continued, including suggested resistance values, timing, duration and the like. This could be done in an iterative fashion over time.

Abstract

One method for diagnosing a cardiovascular-related condition in a breathing person comprises interfacing a valve system to the person's airway. The valve system is configured to decrease or prevent respiratory gas flow to the person's lungs during at least a portion of an inhalation event. The person is permitted to inhale and exhale through the valve system. During inhalation, the valve system functions to produce a vacuum within the thorax to increase blood flow back to the right heart of the person, thereby increasing blood circulation and blood pressure. Further, at least one physiological parameter is measured both prior to and while the person inhales and exhales through the valve system. The measured parameters are evaluated to confirm the initial diagnosis of a cardiovascular condition.

Description

    CROSS REFERENCES TO RELATED APPLICATIONS
  • This invention is a continuation in part application and claims the benefit of U.S. patent application Ser. No. 11/051,345, Feb. 4, 2005, which is a continuation application of U.S. patent application Ser. No. 10/251,080, filed Sep. 20, 2002 (now U.S. Pat. No. 6,863,656), the complete disclosures of which are herein incorporated by reference.
  • BACKGROUND OF THE INVENTION
  • This invention relates generally to the field of diagnostics, and in particular to the diagnosis of cardiovascular conditions. More specifically, the invention relates to systems and methods for stressing a patient's cardiovascular system and then measuring various physiological parameters in order to diagnose the patient's condition.
  • Cardiovascular ailments, such as high blood pressure, coronary artery disease, and the like pose a significant health threat to millions of individuals. The early and proper diagnosis of such ailments can be beneficial in placing the patient on the road to recovery. Over the years, a variety of techniques have been developed to diagnose such conditions. Some of these techniques involve stressing the patient's cardiovascular system by requiring the patient to physically exercise. For example, one common stress test is to place various monitors on the patient and then require the patient to run on a treadmill. As the patient's system is stressed, parameters such as the patient's blood pressure, heart rate and ECG are measured. These are compared against a set of generally accepted “normal” responses, and abnormal responses are observed based upon the set of “normal” values.
  • While such tests are generally acceptable, they are cumbersome and inconvenient. For example, they may require the patient to run on a treadmill while being connected to a variety of sensors. Moreover, many patients are not able to exercise, and the exercise itself limits the kinds of physiological data that can be acquired. For instance, various types of measuring equipment are not compatible with a patient running on a treadmill.
  • Hence, this invention is related to systems and methods for stressing the patient's cardiovascular system in a more convenient and friendly manner. Such systems and methods provide a wide range of advantages as set forth below.
  • BRIEF SUMMARY OF THE INVENTION
  • The invention provides various systems and methods for diagnosing a cardiovascular-related condition in a breathing person. In one exemplary embodiment, the method proceeds by interfacing a valve system to the person's airway. The valve system is configured to decrease or prevent respiratory gas flow to the person's lungs during at least a portion of an inhalation event. With the valve system coupled to the person, the person is permitted to inhale and exhale through the valve system. During inhalation, the valve system functions to produce a vacuum within the thorax to increase blood flow back to the right heart of the person, thereby increasing blood circulation and blood pressure. Further, at least one physiological parameter is measured while the person inhales and exhales through the valve system. This parameter is evaluated to diagnose a cardiovascular condition. Hence, such a method permits a person's cardiovascular system to be stressed, without having the person physically exercise.
  • In one aspect, the physiological parameter is measured in a base line state prior to permitting the person to inhale and exhale through the valve system. The measured physiological parameter in the base line state is then compared with the measured physiological parameter following inhaling and exhaling to facilitate diagnosis. Further, such measurements may be compared with normal or expected responses, i.e. with historical data from healthy individuals.
  • Conveniently, the valve system may be incorporated into a facial mask that is coupled to the person's face. Further, the valve system may include a pressure responsive inflow valve having an actuating pressure in the range from about 0 cm H20 to about −50 cm H20. In some cases, the actuating pressure may be increased or decreased over time and the physiological parameter re-measured. Further, the actuating pressure may be increased or decreased based on the previously measured physiological parameter.
  • In some aspects, the valve system may be further configured to prevent or decrease exhaled gases from exiting the person's lungs during at least a portion of an exhalation. Also, the physiological parameter may be measured following an exhalation.
  • One particular feature is that the physiological parameter may be measured by an imaging or mapping technique, such as by an ECG, by echo-imaging of the heart, by imaging of radio-labeled markers in the blood, by MRI imaging, by CT imaging, by imaging of markers for cardiac ischemic, and the like. Use of many of these imaging or mapping techniques is possible during the stress test since the person needs only to be coupled to the valve system and is not required to physically exercise during the test. Use of the valve system also permits a wide range of parameters to be measured, such as blood pressure, expired CO2, heart rate, air flow and pressure through the airway and lungs, oxygen saturation, blood levels of O2, blood lactate, blood pH, tissue lactate, tissue pH, body temperature, and the like.
  • To enhance the effect of the valve system, one or more substances may be introduced into the person to stress the person's heart. Such substances may be injected into the person's blood stream (such as by use of a needle), may be delivered orally, may be inhaled, or the like. For example, the substance may comprise a volume load of saline solution that is injected into the person's blood stream to stress the person's system. As another example, the substance may comprise nitroglycerine that is injected into the person to lower the person's blood pressure. Other drugs that may be used to stress the heart include adenosine, adrenaline, dobutamine and the like.
  • In another embodiment, the invention provides an exemplary system for diagnosing a cardiovascular-related condition in a breathing person. The system includes a valve system that is capable of being coupled to the person's airway. The valve system is configured to decrease or prevent respiratory gas flow to the person's lungs during at least a portion of an inhalation event to produce a vacuum within the thorax to in turn increase blood flow back to the right heart of the person. In so doing, blood circulation and blood pressure is increased. The system also includes a monitoring system to monitor changes in at least one physiological parameter while the person inhales and exhales through the valve system. In this way, the person's cardiovascular system may be stressed on monitored simply by coupling the valve system to the person's airway and measuring the parameters.
  • In one aspect, the monitoring system includes a computer for evaluating the measured parameter to diagnose a cardiovascular condition. Conveniently, at least a portion of the monitoring system may be physically incorporated into the valve system. The monitoring system may also include a controller to change the configuration of the valve system over time to vary the level of inspiratory impedance. For example, the controller may be configured to change the configuration of the valve system based on the measured parameters.
  • In a further aspect, the valve system may be configured to prevent or decrease exhaled gases from exiting the person's lungs during at least a portion of an exhalation. Further, the valve system may be incorporated into a facial mask that is configured to be coupled to the person's face. The valve system may conveniently include a pressure responsive inflow valve that has an actuating pressure in the range from about 0 cm H20 to about −50 cm H20. Such a valve permits gases to flow to the person's lungs during a latter portion of an inhalation event in order to provide sufficient ventilation.
  • In one particular aspect, the monitoring system may comprise an imaging or mapping system. Examples of systems that may be used include an ECG system, a heart echo-imaging system, a radio-labeled marker imaging system for measuring makers in the blood, an MRI imaging system, a CT imaging system and a cardiac ischemic imaging system. Further, the monitoring system may use a wide range of sensors, such as blood pressure sensors, expired CO2 sensors, heart rate sensors, air flow and pressure sensors, oxygen saturation sensors, O2 blood level sensors, blood lactate sensors, blood pH sensors, tissue lactate sensors, tissue pH sensors and body temperature sensors.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is a flow chart illustrating one method for diagnosing a cardiovascular-related condition according to the invention.
  • FIG. 2 is a perspective view of one embodiment of a facial mask and a valve system that may be used to facilitate a diagnosis according to the invention.
  • FIG. 3 is a perspective view of the valve system of FIG. 2.
  • FIG. 4 is a cross sectional side view of the valve system of FIG. 3.
  • FIG. 5 is an exploded view of the valve system of FIG. 3.
  • FIG. 6 is a schematic diagram of a system for diagnosing cardio-vascular-related conditions according to the invention.
  • DETAILED DESCRIPTION OF THE INVENTION
  • The invention provides various systems and methods to facilitate the measurement of one or more physiological parameters while a person's cardiovascular system is being stressed. The stress tests of the invention may be used when diagnosing a wide range of cardiovascular conditions, such as coronary artery disease, high blood pressure, pulmonary hypertension, cardiac function, severity of peripheral vascular disease, integrity of certain autonomic nervous system reflexes (including the carotid-baro reflex and the vagovagal reflex), intracardiac shunting of blood, and the like.
  • To stress the cardiovascular system, the invention may utilize some type of inspiratory impedance, at one or more predetermine levels, to increase venous blood flow to the heart, thereby increasing-overall circulation and blood pressure. Such a perturbation of the normal physiological system of the body may be assessed by concurrent physiological monitoring. Further, the level of inspiratory impedance, and the way it is altered, may vary. For example, the level of impedance may vary by performing an automatic step-up or step-down of impedance, or it may vary depending upon physiological feedback
  • To prevent or impede respiratory gases from flowing to the lungs, a variety of impeding or preventing mechanisms may be used, including those described in U.S. Pat. Nos. 5,551,420; 5,692,498; 6,062,219; 5,730,122; 6,155,257; 6,234,916 and 6,224,562, and 6,986,349, and in U.S. patent application Ser. No. 09/966,945, filed Sep. 28, 2001 and Ser. No. 09/967,029, filed Sep. 28, 2001, the complete disclosures of which are herein incorporated by reference. The resistance to the inflow of respiratory gases may be set between about 0 cm H2O and about 50 cm H2O and may be variable or fixed as described above.
  • Because the person's system may be stressed without requiring physical exercise, monitoring of a wide range of physical parameters or conditions may be accomplished in a more convenient manner. For example, monitoring during the stress test may include, but is not limited to, ECG, blood pressure, echo-images of the heart (such as with an ultrasonic transducer or catheter), radio-labeled markers to visualize blood flow, MRI-imaging, CT imaging, measurement of expired CO2, heart rate, air flow and pressure through the airway and lungs, oxygen saturation and/or blood levels of O2, blood lactate, blood pH, tissue lactate, tissue pH, markers for cardiac ischemic (including tissue and serum creatinine phospho-kinase, serum troponin, serum adenosine—that may all be measured non-invasively or with minimal invasive techniques), temperature, and the like. In some cases, the imaging may need to be gated based upon the respiratory rate, or motion associated with the change in the position of the heart and other body structures (such as when taking MRI or CT images). Further, the valve system permits measurements to be made while the person is standing, sitting or lying down.
  • Hence, the valve may be configured to decrease intrathoracic pressures relative to both atmosphere pressures and extrathoracic pressures during diagnosis. Its use results in a greater vacuum in the thorax relative to the rest of the body during an inhalation maneuver. This forces more blood back to the chest, thereby increasing blood available for the heart beat. This results in a greater organ perfusion and thus stresses the cardiovascular system in a manner similar to performing exercise.
  • Conveniently, such valve systems may be incorporated into a facial mask to facilitate coupling of the valve system to the person's airway. Before actuating the valve system, the physiological measures may be made in a baseline state. The valve system may then be actuated or coupled to the airway and measurements taken while the person is breathing through the valve system (which functions to stress the person's cardiovascular system). In some embodiments, the valve system may be connected to or be able to communicate with monitoring systems to record, either directly or remotely from a transmitted signal, a wide variety of diagnostic information. These measurements may be taken before, during and after performing the stress test. The level of inspiratory impedance (plus or minus a small decrease of expiratory impedance) may be varied over a wide range of pressure using designs described in the above referenced patents and applications.
  • In addition to the use of the valve system, or as an alternative to the valve system, one or more substances may be introduced into the person to stress the person's heart. Hence, in some embodiments, the person's system may be stressed both by the impedance provided by the valve system while breathing and by the substance that is introduced into the patient. These substances may be introduced at one or more times, and using one or more techniques. For example, such substances may be injected into the person's blood stream (such as by use of a needle), may be delivered orally, may be inhaled, or the like. Further, the substances may be introduced before, during and/or after the valve system is coupled to the person. For example, the substance may comprise a volume load of saline solution that is injected into the person's blood stream to stress the person's system. As one example, the volume of saline solution may be in the range from about 500 cc to about 1,000 cc. As another example, the substance may comprise nitroglycerine that is injected into the person to lower the person's blood pressure. Other drugs that may he used to stress the heart include adenosine, adrenaline, dobutamine and the like.
  • Referring now to FIG. 1, one method for diagnosing cardiovascular-related conditions will be described. As shown in step 10, baseline physiological parameters may be measured and recorded. The baseline parameters are preferably taken before any stressing of the person's cardiovascular system. These parameters may comprise any of those previously described. Conveniently, these measurements may be stored in a computer and used for later analysis when comparing subsequent measurements. At this point, an initial diagnosis may also be performed. For example, a person's blood pressure may be measured. If the measured blood pressure is less than an expected blood pressure for a healthy person having the same physical characteristics (age, weight, sex, etc), then the person can be diagnosed as having low blood pressure. As another example, a person's heart rate variability may be measured, such as by a routine ECG testing analysis. If the heart rate variability is less than would be expected from a healthy patient, then an initial diagnosis may be that the person's heart rate variability is low.
  • The method also involves the step of coupling a valve system to the patient's airway as shown in step 12. This may be performed prior to taking any baseline measurements, provided the valve system is not actuated, or after the baseline measurements have been taken. If before, the valve system may simply be actuated when ready to begin stressing of the person's system. As the person breathes through the valve system, various physiological parameters are measured and recorded as shown in step 14. While breathing through valve system 200, the augmentation of pressures within the thorax increases venous blood flow to the heart, to increase overall circulation and blood pressure. As previously described, a substance may also be introduced into the person to increase the amount of stress on the person's system. One advantage of such a method is that measurements may be made using equipment that have typically been incompatible with stress tests. For example, the person may be imaged in a MRI or CT imaging device while breathing through the valve system. Echo images of the heart may also be taken while breathing through the valve system. Further, other measurements may be taken as previously described.
  • In some cases, it may be desirable to vary the inspiratory impedance level as shown in step 16. This may be the level of inspiratory impedance, expiratory impedance or both. In such cases, the level of impedance may be varied as illustrated in step 18, and the process reverts back to step 14 where the parameters are measured with the modified settings. The decision to vary the impedance may be made based on measurements previously recorded. For example, the computer may be programmed to evaluate the measured parameters over time and to send one or more signals to the valve system to change the impedance based on the analysis. Alternatively, the impedance may automatically vary depending on a certain routine. For example, the computer could control an automatic step-up or step-down of impedance. This variance could also be accomplished manually. Techniques for varying the impedance level are described in the previously mentioned patents and patent applications.
  • Once the appropriate measurements have been taken, the valve system may be decoupled or deactuated as shown in step 20. Optionally, measurements may also be taken after competition of the stress test as shown in step 22. With the measurements taken, an analysis of the measured parameters may be made as shown in step 24. These parameters may be measured against themselves, e.g., the change in blood pressure may be evaluated before, during and after the stress test, and/or against a set of historical data. Such historical data may have expected “normal” responses or ranges of normal responses that are compared against the measured data. If outside of the expected normal ranges, the comparison may be flagged for further consideration. In this way, a variety of cardiovascular conditions or problems may be evaluated in a convenient and more efficient manner.
  • In cases where the parameters were measured and an initial diagnosis was made prior to using the valve system, a further diagnosis may be performed to confirm that the initial diagnosis was correct and that the treatment was at least partially successful. For example, if the initial diagnosis was low blood pressure and the person was permitted to breathe through the valve system, new measurements may be taken to evaluate the person's blood pressure. If the blood pressure rose, then one can conclude that the diagnosis was low blood pressure secondary at least in part to a reduction in central venous volume or cardiac preload. In such a case, the patient could be instructed to continue to breathe through the valve system.
  • As another example, if the initial diagnosis was less than normal heart rate variability, the person may be instructed to breathe through the valve system. If this caused the heart rate variability to increase, then one could conclude that this was a proper diagnosis and may be instructed to continue breathing through the valve system regularly to maintain a heart rate variability which is associated with few lethal arrhythmias.
  • FIG. 2 illustrates one embodiment of a facial mask 100 to which is coupled a valve system 200. Mask 100 is configured to be secured to a patient's face so as to cover the mouth and nose. Mask 100 and valve system 200 are examples of one type of equipment that may be used to stress a person's cardiovascular system. However, it will be appreciated that other valve systems and other coupling arrangements may be used including, for example, those previously referenced. As such the invention is not intended to be limited to the specific valve system and mask described below.
  • Referring also to FIGS. 3-5, valve system 200 will be described in greater detail. Valve system 200 includes a valve housing 202 with a socket 204 into which a ball 206 of a ventilation tube 208 is received. In this way, ventilation tube 208 may rotate about a horizontal axis and pivot relative to a vertical axis. A respiratory source, such as a ventilation bag, may be coupled to tube 208 to assist in ventilation. Disposed in ventilation tube 208 is a filter 210 that is spaced above a duck bill valve 212. A diaphragm holder 214 that holds a diaphragm 216 is held within housing 202. Valve system 200 further includes a patient port 218 that is held in place by a second housing 220. Housing 220 conveniently includes tabs 222 to facilitate coupling of valve system 200 with facial mask 100. Also held within housing 220 is a check valve 224 that comprises a spring 224 a, a ring member 224 b, and an o-ring 224 c. Spring 224 a biases ring member 224 b against patient port 218. Patient port 218 includes bypass openings 226 that are covered by o-ring 224 c of check valve 224 until the pressure in patient port 218 reaches a threshold negative pressure to cause spring 224 a to compress.
  • When the patient is actively ventilated, respiratory gases are forced through ventilation tube 208. The gases flow through filter 210, through duck bill valve 212, and forces up diaphragm 214 to permit the gases to exit through port 218. Hence, at any time the patient may be ventilated simply by forcing the respiratory gases through tube 208.
  • During the exhalation phase of a breathing cycle, expired gases flow through port 218 and lift up diaphragm 214. The gases then flow through a passage 227 in ventilation tube 208 where they exit the system through openings 229 (see FIG. 16).
  • During the inhalation phase of a breathing cycle, valve system 200 prevents respiratory gases from flowing into the lungs until a threshold of negative intrathoracic pressure level is exceeded. When this pressure level is exceeded, check valve 224 is pulled downward as springs 224 a are compressed to permit respiratory gases to flow through openings 226 and to the patient's lungs by initially passing through tube 208 and duck bill valve 212. Valve 224 may be set to open when the negative intrathoracic pressure is in the range from about 0 cm H2O to about −50 cm H2O, and more preferably from about −5 cm H2O to about −30 cm H2O. Hence, the magnitude and duration of negative intrathoracic pressure may be enhanced during patient inhalation by use of valve system 200. Once the intrathoracic pressure falls below the threshold, recoil spring 224 a again close check valve 224. In this way, circulation is increased to cause more blood to flow into the thorax and thereby increase vital organ perfusion. In so doing, the person's cardiovascular system is stressed in a convenient manner.
  • Any of the valve systems described herein may be incorporated into a diagnostic system 300 as illustrated in FIG. 6. System 300 may conveniently include facial mask 100 and valve system 200, although any of the valve systems or interfacing mechanisms described herein or the like may be used. Valve system 200 may conveniently be coupled to a controller 310. In turn, controller 310 may be used to control the impedance level of valve system 200 in a manner similar to any of the embodiments described herein. The level of impedance may be varied based on measurements of physiological parameters, or using a programmed schedule of changes. System 300 may include a wide variety of sensors and/or measuring devices to measure any of the physiological parameters described herein. These sensors or measuring devices may be integrated within or coupled to valve system 200 or facial mask, or may be separate.
  • For example, valve system 200 may include a pressure transducer for taking pressure measurements (such as the intrathoracic pressures), a flow rate measuring device for measuring the flow rate of air into or out of the lungs, or a CO2 sensor for measuring expired CO2. As another example, system 300 may include an imaging device 320 for taking internal images of the person. Imaging device 320 may comprise a CT scanner, a MRI scanner, or the like. Other examples include equipment for producing echo images of the heart, such as ultrasonic transducers that are used either externally or internally within the heart. With such imaging devices, imaging may need to be gated based upon the respiratory rate, or motion associated with the change in position of the heart and other body structures. This may be accomplished using controller 310.
  • The use of valve system 200 permits the use of such imaging equipment because the person's cardiovascular system may be stressed without requiring the person to physically exercise. Instead, the person may sit or lie essentially motionless (except for breathing motion) and be imaged or have other measurements taken.
  • Examples of other sensors or measuring devices include a heart rate sensor 330, a blood pressure sensor 340, and a temperature sensor 350. These sensors may also be coupled to controller 310 so that measurements may be recorded. Further, it will be appreciated that other types of measuring devices may be used to measure various physiological parameters, such as oxygen saturation and/or blood levels of O2, blood lactate, blood pH, tissue lactate, tissue pH and the like.
  • In some cases, controller 310 may be used to control valve system 200, to control any sensors or measuring devices, to record measurements, and to perform any comparisons. Alternatively, a set of computers and/or controllers may be used in combination to perform such tasks. This equipment may have appropriate processors, display screens, input and output devices, entry devices, memory or databases, software, and the like needed to operate system 300. For example, once measurements have been taken and recorded, controller 310 may access a database to obtain information on expected responses. Controller 310 may then perform a comparison to determine any differences and to recommend a possible diagnosis. This information may be stored in a patient record and may also be displayed to a physician and/or printed using a printer.
  • Controller 310 may also be used to assist in performing an initial diagnosis prior to using the valve system. For example, if blood pressure measurements were taken, controller 310 could be used to diagnose whether the measured blood pressure was low based on established blood pressure values for similarly situated individuals. A similar diagnosis could be performed for heart rate variability. After breathing through the valve system and new measurements are taken, controller 310 may be used to compare the measurements before and after using the valve to confirm whether the initial diagnosis was correct and whether breathing through the valve system should be continued, including suggested resistance values, timing, duration and the like. This could be done in an iterative fashion over time.
  • The invention has now been described in detail for purposes of clarity and understanding. However, it will be appreciated that certain changes and modifications may be practiced within the scope of the appended claims.

Claims (15)

1-21. (canceled)
22. A method for assessing a person's physical condition, the method comprising:
measuring at least one physiological parameter of a person while the person is normally breathing with an unobstructed airway to produce a baseline value for the physiological parameter;
interfacing a valve system to the person's airway, the valve system being configured to decrease or prevent respiratory gas flow to the person's lungs during at least a portion of an inhalation event;
measuring the physiological parameter while the person inhales and exhales through the valve system to produce an evaluation value for the physiological parameter, wherein during inhalation the valve system functions to produce a vacuum within the thorax to increase blood flow back to the right heart of the person, thereby increasing blood circulation and blood pressure; and
comparing the baseline value with the evaluation value to provide a suggested treatment regimen for the person.
23. A method as in claim 22, further comprising performing the comparison of the measured physiological parameters using a computer.
24. A method as in claim 22, wherein the valve system is incorporated into a facial mask, and further comprising coupling the facial mask to the person's face.
25. A method as in claim 22, wherein the valve system include a pressure responsive inflow valve, and further comprising setting an actuating pressure of the valve to be in the range from about 0 cm H20 to about −50 cm H20.
26. A method as in claim 22, further comprising increasing or decreasing the actuating pressure over time, and re-measuring the physiological parameter.
27. A method as in claim 22, wherein the valve system is further configured to prevent or decrease exhaled gases from exiting the person's lungs during at least a portion of an exhalation, and further comprising measuring the physiological parameter following an exhalation.
28. A method as in claim 22, wherein the physiological parameter is measured by an imaging or mapping technique.
29. A method as in claim 22, wherein the imaging or mapping technique is selected from a group consisting of ECG, echo-imaging of the heart, imaging of radio-labeled markers in the blood, MRI imaging, CT imaging and imaging of markers for cardiac ischemic.
30. A method as in claim 22, wherein the measured physiological parameter is selected from a group consisting of blood pressure, expired CO2, heart rate, air flow and pressure through the airway and lungs, oxygen saturation, blood levels of O2, blood lactate, blood pH, tissue lactate, tissue pH and body temperature.
31. A method as in claim 22, wherein the measured physiological parameter comprises one or more markers of cardiac ischemia.
32. A method as in claim 22, further comprising introducing a substance into the person to stress the person's heart.
33. A method as in claim 22, wherein the substance comprises a volume load of saline solution that is injected into the person's blood stream.
34. A method as in claim 22, wherein the substance comprises nitroglycerine that is injected into the person to lower the person's blood pressure.
35. A method as in claim 22, wherein the substance comprises a drug that is injected into the person and is selected from a group of drugs consisting of adenosine, adrenaline and dobutamine.
US12/723,205 2002-09-20 2010-03-12 System for sensing, diagnosing and treating physiological conditions and methods Abandoned US20100179442A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US12/723,205 US20100179442A1 (en) 2002-09-20 2010-03-12 System for sensing, diagnosing and treating physiological conditions and methods

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US10/251,080 US6863656B2 (en) 2002-09-20 2002-09-20 Stress test devices and methods
US11/051,345 US7311668B2 (en) 2002-09-20 2005-02-04 Stress test devices and methods
US11/949,490 US7682312B2 (en) 2002-09-20 2007-12-03 System for sensing, diagnosing and treating physiological conditions and methods
US12/723,205 US20100179442A1 (en) 2002-09-20 2010-03-12 System for sensing, diagnosing and treating physiological conditions and methods

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US11/949,490 Continuation US7682312B2 (en) 2002-09-20 2007-12-03 System for sensing, diagnosing and treating physiological conditions and methods

Publications (1)

Publication Number Publication Date
US20100179442A1 true US20100179442A1 (en) 2010-07-15

Family

ID=46329890

Family Applications (2)

Application Number Title Priority Date Filing Date
US11/949,490 Expired - Fee Related US7682312B2 (en) 2002-09-20 2007-12-03 System for sensing, diagnosing and treating physiological conditions and methods
US12/723,205 Abandoned US20100179442A1 (en) 2002-09-20 2010-03-12 System for sensing, diagnosing and treating physiological conditions and methods

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US11/949,490 Expired - Fee Related US7682312B2 (en) 2002-09-20 2007-12-03 System for sensing, diagnosing and treating physiological conditions and methods

Country Status (1)

Country Link
US (2) US7682312B2 (en)

Cited By (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070221222A1 (en) * 2003-09-11 2007-09-27 Advanced Circulatory Systems, Inc. Cpr devices and methods utilizing a continuous supply of respiratory gases
US20080257344A1 (en) * 2007-04-19 2008-10-23 Advanced Circulatory Systems, Inc. Volume exchanger valve system and method to increase circulation during cpr
US20100319691A1 (en) * 2009-06-19 2010-12-23 Advanced Circulatory Systems, Inc. Vacuum and positive pressure ventilation systems and methods for intrathoracic pressure regulation
US9238115B2 (en) 2011-12-19 2016-01-19 ResQSystems, Inc. Systems and methods for therapeutic intrathoracic pressure regulation
US9352111B2 (en) 2007-04-19 2016-05-31 Advanced Circulatory Systems, Inc. Systems and methods to increase survival with favorable neurological function after cardiac arrest
US9724266B2 (en) 2010-02-12 2017-08-08 Zoll Medical Corporation Enhanced guided active compression decompression cardiopulmonary resuscitation systems and methods
US9801782B2 (en) 2014-02-19 2017-10-31 Keith G. Lurie Support devices for head up cardiopulmonary resuscitation
US9811634B2 (en) 2013-04-25 2017-11-07 Zoll Medical Corporation Systems and methods to predict the chances of neurologically intact survival while performing CPR
US9949686B2 (en) 2013-05-30 2018-04-24 Zoll Medical Corporation End-tidal carbon dioxide and amplitude spectral area as non-invasive markers of coronary perfusion pressure
US10092481B2 (en) 2014-02-19 2018-10-09 Keith G. Lurie Systems and methods for gravity-assisted cardiopulmonary resuscitation
US10265495B2 (en) 2013-11-22 2019-04-23 Zoll Medical Corporation Pressure actuated valve systems and methods
US10350137B2 (en) 2014-02-19 2019-07-16 Keith G. Lurie Elevation timing systems and methods for head up CPR
US10406069B2 (en) 2014-02-19 2019-09-10 Keith G. Lurie Device for elevating the head and chest for treating low blood flow states
US10406068B2 (en) 2014-02-19 2019-09-10 Keith G. Lurie Lockable head up cardiopulmonary resuscitation support device
US10667987B2 (en) 2014-02-19 2020-06-02 Keith G. Lurie Uniform chest compression CPR
US10780020B2 (en) 2016-09-30 2020-09-22 Zoll Medical Corporation Maintaining active compression decompression device adherence
US11020314B2 (en) 2014-02-19 2021-06-01 Keith G. Lurie Methods and systems to reduce brain damage
US11077016B2 (en) 2014-02-19 2021-08-03 Keith Lurie Systems and methods for head up cardiopulmonary resuscitation
US11096861B2 (en) 2014-02-19 2021-08-24 Keith G. Lurie Systems and methods for gravity-assisted cardiopulmonary resuscitation and defibrillation
US11246794B2 (en) 2014-02-19 2022-02-15 Keith G. Lurie Systems and methods for improved post-resuscitation recovery
US11259988B2 (en) 2014-02-19 2022-03-01 Keith G. Lurie Active compression decompression and upper body elevation system
US11395786B2 (en) 2014-02-19 2022-07-26 Lurie Keith G Systems and methods for head up cardiopulmonary resuscitation
US11844742B2 (en) 2014-02-19 2023-12-19 Keith G. Lurie Methods and systems to reduce brain damage

Families Citing this family (45)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7195013B2 (en) * 1993-11-09 2007-03-27 Advanced Circulatory Systems, Inc. Systems and methods for modulating autonomic function
US6024089A (en) 1997-03-14 2000-02-15 Nelcor Puritan Bennett Incorporated System and method for setting and displaying ventilator alarms
US7682312B2 (en) * 2002-09-20 2010-03-23 Advanced Circulatory Systems, Inc. System for sensing, diagnosing and treating physiological conditions and methods
US7766011B2 (en) * 2003-04-28 2010-08-03 Advanced Circulatory Systems, Inc. Positive pressure systems and methods for increasing blood pressure and circulation
US20080047555A1 (en) * 2003-09-11 2008-02-28 Advanced Circulatory Systems, Inc. Bag-valve resuscitation for treating of hypotension, head trauma, and cardiac arrest
WO2008051285A2 (en) 2006-04-01 2008-05-02 Medical Service Consultation International, Llc Methods and compositions for detecting fungi and mycotoxins
US8021310B2 (en) 2006-04-21 2011-09-20 Nellcor Puritan Bennett Llc Work of breathing display for a ventilation system
US7784461B2 (en) 2006-09-26 2010-08-31 Nellcor Puritan Bennett Llc Three-dimensional waveform display for a breathing assistance system
US20080255482A1 (en) * 2007-04-16 2008-10-16 Advanced Circulatory Systems, Inc. Intrathoracic pressure limiter and cpr device for reducing intracranial pressure and methods of use
US8210176B2 (en) 2007-06-18 2012-07-03 Advanced Circulatory Systems, Inc. Method and system to decrease intracranial pressure, enhance circulation, and encourage spontaneous respiration
US20090062701A1 (en) * 2007-06-29 2009-03-05 Advanced Circulatory Systems, Inc. Lower extremity compression devices, systems and methods to enhance circulation
US8251876B2 (en) 2008-04-22 2012-08-28 Hill-Rom Services, Inc. Breathing exercise apparatus
US20090277447A1 (en) * 2008-05-12 2009-11-12 Advanced Circulatory Systems, Inc. System, method, and device to increase circulation during cpr without requiring positive pressure ventilation
US20100068718A1 (en) 2008-08-22 2010-03-18 Hooper Dennis G Methods and Compositions for Identifying Yeast
US20100075322A1 (en) * 2008-08-22 2010-03-25 Hooper Dennis G Methods and Compositions for Identifying Mycotoxins and Fungal Species
US8302602B2 (en) 2008-09-30 2012-11-06 Nellcor Puritan Bennett Llc Breathing assistance system with multiple pressure sensors
EP2251660B1 (en) * 2009-05-14 2016-07-27 Drägerwerk AG & Co. KGaA Double temperature sensor
US8962251B2 (en) 2009-10-08 2015-02-24 Medical Service Consultation International, Llc Methods and compositions for identifying sulfur and iron modifying bacteria
US9119925B2 (en) 2009-12-04 2015-09-01 Covidien Lp Quick initiation of respiratory support via a ventilator user interface
US8924878B2 (en) 2009-12-04 2014-12-30 Covidien Lp Display and access to settings on a ventilator graphical user interface
US8335992B2 (en) 2009-12-04 2012-12-18 Nellcor Puritan Bennett Llc Visual indication of settings changes on a ventilator graphical user interface
US8499252B2 (en) 2009-12-18 2013-07-30 Covidien Lp Display of respiratory data graphs on a ventilator graphical user interface
US9262588B2 (en) 2009-12-18 2016-02-16 Covidien Lp Display of respiratory data graphs on a ventilator graphical user interface
US9364624B2 (en) 2011-12-07 2016-06-14 Covidien Lp Methods and systems for adaptive base flow
US9498589B2 (en) 2011-12-31 2016-11-22 Covidien Lp Methods and systems for adaptive base flow and leak compensation
US9180271B2 (en) 2012-03-05 2015-11-10 Hill-Rom Services Pte. Ltd. Respiratory therapy device having standard and oscillatory PEP with nebulizer
US8844526B2 (en) 2012-03-30 2014-09-30 Covidien Lp Methods and systems for triggering with unknown base flow
US9993604B2 (en) 2012-04-27 2018-06-12 Covidien Lp Methods and systems for an optimized proportional assist ventilation
US10362967B2 (en) 2012-07-09 2019-07-30 Covidien Lp Systems and methods for missed breath detection and indication
KR102025571B1 (en) * 2012-07-27 2019-09-27 삼성전자주식회사 Apparatus and method for measuring change in blood pressure caused by breathing control
US9375542B2 (en) 2012-11-08 2016-06-28 Covidien Lp Systems and methods for monitoring, managing, and/or preventing fatigue during ventilation
US8956821B2 (en) 2013-02-06 2015-02-17 Medical Service Consultation International, Llc Methods and compositions for detecting Aspergillus terreus, Aspergillus niger, and mycotoxins
US9358355B2 (en) 2013-03-11 2016-06-07 Covidien Lp Methods and systems for managing a patient move
US9981096B2 (en) 2013-03-13 2018-05-29 Covidien Lp Methods and systems for triggering with unknown inspiratory flow
AT14374U1 (en) * 2014-03-25 2015-10-15 Johannes Dr Krottmaier Device for the non-invasive determination of lactate values and method therefor
US9808591B2 (en) 2014-08-15 2017-11-07 Covidien Lp Methods and systems for breath delivery synchronization
US9950129B2 (en) 2014-10-27 2018-04-24 Covidien Lp Ventilation triggering using change-point detection
US9925346B2 (en) 2015-01-20 2018-03-27 Covidien Lp Systems and methods for ventilation with unknown exhalation flow
US10905836B2 (en) 2015-04-02 2021-02-02 Hill-Rom Services Pte. Ltd. Manifold for respiratory device
US10226201B2 (en) * 2015-10-29 2019-03-12 Invoy Holdings, Llc Flow regulation device for breath analysis and related method
CN110049799B (en) 2017-11-14 2022-04-26 柯惠有限合伙公司 Method and system for driving pressure spontaneous ventilation
US11517691B2 (en) 2018-09-07 2022-12-06 Covidien Lp Methods and systems for high pressure controlled ventilation
US11324954B2 (en) 2019-06-28 2022-05-10 Covidien Lp Achieving smooth breathing by modified bilateral phrenic nerve pacing
US11896767B2 (en) 2020-03-20 2024-02-13 Covidien Lp Model-driven system integration in medical ventilators
US11672934B2 (en) 2020-05-12 2023-06-13 Covidien Lp Remote ventilator adjustment

Citations (70)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2774346A (en) * 1953-07-13 1956-12-18 Dorothy L Bischof Respirator
US3191596A (en) * 1960-09-19 1965-06-29 Forrest M Bird Respirator
US3662751A (en) * 1970-05-20 1972-05-16 Michigan Instr Inc Automatic respirator-inhalation therapy device
US3669108A (en) * 1969-10-20 1972-06-13 Veriflo Corp Ventilator
US3794043A (en) * 1972-11-08 1974-02-26 Lanz Medical Prod Co Endotracheal tube with inflatable cuff and check valve
US3815606A (en) * 1972-09-21 1974-06-11 C Mazal Endotracheal catheter
US3834383A (en) * 1972-12-11 1974-09-10 Puritan Bennett Corp Respiration apparatus with flow responsive control valve
US3933171A (en) * 1974-04-09 1976-01-20 Airco, Inc. Anesthesia breathing circuit with positive end expiratory pressure valve
US4041943A (en) * 1975-08-25 1977-08-16 Miller Bruce B Control apparatus for variable regulation of lung inflation hold time
US4077404A (en) * 1975-09-17 1978-03-07 H. B. W. Medical Instruments Manufacturing Company, Inc. Breathing equipment such as resuscitators
US4166458A (en) * 1975-01-17 1979-09-04 Harrigan Roy Major External cardiac resuscitation aid
US4226233A (en) * 1978-10-10 1980-10-07 Longevity Products, Inc. Respirators
US4259951A (en) * 1979-07-30 1981-04-07 Chesebrough-Pond's Inc. Dual valve for respiratory device
US4298023A (en) * 1980-09-09 1981-11-03 Mcginnis Gerald E Spring loaded exhalation valve
US4316458A (en) * 1978-05-09 1982-02-23 National Research Development Corporation Patient ventilators
US4320754A (en) * 1977-10-07 1982-03-23 Watson Robert L Controllable partial rebreathing anesthesia circuit and respiratory assist device
US4446864A (en) * 1980-07-10 1984-05-08 Watson Robert L Emergency ventilation tube
US4449526A (en) * 1981-11-27 1984-05-22 Elam James O Mask breathing system
US4533137A (en) * 1982-01-19 1985-08-06 Healthscan Inc. Pulmonary training method
US4601465A (en) * 1984-03-22 1986-07-22 Roy Jean Yves Device for stimulating the human respiratory system
US4881527A (en) * 1988-11-14 1989-11-21 Lerman Samuel I Cardiac assist cuirass
US5050593A (en) * 1990-06-01 1991-09-24 Massachusetts Institute Of Technology Respirator triggering mechanism
US5109840A (en) * 1991-02-14 1992-05-05 Specialty Packaging Licensing Company Resuscitator having directional control valve with internal "PEEP" adjustment valve
US5163424A (en) * 1988-11-04 1992-11-17 Ambu International A/S Disposable resuscitator
US5193544A (en) * 1991-01-31 1993-03-16 Board Of Trustees Of The Leland Stanford Junior University System for conveying gases from and to a subject's trachea and for measuring physiological parameters in vivo
US5217006A (en) * 1990-04-05 1993-06-08 Mcculloch Norma D In or relating to a resuscitator
US5235970A (en) * 1990-03-26 1993-08-17 Augustine Medical, Inc. Tracheal intubation with a stylet guide
US5295481A (en) * 1991-11-01 1994-03-22 Geeham Calvin T Cardiopulmonary resuscitation assist device
US5301667A (en) * 1992-08-03 1994-04-12 Vital Signs, Inc. Pressure limiting valve for ventilation breathing bag apparatus
US5305743A (en) * 1992-03-05 1994-04-26 Brain Archibald Ian Jeremy Artificial airway device
US5316907A (en) * 1993-01-22 1994-05-31 Regents Of The University Of Minnesota Enzymatic fluorometric assay for adenylate cyclase
US5355879A (en) * 1992-09-28 1994-10-18 Brain Archibald Ian Jeremy Laryngeal-mask construction
US5359998A (en) * 1992-10-23 1994-11-01 Lloyd Lee J Manual resuscitator
US5392774A (en) * 1992-11-06 1995-02-28 Nissho Corporation Emergency resuscitation apparatus
US5423772A (en) * 1993-08-13 1995-06-13 Daig Corporation Coronary sinus catheter
US5454779A (en) * 1991-04-17 1995-10-03 The Regents Of The University Of California Devices and methods for external chest compression
US5551420A (en) * 1993-11-09 1996-09-03 Cprx, Inc. CPR device and method with structure for increasing the duration and magnitude of negative intrathoracic pressures
US5582182A (en) * 1994-10-03 1996-12-10 Sierra Biotechnology Company, Lc Abnormal dyspnea perception detection system and method
US5588422A (en) * 1992-11-17 1996-12-31 Regents Of The University Of Minnesota Methods and pharmaceutical compositions for enhanced cardiopulmonary resuscitation
US5618665A (en) * 1993-01-22 1997-04-08 Regents Of The University Of Minnesota Enzymatic fluorometric assay for adenylate cyclase
US5643231A (en) * 1993-08-13 1997-07-01 Daig Corporation Coronary sinus catheter
US5645522A (en) * 1991-04-17 1997-07-08 The Regents Of The University Of California Devices and methods for controlled external chest compression
US5692498A (en) * 1993-11-09 1997-12-02 Cprx, Inc. CPR device having valve for increasing the duration and magnitude of negative intrathoracic pressures
US5730122A (en) * 1996-11-12 1998-03-24 Cprx, Inc. Heart failure mask and methods for increasing negative intrathoracic pressures
US5794615A (en) * 1994-06-03 1998-08-18 Respironics, Inc. Method and apparatus for providing proportional positive airway pressure to treat congestive heart failure
US5827893A (en) * 1996-03-29 1998-10-27 Lurie; Keith G. Mechanical and pharmacological therapies to treat cardiac arrest
US5919210A (en) * 1997-04-10 1999-07-06 Pharmatarget, Inc. Device and method for detection and treatment of syncope
US5984909A (en) * 1993-08-13 1999-11-16 Daig Corporation Coronary sinus catheter
US6001085A (en) * 1993-08-13 1999-12-14 Daig Corporation Coronary sinus catheter
US6062219A (en) * 1993-11-09 2000-05-16 Cprx Llc Apparatus and methods for assisting cardiopulmonary resuscitation
US6086582A (en) * 1997-03-13 2000-07-11 Altman; Peter A. Cardiac drug delivery system
US6155257A (en) * 1998-10-07 2000-12-05 Cprx Llc Cardiopulmonary resuscitation ventilator and methods
US6224562B1 (en) * 1998-06-11 2001-05-01 Cprx Llc Methods and devices for performing cardiopulmonary resuscitation
US6277107B1 (en) * 1993-08-13 2001-08-21 Daig Corporation Guiding introducer for introducing medical devices into the coronary sinus and process for using same
US6486206B1 (en) * 1997-09-29 2002-11-26 Cprx Inc. Mechanical and pharmacologic therapies to treat cardiac arrest
US20030062040A1 (en) * 2001-09-28 2003-04-03 Lurie Keith G. Face mask ventilation/perfusion systems and method
US6544172B2 (en) * 2001-05-08 2003-04-08 The Goodyear Tire & Rubber Company Methods for evaluating individuals capacity and establishment of requirements for a job
US6604523B2 (en) * 1993-11-09 2003-08-12 Cprx Llc Apparatus and methods for enhancing cardiopulmonary blood flow and ventilation
US6631716B1 (en) * 1998-07-17 2003-10-14 The Board Of Trustees Of The Leland Stanford Junior University Dynamic respiratory control
US6662032B1 (en) * 1999-07-06 2003-12-09 Intercure Ltd. Interventive-diagnostic device
US20040058305A1 (en) * 2002-09-25 2004-03-25 Cprx Llc Apparatus for performing and training CPR and methods for using the same
US6776153B1 (en) * 2003-03-11 2004-08-17 B. Keith Walker Hybrid atmospheric water heater
US6863656B2 (en) * 2002-09-20 2005-03-08 Advanced Circulatory Systems, Inc. Stress test devices and methods
US20080255482A1 (en) * 2007-04-16 2008-10-16 Advanced Circulatory Systems, Inc. Intrathoracic pressure limiter and cpr device for reducing intracranial pressure and methods of use
US20080257344A1 (en) * 2007-04-19 2008-10-23 Advanced Circulatory Systems, Inc. Volume exchanger valve system and method to increase circulation during cpr
US7682312B2 (en) * 2002-09-20 2010-03-23 Advanced Circulatory Systems, Inc. System for sensing, diagnosing and treating physiological conditions and methods
US7766011B2 (en) * 2003-04-28 2010-08-03 Advanced Circulatory Systems, Inc. Positive pressure systems and methods for increasing blood pressure and circulation
US7836881B2 (en) * 2003-04-28 2010-11-23 Advanced Circulatory Systems, Inc. Ventilator and methods for treating head trauma and low blood circulation
US20100319691A1 (en) * 2009-06-19 2010-12-23 Advanced Circulatory Systems, Inc. Vacuum and positive pressure ventilation systems and methods for intrathoracic pressure regulation
US8011367B2 (en) * 2003-09-11 2011-09-06 Advanced Circulatory Systems, Inc. CPR devices and methods utilizing a continuous supply of respiratory gases

Family Cites Families (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CA668771A (en) 1963-08-20 P. Burke Edward Respirator for laryngectomies
SE389020B (en) 1973-11-13 1976-10-25 Aga Ab DEVICE FOR VENTILATION OF A PATIENT THROUGH A LUNG FAN
US4326507A (en) 1979-11-20 1982-04-27 Michigan Instruments, Inc. CPR Protocol and cardiopulmonary resuscitator for effecting the same
CA1220111A (en) 1983-05-04 1987-04-07 Wallace F. Cook, Jr. Resuscitator bag
EP0139363A1 (en) 1983-08-02 1985-05-02 O-Two Systems International Inc. Breathing apparatus
ATE61525T1 (en) 1986-04-29 1991-03-15 Georges Boussignac CANNULES TO ASSIST VENTILATION.
US4928674A (en) 1988-11-21 1990-05-29 The Johns Hopkins University Cardiopulmonary resuscitation and assisted circulation system
BE1004384A3 (en) 1989-08-03 1992-11-10 Labaere Emmanuel Device for applying on and techniques exhalation.
US5282463A (en) 1991-09-13 1994-02-01 Hammer-Plane, Inc. Anti-disconnect apparatus and method, for breathing systems
US5335654A (en) 1992-05-07 1994-08-09 New York University Method and apparatus for continuous adjustment of positive airway pressure for treating obstructive sleep apnea
EP0756502B1 (en) 1994-04-19 1999-03-03 Jakob Bösherz Respirator, in particular for the treatment of respiratory insufficiency, and a method of operating said respirator

Patent Citations (77)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2774346A (en) * 1953-07-13 1956-12-18 Dorothy L Bischof Respirator
US3191596A (en) * 1960-09-19 1965-06-29 Forrest M Bird Respirator
US3669108A (en) * 1969-10-20 1972-06-13 Veriflo Corp Ventilator
US3662751A (en) * 1970-05-20 1972-05-16 Michigan Instr Inc Automatic respirator-inhalation therapy device
US3815606A (en) * 1972-09-21 1974-06-11 C Mazal Endotracheal catheter
US3794043A (en) * 1972-11-08 1974-02-26 Lanz Medical Prod Co Endotracheal tube with inflatable cuff and check valve
US3834383A (en) * 1972-12-11 1974-09-10 Puritan Bennett Corp Respiration apparatus with flow responsive control valve
US3933171A (en) * 1974-04-09 1976-01-20 Airco, Inc. Anesthesia breathing circuit with positive end expiratory pressure valve
US4166458A (en) * 1975-01-17 1979-09-04 Harrigan Roy Major External cardiac resuscitation aid
US4041943A (en) * 1975-08-25 1977-08-16 Miller Bruce B Control apparatus for variable regulation of lung inflation hold time
US4077404A (en) * 1975-09-17 1978-03-07 H. B. W. Medical Instruments Manufacturing Company, Inc. Breathing equipment such as resuscitators
US4320754A (en) * 1977-10-07 1982-03-23 Watson Robert L Controllable partial rebreathing anesthesia circuit and respiratory assist device
US4316458A (en) * 1978-05-09 1982-02-23 National Research Development Corporation Patient ventilators
US4226233A (en) * 1978-10-10 1980-10-07 Longevity Products, Inc. Respirators
US4259951A (en) * 1979-07-30 1981-04-07 Chesebrough-Pond's Inc. Dual valve for respiratory device
US4446864A (en) * 1980-07-10 1984-05-08 Watson Robert L Emergency ventilation tube
US4298023A (en) * 1980-09-09 1981-11-03 Mcginnis Gerald E Spring loaded exhalation valve
US4449526A (en) * 1981-11-27 1984-05-22 Elam James O Mask breathing system
US4533137A (en) * 1982-01-19 1985-08-06 Healthscan Inc. Pulmonary training method
US4601465A (en) * 1984-03-22 1986-07-22 Roy Jean Yves Device for stimulating the human respiratory system
US5163424A (en) * 1988-11-04 1992-11-17 Ambu International A/S Disposable resuscitator
US4881527A (en) * 1988-11-14 1989-11-21 Lerman Samuel I Cardiac assist cuirass
US5235970A (en) * 1990-03-26 1993-08-17 Augustine Medical, Inc. Tracheal intubation with a stylet guide
US5217006A (en) * 1990-04-05 1993-06-08 Mcculloch Norma D In or relating to a resuscitator
US5050593A (en) * 1990-06-01 1991-09-24 Massachusetts Institute Of Technology Respirator triggering mechanism
US5193544A (en) * 1991-01-31 1993-03-16 Board Of Trustees Of The Leland Stanford Junior University System for conveying gases from and to a subject's trachea and for measuring physiological parameters in vivo
US5109840A (en) * 1991-02-14 1992-05-05 Specialty Packaging Licensing Company Resuscitator having directional control valve with internal "PEEP" adjustment valve
US5454779A (en) * 1991-04-17 1995-10-03 The Regents Of The University Of California Devices and methods for external chest compression
US5645522A (en) * 1991-04-17 1997-07-08 The Regents Of The University Of California Devices and methods for controlled external chest compression
US5295481A (en) * 1991-11-01 1994-03-22 Geeham Calvin T Cardiopulmonary resuscitation assist device
US5305743A (en) * 1992-03-05 1994-04-26 Brain Archibald Ian Jeremy Artificial airway device
US5301667A (en) * 1992-08-03 1994-04-12 Vital Signs, Inc. Pressure limiting valve for ventilation breathing bag apparatus
US5355879A (en) * 1992-09-28 1994-10-18 Brain Archibald Ian Jeremy Laryngeal-mask construction
US5359998A (en) * 1992-10-23 1994-11-01 Lloyd Lee J Manual resuscitator
US5392774A (en) * 1992-11-06 1995-02-28 Nissho Corporation Emergency resuscitation apparatus
US5588422A (en) * 1992-11-17 1996-12-31 Regents Of The University Of Minnesota Methods and pharmaceutical compositions for enhanced cardiopulmonary resuscitation
US5316907A (en) * 1993-01-22 1994-05-31 Regents Of The University Of Minnesota Enzymatic fluorometric assay for adenylate cyclase
US5618665A (en) * 1993-01-22 1997-04-08 Regents Of The University Of Minnesota Enzymatic fluorometric assay for adenylate cyclase
US5984909A (en) * 1993-08-13 1999-11-16 Daig Corporation Coronary sinus catheter
US6656166B2 (en) * 1993-08-13 2003-12-02 St. Jude Medical Guiding introducer for introducing medical devices into the coronary sinus and process for using same
US5549581A (en) * 1993-08-13 1996-08-27 Daig Corporation Coronary sinus catheter
US5643231A (en) * 1993-08-13 1997-07-01 Daig Corporation Coronary sinus catheter
US5423772A (en) * 1993-08-13 1995-06-13 Daig Corporation Coronary sinus catheter
US6277107B1 (en) * 1993-08-13 2001-08-21 Daig Corporation Guiding introducer for introducing medical devices into the coronary sinus and process for using same
US5722963A (en) * 1993-08-13 1998-03-03 Daig Corporation Coronary sinus catheter
US6001085A (en) * 1993-08-13 1999-12-14 Daig Corporation Coronary sinus catheter
US5551420A (en) * 1993-11-09 1996-09-03 Cprx, Inc. CPR device and method with structure for increasing the duration and magnitude of negative intrathoracic pressures
US6604523B2 (en) * 1993-11-09 2003-08-12 Cprx Llc Apparatus and methods for enhancing cardiopulmonary blood flow and ventilation
US6062219A (en) * 1993-11-09 2000-05-16 Cprx Llc Apparatus and methods for assisting cardiopulmonary resuscitation
US6986349B2 (en) * 1993-11-09 2006-01-17 Advanced Circulatory Systems, Inc. Systems and methods for enhancing blood circulation
US5692498A (en) * 1993-11-09 1997-12-02 Cprx, Inc. CPR device having valve for increasing the duration and magnitude of negative intrathoracic pressures
US5794615A (en) * 1994-06-03 1998-08-18 Respironics, Inc. Method and apparatus for providing proportional positive airway pressure to treat congestive heart failure
US5582182A (en) * 1994-10-03 1996-12-10 Sierra Biotechnology Company, Lc Abnormal dyspnea perception detection system and method
US5827893A (en) * 1996-03-29 1998-10-27 Lurie; Keith G. Mechanical and pharmacological therapies to treat cardiac arrest
US5730122A (en) * 1996-11-12 1998-03-24 Cprx, Inc. Heart failure mask and methods for increasing negative intrathoracic pressures
US6086582A (en) * 1997-03-13 2000-07-11 Altman; Peter A. Cardiac drug delivery system
US6078834A (en) * 1997-04-10 2000-06-20 Pharmatarget, Inc. Device and method for detection and treatment of syncope
US5919210A (en) * 1997-04-10 1999-07-06 Pharmatarget, Inc. Device and method for detection and treatment of syncope
US6486206B1 (en) * 1997-09-29 2002-11-26 Cprx Inc. Mechanical and pharmacologic therapies to treat cardiac arrest
US6224562B1 (en) * 1998-06-11 2001-05-01 Cprx Llc Methods and devices for performing cardiopulmonary resuscitation
US6631716B1 (en) * 1998-07-17 2003-10-14 The Board Of Trustees Of The Leland Stanford Junior University Dynamic respiratory control
US6155257A (en) * 1998-10-07 2000-12-05 Cprx Llc Cardiopulmonary resuscitation ventilator and methods
US6662032B1 (en) * 1999-07-06 2003-12-09 Intercure Ltd. Interventive-diagnostic device
US6544172B2 (en) * 2001-05-08 2003-04-08 The Goodyear Tire & Rubber Company Methods for evaluating individuals capacity and establishment of requirements for a job
US20030062040A1 (en) * 2001-09-28 2003-04-03 Lurie Keith G. Face mask ventilation/perfusion systems and method
US7682312B2 (en) * 2002-09-20 2010-03-23 Advanced Circulatory Systems, Inc. System for sensing, diagnosing and treating physiological conditions and methods
US6863656B2 (en) * 2002-09-20 2005-03-08 Advanced Circulatory Systems, Inc. Stress test devices and methods
US7311668B2 (en) * 2002-09-20 2007-12-25 Advanced Circulatory Systems, Inc. Stress test devices and methods
US20040058305A1 (en) * 2002-09-25 2004-03-25 Cprx Llc Apparatus for performing and training CPR and methods for using the same
US6776153B1 (en) * 2003-03-11 2004-08-17 B. Keith Walker Hybrid atmospheric water heater
US7766011B2 (en) * 2003-04-28 2010-08-03 Advanced Circulatory Systems, Inc. Positive pressure systems and methods for increasing blood pressure and circulation
US7836881B2 (en) * 2003-04-28 2010-11-23 Advanced Circulatory Systems, Inc. Ventilator and methods for treating head trauma and low blood circulation
US20110098612A1 (en) * 2003-04-28 2011-04-28 Advanced Circulatory Systems, Inc. Positive pressure systems and methods for increasing blood pressure and circulation
US8011367B2 (en) * 2003-09-11 2011-09-06 Advanced Circulatory Systems, Inc. CPR devices and methods utilizing a continuous supply of respiratory gases
US20080255482A1 (en) * 2007-04-16 2008-10-16 Advanced Circulatory Systems, Inc. Intrathoracic pressure limiter and cpr device for reducing intracranial pressure and methods of use
US20080257344A1 (en) * 2007-04-19 2008-10-23 Advanced Circulatory Systems, Inc. Volume exchanger valve system and method to increase circulation during cpr
US20100319691A1 (en) * 2009-06-19 2010-12-23 Advanced Circulatory Systems, Inc. Vacuum and positive pressure ventilation systems and methods for intrathoracic pressure regulation

Cited By (45)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10512749B2 (en) 2003-04-28 2019-12-24 Zoll Medical Corporation Vacuum and positive pressure ventilation systems and methods for intrathoracic pressure regulation
US20070221222A1 (en) * 2003-09-11 2007-09-27 Advanced Circulatory Systems, Inc. Cpr devices and methods utilizing a continuous supply of respiratory gases
US8011367B2 (en) 2003-09-11 2011-09-06 Advanced Circulatory Systems, Inc. CPR devices and methods utilizing a continuous supply of respiratory gases
US20080257344A1 (en) * 2007-04-19 2008-10-23 Advanced Circulatory Systems, Inc. Volume exchanger valve system and method to increase circulation during cpr
US11020313B2 (en) 2007-04-19 2021-06-01 Zoll Medical Corporation Systems and methods to increase survival with favorable neurological function after cardiac arrest
US8151790B2 (en) 2007-04-19 2012-04-10 Advanced Circulatory Systems, Inc. Volume exchanger valve system and method to increase circulation during CPR
US8985098B2 (en) 2007-04-19 2015-03-24 Advanced Circulatory Systems, Inc. CPR volume exchanger valve system with safety feature and methods
US10478374B2 (en) 2007-04-19 2019-11-19 Zoll Medical Corporation Systems and methods to increase survival with favorable neurological function after cardiac arrest
US9352111B2 (en) 2007-04-19 2016-05-31 Advanced Circulatory Systems, Inc. Systems and methods to increase survival with favorable neurological function after cardiac arrest
US9675770B2 (en) 2007-04-19 2017-06-13 Advanced Circulatory Systems, Inc. CPR volume exchanger valve system with safety feature and methods
US11679061B2 (en) 2007-04-19 2023-06-20 Zoll Medical Corporation Systems and methods to increase survival with favorable neurological function after cardiac arrest
US11583645B2 (en) 2009-06-19 2023-02-21 Zoll Medical Corporation Vacuum and positive pressure ventilation systems and methods for intrathoracic pressure regulation
US20100319691A1 (en) * 2009-06-19 2010-12-23 Advanced Circulatory Systems, Inc. Vacuum and positive pressure ventilation systems and methods for intrathoracic pressure regulation
US8967144B2 (en) 2009-06-19 2015-03-03 Advanced Circulatory Systems, Inc. Vacuum and positive pressure ventilation systems and methods for intrathoracic pressure regulation
US11123261B2 (en) 2010-02-12 2021-09-21 Zoll Medical Corporation Enhanced guided active compression decompression cardiopulmonary resuscitation systems and methods
US9724266B2 (en) 2010-02-12 2017-08-08 Zoll Medical Corporation Enhanced guided active compression decompression cardiopulmonary resuscitation systems and methods
US9238115B2 (en) 2011-12-19 2016-01-19 ResQSystems, Inc. Systems and methods for therapeutic intrathoracic pressure regulation
US11654253B2 (en) 2011-12-19 2023-05-23 Zoll Medical Corporation Systems and methods for therapeutic intrathoracic pressure regulation
US10034991B2 (en) 2011-12-19 2018-07-31 Zoll Medical Corporation Systems and methods for therapeutic intrathoracic pressure regulation
US10874809B2 (en) 2011-12-19 2020-12-29 Zoll Medical Corporation Systems and methods for therapeutic intrathoracic pressure regulation
US11488703B2 (en) 2013-04-25 2022-11-01 Zoll Medical Corporation Systems and methods to predict the chances of neurologically intact survival while performing CPR
US9811634B2 (en) 2013-04-25 2017-11-07 Zoll Medical Corporation Systems and methods to predict the chances of neurologically intact survival while performing CPR
US10835175B2 (en) 2013-05-30 2020-11-17 Zoll Medical Corporation End-tidal carbon dioxide and amplitude spectral area as non-invasive markers of coronary perfusion pressure
US9949686B2 (en) 2013-05-30 2018-04-24 Zoll Medical Corporation End-tidal carbon dioxide and amplitude spectral area as non-invasive markers of coronary perfusion pressure
US10265495B2 (en) 2013-11-22 2019-04-23 Zoll Medical Corporation Pressure actuated valve systems and methods
US9801782B2 (en) 2014-02-19 2017-10-31 Keith G. Lurie Support devices for head up cardiopulmonary resuscitation
US11395786B2 (en) 2014-02-19 2022-07-26 Lurie Keith G Systems and methods for head up cardiopulmonary resuscitation
US10667987B2 (en) 2014-02-19 2020-06-02 Keith G. Lurie Uniform chest compression CPR
US11020314B2 (en) 2014-02-19 2021-06-01 Keith G. Lurie Methods and systems to reduce brain damage
US11077016B2 (en) 2014-02-19 2021-08-03 Keith Lurie Systems and methods for head up cardiopulmonary resuscitation
US11096861B2 (en) 2014-02-19 2021-08-24 Keith G. Lurie Systems and methods for gravity-assisted cardiopulmonary resuscitation and defibrillation
US10406068B2 (en) 2014-02-19 2019-09-10 Keith G. Lurie Lockable head up cardiopulmonary resuscitation support device
US11246794B2 (en) 2014-02-19 2022-02-15 Keith G. Lurie Systems and methods for improved post-resuscitation recovery
US11259988B2 (en) 2014-02-19 2022-03-01 Keith G. Lurie Active compression decompression and upper body elevation system
US11883351B2 (en) 2014-02-19 2024-01-30 Keith G. Lurie Systems and methods for improved post-resuscitation recovery
US10406069B2 (en) 2014-02-19 2019-09-10 Keith G. Lurie Device for elevating the head and chest for treating low blood flow states
US10350137B2 (en) 2014-02-19 2019-07-16 Keith G. Lurie Elevation timing systems and methods for head up CPR
US10245209B2 (en) 2014-02-19 2019-04-02 Keith G. Lurie Systems and methods for gravity-assisted cardiopulmonary resuscitation
US10092481B2 (en) 2014-02-19 2018-10-09 Keith G. Lurie Systems and methods for gravity-assisted cardiopulmonary resuscitation
US11712398B2 (en) 2014-02-19 2023-08-01 Keith Lurie Systems and methods for head up cardiopulmonary resuscitation
US11793714B2 (en) 2014-02-19 2023-10-24 Keith G. Lurie Support devices for head up cardiopulmonary resuscitation
US11844742B2 (en) 2014-02-19 2023-12-19 Keith G. Lurie Methods and systems to reduce brain damage
US11857488B2 (en) 2014-02-19 2024-01-02 Keith G. Lurie Systems and methods for head up cardiopulmonary resuscitation
US11857486B2 (en) 2014-02-19 2024-01-02 Keith G. Lurie Systems and methods for head up cardiopulmonary resuscitation
US10780020B2 (en) 2016-09-30 2020-09-22 Zoll Medical Corporation Maintaining active compression decompression device adherence

Also Published As

Publication number Publication date
US20080108905A1 (en) 2008-05-08
US7682312B2 (en) 2010-03-23

Similar Documents

Publication Publication Date Title
US7682312B2 (en) System for sensing, diagnosing and treating physiological conditions and methods
US6863656B2 (en) Stress test devices and methods
Gold et al. Pulmonary function testing
Quanjer et al. Lung volumes and forced ventilatory flows
Al-Ashkar et al. Interpreting pulmonary function tests: recognize the pattern, and the diagnosis will follow
US8795189B2 (en) System and method for determining pulmonary performance from transthoracic impedance measures
JP5415070B2 (en) Method and apparatus for achieving and maintaining target end-tidal concentrations
Hadcroft et al. Alternative methods for assessing bronchodilator reversibility in chronic obstructive pulmonary disease
CA3005443A1 (en) Devices and methods for monitoring physiologic parameters
Khandpur Compendium of Biomedical Instrumentation, 3 Volume Set
Tobin Breathing pattern analysis
AU2007305491A1 (en) Methods and systems for assessing metabolic transition points
Kispert Clinical measurements to assess cardiopulmonary function
Goldman et al. The rib cage and abdominal components of respiratory system compliance in tetraplegic patients
Reinhold et al. Comparative evaluation of impulse oscillometry and a monofrequency forced oscillation technique in clinically healthy calves undergoing bronchochallenges
Moens et al. Patient monitoring and monitoring equipment
Fauroux et al. Measurement of diaphragm loading during pressure support ventilation
Voter et al. Pulmonary function testing in childhood asthma
JP2576050Y2 (en) Apparatus for evaluating the mechanical state of the heart
Rozanski et al. Lung mechanics using plethysmography and spirometry
McLaughlin Capnography assessment
Aggarwal et al. Correlation of breath holding time with spirometry test-An alternative non technician dependent surrogate test for spirometry
Firnhaber Performance and Interpretation of Office Spirometry
Usui Flow-volume curves in patients with allergic rhinitis
COMROE Causes and differential diagnosis of cyanosis of cardiopulmonary origin

Legal Events

Date Code Title Description
STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION